adult-talking-to-childCreated by Dr. William Glasser, reality therapy and its theoretical underpinning of choice theory provide a wonderful lens through which to help clients evaluate their needs. Individuals are thought to have five basic needs that their behaviors seek to satisfy in order for them to be happy and fulfilled. These are: survival or self-preservation; love and belonging; achievement; independence or freedom; and fun. All behavior is believed to be an attempt to meet these needs—even when the behavior is unhealthy or harmful (Glasser).

Having children and adults evaluate their needs has multiple benefits. It immediately shows the therapist or counselor what is in abundance in these five areas of the client’s world and what is lacking. It provokes client awareness and a highly relevant dialogue, and is empowering for clients in that it helps them to see they are usually the catalyst of any hoped-for change.

In working with children, I utilize a graphing utility, designed by Arlin Peterson, called Pete’s Pathogram (Peterson). The five basic needs are depicted on the “X” axis, and the “Y” axis shows the degree to which the need is being met with a range from 0 (not met) to 10 (totally met). Children “score” their needs with me on the paper graph. Inner-city schoolchildren will often score themselves with a 3 or 4 on the “survival” need.

When asked a series of question that seek to provoke self-reflection, a conversation will usually ensue about the dangerous neighborhood in which they live, fears of gangs, shootings, violence in the home, and sometimes shortages of food. Counselor/therapist and children can process these very real fears and discuss if there is a way to improve the degree to which a need is being met. For instance, asking a child why that score is low and what it would take to make that survival need score a 5 might encourage a conversation about a move to a different neighborhood, their being alone less frequently in the home, providing them an additional meal at school, or having their parents come in for counseling. One by one, clients score each need.

Utilization of this exercise provides an opportunity for immediate insight into the client’s life at a profound level. As counselor/therapist and client reflect on the degree to which a need is being met, the balance or imbalance of the five basic needs in the client’s life becomes apparent. This exercise works extremely well with adults also. The workaholic will score himself/herself a 10 on the achievement need, but he or she will most likely rate low for love and belonging, fun, and freedom.

The evaluative, self-reflective, and internalizing elements of this exercise are extremely rich, in my opinion. Clients are supported to identify ways they can create change for the better. As with the creation of one’s quality world through the use of pictures and words (explained in my first blog), the client’s active role in examining the five basic needs with the therapist can rapidly provide rich content with which to work.

References:

  1. Peterson, Arlin V. (2008). Pete’s Pathogram. Action Printing, U.S.
  2. Glasser, William (1998). Choice Theory. A New Psychology of Personal Freedom. HarperCollins Publishers, Inc., N.Y.

AdobeStock 142240507The pages of women’s magazines are filled with articles offering methods for encouraging men to propose marriage and entire websites are dedicated to increasing a person’s marry-ability. Both men and women can be hesitant about marriage, and when romantic partners have different opinions of marriage, the conflict can be challenging to resolve.

It is possible, however, to have a committed and loving relationship without marriage, and some people who are uncomfortable with marriage ultimately change their minds. A disagreement about marriage doesn’t have to end your relationship, particularly if you both are committed to the relationship.

Avoiding Marriage

If you’re itching to get married and your partner resists, it’s easy to assume there’s a problem with the relationship or that your partner isn’t fully committed to you. These issues could indicate that it’s time to consider moving on. But there are myriad other reasons people are uncomfortable with marriage that have nothing to do with the relationship. Cohabitation is an increasingly popular option; one 2013 study found that 32% of couples chose long-term cohabitation over marriage. Some reasons your partner might be uninterested in marriage include:

The Role of Communication

As with so many other relationship issues, open and honest communication is the key to resolving disputes about marriage. You might assume you know your partner’s reason for avoiding marriage, but you don’t really know until you ask. Hearing that your partner is concerned that marriage might change the relationship will likely feel a lot better than simply assuming your partner doesn’t want to get married because he or she doesn’t love you.

And for partners who want to get married, explaining clearly and logically why you want to get married can make a big difference. The benefits of marriage include automatic paternal legitimation for children, significant tax benefits, and shared insurance. Pointing these out to your partner could help, but addressing his or her concerns is equally important. You might be able to come to an agreement about when you’ll reevaluate the marriage question and how you’ll address insecurities and relationship logistics in the meantime.

While you might feel hurt if your partner doesn’t want to marry you, it’s important to consider that marriage might mean something completely different to your partner. Consequently, it’s wise to focus on other ways to get your needs met rather than making marriage a deal-breaker. If, however, you can’t stay in a relationship that doesn’t end in marriage, trying to push the relationship toward marriage can cause it to fall apart. It might be better to end things now.

Addressing Potential Concerns

If you and your partner agree to live together without getting married, you’ll have the freedom to pick and choose which marriage benefits you want to take advantage of and which you want to avoid altogether. A simple contract, for example, can outline who owns what property and how it will be divided if you split up. And if you have a child together, you’ll need to ensure that both parents are listed on the birth certificate or that the nonbiological parent adopts the child. You won’t be able to get tax benefits, but you can still combine your lives in a way that works for both of you.

