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Archive for the ‘
Your Options ’ Category
Introduction:
Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty, according to the Mayo Clinic. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown, the Mayo Clinic says.
Most cases of scoliosis are mild, but severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.
Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to straighten severe cases of scoliosis.
If a scoliosis curve gets worse, the spine will also rotate or twist, in addition to curving side to side. This causes the ribs on one side of the body to stick out farther than on the other side. Severe scoliosis can cause back pain and difficulty breathing.
Below is a interview with Leah Stoltz, President and Founder of Curvy Girls of Long Island, a Scoliosis Support Group and social work student Silas Kelly. Mr. Kelly attends the Adelphi University School of Social Work and he worked with Ms. Stolz to promote support for scoliosis patients by producing a radio talk show segment on scolisis for Z100 radio show in New York broadcast in July 2011.
Q. Ms. Stoltz, you lead "Curvy Girls" a support group for girls with scoliosis. Can you describe your own experience with the condition?
When I was first diagnosed with scoliosis the summer after sixth grade, I was put into a hard plastic brace that I wore around my torso twenty-three hours a day, seven days a week to stop my curve from progressing. Despite wearing three different braces for the next two-and-a -half years, my spine continued to curve to the point that I had to have spinal fusion surgery when I was 14. On June 29, 2007, I walked into Good Samaritan Hospital and my vertebrae were fused from T5 through L4. That was four years ago. And while I rarely remember having a scar running down my entire back, I always take pride in showing it off. It's like a battle wound. People didn't know what I was going through emotionally all those years, but now they can see my scar. That people get.
Q. How does your support group help participants?
With a statistic of one in forty kids being diagnosed with scoliosis, it was weird to me that I knew no one else with this disorder. In fact, when I did search for other people to talk to, all I found were groups of adults. I knew I needed to talk to other girls who could understand what I was going through—the struggle with finding the right clothes, explaining your situation to friends, doctor's appointments, facing the possibility of major spine surgery, and just dealing with the fact that my spine was crooked. So a little over a year after being diagnosed, I held my first scoliosis support group meeting at my house with four other girls from surrounding areas. We talked about everything from the dreaded plastic thing, what clothing worked to conceal the brace and all the things that typical teenagers can relate to. Basically, we gave each other the sense that we are not alone.
Six years later, we are still holding monthly meetings in my house and have expanded to twenty groups across the country. It has become a network of support and friendship with the goal of eliminating the idea that scoliosis is something one must face by oneself.
Q. Ms. Stoltz, how can social workers help young women like you?
There are two parts to scoliosis: the obvious physical part that the doctors look at, but the second is completely ignored — the emotional struggle. We are given a brace to fix the physical aspect, but this group- these girls' love and support for each other- is the prescription and remedy for the emotional part.
Professionals working with girls with scoliosis need to understand that scoliosis makes us different at a time when all we want to do is fit in. When we are with other kids like ourselves, we do fit in. So the best thing a professional can do is to make sure that we have other kids like us to talk to. It is also important to understand that we are dealing with feeling a sense of loss of control over our bodies, as well as having to wear an embarrassing brace. We bear a secret unless we can tell our friends but many of us are too ashamed to share. You need to help us find our voice to speak up at doctor visits and to our peers.
Q. Mr. Kelly, how were you able to use your social work skills and professional background to help Ms. Stolz?
Social workers, due to the nature of their work, should always have a wealth of resources to tap into. They can help scoliosis over-comers by connecting them with the right resources at the right time. Basically, it is the social worker’s job to know which one of their resources will be most helpful, and to have a good sense of timing about when to connect a scoliosis over-comer.The social worker must be a conduit to make individuals dealing with scoliosis aware of the support entities that are available. This in turn will let them know that they are not alone and they in turn can reach out to others which makes the support network grow.
In this particular case, as a social work student I recognized an outstanding effort from an over comer, Leah Stoltz. I realized that her story needed to be told, and that by providing her with a vehicle to tell her story and the story of the “Curvy Girls” that this in turn would benefit so many other individuals.
Therefore, I used the resources I had (producer experience, outreach experience, media experience, and PR experience) to help spread the word and make it possible for even more people to be helped. (Click here to listen to Ms. Stoltz’s July 2011 radio interview about scoliosis and Curvey Girls.)
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To find a social worker in your area, please click here.
Tags: Leah Stoltz, scoliosis, Silas Kelly, social work
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Introduction
Anna M. Scheyett, PhD, MSW, LCSW is associate dean at the University of North Carolina (UNC) at Chapel Hill School of Social Work. She received her PhD in social work from Memorial University and her MSW from UNC. Her major area of interest, both clinically and in research and teaching, is working with adults with serious mental illnesses.
Dr. Scheyett is on the Board of Directors of the National Association of Social Workers (NASW). She has been active in NASW for 25 years; she served on the NASW North Carolina Chapter Board as member-at-large, secretary, chair of the Social Work/Criminal Justice practice unit, member of the Legislative Committee, and president. Dr. Scheyett is also involved in the National Alliance on Mental Illness, the Council on Social Work Education, and the Society for Social Work and Research. In 2005, Dr. Scheyett received a NC Heroes in the Fight award for community mental health advocacy, and in 2007, she was named NC Social Worker of the Year.
Q. Dr. Scheyett, what options does a family have when they believe an adult loved-one is mentally ill?
This can be a very frightening and painful time for families. The first thing to remember is that ignoring your concerns won’t make them go away. If you have concerns that an adult loved-one has a mental illness, and they are able to listen and talk with you, it is important to talk directly and gently with your loved-one. Let them know about your concerns, that you are there for them, and that you want to help them get help. Talk with them about how mental illnesses are just that, illnesses, not weaknesses or flaws. Provide them with information, particularly about how and where to get help. Offer to go with them. The most important thing is to let them know you want to support them and that you are going to be lovingly persistent in helping them get help.
The situation gets much more difficult if your loved one has symptoms that interfere with their ability to be aware of their mental illness. You cannot force your adult loved one into treatment unless they are a danger to themselves or others; at that point, you can petition the court to have your loved one committed to a hospital. You can consult with a social worker, another mental health professional, or a support and advocacy group such as the National Alliance on Mental Illness (NAMI). A book that some family members have found helpful is “I Am not Sick, I Don’t Need Help” by Xavier Amador.
In all cases, it is important that you get some support and education for yourself as well. Find a professional you trust or a support group, learn about mental illnesses, and have a safe space where you can take care of yourself too.
Q. Is this situation doubly complicated if the loved-one appears to be self-medicating with alcohol or illegal drugs?
Yes, it can be much more complicated. Substances can cloud judgment and make it even more difficult for your loved one to be able to hear you. If the self-medicating is with an illegal substance, there are concerns and risks regarding the law as well. In addition, the health risks increase with substance use as well, so treatment becomes even more crucial.
