Sunday, May 31, 2009
As psychologists began to conduct similar research with humans they found similar results. People who learn to be helpless have an outlook on life that is pessimistic. Optimistic people are convinced they have options and choices in all of life's situations.
So, the concept of Learned Helplessness came into existence in the mid 1960s. Until this time, most psychologists believed one of two concepts: either humans acted the way they did solely because of rewards and punishments or emotional problems were the result of deep, mysterious unresolved conflicts (mostly sexual in nature). By doing carefully designed experiments, psychologists began to recognize the importance of thought processes for determining our behavior.
Several professionals began to discover that helping to change people's thoughts brought about a change in emotions and behavior. Albert Ellis, a New York psychologist, became disillusioned with psychoanalysis and discovered that his clients would get better when he could help them change the way they thought about themselves and the world. Aaron Beck was a psychiatrist who also found that psychoanalysis was not a very helpful treatment for people with problems. Martin Selgiman, a psychologist who was later to become a president of the American Psychologial Association, joined Dr. Beck in the quest for finding out how to find better ways to help people change their destructive thinking.
The researchers had one situation they couldn't explain, however. Namely, not all people who were taught to be helpless in the laboratory actually became helpless. Some people never adopted helplessness as a result of the experiments. As Dr. Seligman pondered this, he recognized that the results depended on the beliefs each research subject brought to the experiments. Those who could be taught to become helpless had a more pessimistic view of life, while those who did not become helpless were more optimistic in their outlook.
This difference in how optimists and pessimists see the world is called "explanatory style." Pessimists explain and understand their lives in three predictable ways. They see misfortune as personal, permanent, and pervasive.
When bad things happen to pessimists they believe they are the cause. This can even happen at an early age. One mother brought her 7-year-old son to me because every time he heard about something bad happening in the world, even on the other side of the planet, he believed that he was somehow at fault. As with many parts of our being, we often learn certain traits at an early age.
Pessimists also believe that troubles will never go away (troubles are permanent). So many of my clients that I see in my private practice don't think their life will ever change. They are skeptical that I can help them and are often in my office because it is their last hope. One of the rewards of my job is to have these folks tell me as they leave one of the early sessions, "Doc, I feel so much better because I finally have hope."
Not only do pessimists believe they are the cause of all their problems or that nothing will ever change, they also believe that tribulations are what life is all about. "My entire life is messed up" is a phrase I hear often. Even though we may talk in therapy about other areas of a person's life that are going well, they still believe that every nook and cranny of their life is futile.
This is the exact opposite of how optimists explain personal misfortune. Optimists will look for causes outside themselves for why life just went off track. They see the causes as external not internal. They also believe that bad things are temporary and the exception to life rather than the rule of life. Finally, optimists don't understand misfortunate as being so pervasive. Although they accept the bad situation, they also are well aware of other areas of their lives that are going well.
Let's look an example. Your house is robbed while you are out for the evening. Both pessimists and optimists would agree this is a very bad situation. However, pessimists would take it personally and blame themselves for not checking the locks or thinking it would not have happened if they had stayed home. The optimist would not shrug off the event in a Pollyanna type of response. Acknowledging the robbery as awful, she would realize that there was probably nothing (reasonably) she could have done differently to have avoided the robbery.
The pessimist would also think the situation was permanent: "Every time I go out for the evening, something always bad happens." or "Now I have to live always thinking about when this will happen to me again." The optimist sees this as a rare event but will probably explore any possibilities for trying to minimize a similar event in the future.
Finally, the pessimist will explain the robbery as a pervasive event: "See, things like this always happen to me." or "This robbery just goes to show you that my entire life is one bad event after the other." The optimist will think about all the things in her life that are still going well. She still has a good job, great friends, money in the bank.
Does all this mean that if you have learned to be a pessimist you have to live the rest of your life this way? Not at all. The opposite of learned helplessness is called learned optimism. This will be the subject of next week's article.
Friday, May 22, 2009
The previous two blogs covered some of what we know about temper tantrums and what you can do to help prevent them. Sometimes this is not enough. Children being children they are going to have a tantrum in spite of your best efforts to avoid them. There are a number of ways to handle a temper tantrum.
