Bullying has become a national epidemic with nearly forty percent of youths admitting to bullying at one time or another. But new research shows that parental behaviors, attitudes and mental health can all influence a child’s potential for bullying. Most parents of children who have been victims of bullying often ask what they can do to protect their children from such harassment. However, new research suggests that the real question to address is how a parent can prevent their child from bullying other children.

Rashmi Shetgiri, MD, FAAP, assistant professor of pediatrics at University of Texas Southwestern Medical Center and Children’s Medical Center, Dallas, and colleagues conducted a survey that identified trends in bullying over a four-year period. They examined the amount of bullying that was reported, and also the additional factors that influenced the rate of bullying. They discovered that the number of children who bullied others rose from 23 percent in 2003 to 35 percent in 2007. Reasons cited for the increase were feelings of neglect or anger felt by the children from their parents. Also, emotional, behavioral and developmental issues were common among children who bullied. And children who reported a mother with mental health challenges showed more potential for becoming a bully. (more…)

Son whispering into father's earConnecting with and creating a stronger relationship with your children starts with listening to them. There are specific skills that a parent can master that can help to show your children that you care. Instead of arguments, listen and show your understanding while maintaining your position. By attending to them and inviting them to talk, you can take steps toward better communication and a great relationship.

Make Sure You Are Paying Attention

Carve time out of your day specifically to communicate with your youngsters, or set aside what you are working on for a few minutes. Make eye contact, turn toward your children, and get as close to their level as both of you are comfortable with. No need to stare.

Be aware that you are talking to another person. How does your body communicate that you are listening? Are your arms crossed, are you pulled away from them, or are you standing over them imposingly? Watch what their body language is saying to you. Use a natural vocal style; your voice often communicates your emotions.

Let Your Kids Start the Conversation

[fat_widget_right]Inviting your children to talk to you is more than just vaguely asking them about their day, feelings, or what happened at school. Give your kids a chance to start the conversation by asking them what they would like to talk about today.

Listen to what they have to say, and remember silence is golden. When you say nothing, it allows them to fill up the space in the conversation with what they want to say and encourages them to keep talking. Give encouragement as they are talking and being open with you.

Remember that you want to be having discussions with your children regularly, not just when they are in trouble. If your children are comfortable talking with you, then even when they are in trouble they should still be comfortable talking with you about their problems. Use simple acknowledgement responses that show you are listening. “I see. Oh. Uh-Huh. Hmmm.”

Identify and Summarize Your Childrens’ Emotions

Listen for and name the feelings you think you hear from what your children are telling you. Respond to the emotions being expressed, and not the content of what is being said when you want to connect emotionally with your kids. How are they saying things? What is their body language? Identify the emotion: “Wow, you are really mad,” or “You are showing me how sad you are.”

When children share their sentiments, they are showing you trust. That trust helps to create a greater sense of connectedness that you and your children can share. Throughout your chat with your children, summarize and paraphrase what you have heard. Do not be a parrot and repeat what you have heard verbatim—just a quick sum of the ideas they are expressing. Providing a rundown of what you heard lets your children know you have been focused on their thoughts and emotions.

By modeling good listening behavior, you can teach your child to pay attention and stay focused during a talk with other people or at school. Remember that you can follow each of these ideas and reinforce the connection that you have with your children.

1 out of 2 people in the U.S. has a chronic illness and in 96% of these cases, the chronic illness is invisible. This means the illness is not readily apparent to others because the person doesn’t use an assistive device like a cane or a wheelchair. Most people with an invisible illness can tell you story after story of family members, friends, co-workers, bosses, etc. who don’t actually believe they’re ill. They’ve been given snide looks when exiting their car after parking in a handicapped spot. They’ve been told by their friends that they look too good to be sick. They’ve been questioned by bosses as to why they miss so many days of work when even a doctor can’t determine an appropriate diagnosis.

These scenarios are all too common and happen to millions of people every day. Most of us are able to shrug it off and move on in spite of anger, frustration and hurt. But what happens when the person who promised to love you in sickness and in health doesn’t believe you’re actually sick? (more…)

A dog patiently holds a leash in his mouth, waiting to be walked.This month our Paramita, or practice on the path towards happiness, is patience. The practice of patience involves a shift in our perspective. Buddhist teacher Sylvia Boorstein says patience “…remains present as long as the mind remembers that things end…when their conditioning causes end…” Conditioning causes are the elements that are coming together in this particular place and time that are causing us stress. In other words, have patience, this too shall pass.

