We see teens with anxiety and depression, exhibiting feelings of hopelessness, worthlessness and a sense of not belonging. Crying spells and fatigue are pronounced, and many teens are turning to behaviors such as drinking and drug usage, food restriction or binge eating, cutting, as well as self-disparaging thinking patterns.

One profound coping tool that Dr. Kay Abrams shares with teens is the notion that simply breathing, slowly, in and out of their nose, with eyes shut, can calm the nervous system and lead them to a sense of safety. When we breathe in deeply, we ask our sympathetic nervous system- the one that is all about “fight of flight”, to quiet down and take a break.  When we can go inward and find calm, we are no longer vigilant and reactive. There is safe refuge to tap right inside of us, at any given moment. The more you practice this “muscle” of calming, the greater your ability to manage feelings of anxiety.

Furthermore, the more you practice quiet calm, with television, phones and all screens OFF, the greater chance you come to realize that it is through quieting our minds that we are grounded in our bodies and find our center, for stabilization and peace.  To quote a yoga teacher I recently heard at Vista Yoga in Atlanta, Georgia, “imagine you are part of the great ocean…each one of us is just a drop in the ocean, but you can find peace just relaxing into the greater ocean that holds us,” and “imagine you are an expansive wall. Every experience you have, positive or negative, every story you tell yourself is like paint on that wall, but the paint can be removed and there you are, expansive and clean and clear…at peace, standing strong.”

Teens need to know that there is a lot of noise in their heads, a lot of projection and fear. But, in their core center is a self that can stand still and strong and calm. There, they can find safe refuge for restoration as they face the challenges of their everyday world. They can learn to respond, rather than react, as they move forward. In this manner, they stand a better chance to thrive and develop with less fear and greater calm.

In addressing how to be calm and confident when managing children, I often impress upon parents the power of their presence.  When you are mindful and present, when you have what I refer to as “pure resolve” in your understanding you are “on the job” without a wish to be elsewhere, without distraction or even a tinge of resentment, children know. Much of misbehavior, testing and provocation stems from a parent-child scenario whereby the parent is overly reactive after being detached.

So what does it mean to be present? It means you are adept at putting other thoughts and needs aside and coming to BE in the present as you manage your children. It means you are physically there….just there. It does not mean taking over, nagging, hovering or talking. In fact, your presence is powerful in its quiet calm, not in reactivity and anxiousness.

Play around with your mindfulness and see what happens. Choose a transitional time such as getting ready to go in the morning, homework time or bedtime ritual. Let go of all your other duties and responsibilities, both mentally and physically. No screens, no checking email, no multi tasking. Practice being 100% present in a resigned, peaceful manner. Be clear and calm about the expectations in your system, i.e. “it is time to get ready for bed…time for your bath and then some reading together.” Keep the communication simple and straight forward. Avoid long lectures, discussions or negotiations.

A study published recently in the Journal of Child and Family Studies provides a more extensive examination of the possible benefits of mindfulness training for children with ADHD and their parents [S. van der Ord & S. M. Bodgel (2012). The effectiveness of mindfulness training for children with ADHD and mindful parenting for their parents. Journal of Child and Family Studies, 21, 139-147]. Participants were 22 8-12 year old children diagnosed with ADHD and their parents. The study was conducted at an outpatient mental health clinic in the Netherlands.

Children and parents were randomly assigned to receive mindfulness training or to a wait-list control condition; the majority of children were already receiving treatment with stimulant medication and remained on medication during the study. Mindfulness training consisted of 8 weekly 90 minute group sessions – the child group included 4-6 children and the parent group included the parents of these children. Children and parents were given structured assignments to complete between the sessions that focused on practicing the skills they had learning in each group meeting.

Mindful Child Training

In mindful child training children are taught to “…focus and enhance their attention, awareness and self-control by doing mindfulness exercises during the training and as homework assignments.” The exercises include sensory awareness exercises, body awareness exercises, breath awareness exercises along with breathing meditation, yoga, and exercises that promote awareness of automatic responding.