The first order of business is perhaps the most difficult. When your child begins the tantrum, if you are like most adults, your own stress level will immediately rise. You may lose focus, your body will become tense, your breathing might speed up, your blood pressure might increase. These physical symptoms will make it difficult for you to think clearly and follow through with your chosen strategies. By keeping yourself calm, you will at least not add fuel to the fire. Spend some time thinking about how you can remain calm when the storm hits.
If you raise your voice, argue, threaten or otherwise match your child’s behavior, your child will have the upper hand. Not only will it make your job more difficult but you will inadvertently reinforce the tantrum behavior with your escalated attention.
You may not need to act immediately. If your child is not in danger or if she is not causing a major public disruption, take a few moments to collect yourself, calm down, and decide what to do. After all, you are the adult and smarter than your kid. Some parents do the old standard counting to ten while they slow down their breathing, relax their body and calm their mind.
If your child is not in all-out mode but merely starting the engine, you might try to reverse the process by trying to connect and reassure him. For some parents it helps to stop what they are doing (if possible) and make eye contact at the child’s level. When you have contact, speak in a soft and gentle voice. You may want to say something like, "It looks like you are starting to get excited. Let’s see if you can remember how to calm yourself down." You, of course would use your own words. This assumes that prior to this, you have taught your child how to do this and have had a lot of practice sessions when he was in a good mood. If you can get some good results, then you can spend time "catching him being good."
With small children many parents find that distraction can often help. You know what interests your child and can use these interests when necessary to break the tantrum chain. Since you now know most of the situations in which your child will have a tantrum (from your Tantrum Diary), plan ahead. When you know these situations are coming up, think about what distractions you can use if you should need them.
If used properly, Time Out can be an effective technique for managing a temper tantrum. Unfortunately, it is often used incorrectly so it has gotten a bad name. If you want to use Time Out at home, pick a place that is dull and boring but not scary: laundry rooms, spare bedrooms, whatever you have available — but definitely not the child’s bedroom or a playroom. Children are different in what they find dull and boring so you may have to experiment a bit.
When the child is in a good mood so that you can talk about her behavior, gently explain that from now on when she loses control, you are going to help her calm down by letting her spend some time in the Time Out Room. Show her the room and tell her that if she can stay in there you won’t close the door. But, if she attempts to come out of the room then you will have to keep the door shut. Then explain that how long she stays in there will depend on her.
Tell her when she quiets down, you will set the timer and if she can remain quiet until the timer goes off she can come out. What she won’t know is that you will set the timer for as short a period as you can — like less than a minute. You are doing this because you are helping her to be successful. When she comes out you want to reward her for her "being quiet" behavior. Being quiet in Time Out means she can’t talk to you but she can talk to herself if that helps to quiet her down. If the child is older, you may let her write in her diary about what is happening to her and what she can do to help herself.
One of the reasons Time Out doesn’t work well is that a busy parent ignores her child when he is behaving well. Remember, that some children don’t know how to tell you appropriately they want your attention. They know they can get it by having a tantrum. Because of this you want to continually give your child attention when he doesn’t expect it. The more attention your child gets for behaving well, the better Time Out will work when needed. Time Out is really shorthand for Time Out From Positive Reinforcement. In other words, Time Out is designed to remove the child from attention when he is behaving poorly.
If you are in a public place when your child decides to go into her routine, have your Time Out plan already in place. Most parents immediately leave the store and take their child to the car. When you are in the car, tell her that when she calms down you can set the timer so that both of you can go back into the store. As always when you use the timer, make sure the time is short enough for your child to succeed. You tell her that if she decides not to calm down, then you will be going home immediately.
While you are in the car with her, completely ignore her after you have given her the instructions. When she is calm, tell her you are going to set the timer so that both of you can go back into the store. She will be in the back of the car and you will be in the front. Ignoring your child means you don’t look at her, you don’t make any sounds, you don’t touch — basically you are invisible. As you can tell this whole process can be very inconvenient for you so you. Therefore, you will need to always assume a tantrum will take place so that you can be prepared. Make sure your shopping is set up in a way so that using your plan is possible.
Some parents have used the timer in a dual role. When the child goes into Time Out, they set the timer and if the child can calm down before the timer goes off, then it is reset again for calm behavior. The first setting is long enough for the child to succeed in calming down and the second setting is short enough for the child to succeed by staying calm.
As we mentioned last week, small children can be quite humorous when they are engaging in Attention Getting Behaviors. If you think this is what is going on, ignoring your child is your best response. In case you missed the link to last week’s video of a small child doing his tantrum thing in order to get parental attention. You can see it here.