References:

  1. Aleccia, J. (2013, April 4). “The new normal”: Cohabitation on the rise, study finds. NBC News. Retrieved from http://www.nbcnews.com/health/new-normal-cohabitation-rise-study-finds-1C9208429?franchiseSlug=healthmain
  2. Roberts, S. (2013, April 9). Against marriage: A ring does not define a relationship. The XX Factor. Retrieved from http://www.slate.com/blogs/xx_factor/2013/04/09/the_case_against_marriage_a_ring_doesn_t_define_a_relationship.html
  3. Schwyzer, H. (2011, February 16). Why some men don’t want to get married. Alternet. Retrieved from http://www.alternet.org/story/149941/why_some_men_don’t_want_to_get_married

When I first read your letter, I wondered if you had visited your personal physician for a checkup recently. I am not a physician, but I am aware that your irritation can be a symptom of many things, among them a nutritional disorder, neurological damage, or medication interactions. So I would advise you first to seek the advice of a medical doctor.

You write that you did not always feel angry, edgy, and unfriendly, and I wonder if you can trace back to the time when your feelings and your behavior changed. Tracking this down might give some clues about what it is that has gone wrong.

You may not have a big social circle, but are there a few friends or relatives to whom you could turn for help? They might have ideas about when, and even why, you changed.

You ask if you are depressed. It sounds like you are, and anger, as you might know, goes hand-in-hand with depression. Anger is even an underlying factor in the development of depression.

You say you are nitpicking and edgy. Who are the people most affected by these qualities? Do they have something in common?

Funny, one of the first things you wrote was that simple questions bug you, so I guess I’m bugging you as you read my reply, because I’ve asked you a lot. So rather than ask anything else, I’ll suggest that after you visit your physician you make an appointment with a therapist, who will ask you to talk about yourself, probably ask questions that annoy you, and who will request that when you’re annoyed you say so. The therapist will also ask you to report when you think the conversation has gone stupid, and you won’t have to worry about being offensive, because the therapist won’t take it personally, and that will help you, eventually, learn how to be the more likable person you say you used to be.

I hope you find your old self soon, and that when found it’s even better than you remember.

Best wishes,
Lynn

woman in therapy is feeling uneasyPremature termination with people in therapy happens with both seasoned and newly licensed therapists. In a study that talked about the therapeutic relationship and psychotherapy outcome, it shows that 20 to 57 percent of people in therapy do not return after the initial session (Lambert). Another 37 to 45 percent only attend therapy a total of two times (Schwartz). Sometimes these people leave without warning, but sometimes they do give some signs they won’t be returning, even if they do not directly explain them. Some will contact the therapists by email, will leave phone messages, or simply will not show up for their appointments. These people may come back much later, or not all. Many will also find a new therapist when they want to resume their therapy work.

There can be many reasons for this. I have had some people and personal contacts share some of their reasons with me. Here are some common reasons I’ve heard:

The ‘Can of Worms’

People realize therapy opened a bigger “can of worms” than they were prepared to handle. They say hindsight vision is 20/20. I wrote in my previous article, Helpful Tips to Make Therapy Most Effective for You, that one of the things to keep in mind during therapy is what you want to achieve or gain in therapy. Sometimes we don’t always know, even when we are posed that question. We can identify that we are struggling in some area of our life, or we are in some pain either emotionally or mentally, and we want some relief. We find the therapist we have a good connection with, make the appointment, and go in for our sessions.

Sometimes, we never know what to expect. Some have really good results; others have light-bulb moments with increased insight. Some, however, are taken aback by the depth of therapy, and they realized they didn’t want to go further at that time. One particularly candid response I heard from someone in this position was, “it was just too hard and painful at the time, and I just didn’t want to see what else was there.”

Subconscious Resistance

I don’t often hear people in therapy say, “I don’t think I’m ready to continue with this issue.” Sometimes other reasons come up, which is known as resistance. Therapy can provide wonderful possibilities, benefits, and outcomes, but occasionally we still resist the experience. This may be because of fear of success, failure, feeling overwhelmed by truth, fear of the unknown, or simply overwhelming emotions.

Therapeutic Breach

Misunderstandings, miscommunications, and impasses can often happen between therapists and people in therapy during the treatment duration. In the study mentioned earlier, the top reason people dropped out of therapy after the initial session was dissatisfaction with the therapist, or the feeling that the therapist didn’t really “get” them. There can be both competent and unprofessional behaviors found in all professions, and this is holds true in the therapy world. Further, even with the best training and the heart to serve people, the best therapists are not omnipotent, nor will they be perfect in their approach.

Many interventions are chosen according to what the person in therapy presents. Some will make unintentional mistakes or misunderstand what people meant. Therapy is not like getting a medical exam. There is no therapeutic equivalent to getting blood drawn, waiting for it to be studied, then receiving a detailed evaluation and report. The journey of healing through therapy must be a collaborative effort to be effective. If or when a therapeutic breach happens, a person may choose to drop out prematurely, or avoid the elephant in the room—the elephant being that there’s something hindering your therapeutic growth; you can feel it’s there but you are not able to talk about it. Alternatively, the person in treatment and therapist could have a dialogue, which can offer the most constructive growth for both parties. Often, however, it’s difficult to initiate that dialogue.

