SUBTLE EMOTIONAL ABUSE

We know and recognize that physical abuse is destructive.  We also know that verbal abuse is destructive.  What many people don’t recognize is subtle emotional abuse.  This type of abuse does not involve physical intimidation, name calling, or obvious threats.  Subtle abuse can be seen in any relationship that involves two people.  It can affect relationships between parents and children, siblings, friends, neighbors, employers, co-workers, and friends. 

                Any relationship that sucks the life force out of you may be abusive.  Any relationship that consistently makes you feel badly about yourself and your abilities is probably abusive.  Any relationship that leaves you feeling demeaned, belittled and crazy is definitely abusive.  How does this happen and how can we recognize the quiet abusive relationship?

There are countless forms of emotional abuse.  The first thing to be aware of are patterns that somehow make you feel you are in the wrong even when you did not do anything wrong.  Guilt equals manipulation, always in the best interest of the person using the guilt and never for the person on the receiving end.  That is a strong statement.  Think about it.  You are talking to someone and they sigh, maybe roll their eyes, and follow up with a criticism that appears valid on the surface but in reality is demeaning and guilt inducing.  For example, “The show I wanted to watch started when you were in the bathroom so I didn’t bother to watch it tonight”.  Since when do we always need company when watching a TV show?  Can we really control when we need to use the bathroom? 

                Everything you say is wrong.  The other person in the relationship is not yelling at you or obviously demeaning you.  They simply don’t seem to agree with anything you say to the point that you begin to think you are not very smart and you start to keep your thoughts and opinions to yourself.  You are left feeling discounted on a regular basis. Maybe the other person in your life is a withdrawer and you are on the receiving end of withdrawal from emotional intimacy.  It may not be the silent treatment per se, but the other person is quiet or obviously directs their interactions to other people. 

                Another form of subtle emotional abuse is the chronic use of joking and sarcasm to put you down and then discount you even further when you try to address the abuse and are told you just can’t take a joke.  This results in a double bind where whatever you say puts you in the wrong and you are left unheard and feeling crazy and “overly sensitive”.   When you are never allowed to say what you are thinking or have a different opinion, you may be in a relationship with a narcissist.  Other versions of subtle abuse involve being made to feel that everything that goes wrong is your fault, even when the situation or event is unrelated to you.  You distracted the other person so their getting lost is your fault is a good example.  You don’t know how to do anything so you are not allowed to do anything on your own, even purchase something at the store.  Even who you are friends with becomes under the other person’s control.

When most of what you say or want is trivialized and you are teased and rebuked for your desires, that pattern also constitutes subtle emotional abuse.  This may involve undermining your work, how you dress, what you read, what you like to do in your spare time.  This is very common in the workplace when a co-worker is jealous or a supervisor is threatened.  You may find yourself feeling as though you have no valid opinions.  The underlying message is that you are incompetent.  This often goes along with subtle threats, such as loss of promotion or raise, being reported to a supervisor, or a threat of leaving in a personal relationship.

                Chronically forgetting something important to you, chronically being late, or simply dismissing what you want but in a pleasant fashion may suggest you are in a relationship with a passive/aggressive individual.   This often goes hand in hand with denial when you try to confront the issue so you are left feeling empty, angry, confused, and demanding.  If your relationship seems based on this pattern, your self-esteem will not take long to be eroded. 

                If you are in any relationship that chronically leaves you feeling confused, embarrassed, intimidated, insecure and anxious, angry, unheard, and “crazy” you may be in an abusive relationship.  What can you do about this?  If the other person is in a position of authority and you love your job, you will have to learn to not personalize and if this just does not work for you, you may have to transfer or find another job.  While this may not be fair, no job is worth being miserable over.  If the other person is a so called friend, try and communicate your concerns and even suggest seeing a psychologist together.  If you are told it is all you and you are crazy, maybe this is not really a friendship.  What are you getting out of this relationship?  Is this relationship mostly based on history?  It may be time to walk away.  Family is a trickier issue.   Depending on the family relationship, you may have to distance or even disconnect.  Especially if the other person is a romantic interest or spouse.  