You can find a nice web site on mindfulness for children developed by the Greater Good Science Center at UC-Berkley athttp://greatergood.berkeley.edu/article/item/tips_for_teaching_mindfulness_to_kids

Mindful Parenting

Mindful parenting is “…a framework whereby parents intentionally bring moment-to-moment awareness to the parent-child relationship.” The goals of the Mindful Parenting program used in this study were to help parents learn to …

1. “be deliberately and fully present in the here and now with their child in a non-judgmental way”;
2. “take care of themselves”;
3. “accept difficulties in their child”; and,
4. “answer rather than react to difficult behavior of their child.”

Because parenting stress can contribute to over-reactivity on the part of parents, dealing effectively with stress was an important focus. Parents were also taught how to encourage their child to do meditation exercises at home and how to meditate with their child.

You can find a very informative article on ‘mindful parenting’ at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730447/

The holidays are filled with stress. Parents are transitioning from work and trying to unwind.  Your children and teens get a “break” but likely have exams to prepare for if they are older.  You may be traveling or having family in, and you likely have a lot of last minute preparations to get done.

Transitions are not only challenging for children. Most adults misbehave during transitions when we have failed to set up realistic expectations or failed to anticipate our needs.

The following bullets are for you to reflect upon during the holiday season….

• Try unplugging from email and your “to do” list altogether. Genuinely walk away and let it be. When you return, you may be all the more able to delete and purge what no longer feels pressing
• Be sure to bring yourself to the present entirely by listening and engaging your friends and loved ones
• Get sleep, breathe deep and take in real food, slowly
• Step outside for fresh air with your kids and your spouse or by yourself to just stretch your legs
• Read a good book and keep the television off
• Seek to help others feel that they matter to you
• Create a quieter and less rushed home environment. Be less concerned about control and your task list and more connected to your heart and just relaxing into anything loving, joyful or playful

I know it sounds impossible, but your body and your central nervous system are habituated to being all cranked up. No amount of wine, chocolate or television is really going to bring you into a sense of fullness in your heart. Slowing down and noticing all that you are grateful for, being present to connect, take interest and play is what will shift your energy from frenetic to calm connection and care, so you may feel some peace for the holidays.

And, don’t forget to meditate about how to live your life a bit different in 2013 so you are less tense, anxious and stressed! Cut something out. Lower your expectations. Figure out a creative shortcut. Delegate.  Get off your screens as I am vowing to do right now.

Yours,

Dr. Kay

Unfortunately, most parents are managing their children with their SNS cranked up high, putting parents and children at risk for way to much reactivity. Before you know it, managing your home and children becomes a daily drama of whining, screaming, begging and bargaining. Too much drama! And, children get quite attached and desensitized to the reactivity. Trust me, it is going to drain you more than them….

When you face your day as a parent or even your morning or evening shift, so to speak, how do you prepare yourself mentally and physically for the pure resolve of being present with your children. Breathe deeply for 5 or 10 minutes to a slow count of 5 or 6, in and out, through your nose, prior to getting up to face your day. Calm, slow, intentional breathing to activate your Parasympathetic Nervous System [PNS].  In this manner, you will be like a calm pilot or nurse who has to face challenges with nerves of steel.  Managing children with calm centered energy means “you rock” with centered power.

No distractions, no resentment expressed in body language or sarcasm. Just calm and pure presence as you manage your little ones. I promise that if you are genuinely present, like a nursery school teacher, with a voice and body that says, “I am here to be present.” In this manner, it is easier to manage little ones who know in a millisecond when their caretakers are preoccupied. Give it a try and come down slow, low and matter-of-fact with your commands and directives. No threats, just simple calm commands with long pauses in-between. Use your voice coming down slow and low with less than ten words.  You will be surprised how it is actually your powerful energy delivered straight to the heart and mind of your child, like an umbilical cord enlivened to direct and guide them that WORKS.  No candy, not applause, no bargaining necessary.

Well one parent messaged our Dr. Kay for advice. Her daughter is being snubbed by the group of girls in her class and she desperately wants to fit in. The girls may not be the best fit for her, but she doesn’t see it that way. She’s in the process of growing up and leaving her childhood behind. She’s full of uncertainty, learning to become independent from her parents, and wanting to feel like she belongs with her friends.

This ‘struggle to secure identity’ can start anytime between the ages of 11 and 15 (sometimes much later). It’s a process that varies in intensity, for some it is an ongoing lost and found process; for others merely a bump in the road.