Giving Feedback

Healing in therapy is not just about getting results and meeting goals; it is also about the process of the therapeutic relationship. It is about how things unfold as you are exploring issues with your therapist. Therefore, sometimes constructive feedback is needed from people in therapy to minimize impasses and misunderstandings. This proactive approach can itself be a reflection of significant growth. For example, let’s say this person has relational difficulties, such as discussing vulnerable feelings. This is a wonderful opportunity to practice giving constructive feedback, which the person can then apply to other relationships. A competent therapist will often be very receptive to constructive feedback at any time during the sessions.

Readiness for therapy often comes at a point where people experience greater pain and discomfort by remaining personally stagnant than by initiating small adjustments in life to feel better in the long run. While there is no exact time frame for those lasting changes to occur, that readiness provides that platform for real growth to occur. The key is consistency. Premature termination sometimes cuts that opportunity short, despite improvements thus far in therapy sessions. Therapy, no matter the duration, is not a pass-or-fail experience, but rather an opportunity for positive growth with the right therapist.

References:

  1. Lambert, M., J. & Barley, D., E. (2001). Research Summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38, 4, 357-361.
  2. Schwartz, Bernard, PhD and Flowers, John, PhD. (2010). How therapists fail: Why too many clients drop out of therapy prematurely. Impact Publishers.

Teenage girl looking thoughtful about troublesIn my work with adult survivors of sexual assault, I am beginning to notice a pattern of behavior that I have termed “wounded attachment.” The impact of childhood sexual assault has reverberating effects on almost every facet of survivors’ livelihood, from relationships with family, friends, partners, spouses, and children to their jobs, finances, faith, etc. It is as if sexual assault redefines one’s pattern of and trajectory in life.

Sexual assault is the act of forcing, enticing, intimidating, or coercing another person to engage in a sexual activity, from fondling to coitus, when the other person is unwilling or unable (as is the case of one who is underage, drugged, or unconscious). Imagine yourself as a child, seeing the world through a child’s eyes, and then being introduced to a violent act—an act that serves to not only damage one’s physical body and mental/cognitive mind-set, but also disrupt one’s spiritual being.

This one act for some—repeated acts of violence for others—does untold amounts of damage to one’s psyche. Yet the resilience I’ve witnessed from many who choose to live their lives after the violence is remarkable. Unfortunately, for many the damage is such that many are unaware of how it has skewed their way of looking at the world. This sometimes is displayed in the relationships subsequent to the sexual assault.

Far too often, survivors believe that once the assault ends, it is done and they don’t need to talk about it. Yet the choices made, the decisions not made, and the relationships that come afterward tell a different story. Wounded attachment is an insidious component that I have seen repeatedly in my work with adult survivors of childhood sexual assault. What is wounded attachment? It’s the unconscious way of being attracted or attached to someone or something that reminds the survivor of or reinforces the wound/trauma, or in this case the sexual assault. At its core, it’s the way in which survivors subconsciously seek out relationships that reinforce the wounded aspect of themselves.

[fat_widget_left]Sometimes it is displayed in the choice of employment/work. For example, survivors may find themselves working at a job that belittles them, makes them feel worthless, or where they feel like they have to make everyone else happy at the expense of their own happiness, thereby reinforcing their wounded concept of self. Another example is when a survivor is continually engaged in romantic relationships that serve to reinforce the wounded parts of self.

As a child, depending on when the assault occurred and the developmental stage in which it occurred, the person seeks to please the adult and gain affection, attention, nurturing, love, trust, etc. A child who has been sexually assaulted blurs that idea of love, nurturing, trust, attention, and affection, and begins to believe that the only way to receive love, attention, etc., is to please the “assaulter.” This remains in effect as the child matures into adulthood.

Although the assault is no longer occurring, if the child did not receive any type of counseling, intervention, or effective treatment to process and repair the damage to the mind, body, and psyche, then this adult is continuing to live out the wounds experienced as a child. As such, the adult becomes caught in a cycle of relationships that reinforce the wounded attachments. Awareness of this plays a crucial role in helping adult survivors of sexual assault move toward recovery, resiliency, and healing.

Most people have experienced trauma at some point in time. The nature of traumatic experiences varies by severity and frequency and also differs with respect to the effect they have on survivors. Some people who have experienced violence, abuse, or disaster develop significant psychological problems and posttraumatic stress (PTSD) as a result of the trauma, while others appear to be more resilient and rebound with very few psychological problems.

Predisposition to mental health issues and stress sensitivity are two factors that have been theorized to affect risk for PTSD in trauma victims. But another factor that is less understood in relation to PTSD is intelligence. Intelligence quotient (IQ) can impact emotional regulation and reactivity and, therefore, it could be assumed that people with higher IQs may be more resilient to trauma.

