Loving a Trauma Survivor: Understanding Childhood Trauma’s Impact On Relationships

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Survivors of childhood trauma deserve all the peace and security that a loving relationship can provide. But a history of abuse or neglect can make trusting another person feel terrifying. Trying to form an intimate relationship may lead to frightening missteps and confusion.

How can we better understand the impact of trauma, and help survivors find the love, friendship and support they and their partner deserve?

How People Cope With Unresolved Trauma

Whether the trauma was physical, sexual, or emotional, the impact can show up in a host of relationship issues. Survivors often believe deep down that no one can really be trusted, that intimacy is dangerous, and for them, a real loving attachment is an impossible dream. Many tell themselves they are flawed, not good enough and unworthy of love. Thoughts like these can wreak havoc in relationships throughout life.

When early childhood relationships are sources of overwhelming fear, or when absent, insecure or disorganized attachment leaves a person feeling helpless and alone, the mind needs some way to cope. A child may latch onto thoughts like

  • Don’t trust, it’s not safe!
  • Don’t reach out, don’t be a burden to anyone!
  • Don’t dwell on how you feel, just move along!

These ideas may help a person cope when they hurt so badly every day and just need to survive. But they do not help the emerging adult make sense of their inner world or learn how to grow and relate to others. Even if the survivor finds a safe, loving partner later in life, the self-limiting scripts stay with them. They cannot just easily toss them and start over. These life lessons are all they have (so far) to survive the best way they know how.

Noticing Trauma’s Impact On Behavior and Mood

Many times, trauma survivors re-live childhood experiences with an unresponsive or abusive partner (an important topic for another article). This often happens without the ability to see the reasons why they feel compelled to pursue unhealthy relationships. Beneath awareness is a drive to revisit unresolved trauma, and finally make things right. Of course, childhood wounds cannot be repaired this way unless there are two willing partners working on changing those cycles. But if these forces remain unnoticed, survivors can get caught in a cycle of abuse.

Even with a safe partner, a trauma survivor may

  • Experience depression
  • Develop compulsive behavior, an eating disorder, or substance dependence to try and regulate their emotions
  • Have flashbacks or panic attacks
  • Feel persistent self-doubt
  • Have suicidal thoughts
  • Seek or carry out the adverse behavior they experienced as a child

Get a printable Flashback Halting Guide with 10 Ways to Help Manage Flashbacks:

Partners of trauma survivors may want desperately to help. But partners need to “be clear that it is not your problem to fix and you don’t have the power to change another human being,” says Lisa Ferentz, LCSW in a post for partners of trauma survivors. Rather, know that both of you deserve to connect with resources to help you find comfort and healing.

Seeing Trauma’s Impact On Relationships

It is important to recognize unhealed trauma as a dynamic force in an intimate relationship. It can super-charge emotions, escalate issues, and make it seem impossible to communicate effectively. Issues become complicated by:

  • Heightened reactions to common relationship issues
  • Emotionally fueled disagreements
  • Withdrawal or distant, unresponsive behavior
  • Aversion to conflict and inability to talk through issues
  • Assumptions that the partner is against them when it is not the case
  • Lingering doubt about a partner’s love and faithfulness
  • Difficulty accepting love, despite repeated reassurance

In a relationship, a history of trauma is not simply one person’s problem to solve. Anything that affects one partner impacts the other and the relationship. With guidance from therapy, partners begin to see how to untangle the issues.

Many people do not even realize that they have had traumatic experiences. Trauma-informed therapy works by helping couples begin to see how they experienced traumatic abuse or neglect, and how it still affects them, and impacts their current relationships. This approach enables the therapist to provide specific insights to help couples separate past issues from present ones. Progress often comes more readily through a combination of individual sessions and work as a couple.

Trauma-informed therapy helps partners give each other the gift of what I and other therapists call psychoeducation – learning to understand each individual’s story, how it impacts their relationship, and how to process thoughts and emotions in healthier ways.

The Importance of Self-Care For Trauma Survivors and Their Partners

Trauma survivors and their partners have different needs for support. How can one respond when the other is grappling with mental health issues? How do you calm things down when overwhelming emotions get triggered?

It takes therapy for couples to find answers that are most healing for them. But some general tips for trauma survivors and their partners that can help are:

  • Have a really good support system for each of you and the relationship. Make time for family and friends who are positive about your relationship and respect you and your loved one.
  • Find a trauma-informed therapist to guide you as a couple or as individuals in your effort to better understand yourselves and each other.
  • Find resources outside of therapy such as support groups or other similar activities
  • Take time for psychoeducation. Learn about the nature of trauma, self-care and healing techniques like mindfulness. For example, one helpful model is Stan Taktin’s “couple bubble.” This is a visual aid to help partners see how to become a more secure, well-functioning couple. Surrounding yourself and your partner with an imaginary bubble “means that the couple is aware in public and in private they protect each other at all times. They don’t allow either of them to be the third wheel for very long, at least not without repair. In this way, everybody actually fares much better.” See More Helpful Resources below.

Communication Tips for Partners of Trauma Survivors

Building a healthy bond with a trauma survivor means working a lot on communication. Grappling with relationship issues can heighten fear and may trigger flashbacks for someone with a history of trauma.

Learning how to manage communication helps couples restore calm and provide comfort as their understanding of trauma grows. For example, couples can:

  • Use self-observation to recognize when to slow down or step back as feelings escalate
  • Practice mindfulness to raise awareness and recognize triggers for each of you
  • Develop some phrases to help you stay grounded in the present and re-direct your dialog, such as:
    • “I wonder if we can slow this down.
    • “It seems like we’re getting triggered. Can we figure out what’s going on with us?”
    • “I wonder if we are heading into old territory.”
    • “I’m thinking this could be something we should talk about in therapy.”
    • “I wonder if we could try and stay grounded in what is going on for us – is that possible?”