Holding a child who is out of control is a very controversial technique. Many people have used this to excess. There are many good reasons not to do this. In 2000, there was a tragic case in Colorado where adults attempted to deal with an out of control child by using a "holding" technique. The child died and the four were charged with the child’s death. Most mental health professionals find these "holding techniques" to be dangerous and not helpful. The technique is a part of something called Attachment Therapy. If you are interested in reading articles on the dangers of Attachment Therapy you can check out this link.
With this said, holding a child is best done with young children and its purpose is make the child feel safe and loved. The traditional "holding" techniques do just the opposite — they make the child feel more frightened and insecure. You want to hold your out-of-control child so that he no longer feels afraid and unsafe. While you are holding the child talk softly and reassure him that he can calm himself down. You can restore his confidence in himself by telling him you love him and always be there for him. If you try holding your tantruming child, then continue doing it only if your child responds well. Otherwise do something else instead.
After the Tantrum Has Finished
Some parents like to talk with their child after the child has calmed down. If your child is capable of talking about his feelings, have him do so. You might want to help him come up with a mutual solution for the next time this might happen. Reassure your child there is a better way to get what he wants. You can then take time to teach your child better behaviors for dealing with feelings such as anger or frustration.
When to Get Help
The first clue that you might need to seek professional help is when you notice that in spite of all the new approaches you are using, the tantrums are increasing in frequency or intensity. Contact a psychologist who has a long history in helping parents dealing with behavior problems. At the same time, have your pediatrician give your child a thorough checkup to make sure there are no physical conditions contributing to the tantrums.
Not just any psychologist will do. The psychologist must be trained, if not certified, in Behavior Analysis. Mental health diagnoses are not particularly effective accept in extreme cases such as autism. Even then you will want a Behavior Analyst to help you deal with the behavior.
Behavior Analysis is a relatively new field. The most likely licensed candidates are psychologists, social workers, and school psychologists. Some states are now beginning to honor licensed Behavior Analysts. If you are interested in this new field you can find out more information at the Behavior Analyst Certification Board web site.
Some Things Not to do
- Never, under any circumstances, give in to a tantrum. Giving in will only reward the tantrum and your child will continue to have them and probably have them more often. Giving in does not mean giving ultimatums by drawing a line in the sand. It means giving your child choices and then spelling out the consequences for each choice.
- Never punish the child for having the tantrum. Time Out is not punishment.
- Don't reward your child immediately after she calms down. This is because in order to calm down, she has to have the temper tantrum first. You will be rewarding the pair of behaviors: having a tantrum and then calming down. Reward your child for being calm for a short period of time after the tantrum stops. This is exactly what you will be rewarding your child for when she is not having a tantrum.
- Watch out for grudges. If you are the kind of person who carries a grudge, don’t let your grudge interfere with your relationship to your child. This may be hard but it is vital to successfully carrying out your plan.
Agassi, M. (2000). Hands are not for hitting. (Ages 4-7) Minneapolis: Free Spirit.
Greene, R. W. (1998). The explosive child. New York: Harper Collins.
MacKenzie, R. (2001). Setting limits with your strongwilled child. New York: Prima.
Nelson, J. (1999). Positive time-out and over 50 ways to avoid power struggles in the home and the classroom. New York: Prima.
Cambridge Center for Behavioral Studies
National Association of School Psychologists
Friday, May 15, 2009
Once you discover those tells — or signals — you will find that trying to prevent a tantrum will eventually be easier than trying to deal with it once it has begun. Your first job will be to take the time to find the tantrum signals, sometimes called "triggers." Successful parents keep a Tantrum Diary so they can have a written record what of sets up the tantrum. Even though you may already know this information a Tantrum Diary may still help you discover some not-so-obvious triggers.
Plan ahead – Try to guess how your child is going to behavior as you plan your day. When you have an idea of what you will be doing during the day, you can compare it to the Tantrum Diary. For example, maybe you need to go shopping and course you will bring your child with you. Your Tantrum Diary tells you that your child has a tantrum in the grocery store about 50% of the time. You also found out that it is more likely to happen when your child is tired or hungry.
