Back to School

Today was the first day of school for my eldest kiddo. It’s his second year in preschool, and overall the transition was smooth. He was hesitant early in the morning, talking about wanting to stay home and missing us when he is gone- but after empathizing with him for a bit, he cheerfully popped into his old classroom, eager to visit the book corner. 

I think about how emotional this time of year is for so many of us. The schedule changes alone can wreak havoc on our systems. For myself, there’s a wild mix of relief at being down to only one kiddo at home in the mornings, grief at no longer having my eldest with me, fear of losing control over his environment, nostalgia over my own first days…I know that for so many other parents, kiddos, and teens it can be filled with trepidation, anxiety, overwhelm, and maybe excitement too. 

I remind myself often that all of those responses are ok. It’s ok that I’m relieved that my eldest son is out of the house- and that I miss him- and that I’m sometimes guilty that I’m relieved. All are true. It’s ok that he would rather stay home, and that he’ll probably enjoy himself once he’s there. Both are true. I try not to resist any of the reality of the experience- his or mine. When he told me this morning, “I want to stay home”, if I had said, “No, you don’t! You’ll have so much fun!” he’d have fought me more. He needs to know that it’s valid to be nervous starting over somewhere. Feeling that validated opens up the possibility of maybe being happy too.

Whatever your response is to the beginning of the school year, breathe it in. I love the seasonal shift from summer to fall- how blue the sky looks, how the leaves are still green but the grass has turned brown, and the fact that even though it’s 92 degrees outside right now, there was a hint of crisper days to come this morning. If you love this time of year, take time to revel in it. If every part of you just wishes it was over- that’s ok too. Pay attention to your breath, and let yourself know that no matter how you’re feeling- you’ve got this.

Empathy First

When I am doing play therapy with a child, I always incorporate parenting work into my treatment plan. If a child is struggling, that usually means that the parent can use some support too. One of the most deceptively simple, and yet wonderfully helpful tools that a parent can learn is to approach their child with empathy first.

What does that mean? "Empathy first" means that in most interactions the parent's primary goal should be trying to understand the child's perspective. For example, when your three year old tips the black beans from his dinner out onto the floor for the dog to eat (which may or may not have just happened to me yesterday!), you take a deep breath, remind yourself that it's not an emergency, and then notice what might be happening for your kiddo, "Hey! It's fun when the dog gets excited about food falling onto the ground isn't it?", or, "Wow- your dad and I have been talking a lot just now. Seems like you're trying to get our attention". After that moment of empathy and understanding, the child is going to be much more receptive to the directive that is likely going to come next, "In our house, we don't dump food on the floor", or "It's not ok to feed the dog from the table". All too often, as parents we jump to the directive first, yelling, "Stop that! Don't throw your food on the ground!"- only to have our child escalate their behavior. 

When I work with parents who have recently had a baby in postpartum therapy we will often work with having empathy for that child as well, noticing when the baby seems tired or what cues they offer when they are hungry. Sometimes this is easier with a very young child because their needs are so simple; they need to sleep, eat, be cleaned, held, or rocked. For older children, it can become more challenging because their needs become less physical and often do not make a lot of sense. When a child is crying because they want to eat cake for breakfast, and they have never had cake for breakfast in their life, it can seem absurd that they are so upset. However, recognizing and responding to the genuine longing and sadness associated with not getting what they want helps children feel secure. This does not mean that the parent should give the child cake for breakfast, but rather that they should acknowledge the emotions they see present rather than ignoring, dismissing, or arguing those emotions away.

"Empathy First" also means approaching your work as a parent with self-empathy. The moment you yell at your child when they do dump food on the floor, or you decide to actually give them cake for breakfast to avoid a fight- give yourself some empathy. Parenting is hard work. Your emotions are valid. Take a breath. Know you are trying your best. Then, remember that your kids are too.

Go Slowly, Mama.

I find that living as a parent, in the midst of routine feedings and diaper changes, meltdowns and storytimes, and the juggling of time and attention to make sure everyone's needs are met, it can be easy to lose my sense of self. I can look back on the past day and have trouble even remembering what I did that morning. 

Of course, as a therapist, I know that the answer to this is mindfulness: taking moments to touch in with myself, notice my breath, notice my emotions, and notice if there is anything I need to keep myself grounded. And yet, for all of us, it is so easy to forget to be mindful, to be swept up in both mundane and new parenting challenges.

My children are my best reminders. Recently, I was changing my older son's diaper, moving quickly so that we could join my infant in the living room and continue with our plans for the day. I used only a small part of my mind to notice what I was doing, mainly leaping ahead to what I needed to do next, and next, and next... Then my son looked at me as I was working swiftly and said somewhat sharply, "Go slowly, Mama!". 

Go slowly, Mama. He didn't like the rough feeling of me rushing through this caregiving task. Likely, he didn't like feeling as though he was just another item on a checklist. He wanted me to slow down, to pay attention to what I was doing, and pay attention to him. To be gentle, not forceful. To be mindful. In that moment, his complaint sparked my empathy for him and my own self-compassion. In my stressful rush to get things done I was neither meeting his needs nor my own. So I took a breath. Slowed down. Noticed my son and noticed myself. I connected with him by meeting his eyes and saying simply, "I've been going too fast, huh?".

