Coping With A New Baby

We are finally back after several weeks of not attending to our blog.  Our IT department, consisting of Rachel, just had a new baby girl.  We warmly welcome our new office baby, Addison.  That being said, it seemed like a good idea to talk about adjusting to a new baby, especially when it is the first child.  Whether your baby is planned, a happy accident, or a scary accident, there is still going to be a major adjustment.  Embrace the time you have with your child as an infant and toddler is actually quite brief and you can never recapture those times.  Obviously, your first adjustment was to your pregnancy.  Some women are blessed with an easy pregnancy and some are not.  If you had a rough pregnancy, separate that experience from the birth of your child.  It was not their fault or your fault; pregnancy is a medical condition and any medical condition can be smooth or rough.  The biggest adjustment that most people complain about is the lack of sleep, fatigue, and lack of opportunity to be spontaneous.  Sleep when your baby sleeps and challenge the guilt you might be feeling about sleeping during the day.  You need to catch up when and how you can.  The fatigue is related to the trauma your body has been through and your current lack of sleep.  

You are also going through some hormonal changes.  If you do not have someone to help you with the baby so you and your partner can get out, plan some outings that you can do with the baby.  It is not healthy to stay in the house all the time.  Strolls in the park or a walk through the mall are good options.  My favorite option was always the book store.  Postpartum depression is another issue faced by many women.  There are many different manifestations of depression from going through the motions and just not enjoying anything, to feeling hopeless and suicidal.  Many women feel guilty that they do not feel bonded to their infant.  It is not a lack of bonding, but an inability to feel pleasure.  Please do not look at this as a character weakness.  Your body has just been inhabited and vacated by an alien being and your body is trying to adjust and may just need a little help.  Yes, you may be able to tough it out, but why be depressed and/or anxious for six to twelve months when there is help readily available.  In addition to medication, therapy can also be very helpful with building your confidence and coping skills.  Babies and toddlers can be a lot of fun if you just let yourself go with the moment.  Seeing the world through new eyes is a real treat. 

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Helping Your ADHD Child

When parents bring in their children diagnosed with Attention Deficit Hyperactivity Disorder, one of the first things they want to know is if there is any help for their child in addition to medication.   There is so much help for your child, at every age. The general theme for your child is to provided structure and consistency in all your routines.  For example, when your child gets home from school, have an established routine that you and your family follow.  It may be as basic as changing clothes, eating a snack, doing a chore, and then starting on the homework. Homework should be set up in a quiet part of the house, without clutter.  This can be either at a desk, or even a dining room table. Your child will do best if it is always the same place in the house. For children in grade school and middle school, you may have to sit with them as they do their work.  But even if you do not do that, review your child’s agenda with them, make sure they have all the materials available for homework and/or projects, and help them organize the order in which they do their work.  After each completed assignment, go over it with them, point out mistakes and have them correct the work.  

All completed work should go into a homework folder that they take to each class and never leave in their cubby, desk, or locker.  If they have to study for a test, do not wait until the day before.  Help your child schedule the study time across a few days, starting with reading and reviewing, and the day before, testing them on the material so they actually learn how to study.  Projects should be scheduled out with your child so they do not try and get it all done the night before.  Do not do the work for your child because then they are losing a learning experience, and they are learning that you will rescue them. Some teachers will schedule out sections of the project, but if not, you can do this with your child.  Make sure everything is in its proper place and packed up and ready for the morning before you consider homework completed.  For children who seem to be coping with their medication wearing off just at homework time, talk with your Doctor about a small dose of medication to get them through homework.  If you are ambivalent about this, I understand.  However, it is much worse for your child if they can not complete their assignments and fall behind their class.  It is detrimental to their academics, but more importantly, it may become detrimental to their self esteem and confidence.  If you have a child who is just too distracted to do homework at home, you might have to take them somewhere to complete homework before going home from school.  Give them a snack and then take them to the local library, bookstore, park, or anyplace you feel they will be comfortable and not overly distracted.  Do not go home until everything is organized into their back pack for the new school day.If their room is a mess, help them organize the room in a very simple way.  Bins are great for grouping toys together.  Organize with them as many ADHD children really have no idea how to organize and it is a skill that may take years to develop.  Don’t tell your child to clean up their room and really expect it to be picked up.  Sit in their room with them and either tell them what to do task by task, or do it with them (not for them).  Be patient, your ADHD child is capable of learning general management skills and study skills; it will take more time than with the average child.  However, it is so worth the patience and the wait.

