mother with arm around daughterWhy is it that, in today’s society, parents have so much difficulty getting their kids to transition into adulthood? How is it that many parents find that their kids are seemingly incapable of becoming independent adults?

The simplest answer seems to be that our views and values on family life have changed. I believe much of this has to do with the way family life is depicted in the media: we do so much for our kids that it prevents them from doing for themselves and, as a result, prevents them from learning how to be independent. Many parents find themselves frustrated about the fact they have adult children still living at home, with a burgeoning sense of entitlement, because they supposedly can’t make it on their own.

If we go back 40 years or so, we see a time when kids typically learned the natural and logical consequences of the choices they made. If they did not do their homework, their grades reflected that. Kids performed chores without the expectation of an allowance. Kids were uncomfortable enough with their parents’ rules that they often looked forward to moving out once they were old enough so they could make their own rules and choices. Childhood and adolescence was a training ground to provide the opportunity for kids to learn the skills they needed to one day function as independent adults.

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Fast forward to the present. Technology has exploded. So has the experience of and demand for instant gratification. There is less reason and opportunity for kids to experience the discomfort that often comes with the necessity to problem-solve or use their imaginations. And as parents, we have evolved to the point where many of us don’t want to see our kids be uncomfortable at all. It seems that every parent’s goal is to see his or her kids “happy.” While that’s not unreasonable as an ultimate hope, we have taken the idea of removing discomfort from our kids’ lives to the extreme.

As parents, we have evolved to the point where many of us don’t want to see our kids be uncomfortable at all.

We have confused the ideas of caring for our kids and caretaking. Caretaking is anything we do for our kids that they can do for themselves. Caretaking stunts our children’s growth because they are deprived of the chance to learn the skills needed to entertain themselves, solve problems, resolve conflict with peers, and to take responsibility for themselves and be accountable. Life skills that should be learned in childhood and adolescence are often postponed until kids are in their twenties and thirties, and sometimes, learning the life skills needed to function as independent adults are delayed indefinitely.

While caretaking typically comes from a spirit of caring, love, and the desire to see our kids to be happy and healthy, it can become unhealthy and a cycle can develop that looks a lot like this: kids find themselves dealing with stress and/or struggling, so they immediately go to their parents. Problem solved. Except not—not really. As the cycle continues, kids learn to look outside themselves for ways to cope. Over time, the cycle carries into adulthood.

So how can we break this cycle? The solution is to help kids foster internal coping skills, develop confidence, self-esteem, and self-efficacy, and allow them to experience discomfort in order to learn that they have the survival skills they need and can be successful at facing challenges and obstacles.

Some Dos and Don’ts for Helping Kids Transition into Adulthood

All of this is not to say parents should give up; it is to say, rather, that parents need to allow kids to have control over their lives as they enter adulthood. While parents need to avoid always rescuing kids when they mess up, kids launching into adulthood need to know that their parents have their back. Be sure to show plenty of compassion and empathy, while at the same time holding kids transitioning into adulthood accountable.

people with umbrellas waiting to cross streetMost of the people who come to my office are contemplating a life change or trying to feel better about one that happened recently. They feel stressed and unsure about decisions they have to make, such as a parenting issue or what to do after graduation. Or they are unhappy about a decision that has been made for them (divorce, layoff, medical issue).

Many times, there is some room to move within this uncomfortable spot. A person can try to improve a relationship, job marketability, or health. But what are we to do when a life situation involves working with the unchangeable? How does solution-focused therapy help people live and thrive when something about their situation is completely outside their control?

Have you been stuck with a situation that feels unbearable? This might include:

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Feeling powerless and at a dead end is how some people I work with describe themselves in these situations. They can take some small steps in some of these cases, but for the most part these people feel like they have no control.

I find it to be NOT useful in these moments to remind people of all they have. Someone who is mourning the end of a relationship is unlikely to appreciate his or her health, and someone whose financial woes have overtaken daily life is usually unable to be glad that at least he or she has a job. A couple struggling to conceive a child may not feel fortunate that “at least” they have this or that. Gratitude is a powerful, necessary element of life which unfortunately does not initially help those who are feeling regret, guilt, and sadness.

Gratitude is a powerful, necessary element of life which unfortunately does not initially help those who are feeling regret, guilt, and sadness.

When we must live with the unchangeable, I find it most useful to find outlets for the feelings that result from our position of powerlessness or suffering. There are plenty of tactics that we can use with cognitive therapy to help someone compartmentalize thoughts about his or her situation so that the person can function throughout the day. But what about those unstructured times, such as in the shower, driving, or late at night when the house is quiet, when the feelings creep in and feel hard to withstand?

Acknowledge your feelings, but give them a place to go. Even if you write the same thing down every night for a month in a cognitive thought chart, it is important to allow your expression to have an outlet. This could also look like a journal, a walk where you allow your thoughts to fill the time, a yoga or exercise practice, or creative expression such as painting, gardening, or baking.

Accept that, for now, these feelings and thoughts about your unchangeable situation are going to be with you for a while, but they do not have to paralyze you or sink you like an anchor. For example, people who struggle with grief come to think of that heavy feeling as one that can accompany them for a few hours but does not have to keep them from going about their days. In time, this becomes easier as you welcome the feelings that come and then go in waves. When they arise, they can go with you throughout your day. You can familiarize yourself with what they feel like and be extra compassionate with yourself. You will see that your feelings are nothing more than emotional states that come and go throughout your life. You can endure them. You were built with resilience to manage them.

Make some meaning out of your daily routine that gives you power over your situation. You may not be able to swap out your boss, move the calendar forward faster, or undo something you regret, but you have control over how you think and feel about these things today. Take charge of what you can. Have a brainstorming session about what could be part of your day that you think will help you feel good. Start with little things—guaranteed things that you know bring you happiness. Start your morning in the most positive way possible, employing these ideas as much as you can. Hang your expression of art or wear a token of strength or memory to remind yourself that you are honoring the unchangeable but not controlled by it.

How a Therapist Can Help

Seek therapy to put this situation to rest. It might sound elusive, but many people find that achieving peace with their situation is a process that is helped by the presence of a skilled professional. A therapist can help you understand why you might be stuck on a certain part of your story, or help you gain clarity to the meaning of holding on to the feelings you have.

At the very least, it is a great relief to have another person on your team during a time you feel powerless. We all need someone who believes in our ability to endure the unchangeable, and who can abide with our journey.

Two rock musicians on stageHeavy metal, punk, and other loud, aggressive varieties of music have been historically blamed for things such as child murders and satanic rituals, and some may suspect their influence even today. According to a small new study published in Frontiers in Human Neuroscience, however, heavy metal and similar musical genres might actually help calm angry listeners.

Heavy Metal: A Calming Influence?

Researchers recruited 39 people who regularly listen to music the researchers classified as “extreme”—heavy metal, hardcore, punk, and emo. Participants, who ranged in age from 18 to 34, participated in a 16-minute “anger induction” session. During the session, participants discussed high-stress topics such as relationship problems and financial problems. Researchers then gave participants 10 minutes to listen to the music of their choice and 10 minutes of silence.