Suggest counseling and if the other person refuses or does attend but dismissed it, work on yourself until you become stronger and more confident and then what ever you decide will just flow naturally.  Remember, you can emotionally die from constant long term pin pricks just as much as from an emotional knife wound. 

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POLITICS

I was recently asked to write a blog regarding politics.  Specifically, how to handle extreme differences in political views within families and also with friends.  From a  psychological perspective, politics appears to be an extension of how people perceive their lives and who they think will best help them either keep what they have or improve their lot in life.  When listening to people’s views, it is important to try and understand what they are concerned about and how that concern is being expressed.  Listening to someone does not mean you have to agree and the politics of the day is simply not worth damaging a relationship.  If you and the other person are just not able to remain calm when discussing politics or current events and governmental policies, agree to not discuss the subject. 

If you find yourself feeling angry and anxious when listening to people discuss politics, especially the current presidential election, remove yourself from the situation.  You might argue back that you want to know what the opposing side has to say and I agree it is important to know what all candidates have to say, but it is not worth agitating yourself or losing relationships.  Someone recently told me that they lost respect for some friends and family members because of their choices.  While you may not understand where the other person is coming from, it is wonderful that we live in a time and in a country where we are all allowed to have our own opinions and voice them, without fear of retaliation.  Rejoice in that process.  We are so fortunate to live in this time and this country.

In terms of social media, remember to play nice.  Address the issues, not the person or their personality traits or looks.  Someone you care about is reading what you are putting on social media, and a hostile approach may harm a relationship you do not wish to harm.  You are certainly within your rights to make comments, but be elegant.  If you see that someone has posted something you feel is inappropriate, you can always privately message them or talk to them about how you feel.  While you may not get the response you want, at least you will have said what you feel you need to say.  There is a difference between an informative post and one that is just hateful.  For example, comparing someone to Hitler is not informative.  If you feel you just can’t get anywhere with the other person, think about deleting their post, making a comment about sticking to the issues, or rethink your relationship with that person.  In terms of jokes and/or funny memes, if they are offensive, don’t post.  Be respectful of others.

            Someone else brought up in therapy that they felt like a family member was putting pressure on them to change their mind.  In a soft, but firm and even tone, let the family member know that you respect their right to their opinions and you want the same respect back from them. In other words, set a boundary with others.  People have been disagreeing about leadership since there have been people and groups and societies.  As long as you are not in a situation where basic human rights are being violated, let it go. 

Talk to people with similar views or talk to people with different views that are respectful of your views.  Remember, when this election is over, we will be moving on to something else.  That being said, if you are interacting with people who continue to yell and complain and try and change your mind about what you think, look and see if they try and do this to you about other topics.  Maybe it is the relationship in general you need to examine.  If their behavior only involves politics, agree to keep that topic off the table.  If they keep bringing up politics in a way that makes you uncomfortable, upset, angry or resentful, tell them that you would rather not discuss politics and change the subject.  You do not have to discuss a topic that you do not want to discuss.  
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SELECTIVE MUTISM

  

Selective Mutism (SM) is an anxiety disorder that typically appears before the age of 5.  Many children are not diagnosed until they begin school, as they typically talk to immediate family members living in their household.  These children present as extremely shy, and find themselves unable to talk in social settings.  It is not a refusal to talk, but an emotional inability to talk.  Some of these children struggle with maintaining eye contact or even giving non-verbal responses to other people, such as nodding their head in response to a question.  Progress can be fast or very slow, and must be measured by very small gains.  Children with SM are sometimes misdiagnosed with oppositional defiance, but it is not an oppositional disorder.  Their inability to communicate in social settings stems from anxiety.  Often children with SM are also diagnosed with social anxiety.  Language skills typically develop normally.  Academic skills are more difficult to determine due to the fear of speaking, and as such, I have included some recommended accommodations that that might be both helpful for the child’s academic advancement and academic assessment.

