Symptomatology

Reflection--Photographer unknown

He over-eats because he’s nervous.

She over-sleeps because she’s sad.

He hits because he doesn’t know another way to show he doesn’t understand.

Her stomach hurts when there’s a test

His when a certain uncle comes.

She ‘checks out’ when her parents fight

or students raise a hand.

He cries with every little scratch.

She’s stoic with a shattered arm.

Their eyes glaze over at the sight of checkered shirts

Or painted nails

A hairdo

A certain aftershave

Or lip balm.

He can’t sit still.

She won’t stop day dreaming.

He mopes. She cries. He pouts. She flies

Off the handle

If someone meets her eyes.

He wets the bed.

She carves red lines into her thigh.

He fights because he’s scared.

She spits because she’s feeling trapped

and

flirts because it is the only way she knows

to interact.

They’re judged

For all

Of the above

When in fact

Their behaviors speak a loud broadcast

Of unabated stress

And lives

That turned

Hard

To survive.

 

 

 

For The Daily Post

Controversy: Friend or Foe?

heart-stone

In the current climate of contention, many seem to see controversy as indication of animosity or ‘wrongness’ rather than an entry point to discussion.

What is that turns a difference of opinion or even heated disputes into declarations of allegiance or betrayal?

How does dissent become a call for combative rhetoric, rather than an invitation for conversation and possibly a point of understanding where one might’ve been wrong, been wronged, been blind, been blinded, yet can still find growth?

Why do so many find arguments a threat and varied views a sign of weakness or enmity?

Where have we gone so wrong, so long, that we forgot what we should already know?

In the give and take of conversation, even very young children learn that not all share their point of view, and that they cannot always get their way (not should they). They hopefully learn how to persuade as well as how to accept that not all persuasion means they’ll get their heart’s desire … That they aren’t wrong to have wishes even if those did not manifest, and that to not get their way doesn’t make them weak or ‘losers’, nor does it make the other ‘stronger’ or a ‘winner.’

Living as part of a healthy society requires we accept differences and listen to more than just the echoes of our personal view chambers – be it in the small groupings of family, classroom, playground, and work environment; or in the bigger congregations of towns and cities, countries and religions and cultures and the whole blue marble we’re all traveling on.

How much do we lose if we refuse to engage with anyone who sees a different perspective; if we attack any who disagree with words that are meant to silence, put down, dismiss, disown, distract?

How much do we limit our humanity – and our children’s, for they are watching – if we divide the world into ‘us’ and ‘them’; into those in the ‘right’ and those in the ‘wrong’ (and any who do not share our views we place automatically into the latter …). If we split the world into those who are ‘with us’ and therefore somehow morally superior, and those who ‘must be against us’ if they challenge things to not be exactly as we see then?

Controversy is the soil of growth. It can be made good use of, or it can be muddied into insult-slinging till it buries up real issues under heaps of refusal and refuse. Dissent can offer new space and pathways, or it can become no-mans-lands where any who dare venture risk a wounding and the blame for encroaching their view point onto another’s walled-off boundary.

I listen to children negotiating play: who will be whom, what the rules would be, how best to proceed, who gets to ‘be whom’ for how long, how far to push the limits of roles and imagination and possibility … And I think to myself: It is from the mouths of babes we should re-learn how to engage. How to take turns listening. How to accept that we do not hold absolute truth about almost anything, and that our views do not give us the right to hurt, to harm, to wound, to bully.

Much power is already cemented into viewpoints. An ossification of attitudes as proof for battles ‘won’ or ‘lost’ in pseudo-righteousness tips the balance of discussion so it loses any common ground and becomes blind to shared humanity and understanding. It is past time we all re-learn, remember, and take on added practice … for how to keep open hearts to and amidst controversy.

negotiation--prepare2play

Photo by: prepare2play

 

For The Daily Post

For The Record

dressup

 

For the record, she is fierce, even if she is in fluffy skirts and fleecy socks and every color of barrette holding on to dear life in her hair.

For the record, she is loving, even if she screams at her baby brother, narrows her eyes to daggers when she doesn’t get her way, and pushes every one of her mother’s buttons till something gives and tantrums fly.