[fat_widget_right]Half of the participants selected songs with themes of anger or aggression, with others choosing music that focused on themes such as isolation or loss. The participants reported that the music helped them feel calmer and happier. Researches found that the effects of listening to the so-called “extreme” music were similar to the effects of 10 minutes of silence, suggesting that both can be calming. Many participants reported feeling inspired after listening to music, and researchers noted that participants were less irritable and aggressive after hearing the music of their choice.

The research team suggests that, rather than being a catalyst for negative or aggressive emotions, angry music can help listeners process their feelings and as a result lead to greater well-being. Because the study occurred in a lab setting, researchers say they will need to replicate their findings in more natural environments. The effects of listening to angry music in a lab might be quite different than the effects associated with listening to the same type of music alone in a bedroom, for instance. Additionally, the sample size was a small one, so research on a larger group is necessary to confirm these findings.

Reference:

Head-banging tunes can have same effect as a warm hug. (2015, June 17). Retrieved from https://www.uq.edu.au/news/article/2015/06/head-banging-tunes-can-have-same-effect-warm-hug.

Woman looking out windowThere is a paradox when it comes to bipolar mood episodes in terms of the treatment versus the prevention of episodes. On the one hand, the treatment of mood episodes can be rigorous, prolonged, and unsatisfying for people with bipolar and those around them. However, there are things people with bipolar can do to empower themselves in managing and, in some cases, staving off mood episodes.

Here is a focused outline on three self-guided components for living with bipolar: sleep, self-care, and support.

1. Train Yourself to Sleep

Your body responds to natural circadian rhythms. Based on a 24-hour cycle, a person’s physical and mental processes (e.g., mood) are affected by the changes of light and darkness. Setting the same wake and sleep schedule can dramatically improve your mood. Try to go to bed around the same time each night (even weekends) and get up around the same time in the morning. To do this, utilize these sleep hygiene tips.

Establish a routine to wind down in the evening. Pay attention to what time it is, so there is room to slowly navigate the dental routine, preparing for tomorrow’s workday, and the contact lens storage process. Avoid projects and other mentally taxing activities. Instead, read a novel, take a shower, or do some light stretching in the evening. Using alcohol, nicotine, or other drugs can disrupt nighttime habits, which consequently leads to increased stress and less capacity to manage it. Finish eating at least two to three hours before you go to bed, and abstain from caffeinated beverages in the evening. It takes approximately six hours for caffeine to leave the body, so a reasonable rule would be switching to decaf by 4 or 5 p.m.

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When you are ready to hit the sack, use your bed for two things: sleep and sex. This means not binging on Netflix or writing a dissertation from the confines of the bed. Train the body to know that when you are getting into and lying in bed, it is time to fall asleep. You do not want to be alert in front of a screen or stimulated by a task you are doing while in bed. Consistent, alert activity in bed teaches us to be awake; when we do want to go to bed, the brain is confused as to whether dreamland is approaching or to perk up for Breaking Bad.

Similarly, do not submit to long periods of insomnia (no more than 10 or 15 minutes at a time). Although seemingly counterintuitive, this goes back to the idea of training the body. After 10 to 15 minutes of not being able to fall asleep, do not continue counting sheep; go to another room and get a glass of water, read a brief article or part of a book, and wait until you are a little sleepy before returning to bed. This reminds the body that the bed is for sleeping. Life can get in the way, but aim for seven to eight hours of sleep per night.

2. Practice Regular Self-Care

Recent research shows that exercise is at least as effective for relieving depression as antidepressant medication. It also comes with a lot of less intrusive side effects (i.e., feeling relaxed, improved sleep and energy levels). Exercise regularly and make sure to finish a few hours before bedtime. Our bodies did not evolve to sit in office chairs for 12 hours per day, so getting your heart rate up or simply going for a long walk is a great stress release.

The more one understands about contributing factors to bipolar episodes, the more empowered he or she is to take preventative actions. You can develop a lifestyle management routine around your specific needs for mental health.

In addition, the mind, which regulates the flow of energy in our bodies, needs time to regenerate without stimulation. Develop a mindfulness practice or other type of spiritual process that you really value as necessary for mental well-being.

Prayer or meditation is best practiced in the morning after waking up. This establishes an intention for mindfully approaching daily life. Sit in silence while paying attention to your breathing for 20 to 30 minutes (start in smaller increments). Mindfulness group practices and classes are ever more ubiquitous and offer instruction to guide your work. Practicing these techniques within a community can be especially powerful. Contemplative activities are not rooted in gaining or self-improvement, which drive our identification with productivity. It is a commitment to sustaining a healthy lifestyle for the betterment of your relationships with others. Being curious and actively aware of the present will elicit awareness to subtle symptoms while decreasing impulsive behaviors.

A simple tracking sheet for mood and anxiety levels as well as self-care initiatives is a constructive way of monitoring behavioral and mental changes. Use a spreadsheet and leave it next to the bed or, if applicable, next to your daily supplements and/or medication box. Quickly note on a scale from 1 to 10 (1 being depressed and 10 equaling manic symptoms) what your mood was for the previous day. You can do this for anxiety levels as well. Also, note whether you exercised or practiced other self-care (yoga, meditation, etc.) and any significant events (interpersonal issues, medication changes, etc.) that took place. Over time, you will have a noteworthy amount of data to compare the actions you have been taking with changes in your routines, moods, and levels of stress. Utilize the correlations you find and make predictions about what you need to do—or not do—in order to stay on top of emerging problems.

The more one understands about contributing factors to bipolar episodes, the more empowered he or she is to take preventative actions. You can develop a lifestyle management routine around your specific needs for mental health. This includes clues to early warning signs and possible factors you have identified that get you into psychological trouble.

3. Lean on Others for Support

The effects of bipolar rarely occur within a vacuum. When a person tries to manage it alone, it can consume the person. Like any stressor or bothersome life event, the symptoms of bipolar pull on relationships. This becomes a systems issue that requires the support of others. Wright et al. (2009) state that “family members and friends are generally good observers and may be able to recognize the subtle changes in behavior, emotions, and thought processes that signal the onset of mania.”

Having individuals in your life who are aware of your historical battles raises the likelihood that mood changes will be identified before complete manifestation. Talk to people who are close to you when you have medication or drug-use changes, feelings of depression, or energy changes, and allow space for them to discuss your routines or behaviors. Appreciate their information and knowledge while assuming they love and want the best for you. Transparency will alleviate the concerns of others and lessen the burden you feel for managing the prevention of mood episodes.

It is essential to develop close relationships with your health providers so they have a longitudinal vista into your mental health. If you wanted to see how your face aged over time, you could take a selfie on a daily or weekly basis and run the images through a video program. Similarly, regular meetings with a psychotherapist will foster insight, but also enable the psychotherapist to notice subtle changes in your mental health presentation. A psychotherapist typically takes a “snapshot” of you each week—or two—and, akin to a series of selfies, compares and contrasts the “images.” This clinical timeline is examined with you in order to make correlations and inferences about mood episodes as well as behavioral changes. A disciplined regimen of psychotherapy is necessary to understand our habitual processes. You become aware of the holes you continuously fall into despite seeing warning signs.

If you can regulate your sleep, monitor internal changes, and stay physically active—while also training your mind—you and your therapist might not have much to talk about.