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Coping With National Tragedies

When tragedy hits our country, it hits all of us. Most of us experience a dizzying array of emotions from shock, sadness, disbelief, grieving, compassion, and even relief that the tragedy did not happen to us. The shooting at a small elementary school in Connecticut earlier this month shocked us all. How did this happen? Our children should be safe. How did that young man reach a point where he felt he had to kill his mother as well as innocent people and children? These are questions that have been asked since we heard about the shooting. These are the same questions that were asked when there was a massive shooting at the movie theater  at Columbine, at college campuses. Not only do we ask how these mass murders can happen, how can we prevent them, but how can we protect ourselves and especially our children? As the media uncovers more of the background story of this tragic event, and we hear and read stories daily, some will experience media induced post-traumatic stress. Everyone related to that school, students, siblings, friends, family, teachers, staff, neighbors, will develop some form of post-traumatic stress to accompany their grieving. It is very normal to experience stress in response to a traumatic event. However, if we buy in to the fear and begin to obsess about the event, keep our children from going to school, never go in to a movie theater  or back away from any public situation that involves large groups of people, then we reinforce the fear and make it part of us. In a way, that gives the shooter more power over us. To stay empowered, we must remember that we are no more vulnerable than we were before, we are just more aware of our vulnerabilities. These mass shootings are the exception rather than the rule, so they stand out. Think about all the millions of children that go off to school daily and are safe. Think about all the millions of people that go to the movie theater daily and are safe. If you have ever been in a car accident, you might recall feeling very jumpy when next you started to drive. Every shadow felt like a car crashing into you. It is not that you are more vulnerable to a car accident; it is that you are now much more aware that it can happen. If you give in to the fear and stop driving, it will be very hard to ever get comfortably behind the wheel of a car again. If you stop going to the movies, it will be hard to go back again. If you don’t send your children to school, you are telling them the world is too dangerous for them to go out. Yes, we need to be aware and take whatever precautions are available, but then we just have to go out and live our lives. 

In the county in which I live, there were rumors that kids were going to go to school with guns and there were going to be shootings. I sent my children to school with the message that we can’t cave in to rumors and stop living. As I dropped them off in the morning, I noticed that most of the parking lot was empty. At the end of the day, my children told me that most of their classes were virtually empty. What were we telling our children that day? We were telling them to believe wild rumors, give in to them, hand our power over to people that are not even rationale, and be afraid to live our lives. That is not the message we want to give our children or ourselves. We need to be stronger than that so we don’t live in the shadow of tragedy and fear.

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Family Rules for Consistent Parenting

 Children respond to structure and consistency. Any loop hole, such as not following through on a consequence, and your plan falls apart. If there are too many rules, especially if you have more than one child of varying ages, it becomes too hard to keep track. Behavior charts are great if you keep them simple and you are willing to be dedicated to them. However, many families find it too difficult to follow through with charts for more than one child. Grounding is also an option that many parents choose. However, there are two potential problems with this approach. First, when you ground a child, it means you have also grounded yourself in order to enforce the grounding. Since you did not do anything wrong, I don’t see why you should be grounded. I recommend a very modified version of grounding in which your child is grounded until they work off whatever consequences you have given them. Secondly, children often forget exactly why they are grounded, losing its effectiveness, and parents forget to enforce the length of the grounding or feel sad for their child, and lift the grounding. This also negates the consequence. For the family that wants some basic rules for parenting that does not involve too many steps or behaviors to keep track of, there is one basic principle and three general rules.

        

    Principle One: Tell your child exactly what you expect, when you expect the chore or work to be done, and how you expect the chore or work to be done. There is no guess work and no wiggle room to avoid the expected task. Remember, however, that we are working with children and it is unlikely you will get an immediate response. Let’s face it, whatever it is that you want your child to do is most likely not on the top of their priority list, competing with their favorite game, TV show, or playing outside with friends. It is perfectly normal and all right to have to remind your child of their chores or tasks. Therefore, incorporate one warning. Let your child know that this is their one and only warning. This means you do not give your child 5 or 6 warnings until you are worn down and start yelling. If you are yelling at your child, you most likely waited too long to intervene. Now your child just sees you as mean and you have to enforce your rule/expectation and deal with your inner guilt or anger. If you stay with one warning and then calmly give the consequence, you can avoid the anger/guilt cycle.