To test this theory, Naomi Breslau of the Department of Epidemiology and Biostatistics at the College of Human Medicine at Michigan State University recently led a study involving 713 17-year olds. The participants were assessed for trauma history, type of trauma classified as assaultive trauma (sexual trauma, rape, life threatening trauma), or general trauma (accident, illness, disaster) and IQ taken at age 6. Breslau used this information to see how these factors affected PTSD at age 17.

She found that surprisingly, individuals of assaultive trauma were not more likely to develop PTSD than those of general trauma. However, Breslau did find a link between IQ and PTSD. “A drop of one standard deviation in IQ score measured at age 6 increased the relative risk ratio of PTSD resulting from either trauma type by approximately 50%,” she said.

This result can be interpreted in several ways. First, individuals with a lower IQ may be less able to regulate emotional reactions and thus be more vulnerable to PTSD. Second, making meaning of trauma and assigning context to a traumatic event may be easier for people with high intelligence. This can protect people from negative emotional responses and triggers, and decrease their vulnerability to negative mental health outcomes like PTSD. Although these findings clearly demonstrate a link between IQ and resiliency/vulnerability, more work should be done to determine how this link impacts younger and older individuals.

Reference:
Breslau, N., Chen, Q., Luo, Z. (2013). The role of intelligence in posttraumatic stress disorder: Does it vary by trauma severity? PLoS ONE 8(6): e65391. doi:10.1371/journal.pone.0065391

woman consoling her crying childTornado season is well underway, initiated this year by the recent tornado in Moore, Oklahoma, but severe storms and natural disasters can happen at any time. These events leave residents devastated and entire communities completely decimated. Round-the-clock news coverage tends to fade afterward, making it easy to forget about these events altogether. But for the people who survive massive disasters, the consequences last much longer than the news cycle, and extend much deeper than property damage and scrapes.

Shock

In the immediate aftermath of a natural disaster, the first reaction is often a combination of shock and denial. Sometimes this can make it challenging to take the necessary steps to begin picking up the pieces—calling insurance, assessing what property was lost, even finding temporary housing. But shock tends to give way to much stronger feelings, which can hit days, weeks, or months after a disaster strikes.

Feelings of Insecurity

Home is a place that most people spend their entire lives believing is a place of safety and refuge. But when a storm comes tearing through your house, this security can go out the window. People who have survived storms may experience nightmares, anxiety, extreme concerns about storm safety, or obsessive preparation to avoid the next disaster. The insecurity can be especially pronounced in children, who may feel constantly unsafe.

Posttraumatic Stress

Extreme stress is common in the aftermath of a storm. But when it persists for months, it can lead to posttraumatic stress (PTSD). People with PTSD may experience flashbacks to the storms, panic attacks, an extreme startle reflex, persistent avoidance of things that remind them of the storm, and anxiety and depression. PTSD can also interfere with a person’s ability to control emotions, leading to angry outbursts or crying spells, for example.

Other Mental Health Conditions

PTSD isn’t the only long-term consequence of surviving a natural disaster. For people already experiencing a mental illness, a traumatic event can make symptoms worse. And for others, a natural disaster can spark depression, extreme stress, generalized anxiety, eating and food issues, obsessive-compulsion, and a host of other problems. Sometimes these issues arise as a result of a person’s attempts to control the environment after a storm takes away control.

Effects on First Responders

Storm survivors aren’t the only people who suffer when a natural disaster hits. People who are on the scene at the time of the storm or who witness the immediate aftermath—including first responders such as police officers and fire fighters as well as the media—can also experience psychological symptoms. They could be haunted by people they were unable to save, by images of injured people, or by the massive nature of the destruction. Some witnesses may even feel guilt that someone else’s home or life was destroyed but theirs wasn’t. The symptoms for witnesses and first responders are often the same, including PTSD, depression, and other mental health conditions, and people who are present in the aftermath of a storm may need as much help and support as the victims.

References:

  1. Hellmich, N. (2013, May 21). Kids who survived tornado face emotional after-effects. USA Today. Retrieved from usatoday.com/story/news/nation/2013/05/21/psychologist-impact-kids-disasters/2346773/
  2. Pearson, C. (2013, May 21). Oklahoma tornado PTSD: How survivors are coping. The Huffington Post. Retrieved from huffingtonpost.com/2013/05/21/oklahoma-tornado-ptsd_n_3314640.html
  3. Rossi, B. (n.d.). The psychological aftermath of the Oklahoma tornados. WSJ This Morning RSS. Retrieved from blogs.wsj.com/wsjam/2013/05/22/the-psychological-aftermath-of-the-oklahoma-tornados/

It has been well established that adverse childhood experiences (ACE) result in negative outcomes. People who have experienced neglect, emotional abuse, domestic violence, childhood sexual abuse, physical abuse, or other traumatic events in childhood are at increased risk for psychological and physical illnesses.

Divorce, death of a parent, caregiver mental illness, and other environmental factors also place children at increased risk for negative behaviors, including smoking, drug use, and sexual risk taking. Psychological illnesses such as post-traumatic stress, depression, anxiety and even suicidal ideation are often associated with ACE.