Knowing this can help you to expect your child to be unruly in the store. What to do? Make sure she is well rested and fed. You also discovered that certain items in the store attract her attention and set off inappropriate behavior. Since children love to be helpers, you will tell your child that you are going to play a game today (smart parents make a "game" of everything they want their child to do). The Grocery Game must be explained in such a way as to make your child interested and eager to play. There are so many way to do this. Being mommy’s helper can be part of the game. Letting her pick out items on the shelves from the grocery cart she will be sitting in can get her interest. Letting her actually take some of the items off the shelves is another option. As you can see, keeping her busy, away from boredom, and always interacting with you (attention) can often bring big rewards for you.
Sometimes the sameness of a place can begin to induce boredom in a child. What a surprise, because this never happens to us adults. If your Tantrum Diary tells you that playing or drawing or any other activity has about a 45 minute limit before a tantrum is inevitable, then you want to change the environment prior to this time limit so that a new stimulation will keep your child’s brain from turning on the tantrum switch.
As we mentioned above, physical situations can temper tantrums more likely. As adults we can also get grumpy when we are hungry and tired. Fortunately, not too many of us throw a temper tantrum in these situations. Remember, from last week’s blog, that your child may not have developed language or coping skills for these feelings. Your child has learned there is only one way to be expressive when frustrated and perhaps get you to help solve a problem.
Most parents know that tantrums often occur when the parent is busy and needs to finish what he or she is working on. Again your Tantrum Diary may show you that your child has tantrums when you are fixing a meal or on the phone or sending email. But it doesn’t happen all the time. The diary will also show that when you can engage your child during these times, the tantrum is less likely. For example, maybe you found out accidently that meal preparation can be easier if your child is with you and allowed to help or even snack and watch. Maybe phone calls will be more calm if your child can sit on your lap or draw a picture for you or your friend on the phone. Find out what works for your child. Ask other parents what they do. I have found that parents can be extremely creative when they put their minds to it.
Maybe your diary showed you that during an art activity, your child has a tantrum when he can’t use the scissors in the art box because he is not old enough to handle them safely. Maybe other objects in the house like certain papers, your cell phone or some kitchen utensils are also off limits for your child. Hide them so the child cannot see or touch them. Some parents get substitute items such as their child’s own "cell phone" (most people have old ones laying around) or a beat up kitchen utensil. Often your child is merely trying to imitate your behavior and can’t understand why you won’t allow this.
Your diary might show that visiting new places or spending time with people the child doesn’t know can create anxiety and uncertainty in your child. Children often do best when they feel safe (and well fed and rested — oh, yes, we already noted that). Explain everything to your child ahead of time such as what to expect when some unfamiliar events might take place. Ask your child if he has any questions. If you can anticipate any problems tell him what you can do if he feels upset. Help him feel safe and let him know you will be there for him.
Again, boredom is a trigger that makes most humans feel uncomfortable. How many times did you complain to your parents by saying, "I’m bored, there’s nothing to do." Our brains, from birth, are meant to be curious and explore the world. Always be on the lookout for something new that might grab your child’s attention. Then save it for those times when you need to interrupt your child’s boredom triggers.
It is not a secret that tantrums often occur at the end of an activity your child is enjoying. Give her a 10-minute warning, a 5-minute warning or whatever time intervals seem best with your child. Portable kitchen timers are one of the best tantrum tools parents can have. "When the timer goes off, you only have five minutes to finish coloring." "Now, we’ll set the timer to let you know when you need to put away your crayons and books." "Your time is up. Let’s see if you can get everything put away before the timer goes off again."
We could do an entire mini-series on this topic. Attention is one of the most powerful motivators for young children. They are really good at getting our attention when they want it. It makes no difference that the attention you give them is "negative" because for young children, attention is attention. Our kids teach us to pay attention for misbehavior and then we basically leave them alone (ignore them) when they are behaving well. You want to reverse that. Remember the phrase "Catch them being good." In the paragraph above, each time your child is successful (you always manipulate things to increase the probability this will happen) before the timer goes off, you will reward her with hugs and kisses, verbal attention, stars, whatever turns her on. This is especially effective for managing triggers. In the presence of a potential trigger let her earn something important for behaving well. Be sure not to reward her for "not having a temper tantrum." You want to reward her for what she does rather than what she doesn’t do.