Q. How can a social worker help?
Social workers can help families in a number of ways. They can be excellent sources of information about mental illnesses, about laws and policies, about resources for treatment and about benefits and entitlements. They can help families advocate for good services for their loved one. Social workers can also play huge roles in helping families deal with the feelings of grief and fear and guilt that families may experience when they have a loved one with a mental illness.
In addition, social works can advocate for policies that provide fair and adequate treatment for people with mental illnesses and that protect their rights and autonomy. Perhaps most importantly, social workers can convey a message of hope and recovery. With support, education, respect, and choice, people do recover from mental illnesses and have meaningful lives–support and education are essential and social workers can play key roles.
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To find a social worker in your area, please click here.
Tags: Addictions, Anna Scheyett, mental illness, substance abuse
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Introduction
It all begins with a thought. Are you aware that your thoughts command the attention of your body? If you have happy thoughts, your body reacts. Your facial expression, your eyes, your walk even your internal body reacts to your good or happy thoughts. This is why often a person who is in love "glows." In contrast, when a person has angry, bitter, toxic thoughts, their body may react in quite the opposite manner. Research supports the assertion that illnesses such as depression, mental illness, diabetes, high blood pressure, cancer, etc., can originate from stress originating in one's thoughts.
The bitterness of the old man and the anger of the woman next door may have all began with bitter thoughts. Bitter thoughts most often begin in unforgiveness. Yes, unforgiveness. Someone crosses you or hurts you and you hold that thought; you continue to remember it and then you guard yourself from letting it ever happen again. You continually think about it because you want to ensure that you protect yourself against it happening again. What you may be doing is holding on to something that will affect you emotionally and physically. Inevitable hurts and disappointments will continue to happen to us yet, we can decide to maintain a positive attitude and remain free from toxic thoughts. Unfortunately, over time, negative thoughts can build up and illnesses may manifest in our bodies.
The Impact of Negative Thoughts
Research proves that negative thoughts turn into fear, fear into stress and it is stress that causes physical illness. People who go through a trauma in their lives such as a death, divorce, family illness, may suddenly find that they develop an illness. The series of stressors develop into illness and stress can only be managed and maintained at bay by the power of our thought life. Things that cause us these stressors are:
Regret – Many of us live with regret about things we cannot change. We need to begin by forgiving ourselves and working at changing today for the better.
Negative thoughts – thoughts such as "I can't, I won't, that's too hard, I'm shy" are all negative thoughts.
Disorganization and disorder – living a life that wreaks havoc in your personal life and your environment commands stress.
Speaking Negatively – "I will get diabetes's because it runs in my family," "things always go wrong for me," "I'm not lucky in love," "I was born to fail," or "it's because of my ethnicity" all negative words.
Conclusion
Despite your circumstances, you have the power to determine your attitude. With a positive attitude, you will decide your outcome and it will come to pass because your attitude will keep you focused on the goal. With such determination, it is impossible to fail at anything! There is power in thoughts. Your thoughts birth words. Your words birth habits. Your habits birth your environment. Your environment is a result of your thoughts. It is a viscous cycle that begins and ends with your thoughts. Detoxify your thoughts maintain good, clean, positive, goal oriented thoughts. Believe the best is yet to come despite the circumstances. Dispose of the debris of toxic thoughts and find the best in the midst of your circumstances.
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Tags: It All Begins With a Thought, Nilda Perez, Social Work; social workers
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SECTION ONE: Laying a Foundation for Change
Understanding the Stakes
Understanding what is at stake in a custody battle is critical. As a child custody mediator and therapist specializing in higher-conflict child custody cases, I've learned that most parents are unaware of how high the stakes are. They fail to realize that how they handle themselves, even if the other parent won't play fair, can mean the difference between their child growing up to be strong and self-reliant, or an angry substance abuser. While this may sound extreme, I assure you it is not.
No parent gets into a custody dispute with the intention of going broke and jeopardizing the welfare of his or her kids. But losing one's life savings and putting children at risk, psychologically if not physically, is often exactly what happens. This is almost always the case when one parent decides not to play fair in order to seek revenge on the other. In this chapter, we will look at the real costs associated with a custody dispute.
The Human Costs: How Does Separation or Divorce Affect Kids?
Research into the impact of separation and divorce on kids reveals that most children do fairly well after an initial adjustment period, so long as the following four factors are in place:
- Sound parenting
- An effective shared-custody plan
- Little or no exposure to parental conflict
- Consistent quality time with the non-residential parent
When these factors are present, separation or divorce is more likely to promote resilience than emotional or behavioral problems. On the other hand, when these factors are absent, problems are likely to occur. Determining the exact effects a custody battle will have on a child is almost impossible to do. It is a simpler process to determine which kids are more at risk than others.
One of the best predictors that a child will adjust well is whether his or her parents were able to resolve conflicts in a healthy way before their breakup. When absent, parents tend to bring their combative ways with them into the courtroom where the proceedings quickly turn unproductive if not disastrous.
Other risk factors for kids include:
- Violence—history of domestic violence and child abuse
- Drugs—active parental substance abuse
- Change—multiple changes of residence and school
- Friends—absence of peer support
- Money—degree of financial hardship caused by breakup
- New partners—introducing new adult partners to kids too soon after breakup
- Loss of contact—little or no contact with the non-residential parent
- Mental health—debilitating parental mental illness
If a child is struggling with any of the risk factors mentioned, he or she is more likely to struggle with serious long-term problems such as:
- Intense anger—which may be displayed at home, school and in the community
- School problems—including poor grades and problems witht eachers and other students
- Substance abuse—more likely to experiment with, and abuse, drugs
- Mental health problems—such as depression and anxiety
- Legal trouble—more likely to get in with the wrong crowd and get into legal trouble
- Teen pregnancy and sexual diseases—more likely to start having sex at a younger age and to engage in unsafe sexual practices
- Running away—most teens who run away are from broken homes
- Risk of suicide—kids may start thinking about suicide when they feel that their situation is unbearable and is unlikely to improve
These are the human stakes connected with fighting over custody. If your children aren't suffering from the nasty side-effects of your dispute, be thankful. But also be careful to look deeply. Seeing the problems our kids are having can be more difficult than it seems. Some children are reluctant to reveal how they really feel. Others may take on the "good child" role, driven subconsciously by the fear of being abandoned. In their minds, if one of their parents can be sent away for not being "good," perhaps the same thing could happen to him or her.