If your child is also looking for acceptance, and having trouble finding their way, check out a few of Dr. Kay’s tips:

• Social adversity builds strength in character and in coping.  Parents need to be supportive, but not too intrusive. Tweens need to solve their social dilemmas because that is exactly the developmental challenge they face.

• While parents need to encourage their tween to be their authentic self among peers, it is also key to recognize the importance of fitting in.  As long as your family values are not compromised, it is well-advised to allow your child to have some of the same or similar styles of clothing and accessories as her peers.

• Our children pick up on our fears, doubts and anxieties. Be careful not to project your own fears and past wounds onto your daughter.

• Offer them an opportunity to sort out her thoughts and feelings. Engage in active listening, rather than advising, which could resort in the loss of open dialogue. It is through active listening that they will feel affirmed and empowered.

Want to read more? Check out the rest of the article and tips here:On the “Outs” Wanting “In” Cliques & Conflicts in the Tween Scene 

Today’s tips all surround what to do if your child is having trouble sleeping through the night. The question came originally from a mother whose 7 year old was having trouble sleeping weeks after seeing a scary movie. Definitely frustrating and tiring for his busy parents.

Here are a couple of the things Dr. Kay recommended. Honestly, they will work for many different situations so take note!

• emphasize what to do, rather than what to think
• Emphasize the behavioral goal, rather than the unwanted behavior.  For example, “Nighttime is for sleeping, and you can sleep through the night…get up in the morning when the alarm rings.”
• Keep your tone very matter-of-fact. Do not threaten consequences or punishment!  Emphasis is on mastering the goal.
• The parent with the stronger conviction, the one who will not waver, is the better choice for redirecting Josh back to bed.
• There is no need for any emotion or drama, such as anger, scolding or pleading. Keep your tone neutral and definitive. Repeat yourself and stay clear, as if you are directing a plane to its landing.

If you are interested in reading more of the tips she gave these parents, read the full column here:  Good Night, All Night

Today we’d like to take a moment to talk about a serious, but treatable, condition: Postpartum Depression. It is a mental health problem that affects an estimated 9-16 percent of new mothers¹.

So what is it exactly? Well, postpartum depression is a type of depression that occurs after a woman gives birth. It is thought to be caused by all of the significant shifts in hormones. Particularly (new research has begun to show) by a type of estrogen called estradiol². Not to mention that of course while the body is going through these changes, the person themselves is dealing with things such as an entirely new family dynamic.

More common than postpartum depression is what we call ‘baby blues’. It is experienced by roughly 50% of new mothers². For the first couple weeks after giving birth, new mothers can just feel kind of out of it and not quite like themselves.  So it can be kind of hard to tell if it’s just ‘baby blues’ or depression. Baby blues, however, tend to be very limited and does go away on its own relatively soon and quickly. When it gets more intense, and goes on for a longer period, it becomes a serious form of depression. Postpartum depression can come with a loss in interests; affect your ability to function, lead to sleep disturbance and withdrawal. It is an especially big problem because it comes at a time when all of a sudden you are supposed to be caring for a new life.

It also can really have an impact on your family. A child whose mother has postpartum depression can withdraw, have development issues, and are at a higher risk to develop anxiety disorders and depression of their own. Postpartum depression can also affect the father. After all, he is also dealing with the same family and marital changes¹ and not having the mother at 100% makes it all the more difficult.

Part of what makes postpartum depression so heartbreaking is knowing how much the new mom is missing out on.  The depression takes them away from enjoying their newborns first days and weeks. Not fully being able to experience having a new addition to their family. So if you or someone you know is suffering from postpartum depression, please contact our practice. Symptoms of postpartum can be alleviated through psychotherapy.