Try to set expectations and demands that match your child’s developmental level. A successful child is a happy child. You also need to know the difference between requests and demands. A request is something ask your child to do but you are okay if she refuses. A demand is something the child must do. Moms tend to be more inclined to ask questions, "Would you like to go and wash your hands now?" Although you mean this as a demand (no choices available) it sounds like a request and will confuse your child because you really meant to say, "It’s time to eat so please go and wash your hands."
When situations come up where several possibilities are okay with you, give your child choices. Having choices is important to us humans and your child is being more aware of this as she ages. Having control over the little things may help avoid power struggles over bigger things. Often, children engage in temper tantrums because it is the only skill they know. Identify replacement behaviors you want from your child instead of the tantrum behavior. Then teach these behaviors when he is pleasant and you are in a good mood. Practice the new behaviors until he is proficient. Make it fun – a game. Tell him how much more enjoyable this will be for both of you than feeling badly during a tantrum.
Sometimes we parents are so tired of fighting with our children and having to put up with their tantrums, we begin to draw mental lines in the sand. We start to see all minor indiscretions as places where we need to take a stand as the adult authority figure. This often becomes a no-win situation for you. There will be times when ignoring a temper tantrum is your best choice. Letting your child ride it out will also teach him that not all temper tantrums will engage you. Your Tantrum Diary might give you clues as to when, what, and where you can basically let the performance run its course. Ignoring behavior on your part means you basically make yourself invisible: no sounds, no eye contact, no physical closeness. Some time after the tantrum is finished and your child is behaving well, give him lots of attention (for doing good). Be careful not to do this right after the tantrum is finished because you will then teach your child he can get your attention by having a big tantrum followed quickly by doing something that will please you.
You, in addition to your child, also need to be rested and stress free. Ever notice how your child’s behavior will often match your well-being? The Tantrum Diary will give you a sense of control. Planning ahead will give you a sense of control. Managing the tantrum triggers effectively will give you a sense of control. Enjoying your child in formerly rotten situations will give you a sense of control. When you feel in control, you will have more tolerance for those small things that used to set you off.
To learn about managing your stress click this link. Then click on the link to the left that says "Downloads." In the window that pops up click on "Stress Management." This will lead you to a complete set of instructions for developing and mastering skills for dealing with stress.
Finally, learn to laugh at some of the behaviors that used to be so annoying. When some parents laugh at the tantrum it surprises the child and halts the tantrum. Be careful using this, however, because you want to focus on your child’s behavior, not his worth. Many parents will laugh with each other in private or with their friends. This can often make a tantrum more tolerable or manageable in the future. Here is a funny video that was taken of a toddler’s temper tantrum. Read again the importance of attention.
Sunday, May 10, 2009
Is there a Mom alive who has not been the target of a temper tantrum? Is there anyone who has not seen one? This article is the beginning or a series of three articles on the subject. This, the first one, will describe and help us better understand what temper tantrums are all about. Stepping back from emotional situations can give us perspective and help to find ways to deal more effectively with unpleasantness.
Introduction to Temper Tantrums
Most parents share the common frustration of the Terrible Twos. The first child to go through this stage is often the worst (so it seems) — partly because we don’t know what to expect and because with the next child it already looks familiar. In this first part of a three-part article, I want to help you understand the "normality" of temper tantrums. Why do so many children go through this stage? Next week’s article will look at what parents can do to anticipate and possibly help prevent or moderate temper tantrums. The last will offer some suggestions about what you can do when the child has a temper tantrum regardless of the preventative techniques you use. We’ll also consider what can be done post-tantrum. What can you learn from each temper tantrum that might be useful for the next episode? Additionally, this last post will include some suggestions about how and when you might want to seek professional help. The article will also offer book suggestions for those of you who would like to have a reference handy.
One of the first problems that pop up around temper tantrums is the inclination for parents to take it personally. I sometimes wonder if there is a special place in the parent brain that automatically judges oneself when our child misbehaves. It is so easy to do so and so many parents are self-condemning as the result of temper tantrums.
Why shouldn’t you take it personally? One reason is that you are probably not responsible for the tantrum. Good parents have kids who behavior miserably (it sometimes works the other way around, too). Those of you who know about the Domino Effect will understand that your child’s behavior belongs in the Life Domino. This means you have no control over another person’s (your child’s) behavior. Neither girls nor boys generally have more tantrums than their opposite gender. We also know that over 50% of young children have an average of one temper tantrum a week.