            When I read Individualized Education Plans (IEP) and 504 plans, I have often noticed that the child’s behavior is frequently characterized in terms of a refusal to engage in certain behaviors.   These children do not refuse to engage in behavior, they are fearful of engaging in certain behaviors.  Anything that draws attention to them or makes them feel like they are standing out or targeted, will activate the SM.  Even being taken out of the class to work with an individual that focuses specifically on them and that they may not have developed a relationship with, will make the child shut down, a common aspect of SM.  Some children are even very uncomfortable being pulled out of class for testing and may do much better being allowed to take all tests in class.  If the teacher determines the child is not coping well with the testing in class, the teacher can recommend that the child be pulled out at that time. 

            Some IEP and 504 plans suggest that the child avoids other children and does not make friends.  I find that to be contrary to what many children and their parents have shared with me. These children often have friends in the neighborhood or through family that they play with, even if they are not verbal.  Again, it is not that these children refuse to talk or engage in group activities, they are afraid to talk or engage in certain group activities.  If gently guided to a group activity, some of these children will sit with the group, and when comfortable, will interact nonverbally.  Children that  have trouble gathering information they need for class activities may benefit from being provided with  a class ‘buddy” or having  instructions written down for them. Providing the child with their own white board to use for written communication can also be very helpful. This way the child has the opportunity to respond to written directives and can write a question if they require more information to complete an activity.  At some point, when the child is ready, they can be recorded by a parent while reading so the teacher can assess their reading.  This can gradually be phased in to the child being present while the teacher listens to the tape.

            Some of these children are even very uncomfortable showing their work, which is another manifestation of their anxiety.  It is not an oppositional behavior. The child is very uncomfortable when they feel people are looking at them, and this includes knowing that someone is looking at their work.

            Given what I have read in many IEP and 504 records over the years and some possible confusion about the nature of SM and the best accommodation options for these children, the following accommodation recommendations are provided as a guideline for your consideration:

1.      Use the least restrictive environment possible.  It is important for the child to feel part of the group.

2.      Allow nonverbal communication such as pointing, head nodding, shaking head yes or no, thumbs up or down to indicate yes or no. Using one finger for yes and two fingers for no can also be very helpful.

3.      Use both verbal and written alternatives for presentation of class material.

4.      Use video and/or audio taping at home. This works better when set up and monitored with a therapist.

5.      Place the child in small work groups even if they do not appear to be participating.

6.      Use testing accommodations such as taping reading fluency lessons at home with video or audio tape as you work on a gradual introduction to verbalization in the classroom.  The following steps might help in this process:

a.      Allow the child to tape their lessons at home when they have reached a solid comfort level with the teacher.  They may refuse at first, so give it time.

b.      Allow and encourage the child to tape a verbalization with a parent present in the school setting, maybe when their classroom in empty.

c.       Encourage the child to tape part of a lesson on tape followed by whispering the lesson to her teacher or mother within the class setting without other students present.

d.      Have the child whisper the entire school lesson in the classroom with only the teacher present and maybe a parent in the hallway or back of the classroom.

e.      Then have the child whisper part of a lesson to another student they are comfortable with in addition to the teacher.

f.        Attempt to have the child verbalize an entire, but brief, lesson to the teacher.

Each individual step that may appear to be very small is, in actuality, a huge leap for the child as they may feel the words are stuck in their head even though they want to speak.  Even the smallest of successes from a child with SM, such as looking at the teacher or sitting with the group, should be calmly and fully praised.  Do not praise the child for these efforts in front of others, but do so quietly and privately. 

7.       Provide related services such as speech and language therapy, occupational therapy, and the services of an applied behavior analyst.