Communication can also help a partner comfort a loved one during a flashback. Techniques include:

  • Reminding the person that he or she is safe.
  • Calling attention to the here and now (referencing the present date, location and other immediate sights and sounds).
  • Offering a glass of water, which can help stop a flashback surprisingly well. (It activates the salivary glands, which in turn stimulates the behavior-regulating prefrontal cortex.)

Healing childhood wounds takes careful, hard work. But it is possible to replace old rules bit by bit. Finding a therapist who can recognize and acknowledge the hurt, which the survivor has carried alone for so long, is key to repairing deep wounds.

Partners may decide to work individually with their own trauma-informed therapist, while working with another as a couple, to provide the resources they need. When a survivor of early trauma can finally find comforting connection with a therapist, and then with their partner, the relationship between the couple can begin to support deep healing as well.

The more we understand about the impact of trauma, the more we can help those touched by it to go beyond surviving, and find the healing security of healthier loving relationships.

More Helpful Resources

Articles and Websites

Helping a Partner Who Engages in Self-Destructive Behaviors” by Lisa Ferentz, LCSW

Trauma-Informed Care; Understanding the Many Challenges of Toxic Stress” by Robyn Brickel, M.A., LMFT

Sidran Institute (resources for traumatic stress education and advocacy)

Books

Wired for Love: How Understanding Your Partner’s Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship by Stan Tatkin, PsyD, MFT

Allies in Healing: When the Person You Love Was Sexually Abused As a Child by Laura Davis

Trust After Trauma: A Guide to Relationships for Survivors and Those Who Love Them by Aphrodite Matsakis

Mindsight: The New Science of Personal Transformation by Daniel Siegel

 

How to Teach a Child About Being Grateful

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Recently I received a question on Twitter: “Do you have any suggestions for teaching a preschooler appreciation for [a] gift given to him, even if he doesn’t like it?”

When a child says “please” and “thank you” during the early years (18 months to age 3), it’s pretty much a rote expression, automatic and mechanical. If you think about it, you probably had to prompt your child by saying, “What do you say?” so he would remember to express thanks. At that age, most young children don’t fully understand the social graces behind saying “please” and “thank you”; they just know they’re supposed to say them.

At around ages 4 to 6, when a child begins going through the developmental phases that ignite independence and assertiveness, is when refusing to say “thank you” can rear its head. Not saying “thank you” isn’t really about misbehaving, it’s more about the fact that the child doesn’t have a fully formed habit of saying “thank you” when he receives something he doesn’t like. They’re not old enough to understand all the complexities of using social graces. They need to be taught, without punishment, so they can learn.

Proactive Ways to Teach Appreciation

Teaching a child to be grateful, like most things in parenting, is not a one-shot deal; it’s an ongoing process. Most parents are embarrassed when their child doesn’t say “thank you,” and rightfully so. However, if all you do is correct and punish after your child hasn’t said “thank you,” then the teaching moment easily can become a power struggle, not a lesson.

  1. Model, model, and model some more. Let your kids hear you say “thank you” a lot. When you’re given a gift or someone does something nice for you, say “thank you.” Say “thank you” to the cashier or the dry cleaner. Let your child know that when normal things happen, you express gratitude.
  2. Point out details. Make a habit of pointing out the little details you like about things. Share what you like in the pictures they draw, and compliment how nicely they’re eating, how quickly they got dressed, and how they stopped what they were doing so they could listen to you. This not only builds rock-solid self-esteem, but it also helps a child understand how to pick out one detail he does like from a gift he didn’t like so he can genuinely say “thank you.” After all, no parent wants to hear, “Saying ‘thank you’ for something I hate is lying!”
  3. Donate. We had a rule in our house: about a week before each birthday or holiday, the kids had to survey their toys and clothes and pick out a few things to donate to those who were less fortunate. To avoid possible last-minute hesitation about giving something away that was theirs, the kids were in charge of packing up the stuff and I was in charge of delivery. We also made sure to praise them for their generosity so they could see how the whole process worked.
  4. Practice makes perfect. This is especially true when it comes to teaching appreciation. Give your child opportunities to do nice things for others in the family. This teaches him about learning to extend kindness and about receiving appreciation in return.

If your goal is to release a respectful, well-mannered child into the world, then please know that refusing to say “please” and “thank you” does come up over and over again as they age. If you’re embarrassed, try saying, “Please excuse her, we’re working on social graces, again.”

The views expressed in this article are those of the author and do not necessarily represent the views of, and should not be attributed to, POPSUGAR.

 

https://www.popsugar.com/moms/How-Teach-Child-About-Being-Grateful-27334476

Toddlers and Self-Control: A Survival Guide for Parents

Picking up the remote after you’ve told your child not to touch it five times in 10 minutes. Slapping a friend who took the last train off the table at child care—right after she agreed with you that ‘hands are not for hitting.’ Running directly into the ocean after you’ve clearly explained that he can’t go in the water without an adult. These are typical toddler moments that all come down to one thing: self-control, and the lack of it.

Why do young children have so little self-control? The part of the brain responsible for exerting control over the emotional, impulsive part of the brain is not well-developed in children under 3. This is why toddlers are much more likely to act on their desires, such as yanking a toy out of a friend’s hand, rather than saying to themselves, “I really want that toy, but it’s not right to grab, so I am going to go find myself another toy.”