Another part of the parent brain gets us to think that the behavior of our children is a reflection on our parenting skills. This is why talking with other parents of young children can be so refreshing. We then know we are not alone. Not only do their kids throw tantrums but the parents also think and feel like you do. One of the most productive things a parent of a young child can do is to expect their child will have temper tantrums. It begins somewhere in the first year and can last up until year five. We know that almost three-quarters of children between the ages of 1½ and five years have tantrums.
So why do young children even have temper tantrums? Life would be so much more pleasant if they just wouldn’t upset us so with their tantrums. When you think about it, it makes sense that young children should have temper tantrums. Frustration is one of the common human experiences and it begins to be felt at an early age, around one or two. What a coincidence.
As babies’ brains begin to develop a sense of independence, this new found awareness sometimes outpaces the necessary skills for independence. Not only is your baby trying to convert a brain concept into a physical action (putting on her own socks) but her brain also knows when it is not being done right. So we have a conflict between the part of the brain that knows what it wants to do with the part of the brain that doesn’t know how to do it. Have you as an adult ever had this experience? Of course.
What do adults do when they are frustrated? Cussing is a common reaction. Screaming, throwing something, just giving up or asking for help are common adult reactions. Your baby can do all of these except those that need advanced verbal skills. Can you imagine what it would be like if, when you were frustrated, you did not have the verbal skills to tell someone what you wanted? You already know that your toddler’s vocabulary is quite limited. But did you know that when a toddler speaks to his parent, the parent may only understand what is being said about half the time. How often has a tantrum erupted when you didn’t understand what your child was telling you she wants? Your child wants something from you and when she doesn’t get it, WHAM!
Frustration often occurs when we know that we have certain choices in a situation but have few skills to implement one or more of those choices. Another part of the growing baby’s brain is an awareness of choices but without the necessary skills to make the choices happen. The needs of newborns and infants are quite simple: food, sleep, and having someone clean them up. Getting their basic physical needs met keeps them happy. By the age of two these needs become more plentiful and diverse. It's around this time that one part of their brain runs ahead of another part of their brain.
Some professionals have called the Terrible Twos by another name: First Adolescence. Becoming a teenager is another time when new awareness often proceeds faster than the capacity to make good decisions. Teenagers have a new sense of being independent (again) but become frustrated and angry when many of their new choices are confined by adults in their environment.
Understanding this growth pattern in your young child can be a time for you to recognize that your child is in a transition stage of healthy childhood development. We often see our tantrum prone children as too determined, too self-centered, too sensitive, and maybe even too creative. When you think about these traits they are actually good ones. They can potentially be used for living a productive and happy life as an adult. It is your job as a parent to begin to help your child channel these traits into new behaviors that your child can more effectively use as she gets older.
Some parents wonder if children are purposeful in their tantrums. "Are they doing this to just bug me?" The brains of toddlers are not developed enough for them to be plotting how they can get back at you. They are too young to even enjoy watching you lose it. This only happens when the teen hormones kick in. A toddler's brain interacts with the world (and you) in a very simple, non-adult way. There is also a good likelihood that neither you nor your child enjoy these difficult moments.
Psychologists who study young children tell us that temper tantrums change over time — even though for many parents a temper tantrum is a temper tantrum is a temper tantrum. As we’ve mentioned above, two-year olds begin to recognize they can interact to change their limited environment. When this recognition clashes with a two-old’s skills temper tantrums often result.
By age three, language begins to become less simple and less limited. During this year, parents report that tantrums begin to subside in frequency and when they do occur they may be less intense. Unfortunately, this newly developing brain might also have learned that temper tantrums can be an extremely effective tool for getting something from adults, such as attention.
It is common for four-year olds to become quite skilled at interacting with their world with less adult help. In addition to their advanced physical skills they also have a much larger vocabulary. They may have also learned some rudimentary interpersonal skills such as the appropriate expression of anger, compromising and the beginnings of empathy. With this said, children as old as six can still have temper tantrums for a variety of reasons.
I hope this gives you some sense of what temper tantrums might be like from your child’s experiential vantage point. As awful as tantrums are, they are a natural part of a child’s growing up during a time when he is not being quite ready for the complexities of the surrounding world.
Next Friday, you will find an article that is more practical — strategies you can use to minimize the possibility of temper tantrums happening.
Friday, May 1, 2009
Q: I have heard about two kinds of eating disorder: anorexia and bulimia. Are there are other kinds?