8.      Do not single the child out and make them the center of attention.

9.      Provide a structured setting within the classroom routine.  These children do better with predictability.

10.  Provide a safe place in the classroom such as a desk with a partition so the child can reduce all the stimulation from the classroom.

11.  Do not expect the child to talk.

12.  Do not comment to the child if you do hear them talk.

13.   Provide a “buddy” for the child that sits next to them and helps the child manage classroom communication and expectations. Rotate the buddy weekly so the child has interaction with several children in the classroom.

14.  Ask the child questions requiring only yes and no responses.

15.  Do not pressure the child for eye contact and allow it to occur naturally.

16.  Give the family advance notice of any changes in routine such as planned substitute teachers, guest speakers, and field trips.  Allow a parent to be present during these situations.

17.  Weekly communication between the teacher and the parents is very helpful.

18.  Do not draw attention to the child but either talk with her privately or positively comment on good behaviors in general.  Stickers for success also work quite well.

19.  Be aware that these children are sensitive to loud noise or being overwhelmed by a lot of activity or chaos.

20.  Explain to these children how you feel so they do not have to guess, which tends to make them more anxious and uncomfortable.

21.  Be concrete as children with SM often have difficulty understanding abstract language.

22.  Quarterly meetings with all related service providers and the teacher are very helpful to both the teacher and the parents.

23.  Minimize direct questioning in front of others.

24.   Provide these children with word prediction software to encourage them to communicate with written responses that can be heard by the teacher.

25.  Provide one-on-one time with the teacher to play a simple and familiar board game or computer game.  These familiar activities that are not performance based may allow children with SM to become more comfortable and transfer that comfortability to verbally engaging with the teacher. This may have to occur several times to reach a higher level of comfort with the interaction between teacher and child.

Please keep in mind that progress may seem very minimal to the adults involved with the child with SM.  However, each minor success builds a foundation for the next success and progress is progress.  Plateaus are also not uncommon, and you can use that time to reinforce what has already been accomplished.  Although not yet mentioned, some children respond better to treatment when they work with a psychiatrist and take medication.  Parents worry about medication, but it is helpful and usually temporary.  The medication often allows the child to progress more quickly through the therapy process.  Whatever you decide, be patient and advocate for your child.  Some schools are very cooperative and unfortunately, some schools are not.

      If you are interested in reading a picture book about therapy with your child to get them ready for therapy, consider reading our new book, “I Have A Voice”.  You can also find great resources through the Selective Mutism Foundation. http://www.amazon.com/gp/product/1616337281?ie=UTF8&camp=1789&creativeASIN=1616337281&linkCode=xm2&tag=theshrlin-20

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When Your Voice is NOT Heard:  TOXIC PARENTS

There are, unfortunately, so many different types of dysfunctional family systems that I cannot fit them all into one blog.  Today I am going to focus on the adult who has parents that are dysfunctional and toxic.  We expect our parents to be the people that love us the most in the world.  To have our back and love us unconditionally.  Unfortunately, it does not always happen and many people stay in a state of denial for many years.  Some people spend their adult lives trying to earn the approval of parents that are just not capable of approval or unconditional love. Instead, they experience years of guilt, pain, frustration, emotional abuse and manipulation, financial burden, broken relationships, and chronic disappointment. At some point, many people realize that their parents are highly dysfunctional and toxic, but they don’t know what to do about it, how to heal some of the damage.

            A relationship with toxic parents is like an emotional and spiritual cancer.  This type of relationship is typically based on behaviors and manipulations that are emotionally damaging, leaving you feeling guilty, insecure, controlled and manipulated, threatened, and beaten down.  It just does not feel safe.  In a healthy relationship, the caring, love, and respect is mutual and nurtured throughout the years.  Compassion is freely given, without manipulation or strings attached, such that both sides feel loved and supported. Unlike other relationships, when the toxic person in the relationship is a parent or parents, it can leave you feeling burdened and trapped.  In most cultures, we are taught to respect our parents.  In most religions, we are also taught to respect and honor our parents.  If a friend or spouse is abusive we are encouraged to leave.  When contact is cut off with a parent, there is much less support and understanding, especially from people who are blessed with healthy parents. At this point, you may feel your guilt is on steroids and dominating your life.  