            Family Rules:

1. Show respect for parents and other adults. This means no arguing, even when you think you are right.

2. Do what you are told when you are told, with respect.

3. What you are asking for, when you argue, the answer is automatically no.

            Before you start a new program of rules and consequences, you will need to sit down with your child/children and explain the new program. Make sure they understand what is expected and what will happen if expectations are not followed. It is often helpful to have your child explain the system back to you and correct any misunderstandings. It is also important that you and your spouse or other caregiver collaborate on a list of chores and consequences you agree will reinforce your new expectations. Consequences should be immediate, concrete, and short. If you make the consequences long term, two problems may occur. First, your child may forget why they are being punished and just see you as mean. Second, as the parent, you are more likely to cave, diminishing the impact of your intervention.

            If you would like more detail about how to set up the rules and consequences in a user friendly way for your family, visit our bookstore and purchase our Interactive Worksheet: FAMILY RULES FOR CONSISTENT PARENTING. Happy parenting.

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New Year Resolutions

Happy New Year to everyone. With all the festivities over, the gifts given and received, family and friends visited, parties attended, it is time to get back to our normal routine. Or is it? So many people make a lengthy list of New Year’s resolutions and others, so discouraged from past resolutions that never went anywhere, have given up on making new resolutions. The end of the year is a good time to look back and see what your year has been about. How did you cope with whatever was not in your control? What was under your control that you actually changed or decided to keep in your life? Let’s start with the resolution list. If it is not a realistic list, you will be setting yourself up for failure. For example, if you state that you will never eat another carb, how likely is that really? If you want to change your life style, make small incremental goals that are more likely to lead to success. Many of us have either known someone or have ourselves purchased a gym membership with good intent. After a week of frenzied exercising, we are so sore that we are turned off and never go back, stating we don’t like it or we don’t have time. However, if you want to exercise more, maybe go for a 20 minute walk two to three times a week and gradually increase your speed and distance. As this gets easier, maybe increase your time or the number of times you walk. If you really want to join a gym, go slow. Have a trainer set up a program for you, possibly starting only 30 minutes twice a week and working your way up to a 60-minute session. If you do not like to exercise by yourself, check out a class. If you are self-conscious, go with someone and/or line up in the back so you don’t feel so exposed. Remember, the key is to set yourself up for success. If changing your eating is your goal, maybe consult with a nutritionist and learn how to eat healthy, allowing yourself to eat healthy carbs with some treats thrown in. If you feel deprived, your likelihood of success will go down. Maybe you want to read more. Again, telling yourself that you will read an hour a day may be very unrealistic. Look at your schedule and life style and set aside some time two to three days a week where you have some quiet time to read. Whatever the content of your desired change, take small, doable steps that you can gradually increase and set yourself up for success. Remember, success builds on success.

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Coping With The Holidays 

I hope this blog finds everyone having had a nice Thanksgiving. Some people love the holidays, some people hate the holidays, some people tolerate the holidays and some people are just overwhelmed by the holidays. Where ever you are on this continuum, you don’t need to adapt to the holiday season, rather, make the holiday season adapt to you. At this point you are probably asking yourself what I am talking about. Depending on where we are in our lives, our history will interact with and influence our experience of the holiday season. If we are older and have already experienced many losses, or we have experienced significant losses at any age, we may focus on the people we miss. We may miss past holidays that were good or we may remember in too much detail past holidays that were not so good, or even traumatic. We may feel pressured to make the holiday a certain way for our children, family members and friends, resulting in stress and anger instead of joy and happiness. We may also feel pressured to keep old family traditions alive, but they may no longer work for us. This is where we get back to making the holiday season adapt to you. It is so important to stay in the here and now. While most of us have people that we miss either due to death or distance, we need to focus on whom and what is in our lives now. If you don’t like crowds, don’t go to Black Friday and stay away from the malls in mid-day.