For those of you who see several of the risk factors above in your children, there is good news. While your kids might currently be on the wrong path, there is a great deal you can do to turn things around, even if your ex won't play fair. Ways to do just that will be presented in each of the following chapters in this book.
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All of the proceeds from the sale of this book are being donated to the non-profit International Center for Peaceful Shared Custody.
Tags: resolving custody disputes, social workers, Tobias Dejardins
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By Tony Madril, MSW, BCD
Introduction
All too often, children are operating outside the realm of parental control; they are doing and saying what they please despite the best efforts of their parents. This is a common complaint shared by many families seeking the help of amental health professional. Parents with unruly children often feel overwhelmed and ineffective. Simply put, they are out of things to try, and need practical answers to some tough parenting questions. If this is you, let me offer you a fewhelpful suggestions.
First, it is important to recognize that while every family is unique, there aregeneral principles from evidence-based psychotherapies to help guide you inyour quest to quiet your child's resistance. One such principle suggests that for families to function optimally, parents must establish and maintain a suitableamount of behavioral structure for children. Practically speaking, this means parents must design and introduce a set of family rules that clearly communicates to children how they are expected to behave both in and outside of direct parental supervision. Another principle, from behavioral therapy, further suggests that parents create a system of behavioral reinforcement, a practical means of shaping a child's responses to family rules through the systematic applicationf meaningful rewards and consequences. Parents who exercise these principles are destined to become the "master architects" of the family realm.
The first step to becoming the master architect of your family is to identify the type of behavioral structure presently in place for your child. The following questions will help you do this; they can also help you identify the strengths and weaknesses of your own unique way of shaping your child's attitude and behavior. Answer the following questions alone if you are a single parent, or together with your parenting partner:
- Are there specific family rules in place for my child to follow?
- Have I communicated the family rules to my child in a way that makessense to him based on his age and particular stage of development?
- If asked, would my child be able to define the family rules and expectations I want her to follow in a clear and accurate manner?
- Do the family rules and expectations currently in place fit the present needs of the family, or are they ineffective and outdated?
- Is there a system of meaningful rewards and consequences in place to increase the likelihood that my child will adhere to the family rules?
- Am I appropriately reinforcing the family rules on a regular basis?
If the answers you provided suggest that, the type of behavioral structure you have in place now requires some attention, not to worry. Most behavioral structures do. Like the family system itself, behavior modification systems for children are dynamic; you can re-evaluate and adjust them at anytime to meet the changing developmental and behavioral needs of children. Here are some guidelines I recommend you follow as you consider the possibility of enhancing your child's behavioral structure to fit his or her specific needs:
Guideline #1: Write family rules to fit the developmental needs of children.
In childhood there are several developmental tasks geared toward teaching children the specific skills they will need to successfully manage the demands of life at every stage of growth. For example, the infant who learns to trust others and the world will likely succeed at establishing and maintaining meaningful friendships with peers during school age. While it would not be appropriate for a parent to assign an infant a family rule at this beginning stage of life, a reasonable expectation for parents with infants would involve spending adequate amounts of time with the infant, providing love and nurturing. Doing so will help the infant develop a strong sense of safety and security that he or she will need to build trust with others; this is the first developmental task of childhood.
Similarly, parents with older children are encouraged to begin to view their child's challenging behaviors as an outward expression of their underlying developmental need: in this case, the unconscious drive of the child to learn the skills of self-control. It is, therefore, important that you begin to think of the behavioral structure you are creating now as the strong foundation your child will need to support their successful progression through the developmental stages of childhood, adolescence, and young adulthood. Understanding this concept is crucial. Research studies indicate that the guidelines for acceptable behavior parents give children are instrumental in teaching them the skills they will need to accomplish important developmental tasks later in life.
That said, I suggest you begin drafting your family's rules by prioritizing your child's non-compliant behaviors by severity and potential risk of harm. Behaviors such as physical aggression, verbal threats, touching others, and inappropriate sexual behavior should be first on the list for intervention. For example, if your child hits others, you would want to demonstrate to them the seriousness of this act by establishing a "no-hitting" rule that corresponds with an immediate behavioral consequence. You would simultaneously want to reward your child for taking any actions that demonstrate the use of self-control. Gradually, your focus will shift from attending to your child's negative behaviors to his willingness to comply with family rules and other behavioral expectations. In technical terms, this process of parental intervention is called behavioral shaping, and the focus of my next guideline.
Guideline #2: Reinforce appropriate behavior using meaningful rewards and consequences.
A thoughtful application of rewards and behavioral consequences to a child's problematic behavior can dramatically improve the situation. With a little training, a parent can wield the strength of such a system to develop desirable behaviors in children such as behavioral compliance while decreasing unwanted behaviors such as fighting and tantrums. (It is important to note that positive reinforcement and minor punishment are the proper terms to refer to this process of shaping human behavior; however, I have replaced these somewhat technical terms with "rewards" and "behavioral consequences" for clarity and ease of recall.)
Rewards, then, refer to the presentation of a particular incentive or event (attention, praise, a family outing) by a caregiver that increases the likelihood that a child will comply with a behavioral expectation. Meaningful rewards are those incentives that inspire your child to take desired actions. For example, if your child willingly takes a bath before bed when you remind him of the allowance he can earn for cooperating, the allowance is a meaningful reward to your child. You can identify other such rewards through careful observation of your child's reactions to other possible incentives, and through direct conversations with them about what he or she might like to earn.
Behavioral consequences, on the other hand, refer to the presentation or removal of a certain incentive or event in response to a child's misbehavior that decreases the likelihood that he will repeat this behavior. Like rewards, I recommend you base your behavioral consequences upon the strength of the approach to motivate your child. The following are some examples of appropriate behavioral consequences for children: brief time-outs, assignment of an additional chore, loss of free time, failure to earn allowance, and a loss of points, if you are using a chart to monitor your child's behaviors.
Now that you have established a program of suitable rewards and behavioral consequences for your child, here are some recommendations for putting them into place. First, schedule some time to sit down with your child to introduce and explain the family rules and behavioral expectations you will expect her to follow. Take care that the information you communicate is spoken at a pace and developmental level that she can easily comprehend. You may even want to ask her to repeat back what she heard you say for clarity.
Second, explain to your child what actions you would like her to take in place of those, which violate the family rules. For instance, you might tell her, "Instead of hitting, I would like to hear you tell me that you're angry, see you walk away from the situation, or even hear you yell if you feel this will help. You will earn 10 points toward your weekly allowance if you do this." Afterwards, your child will know what behaviors you want, and which you will reward, exactly!