For the record, she is smart, even if she cannot quite “do numbers” the way some of her classmates can and even if her words tend to come out upside down and sideways and in the wrong order and all too often not quite on the topic.

For the record, she has lots to say, even if she shrugs an “I don’t know” or grunts a precocious “whatever” because explaining feels too hard and some words hide and narrative does not form the way she senses that it ought to.

For the record, she is funny, even if she may not laugh at some jokes other people say, because she doesn’t get the puns and is still out to lunch on idioms and doesn’t quite see humor in confusing riddles.

For the record, she is thoughtful, even if she often acts before she seems to think (because she cannot always get the thought in time to matter), and reacts as if she doesn’t care (when she if fact cares more than many).

For the record, she is brave, and utterly indomitable. She works harder than most realize and deals with more frustration than is reasonable. And yet, she does still try. She may do so in frowns and pouts and at times even in ways that appear less than fully loveable. But she has no bone in her that isn’t kind. Just all too many that are over-tender.

For the record, she is a handful and a heart-full. She is bubbling with spirit and wriggling with life. She’d keep you on your toes, but oh boy would you earn a good dance for it! For a little body, she packs some serious soul punch.  She is fabulous personified. A guaranteed-to-wake-you-up-in-the-morning child.

 

 

For The Daily Post

Her Whole Life in a Plastic Bag

three-clock-bears

Photo: threeoclockbears.com

 

Tamina attended first-grade in a Harlem public school. She was homeless most of that year. Her mother lost the apartment after she lost her job. Sometimes they stayed with relatives but mostly Tamina, her mother and her sister slept in shelters where they could never stay very long. They carried their belongings in thick black garbage bags, protection from the weather. Tamina used to have a teddy bear, but it got left in a shelter and her mother was ‘too tired’ to go back for it. Tamina never got it back.

Tamina had very little. Other children had a home, their own bed, place for their stuff, more stuff. So she stole. Mostly small things: erasers, crayons, hair-pins. Things she could hide in her pockets and later in her black garbage bag. If confronted, Tamina would furiously demand it “was always hers.” I suspected she often believed it and wondered if some items resembled things she once had and owning them was a link to a time when life was less overwhelming. Beyond an overall language delay, Tamina seemed confused about concepts like the difference between possessing and owning: in some shelters cots were ‘first-come-first-serve’ and while you had it, it was ‘yours’ even if it did not remain so for long. You had to ‘watch’ your stuff or have it disappear. Why could an unattended eraser not be ‘hers’?

 While children often crave things that are not theirs, Tamina’s stealing was possibly about unmet needs. Her mother was “always mad and cussing” and Tamina could not rely on her for support. Children whose ‘hungers’ are neglected seek other ways: become secretive, dissociate, numb themselves with substances, steal, hoard. These behaviors often further distance them from care and social support, when they in fact communicate confusion, loneliness, anger, loss, and shame.

[The above is an excerpt from “Communicating Trauma” Routledge, 2015]

Communicating Trauma-Yehuda

Homelessness does not necessarily mean neglect, but the realities and causes of homelessness pose many risks, especially to children. In addition to loss and grief, there are increased health and safety risks, along with reduced access to care. Children without homes suffer insecurity, and their caregivers may be too overwhelmed to attend to their emotional needs. Depression, posttraumatic stress, illness, disability, poverty, domestic violence and other life-crises are all too common among parents of homeless children. Any one of these factors can overwhelm a parent and reduce their availability, let alone when such factors combine.

Having no place to call home–in all the forms it takes–can be distressing and occupying. It leaves children anxious and unavailable for learning. Homeless children are often wary and worried, angry or withdrawn. They are three times as likely to require special-education, four times as likely to drop out of school, and almost nine times as likely to repeat grades.

Homelessness devastates. It is crucial we work together to understand it and resolve it as well as support families in crisis and address risk factors before they reach a loss of home, hearth, and heart.

 

 

“I tried and I tried”

Everything is harder for this little one.