Stress could, in fact, be celebrated as the only opportunity we have to practice patience. Of course, our habitual tendency is to react against stress rather than greet it with enthusiasm, but that doesn’t mean it’s impossible to do so. Try it sometime.

We sometimes object to the idea of patience, as if it will make us passive patsies and “someone will get away with something” (oh, no!). Holding this attitude, we ignore the depth of harm we do in our impatience, and also misinterpret the actual practice of patience. Patience isn’t standing by while harm is done to us or to someone else. It is not about letting someone take advantage of us or abuse us. Patience is the capacity to calm the mind under stress so we can see our way clearly. In an abusive situation, for example, patience can lead us to make a plan for our safety, and come up with an exit strategy that will actually accomplish our freedom. Impatience can lead to running out of the house without clothes or money or any support at all, and where does that end up? Not in a good place, usually.

What Does Patience Have to Do with Happiness?

Patience is the antidote to anger. If we are irritated or angry or even feel violent impulses, we can actually learn to wait until the feelings pass, which they will. Anger can be difficult to work with, because it so strongly compels us to action. We often feel we will have no relief until we let it all out. In truth, we always do harm when we act out of anger, whether towards another being, a circumstance, or ourselves.

Patience comes from having confidence, born of awareness, practice, and experience that the storm will pass, and that if we ride it out, all will be well again. I recently heard a woman on the radio describing her radical approach to conflict in intimate relationships; instead of “Never go to bed angry” she suggested just going to bed, and seeing if you are still angry in the morning. Given the impermanent nature of all emotions, this approach makes sense. If there is something you can do about it, no need to get upset. If there is nothing you can do about it, there is no need to get upset.

[fat_widget_left] The therapist who changed my life in my mid-twenties used to tell me, “The reward of patience is patience.” I didn’t find that appealing in the least, and I told her so. I may have said, “So what?” or “What’s that got to do with me?” I was impatient and had no interest in slowing down. I could not conceive of any possible benefit to patience. If it was its own reward, that meant nothing to me. Twenty-five years later, I think I may have finally caught on a bit.

When I put some effort into practicing patience in one area, such as in traffic or with a person I might find irritating, then patience is more likely to arise spontaneously, without effort, when I need it most. I was on an airplane recently that had been delayed by weather. We were two hours late taking off, and most of us were going to miss our connections. The man sitting next to me was extremely fretful and frustrated and tense, and I found that I was actually quite relaxed. We chatted a bit, and I tried to cheer him up, but I could see how deeply attached he was to feeling upset. He told me he traveled a lot for business and it was just getting worse and worse. I agreed that air travel has grown pretty unpleasant for most of us, but I noted to myself that, above all, we have the experience we create for ourselves. That day I realized that my efforts to develop patience had paid off—I felt patient without even trying!

What does patience feel like? For me it is relaxing, energizing, with a clear tone, like a bell, and a view that goes on as far as the sky. Patience is the willingness to stop stirring the water of the pond we are trying to look into. Patience sets down the stick and waits for the natural clarity of the settled water to arise. (Of course, as a teacher of mine noted recently, then we can see all the junked tires, tin cans, and skeletons down there on the bottom!)

Patience is trusting our natural minds to know what to do when we stop disrupting and distorting what is actually happening in the here and now, and practice mindfulness.

Now, I eventually ended that plane trip in a miserable heap, having missed too many planes to reach my destination and having a respiratory illness that forced me to make a last-minute decision to just go home. So, patience is not the answer to everything, nor is it guaranteed to stick around all the time. What stands out in my mind is the contrast between myself and that fellow steeped in anxiety on the airplane, and the knowledge that it is possible to feel calm even when our impulses drive us strongly toward distress. The reward of patience is, in fact, patience!

Five Steps to Cultivate Patience:

What other ways can you find to practice patience?