In fact, Tuning In, ZERO TO THREE’s national Parent Survey, found that parents’ expectations of their toddlers often outpace what toddlers are actually able to do when it comes to self-control. When parents were asked at what age children have the ability to resist doing something that parents have forbidden:

  • 56 percent of parents said children could do this before age three (including 18 percent of parents who believed children possessed this ability by six months of age)
  • 44 percent of parents said children could do this at age three years or older

Children don’t actually develop this kind of self-control until 3.5 to 4 years of age, and even then they still need a lot of help managing their emotions and impulses.

It’s not surprising so many parents have an ‘expectation gap,’ especially with so many 2-year-olds who are so verbal and able to repeat many of the rules parents have laid out. It can be very confusing. But being able to repeat a rule or expectation is not the same as being able to follow it.

Life with your little one will be (hopefully) much less maddening when your expectations for her are in line with her abilities. It can be a relief to know that your child is acting his age; that he needs help to learn to manage his impulses, and that he is not “misbehaving,” or purposefully trying to drive you crazy, as much as it feels that way. Here are some ideas for nurturing self-control:

1. Recognize that it’s not easy being a toddler.

There are an awful lot of things toddlers need to do that they don’t want to do, like getting in the car seat, stopping play to take a nap when they are NOT tired, or sharing their treasures. Let your child know you understand: “You are really disappointed that we can’t go to the playground today.” “You are mad that I won’t let you have ice cream before dinner. I totally get that.” “You are so frustrated with that train—it is so hard to make it stay on the track.” Giving your child the words to describe his feelings is the first step toward helping him manage his emotions and develop self-control.

2. Play games that require impulse control.

Color one side of a paper plate red and the other green, and play some “stop and go” games. For example, when you are outside playing, your child runs toward you until you put up the red sign. Then she runs again when the sign is green. Play “freeze dance” with music. When the music is on, your child dances; when you stop it, she has to freeze. Read books about children who get angry or have tantrums, and talk about how to handle these big feelings. Use your child’s pretend play as an opportunity to teach self-control. When a stuffed animal gets really mad or does something it shouldn’t, problem-solve how ‘Mr. Bear’ might deal with the challenge he’s facing.

3. Make a plan for how to help your child cope with experiences that are especially hard for your child.

Some toddlers have a hard time with transitions, while others have a hard time at birthday parties or adjusting to large group experiences. Think about what situations tend to trigger challenging behavior from your child. Making small adjustments to family routines (like re-thinking taking your toddler to the toy store after a bad night’s sleep) can help to reduce challenging behaviors, with more ‘Yesses’ and fewer ‘Nos’.

4. Set appropriate limits with natural consequences.

Even though your child may not be able to follow a rule yet, it is still important to set expectations. The key is to take a teaching and guiding approach with clear and natural consequences. Stay calm and explain the rule (“No throwing toys. If you throw the truck, I will have to put it away for 5 minutes”). If your child tests the limit, which is to be expected, calmly implement the consequence. Through everyday interactions like these, children develop the brain connections they need to master the skill of self-control.

5. Take your own temperature.

As a parent, you have a lot of power. Your child is taking his cues from you when it comes to managing emotions. Learning to manage and make sense of your own feelings—and getting help when you need it (and we all do)—is the best way to help your child develop self-control. Responding thoughtfully, rather than reacting, is one important way that parents make the difference in how their young children are learning and growing.

https://www.zerotothree.org/resources/1603-toddlers-and-self-control-a-survival-guide-for-parents

Why Don’t Teachers Get Training On Mental Health Disorders?

Teaching may be one of the most difficult jobs in the world, with expectations and demands coming from all sides. Teachers juggle content standards, the social and emotional needs of students, behavior, and often trauma, but they also are the first line of defense when students have mental health problems. Paying attention to all these elements helps create a well-run, high functioning classroom, but dealing with all of them well — often in overcrowded classrooms — can feel completely overwhelming.

To make it worse, most teachers are given very little training on how to detect mental health disorders in students. The National Institute of Mental Health estimates that one in five children has or will have a severe mental health disorder, so the lack of training is a huge disservice to teachers who are likely to encounter these issues in their students.

In an article published by The Atlantic, Jessica Lahey combines her personal experience dealing with mental health issues in the classroom with research on how teachers might be better prepared. She points out that often teachers aren’t even aware of mental health practices used by other staff in the building where they work. She writes:

As an increasing number of schools roll out evidence-based mental-health programs such as Positive Behavioral Interventions and Supports (PBIS), teaching that promotes appropriate student behavior by proactively defining, teaching, and supporting positive student conduct, and Trauma-Sensitive Schools, programs aimed at reducing the effects of trauma on children’s emotional and academic well-being, educators need to be at least minimally conversant in the terminology, methods, and thinking behind these strategies. These programs provide strategies that can be highly effective, but only if the teachers tasked with implementing them are sufficiently trained in the basics of mental-health interventions and treatment.

Some teachers may feel this type of preparation is not their job, but it is easy to confuse the symptoms of a mental health disorder with run-of-the-mill misbehavior, and how a teacher handles those situations affects the learning of every child in the classroom. If the teacher’s job is to teach the whole child, mental well-being and support is part of the description.

http://www.theatlantic.com/education/archive/2016/10/the-failing-first-line-of-defense/504485/

What Really Happens in a Therapy Session

When you take your car to the car mechanic, you know what’s going to happen: Your car will get repaired.

When you break a bone and visit your doctor, you know what’s going to happen: Your bone will be set in a splint or cast and eventually heal.

But when you make an appointment to see a therapist, do you know what’s going to happen? Many people aren’t quite certain. Will you just talk? Will you have to discuss your childhood? Will you be “hypnotized?” And what’s the “point” of seeing a therapist, anyway? Why not just talk to a friend?

There is a great deal of uncertainty in our society about what actually happens during a therapy session, what types of issues and problems are suitable for therapy, and what benefits a therapy session can provide. I’d like to address a few typical questions—and misconceptions—about what therapy is, what it isn’t, and how it really works.