Some research has even suggested that ACE increases the likelihood of cancer and other chronic illnesses by way of risky and maladaptive behavior and through changes in physiological and biological elements during childhood. Specifically, incidences of lung cancer and heart disease have been found to be higher in people with ACE most often as a result of smoking. However, until now, no study has looked specifically at how ACE affects risk of all cancers in childhood and adulthood.

Monique J. Brown of the Department of Family Medicine and Population Health at the Virginia Commonwealth University School of Medicine in Virginia wanted to examine whether or not ACEs increased overall risk of cancer. Brown assessed a large sample of participants and evaluated their ACE in relation to either cancer in childhood or adulthood.

She found that over 60% of all the participants had experienced at least one ACE and nearly 10% had a history of cancer. Of all the types of ACE, childhood sexual abuse was the most common in those with adult cancer, but appeared to have little impact on childhood cancer. The rate of cancer prevalence among the participants with ACE was much higher than the national average of 4.2% and suggests that ACE, and in particular, childhood sexual abuse, has a strong indirect impact on cancer risk in adulthood.

Brown was unable to find any evidence of ACE influencing childhood cancer risk, which suggests that biological and physiological effects of ACE may have less of an impact on overall health than the behavioral and emotional impacts of ACEs. Brown believes that these results reveal a particular segment of the population in need of early intervention. She added, “More research should focus on the impact of sexual abuse ACEs and adverse health outcomes.”

Reference:
Brown, M.J., Thacker, L.R., Cohen, S.A. (2013). Association between adverse childhood experiences and diagnosis of cancer. PLoS ONE 8(6): e65524. doi:10.1371/journal.pone.0065524

Indian woman wearing traditional dressA name, or identity, is a powerful thing. It is a descriptor that allows people to make quick judgments and assumptions about us. While we can understand the harm of assumptions, for the human mind it is a fast way to categorize a lot of information in a short amount of time. Assumptions also give us social context for the “rules” we need to interact with new and different people.

If you are at an event and you overhear someone talking about their upcoming church event, you might make an assumption about them. Based on that assumption you may speak differently to them. Perhaps you would avoid using curse words, for instance. Or, you may avoid interacting with them altogether.

Names and identities are our first impressions. How we dress, the way we wear our hair, how we behave, and even where we go all begins with our identity and what we call ourselves. Whether it is religion, sexuality, or gender, if it is part of an identity then it will influence how you present yourself to the world and how you interact with the world. The critical factors in creating an identity are that it describes who you are and it is self-chosen.

Identity Describes Who You Are

Our names and identities describe who we currently are. It is a present-day representation of how we perceive ourselves in this world. During my first day of high school, our gym teacher took attendance. She paused when she came to a girl who she had taught since kindergarten and asked, “Is it still Susie, or is it Susan now?” Upon the transition to high school and young adulthood the teacher recognized that the student may no longer see herself as a child and may prefer a different name to the one she previously used.

The name and identity that we have at 15 years old may be different than when we are 25 or 50 years old. As we grow, change, and have new experiences what we call ourselves may change as well.

Identity Is Self-Chosen

The second important point about our identity is that it is self-chosen. Other people may give us names (e.g. our parents) and labels (e.g. society) but an identity can only come from us. An identity represents how we perceive ourselves and how we want other people to perceive us. A label is a descriptor given to us by others based on their stereotypes of us.

My father is from Nigeria (African) and my mother is from Mississippi (African-American). I am truly African-American as a blend and product of them. There are many times when I publically call myself African-American, but I also call myself black, more privately, as that term resonates with me. For me, black describes the uniqueness of my culture: growing up American, but also as a first-generation American in many ways. Black describes the complexity of my experience in a way that African-American does not.

Depending on the situation and circumstance what we call ourselves may change. Perhaps our identity changes over time. What once resonated with us no longer does. Identity is a personal process and decision about what you call yourself. It is a process that is complex and full and fluid. It may change with time, or it may change with the environment or circumstance.

For example, I make a distinction between what I am comfortable with publicly versus privately. I am uncomfortable with some people calling me black and I use the term African-American publically. Similar to people who use familiar and formal names, different relationships have different ways of relating to each other.

Consider taking time to review your own identity. What names and identities do you have today? Is your identity based on your relationships (i.e. sister, partner, father, etc.)? Is it based on your work? Is it based on your religion? Or your sexuality?

What creates the identity that you have today? Is it different than it was 10 years ago? Do you think that it will be different 10 years from now? Share your thoughts and experiences with us; we want to hear from you!

woman-office-0624135I love my job. Love it. There are, of course, days like this one, when the 100-degree weather makes me want to bypass my office and head straight for the beach. For the most part, though, a day spent doing therapy is a day that fills me with deep satisfaction and a sense of accomplishment.

I haven’t always loved my job. In fact, for some time in college, I honestly hated it. A favorite professor recommended me for a coveted position as a psychological research assistant on a study being done at the world-renowned National Children’s Hospital. This particular study focused on how the quality of life for chronically medically ill adolescents may be improved by a part-time job at a fast-food restaurant. The position was a huge deal for an undergrad, and I was thrilled just to land a gig in my field instead of toiling at a children’s boutique, where I had been (I didn’t much love working there, either.)