Hugging self: hands wrapped around bare legsI decided to dedicate myself to investigating and writing about the experience of body in transgender people. Though I am by no means an “expert” in working with this population, I have learned significantly from people I have worked with who identified themselves as transgender. I set out to organize my observations and insights by grounding them in current research, to offer something of use to the reader that is legitimized by work in the field. It struck me that in looking at body-appearance satisfaction we could learn a lot from people who experience being born with, and living with, a body that they experience as opposite of what they were suppose to have.

What is the nature of the relationship to the body for transgender people? How do they value their body? How do they take care of it, take pleasure in it? How do they deal with other people’s perceptions versus what they see or what they wish they could see? Does that change if they are able to change their body to look like what they believe they were supposed to have? What I was to discover was a dearth of research and a complete lack of theory or even sufficient conversation on the topic. There was certainly almost nothing scientific or academic of any use to working with clients. So here are my truncated thoughts combined with what I learned in my search for information on a very complicated subject.

For those new to this area, know that for transgender people, the desired body isn’t a thought, or a feeling, or even a drive. History has shown that the experience is relatively unchangeable. I would describe it as an experience of persistent identity messages incongruent with the physical body. There is a “hardwired” nature to this lived experience, though science hasn’t found the neural connections yet. Despite abusive efforts to create aversion in people who feel they are in the wrong body, to force them to stop thinking of it and stop expressing it (society can’t handle ambiguity or non-conformity, apparently), transgender people don’t stop being transgender.

[fat_widget_right]For most documented cases, it has proven to be a life-long struggle between the inner sense of self and the physical, external self. It has also, for most, been a struggle between expressing the true self and repressing it in order to earn or keep acceptance and belonging in relationships and in society in general. The extent that people (often rightfully) fear societal reactions to their true identity is directly related to how much psychological distress they suffer.

Interestingly, to the transgender child, there is no incongruence or distress about the body until they are confronted with the gender that is socially assigned according to the worlds’ image of them. They are often shamed, ridiculed, and otherwise discouraged from expressing what they consider to be their true selves, from an early age. You don’t have to be a therapist to think about the impact of such conditions of worth on the development of self-esteem. Indeed, transgender people have the highest rate of suicide.

There is some published anecdotal evidence that children who are allowed to explore their gender-related interests and self-expressions without external pressure to conform are better adjusted. There is also some research that suggests that trans people who have the resources and support to transition—and who believe they will be able to “pass” as the desired, chosen gender—have better mental and physical health outcomes. Also, while trans people have been shown to be at greater risk for developing eating disorders due to body-image dissatisfaction, depressive symptoms, and low self-esteem—they have also been shown to have reduced risk of these problems after gender-confirmatory surgery.

How do we begin to support these people or even understand their struggle and offer them hope? What is our role as therapists or friends in supporting transgender people? We know that body image issues are a problem for women who feel the pressure to conform to societal ideals and this can result in negative self-perception and negative health outcomes. In clinical studies, trans people have been described as being obsessed with the aesthetics of outward appearance. It makes sense that a trans person, having to live with a body that looks nothing like what they want and one that is often in complete opposition to social ideals for the gender they feel they are, would have even worse self-perception and greater negative health outcomes. So how do we help?

I believe in the fundamental healing value of acceptance and understanding of human experience. In my role as a therapist, I must be a non-judgmental mirror for the people I work with. In asking “what” rather than “why” questions, like at the outset of this article—I can get closer to an understanding that can allow me to mirror a person’s inner view of themselves. In that way I can strengthen the sense of self and self-worth of a person. I work to emphasize the importance of the functions and joys of the body, not just its appearance.

I share the idea that self-esteem comes from dedication to loving self-care and encourage habits that lead to better relationship to the body. This can be life enhancing for a person who has had very little acceptance and hence suffers low self-worth. Indeed most trans people I have met tend to focus on the well-being of everyone other then themselves. However, to truly support trans people in healing their relationship to the body, I must also educate myself on their unique experiences and needs, whether they are in transition or not. I must also be political in joining the struggle for their rights, including educating others. I must be an advocate that supports their rights to dignity and well-being, if that involves gender-confirmatory surgery or other procedures or services. Hopefully this article is a drop in the bucket towards that monumental task.