Q: Do I have to be “sick” or “disturbed” to go see a therapist?
A: No. Thinking that one has to be “seriously disturbed” in order to see a therapist is a myth.

While some therapists do specialize in severe emotional disturbances—including schizophrenia or suicidal thoughts—many focus on simply helping clients work through far more typical, everyday challenges like mapping out a career change, improving parenting skills, strengthening stressmanagement skills, or navigating a divorce. Just as some physicians specialize in curing life-threatening illnesses, while others treat “everyday” illnesses like flus, coughs, and colds, psychotherapists can serve a wide range of clients with a range of needs and goals, too.

In fact, most of my clients are successful, high-achieving people who are quite healthy, overall. Most are challenged by a specific, personal goal—like losing weight, creating more work-life balance, finding ways to parent more effectively, or feeling anxious about dating again after a rough break up.

Q: How can I choose the right therapist for my goal/situation?
A: Choosing a therapist is like choosing any other service provider—it’s a good idea to visit the practitioner’s website, and read client testimonials or reviews (if they have any—many do not, for confidentiality reasons). It’s also good to ask friends and family members, or your physician, for referrals (and of course, check to see who is covered in your health insurance network).

If you are hoping to work on a specific issue—overeating, smoking, making a career change—try to find a therapist with expertise in that area. Many list their specialties or areas of focus on their websites. There are therapists who specialize in relationship issues, parenting issues, anger management, weight issues, or sexuality—pretty much any issue, goal, or situation you can imagine. If you’re not sure about someone’s expertise, just call them and ask. If they can’t be of assistance with your issue, they may be able to refer you to someone who can.

Q: What actually happens during a therapy session?
A: Each session is, essentially, a problem-solving session. You describe your current situation, and your feelings about it, and then the therapist uses their expertise to assist you in trying to resolve that problem so you can move closer to having the life you wish to have.

At the beginning of a session, the therapist typically invites you to share what’s been going on in your life, what’s on your mind, what’s bothering you, or whether there are any goals you’d like to discuss. You’ll be invited to speak openly. The therapist will listen and may take notes as you speak; some, like myself, take notes after a session. You won’t be criticized, interrupted or judged as you speak. Your conversation will be kept in the strictest confidentiality. This is a special, unique type of conversation in which you can say exactly what you feel—total honesty—without worrying that you’re going to hurt someone’s feelings, damage a relationship, or be penalized in any way. Anything you want—or need—to say is OK.

Some therapists (like myself) may give clients some homework to complete after a session. That homework might be to set up an online dating profile and reach out for a first date, or to exercise three times a week. It may be to spend some time each day pounding a pillow to safely release pent-up emotions, make a nightly journal entry, or any number of “steps” and “challenges” relevant to your goals. During your next session, you might share your progress and address any areas where you got frustrated, stuck, or off-track.

Of course, every therapist is different, every client is unique, and every therapist-client relationship is distinct as well—which means that there is nouniversal description of a therapy session. Some therapists employ dream interpretation in their work. Others bring music or art therapy into their work. Others incorporate hypnotherapy, life coachingmeditationvisualization, or role-playing exercises to “rehearse” challenging conversations. The list goes on and on. Ultimately, regardless of their approach, a therapist will listen without judgment and help clients try to find solutions to the challenges they face.

Q: Will I have to talk about my childhood?
A: Not necessarily. Many people think that visiting a therapist means digging up old skeletons from your childhood, or talking about how awful your mother was, etc. That is a myth. What you talk about during a therapy session will largely depend on your unique situation and goals. And depending on your goals, you may not actually talk about your past that much. The focus of your therapy is as likely to be your present-day reality and the future that you wish to create.

That being said, if you REALLY do NOT want to discuss your childhood, the intensity of your desire NOT to talk about it might suggest that you should! When people have strong negative emotions—about their childhood or any other topic—it’s typically worth doing some excavating to figure out why that is. Whatever is causing them to feel such strong emotions about the past is more than likely impacting their present-day life in some way, too.

Q: How long will I have to go to therapy?
A: This varies from person to person. I’ve had clients who booked one session, we worked out their issue(s), and they were all set: They marched out and didn’t need a follow-up session. Sometimes, one brave, honest conversation is really all you need.

Other clients have booked sessions with me over a period of several weeks or months, focusing on one issue, resolving that issue, then perhaps moving on to a different challenge. Then there are other clients who I’ve been working with for some time—they appreciate having a weekly, bi-weekly, or monthly “check-in.” They may share their feelings, sharpen their life skills as needed, or perhaps enjoy a deeply nourishing guided meditation or hypnotherapy experience to de-stress. As one client put it, “Every two weeks when I meet with you, I leave your office feeling like you pressed my reset button.”

Therapy is really about whatever a client needs—a one-time conversation, a temporary source of support during a life transition, or an ongoing experience to optimize health physically, mentally, emotionally and spiritually.


Q: Is meeting with a therapist over the phone—or through video chat—just as effective as meeting in person?
A: That depends on your personality and preferences. In the state of Hawaii, where I live, at least one insurer that I know of covers doing therapy virtually via video chat (like Skype or Facetime). This makes it a convenient option for people. Many of my clients do enjoy having some, or all, of their sessions via video chat because it means they don’t have to take time out of their busy schedules to drive, park, and so on. They can just close their bedroom or office door, pick up the phone or log in, and away we go—very convenient.

Where feasible, I suggest trying out both ways—do a traditional, in-person therapy session and then try a video session—and see which format is the best fit for you.