References:

  1. Archer, A.J. (2013). Pleading Insanity. Bloomington, IN: Archway Publishing.
  2. American Psychiatric Association. (2013). Diagnostic & Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  3. Kirsch, I. (2010). The Emperor’s New Drugs: Exploding the Antidepressant Myth. New York: Basic Books.
  4. Kirsch, I., Deacon, B.J., Huedo-Medina, T.B., Scoboria, A., Moore, T.J., & Johnson, B.T. (2008). Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. Public Library of Science Medicine 5 (2): 260-268.
  5. Miklowitz, D.J. (2014). Bipolar Disorder. In: D.H. Barlow (ed.) Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual. (5th ed.). New York: The Guildford Press. 462-501.
  6. Murray-Swank, A., & Dixon, L. (2005). Evidence-Based Practices for Families of Individuals with Severe Mental Illness. In: R.E. Drake, M.R. Merrens, & D.W. Lynde (eds.). Evidence Based Mental Health Practice. A Textbook. New York: W. W. Norton & Co., pp. 425-452.
  7. National Institute of General medical sciences: basic discoveries for better health. Circadian Rhythms Fact Sheet. Content reviewed November 2012. Retrieved from: http://www.nigms.nih.gov/Education/Pages/Factsheet_CircadianRhythms.aspx
  8. Siegel, D.J. (2010). The Mindful Therapist: A Clinician’s Guide to Mindsight and Neural Integration. New York: WW Norton & Company.
  9. Wright, J.H., Turkington, D., Kingdon, D.G. & Basco, M.R. (2009). Ch. 8 Mania. In: Cognitive-Behavior Therapy for Severe Mental Illness. An Illustrated Guide. Washington, D.C.: American Psychiatric Publishing, Inc. pp. 181-209.

Crisis Counselling Sign, Golden Gate Bridge, San FranciscoThe Golden Gate Bridge, which connects San Francisco and Marin County, is a marvel of architecture and engineering. It’s an internationally recognized symbol of American culture and ingenuity. It’s billed as one of the top tourist destinations in the world.

It’s also, sadly, a well-known suicide hotspot where more than 1,600 people have jumped to their deaths since the span opened in 1937.

Suicides from bridges and other high points have long been a concern for communities. Much has been done in the way of suicide prevention by adding barriers designed to make suicide more difficult, posting signage with helpline information, and installing special phones that connect a person directly to crisis help. Such efforts, though, have generated some debate regarding just how helpful they may be. Some wonder, in fact, if it’s possible they do more harm than good.

Let’s take a look at some of suicide prevention methods in use today on bridges around the world to see whether their intended use and results are as solid as the bridges on which they are installed.

Prevention Signs and Phones: Are They Effective?

On some high bridges, you might see a sign with a message that reads something like, “There is hope. Make the call.” For some people, people at the right place at the right time, this message could be a lifesaver. Some have speculated, though, that suicide prevention signs and phones, while clearly well-intentioned, could inadvertently contribute to the problem by planting the idea of suicide. Could they give someone who otherwise was not considering jumping—from that spot, at least—the idea to do so?

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There is no known evidence or research to support this possibility. What little evidence we do have tells an important, more optimistic, story, even if not everyone is buying it. Data collected from several bridges suggests that prevention signs may have an effect on the number of suicides per year—albeit minimal.

Researchers studied data from the Sunshine Skyway Bridge in St. Petersburg, Florida to analyze the period before and after emergency crisis telephones and signage were installed. The results from examining three-year periods before and after signs and phones indicated that the suicide rate dropped from 8.3 per year to 6.3.

In another example, in the mid-2000s, the New York State Bridge Authority (NYSBA) created a comprehensive suicide prevention plan to address this public health issue. Consulting with experts in the field, they concluded that the best possible prevention method was establishing a human connection between someone considering jumping and a mental health professional or law enforcement official. This led to the installation of emergency hotline services on every bridge, an awareness campaign for the public on use of the hotline, and increased emergency training for police dispatchers. The NYSBA declared the program an immediate success, citing that calls from the hotline phones began coming in less than two months after installation. In fact, the first call from a person using the phones resulted in a life saved.

Not everyone is convinced that signs and phones are effective, however. Reacting in 2013 to plans by the city of Pasadena, California to post four signs with a message and hotline number on the Colorado Street Bridge, site of more than 150 suicides over the past century, the then-medical director of the American Foundation for Suicide Prevention expressed doubt that they would have a measurable effect. “It’s a nice first step,” Dr. Paula Clayton told KNX 1070 Newsradio, “but the Golden Gate Bridge does have signs, and yet it hasn’t changed the rate of people dying by jumping from that bridge, so it’s doubtful.”

Dr. Lanny Berman, then-executive director at the American Association of Suicidology, told The Oregonian in 2013 that phones aren’t the answer. “No data shows this method is effective,” Berman told the newspaper. “The only data that exists, both in this country and internationally, regarding prevention of jumping from height, are barriers.”

Physical Barriers: The Gold Standard?

In the city of Bern, Switzerland, a safety net was installed on the Muenster Terrace, another popular spot for suicides. An analysis of the data conducted in 2005 by researchers Reisch and Michel (2005) found that in the years following the installation, no suicides occurred.

Some have speculated that suicide prevention signs and phones, while clearly well-intentioned, could inadvertently contribute to the problem by planting the idea of suicide. Could they give someone who otherwise was not considering jumping—from that spot, at least—the idea to do so?

Go ahead and read that last sentence again: zero suicides after the installation of the safety net. They also found that the overall rate of suicides by jumping from any place in Bern dropped significantly after the net was put up, suggesting that potential jumpers most likely did not move to another high point.

Researchers Bennewith, Nowers, and Gunnell (2007) examined a barrier on the Clifton suspension bridge in Bristol, England and found that it reduced suicides by 50%. They also believe it may correlate to an overall decrease in suicides in the area.

Physical barriers designed to prevent suicide from bridges come in many forms, ranging from high fences topped by barbed wire to sloped walls to safety nets. Their purpose is to make it impossible (or at least very difficult or inconvenient) for a person to leap to his or her death, and there’s abundant evidence showing they work.

In 2008, the 988 Suicide & Crisis Lifeline (a network of crisis centers in 49 states and the folks handling those hotline calls from bridges) stated matter-of-factly, “The use of bridge barriers is the most effective means of bridge suicide prevention. Subsequently, as bridge/transportation authorities or other stakeholders approach the Lifeline with requests for implementing bridge phones, the Lifeline should emphasize the need for barriers as the most effective solution.”

In reaching its conclusion on bridge suicide prevention methods, the Lifeline detailed three studies (including one of the Golden Gate Bridge and another conducted on the Sunshine Skyway Bridge) where the efficacy of suicide prevention signs and phones as the sole method of prevention is put into question, pointing out that suicides have still occurred from these points after signs were installed. Lifeline believes that signage and phones should be used as supplements to physical barriers.