Her body doesn’t quite know how to calm itself. Her hands don’t always know the extent of their reach. She trips. She falls. She bumps into. She upsets the cup, the plate, the markers on the desk. It takes her longer to climb up a flight of stairs. She needs help tackling them going down. Her mouth doesn’t quite make sounds as easily as others’ can: words come out jumbled, not always the right sounds or meaning, often in a mismatched grammar and word order. Food gets messy. Swallowing’s tricky. She gags. She coughs.

But she tries.

Oh, boy, she tries.

And tries.

And tries.

She’s a perfectionist, too.

Indomitable.

Determination personified.

Everything requires repetition. Still she tries again. Again. Again. She shakes her head at any suggestion she accept the unperfected.

“I do more time,” she insists, sometimes in tears but with no less conviction.

And she does. ‘More time’ and time again and then again and then some.

And slowly, sometimes out of the mist of helpless frustration and gritted teeth and hugs and endless patience — she succeeds.

A circle that closes. A list of items in a category. An idea expressed. A multisyllabic word with no sounds missing. A full sentence with all words in attendance. A coat pulled on without assistance. A triangle traced. A tower of blocks. A pattern of beads. A banana that peels without the insides getting mashed. A sip of apple juice from an unaided cup, no spill, no cough.

“I tried and I tried,” she beams. Each time anew. Sometimes with tears still glistening from the last attempt that didn’t quite get up to her own standards. Each time there’s fire in her eyes.

“I told you I can!”

Indeed you had.

Indeed you can.

Hats off, little one.

Every. Single. Time.

drseuss-determination

 

For The Daily Post

 

Tom’s Secret

The animation video below was chosen to lead the European Day on the Protection of Children against Sexual Exploitation and Sexual Abuse which is held on November 18.

The five-minute video had been originally launched in Hebrew, and was since translated to Russian, English, and French. It guides parents, teachers, and other caregivers in ways to identify and react to cases of sexual assault and abuse in children. It has been incorporated into learning programs in Europe, Asia, and the United States.

The clip portrays with sensitivity and clarity the reactions children often have to sexual abuse: dissociation, denial, secrecy, fear, worry, shame, and more. It also shows the behaviors children might display and which should be treated as red flags: reluctance to do things or go places they might’ve enjoyed before, irritability, sadness, refusal, lack of appetite, bed-wetting, physical complaints, etc. While these may not be specific to sexual abuse, they are often representation of distress, and need attending to.

It is a fact that most children who endure sexual abuse don’t tell. At least not directly.

It is also a fact that many parents/teachers/caregivers don’t know when to ask or how to ask or what to do or say if they find out something did take place. They may not understand how a child can seem okay, even when they are internally not okay. Even those who want to help, may not know how to go about it.

This video offers a good start.

Watch it. Share it widely.

 

 

For the Hebrew version, and more information (in Hebrew) about sexual abuse of children, and ways to identify and respond to red-flags, click on the link to an article below:

http://www.ynet.co.il/articles/0,7340,L-4880054,00.html

 

New Beginning: Habit & Opportunity

opportunity

“He still won’t read.”

The mother’s voice held disappointment and frustration. Her son struggles in school and was required by teachers to read every day over the summer, but hadn’t.

“I did read!” he protested, pouted. Hurt. “I read two whole books!”

“Only because we made you read!” She retorted and turned to me. “Every day is a new excuse. He’s too tired, the book is boring, it’s too hard, he’ll read later, he hates reading, it is stupid … He’ll do anything to avoid it.”

He stomped to the chair. Sat dejectedly. I patted his arm. “I’m glad you read two whole books,” I said. “Which ones?”

He brightened. Threw a “you see?!” look at his mom, and told me. We discussed what he liked about the stories, what he didn’t. What was hard, what wasn’t. We then went over a list of possible titles to follow.

I scheduled a time to speak with the mom. Her frustrations need venting, and she needs solutions, but we can talk about her disappointment without him needing to be present.

♦♦♦

Every child is different but the complaint is not unique. Children and parents rarely battle over things that are fun and easy. It is the stuff that’s hard, confusing, boring, tedious, or appears to be of import to one side but feels less so to the other … where lines get drawn in the sand and stubborn frustration ensues.

