LIFE ASSESSMENT

Where are we in life?  Do we feel our life is meaningful?  Have we met our goals?  How do we assess where we are and if we feel we are falling short, how can we change?  All good questions with many different answers depending on who you are talking with.  Here are some general guidelines you can follow:

1.       What activities or times in your life have been the most meaningful?  Are you still engaging in those activities and if yes, are they still meaningful?  If the answer is no, what can you do now to bring meaning into your life?  As we grow and change, what brings meaning to our life also can grow and change.

2.      What in my life would I be willing to sacrifice and for what?  Sacrifice can come in small ways as well as large ways.  Can you give your time to a special cause or person?  Is it time to volunteer or change the direction of your volunteering?  Is it time to engage in an activity that is for you, such that the meaning is also for you?

3.      Do you let the people in your life know how important they are to you and how much you love them?  Even when people know you love them, it is always nice to hear.  Is there someone in your life that you trust enough to share some of your hopes and dreams with?  If yes, get started and if no, put yourself out there to eventually find that person.

4.      If you were given another chance at life, what would you do over and how?  Since we will not be given that chance, we can look at our answer for guidance for what we want to do differently in our present and in our future.  For example, if we wish we had made more friends, we can begin to work on that now.  If we wish we had a job we enjoyed, again, we can work on that now.

5.      What do you think would bring you the greatest realistic happiness?  I use the word “realistic” intentionally.  A fantasy is not going to change how you live and love your life.  Thinking about realistic changes in your life can help you and what you already have in your life that brings you happiness.

6.      What achievements in your life make you happy?  Your marriage, children, friends, career or how you handle your career?  Maybe you are happy with how you treat people or things you have experienced.  It is always helpful to be aware of what has been good in our lives and what is good in our lives.  Even on our worst days, if we allow it, there is always something good to hold onto.

7.      What are you biggest mistakes and what did you learn from them and how can you correct them?  To gain wisdom, we must make mistakes and learn.  If we are blessed, we will live long enough to have earned some wisdom.

8.      What will I regret not doing in my life?  Some regrets we will not be able to fulfill, but there are still many that we can.  Work on the ones that are still available to you.

9.      If I were guaranteed success, what would I try to accomplish?  Often it is our fear that holds us back.  Use this question to ask yourself what would you really want to work on accomplishing and what are the steps to begin to take you in that direction?

10.  What are your most important goals in your life and what are the initial steps you can take to achieve those goals?  Can you make a realistic time line?  Do you have any family or friends that can help you with guidance or practical support?

11.  If you could give your children three pieces of advice for life, what would they be?  Apply that advice to yourself.We hope you enjoyed reading our blog.  Please like us on Facebook and share our blog with others.  We also would appreciate your comments and we are happy to consider your ideas for topics we can address in our blog.

 WHEN YOUR CHILD IS THE BULLY

When you get a phone call from the school regarding bullying, our usual parental response is concern that our child was bullied and hurt.  However, when you are the parent of the child who engaged in the bullying behavior, the emotional reaction can be denial, shock, despair, sadness, disappointment, embarrassment, shame, and self-blame.  Let’s start with a definition of bullying.  Bullying involves an unbalanced relationship between two people involving a pattern of intent to hurt through aggressive (physical and/or emotional) behavior.

Children are not small adults.  They are still in the process (as are some adults) of learning all the verbal and nonverbal subtleties of human communication.  Young children are not yet able to engage in abstract reasoning, meaning that their communication and understanding is still very concrete.  It is still challenging for them to put themselves in another’s place and truly feel empathy.  The first thing we need to do as the parent is to look at the history of our child.  Have they been on the receiving end of bullying behavior, possibly by an older child or even an older sibling?  Are they having trouble socially, making friends?  Do they feel like part of the group or do they feel isolated?  Has something happened in their life that confused them or lead to feelings of anger?  Are they imitating some behaviors they have observed in life or on TV or other social media?

            Whatever may be contributing to their behavior, remember that your child is not a small adult and they are learning to navigate the social world and will make mistakes.  That being said, you do need to talk to them about their behavior.  If your child totally denies their behavior, let your child know that you believe a lot of their version, but does the other child have some credibility in what they are saying.  If your child can acknowledge that the other child may also be telling the truth from their point of view, than accountability and compassion can be part of your conversation.  As your child tells their story, have them also tell the story through the other child’s perspective and see that child’s point of view.  If your child is in defensive mode, this may be a very hard step for them.  Help them put themselves in the other child’s place by asking them how they might feel or react if someone treated them the way they treated the other child.  If they have a younger sibling ask them how they would feel if someone mistreated their younger brother or sister.  Older siblings tend to be protective of younger siblings in situations outside the family.

