Stress Part 2

Virtually everything that happens to us has the potential to be a stressor. Some common causes of chronic stress include:

1. Time, 2. Responsibilities, 3. Personal problems, 4. Work, 5. Lack of sleep, 6. Bottled up emotions, and 7. Pressure of finances.

What makes an enormous difference is the management of these sources of stress. By management, I mean how one internalizes what happens to us. Internalization of stress is a process and the process is shaped by our attitudes. Some of these attitudes can lead to an increase in stress and include:

1. Worrying about situations we can’t control

2. Not seeing choices that are available to us to manage difficulties

3. Inability to successfully access the importance of certain outcomes

4. Unrealistic expectations

5. Being overly self-critical

6. Ignoring positive feedback from friends, partners, loved ones

7. Expecting a neat and easy solution

8. An all or nothing approach

Bearing these in mind, at PsychotherapyWorks our model of treatment includes a  number of important interventions that, once practiced and rehearsed over time, can replace stress management strategies that are not working.  Such strategies include:

1. Refuting irrational beliefs of all kinds

2. Practicing positive self talk

3. Limiting comittments so that one is not overworked

4. Learning to relax

5. Using exercise to release tension

6. Learning appropriate time management

7. Learning how not to over-magnify events.

8. Learning the value of play for everyday success and happiness

Some reminders along the way:

1. Don’t sweat the small stuff

2. When managed well, it’s all small stuff

In the final analysis, too little stress makes for a boring, frustrating and basically unproductive life. Too much stress can leave us overwhlmed, irritable, exhausted and sometimes even sick. Just enough stress helps us feel motivated, excited, creative, energized, and vital.

Stress effects everybody, young children, children, adolesecents, young adults, and adults, couples, and the elderly. At PsychotherapyWorks we have used original and well researched methods to treat stress in all these populations. Check out our web site and let us know what you think.

Schools In (Managing Transitions)

Well it’s that time of year, when we labor through the hottest part of our summer months and inch our way forward towards a new academic year. Yes, in most areas, we are a short 3-4 weeks away from the first day of school. All across the country, our children are savoring those last days of “freedom” and department stores are readying their “back-to-school” advertising. Soon, the papers and TVs will be littered with all manner of back to school stuff. Certain jurisdictions will even sponsor tax-free shopping days to attract your business. Yes indeed, the school year is just around the corner.

Whereas for many children this time of year is exciting, it’s also a time of change and transition that is ripe with all kinds of psychological concerns. Whenever we see transitions in a child’s school experience, it certainly the case that the child/adolescent will be challenged. Certain of these challenges include: meeting new peers, navigating an unfamiliar environment, meeting new teachers, adapting to new levels of expectations, new structures for organizing the day, new foods, new everything. Adapting to so many changes is challenging to anybody, but especially for children. Easing the transitions and helping children adapt is an enormous priority for parents, and if your child is transitioning in any way from one school to another, it’s considerably important to be aware of how your child is managing the stress implied in navigating the change. Here’s a remarkable story of one such change.

A family that I was working with reported that their 3 year old daughter was getting ready to move from one daycare to a new daycare. This family was employed by an institution that had two day care centers, one for the first 2 and half years of life and the other for 2.5 to kindergarten. Since their daughter was 3 years old it was time for her and her friends to move to the new day care. To help the child, she went daily for a period of two weeks to the new day care center to meet her new teachers, become familiar with her new room, and overall, to gain a measure of safety in her sense of belonging to the new daycare center. Meanwhile, at the old center she was in the process of saying goodbye to all her old teachers, old rooms, and her existing daycare center recognized that it was important to honor this part of the child’s transition.

During this period of change, the parents reported that their daughter came to their bed one morning, woke up both parents, and told them a dream she had. She told them that she had a dream that she was in a plane and that she was going somewhere. Mommy was driving the plane and everything was OK. The plane landed and it was “all OK.” Daddy was there to see us when the plane landed.

This is a marvelous dream and I explored with the family the way in which the dream suggested that the child was acutely aware of being in a transition from one place to another (the plane), that the transition was safely anchored (mommy driving the plane), that the transition would go smoothly–that she would have little difficulty adapting to the process (the plane landed and it was “all OK”), and that she would feel embraced by the teachers and structure of the new center (she lands and her daddy is there is greet her).

What I found truly marvelous about this dream is that it suggests what we know as psychologists, that is, that children undergo psychological processes that are remarkable when their life propels them into transitional periods. What more, the parents of the child were concerned about their daughter’s transitional process between daycare centers and were concerned that she make a successful transition. Their concerns were warranted, and we were able to see in the dream a communication to the parents that their daughter’s transition would be safe and successful. Recognizing that the daughter’s psychological process was secure, the parents were able to let-go of the stress they had about their daughter’s transition and simply be as supportive as possible for their daughter. In the end, the parents were less stressed, felt more secure about their daughter’s process, and their child made a seamless transition between centers, and is thriving in the new daycare center.