Q: Why see a therapist? Why not just talk to a friend or someone in my family?
A: If you are blessed with caring, supportive family members and friends, by all means, share your feelings, goals, and dreams with those people. They are a big part of your support network, and their insights and encouragement can be very helpful. However, people who already know you might not always be completely objective when listening to you. For example, you may want to change your career, and you confess this dream to your wife. She may want to support you 100%, and try her very best to do so, but she may also be dealing with emotions of her own—such as anxietyabout how a career shift will change your lives, not to mention your income. These emotions could make it difficult for her to listen and support you objectively.

This is why working with a therapist can be so valuable. It’s a unique opportunity to share everything you’re feeling, and everything you want to create, without anyone interrupting you, imposing his or her own anxieties onto the conversation, or telling you that you’re “wrong” or that you “can’t.”

A therapy session is a space where you don’t have to worry about hurting anyone else’s feelings—you can be totally honest. It also means you have the potential to solve problems faster and with greater success. In the long run, that’s better for you and everyone else involved in your life, too.

To sum it up:
Therapy is a valuable tool that can help you to solve problems, set and achieve goals, improve your communication skills, or teach you new ways to track your emotions and keep your stress levels in check. It can help you to build the life, career, and relationship that you want. Does everybody needit? No. But if you are curious about working with a therapist, that curiosity is worth pursuing. Consider setting up one or two sessions, keep an open mind, and see how things unfold. You have very little to lose and, potentially, a lot of clarity, self-understanding, and long-lasting happiness to gain.

Suzanne Gelb, Ph.D., J.D, is a clinical psychologist and life coach. She believes that it is never too late to become the person you want to be: Strong. Confident. Calm. Creative. Free of all of the burdens that have held you back—no matter what has happened in the past. Her insights on personal growth have been featured on more than 200 radio programs, 200 TV interviews and online at TimeForbesNewsweekThe Huffington PostNBC‘s TodayThe Daily LovePositively Positive, and much more. Step into her virtual office, explore her blog, book a session, or sign up to receive a free meditation and her writings on health, happiness and self-respect.

Raising Children With Mental Illness

By Melinda Cook | Oct. 05, 2018

 

My kids are all adopted from foster care. I got my girls when they were five and six, and my son came when he was seven. They all came from abusive or neglectful pasts and have struggled with their mental health since before they first stood on my doorstep. And before you ask: Yes, I had been fully prepped on their family histories before I adopted them.

My son’s official diagnosis is Disruptive and Dysregulated Mood Disorder with PTSD flashbacks. He has a family history of schizophrenia and had been severely abused by his birth family. Last year, a prank pulled on him by another boy triggered horrible memories that my son’s mind had locked away. Now, he hallucinates. He dissociates. He hears voices.

I remember sitting in a counselor’s office, staring intently at a picture on the wall as my son told the counselor about the voices he heard and the things he saw that I knew didn’t exist. My son talked about a hand that came over our car and a shadow that came out of his bedroom wall. I tried so hard to concentrate on the picture so I wouldn’t cry. It didn’t work. When the tears began to roll down my face, I was careful not to make a sound. The counselor noticed, so he spoke reassuringly to me, “A lot of things can make a person see things that are not there.”

My son explained how hard it is for him to determine that these things aren’t real, because they feel real to him. He just wanted them to stop. The counselor thanked my son for telling him about what happened and told him he believed him. We went from the counselor’s office to the psychiatrist’s office, where my son had to tell the story again. I never realized how tired you can get from just listening. I was exhausted, and nothing was even happening to me.

Sometimes, I try to imagine what my son is going through, and I wonder if I could get up the next day if I were him. I honestly don’t know. My children are the strongest people I know. They keep going, despite anything and everything that tries to stop them. And I do my very best to help as their mother.

Lessons To Follow

Raising children with mental health conditions is challenging. Patience can wear thin, because you want your child to do the things you need them to do. Frustration can leak into your communication. Walls can go up. Instead of loving each other, you feel like you’re at war.

When I really examined my frustrations, I noticed a lot of my anger came from a place of shame. I wanted my kids to act “appropriately” in public. When they didn’t, I would get frustrated. I cared more about what others thought of me than what my children thought of me—but that was getting my family nowhere. It especially wasn’t helping my children and their recovery.

If you’re a parent raising children with mental illness, I want more than anything for you not to make the same mistakes I made. So here are some of the most crucial lessons I’ve learned about supporting a child experiencing mental illness:

• A diagnosis provides a roadmap to recovery. How can you start on a journey if you don’t know your first step? Understanding your child’s diagnosis is critical. This knowledge can help you find ways to cope. For example, my son went through psychological testing after his

first suicide attempt. His symptoms had impaired his thinking so much that he lost three grade levels of reading comprehension. That was crushing to hear, since we had spent several years working to overcome his reading disability. But having him tested gave us a game plan.

• Open communication is key.  Make sure you’re not shutting off communication before you give your child a chance to explain how they feel. Don’t come to any conversation with the idea that you already know all the answers or how to fix everything. If we took all the energy we initially spend as parents trying to “fix” our children who live with mental illness and instead focused that energy on understanding them, we would get them the right help faster. It’s amazing the answers you can get and the solutions you can come up with together if you first start conversations with respect and empathy.

• Care for yourself, too.  It’s called self-care. When I first heard about it, I laughed. When do I have time for that? I’m a single parent. I work all day and then my kids need me. But what kind of “me” do they need? A healthy one, a happy one, a supportive one. So, plan time for yourself. Find an outlet. Find support. I love walking, blasting music when I drive by myself, writing, painting, gardening and anything that reminds me I am alive. I now know that the best parents are like flight attendants: If we hit rough patch and the oxygen masks drop, put your own mask on first before you help anyone else.