The strongest piece of evidence for physical barriers as a suicide prevention tool, however, emerged in Auckland, New Zealand, where safety barriers were removed from the Grafton Bridge after having been in place for 60 years. After removal of the barriers due to complaints of unsightliness, suicide researcher Annette Beautrais and her colleagues found that suicides from Grafton Bridge increased from three in the four years preceding the removal to 15 in the four years after removal. This prompted the reinstallation and redesign of the barriers, after which zero suicides occurred from the bridge. This was the only known time and place in the world that physical barriers have been installed, removed for a period of time, and then reinstalled, providing the opportunity to study the effect in a way that would have otherwise been highly unethical.

Lessons Learned: The Future of the Golden Gate Bridge

We end now where we began—at the Golden Gate Bridge, where 38 people died of suicide in 2014 alone and where debate regarding the installation of safety barriers has raged for decades. Progress had been stalled by financial cost and questions of effectiveness, but things are changing. Last year, the Highway and Transportation District, the agency that oversees the Golden Gate Bridge, approved a $76 million project that will install safety nets on the bridge—an action, according to the evidence, that will save lives.

Knowing what you know now, what are your opinions on these types of suicide prevention methods? Have you seen backlash against barriers or signs in your community?

Do signs, phones, and barriers simply distract from the larger issue of creating better access to mental health care for people with suicide ideation?

References:

  1. Aleaziz, H. (2015, February 3.) 38 Golden Gate Bridge suicides last year, down from 2013 spike. San Francisco Gate. Retrieved from http://www.sfgate.com/bayarea/article/38-Golden-Gate-Bridge-suicides-last-year-after-6059465.php
  2. Beautrais, A. L., Gibb, S. J., Fergusson, D. M., Horwood, L. J., Larkin, G. L. (2009). Removing bridge barriers stimulates suicides: An unfortunate natural experiment. Australian and New Zealand Journal of Psychiatry, 43 495-497.
  3. Bennewith, O., Nowers, M., Gunnell, D. (2007). Effect of barriers on the Clifton suspension bridge, England, on local patterns of suicide: Implications for prevention. The British Journal of Psychiatry 190(3). 266-267. Doi: 10.1192/bpj.bp.106.027136
  4. Cabanatuan, M. (2014, June 28). Golden Gate Bridge board OKs $76 million for suicide barrier. San Francisco Gate. Retrieved from http://www.sfgate.com/bayarea/article/Golden-Gate-Bridge-going-to-get-suicide-nets-5585482.php
  5. CBS Los Angeles. (2013, June 21). Signs Along Pasadena Bridge Aimed at Curbing Suicides. Retrieved from http://losangeles.cbslocal.com/2013/06/21/signs-along-pasadena-bridge-aimed-at-curbing-suicides/
  6. Draper, J. (2008). Suicide prevention on bridges: The national suicide prevention lifeline position. Retrieved from http://host31.spidergraphics.com/spv/doc/SUICIDE_BRIDGES_Lifeline_Position_Paper_Final_6-16-08.pdf
  7. Glatt, K. M. (1987). Helpline: Suicide prevention at a suicide site. Suicide and Life-Threatening Behavior, 17(4), 299.
  8. Lester, D. (2005). Suicide by jumping from bridges. Perceptual and Motor Skills, 100(3), 628-628.
  9. New York State Bridge Authority. (2007). A comprehensive plan for suicide prevention New York state bridge authority briefing & summary report for consideration by transportation agencies. Retrieved from http://www.nysba.state.ny.us/Documents/NYSBA%20Suicide%20Prevention%20Summary%20Report.pdf
  10. Pogash, C. (2014, March 26). Suicides mounting, Golden Gate looks to add a safety net. The New York Times. Retrieved from http://www.nytimes.com/2014/03/27/us/suicides-mounting-golden-gate-looks-to-add-a-safety-net.html?smid=fb-nytimes&WT.z_sma=US_SMG_20140326&bicmp=AD&bicmlukp=WT.mc_id&bicmst=1388552400000&bicmet=1420088400000&_r=1
  11. Reisch, T., Michel, K. (2005). Securing a suicide hot spot: Effects of a safety net at the Bern Muenster Terrace. Suicide and Life-Threatening Behavior 35(4). 460-467
  12. Stabler, D. (2013, February 2). Vista Bridge: Is it time to stop the dying at Portland’s iconic bridge? The Oregonian. http://www.oregonlive.com/living/index.ssf/2013/02/post_37.html
  13. Walsh, B. (2011). Evaluation of the suicide prevention activities at Gap Park: Crisis telephones. Sydney, NSW: Lifeline.

Close-up of a crowCrows and ravens are a long evolutionary chain away from humans, but some of their behavior closely resembles that of humans. Viral videos of crows that talk and count frequently make the rounds on social media. Until recently, scientists were unsure how basic math skills evolved in crows, but a study published in the Proceedings of the National Academy of Sciences offers insights into why and how crows count.

Counting Crows Have Human-Like Neurons

Researchers have long puzzled over why crows seem able to count. The brain structures that enable humans and other primates to count evolved long after crows and humans shared a common ancestor. This suggests that counting may have independently evolved in crows.

To explore how crows’ brains enable them to count, Helen Ditz and Andreas Nieder, researchers from the University of Tübingen, trained carrion crows to play a numerical matching game. The crows saw between one and five dark dots inside a gray circle on a computer screen. Crows who tapped the same number of dots when it appeared again received a treat. The size of each dot, as well as their placement within the circle, randomly varied. This means that the crows weren’t just measuring shapes; they were counting the number of dots, or at least memorizing what particular quantities of dots looked like.

On average, the crows got the answer right about 75% of the time—a figure that can’t be explained by chance alone. In most cases, the mistakes occurred when the difference between images was only one dot.[fat_widget_left]

The crows wore surgically implanted neuron sensors as they played the game, enabling the team to observe the activity of about 500 neurons. Approximately 100 neurons behaved differently depending on the number of dots the crows saw. Some neurons showed activity only when there were three dots, while others showed activity only with one or five dots, suggesting that the crows’ neurons might behave differently depending on how many dots the crows counted.

Though the part of the primate brain that allows counting works differently, the neurons behave the same. Just as crows’ neurons light up according to the number of items they count, so too do primate neurons. The correlation between neuron activity wasn’t perfect. For example, “four” neurons still responded when there were three or five dots, though not as dramatically as they did when there were four dots.

The researchers say that their results could shed light on the evolution of counting in both humans and crows. Because similar neuronal processes enable both species to count, the common ancestor of crows and humans—who existed more than 300 million years ago—might also have been able to count.

References:

  1. Ditz, H. M., & Nieder, A. (2015). Neurons selective to the number of visual items in the corvid songbird endbrain. Proceedings of the National Academy of Sciences. doi:10.1073/pnas.1504245112
  2. Johnson, S. K. (2015, June 24). Counting crows’ neurons work just like yours. Retrieved from http://arstechnica.com/science/2015/06/counting-crows-neurons-work-just-like-yours/

Moving boxes in empty roomMoving or relocating, be it near or far, is a great reason to plan ahead and seek help from a therapist. After all, there is substantial evidence showing relocation causes significant psychological stress and associated emotional challenges. Rarely, though, do I hear people cite a move as the reason for coming to therapy.