This story echos a familiar theme: that our psychological constitution is at work in the transitional periods of our lives and that attending to the psychological needs of our children when their in such phases of their life is really the best possible expression of our parenting. Making children feel safe, allowing them to express their feelings, appropriately monitoring their safety, giving them space to adequately say goodbye to previous teachers, schools, classes, encouraging their capacity to adapt and meet the challenges of their new environments, managing our own stress during their transitions, all of this and more is the stuff of good parenting when our children are transitioning.

And it’s quite clear that children of all ages are so challenged. Whether it’s transitioning to new schools, to new grades, moving between schools in a community (from home or daycare to kindergarten to elementary school, middle school and finally, high school), or to college; the psychological process at work in adapting to the new place and all the challenges therein constituted are a core component of successfully managing the transition.

Now, what are some of the markers that suggest that our children are having problems making the transition. First and foremost, a change in the usual experience you as a parent have of your child. Are you noticing a shift in your child’s behavior with you, with siblings, with friends that seems out of sorts with how you know your child to be. A dramatic shift in your child’s behavior may suggest the need to talk with your child about how they are managing their new environment and how they feel about the new place, as well as their feelings about any old places they may be transitioning from. The take home message here is for parents to be mindful of their children’s behavior during transitional phases of their life and to give them as many opportunities as necessary to talk with you about what’s happening for them. Secondly, are you seeing aggressive behaviors, angry behaviors, irritation that seems out of keeping with your child’s usual behavior. What we have noted over years of working with children is that so often a child who is struggling with a transition will evidence a new-found aggression. Rest assured that this is not an end in itself, but rather is an attempt by the child to get some help by getting attention paid to them. Third, are you seeing a change in academic performance that does not seem to fit how you have known the academic abilities of your child. Such a change may indicate a number of things, such as the need for a parent-teacher conference, for adjustment of the child’s learning environment. Equally so, it may indicate a problem with hearing, vision, or attention and focus problems. Moreover, an academic shift may suggest that there is an emerging area of academic weakness for the child that requires support. Finally, an unusual change in your child’s academic performance may suggest problems with peer affiliation, and could be the result of feeling overwhelmed by new peers, being bullied by certain peers, or a host of other peer related and environmental concerns.

Perhaps the single most important role for our children is played by the parents in, what Dr. Kothari calls, being “mindful” of your child’s transition, paying attention to their process, noticing shifts in their personality, behaviors, and overall mood. Research on children suggests that the more the parent is appropriately tuned in to their children’s psychological processes of adapting during times of transition, the more successful the child will be in meeting the challenges of the transition.

Sometimes our children have difficulties making transitions and the problems implied may be scary, overwhelming, or simply painful. Whenever your seeing problems that rise to such a level of concern it’s often helpful to seek out professional consultation and the research is clear, the sooner the better. At PsychotherapyWorks we are dedicated to your child’s health and well-being and Dr. Kothari is an expert in understanding the enormous web of factors that are implied in the relationship between your family and your child’s educational process. Consultation is often the most helpful way to ease your mind, acquire much needs supports for the family and the child, as well as assistance and advocacy for your child’s rights within their school system.

We invite your comments and questions about the content of this blog and hope to hear from you about ways in which you are working to support your children. Do not hesitate to write back.

Psychological Mentoring (What is it?)

As a psychologist whose practice is both academic and clinical, my research in psychotherapy outcomes has been organized around the therapeutic practice of Psychological Mentoring and in two distinct ways. First, in my academic roles Psychological Mentoring has to do with educating the next generation of psychologists so that they have a variety of skills to manage the enormous volume of complexity that is found in working with human beings. In academic psychological mentoring, I feel a responsibility to my students’ future patients. Knowing that my students are equipped with a healthy appreciation for the unfathomable complexity of human experience and how to manage that complexity in empathic and creative methods that serves the greater good. That is the way academic psychological mentoring proceeds.

Therapeutic Psychological Mentoring is a creative process anchored in the mythology of the hero’s journey, the young persons successful transition into adulthood. We see such a mythology depicted in the movies such as Star Wars, The Lord of the Rings, & The Karate Kid (just to name a few). In many years of clinical practice, what I most often see is the human experience of having become profoundly stuck in the process of making the transition to mature adulthood. This stuckness can take many forms but overall what happens is the person cannot seem to get on track with their life in a way that feels satisfying to them, and which is perceived by others close to them as an appropriate path for them to fulfill their unique potential.