Vulnerability is an emotion that affects individuals suffering from eating disorders in a multitude of ways. It is the opposite of being in control and a state of mind not particularly comfortable for people suffering from this mental health issue. Feeling vulnerable is an uncomfortable feeling for many of us, but even more so for individuals suffering from an eating disorder. Not feeling in control often acts as a trigger that begins the destructive cycle of disordered eating. A trigger is any input that a person receives; either from their environmental or an internal thought that creates an uncomfortable feeling.

It is important to note, for these individuals their eating disorder is what allows them to cope with emotions. As a whole, individuals suffering from an eating disorder tend to view things in black and white terms; meaning their behaviors and thoughts are either right or wrong/good or bad. This strict thinking pattern leaves little room for ambiguity. Ambiguity is not only part of being vulnerable, but also part of everyday life, so it is important to learn how to navigate through it. (more…)

Did you know that according to Patrick Carnes, Sex Addiction Expert, he reports that relapse happens for most individuals who struggle with sex addiction in the second six months of recovery? Most individuals gain traction in recovery through counseling, support groups and establishing strong boundaries. It is very important that individuals who struggle with sex addiction stay proactive in their recovery and the journey to having healthy and satisfying relationships.

These are three effective ways to avoid relapse in a sexual addiction recovery program:

1. Be humble:

For many individuals who struggle with sex addiction the first six months to a year is the first time in a long time that their mind and actions are not filled with double mindedness including acting out, lying, etc. When individuals start to feel good about their progress, there can be a temptation to loosen their established boundaries. This can be dangerous which is why most individuals who struggle with sex addiction relapse in the first year (second six months) of recovery. It is imperative to stay on a plan that they review with accountability partners especially early in the recovery process. Being humble recognizes that this will be an ongoing battle and that they will need to stay sharp every day to stay consistent and free. By staying humble, one will recognize when temptations or compromise is coming and be willing to take an even stronger stand rather than backing off! If they want to continue their journey, they must stay humble and they will stay on the right path! (more…)

Business woman riding scooterWhich of the following statements are true?

People with high self-esteem:
A. Are convinced they can never be wrong
B. Don’t usually appreciate negative feedback
C. Think whatever they do is great
D. Couldn’t care less what others think of them
E. All of the above

Answer: None of these are true of people with genuine self-esteem! The truth is, the higher your self-esteem, the better you tolerate criticism and disappointment.

Let’s go over these again and get the real scoop on people with high self-esteem:

False: They’re convinced they can never be wrong
True: People with healthy self-esteem aren’t delusional; they know and accept that sometimes they mess up. (more…)

Man yelling in megaphone at himselfThis article is part of a series that explores the ways that specific “clusters” of depression symptoms manifest to create different experiences of depression. The previous article in this series discussed the low-ambition experience.

Self-attack is my term for thinking mean, diminishing, insulting, and shaming thoughts about oneself. People often think of this as low self-esteem, but I think self-attack better describes what is actually going on. People who experience depression often think like this, but it is also possible to engage in self-attack and not meet the full criteria to be diagnosed with depression. Whether or not your self-attack is part of depression, this is a very painful, disabling, quality-of-life-reducing, and even life-threatening way to exist.

In fact, I believe self-attack is possibly the most common type of misery and symptom of depression. So many people frequently say things to themselves—whether they even notice or not—that diminish or shame them: “I’m a failure,” “I’m stupid,” “I’m lazy” “I’m unlovable,” (which may sound like “I’m fat and ugly”, or take other forms), “I’m a terrible parent, employee, friend, spouse…,” “I can’t do anything right,” I’ll never be good enough,” “I’m not worth what I have,” and so on.

It may surprise you that people attack themselves for good reasons. Many do it because it’s how they understand love—it’s how their parents “loved” them. Others think that shame is the only thing that motivates them. Once people learn to handle themselves this way, they practice it over and over and over, and learning to do something different is very difficult.

I often ask people who are plagued by self-attack, “What if someone were following you around all day saying these things to you?” Most people would yell at them, argue with them, stop them, fight back, or at least get away from them. But when it’s their own voice, they listen and believe it—and it’s devastating.

This can change. There are ways to change this on our own, and ways that psychotherapy can help. In either case, the key is to develop an internal parent who parents us the way good parents do.