• A family crisis plan is crucial.  I learned in NAMI Family-to-Family that a mental health crisis plan needs to be in place before your family is in crisis. So, on a calm day, I asked each of my kids what we should we do if we have another mental health crisis. Their responses, to this day, are some of the most insightful and caring suggestions I have ever heard. My oldest daughter wanted consequences for someone not following family rules or hurting others. My middle daughter wanted us to “talk things out if things get bad.” My son’s contribution was that he wanted everyone to be kind. It’s funny; as parents, we have the answers if we just ask questions and listen.

Be The Reason Your Child Gets Help

Acceptance is the first step for a person’s mental health recovery. Self-acceptance is important, but just as important is receiving acceptance from loved ones. Accepting your child’s condition doesn’t mean that you aren’t scared. It just means that you see the problem for what it is—not the person as being the problem. We must accept and believe our loved ones to start getting them help. If we don’t, we run the risk of being the reason they don’t get help.

We can’t discount or ignore our loved ones’ thoughts, feelings and behaviors just because we don’t understand them or wish they were different. We have to do better than that. We need to seek to understand their reality. We need to truly listen to what they say. Do not listen to speak or refute, but listen to understand.

As parents, we must be open. We must be open to all there is to learn—even when something scares us. If we are open, then those living with mental illness (including our own children) have a chance. How many people are out there right now feeling alone, struggling with the fear of rejection from the ones they love because they hear voices or see hallucinations? How many are alone and feeling lost, but are more afraid of losing the ones they love than dealing with their mental anguish?

I remember thinking how simple and matter-of-fact my son’s counselor was when he said those three simple words, “I believe you.” I also remember how relieved my son seemed after he heard them. Odds are, your children won’t go to a counselor when they first feel something isn’t quite right. They’ll come to you. So please, stay open and believe them. Believe them so they don’t have to be alone. Believe them so they can get help. Believing may save their lives.

 

Melinda Cook is a 43-year-old single parent of three. Before she became a foster mother, she worked for a shelter for abused women and children. She is now a Certified Family Support Partner through the Department of Health and Welfare for The Family Resource Center in Idaho Falls, Idaho, a local counseling company. She began writing about her son’s experiences to help others and writes a blog at myfamilyunbottled.weebly.com.

https://www.nami.org/Blogs/NAMI-Blog/October-2018/Raising-Children-with-Mental-Illness

The Power To Create Change Comes From Within

By Katherine Ponte, BA, JD, MBA, NYCPS-P, CPRP | Oct. 24, 2018

 

Stigma is a shield created by society, made up of misunderstanding and fear of mental illness. When we look away from someone behaving erratically or “strangely” on the street, that’s the fear society ingrains in us. Perhaps we’re scared to consider the possibility that the same could happen to us; that we might be shunned by society, too.

The shield of stigma also stops us from seeking help for our own mental health. When faced with a stressful life event or emotional challenges, we might carry the hurt or confusion inside. Perhaps we avoid facing a potential diagnosis, so our illness only grows worse. Stigma facilitates mental illness turning into the “monster” it doesn’t have to be.

Social perceptions need to change. However, stigma is so deeply rooted in societal norms that it can take a long time to eradicate. And people like me, people living with mental illness, can’t wait on society to change. We need to live now. In fact, we need to be pioneers.

Our Experience Combats Stigma

First, we need to overcome our own belief in society’s fears. This requires finding hope, and specifically recognizing the possibility of recovery. Recovery from mental illness is living a full and productive life with mental illness. With this mindset, we can take ownership of our condition and live a fulfilling life. This can be one of the most powerful forces for change.

Stories of living fully with mental illness can help reshape society’s bias. They also provide inspiration and guidance for other people living with mental illness. This is the power of peer support and sharing lived experience. It creates a cycle of more people finding recovery, and then in turn, society seeing more positive examples of people living well with mental illness. Society needs to see what life with mental illness can and should be—a life of possibility, not a life sentence.

Our Experience Inspires Others

When people share their mental health journeys, it also helps set our own expectations. Recovery is hard and there is no smooth path to get there. It’s also not a cure, it requires continuous patience, discipline and determination. There will be stumbles and uncertainties along the way. This is the reality of mental illness. That’s why relatable, real-life examples are so valuable.

Knowing that others are going through similar challenges can help us build resilience. The result is self-empowerment by the example of others. We, the mental health community, rely less on the image society projects upon us, and instead focus on the image reflected to us by our peers. This is the power from within ourselves and our community.

I believe that this type of person-driven recovery has been overlooked as a way to combat social stigma. It’s become so ingrained that not even people with mental illness think recovery is possible. Too many of us allow society’s fears to become our own. Together, we can reverse the vicious cycle of stigma and instead, power the virtuous cycle of hope and recovery.

 

Katherine Ponte is a Mental Health Advocate and Entrepreneur. She is the founder of ForLikeMinds, the first online peer-based support community dedicated to people living with or supporting someone with mental illness and is in recovery from Bipolar I Disorder. She is on the NAMI New York City Board of Directors.

https://www.nami.org/Blogs/NAMI-Blog/October-2018/The-Power-to-Create-Change-Comes-from-Within

Tips For Successful Family Therapy

For most my life, my mom and I have had a turbulent relationship. Vague reassurances from others that “everyone has family problems” never helped with our nonsensical fighting or how I felt. I never knew what to do, but I knew it had to stop.

Family relationships are sometimes responsible for life’s biggest conflicts. They’re often complicated and can span decades. For many, it’s the steady drip of unresolved arguments and personality clashes that leave lasting feelings of resentment and bitterness. But there is a way to work through this. There is a hopeful course of action—it’s called family therapy.