This was going to look fantastic on my résumé; it was the kind of thing that would provide relevant experience and help usher me into grad school. I should have been overjoyed, and started out that way. But that soon fizzled, and instead I found myself downright miserable. The “gig” was not at all what I thought or hoped it would be. I had little to no interaction with the research participants. Instead, I spent every day hunched at the computer, matching subjects to controls, inputting boring data, and counting the slow minutes until I could head home.

According to positive psychology, we are happiest when the work we do, whether at home or on the job, allows us to use our signature strengths. Martin Seligman, the psychologist at University of Pennsylvania who pioneered the positive psychology movement, defines signature strengths as “strengths of character that a person owns, celebrates, and frequently exercises.” These are the personal traits and skills that come naturally, and that give us a sense of fulfillment and purpose when we use them.

Seligman has identified 24 unique character strengths, including fairness, curiosity, creativity, and humor. My VIA Signature Strengths survey results—which identified my top five strengths—help explain why, between my two jobs in psychology, I was woefully unhappy as a research assistant but have been blissfully content as a clinician.

My top three signature strengths are curiosity, love of learning, and perspective. Seligman and Christopher Peterson define these traits this way:

Doing therapy, I get to utilize all three of these strengths in my work. My sense of curiosity makes me truly interested in my clients and their personal stories. Because I love learning, I eat psych books like they are candy and very much enjoy attending conferences about new methods and ideas in my field, then immediately use what I learn in therapy sessions. Perspective (or wisdom) is a strength I try to employ daily by helping others look at themselves and their situations in healthy, encouraging ways.

A look at my relative weaknesses on the signature strengths survey also explains why my research assistant job didn’t work for me. The traits I seem to value least, and engage least frequently, are persistence, self-regulation, and prudence.

The research assistant job required hours of monotonous sifting through surveys and entering numbers into a statistical analysis program. This task required perseverance and discipline, two of my weaknesses. I was bored, edgy, and unfulfilled. I was impatient to learn the results of the findings, but it would be months until they were revealed. Day after day was the same—columns of numbers and the click-click-clack of computer keys. My curiosity was not satisfied, and my self-control was tested. I made regular trips to the vending machine, where in my careful scientific process I learned that I preferred Cheez-Its to Cheese Nips. I explored the wings of the hospital, discovering that the interns in the cardiology unit were better looking than those in rheumatology. I found myself daydreaming constantly.

Moreover, I became an unpopular, dissonant voice at the Adolescent Employment Readiness Center, as my unit was called. Since prudence was not one of my strengths, especially as a 20-year-old student, I made it all too clear that I did not believe that working at McDonald’s was the best use of time for a teen in remission who may not live to see his 20th birthday. As a passionate, wide-eyed kid myself, I thought our teenage subjects should be celebrating their periods of remission by sailing, surfing, seeing the world—anything but flipping burgers.

I am incredibly lucky. I was able to find a career that is in alignment with my signature strengths. Not all of us are as fortunate. Nonetheless, even in less-than-ideal situations, you can work toward finding opportunities to utilize your personal character strengths as often as possible. Research shows we are happiest when we are using our strengths regularly and in novel ways. By exploring the hospital and comparing the nuances of cheese-flavored snack foods, I engaged my curiosity and love of learning at my boring research job.

If your job or life circumstances don’t naturally engage your strengths, you can and should look for creative outlets for their expression. For example, if your strength happens to be my weakness of self-regulation, and you are in an unstructured environment, use your skills to bring order to the chaos. Help your coworkers organize their desk drawers or create a method for arranging their daily to-do list. If humor is one of your strengths, find ways to bring laughter to the board room or break room.

The most important point from the research on signature strengths is that we are happiest and most productive when we are living as an expression of our strengths rather than frantically trying to develop our weaknesses. I might look at my weaknesses and berate myself for being flighty, undisciplined, and impulsive. I could focus on these shortcomings and spend a bulk of time and energy making efforts to overcome them. To do so, according to positive psychology, is to expend precious energy swimming against the current of our most authentic selves.

It is worth investing a bit of effort to improve upon the weaknesses that handicap us and hold us back. Truth is, I do have a bit more stick-to-it-iveness and self-control now than I did in my college days. My mindfulness practice has helped me with that. Still, I am bored easily, relatively impatient, and I tend to speak my mind, so it doesn’t surprise me that persistence, self-discipline, and prudence remain my weaknesses.

Three times today I’ve abandoned writing this article to do something else. Because I’m curious and love to learn, I went to find the reference for another article, and found myself distracted by another couple of pages that popped up in my Google search. When I set out to write, I know that this will be the way things go, so I give myself the time for what will inevitably be my process. I allow and engage my strengths, and don’t beat myself up for my weaknesses. By permitting myself to work at a comfortable pace, I am able to eventually accomplish what I set out to do in a way that feels genuine to me.