How the Parenting We Experience Affects Our Brains
This is the most important thing to know about how to become a happy, well-functioning adult. Generally, when children are parented by caretakers who understand their feelings and needs and respond to them compassionately and protectively, children learn to respond similarly to themselves. Over time, children build skills in parenting from imitating their parents. This is how we know how to take care of ourselves as adults.

We now know from neurological research that we are hard-wired through special neurons to imitate our parents. Our brains learn how to act in the world by incorporating the things that we see our caretakers do when we’re children. It’s a great system when we have parents who act in nurturing, protective, and wise ways. It doesn’t work so well when our parents are abusive, neglectful, unhappy, or dysfunctional people themselves.

We also see that our brains are able to re-wire throughout our lives, so if this doesn’t go well when we’re children, we can usually still change what goes on in our brains when we’re adults. This is what psychotherapy and EMDR do, but there are also ways to work on this outside of therapy.

We also know that when we close our eyes and imagine something, the same pattern of functioning occurs in our brains as when we look at something. So if you see your best friend, then close your eyes and imagine your best friend, your brain will be doing the same thing. This makes guided imagery very powerful. Anything we do that involves imagining being parented, or parenting ourselves in a nurturing, compassionate, protective, wise, functional way, can actually help build the brain structure we need to be the adults we would have been if we’d had better parents.

The Experience of Parenting Yourself
There are many ways to do this, but let’s take a couple moments to try out one. Think of a problem that is upsetting you right now—nothing too upsetting. Now imagine you have a niece or nephew, four to ten years old, who comes to you for help because they are struggling with a similar problem. With the most nurturing, protective, compassionate part of yourself in charge, what would you say to them? Write this down.

What would you do for them? What do you think you could give them that would help them feel a little better? Try expressing your understanding of their feelings and needs. Normalize what they’re experiencing. Show them compassion. Offer forgiveness if they need it. Offer solutions or ways to get solutions. Offer to stay with them through the process. Comfort them any way you can imagine.

Of course, this exercise is just a beginning. But once you learn to do this, and can do it with yourself, you have access to one of the most powerful tools we as human beings have to be happy and functional.

Psychotherapy
Psychotherapy can help with this process in many ways. For example, my clients usual begin to heal when I treat them with respect, am very genuinely interested in them and amazed by who they are, reflect what I see as I come to understand what they’ve had to overcome and how, and encourage them without shaming them. Being consistent and compassionate, listening carefully and responding with insight,  is what parents are supposed to do with children so that they can develop into happy adults. Many parents don’t or can’t do it well—usually because their parents couldn’t do it with them.

By being treated this way, people learn to treat themselves and others that way. They learn to expect healthy relationships where they are treated with a similar respect. It helps people express the feelings they haven’t felt safe to express and to feel more capable of coping with painful feelings. It builds self-esteem and confidence. In this environment, depression usually recedes.

Self-attack is very destructive, but can be overcome by developing a compassionate, nurturing, protective parent inside.

For the past two decades, science has been uncovering some important features of traumatized clients. There is mounting evidence that traumatized individuals vary widely in their ability to adapt to trauma, in part due to underlying physical factors. For instance, some see the presence of chronic emotional trauma as having the potential to cause permanent physical damage in at least the hippocampus (Sapolsky, in Why Zebras Don’t Get Ulcers (1994) argues that chronic stress is a significant cause of aging in several species). This might mean that some individuals who have gone through multiple traumas or what in the DSM V will likely be called Disorders of Extreme Stress NOS, because of a changed hippocampus, might have diminished abilities to perceive or recover from subsequent stressors.

Other studies have show that certain traumatized populations (traumatized women and combat veterans) show similar characteristics of neurological dysregulation. Susan Johnson noted (Emotionally Focused Couple Therapy with Trauma Survivors, 2002) that one implication is that such individuals may be unable to use their emotions as an appropriate danger signal to prompt adaptive action. The chronic activation in their brain systems seems to result in overreactions to non-emergencies and freezing responses in the presence of real danger. (more…)

Many people in relationships feel this way, exasperated because they are doing everything they know how to do to make their partner feel loved. Couples come into my office usually at the end of their rope because they have tried, and tried, and tried to make the marriage work and nothing they have tried seems to be making it better. This is so frustrating for couples. It drains the life out of many marriages and relationships. It pushes people so hard sometimes they end up convincing themselves they just can’t make this marriage work anymore and they end up leaving. This can be frustrating and maddening for people who want to love each other but can’t find a way to do that.