Go shopping at dinner time when the mall empties out or go to stores that are either not in the mall or have their own entrance. Give yourself permission to not overextend the holiday budget and make a plan of action regarding what you can spend for each person on your list. If you love to decorate, decorate. If you don’t love to decorate, then don’t. If you want to decorate differently this year, then do that. If you like holiday parties, then go to them, and if you don’t, then don’t go. If you like to entertain, then entertain and if you don’t, then don’t. Some traditions you may wish to keep and some you may wish to replace with new ones. I hope you are getting the message to embrace the holidays in anyway that works for you. Some years you may go away and some years you may stay home or visit friends and/or family. Each year does not have to be the same if you don’t want it to be, or it can be as similar to past years as you wish to make it. If you have children grieving, don’t minimize their grief, but don’t make the entire holiday about grieving. Show your children the balance of missing people, but still going forward and living life. If you have had trauma in your past associated with holidays, remind yourself that you are older, wiser, and stronger and your current holidays belong to you and not to your past. Patients often ask me for suggestions for gifts and activities for children. Here are a few suggestions for you to consider.

http://www.theshrinklink.com/Gift-Suggestions.html

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Coping with Peri-Menopause and Menopause

Welcome back to Shrink It Down. I hope everyone had a great Thanksgiving. Today I want to talk about peri-menopause, also known as pre-menopause, and menopause. So many women come to me in a state of confusion. It is not unusual for women to be referred to me to rule out a psychological problem, even though they have no history of psychological problems and no recent history of problems other than physical and psychological symptoms that are new to them. A thorough interview often suggests peri-menopause and a referral to their Gyn. Doc. On average, most women begin their journey into peri-menopause in their late 40’s and menopause in their early to mid 50’s. However, it can start as early as the mid to late 30’s or as late as the early 50’s. A woman is not in menopause until she has missed 12 consecutive menstrual cycles. Typically, your symptoms will tell you that you are in peri-menopause long before blood work validates what you already know. Peri-menopause is a natural transition of changes and loss of hormone levels. How you deal with this journey interacts with your personality, experiences and current life stressors.

Common symptoms may include irregular periods, hot flashes, night sweats, sleep difficulties, fatigue, irritability, depression, weight gain, fuzzy and foggy thinking, anxiety, headaches, poor stress tolerance, thinning hair or loss of hair, vaginal dryness, and even joint stiffness. Decreased sexual desire is also very common. Any combination of these symptoms is a lot to deal with, especially if you have other stressors in your life such as adolescent children at home, maybe taking care of aging parents, stressful job, money problems, relationship issues, or any loss in your life. I refer to peri-menopause as a scenic journey that involves some hazing into the next chapter in our lives. Everyone has their own collection of symptoms that are most challenging to them. I strongly encourage you to focus on acceptance with elegance and a great sense of humor. If you are hot, let yourself be hot without apology and your family will adjust to freezing for awhile. If you have night sweats, keep clean sleep wear by your bed side, along with a large towel you can use to cover the damp part of your bed so you don’t have to get up and remake your bed, somehow doing this around your husband or partner. Biotin is great for thinning hair, black cohash is good for hot flashes, and your Dr. can prescribe hormonal creams for dryness. Work with your Doctor regarding hormone replacement, natural remedies, and symptom relief. Make sure you are working with someone you are comfortable with and who is receptive to both traditional and homeopathic interventions. Many women find therapy to be very helpful as they learn to deal with the physical and emotional changes they are experiencing. Two main issues that women often address in therapy are their mood regulation when their children come home from school and the after school chaos overwhelms them. Often a mild anti-anxiety in the late afternoon on a rough day can be very helpful. The second main issue is what I refer to as swiss cheese brain. This is when you have holes in your memory and the holes keep moving, like in a carnival game. The most important intervention for swiss cheese memory is that sense of humor I mentioned, and good notes. Although this is not actually one of the major problems women bring in to therapy, decreased libido can present a problem for some couples. When women bring their partners in to discuss the situation, some education and suggestions are often all it takes to get partners on the same page. Talking to friends or relatives also on this journey can be helpful, as long as it is not just a litany of complaints. This is a time when you really need to take care of yourself with eating healthy, exercise, relaxation, and socialization. There is life after peri-menopause, I promise!

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