Further Reading

http://www.apa.org/pi/women/programs/depression/postpartum.aspx

http://www.womenshealth.gov/publications/our-publications/fact-sheet/depression-pregnancy.cfm

http://www.webmd.com/depression/postpartum-depression/postpartum-depression-topic-overview

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004481/

Work Cited

¹ Postpartum Depression Retrieved March 28, 2012 from American Psychological Association. Website: http://www.apa.org/pi/women/programs/depression/postpartum.aspx

² Groundbreaking Research into Postpartum Depression Retrieved March 28, 2012 from National Institute of Mental Health. Website: http://www.nimh.nih.gov/media/video/postpartum-depression.shtml

My name is Dvora Gautieri and I just wanted to take a short moment to introduce myself. I have recently come aboard with Abrams and Associates to kick start our social media outreach program. Basically, you’ll be seeing me pop up on our Twitter, our Facebook, and right here on our blog. You should also look forward to our monthly newsletter starting up in the next month or two.

What all of this is meant to do is to just open up discussion. There are so so many topics for us to learn about together, and just maybe we’ll help better each other’s lives. So I hope you’ll join in with us from time to time.

Next week will hopefully bring a blog post about women’s mental health and sexual education, but for now I hope you’ll enjoy some of the articles we have on our website (http://abramsandassociates.com/articles-resources/). I’ve been in the middle of reading one of Dr. Kay’s column that was published in Washington Parent Magazine. It talks about parenting in an age full of anxiety and the differences between parenting in previous generations and what today’s generation faces. “For example, children can no longer run around outside with a sense of freedom, nor can they always solve their own problems without adults intervening”. I personally also think this reminder is very important “Step back and try to see your child for who she is, rather than what you expect or need her to be”. To read from from her article “Parenting in the Age of Anxiety” click here

Well, that’s all for now. I look forward to speaking with you all soon. Have a great weekend!

The messages we all receive about food are confusing, to say the least.  They tend to get divided into two camps: one that involves eating tons of fast food and binge eating and one that involves trying to be as skinny as possible. These two camps also directly correspond to the three major eating disorders.

Anorexia is a disorder in which the person starves themselves. They literally are so afraid of any amount of fat, of gaining any weight that they eat next to nothing. Someone with Bulimia binge eats and then purges themselves by doing things such as forcing their body to throw everything up. Then there is a disorder involving straight binge eating. Someone eats and eats and eats¹. This leads to obesity and other health issues such as diabetes²(Taylor, Zanthe).

If you’re in doubt of the seriousness of these issues, you should know “that they have the highest rate of mortality for any mental illness”² (Taylor, Zanthe). 

Sounds rather bleak, we know. So it is also important to understand that eating disorders are not really about eating. Often there are underlying addiction and/or mood disorders as well as developmental issues and interpersonal deficiencies.

So what can we all do? What can you do as a parent? Well, Dr. Kay has several things to say on the subject. Starting with understanding that one of the places children learn eating habits is from watching you. If you eat healthy, it will help them. If you binge eat, they’ll think that’s okay too.  “It’s a tough balance,” says Dr. Kay “You have to try and give a moderate and flexible approach to food and body without talking too much about it.”  Pushing a ‘healthy’ lifestyle too much can create anxiety as well as a fear of fats and fear of diabetes or heart disease. Anxiety is contagious and what underlies anorexia is anxiety. Yet, the opposite extreme is just harmful. You just have to do your best to help them understand.

In addition to leading by example, parents should try things such as having set meal times, eating as a family, and not having an open 24/7 pantry policy. Try finding active activities to do with your child; even just taking an evening walk³.

Most of all make sure they understand you love them no matter what. Teach them to love themselves no matter what.  Combine that with a healthy lifestyle and you’re already giving them a better starting point.

For more information and up to date news on eating disorders and the fight against them, please visit the National Eating Disorders Association website: http://www.nationaleatingdisorders.org/. If you or anyone you know is suffering from an eating disorder, please seek help from a mental health professional.

Sources

¹ “What is an Eating Disorder” National Eating Disorders Association 2005 http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/WhatIsEd.pdf

² Taylor, Zanthe “The Conflicting Messages on Parenting and Food” Psychology Today, 2/24/12 http://www.psychologytoday.com/blog/million-meals/201202/the-conflicting-messages-parenting-and-food

³Dr. Kay’s article “Eating Disorders: Is Your Child at Risk?” http://abramsandassociates.com/wp-content/articles/EatingDisorders_IsYourChildAtRisk.htm

Imagine a job description for today’s generation of parents. What attributes promise success? Some would say that parenting requires wisdom, humor, patience and organization skills, for starters. It also requires good management skills, a sense of moderation, flexibility, intuition, empathy and persistence. As metropolitan parents, we need time to chauffeur our kids to soccer and “quality” time to engage our children without e-mails or answering machines.