            Help your child own their behavior and take responsibility for their actions.  Let them know that you love them and everyone makes mistakes.  Mistakes are how we learn.  However, teach them that it is important to not keep making the same mistakes over and over as that will develop into a pattern of behavior, which is much more difficult to control and change. 

            As we mentioned earlier, it is important to talk to your child about how they perceive themselves socially.  If they feel they need to bully in order to not be bullied, you may need to conference with their teacher and guidance counselor.  Help them build up their self-esteem so the words and actions of some of their peers are not so damaging.  If they are not already in an after school activity, that can often help as they feel they have a home base of friends.  Teach them how to make friends and if you feel they are not receptive or your interventions are not working, take them to a child psychologist for some professional intervention and social skills training.  

            Most importantly, if your child has bullied someone, it does not mean that you are a bad parent.  Children are brutal as they navigate the social waters of their age group.  Most children will grow out of this behavior and will look back on their bullying behavior with regret.  We want to make that experience is as short term as possible for them.  For those children that do not outgrow bullying, there are most likely other issues that need to be addressed and as a parent, you can only work with what you have.  Patience, love, support, structure and boundaries are typically the keys to successfully raising children, along with acceptance that our children are not perfect.

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THE EMOTIONAL FALLOUT OF PSYCHOTHERAPY

There are two main topics I want to cover today.  First, when you may have been emotionally abused by a therapist and second, when you get healthy and the people around you do not. 

As in any field, not all therapists are good at what they do and not all therapists are nurturing and/or healthy.  It is not the therapist’s job to judge you, dismiss you, demean you, or manipulate you with guilt.  Follow your instincts and if you feel uncomfortable with the therapist, seek out someone else.  That being said, keep in mind that the therapy relationship may seem strange to you at first as you are disclosing personal and intimate information to a stranger in a timed and professional session.  Give yourself time to get used to the nature of the relationship and you will start to feel much more comfortable with what therapy has to offer.  When you leave a session, even if you feel emotionally stirred up, you should also leave feeling heard and optimistic regarding your mental health and well-being.

It is not the therapist’s job to tell you what to do, but to help you reach a level of self-confidence so that you are able to make your own decisions.  How the therapist helps you get to that place depends on the therapeutic orientation of the therapist and what you bring to the therapy in terms of your history and past experiences.  Much of therapy is based on the relationship that develops between you and the therapist.  

Without trust, you will not be able to disclose information you do not typically share with others and while a highly trained therapist may be able to read a lot between the lines, no therapist is a mind reader.  If you disclose to the therapist and they seem to dismiss you or judge you, first discuss it with them and make sure you are not misinterpreting what they are trying to share with you. 

There are different therapeutic orientations and you may want to do some research on this before selecting a therapist.  You may find a wonderful therapist but their orientation does not work for you.  For example, a cognitive-behavioral therapist may not spend a lot of time on your past but focus more on your current coping skills while a psychodynamic therapist will spend much of your therapy on your past.  Regardless of orientation, you should always feel heard and respected.

            The second point is when you get healthy and begin to recognize that some or many of the people in your life are not just dysfunctional, but toxic.  A toxic person behaves with a pattern of intent to hurt you and others.  As you get healthy, you will most likely start to eliminate some people from your life.  You will set healthier boundaries and you will experience less tolerance for bad behavior.  This may feel counterintuitive; to let go of people in your life, especially when it involves family members.   Some of the people you considered friends are really just relationships based on shared history and you may feel you are getting rid of everyone.  This might even scare you.  However, you will have emotional room to develop healthy relationships with others that will enhance your life and will allow you to enhance their life as well. 

            One of the hardest issues in therapy is when you realize you have a toxic relationship with a family member, such as a parent or child or sibling and you may need to disconnect from that person. 

 Other people in your personal community may disapprove of what you are doing because they do not really understand what is happening or they may not have all the information.  For example, you may have hidden abuse and someone outside of that relationship does not know what you went through and can only counsel you based on what they know and not what is real.  If disconnecting a relationship feels right to you and you and your therapist have worked on this issue, follow your instincts.  This is your chance for a happier, healthier, fuller life, but the path may seem lonely at first and may be one of the biggest fallouts of therapy.  We hope you enjoyed reading our blog.  Please like us on Facebook and share our blog with others.  We also would appreciate your comments and we are happy to consider your ideas for topics we can address in our blog.

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

We hope you enjoyed reading our blog.  Please like us on Facebook and share our blog with others.  We also would appreciate your comments and we are happy to consider your ideas for topics we can address in our blog.