Everyone starts off with the best intentions. Good people work their hardest to make a marriage or relationship work. Usually people have lots of successes in their lives.  They look at their histories and they say to themselves, “Heck, I know how to achieve things. I am a success at school and work. I am good at getting things done. I can accomplish things. I can make this work.”  The best intentions drive people to do things for the other person. That’s our nature. If we choose to be in a relationship, we have decided to do what we can to make it work. (more…)

Macaw parrotTherapist: “Sounds like you’ve been busy.

Sonya: “I have. I feel like I’m always busy… too busy. I never have time to just enjoy life. I can’t remember the last time my husband and I had any quality time together. I worry about our relationship sometimes, but we rarely find time to talk about anything other than our kids.

Therapist: “You’re worried about your relationship, but you’re both more focused on your kids than each other.

Sonya: “Yeah. It scares me that we can’t find any time to focus on each other. We just can’t seem to make our relationship a priority.

Therapist: “You’re scared that your relationship isn’t a priority.

Sonya: “I am. I don’t know what I would do if our relationship fell apart. I can’t even imagine life without him.

If you read the above vignette and felt like Sonya’s therapist was just paraphrasing and repeating everything she said, you’d be right, sort of. Sonya’s therapist isn’t repeating her statements because she’s disinterested or bored, however. The above conversation is a perfect example of the Rogerian technique called restatement. Restatement is a basic counseling intervention and one of the hallmarks of Rogerian psychotherapy. This technique involves capturing the essence of a client’s statement and then restating it. The most rudimentary function of this approach is to provide an opportunity for clarification. If a client hears something in the therapist’s restatement that differs from what he or she meant to convey, the client can clarify and make sure he/she and the therapist are on the same page before continuing. On a deeper level, the technique can also serve as an effective way to probe clients’ statements– when clients hear their words repeated back to them, they know their therapist understands them. This understanding often encourages clients to delve deeper into the issue at hand.

Although often effective, restatement interventions can sometimes leave clients asking the question, why does my therapist sound like a parrot? Why am I paying someone to repeat everything I say back to me? How can this possibly be helpful? And even if it is helpful, why can’t I just ask a friend to repeat what I say?  To better understand how powerful a therapist’s restatement interventions can be, let’s take a closer look at one of the most basic tenants of Rogerian psychotherapy: the client is at the center of the therapeutic experience.

Rogers’ theory and approach to psychotherapy places such value on the client that Rogerian therapy and Client-Centered, or Person-Centered, therapy are terms that are used interchangeably. At its core, this means that clients are viewed as the experts on themselves. The therapist’s role is not to interpret clients’ experiences or make suggestions by giving them direct advice, but rather to serve as a mirror to the client, allowing them to see themselves, as they are, and to use this self-awareness to inspire changes.

Take the example given above. If Sonya were talking to a friend, the friend’s response to the first statement would probably have been one of commiseration. Her friend might have reviewed the events of her equally grueling day, complaining about her difficult boss, her overscheduled kids, and her forgetful husband. Alternatively, the friend might have shared some of the strategies that she uses to manage her time. In either case, the friend would have jumped into the spotlight and the focus would have shifted to the experience of two people, rather than remaining centered on Sonya. This is absolutely fine, and even valuable, within the context of a friendship, but it does not allow Sonya the opportunity to look more deeply into why her harried days are so distressing. A therapeutic relationship, rooted in Rogers’ theory, on the other hand, creates an environment and the dynamics necessary to explore issues at the deepest levels.

While at first glance, the Client-Centered restatement approach seems easy, even lazy, and it takes a great deal of training and practice to do it effectively. It requires considerable discipline to sit and listen– not to interject your own agenda, not to offer advice, not to tell your own story–but to hold up a mirror so clients can see themselves and determine whether the image they see aligns with who they wish to be. It also requires therapists to trust that clients have the answers within themselves. When clients are given the time and space allowed for by Rogerian therapy, they develop the insight necessary to move toward real, life-changing action.

 

 

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