How can any one person qualify? And, in order to parent with confidence, where is the job training in the face of such varied and ever-changing demands? To add to our angst, we parents have only limited influence, within a relatively short period of time, to learn new skills, practice and determine what is effective for our particular child.

Our influence as primary caretakers is greatest during the early years, when children are most dependent. Predictable rules set the foundation for trust and security. As children mature, they attain greater ability to cope and adapt and are better able to handle autonomy. The mature teenager has enough common sense to finally practice independence.

Most of us test weak authority figures by being noncompliant. Insecure authority is demonstrated not only by parents who cannot set appropriate limits but also by agitated parents who use emotional threats or physical force.

Without appropriate limits and consistency, children can become anxious and reactive. They frequently misbehave when demands are confusing. Angry feelings and opposition are natural reactions to inconsistency.

When we parents cannot maintain our authority due to stress or insecurity, we jeopardize our ability to manage our children effectively. At such times, children not only act out, but may develop social-emotional immaturity as well. Alternatively, a temperamentally difficult child may challenge parents to the point of exhaustion, diminishing their confidence. In either case, the family system is less harmonious and less productive. Trust and respect may be further undermined as parents react to misbehavior with harsh threats or bribes to regain control.

How do we raise our children with greater confidence and less exhaustion? And, how do we maintain calm benevolent authority as we set the necessary boundaries that promote security and growth?

Know your limits…

Know thyself and know thy child so you can better respond to your needs and hers. Know how to refuel and rejuvenate yourself. If parenting with confidence requires creativity, problem-solving and frustration tolerance, it makes enormous sense that we must take care of ourselves in order to manage our children effectively. We simply parent at our worst and our children behave at their worst when we are not mindful and present.

The goal of parenting is not always about “happy”…

We all want happy friendly children, but fostering short-term gratification to achieve “happy” children may result in long-term relationship problems. We parent to help our children get along in the world, which means that they are going to be frustrated and will not always want to do what is best for them.

One fundamental requirement for confident parenting of children is the ability to tolerate being disliked and to ignore expressions of frustration that are intended to undermine your authority. If children play the drama card by exclaiming, “I hate you,” or “You’re the meanest,” avoid getting “hooked.”

We are “hooked” when we argue, defend our decision, or worse, give in and change our minds to make peace! Where appropriate, empathize briefly with your child’s frustration. If you have broken a “promise,” apologize. We need to model accountability if we expect our children to be accountable. Then set your limit or state your command firmly and repeat it as necessary without adding threats for leverage.

Set limits carefully and thoughtfully to secure consistency …

Unless you are dealing with a true emergency, when you are uncertain how to respond, ask children or adolescents to “wait.” This gives you time to make a confident, sensible decision. Avoid reactive, knee-jerk parenting. It pays to remember that “an emergency on their part does not constitute an emergency on our part.” Reactive parenting is knee-jerk parenting, and it is ineffective. When we manage behavior according to our mood or energy level, we tend to be inconsistent.

Reactive parenting often results in yelling, threatening and bribing. We engage in shortcuts to managing behavior when we feel hurried, lazy or out of control. Our children are clever enough to recognize and exploit this beginning at a very young age.

A worn-down mom enters my office announcing, “I am a screamer…my mother was a screamer…the problem is I keep screaming, and they don’t listen anymore!” This parent is feeling more powerless than ever. She feels she must do something even more threatening or dramatic to be taken seriously. That’s called “learned helplessness.” We learn to be helpless after repeatedly feeling ineffective.

As parents, we need to watch what is working and what is not in order to plan in advance. In this respect, parenting is not different from good management skills. Imagine if your boss responded to requests or problems on a whim, according to her mood at that particular moment. She would not earn or deserve respect.

Communicate specific and age-appropriate expectations for behavior…

A mother is standing in a deli line trying to place an order, but her 2-year-old is clearly annoying her, bouncing up-and-down and grabbing, so she snaps, “Be good!” Her son is not certain what “be good” means. She did not tell him specifically what he was doing wrong or specify what he should be doing instead. Quite innocently, he continues to bounce up-and-down. Now she adds, “If you don’t stop that, we’re not going to get ice cream.” The child gets the “no ice cream.” He freezes. Then he wails!