            This is the person who gave you life and raised you.  They supplied all your basic survival needs such as food, clothing, and shelter.  They were supposed to give you unconditional support.  Unfortunately, for some, this is the person who constantly criticized you, put you down, and manipulated you with guilt.  They lied to you and about you, embarrassed you, sabotaged all your relationships, controlled you and never seemed to let you go.  Rather, they trapped you and convinced you that you were at fault, inadequate, unappreciative, and undeserving of love and respect.  You may feel that if your own parents could not love you that you must be unlovable. 

            Reasoning with a toxic parent does not work!  Sacrificing your life for a toxic parent does not help as it is expected.  Being the perfect child does not help because the toxic parent is always disappointed and wants something more.  These parents make sure you never develop a close relationship with siblings or other family members or friends.  They keep you isolated so they can have more control over you.  Toxic parents are an EMOTIONAL CANCER!

            What do we do with cancer?  We eradicate it and get it out of our body.  This is what we have to do with toxic parents and any toxic person in our life.  These people suck the life force out of us and if we keep them in our life, we have no joy and no quality of life.  Remember, your parents chose to have you and it was their job to raise you and provide for you.  That does not mean you owe them every part of you and your life.  To disconnect from parents you will have to deal with guilt, grieve over the loss of the parents you wanted and deserved, accept the disapproval of some family members, maybe even siblings, and most importantly, setting strong boundaries.

            How do you start?  First comes the acceptance that you have a toxic parent who is a destructive force in your life.  Not only can you not change your parents, it is not your job to change your parent.  The only person we can ever change is ourselves.  Accept that your parents are damaged and dangerous to you.  Next, be very aware of guilt and how your parents use guilt to manipulate and control you.  They have most likely been doing this to control you your entire life and they know exactly what buttons to push. 

 When someone tries to manipulate you through guilt, it is in their best interest, not yours.  Acknowledge the guilt as manipulation which will help you not buy into it.  Very importantly, if you cannot completely disconnect from your parents, limit your contact with them as much as possible.  You are not responsible for their happiness or the consequences of their choices.  You do not owe them your life.  They are adults, as are you.  You have to live for you, not your toxic parents.  Stop giving up your relationships and your life goals to please parents that cannot be pleased.  Give yourself permission to live your life for you, with healthy and balanced relationships, mutual love and respect, and balance and stability.  If you can’t do this on your own, do not hesitate to seek professional help as this is a very difficult and challenging process.

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2016 NEW YEAR RESOLUTIONS

Happy New Year!  Many of us look at the New Year as a time to change our lives.  We often see it as a new beginning and as a way to re-invent ourselves and our lives. While we are trying to motivate ourselves through the new resolution, we also have to be ready for the change as most change is challenging.  If the behavior we wanted to change was easy, we would not need the resolution.  Psychological studies have shown that approximately 50% of adults tend to make New Year resolutions, especially regarding weight loss, exercise, smoking cessation, and better money management and debt reduction. Other common resolutions include but are not limited to getting more organized, volunteering and helping others, learning something new, drinking less, enjoying more family time, and generally enjoying life more.

Please keep in mind that if a resolution is unrealistic, you may be buying into false hope and setting yourself up for feelings of failure. Your resolution has to be realistic and match your internal view of yourself and what you are capable of given your life situation.  For example, debt reduction is a wonderful goal, but it has to match your income and fixed expenses.  It would be unrealistic to reduce your debt by an amount that is not commensurate with your income. Also, if you make a resolution but tell yourself that you don’t really believe you can do it, the resolution can lead to negative self-talk, making you feel like you failed. 