Third, provide opportunities for your child to practice the skills of self-control. Practice role-playing how your child would go about applying specific tools (such as those Safety Tools described in Table 1) to "real life" situations, which typically trigger strong emotions for him or her. Fourth, prompt your child to use his new safety tools. For example, to encourage your child to adhere to the no-hitting rule when upset, you might say something like "Remember your safety tools: You can take a personal time-out if you think you need to. It might help. Hang in there, I believe in you!" You can also provide a visual prompt by modeling the desired behavior when you become upset or angry. Fifth, promptly reward your child for any actions he takes to demonstrate the desired behavior. Remember: reinforcing approximations of the desired behavior can increase the frequency and consistency of the behavior.
Lastly, follow a violation of a family rule or behavioral expectation with a reasonable and timely behavioral consequence. If followed regularly, this program of behavioral modification will teach your child the fundamental principle of cause and effect. In other words, it will help your child understand the parallel relationships between cooperation and the acquisition of rewards, and non-compliance and the acquisition of negative consequences. Over time, these parental interventions will teach your child the benefits of thinking through a situation–critically–before choosing a behavioral response. Your child's use of this critical cognitive skill will promote the gradual development of self-control and the willingness to cooperate with others.
Moreover, if your family's rules reflect widely held conceptions of what is appropriate and expected behavior within larger society, your care to prioritize and counteract your child's non-compliance will spark a growing awareness and an eventual respect for the cultural norms of society. Teaching your children to measure their behaviors against a discriminating code of family ethics will help prepare them to meet standards of behavior upheld by contemporary society. This will be more and more important as your child enters adolescence and young adulthood when standards of personal conduct and societal costs for breaking rules are much higher.
Table 1 Safety Tools for Children, Adolescents and their Families
Tool Definition
| Tool |
Definition |
| Stop, Think and Choose |
Stop what you are doing, be aware of your thoughts, and carefully consideryour choices and the consequences of each possible choice. |
| Personal Time-out |
Briefly excuse yourself from a situation that may cause you to make a decision that you could regret later. |
| Talk About Feelings |
Talk to someone who you feel you can trust. Name your feelings and explain to the person how these feelings are affecting you. |
| Positive Self-talk |
Use your mind like a tape player: repeat the positive statements you have created for yourself when you are going through a stressful time. |
| One-minute Vacation |
Vacation Imagine a special place where you can feel safe, relaxed, and free from all of your problems. Use your imagination to create the details. Stay in this special place for least one minute. |
| Check Boundaries |
Check to see if you are invading the personal space of others around you. Ask someone, if you are not sure. |
| Deep Breathing |
Take several, long and deep breaths when you are having a hard time managing your feelings. |
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Guideline #3: All adult caregivers will discuss and agree upon family rules.
Every family is a system, and like a system, the characteristic way in which family members relate to one another ultimately determines how the family will function as a whole. Like a thermostat that systematically works to create a safe and comfortable living environment, which the family can enjoy, adult caretakers have a wonderful opportunity to create a safe and loving family environment for children by agreeing to work together.
In simple terms, this means that adults involved in the care giving and supervision of your child must work together to draft family rules that make sense to everyone. While this may seem obvious, disagreement about family rules is one of the most common reasons parents struggle to resolve their child's behavioral problems successfully. Parents and caretakers who disagree about family rules will unintentionally create a system that encourages non-compliance. For example, if Parent A gives a child a behavioral consequence for violating a family rule and Parent B annuls it because the child cries and promises "never to do it again," the child ultimately learns that crying and negotiating are tools to control others; in this case, his parents. This experience also communicates to the child that family rules and behavioral expectations are essentially, flexible.
Here are a few suggestions I recommend for you to begin the collaborative process of writing your family's rules in a way that makes sense to all: 1. Arrange a time that you and your parenting partners can sit down, uninterrupted, to discuss the matter of establishing a list of family rules and behavioral expectations for your child. An hour to an hour and a-half should suffice.
2. To begin the discussion, ask each person about the specific behaviors they are seeing from the child, which may be causing problems within the family, in school, etc. Is everyone witnessing the same behaviors from the child? Does everyone believe these behaviors are problematic? If everyone agrees, move onto the next step. If not, take a few moments to discuss the differences of opinion present within the group. Doing so may give each person a valuable glimpse into the underlying beliefs about discipline and other parenting practices, which could be unconscious, and contributing to the style of parenting within your household. Talking about these differences may also help the group identify and separate old, undesirable beliefs about parenting and discipline from those constructive parenting behaviors the group wishes to reinforce.
3. Ask for commitment. Once the group has developed and consented to a list of family rules, ask each parenting partner for their verbal commitment to do their part to reinforce them with your child. In what ways will each parenting partner help to reinforce the family rules? Are there specific activities or interventions that individuals are willing to do to help reinforce the rules on your child's behalf?
4. Schedule regular check-ins. It may be helpful to schedule regular check-ins with your parenting team for the first few months following the implementation of family rules and the new behavior modification system. This will help resolve any problems that may arise in the beginning stages of the structural changes taking place within your family.
Kurt Lewin, a German-American psychologist, discovered that when 51 percent of the variables in any system change, the remainder of the system organizes itself at a higher level of functioning. This is great news! However challenging the task of getting your parenting partners to collaborate, you can rest assured that your family only has to go a little more than half the distance to earn many of the benefits that stem from family-systems change. The more your parenting partners work together to reinforce family rules, the more your child is equipped to meet his or her full behavioral potential.
Guideline #4: All adult caregivers will consistently reinforce family rules.
Over the years, I have met several parents who have an expressed disbelief that behavior modification programs actually work, especially in children with hard-to-treat symptoms. They say, "I've tried that already, it doesn't help." A close look into these situations typically revealed a problem with the timing and delivery of the proposed behavioral interventions, not with the behavioral program itself. In many cases, the rewards and behavioral consequences were delivered too late, or too infrequently to have any significant impact upon the child. Therefore, it is important that all parents understand the key role consistency plays in creating positive outcomes for children whenever behavior modification techniques are used.
Although there are a number of evidence-based, behavioral techniques available to treat conduct problems in children, none of them are effective alone: appropriate timing and consistent delivery of behavioral reinforcements over time must accompany the behavior-change program in order for change to follow. One study of behavioral techniques and children found that continuous reinforcement (reinforcement every time a desired behavior occurred) most often led to higher levels of performance of new behaviors, whereas inconsistent reinforcement led to problematic behaviors that were more difficult to extinguish.2 In other words, parental diligence to follow through with treatment recommendations must always accompany the implementation of any behavior modification program. This helps ensure that best possible outcomes for children and families are met.