Too often, parents threaten consequences that they cannot follow through with. Try to state the behavioral expectation rather than focusing on the unwanted action. It is also more helpful to emphasize the reward of cooperating, rather than to threaten a loss. To say, “If you don’t get dressed right now, no TV for you!” is to threaten loss. To say calmly, “When you are dressed and ready, we can watch some TV,” is to emphasize the reward that comes with cooperation. Expectations for behavior, or rules, as well as positive or negative consequences need to be spelled out calmly and specifically. When expectations are unclear or emotionally threatening, misbehavior is more likely. In the example above, the mother might have bent down to her son’s level and calmly said, “Please hold my hand and stay with me.” There’s no need to mention ice cream.

Behavioral expectations need to be age appropriate. We would not ask a 5-year-old to fold and put away the laundry. If your child is distractible, it would not be effective to give him five commands and then leave the room! When rules are not suitable to a situation or to the child’s ability, limit testing and misbehavior are inevitable.

Finally, most children cannot read our minds or anticipate our expectations. So get in the habit of stating the expectation for behavior. We do this all the time when we say things like, “All done! Let’s put the toys away now,” “Before you leave the table, bring your dishes to the sink, rinse them and set them in the dishwasher.”

Keep “one foot in and one foot out”…

Lessons in cooperation and accountability must include one more ingredient, empathy. Without sufficient empathy, motivation may diminish. Having empathy does not equal indulgence. Empathetic limit setting prevents resentment and opposition. Confident parenting requires the ability to “keep one foot in and one foot out,” with enough empathy for validation but enough emotional separateness to avoid overreacting or indulging, sabotaging your own authority. For example, if your son loses his temper and hits his friend, you tell him, “It looks like you are having a hard time. I know it feels bad to be that mad, but we cannot hurt people when we are mad. Playtime needs to end now. Next time use your words.” Because you have “one foot out,” you are calm. Because you have “one foot in,” you have empathy.

Confident parenting requires thinking about the big picture…

How do we figure out what expectations are appropriate for a particular child or situation? By stepping back and looking at the big picture! In this manner, we might be able to repair a problem with the system rather than harping on behavior. Here is an example.

“Mornings are a disaster!” reports one mother. Her husband works late and sleeps in. She wakes her boys who go straight to the television while she showers. After the shower, she yells at the children to get ready for school, sending her 4-year-old “to get dressed.” Ten minutes later, after emptying the dishwasher, she finds him playing with his toys. Again, she starts yelling at him and threatening.

This couple needs a new “system.” What they are currently doing is not helping their very young boys get ready. Mother may need to reschedule her shower. Parents may also forbid TV or allow it only after the children after are ready from “head to toe.” Dad may need to change his work schedule in order to help in the morning until the children are older. There are no absolute rights. There is what works for you and your family.

Systems change and are not absolute. Behavioral expectations evolve based on changing needs and motivations. By stepping back and assessing the big picture, you can develop a system that works for you and each of your children. Hopefully cooperation is enhanced, while threatening and yelling are minimized.

A word of caution…

Whenever you significantly change your parenting style, children need time to adjust. Often, misbehavior and noncompliance worsen before improvement is seen. Your children want things to stay the way they are, even if it has not been good for them or for you. At least it is familiar. And naturally, as you become empowered, there is some loss of power for them. This is why it is especially hard, but not impossible, to parent during adolescence. As one out-of-control teenager wisely said, “It’s too late now! All this time they let me do whatever I want! Now that I’m in trouble, they think they can parent me!”

The job of parenting is a privilege and an honor. Parenting for the children in the new millennium is also an overwhelming challenge. No one of us alone could possibly master all the job attributes required to parent with confidence and consistency. Job training would certainly be helpful in our efforts to remain mindful about how to refuel ourselves and stay focused as parents. We have only a brief time to use our own influence to empower our children with the confidence and reasoning required to navigate and succeed in our ever-changing world.

—-

Originally Published in Washington Parent Magazine, October 2002