Giving It A Chance

Family therapy is a collaborative and inclusive process which focuses on the family as a unit. Family therapists are skilled in dealing with a variety of conflicts whether it involves communication issues, estrangement, financial problems, divorce, a death in the family and more.

There might be a time before starting therapy when you won’t want to go. I certainly didn’t. My mom certainly didn’t. The pains of having to sift through years of battles wasn’t appealing. But without confronting the past, we are bound to repeat the same mistakes. Therapy may lead to the resolution you’ve been searching for. It’s important to give it a chance.

Finding The Right Therapist

I knew that the family therapist I chose was effective because within our first few sessions, I felt comfortable. I knew I would be able to open up to her. And I never dreaded talking in session. She also brought up Narcissistic and Borderline Personality Disorder in regards to my mother. This helped me to trust my therapist and her expertise even more, because she was able to spot that early on.

If you feel that a therapist is not effective, it’s okay to keep looking. In my experience, most therapists don’t take it personally. In fact, they encouraged my family to find the right fit for us. Your comfort level and ability to open up are essential in a therapeutic relationship.

Over time, your therapist will learn your family’s communication style. Some families are louder than others, while some fill the minutes with silence. Certain family members may be withdrawn at tense moments, while others might be aggressive. Your therapist will be see these differences and guide each of you accordingly.

How To Have Effective Therapy Sessions

A typical therapy session is 50 minutes, once a week. It’s a short amount of time to work through a lot of issues among multiple people. In order to best use your time with your therapist, here are a few tips to have effective sessions.

  • Prepare prior to therapy. Each family member should jot down questions or issues they would like to discuss.
  • If there is one family member you don’t get along with, carefully decide what you’ll say to them when you have your chance to speak.
  • Remain strong and respectful.
  • Speak calmly.
  • Try not to argue.

You may feel as though your family will never resolve long-standing conflicts. But it is possible. With listening and restraint, your family can reaffirm its bond and clear up old disagreements and hurt. Or you may decide it’s time to move on. For me, the decision to lessen contact with my mother, while controversial to some, was the right choice. I am no longer consumed with guilt about not being able to get along. Without therapy, I know I would still have an extremely close and volatile relationship with her.

Because it was such a positive and powerful experience for me, I always recommend family therapy to others. Even the more exhausting and uncomfortable sessions were necessary. Without them, I wouldn’t have been able to identify toxic patterns of behavior, understand my depression, or take control and realize what I needed to do in order to change my life.

There is nothing to fear about family therapy—it’s a safe place to work through negative feelings and move forward. Any decisions you make with your family will be based off careful discussion and thought. When I look back now, I know I wouldn’t have made the same choices without the support of my therapist.
Amanda C. Dacquel is a mental health writer and advocate. In 2014, she started TheCurrentCollective.com to share mental health experiences, resources and news. You can connect with her at AmandaDacquel.com.

Overcoming Stigma

I was sitting alone in the hallway of the Carter Center conference area in Atlanta during the 2012 Rosalynn Carter Symposium on Mental Health Policy. I had just finished being a panelist and talking about how employment and education helped me overcome the stigma associated with my depression. The conference was still in session, so I had the hallway to myself. I sat quietly, reflecting on the fact that I had been invited to speak here as both a clinician working in community mental health and a person living with depression.

Two scenes flashed through my mind highlighting two very different points in my life: getting offered a job as a therapist at the mental health center where I completed my internship for my Master’s in social work, and sitting in a psych ward on the eve of my 18thbirthday, wondering if I would graduate from high school.

Persevering Through Depression

It took many years of perseverance for me to become that professional sitting on a panel at a national conference. Though I managed to graduate from high school, I dropped out of college at 19 as my depression worsened. I was unemployed, and my only income was Social Security disability. Years of failed depression treatments included medication and talk therapy.

I spent most of my time alone doing what I refer to as “stewing in my own depressive juices.” This lasted for 10 years. During that time, I was challenged by the symptoms of mental illness— insomnia, loss of appetite, lack of concentration, suicidal thoughts. After a decade of being unemployed and living on Social Security, I decided that for my own survival, I had to return to school and complete my social work degree. Of course, my depression was against this:

“You can’t go back to school; you will fail.”

“You won’t be able to concentrate enough to complete your assignments.”

“You’re too stupid to get a college degree.”

Somehow, I decided to talk back to these negative thoughts. My response was simple: “I’m just going to do the best I can.”

And I did. I got myself back to school and finished my degree in social work. Around that time, I also tried a different treatment for my depression, and it worked. Things got easier.

Today, I feel incredibly lucky to say that I am doing exactly what I want to be doing. But really, luck had little to do with it. Besides my symptoms of depression, I faced an additional barrier to school, employment and inclusion in general: unhelpful attitudes from well intentionedhealth professionals—in other words, stigma.

Learning To Reject Stigma

One mental health professional once told me, “Maybe you’re not getting better because you’re not trying hard enough.” Another warned me, “You might not be ready to go back to school full time. Shouldn’t you just take one class and see how that goes?” A psychiatrist decided, without asking for my opinion, that I should be sent to live in a group home for people with mental illness. (That did not happen, and that treatment relationship ended that day.)

These scenarios were fueled by the stigma associated with mental illness—stigma that ultimately serves to limit and exclude rather than encourage and include. Had I listened to those professionals, I might never have returned to school or entered the workforce.

So how did I overcome the stigma that I faced? I rejected it. Rejecting—or overcoming—stigma, whether it be self-stigma, public stigma or structural stigma, is one of the keys for those of us living with mental illness. This is not an easy task, to be sure, but it is becoming more possible and a bit easier as more and more of us of speak out about our mental health conditions.