Behavioral management problems in children remain a problem for many parents today. For example, in the report, America’s Children: Key National Indicators of Well-Being 2008, "five percent of parents in the United States reported that their child had definite or severe difficulties with emotions, concentration, behavior, or being able to get along with other people." While this figure may sound discouraging, now, more than ever before, we are bound to hope: Most of the symptoms and distress associated with childhood and adolescent behavioral disorders are treatable with timely and appropriate interventions. Behavioral therapy combined with treatments from other evidenced-based psychotherapies is highly effective in successfully resolving hard-to-treat behavior problems in children. It is therefore imperative that parents learn effective strategies to make practical use of these treatments: understanding how to apply these therapeutic concepts is the key to establishing and maintaining winning influence over children.
I recommend that parents begin this process by prioritizing their child's problematic behaviors according to the risk of a particular behavior to cause harm or disruption. Next, it is important that parents set a strong foundation for behavioral modification by establishing a set of family rules that addresses the developmental needs of children. The ability to interpret your child's "acting-out" behavior as a developmentally appropriate way of communicating his need to learn the skill of self-control (not to punish you) can be liberating. Moreover, the thoughtful development and consistent application of meaningful rewards and consequences to your child's behaviors is a powerful way to strengthen adherence to family rules and other behavioral expectations. Lastly, it is important to remember the benefits of working together with your parenting partners to affect positive change on behalf of your child: without this level of cooperation, the behavior modification techniques discussed in this article may simply, not work.
In closing, I would like to encourage struggling parents by noting that researchers are working to gain new scientific insights that will lead to better treatments for mental, emotional, and behavioral disorders in children. Innovative studies are also exploring new ways of delivering services to prevent and treat these problems; and research efforts are expected to lead to more effective uses of existing treatments, so children and their families can live happier, healthier, and more fulfilling lives. Be well.
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Tony Madril, MSW, BCD is a board-certified clinical social worker, licensed to practice psychotherapy in the State of California. He has over a decade of experience treating children and adolescents with an array of emotional and developmental disorders.
Tags: Getting a Grip on Out-of-Control Behaviors, Tony Madril
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By Bonnie Camp, BSW Student (2010)
Introduction
When the hustle and bustle of the holidays is fast approaching, it is important to remember our loved ones who are in area nursing homes. This can be a depressing time for them. They are separated from the normal routine and for many of them this may be their first time away from home during the holidays. Family members should realize the importance of reaching out to their family and friends living in nursing homes and try to make their loved ones holidays as "merry and bright" as possible.
Too often residents feel forgotten and unimportant during this time of the year. While everyone is out shopping and making cookies and wrapping presents, our older adults may be sitting and waiting for a friendly visit and/or to be included in the holiday festivities in some way. Investing in your loved one can be key to a happier holiday for both you and your loved one.
Visiting Often
One of the ways you can keep your loved one involved in the holiday spirit is to visit them often. Visits from family and friends are always welcome and especially dear around the holidays when they may be feeling a little neglected. The time you spend with your loved one can be a positive experience for both of you. It can help their day go a little faster, and of course seem a little more special because of a visit from a family member or friend.
Taking a loved one home, if it is at all possible while you are preparing for the holiday festivities, will make them feel they are still a part of the celebration. If your loved one is physically able to leave the facility to share in your holiday experience , it can make the holiday all the more special for them and you. Residents are very grateful to have the opportunity to be with loved ones during the holidays and they are appreciative of the time you are willing to spend with them. Also, another plus is that once you have them home their enthusiasm is contagious!
And while we are on the subject of visits, visits are GREAT! Nursing home residents love visits. Many treasure visits with children and grandchildren the most. Children, while adequately chaperoned, can be a real source of enjoyment and pleasure for an older adult. And don't rule out visits from pets as well. Many of our nursing home residents love to have visits from pets. Check with your nursing home to see if there is anyone available for pet therapy. Quite a few nursing homes have people who are willing to bring in their pets who have been certified to do friendly pet visits. If this is the case in your loved one's nursing home, see if there is a list that your loved one can put their name on requesting a friendly visit from the visiting pet the next time they come into the facility.
Spirituality and the Holidays
Getting your loved one in touch with their spirituality during the holidays can be especially helpful as well. The holidays are a time when many older adults reminisce of days gone by. While this is usually a pleasant experience, it can be a little sad because of the many losses we experience by the time we are older adults. A resident's spirituality can be a comfort and a source of strength for them during the holiday season. Getting your loved one in touch with a counselor or person from the clergy can be helpful in addressing the loneliness and spiritual concerns that they may have in their lives. Most nursing homes are good at having an area priest or pastor available to visit with residents. Speaking with the nursing home social worker or administrator and setting up a visit for your loved one can be a source of personal strength and encouragement for them during the holidays.
The Importance of Involvement
If at all possible, try to get your loved one involved in a project that allows them to reach out to someone else. Most residents love to be productive and involved in other people's lives. You never lose the urge to make a difference to someone less fortunate than yourself.
There are all types of projects that older adults can get involved in. Making holiday cards is one activity that does not require a lot of energy and can be done at a resident's leisure, when they are feeling up to it. Depending on how involved the resident wants to be, they can either make cards for their friends and family or they can make cards for other people in the community who could use a friendly reminder that they are being thought of.
Another project that is special to my heart is the "Holiday Diary". This can be done with the assistance of a family member or friend if need be, but the idea is to get the resident to document a holiday remembrance so that it can be saved as a keepsake for the family record. It can be called the "Twelve Days of Christmas". For this project, the loved one recalls a special holiday moment, a story, a gift received and/or given or special holiday song that meant so much to them and maybe still does for each of the Twelve Days of Christmas. This is a great way to find out about holiday traditions and special times that happened long ago. Keeping a written journal of these special moments can be a treasure in years to come.
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Bio:
Bonnie Camp is a senior at Richard Stockton College in NJ and plan to graduate with a Bachelor’s in Social Work, a minor in gerontology and a minor in writing in May 2010. She is a trained volunteer with the New Jersey Office of the Ombudsman for the Institutionalized Elderly and a hospice volunteer. Ms. Camp is also the unit chair for NASW Cape May-Atlantic-Cumberland unit.
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Introduction
Moms need time to replenish their energies and enthusiasm. Children benefit from learning to spend independent time. In training the kids to play alone, and give Mom time she needs for herself, keep these six guidelines in mind.
- Age One: Safety needs must be met.
- Age Two: The age of the child, and the child's interests, must be taken into account.
- Age Three: The number of children must be considered.
- Age Four: Mom must put her guilt and some expectations aside.
- Age Five: Mom may have to lower her neatness standard.
- Age Six: Kids can be taught. Explain things to the kids when they are old enough to understand Mom's need for some time.