People typically pursue therapy when they are in emotional anguish or unhappy. In many cases, psychologists hear about emotional and physiological symptoms such as depression, anxiety, insomnia, worry, or stress that make coping with daily tasks challenging. Other times, the reasons for seeking therapy are relational, such as problems at work, bad behavior at school, relationship discord, or lack of friends.

Any or all of the above could result from relocating. Fortunately, the emotional, physiological, and relational difficulties associated with moving can be averted or ameliorated with early intervention.

The personal and social changes involved in a move vary widely with individual experiences and backgrounds, making such changes almost impossible to generalize. Nonetheless, commonly there are environmental/external or individual/internal factors at play. Environmental factors may include cultural or language differences, finances, and reasons for relocating. A family moving to London for a job promotion is very different than a family fleeing to Miami after a natural disaster, such as Haiti’s 2010 earthquake.

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The larger the cultural differences and the greater the geographical distance between the place of origin and the new home, the more complicated the adjustment to the new life is likely to be. A move to a country with an unfamiliar language may be more stressful than relocating within your home country. According to Kupka and Cathro (2007), who studied a sample of German expatriated families, expatriates rely more on social support from other expats in their adaptation to the new environment when there is a greater cultural distance. The existence of a social network in the new home may improve the well-being and adaptation of the moving family.

The larger the cultural differences and the greater the geographical distance between the place of origin and the new home, the more complicated the adjustment to the new life is likely to be.

Personal or internal factors may increase or ameliorate the stress surrounding the move and transition. Working at a counseling center in Tokyo, I found that many of the people in therapy who struggled with adaptation to their new environment and to cultural norms had experienced similar emotional distress back home. When someone had difficulty making new friends or assimilating to a new social group in Tokyo, we often found a history of family disengagement or painful and traumatic interpersonal relationships at home. Moving rarely solves the problem by itself.

Church (1982) supported these anecdotal observations while surveying families that had relocated internationally. The researcher found that people with preexisting, untreated psychological conditions tend to develop more problems in the international assignment. On the other hand, those who had experienced previous successful moves or had a higher experience of self-efficacy tended to adapt more successfully and faster.

Personal factors such as previous losses, forced moves, and a history of complicated adjustments may complicate the adaptation and perhaps escalate to social and psychological issues that interfere with daily functioning. For example, a family forced to move because of war or a natural disaster may be ill-prepared to face the challenges of the new adjustment. Contrastingly, a family excited about their new life that has developed accurate expectations, a connection to their future community, and has educated family members about the transition is likely to experience less stress and fewer difficulties adjusting. Planning and preparation, education, and anticipation of challenges related to a move may function as buffers to the development of more severe social and psychological problems.

Early intervention can build protective factors and coping skills to face the stress of change and adjustment. Research on families relocated internationally by companies has found that the success of the international job is related, among other factors, to the adjustment of the employee’s partner to the new country. When partners did not adjust and families had to return to their country of origin before the completion of the contract, the result was major financial loss for the companies.

Thus, multinational companies were motivated to invest in research into factors that would make the adjustment to moving successful. Then companies invested in implementing those findings. For instance, companies hired consultants to educate about cultural differences, to develop realistic expectations for adjustment, and to create social networks to embrace and help acclimate families. In many international schools, there is a process of absorption that may include assigning buddies, as well as teachers, counselors, and volunteers monitoring daily progress and creating experiences of inclusion for new students. On the other hand, there are schools that lack experience absorbing new families, often throwing new students into large classes with only a brief introduction and an expectation to fend for themselves. Some students adjust and thrive in almost any environment, while others struggle and develop physical, social, or emotional problems. Because the failure of an international assignment may cost 2.5 times the salary of the employee—sometimes more than $1 million—multinational companies began investing in preparation and support for families relocating.

If faced with a move, consider seeking the help of a therapist or other expert guide. The cost of help will likely reduce the emotional cost and improve emotional gains associated with relocation.

References:

  1. Church, A.T. (1982). Sojourner adjustment. Psychological Bulletin, 9, pp. 540-572.
  2. Kupka, B., & Cathro, V. (2007). Desperate housewives – social and professional isolation of German expatriated spouses. International Journal of Human Resource Management, 18 (6), 951-968.

Emotional eye“…Not all psychological impacts can be encompassed by a list of symptoms or disorders.” —From Principles of Trauma Therapy

Make no mistake about it, Principles of Trauma Therapy: A Guide to Symptoms, Evaluation and Treatment is a psychiatric textbook. However, it is a rare breed of psychiatric textbook. It has a soul. To borrow from the dialectic wisdom of Marsha Linehan, the question in mental health treatment is often “What is being left out?” This book fills the void in terms of a comprehensive examination of the causes of trauma. It is not solely focused on the lists of symptoms. There are some areas where the book has “left out” important information, but emphasis on cultivating compassion for trauma survivors makes up for it.

John N. Briere and Catherine Scott describe how challenging behaviors exhibited by people who have gone through traumatic events are normal and within the context of psychological resilience: “Although therapists may interpret these behaviors as ‘resistance,’ such avoidance often represents appropriate protective responses to therapist process errors.” (p. 170). The adaptive functioning—or attempts to “metabolize” the trauma—is often interpreted as sabotaging or therapy interfering, but in reality, it suggests the clinician is in error (e.g., moving too fast in therapy). Unfortunately for the person in therapy, these attempts to lessen the pain can inadvertently prolong their trauma (this is what’s called the “pain paradox”). The unskillful attempts used to extinguish the pain often produces an increase in pain for the individual.

[fat_widget_trauma_ptsd_right]The pervasive message in Principles of Trauma Therapy is that a person’s symptoms due to a trauma can resolve via therapeutic engagement within a safe, therapeutic environment. The treatment approach is eclectic, and it weaves together strategies from various models (e.g., cognitive behavioral therapy, psychodynamic approaches, and mindfulness). People in therapy are given the opportunity to develop a coherent narrative of their past experiences, while learning stress reduction skills and psychoeducation through validation, respect, and supportive encouragement.

At the heart, Principles of Trauma Therapy comes from the theoretical perspective of exposure therapy and much of the content centers around this orientation for treatment. The clinician invites the person in therapy to develop alternative perceptions to their negative beliefs about themselves (oral and written) and the environment where the trauma manifested, while reducing “conditioned emotional responses” (CER).

To simplify, the recollection of the traumatic memory (i.e., exposure) occurs by activating the emotional states and schemas. The “disparity” that occurs is based on the idea that the therapy space is safe, so the person in therapy is counter-conditioned to realize they will not be harmed by experiencing the intense emotions that surround the memories. The integration of memories and emotions through exposure—along with the inability to avoid (i.e., CER) in the moment—creates resolution. The emotions are no longer as powerful. The positive results occur if the clinician is able to finesse the client’s capacity to “regulate and tolerate the associated painful affect” (p. 267). Briere and Scott advocate a titrated exposure to avoid both undershooting the level of exposure and not overwhelming the person in therapy. This person should be emotionally activated to allow processing to take place, but not to the point that their coping resources are overwhelmed, which leads to avoidant behaviors (i.e., to seek safety from the distress).

Exposure therapy techniques are undoubtedly effective and reliably decrease posttraumatic stress. However, the dysregulated elephant in the room during my review of this book was a question of ethics: is exposure therapy humane?