A: Yes there are. We know that about 5% of teenagers and young adult women have either anorexia (self-restricted eating with severe weight loss) or bulimia (binge eating followed by purging).
However, young females can have other types of eating disorders like Bulimiarexia. The is the condition where some women live on 500 calories a day, are extremely thin and also purge their food. This is one of the most dangerous conditions and has a high mortality rate.
- Purging Disorder. We have recently noticed that some women purge even though they don’t binge eat. Sometimes the purging will be induced by enemas or the abuse of laxatives or diuretics. Purging is most often done in secret accompanied by lying if questioned about the behavior.
- Binge Eating. Although binge eating is often a sign of bulimic behavior, we know that binge eating can occur without self-induced vomiting. What constitutes a binge can vary from person to person. Some people who think they binge are actually eating an appropriate amount of food.
- Chewing and Spitting. I’ve only encountered this twice in my practice but there is mention of it the professional literature. These females will eat food (sometimes large amounts) but will not swallow the food. One client I had would carry food and plastic bags in her purse. She would chew the food and then spit the chewed up food into plastic bags which she would put back into her purse.
Q: Why are some teens more anxious than others about dating?
A: By definition, the teen years can be filled with strong emotions. Anxiety, jealousy, and anger are part of making the transition from childhood to adulthood. Dating and romantic relationships during adolescence can add more emotional strain.
Research by psychologists at the University of Miami in 2007 found a strong correspondence between the amount of anxiety a teenager experiences over romance and the quality of close friends. The researchers found that two elements can influence teenage romance. First, a teenager will probably have less problem in dating if he or she has a number of supportive friends of both sexes. Secondly, dating is more difficult for those with little or no dating history. Like jumping into cold water, once a teen has started to date and has supportive friends, the situation tends to improve.
Q: My daughter recently told me about a friend who cuts on herself when she is feeling bad. Is this common?
A: Yes, it is more common than many people realize. The frequency is possibly between two and three percent of high school age females. The World Health Organization estimates that four times as many females than males attempt to harm themselves. The most common form of self-injury is cutting and the most prevalent place on the body is on the arms.
Many young girls will cut themselves, for example, to relieve tension and painful emotions. Others, ironically, will injure themselves to cause themselves to experience a type of pleasure. In these girls, self injury may release a type of opioid in the brain that make them feel better. Certain conditions increase a girls’s risk for self-injury: Any previous suicidal attempts; sexual intercourse before the age of 15; same sex romantic interest; poor social support; minimal attachment to parents.
Q: I’ve just quit smoking and am concerned about relapsing. What are the reasons people start smoking again?
A: Excellent question. The common wisdom has believed that smoking relapse is the result of drinking alcohol or coffee, being around others who are smoking, or socializing.
However, a recent study a few years ago found out this wasn’t so. Psychologists at the University of Pittsburgh Smoking Research Group wanted to find out what really got people to relapse. They discovered the most important reason for smoking relapse is negative emotions and distress. In order to guard against smoking relapse you need to find new ways of coping with strong negative emotions. You may want to check out The Worry Free Life -- a book full of coping techniques for distress and negative emotions.
Q: My best friend thinks that maybe I need to see a psychologist for therapy. Although I’m not against the idea, I’m not sure how to find a good therapist. I have heard too many horror stories about therapy and I also know that many people have been helped by it. What’s the best way to go about finding a therapist who might be right for me?
A: This a question I wish more people would ask who, not only are thinking of beginning therapy, but have also been in therapy for awhile but feel like they are not making any progress. As with people who seek the services of any professional you want to be able to make an intelligent decision.
Years ago a prominent psychologist, Arnold Lazarus, devised a questionnaire to evaluate the behavior and personality of a therapist. I give a copy of this to every one of my clients on their first visit. If you are interested in obtaining a copy, send me your request to me and I’ll send you the 2-page form that I use. It has 17 items for you to consider. On the second page, you can score your answers to determine if the therapist and you might be a good fit.
Here are some examples from Dr. Lazarus of the things to consider about a therapist:
- I feel comfortable with the therapist.
- The therapist does not treat me as if I am sick, defective, and about to fall apart.
- The therapist has a good sense of humor and a pleasant disposition.
- The therapist admits limitations and does not pretend to know things he/she doesn't know.
- The therapist answers direct questions rather than simply asking me what I think.