How I could get the kids to play alone, and how safely they were able to play alone varied greatly as my two daughters grew. When the first one was a baby, I invested in an expandable circular gate that almost filled the living room. I would load in the safe toys and let the little one play. This would give me up to 45 minutes of reasonably free time one to three times a day with an occasional check for safety.
The Playpen Method
The playpen method works best with one child. There is a safety concern about putting two babies in a pen alone or leaving one baby in a pen alone in a room with an older, but not yet responsible enough sibling. When daughter #2 came along, I would need to find a safe alone activity for her while baby was in the pen. This need was the mother of invention of a strategy that worked very well for one toddler, and then two.
I emptied out the bottom shelves of two kitchen cabinets and stocked them with as many toys as would fit. Since my kitchen had a narrow pantry where I spent most of my cooking time, this was perfect. I was able to do my kitchen chores and keep peripheral vision on the older child while the baby was in the playpen. This technique was very effective when the second baby became a toddler. It helped the girls to learn to play together and feel safe that Mom was nearby. As children become used to playing together there can be a significant yield of "Mom" time.
Create a Safe and Interesting Play Area
If Mom has a different set up in her house, she might create a safe and interesting play area in another room adjacent to the kitchen, or a room in which she spends a lot of time. It is important that the set up allow a peek at the kids when safety is an issue. There are very "cool" large puzzle mats one can purchase that define play spaces. Your child can be taught that a certain space is his play spot while Mom is in the kitchen or busy in another room. The ages of the kids will determine how far away Mom wants to go while the children are in their special areas. Turning one room, (if you have the space) into a special (safe) playroom, can give the kids lots to do for a few hours. The trick is to keep a safe and interesting inventory that gets updated to fit the ages and changes in the kids.
"Baby proofing" the house also helped when the kids were between 2 and 5. Taking away dangerous things or those I wanted not to break, and installing a gate at the bottom of the stairs, allowed the kids play and roam a little while I did house tasks, read or rested. Actually taking a nap did not meet safety concerns when the girls were very little.
Have Consequences for Infractions of the Rules
I did not have a room to devote to playing when the kids were young enough to be left in a room alone. Instead I cleared out a space in the basement, which was dry, but not finished, and installed an old kitchen table I found in a recycle store. Once I helped them to go down, or they were safe enough to descend on their own, the girls could paint, use clay and make as much of a mess as they wanted to. The key was to be sure there was nothing toxic in the basement. Also, it is important to explain to the children what is expected of them, and what their responsibilities are in relation to the space. Have consequences for infractions of the rules. They learn best this way.
The consequences do not have to be large. My girls knew what they could do in the basement and what not. One thing that helped was for me to spend a little time down there with them helping them to acclimate to the space. Once they were comfortable and felt it was their own, it successfully occupied many hours of many days.
Once my kids could go outside alone in the backyard I could keep an eye on them from the kitchen windows. We lived on a dead end street. Had we not, I would have fenced in the yard. In the winter the girls could play in the snow for a bit, but they would get cold and want to come in. Depending on what your children enjoy, you can plan an indoor activity for them when the weather—or safety issues—call for inside playing. One of the things my girls liked to do was to paint macaroni and when it was dry, string it into necklaces. This required some Mom time to help explain the activity, but once done, they were happy for at least an hour.
It is important to know what your kids enjoy doing and have the materials available for these activities. Mom must accept that some time may be required in orientation and motivation, in order to have the respite time she needs. She may also have to resolve herself to the fact that her house may not stay as neat as she would prefer. This is the reality of kids. When I moved out of the house in which my children grew up—the house I had tried so hard to keep clean—I discovered that there were areas that I never could have reached or even considered cleaning. As I was driving away, leaving the house "broom clean" for the next tenant, I realized that all those years of cleaning had not made as big a difference as I had thought. Maybe I didn't have to care as much!
Tricks of the Trade — Having Your Own Time
One of the "tricks of the trade" of having your own time is to get rid of your guilt. It is okay for kids to have some time playing alone. It will build independence and trust in themselves. But Mom, you may have to adjust your expectations about how long the "left alone" time will be. If you put in a little "up front" time getting the kids into an activity and helping them to understand that Moms are people too, you may find that you can work your way into having a little "Me" time almost every day.
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Sally had been a soldier's wife for all twelve years of their marriage. She endured separations while her husband, Tom, was called to duty, and she toughed out raising twin boys alone. Sally said Tom loved her because, in his words, she was a "team player." But ever since Sally learned that Tom was killed in a roadside bomb in Iraq, Sally doubts whether she can be a team of one. "I'm really not that strong," Sally said. "It's just a good act."
When Rolanda was shot out of her helicopter, her husband Ray said he had no choice but to "pull himself together." He had to focus on his job and raising his stepdaughter. "I only cry at night, and then only for a second or two. We were practically newlyweds. I don't even know what I'll be missing."
"At least the kids are grown." It was the first thing that came to Linda's mind when she heard that her husband was killed in an ambush. But the relief was short—depression set in, and Linda felt "ashamed" for falling apart.
These stories provide a glimpse into the plight of many of the American families of downed warriors in Iraq. Each family's grief is unique, but most share issues that are familiar to mental health professionals–adjustment, loss, grief, and anger.
Some families rely on friends, the Armed Forces community, and supportive family for help. But one of the issues that many (certainly not all) of these families also share is their reluctance to use the mental health services available to them.
Why? What makes providing counseling to these families so different from non-military families in mourning? And how can mental health professionals serve these families' needs?
Let's start with learning a little more about some of these families. Bear in mind, that there are many reactions to the loss of a family member and that not all families of downed warriors react the same. Yet, a constellation of beliefs, fears and adjustment issues does exist amongst many of these families, and it is important to become familiar with them.
At first, it seems that the most common issues of military families do not differ from the problems of families not in the military. People are people, as some say. After all, humans share common problems. Yet, military families often add elements to these issues that are unique to them.
Many families worry about being seen in counselors' halls and waiting rooms and about being judged and "found out." They also worry about confidentiality. They believe that no matter what the organization, if it's affiliated with the armed forces, it will keep records that could easily be shared with other branches and departments.
Non-military families may have similar feelings, but military families carry with them an extra dose of shame of being "found flawed." They also say they "have had it" with the power of military and government rules. They long for privacy, and they have far higher doubts that their insurance can protect them.
When the emotional and behavioral problems become too great, families might reach out to the mental health services of their insurance plans. Many families experience uneven quality of services, problems of continuity of care, restrictions on the number of mental health sessions or lack of freedom to choose they want.
Yet, non-military families experience these same issues. The difference is what one of my clients called "reaching the end of her rope" with her insurance. These families have higher expectations of the quality of their care. They believe that serving and sacrificing for their country permits them better treatment.