There are a couple of areas that should have been addressed more thoroughly in the text. Exposure therapy techniques are undoubtedly effective and reliably decrease posttraumatic stress. However, the dysregulated elephant in the room during my review of this book was a question of ethics: is exposure therapy humane? This form of therapy elicits pain for the person in therapy, often expressed in the form of panic attacks, dissociation, and intense anxiety through a re-experiencing of the trauma. Is it morally right for clinicians to prescribe this approach? Does the end justify the means? Or, are there other treatment approaches that can be used to relieve the immense amount of suffering experienced by trauma victims?

Principles of Trauma Therapy provides only a brief conceptualization of eye movement desensitization and reprocessing therapy (EMDR). In 2004, the APA acknowledged EMDR as a recommended effective treatment of trauma. According to Shapiro (2001), EMDR is the most empirically studied treatment for posttraumatic stress (PTSD). The philosophy of EMDR treatment does not differ drastically from exposure therapy: deconditioning disturbing input, redefining the event, finding meaning in it, and eliminating self-blame, while integrating new skills (Shapiro, 2001). The stark difference between EMDR and exposure therapy is the method of delivery, as well as the path a person in therapy takes toward healing. Exposure therapy is analytical with a narrative-driven process that involves a significant amount of “homework” assignments for the person in therapy. It also runs a risk of vicarious traumatization (for both the therapist and person in treatment) due to repeatedly describing the often horrific events.

The internal process of EMDR utilizes an approach of holding a negative cognition (e.g., “I am unlovable”) paired with what is often an image of the traumatic event (a pre-established target). The person is instructed to focus on the image, negative thoughts, and body sensations while simultaneously engaging in EMDR processing using sets of bilateral stimulation (e.g., eye movements, auditory stimuli, or tactile sensors). They are witnessing in their mind’s eye what surfaces. The clinician does not hear all of the details of the trauma, nor does he or she provide analysis of the experience. Dialogue is at a minimum. It is provided through repeated, brief check-ins between sets of bilateral stimulation; “What comes up now?” or “What did you notice that time?”

Principles of Trauma Therapy has an agenda in terms of promoting exposure therapy, but it also offers a holistic array of coping strategies—for both the therapist and the person in therapy—to increase one’s awareness of bodily reactions and ways to create a vocabulary for the feelings that arise. This mindful mentality is more than a subtle emphasis. Empirically validated mindfulness interventions are presented (e.g., acceptance & commitment therapy, dialectical behavior therapy, mindfulness-based stress reduction, and mindfulness-based cognitive therapy) as to disillusion the reader from the spiritual, Buddhist connotation. Clinicians are encouraged to maintain an open awareness to their own mental states (e.g., reduction of reactivity) without judgement, in order to mirror this process for people (e.g., attending to the breath, a here-and-now focus). There are also scripts for new clinicians and comprehensive assessment material that is applicable to anyone in therapy.

Principles of Trauma Therapy has a final, comprehensive directory of trauma-centered psychopharmacological interventions with content relative to psychobiology. This is extremely informative, but one has to question some of the research that was referenced. One concluding statement regarding the efficacy of selective serotonin re-uptake inhibitors (SSRIs) as antidepressant medication gave me pause. It was noted that SSRIs “have been found to be equally effective in reducing symptoms and improving quality of life across most clinical trials” for many diagnoses. The example reference was to a 2000 study comparing monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants and some selective serotonin re-uptake inhibitors (SNRIs) for depression. [1] The citation did not match the broad sweeping claim as the study itself notes “clinically insignificant” differences in efficacy as well as tolerability between SSRIs. [1] Read this section with a grain of salt and consider newer research when determining the efficacy of medication for victims of trauma.

Despite the focus on the individual in this book, the reader is walked through the “victim variables”, “characteristics of the stressor”, and “social response and supports” that affect the outcome for the trauma victim, which forces a cultural vista. Briere and Scott implicitly connect to the fact that our society’s disenfranchised groups of individuals (e.g., people of color and in poverty) are much more susceptible to posttraumatic symptoms.

Trauma is no longer just a micro level problem, but an issue of social justice and equality. The book maps out the generational influences and cyclical effects of trauma. There is an “additive effect” of multiple traumatic events throughout one’s life. For example, a survivor of childhood abuse who has residual effects into adulthood will react with “especially severe, regressed, dissociated, or self-destructive responses to the adult trauma” (p. 22). Earlier treatment interventions are essential to desensitize these reactions to stress.

Briere and Scott provide a stylish blend of the metaphysical and tangible aspects of trauma. They do this with learned experience, academic research, and hope as a means to expose the wide-ranging consequences of trauma. If you are a clinician searching for an in-depth examination of the components, conceptualization, causal mechanisms and treatment of trauma, then Principles of Trauma Therapy is here to the rescue.

References:

  1. Mace, S. and Tayler, D. (2000). Selective serotonin reuptake inhibitors: a review of efficacy and tolerability in depression. Expert Opinion on Pharmacotherapy: 1(5). 917-933.
  2. Briere, John & Scott, Catherine. Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment (2nd Edition). SAGE Publications, Inc; Second Edition – DSM-5 Update edition (March 26, 2014).

Woman's hand leaving flower on tombstoneThe phrase “moving on” is common in the grief and loss world, but it isn’t very well understood or, frankly, all that helpful.

What does it mean? What does moving on look like? How does one actually do it?

Unfortunately, there isn’t a clear answer to those questions.

However, there are things it can be helpful to know about “moving on” after the death of a loved one, divorce, or other painful life event.

1. You Are Not Responsible for How Others Feel about Your Grief Process

Typically, it feels like what those around us mean by “moving on” is for us to stop hurting, stop talking about it, stop remembering, stop crying, and just stop grieving. They talk about wishing we would stop dwelling on the hurt and encourage us to just let go and accept what happened.

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The truth is, what they actually want is for us to stop making them uncomfortable about our pain. Let’s face it—being with someone who is in pain and grieving isn’t the easiest of experiences. It’s difficult to watch someone we love hurting so deeply.

But other people’s discomfort with your grief is their business, not yours. You are not responsible for making them feel more comfortable.

2. Moving On Doesn’t Mean Forgetting

I suspect that the primary difficulty many of us have with the phrase “moving on” is that it often feels as if we’re being told to forget our loved one or the relationship we once had.

That’s not what moving on means. Moving on is more about learning to live what I call a both/and life rather than an either/or life. It’s not about grieving or forgetting, happy or sad, black or white. It’s shades of gray.

It’s about learning to live a full and happy life even as you miss and long for what you have lost. It’s about remembering and honoring the one you loved while also embracing the beauty and fullness of the life you still get to live. It’s about the brilliance of your love and the shadow of your loss coexisting in this complex and expansive experience we call living.

Grief and loss are complex, multifaceted, and multilayered. Loss and our experience of grief are integrated into our lives, not things we get rid of.

3. Moving On Doesn’t Mean the End of Grief, Either

Moving on from grief doesn’t mean a static end. It doesn’t mean suddenly we’re done grieving and will never hurt again. Moving on is more about moving forward than being done.