I use the term “mature adulthood” in order to describe psychologically mature adulthood as discrete from and an evolution of what we popularly refer to as adulthood. The popular notion of adulthood is, in fact, a fairly simple construct that has its footing in the ability to access certain rights: the right to consume alcohol, to consume tobacco products, to vote, to access lines of credit, etc. The popular understanding of adulthood also has to do with services requirements, most of which are voluntary, such as: service in the military and participation in local community activities. What more, the popular understandings of adulthood emphasize certain roles, such as: independent living, successful financial management, domestic partnership or marriage, and the transition to father/motherhood. Though much is implied in this short list, it’s remarkable to see that the emphasis in the popular culture has less to do with the psychological processes implied in entering into mature adulthood and often has to do with biological markers, as in, ‘now your 18 so your an adult.’ What’s emphasized here is the biological marker and not the psychological process. And it’s often the case that being 18 and being ready to tackle the challenges of adulthood are completely out of sink.

Psychological Mentoring is intentional in looking at the psychological process that gives the person the solid footing to successfully navigate the stresses, challenges, and transitions that are naturally implied in development into mature adulthood. What I’ve been seeing for many years now in clinical practice with children and adolescents is large groups of children and adolescents whose experience emphasizes the biological markers and de-emphasizes the importance of the psychological process that is the core component for the successful management of their life in all its complexity. Equally so, what were seeing with adults is often biological adults, adult by fact of their age; but whom are psychologically locked into childhood or adolescent patterns that often have the effect of undoing their attempts at successfully managing the challenges of adult living. Adults in this situation are particularly challenged because everything in their life says “act your age”, “grow up”, “just do it”, and yet their often stuck, overwhelmed, unsure, unsafe, dis-empowered, feel unable to make sense of the simple ways they could help their own lives. What more, there is a cascade effect for such feelings, in which what first begins as feeling overwhelmed eventually becomes clinical depression or an anxiety disorder, a severe relationship complex, in which the person begins to turn on themselves. We see vegetative problems in that there are changes in sleep patterns, a change in eating habits, lack of exercise, withdrawal from friends and loved ones, with the level of severity often increasing in proportion to the length of time in which one has felt unable to cope with the demands of adulthood.

In my work as a psychologist, I regularly find myself in this kind of complex work & I have been impressed with how even the most unusual of problems in living can have as its nucleus inadequate preparation for mature adulthood. At PsychotherapyWorks our attitude towards this problem is that the problem can be solved, that the questions posed by our problems in coming to mature adulthood are important markers for development, that the fact of their being a problem implies an answer & that by answering such questions one naturally enters into the process of preparing to enter into mature adulthood.

And the method in which the questions about mature adulthood are answered is mentoring. Mentoring has many qualities, first of which is its empirical footing. In my work with graduate students we have seen over and again, that the mentoring process delivers in terms of helping individuals both recover from diagnosed medical conditions such as anxiety and depression, but also in terms of getting on track with their lives in a way that makes sense and provides personal meaning and satisfaction in their living. Self-report measures at the close of treatment have demonstrated the clinical efficacy of mentoring interventions over a 28 week period in which there was 1-2 times weekly outpatient sessions for children, adolescents, adults, and couples. Overall, the data is clear: Psychological Mentoring Works.

In our actual clinical practice, what makes Psychological Mentoring work is the relationship between the psychologist and the client. At PsychotherapyWorks we are committed to modes of relationship that meet the client’s needs. We are not about the business of deploying a “traditional” psychotherapy method in treatment. The idea of an analyst sitting quietly, taking notes, is not what were about. Psychological Mentoring implies the development of a real relationship with the client, where the client’s primary ways of concerting are often the way in which the therapist will connect with the person in the treatment. It’s not unusual to see Dr. Kothari playing a game of catch with a young man, taking a walk in the gardens or the surrounding neighborhoods or parks that are part of the beautiful landscape for the setting for the mentoring process, sitting by a local stream and talking with a young man about his life and the ways he can make his life come alive in ways that make sense to him.

Certainly Psychological Mentoring is not our only methodology. In fact we at PsychotherapyWorks are grounded in a number of empirically validated treatment methods. However, what we have found is that a core component of almost all of these treatment models is some type of Psychological Mentoring. That said, when Dr. Kothari works behaviorally with children and adolescents diagnosed with ADHD, we do both the behavioral work, the social skills training, the focus and attentional training, but we are also building the relationship with Mentoring so that the behavioral and skills training work is even more effective. Overall, this method of working on Mentoring in therapeutic work has been significantly rewarding and is a remarkable psychological tool for facilitating the development of mature adulthood.

Finally, if you have any quetions or comments we invite you to share them and we will certainly respond.