These families feel hurt and disrespected. When these feelings become too painful, the families often avoid seeking help.
The latest information about the unacceptable quality at Walter Reed Veterans Hospital reinforces their lack of trust in all services. However, there are many excellent Veterans Administration hospitals. When frustration peaks, it is easy to toss all hospitals and services into the "not good" pile.
Unfortunately, traveling to a quality Veterans Administration hospital is not easy. Military families may not have the financial ability or the family resources of a grandmother or aunt to assist with child-care. As one of my clients said, the families get "jaded and just give up."
Since these families have now experienced both the anguish of not being able to control their grief reactions and also the shock of seeing what they perceive as a weak and shameful self, their trust in most military mental health services finally erodes. They believe that if they can't trust themselves any longer, then they certainly aren't going to trust the institution that let them down.
Like many American soldiers who fought in Viet Nam, the American soldiers of Iraq and their families risk experiencing negative judgments from the public because of the civil and military difficulties, length of time of the war and loss of lives.
Families often worry about being accepted as well as valued for their patriotic contribution and sacrifice. One wife and mother said, "In the beginning, everyone clamored to wear a 9/11 pin. Now, no one wears one anymore."
Military spouses are usually viewed as hardy, "salt-of-the-earth" type of people who raise resilient children to withstand relocations, absent parents and emotional pain. When the death of a spouse and parent occurs, these families often experience shame in feeling weak, out of control, and emotional.
The comments of one daughter speak for many: "I feel like I'm a disappointment to my father's legacy. He would be furious if he saw me crying and just being a basket case right now."
Military personnel often choose spouses whom they think can manage the anxiety of military life. The spouses often fit along a range from "independent and capable" to "can carry out orders." Imagine, then, the shock when some spouses find that after the death of their husband or wife, their life, household and financial management abilities crumble.
"I thought I had everything under control. I guess I've just been a soldier, not an officer," one wife said. She was fine as long as her husband provided a script, but she faltered at making new decisions.
Like trauma survivors of the Holocaust and childhood sexual abuse, many surviving military spouses and family members describe themselves as "living on two tracks." One track takes them through daily life and the image they present to the world.
But the other track leads to their darker world inside, filled with anxiety, anger and depression. Even worse, some feel like imposters. "If you can fake it, you can make it," becomes their rally call.
Unresolved grief is one the biggest issues that military families report. As a result of their difficulties in handling grief, the families experience several "disconnections" between:
a) what was—and still is—expected of their coping skills,
b) their previous view of themselves as hardy, tough and sturdy,
c) normal grief and adjustment reactions, and
d) their struggle to view these reactions as normal and not weak or shameful. Families often
say things such as "I always saw myself as strong." Shame and confusion replace confidence.
To deal with their grief, families frequently rely on the same ineffective and often damaging coping mechanisms of non-military families. For example, depression, substance abuse or difficulty in working and parenting might occur.
What makes these grief responses of military families so different is that their unique burden of shame of not coping better, disappointment and anger in the quality of their mental health services and lack of perceived national support heightens the emotional intensity, duration, frequency and resistance to changing their ineffective coping tools.
Grief is already a lonely experience. This extra burden makes it even heavier. Soon, the families are caught in a shame-grief-shame cycle that eats away at their ability to change their behavior and negative self-view.
Finally, like many widows and widowers, the spouses often reassess their marriages. For example, wives might discover that they are "relieved" to be out of a bad marriage. Children also may see the deceased parent differently.
The difference in military families is the perceived pressure from the military community to maintain positive views of the deceased partner or parent. For example, serious flaws, such as domestic violence or child abuse might get overlooked. Children may have to work extra hard to conceal their anger at the living parent for having chosen a bad partner.
Military families often flip-flop internally between seeing the truth and glorifying the deceased. The family members sense a heightened taboo against saying anything negative about the deceased and keep secrets about their real feelings.
One of the surviving spouses described the difficulty of "keeping up appearances" that her husband and the father of her children was a "good man." "I don't know who I am anymore," she said. Over time, family tensions increased. The children sensed the lie, and the truth came out only after one of the children arrived at school drunk.
1. Renew your trust in mental health professionals. Try them out—just as you might try out a family physician. Find a person who makes you feel comfortable. Many professionals are willing to speak to you on the phone or provide a free consultation. Some people "Interview" several therapists. Ask openly about their willingness to work with military families. Ask if they have expertise with your specific issue.
2. Rethink your views of seeking help. You deserve to be happy and in charge of your life. Seeking help does not mean you are weak or ineffective. There is no shame in using therapists, pastors and other mental health professionals. In fact, most professionals know that the strong are often the ones most likely to ask for help.
3. Before you go to your appointment, make a list of the topics you want to discuss. Include information such as: a) when the problem began, b) what measures you've taken to solve the problem, c) why you think your efforts didn't work and d) what do you think might work.
4. If you don't like your therapist, speak up about what's not working. Consider trying the therapist for another visit before you select another one. Keep up the momentum of seeking help. If you thought you needed help, follow through on that instinct. Problems sometimes have a way of losing their urgency, but don't let this lull fool you. They tend to crop up again if you don't make effective changes.
5. Contact the Counseling Network of the Special Operations Warrior Foundation Counseling Network., www.specialops.org, a select network of therapists who are providing mental health services for free to families of downed warriors of the Iraq war.
The Warrior Foundation's initial mission was to guarantee college educations to all the children of downed special operations warriors. Over time, however, these families expressed their strong desire to receive counseling from outside their insurance company and the military establishment. Right now, there are over 600 children whose college education will be paid for by the monies that the Foundation raised.
The main office of the Foundation is in Tampa, Florida. Carolyn Becker is the Counseling Director. My husband and I have worked with Carolyn in setting up a free counseling network of volunteer counselors. If you are a family in need of help, you can contact Carolyn Becker at
beckerc@specialops.org
Or you may call Dr. L.B. Wish at 941-363-0505 in Sarasota, Florida or reach her by e-mail at dr.l.b.wish@comcast.net.
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As I sit across from Elizabeth during our last meeting, I realize that she is not the woman I first met. I first met Elizabeth five years ago when her daughter Natalie came to the hospital with new onset seizures. She and her husband Miguel were understandably terrified and unaware of the long road that lay ahead of them. We sat together in that uncertainty.
When a child is diagnosed with a new illness or condition, parents grapple with their own emotions while trying to attend to the immediate needs of their child. Suddenly, the hope and excitement they held for their child's future is diminished. Instead, they may be filled with overwhelming fear and concern. They have questions about the present situation as well as what the future may hold. Each family member experiences the diagnosis in their own way and feels their own personal loss as a result.