Grief and loss are complex, multifaceted, and multilayered. Loss and our experience of grief are integrated into our lives, not things we get rid of. Grief changes and morphs over time. We get stronger as we carry it, the edges of it round and dull, and with time it begins to take up less space in our lives. It doesn’t simply disappear. Grief can (and will) continue to remind us of our loss throughout our lifetimes, in different ways and at different times.

We move forward with life, embracing the fullness of it, even as our loss becomes part of who we now are.

4. Ultimately, You Get to Define “Moving On” for Yourself

People will have all kinds of advice and well-meaning intentions about how you should move on, when you should do it, and what it should look like. They, however, cannot determine that for you.

There are no timelines or rules to the grieving process. You will move through it at your unique pace and not one minute faster. The process of grieving is unique to each of us. No amount of pressure from others can make us move through our process any faster, not in any kind of healthy way.

Only you can know when you are ready to move forward after your loss. Only you can decide what it means to let go or accept the loss you experienced. Only you can truly decide what it means to move on and move forward.

Whatever that looks like for you, it is perfect and right.

man hugging pillow“Some days you eat the bear, some days the bear eats you.” —Iain Matthews

Sometimes, we get so mired in our thoughts and feelings we forget to see the bigger picture. When that happens, it’s good to look for even the tiniest crack that might open you up to a softened heart or a wider view. That softened heart is not just for others, but toward your own, sweet self.

Paradoxically, this requires both surrender and effort. You must surrender to your truth emotionally, physically, and cognitively, in this moment. Then, make an effort to do what you can to shift gears. If that’s not possible, accept the circumstances and your state of mind, and recognize they won’t last.

When in the throes of an overwhelming emotion such as anger, depression, anxiety, or grief, it may seem as if that’s all there is. Luckily, there is much more to you and your life than the challenge du jour—so much more. Yet, in the midst of jangled nerves and incessant negative thoughts, it’s all too easy to forget everything that is going well. Take a minute and think of everything that is working well for you.

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Now, think of the millions of thoughts and feelings you have had in your life. Some lasted a nanosecond, some longer. Each one came and went. When you are in a negative emotional tornado and it feels as if you are being swept up and carried away, remember: you will land. Sometimes it might be with a huge thud that rattles your bones; other times, it will be gentle. You can’t always control the landing. You can control how kindly you treat yourself in the process, though.

In addition to exercising self-compassion, it’s helpful to cultivate an inner sense of knowing—knowing when to make a Herculean effort to face some demons, and knowing when the best you can do is to keep breathing until the bad experience ends. It will end. Bad things will happen, internally and externally. The more you appreciate the ebb and flow of life, and the less you fight what is, the sooner you may feel a renewed sense of equilibrium and joy.

Trying to control all the variables, beyond a reasonable amount of preparedness, just sets you up for misery. The task is to live this moment, no matter how it appears.

Despite all the evidence to the contrary, there are people who think they should feel happy all the time. The last person who told me he was happy every day died suddenly at age 50 of a massive heart attack. How could anyone be happy 24/7? Only if the person is in denial—of life’s vicissitudes, of his or her ever-changing inner landscape, of everyone else’s ever-changing inner landscapes, of collisions between these landscapes—could that be the case.

Life is messy. Things don’t always go your way. People do what they want, not what you wish they would do. Your body throws curveballs at the most inopportune times. Furnaces shut down when it’s 20 below. People and pets die. You can run out of money. Best friends move far away. Children, too. Trying to control all the variables, beyond a reasonable amount of preparedness, just sets you up for misery. The task is to live this moment, no matter how it appears.

Railing at what is and resisting reality only creates more suffering. Yet, it is supremely difficult to embrace life on life’s terms. Why? Because the ego wants what it wants, exactly as it wants it, all the time. Consciously, few people would say that’s how they think things should work, but unconsciously, where that little child lives, that’s the belief. Otherwise, why would Buddhists and other like-minded philosophers have had to work for millennia to help people think differently?

As helpful as it is to continue practicing unconditional self-acceptance and acceptance of reality, it is equally useful to create a soft landing spot when life feels like it’s tossing you around. Softening your heart to yourself and your experience, with self-compassion, is another way of being in the moment. It’s important to have compassion for the anxious parts of you that don’t know what’s next, for the sad parts that are still grieving, and for the child parts that look to the loving adult within you to watch out for them, even when all you can do is offer a soft inner comforter to cushion the fall.

Creating a soft landing spot takes practice. It consists of first paying attention to what you feel in your body and taking some time to describe those sensations. As this is not a typical human activity, it can feel weird, awkward, and difficult. With practice, it gets easier. Think of it as learning a new language—the language of your body.

Then, check in with your feelings. If you only find one, dig a little deeper. Feelings usually come in clusters. When you have unearthed yours, ask yourself where they came from. Are they remnants from the past? Are they created by current, catastrophizing thoughts? If so, lovingly, patiently work with the parts of you that remember feeling this way before, perhaps in childhood. Give those parts a voice. Let them speak to you. If they are not ready, let them find repose somewhere, either in your heart or somewhere else safe and serene.

Next, listen to your thoughts. If you can write them down, all the better. Are they true? When flooded with negative thoughts, you might believe that’s your reality. It isn’t. It’s simply a temporary state of mind, even if it has existed for a long time. Challenge these unhelpful, possibly habitual, ways of looking at yourself, others, and life. If you use questions, you can answer them and reach a new paradigm.

The most important thing to offer yourself when life is hard and you feel lower than a snake’s wiggle is a feeling of safety. In some ways, all inner work builds toward a greater sense of internal safety.

Couple hugging and holding handsAccording to the Centers for Disease Control and Prevention, in the United States 6.7 million women between the ages of 15 and 55 experience either problems getting pregnant or carrying a pregnancy to term. That is more than 10% of women in this age range. Chances are you or someone you know has experienced or will experience challenges related to fertility.

Infertility often has biological causes, but the emotional effects can be especially devastating for a couple trying to conceive. The National Infertility Association discusses these emotional effects, which may include:

In addition to these symptoms, I have noticed the people I work with in therapy experiencing the following:

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Infertility is traumatic. In addition to depression symptoms, it is quite common that couples experiencing infertility will experience anxiety in response to certain situations or triggers (such as seeing pregnant women, pregnancy tests, babies on TV or in person, etc.). They may experience intense emotion around certain times of the month, particularly the times near ovulation and when a period is due. Going in for fertility treatments may become very triggering and anxiety provoking, particularly if previous interventions failed. Sadness and grieving are common, particularly around holidays and other important life events.

When someone is experiencing infertility, negative beliefs about one’s inadequacy or defectiveness may come up. Both partners may question why their bodies are not functioning like seemingly everyone else’s, especially when those around them are having babies, apparently without any trouble.

If there has been past pregnancy loss, other triggers for anxiety, depression, and intense emotions may come up, including the date a baby was due or times of year associated with the loss. Triggers can seem unrelated or random but still have a profound effect on the emotional reaction of the people going through this difficult situation. For many, infertility feels like riding an emotional roller coaster of anticipation, worry, sadness, grief, and anger.