To change a behavior, you first have to change your thoughts and expectations and you have to be realistic with the goals you set.  To help reach this goal, try focusing on one resolution at a time.  Set realistic goals in steps or chunks.  For example, with debt reduction, first stop putting any more charges on your credit cards.  Pay some over the minimum on each card but target one card to pay down to zero, however long that takes.  Once that card is paid, target another card, and so on.  Make your resolutions daily and not yearly.  Every morning, remind yourself what your goals are for that day and reinforce your resolution with your recent success. Ask yourself how you are going to meet your goals today.  When you achieve smaller goals along the way, it is less overwhelming and much more reinforcing.  It is also very helpful to enlist the help of someone else, like a support buddy.  This can be a friend or a family member.  Depending on the resolution and goal, it can even be a co-worker or a support group (like weight watchers for weight loss).  Practice your new thoughts based on supporting evidence.  For example, for weight loss, remind yourself that you have stopped gaining weight and have started to lose weight.  For debt reduction, remind yourself of the decreasing balances on your credit cards.  Verbally reinforce for yourself how good your success feels and how much you want to continue to feel that success.  Be aware of your thoughts and feelings, especially those thoughts that might sabotage your success. 

Don’t forget to have fun and reward yourself along the way.  It is important to recognize and acknowledge those intermediate successes so the journey does feel impossible.  Most importantly, have a plan for relapse prevention and goal maintenance.

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HOLIDAYS 2015 

The holidays are once again fast approaching and maybe this will be the year that we do things differently. So many of my patients and friends confide in me that they really do not enjoy the holidays. They rush through Thanksgiving and dive head first into shopping for gifts, sending out cards, going to parties and giving parties, and find themselves feeling flat and tired. Let yourself enjoy each holiday in its own right.  

Halloween is a lot of fun, especially when you have children who are excited about their costumes and all the candy they will receive. Thanksgiving truly is a day to give thanks for what we have, family, friends, a safe place to live, and food to eat. 

Try and really look at the difference between wants and needs. If all your needs are met and you are able to have some of your wants, than you are much better off than many people around the world. As for the post‐Thanksgiving holidays, make your budget, your list, and methodically make your way through and really enjoy the processing of selecting gifts and wrapping them and anticipating the pleasure of the person you are giving the gift to. If you have to spend time with family members that you really do not enjoy, try and look at what you do like about that person and remember that every person has a story and you may not know their entire story. Wish them well in your thoughts and maybe you will even see them smile. If you are missing people that have passed away or are not able to be with you this year, focus on the positive memories. For those people that cannot be with you this year, call them. Maybe even arrange a group call on skype or face time. Share memories and remember what you are thankful for. Even if your life is not where you want it to be, there is always something to be thankful for and something to share. HAPPY THANKSGIVING AND HAPPY HOLIDAYS!
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SOCIAL MEDIA ADDICTION

Everybody has an opinion about social media.  Some people do not see or understand the attraction to social media and other people cannot understand why more people are not more involved.  Like anything else in life, we all don’t like the same things.  For those of us who do like social media, some are involved on a very minimal level and others are involved throughout their day.  The question is; when is it too much?  When social media is used as an escape it is too much. 

If someone turns down a social invitation or time with family because they want to update Facebook or follow someone on Twitter, it is too much.  Social media should add to the quality of our lives, not become the focus of our lives.   There is nothing wrong with enjoying pictures on Instagram or Facebook, or following someone on Twitter.  However, to put anything meaningful on these sites, you have to go out and live life.  If your children seem overly consumed, maybe limit them to an hour a day.  And while you are at it, limit yourself to an hour a day.  I have met people who proudly tell me that they spend up to five hours a day updating all their social media.  What else could have been accomplished in that five hours?  Maybe spending time with family or friends, working out and exercising, learning a new hobby or skill, reading a book.  Social media is an adjunct to life, not the center of life.  

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