Parents cajole. They threaten. They withhold privileges. They might use shame as ‘motivator’ by characterizing the child as lazy or ungrateful, oppositional, immature …

Not surprisingly, these tactics rarely work to ‘motivate’ learning. Nor do they solve whatever problem underlies a child’s reluctance to read: difficulty decoding, difficulty comprehending, delays in language and learning, issues with processing and retrieval, attention issues, stress and overwhelm …

A new school year is seen as opportunity for new ways of learning, new progress, new habits. Parents expect their children to enter school with gusto after a summer’s break and to give it their all. They often expect improvement of whatever issues may have been present the year prior. They verbally and otherwise communicate their expectation that the child prove himself or herself as mature and hardworking, and overcome whatever habits held them back.

A new grade and new beginning indeed offers much new opportunity for doing things differently. However, for that to happen we cannot fall back on failed methods or less-than-helpful habits. If children knew to do better on their own, they would do so already. No child wants to fail. No child enjoys the negative attention of reproach if they can get the positive attention of pride and praise.

♦♦♦

“So what am I supposed to do?” the mother asked when we met. Exasperated.

“You did the best you could last year, and this year we’ll have to work together to do better,” I replied.

She was taken aback. She didn’t expect me to include her in the assessment of last year’s difficulties …

I did not mean blame, but I did mean accountability. Parents often do the best they know, but they are often overextended themselves, and some don’t quite follow through. They may want to follow suggestions but only do so sporadically, or expect the child to take full responsibility for remembering new tasks that they themselves forget … then feel pressed to blame or require … They may get discouraged at the first sign of difficulty (not unlike the child, maybe …) and not continue to work toward new habits when the implementation hits a bump or scheduling needs to be adjusted. They may balk at taking on more responsibility in a life that may already feel too stressful (again, not unlike the child…).

Parents deserve guidance. Shame does not work any better on adults than it does on children … Parents can use encouragement, not blame. Many can benefit from reminders and a pathway to setting new habits. It is not a weakness or poor parenting to make errors or get frustrated or not follow through. People aren’t perfect. We all need help in some areas.

♦♦♦

For this boy, now in mid-grades, and often argumentative and quite fed up with “everything being too difficult”–new habits will (hopefully) include less fighting and more working together, less demand and more playfulness, less critic and more problem solving, less rigidity and more predictability, less shaming and more understanding.

Practically speaking?

  • Setting a weekly schedule where one of the parents reads TO him every night or almost every night (on the benefits of reading check: How early? For how long? ).
  • Separating the child’s own reading for decoding and school, from the parents reading TO him for literary exposure and pleasure.
  • Taking care to not make a parent’s reading time an opportunity for ‘testing’ vocabulary or memory about the story (talking about the story is fabulous, quizzing is not).
  • For books mandatory for school (but too difficult for the child’s reading level), using audio books as accompaniment to printed/electronic book. This helps the child follow the written word and assist him with decoding and comprehension.
  • Placing reminders for reading-time and having a timer he can set to ensure he is reading long enough and can do this independently.
  • Scheduling daily reading (for school and book logs) at a time that is realistic, rather than opportunistic.
  • Providing assistance with homework and/or test preparation, so that the child is not left to manage what is too difficult on his own, and ends up too stressed and exhausted to optimally process information.
  • Incorporating narrative into the day to day and offering modeling of narrative instead of requiring the child to constantly answer questions.
  • Offering a model for making time for reading. Adults who read are more likely to have children who enjoy reading.
  • Setting the child up for success, not failure: rather than focusing on a day he didn’t read or what he isn’t doing well yet, offer praise when he does do his reading without arguing; remind the child what worked before and what he can try to do again; offer solutions, not reprimand.

♦♦♦

In this new school year, what old and less than desirable habits can your child replace with brand new opportunity?

What steps can you take to help?