Finally, I return to my signature strength of perspective/wisdom. I always enjoy sharing what I know with others, and helping them potentially gain insight, which happily propelled me to continue writing and to finish this article. I close by encouraging you to discover your own signature strengths and align your life with their expression. Become aware of your weaknesses, too, if only to learn forgiveness and a better understanding of where you may be challenged. By using your strengths creatively and consistently, you will create for yourself what positive psychologists call “the good life,” and be happier for doing so.

Losing a family member is one of the hardest things a person can experience. Many families pull apart and suffer extreme emotional distress after the loss of a child or parent. This is especially true if the loss is sudden and from an accident or suicide. But even anticipated deaths, like those resulting from terminal illnesses such as cancer, can cause immense emotional pain that some people cannot easily overcome.

Although research in this area is extensive, another type of loss that can have similarly negative effects has not been examined nearly enough. When a person loses a sibling, the results can be equally as devastating, and in fact, some believe even more difficult than losing a parent or other family member. Siblings often represent the longest friendship and closest relationship many people have had.

When a sibling dies, the effect can be traumatic and even life-threatening if the death is sudden. People can become easily depressed when they are overwhelmed with grief. These emotions, if not reconciled, can put someone at risk for suicide.

Mikael Rostila of the Centre for Health Equity Studies at Stockholm Univesity in Sweden wanted to see if sibling death resulted in increased suicide in surviving siblings. To assess this, Rostila looked at population data between 1981 and 2002 on over 1.7 million Swedish adults between the ages of 25 and 64.

The analysis revealed that women who lost a sibling were 1.5 times more likely to commit suicide in the two decades following the death than those who did not experience the loss of a sibling. Men were 1.28 times more likely to commit suicide. And if the sibling death was the result of a suicide, the rate increased to 3.19 times for women and 2.44 times more risk for men.

Other types of deaths, such as cancer, resulted in much lower suicide rates in surviving siblings and there were relatively no differences by gender for these suicides. Additionally, Rostila did not find any association risk for suicide based on length of time since the sibling death. This research provides new and much needed insight into the effects of a sibling death on surviving siblings. Rostila added, “The mechanisms linking the death of a sibling and completed suicide among the bereaved person need to be further investigated.”

Reference:
Rostila, M., Saarela, J., Kawachi, I. (2013). Suicide following the death of a sibling: A nationwide follow-up study from Sweden. BMJ Open 2013;3:e002618. doi:10.1136/bmjopen-2013-002618

mother-daughter-blowing-bubbles-0621136Play therapy has become a very important element of my work with families and children. In this article, I hope to give you parents some idea of how powerful play can be as an intervention as well as some ideas of how to utilize play with your own children.

Play Therapy at Work

It is Father’s Day as I write this article and I am reminded of one particular case where play therapy had a profound impact on a family. This family had a child with severe autism. They were unable to manage him at home and he was living at the residential treatment facility where I worked. The child in question was very routine-oriented, and he had an extremely restricted range of activities in which he would engage. If he wasn’t repeatedly watching small snippets of Disney videos, he wasn’t happy.

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To make matters worse, if he wasn’t happy, he tended to throw tantrums, or hit and bite those around him. As a result of these behaviors, not only could he not live at home, but the family was challenged to even have him home for short visits. They had to put the entire house on lockdown to prevent their son from wandering away, and at least one of them had to take time off of work to stay up all night to supervise their son.

When this child came onto my caseload, another therapist and I decided we wanted to work with the family to improve the quality of their interactions with their son and make their time together less stressful and challenging. We decided to use a therapy called Theraplay to accomplish this. We did several sessions with the child in which we exposed him to various new activities. We made note of what he liked, what he disliked, and what he just didn’t seem to get (but didn’t hate).

We expected to see a lot of behaviors due to the change in routine, but that wasn’t the case. We quickly found that there were a number of activities that the child seemed to enjoy. Furthermore, we found that a number of activities that he didn’t understand at first he learned and started to enjoy in subsequent sessions. Pretty soon, we had a list of about 20-or-so activities that required minimal material (about $20 of stuff from the dollar store) that he enjoyed. We could easily keep the child happily engaged for over 30 minutes at a time.

We then started doing sessions with the family at their house. First, they watched as we played with their son. Then we started showing them how to do the games. During the course of this session, we were demonstrating a modified version of catch. The child tended to want to catch the ball when thrown to him, but would then walk over and hand the ball back to us instead of throwing it. We learned that playing catch over a table got the child to actually throw the ball back.

As we were demonstrating this, he started throwing the ball to his dad and playing catch with him. Dad immediately started tearing up. He said, “This is the first time I’ve ever had a catch with my child.” There was not a dry eye in the room after that. What father doesn’t want to have a catch with his son? Imagine having to wait 17 years to make that happen. It was an unexpected, but awesome outcome of our therapy.

The Importance of Play in Development

Play is one of the fundamental ways in which children learn. Through play, they learn to how to connect or form secure attachments to others. The quality of the relationships children have growing up will impact the quality of the relationships they form as adults. So it stands to reason that good, quality play as a child can lead to quality relationships in adulthood.