According to The Epilepsy Foundation, seizures are the third most common neurological disorder in the United States following Alzheimer's disease and stroke. The Epilepsy Foundation reports that approximately 300,000 children under the age of fourteen have been diagnosed with epilepsy (EF, 2007). Seizures occur when there is an abnormal discharge of electrical activity in the brain. The type of seizure determines how it will present itself (generalized versus partial). A seizure's type, location, and duration are some of the factors that determine its impact (Browne & Holmes, 2004). Medication is typically the first treatment used. However, when seizures do not respond to treatment with medication, interventions such as surgery are often explored.
Living with a seizure disorder affects the child as well as the family. Siblings, spouses, and extended family members often feel rejected or ignored during medical visits and hospitalizations. Parents may become over-protective for fear that their child will have a seizure in their absence. As a result, children with seizures may feel isolated and frustrated by the lack of normalcy in their lives. Many studies indicate that a parent's perception of their child's condition has a dramatic impact on the child's perception. Thus, parents not only have the opportunity to enhance how their child experiences epilepsy but also how the child shares it with the world (Shudy, Lihinie De Almeida, Ly, Landon, Groft, Jenkins, & Nicholson, 2006).
Unfortunately, Natalie's seizures became more and more difficult to control. Despite multiple medications, her seizures persisted. When she was three years old, Natalie underwent epilepsy surgery. To everyone's dismay, Natalie's seizures returned after only a brief reprieve. Weeks, months, and years continued to pass. Her older sister Emily felt things would never be the way they used to be. The girls' parents struggled to meet financial demands while seeking every treatment available. As a result of enduring daily seizures Natalie missed many opportunities to interact with her peers.
The stressors of a seizure disorder or other chronic condition are often too much to bear. Couples may divorce, patients and siblings experience depression, and families withdraw from available support systems. But there is hope and there is help. Elizabeth and Miguel were determined to keep their family intact throughout the years of hardship they encountered. Although difficult at times, they learned how to let people help them along the way and teach them new tools to navigate the often winding road they were on. The family learned how to talk openly about the impact of this devastating condition. They learned how to be angry, not with each other, but with the change in the life they had known before. They learned how to grieve for what they had lost and for the pain they felt. Most importantly, they learned to hope for the good days and to strive for moments when they could enjoy one another.
Every day, families are struggling to take care of a child with seizures while also struggling to keep their family unit intact. A seizure disorder can not be "solved" with medication alone. It impacts patients and their families on a physical, social, emotional, and financial level. Optimal treatment requires care delivered by a multidisciplinary team. Natalie and her family were treated by a Comprehensive Epilepsy Center. The focus of their care was not only on medical intervention but on the family unit as a whole. Important elements included medical and surgical care, nursing care, neuropsychological assessment, and psychosocial team support for the parents, patient, and siblings.
At age seven, Natalie told her parents and her treatment team that it was time to have another surgery. After undergoing a second epilepsy surgery, Natalie is currently seizure free. The family routine still includes trips to the physical therapist and frequent doctors' appointments. However, life has returned to a kind of "normal". Both girls are cheerleading, enjoying school, and looking forward to school dances. Their parents enjoy date night and look forward to planning the next family vacation. Of course, there are moments of sadness and anxiety for everyone. But when that happens, Natalie says "Come on guys, you gotta be brave".
At the end of our time together , I look across the table at Elizabeth and I know we are ready to part ways. The woman I met five years ago felt hopeless and lost. Sitting across from me today, she is full of hope and direction for the future. The journey is far from over but she now walks it with a different beat: she is an advocate, a warrior, and a hero.
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Is there a relationship in your life that you would consider toxic? Toxic relationships are volatile, angry and abusive. They hurt you and typically are so unpredictable that they leave you feeling as if you did something wrong. Many of my clients who are in a toxic relationship come in feeling as if they had just finished emotional combat. They look dazed, hurt, and confused.
I recently met with a woman who was pained by her daughter’s estrangement. She came in holding her head in her hands, wondering what she had done to deserve the venom her daughter spewed at her. She told me that her daughter became angry because she wouldn’t provide her with a family heirloom that she felt was due her. My client explained to me that the daughter believed her mother “owed her” the antique and when the mother gave it to another relative, the daughter expected her mother to compensate her monetarily for it.
My client was confused, wondering if indeed she had owed her daughter compensation for the antique. Although she stated that they had never discussed this arrangement, her daughter was so angry with her that it made her doubt her own sense of reality. She anguished about her decision and unmercifully questioned whether she had been insensitive to her daughter. As she described her daughter, it was apparent that this daughter went on frequent rampages, was unpredictable, and would verbally attack her mother.
People who are toxic can change moods and demeanor in a very short time. They perceive reality differently than you or I, most often feeling a great sense of entitlement. They frequently deny any wrongdoing. Unfortunately, people who relate in a hostile and abusive manner justify their behavior as warranted. Consequently, my client would never be able to please her daughter, and she needed to recognize that her daughter had an illness that would make having a healthy lifelong relationship with her most unlikely. Although I had never diagnosed the daughter, I suspected that her daughter had a mental illness or personality disorder.
Hostile and abusive people who have violent mood swings and misperceive reality typically have an illness that is not going to get better by itself. It would not matter how my client had reacted, because it would not have changed her daughter’s misconception and the toxic reaction that she received. When my client realized that her loved one might possibly been suffering from a mental illness or personality disorder it took the sting out of the relationship. It helped her to realize that she could do very little to change the relationship and that her job was to take care of herself. In other words, it took the power out of her daughter’s words and actions. She no longer took things personally in this toxic relationship.
My client needed to educate herself about personality disorders and mental illness. She needed to seek out assistance from groups who felt similar pain. She might even benefit from groups like NAMI, the National Alliance for the Mentally Ill. This client followed my instructions and while she does not condone her daughter’s behavior, she understands it better and takes it less personally.
My client needed to detach with love. This means minimal contact with that person for the sanity of the healthy party. This can be terribly difficult if there are children or grandchildren involved with whom you desire to maintain a relationship.
Most people have at least one person in their life that could be considered toxic. If you have a history with someone who is impossible to please and despite all your good intentions continues to harass you for not being good enough to them you might want to educate yourself about mental illness and personality disorders.
Researching books or going to the Internet for information to gain greater insight into will help to empower you. Seeking out an evaluation at your local mental health center can also provide you with coping skills to offset the negativity. Regardless you have to learn how let go of the relationship that you so badly want with this person and accept reality for what it is. Although no one can diagnose a person based on hearsay alone, skilled professionals can help you deal with erratic behavior that is angry, hostile and judgmental. Sometimes, your only alternative is to detoxify.
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