I hear his voice in my head often now, the tone of his impatience, "Go slowly, Mama." It reminds me even when I am close to tears (or in tears!) from the stress of the day that I can slow down. Breathe deeply. Look at the curve of my youngest son's cheek, and the strength in my older son's legs. Notice my emotions and breathe into them, whatever they are in that moment. It's rarely easy- it's habitual to run through our days without really paying attention to right now, trying to prepare for the next thing. But hearing his voice reminds me that I am more patient with my children and myself, more joyful, and more able to reconnect with all that is around when I do slow down, just for a moment.

If you're also looking for support in going more slowly and practicing mindfulness in your parenting, feel free and contact me.

Perinatal Mood and Anxiety Disorders: Common, Temporary, Treatable

When new parents first imagine having a child, they often have all sorts of fantasies about what the pregnancy or postpartum period with their beautiful baby will look like. Images of snuggling for hours, smelling their new baby's head, and falling instantly in love with this little person seem natural. However, most of new parents realize quickly that while filled with adorableness and joy, parenthood is exhausting, bewildering, and often very anxiety producing. In fact, the most common complication of pregnancy and childbirth is a perinatal mood disorder (PMAD) - including depression, anxiety, OCD, and rarely, psychosis. Research shows that at twelve weeks postpartum 1 in 7 women will meet the criteria for a PMAD, and that increases as the year goes on, to 1 in 5! That means 20% of women who have been pregnant or had a baby (and that includes women who have suffered a miscarriage or had an abortion) will have a recognizable, treatable mental health disorder. Biological mothers are not the only ones at risk- adoptive moms, same sex partners, and dads are also at risk for a PMAD following the introduction of a baby into their lives. In that first year postpartum a full 10% of dads meet the criteria for a PMAD.

These parents can feel an immense amount of shame. Despite the widespread prevalence of these disorders, there is very little education or acknowledgement about them. Remembering the fantasies of what parenthood "should" feel like, a new parent with a PMAD is not only suffering from the symptoms of the disorder itself, but also from the horrifying belief that they made the wrong choice, and that they should not be a parent.

This is so far from the case. Just because you have a PMAD does not mean that you should not be a parent, or that you are not able to do a wonderful job as a parent. It does mean that you should seek help, and know that help is available. The postpartum therapy and cognitive-behavioral and mindfulness strategies I incorporate at the Relationship Center of Conifer can bring relief to the anguish you are feeling. You are not alone.

-Wisner KL, et.al, JAMA Psychiatry 2013
Paulson, et.al,JAMA. 2010

Why Play Therapy?

Before going to graduate school, when I first imagined working as a child and family therapist, I was uncertain what therapy for children would actually look like. I think this is true for most of us; when we are inexperienced with the therapy process, our impressions are often taken straight from the media, with a zen-like therapist sitting across from a distressed adult who may or may not be laying on a couch, enumerating their struggles. How exactly does an active five year old fit into this picture?

Whether or not the zen-like therapist and the couch is an accurate picture of adult counseling, effective child therapy looks pretty different. It can be loud, active, and messy. It is often filled with music, movement, sand, art, and toys.

The efficacy of play therapy is based in neuroscience. The left side of the brain, responsible for logical decision making and linear thought isn't fully developed until adulthood; whereas the right side, responsible for emotions, and creativity is well developed at birth. Play therapy takes direct advantage of this natural brain development, allowing children to tap into their creative, emotional side to heal. We call play the language of children, because it is exactly that: their innate way of thinking, communicating, and being in the world.

There are many, many types of play therapy- all of which tap into play as a child's greatest strength. For example, in directive forms of child counseling, like Autplay TM, I introduce the child to a number of playful activities and games that teach skills the child may be struggling with. They may blow bubbles to work on body and breath awareness, role play dealing with peers using puppets, or draw a picture of how it feels in their body to be angry. This can be enormously beneficial for a child with autism or ADHD who needs help with regulating emotions and social skills, or for a child who recently experienced a trauma and struggles to calm their nervous system.

In more non-directive play therapy, the child is 'in charge' of the session. They are able to play however they choose, and through this play I am able to gain a greater understanding of their inner world. I have had clients come into session and pull out the dolls and act out scenes of bullying at school, or dump every single toy I own into the sand tray, giving me a clear picture of their inner chaos and overwhelm. As the child plays out how they feel in the world, I am able to give them language for their emotions, model self-regulation skills, and provide a safe space to explore frightening or upsetting experiences. This can help heal trauma, depression, anxiety, and aid in big life transitions like a move or the death of a loved one.

Both the directive and non-directive play therapy I practice at the Relationship Center of Conifer speak to the fully developed right side of the child's brain, while helping strengthen and grow the left side, so that my child clients are more integrated, confident, and resilient moving forward.