 

After working as a therapist and witnessing the negative effects of stigma on clients and their family members, I decided to develop a stigma-reduction training curriculum called “Overcoming Stigma.” I spent several months reading every scientific article I could find about stigma research. Most of it simply documented that stigma exists (in hospitals, in psychiatry, in substanceusetreatment centers, in pharmacies, universities, employment, housing, etc.) and that levels of stigma have not changed over the last decade.

According to many studies, effectively reducing stigma pointed to one intervention: contact with someone successfully managing a mental illness. One shining example of this is NAMI’s In Our Own Voice (IOOV) program. People with mental health conditions share their powerful personal stories in this free 60- or 90-minute presentation. I decided to integrate elements of IOOV into the beginning of my trainings by briefly disclosing my own depression and giving a few examples of my experiences with stigma. The rest of the training includes a description of the seven most common types of stigma experienced by people with mental illness and substance-use disorders, research about the effects of these stigmas, ways to reduce stigma, and the clinical and agency assessment tools I developed.

I have presented Overcoming Stigma trainings in many different health care settings, and the curriculum continues to evolve, always guided by the latest stigma research. Recent research shows that stigma training needs to be ongoing instead of a one-time thing and, it likely needs to address many stigmas all at once.

My trainings get everyone involved in the discussion; I like to ask for anecdotes from attendees. Here are some real-life examples of stigma shared by health care professionals who have attended my trainings over the past several years:

• A cardiac surgeon said he would not do surgery on a person with schizophrenia because he didn’t think the person would be able to do the required follow-up care.

• A therapist shared that as a Ph.D. student, he was told he would lose his scholarship if he left for “depression” treatment but could keep it if he left for “medical” treatment.

• A mother puts off making an appointment for her daughter to see a therapist despite her daughter experiencing severe symptoms of anxiety because she doesn’t want her daughter to be labeled as “crazy.”

• A physician attendee said it was well known in her neighborhood that her son had been hospitalized with bipolar disorder and no one acknowledged this fact (much less offered any type of support).

• A mental health clinician working in an emergency room said doctors and nurses often referred to patients in the ER with mental illness as “her patients,” rather than “our patients.”

If I do my job well, attendees leave with the understanding that we all have a role to play in reducing these harmful kinds of stigma. Personally, I still experience stigma, but I am no longer limited by it. I sometimes even chuckle when I hear someone say something particularly stigmatizing because I immediately think, “Well, that’s going to be part of my next training.” That’s not to say it isn’t still discouraging to see or hear things that continue to perpetuate stigma, but for me, there is a feeling of freedom and power in being able to turn a potential lost opportunity into one that is gained.

 

Gretchen Grappone, LICSW is a trainer and consultant with Atlas Research in Washington, D.C. Her work includes projects with VA medical centers, community mental health centers and other health care settings around the country. She lives in New York City.

https://www.nami.org/Blogs/NAMI-Blog/October-2018/Overcoming-Stigma

Reflections On Medicine, Shame And Stigma

As I was entering medical school, I found out that my mother had made a postpartum suicide attempt. I did not find out from her; it was shared with me in hushed tones by another family member who thought I should know, “now that I was going to be a doctor.” I was quite surprised by this information. And it made me sad to think that this wasn’t a topic she felt she could openly discuss.

Suicide is a challenging issue for all of us. Secrecy surrounds the topic, with shame as a common co-traveler. That’s why it’s an honor for me to be a small part of NAMI’s movement to make seeking help and support more acceptable. I’ve met many resilient people in the NAMI community who have overcome suicidal thoughts or actions. Often because there was a person who stood by them during a crisis or a new treatment approach that made a difference in their life. Some found sobriety for a co-occurring substance use disorder. Others found clozapine or lithium, which have been shown to reduce suicidal thinking. Some learned coping skills through a psychotherapy like cognitive behavioral therapy or dialectical behavioral therapy. Many found relief in the community of NAMI. Regardless of how, their suicidal thoughts or actions were talked about and changed.

My field sorely needs similar conversation and change. Doctors also have high rates of suicide and it’s a major issue that some of the doctors we turn to for care are often not taking care of themselves. We need to teach help-seeking behaviors in the medical and psychiatric fields. Doctors need the same support and encouragement to get help as their patients.

I lost a patient to suicide early in my psychiatric residency. This was a person with many strengths, who was also in tremendous psychological pain. I worried about him during off-hours and felt powerless to help at times. After I learned of his tragic outcome, I was upset, slept poorly and struggled at work for months. I was worried I had said the wrong thing or had failed in some way as an inexperienced psychiatrist. I seriously considered leaving the field and entering another specialty. I was lucky to receive support and empathy from my colleagues and supervisors as they encouraged me to seek therapy. I did my best to carry on, but I never forgot about this patient and his suffering.

Last year, at an American Psychiatric Association (APA) event, I was impressed that even doctors are wondering if they worry, struggle and stress too much. APA president Anita Everett reviewed the stresses that commonly consume doctors and announced that psychiatric wellness would be a core feature of her leadership. Dr. Everett’s thoughtfulness and openness on the stresses doctors face and her emphasis on help-seeking was powerful; her efforts have started many overdue conversations across the entire field of medicine. Unfortunately, the same shame that led to the secrecy around my mother’s postpartum suicide attempt is alive and well in the medical field.

Doctors don’t have all the answers for stress, mental illness and suicide—our most challenging aspects of being human. Medical culture needs to continually evolve and learn from the remarkable and resilient people like those I have met at NAMI. Facing your mental health challenges head-on and working to get help with a supportive community behind you is a key piece of NAMI culture. It’s a culture we can all learn from.

 

Ken Duckworth is medical director at NAMI.

https://www.nami.org/Blogs/NAMI-Blog/September-2018-(1)/Reflections-on-Medicine-Shame-and-Stigma