When someone is experiencing infertility, negative beliefs about one’s inadequacy or defectiveness may come up. Both partners may question why their bodies are not functioning like seemingly everyone else’s, especially when those around them are having babies, apparently without any trouble. People struggling with this issue may question their value and their self-worth can take a major hit, resulting in magnified depression and hopelessness.

The stress and trauma that result from infertility can also have a negative impact on a relationship. Because both partners experience their own challenges in infertility, they may be more prone to snapping at each other, taking things personally, or feeling disconnected.

There are steps people who are experiencing the emotional complications of infertility can take in order to cope and eventually thrive through this major life challenge.

1. Seek Professional Assistance

A mental health professional can help address the symptoms one is likely to encounter when experiencing difficulties related to infertility. Coping skills, trauma work, and couples counseling are just a few of the areas a therapist can help someone to work through to make this difficult path more bearable.

When working with people with infertility issues, I often utilize eye movement desensitization and reprocessing (EMDR) therapy to address negative beliefs about worth and defectiveness. EMDR has also been helpful in addressing and reducing disturbance related to fertility treatments, pregnancy loss, and worries about the future. When trying to get pregnant and while pregnant, stress management is essential in helping the body to be at its best to conceive and carry a baby.

2. Give Yourself a Break from Social Media

Social media can be wonderful, but they can be triggering for someone who is going through infertility. People love to make pregnancy and birth announcements through social media. Someone experiencing infertility may be much more sensitive to these announcements, as they can feel like a reminder of the pain that person is bearing.

If such announcements are triggering, give yourself a break and stay off social media for a while. Work with a therapist to decide when and how you will begin to engage in social media again. Working through some of the trauma and practicing coping skills regularly can help reduce the triggering effect of social media.

3. Acknowledge and Feel Your Feelings

Emotions are meant to be felt. One of the main jobs of an emotion is to alert us that we need to pay attention to something. Emotions can do what they are supposed to do only if we are willing to acknowledge and feel them.

The human body and brain are very good at working through difficult material when we stop avoiding emotions and allow ourselves to feel fully. A therapist can help with learning to tolerate and regulate emotions.

4. Celebrate and Enjoy the Little Things

Infertility can consume your life. From your thoughts to your time to your emotions and your relationship, it seems that there is not an area that infertility does not impact.

With your partner, find reasons to celebrate life. Engage in fun activities that you wouldn’t or won’t be able to do while pregnant or with a newborn. Try to soak up the moments of joy, calm, and fun as they come up. Seek out new hobbies or activities you have wanted to try. It is important to find joy and meaning in life, even when you are going through a difficult time.

References:

  1. Centers for Disease Control and Prevention (2006-2010). FastStats: Infertility. Retrieved from http://www.cdc.gov/nchs/fastats/fertile.htm
  2. Dunkel-Schetter, C., & Lobel, M. (1991). Psychological reactions to infertility. In A. L. Stanton and C. A. Dunkel-Schetter (Eds.), Infertility: Perspectives from stress and coping research (pp. 29-57). New York: Plenum.
  3. The National Infertility Association (2014). Emotional aspects of infertility. Retrieved from http://www.resolve.org/support/Managing-Infertility-Stress/emotional-aspects.html

Side view of mother and childParents in previous generations used to parent with one central theme in mind: obedience. It didn’t matter how you felt, what you thought, or what you wanted. As a child, you simply did what you were told.

As the concepts of emotional development and self-expression in children began to give kids more of a more prominent voice, we should ask, what are we doing with that voice now?

I believe parenting is entering a new generation where emotions are dictating our every move. Some examples you might recognize include:

These are some of the trends that we are seeing now, and they can be detrimental to a child’s growth. Some children are not learning to put their emotions aside. Their moods are driving their behavior, motivations, and how they treat others. If they don’t “feel” like doing something, they won’t do it. If they are angry, they lash out. Children’s emotions are officially taking over, and I don’t necessarily think that was the goal when the exercise of self-expression for children was first encouraged.

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The Repercussions of ‘Emotions-First’ Parenting

Too often, the way seems to be to point the finger at something or someone else, then later wonder why so many children grow up and have difficulties with jobs or relationships. As parents, it’s often easier to point the finger at people such as teachers and accuse them of failing to do their jobs instead of helping your children adjust to an imperfect world. Children whose parents put their emotions first are navigating the world through a happiness lens, and if they are not happy, they are likely not engaging. The process of life becomes looking outward versus inward, and children may become experts at finding other people’s flaws but in the process lose the ability to process their own.

Children are learning that their moods dictate what they should do, and not the other way around. As a result, they may stop doing things when they become harder, and they may avoid social circles and relationships that don’t make them happy all the time. This can also manifest as less motivation to take risks or put themselves out there because of discomfort.

The Road Is Often Paved with Good Intentions

Where do we go from here? Most parents mean well and deeply want their children to be happy, but we as parents need to start making some serious changes. Here are 11 ways we can take our children’s emotions into account while also being the best parents we can be:

  1. If you are accepting your child’s emotions, this includes all emotions. It does not mean creating an “always make you happy” situation. You have to allow your children to process their emotions when things aren’t going their way, which will help them build resilience.
  2. Behavior and feelings are different. Your children are allowed to FEEL however they do. This does not give them a pass to BEHAVE however they want. Hold children responsible for their behavior and let them know that they have a choice in how they manage their feelings.
  3. Promote looking inward, self-regulating, and taking responsibility. Today they may have the worst math teacher on the planet, but someday your children may have the worst boss in the world. In either situation, they must learn to cope.
  4. If we cannot accept when our children are anything but happy, we are setting them up for a race they will never win.
  5. Consider using consequences instead of reward systems. Reward systems are unrealistic and confusing to children, and they do not work long-term. Consequences help develop consequential thinking, which is key to self-regulation and thinking beyond the present moment.
  6. If your child screams at you and you give in, you are teaching him or her that emotions rule. Show your child that behavior rules by remaining calm and shifting your stance only when he or she makes better choices.
  7. Allow your child to feel emotions. Sit with him or her. Explore instead of fix. Process instead of numb. Trust in your child and he or she will trust in themselves.
  8. Reframe discomfort as growth. Teach your child essential skills for coping or consider finding a therapist to help him or her learn and utilize coping skills.
  9. Let your child make mistakes, take risks, and mess up. Natural consequences are sometimes the best consequences.
  10. Put boundaries on anxiety and anger. Anxiety is at the root of many behavior issues we see, and we too often allow children to behave disastrously because of it. Anxiety is an intense emotional response and it needs boundaries.
  11. Process your own emotions. If you are unable to feel your own range of emotions, it’s going to be very difficult to be with your child as he or she is feeling his or her own. Practice sitting with your child and remind yourself that it is OK that he or she is feeling.

Parenting is by far the most difficult job, and there is no one way to do it perfectly. You will mess up, you will face all sorts of emotions, and that’s OK. It can become a beautiful model for your children to follow. The best thing we can give ourselves and to our children is the ability to self-reflect, change, and grow. Teach them to look inward instead of outward for happiness, what it means to work hard for something despite discomfort, and how to take risks doing what they love.

It is an incredibly important milestone for civilization as a whole that we are allowing our children to have a say and to express themselves. Now, however, we must do the hard work of teaching them what to do with the emotions they are expressing.

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.