Through play, children learn how to self-regulate. We get excited as we play games with each other, but then we learn how to self-calm and soothe to continue to excel at the games we play. We learn when it is appropriate to get excited and when we need to calm. In fact, I find that using play with children who have problems with regulation is a fantastic way to teach them impulse control and self-control.

Finally, through play, we learn how to socialize. We learn such things as taking turns, cooperation, and competition. We learn about rules and creativity. Through play we develop the basic skills that allow us to navigate the challenges that life presents us. Kids who don’t play are often at a great social disadvantage compared to kids who play.

Guidelines for Play

Ok, so play is important. However, the best play has some structure. To maximize the impact of play on your child’s behaviors, here are some basic guidelines to follow.

  1. Play with your child. When engaging in play, do things that involve interaction between you and your child. It’s not enough to simply be in the room (what I call proctoring). It’s great to sit with children as they do a puzzle, but it’s better to do the puzzle with them. You want to promote that social-emotional connection with you. You want to make yourself a source of never ending reinforcement in your child’s eyes. So, do activities that promote things like touch and eye contact (something the typical child with autism might be struggling with and need practice to do or tolerate). Make the time your child spends with you silly and fun; watch how your child positively responds to you in other situations.
  2. Keep it simple and developmentally appropriate. Make sure the activities you do with your child are geared towards their mental and emotional age. In the example at the beginning of the article, even though the child was 17, he enjoyed things like holding hands, rocking, and singing “Row Your Boat.” He enjoyed the sensory nature of the rocking, as well as the familiarity of the song. Other teenagers might enjoy singing and dancing with you to music they like. Again, focus on enhancing the connection between yourself and the child.
  3. It’s ok to be silly (in fact, it’s recommended)! The games I play with my kids (at home and at work) aren’t complicated. In fact, on the face of it they are pretty silly. I find that even with more resistant, morose children, silliness draws them in. There’s something about being silly with someone else that just brings down defenses. Besides, taking time to relax, laugh, and be a little silly is FUN! It’s a marvelous way to spend some time.
  4. Inexpensive is better! It’s very easy to spend a lot of money on toys. Heck, expensive toys can be great (I adore my Xbox). but for the types of interaction I’m thinking about, expensive toys are unnecessary. Blowing a feather back and forth, blowing bubbles, playing clapping games, or playing “red light, green light” require very little in the way of materials. Be creative and see what kinds of things are sitting around your house and look to those for inspiration. Have you ever seen a young child at Christmas? They open up all their expensive presents and spend most of the time playing with wrapping paper and boxes. Tap into that instinct with your child and you will be well on your way to successful play.

Ways to Use Play Therapeutically

Here are some more ideas on how to structure play sessions with your child to get specific results.

Planned sessions to increase engagement: While my usual play style is typically to improvise with whatever is at hand and make things up as I go along, I find that planning out sessions can be helpful when trying to engage with a child. I simply make a list of 5 to 10 activities that I want to do before I do the session and try to at least get through those. I make note of what activities seemed to get the child to respond positively to me so I can use them again later. If I don’t do this, I tend to more easily get shut down by the child if he/she doesn’t immediately engage with me. I focus on activities that promote touch, eye contact, and positive sensory experiences. Good examples are singing/clapping games, blowing up a balloon while the child holds the balloon, and blowing a feather back and forth between your hands and the child’s hands.

Repeated sessions to increase skills: If I am trying to help a child acquire or improve a skill, then I want to focus on repeating activities between sessions instead of changing things up frequently. Repeated exposure is good for skill acquisition. For example, I often use play to teach deep breathing through things like blowing bubbles, singing, and a game called “monkey ride” (in which I put a stuffed monkey on the child’s belly and then have him take a deep breath in and give the monkey a “ride” up to my hand which I place a couple of inches about the monkey’s head). I will repeat these games and variations of them through several sessions until the child has mastered belly breathing.

Short sessions for planned breaks from difficult tasks (The head cooler): When a child gets upset, frustrated, or anxious during specific situations, play can be a great way to manage this. For instance, a lot of my kids have problems around homework. They get upset if there’s too much, or if they don’t understand it. Some can’t make themselves take a break before the homework is complete. These children then get so upset they couldn’t do the work even if they wanted to. The poor parents are stuck not only trying to calm an upset child, but also facing daunting task of getting the child to return to finish the dreaded homework. Hours of this every night can be a major stressor for the whole family.

To counteract this, I suggest trying many short spurts. The parent works with the child to do homework, but also watches the child for the initial signs of agitation, frustration, or upset. As soon as the parent or child notices those signs, they take a short break. During the break, they spend just a few minutes doing something fun and silly (no video games or other major distractions). The goal of the activities is to allow the child’s head to “cool off.” Once calm, the child returns to the homework with a clear head. Families that have been successful in doing this find that not only are there fewer fights and tantrums around homework, but that more homework is getting done in less time.

The bottom line is that play is important. The more challenges you face with your child, the more important it is to put time aside every day to have some positive interactions. Be silly and have fun. Please share in the comments section your ideas for play or any questions you might have. In the meantime, play more with your kids and remember to BREATHE. You’ve got this!

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.