If you need help to formulate a plan–it is okay to ask for it. That, too, is an opportunity.

reading-extinction-buzzfeed

from Buzzfeed.com

 

 

Stressful Situations Simulation: A resource

Below is a good resource and simulation of stressful situations that can be immensely helpful to parents and caregivers. I especially recommend the ones involving “Family Support”: “Calm Parents, Healthy Kids” and “Building Family Bonds.” These scenario simulations inform, teach, and actively guide parents and caregivers through various scenarios of interactions with toddlers in commonly challenging situations.

The resource can be invaluable information for parents and caregivers who are inexperienced and/or may have had less than good enough parenting themselves, and who may not know how to facilitate clear, supportive interaction with their own children, especially under stress. The simulation is presented in a non-shaming, educational way, and provides the participant with an active role in choosing different ways of responding … and being able to see the possible reactions to them … It also allows the participant to ‘re-do’ situations so they can experience how better choices can bring better results …

Practicing is important for any skill, let alone for skills one needs to apply in stressful situations. The very way our brain processes information is affected when we’re stressed, so it helps to already know what to do beforehand. Also, our own stress and how we manage it gets communicated and passed onto children in our care. This makes it doubly important to learn and practice (and then be able to model) new skills when one is calm and in neutral situations–as this simulation allows one to do.

Calm, informed caregivers help raise calm, healthy, competent kids. This can help!

I highly recommend you take a look and see:

https://conversationsforhealth.org/#conversations

bubble happy

 

Communication and Collaboration

Upcoming Webinar!

Communication and Collaboration: Multidisciplinary treatment of traumatized/dissociative children

Friday, May 20, 2016
2:00 PM – 3:30 PM Eastern Time

Registration now open! (please see disclaimer in bottom of post)

spacornerJuly12no5

Photo Credit: A.A.

Abstract
Treatment of traumatized and dissociative children is most often discussed in the context of psychotherapy. However, traumatized and/or dissociated children often come into contact with additional professionals. Like all youngsters, traumatized children need to manage everyday interactions with caregivers, educators, and routine childhood medical and dental care. Yet many also face clinical interactions with speech-language pathologists, occupational therapists, physical therapists, medical professionals, and more. This is because trauma places children at a high risk for developmental issues, and because children who already have developmental and/or health issues are highly vulnerable to trauma. In addition to clinical care, many traumatized children encounter legal personnel, forensic evaluators, child protective services, foster care staff, etc.

Posttraumatic and dissociative reactions are not limited to the therapist’s office. Just as communication issues aren’t segregated to speech-language pathologist’s office, asthma to the doctor’s, or sensory integration issues to occupational therapy. Various issues can complicate children’s presentation and behavior, and traumatized youngsters are often judged as difficult, aggressive, manipulative, immature, unpredictable, and inattentive. This can result in painful consequences (e.g. loss of placement, shaming, treatment failure), which further increase stress and reinforce the need for dissociative coping. In addition, caregivers routinely face challenges that can affect course of treatment, and professionals do not always ‘speak the same language’ when it comes to describing, assessing, and treating the child (and/or family). Even when professionals are trauma-aware, coordinated care is not always easy to achieve … and yet is essential for effective stabilization, minimizing compartmentalization, and carryover.

This webinar will look into the often complex realities of caring for traumatized/dissociative children and adolescents, the tapestries of clinical encounters many face, and how these may shift throughout infancy, childhood, and teen years. The challenges (and potential) of coordinated care and communication will be discussed, as would logistical and ethical limitations and suggestions for managing them. Clinical vignettes will serve as a window into ways for improving communication among child/family professionals, and will provide examples for practical solutions for increasing regulation and decreasing posttraumatic activation in all involved. The role of caregivers and the child as part of the team will also be examined.

Objectives
Upon completion of this webinar, participants will be able to:

  • Identify the connection between trauma and care utilization in children and adolescents.
  • Describe three challenges to coordinated care
  • List five strategies therapists can apply to improve communication and coordination in the multi-disciplinary treatment of traumatized/dissociative children

For more information and to register

Disclaimer: I volunteer my time and expertise for this webinar, and do not receive any financial gain from it. Registration fees are collected by ISSTD, which hosts the webinar, is responsible for all fees and/or refunds, and provides an option for CEs for attendance.