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March 15, 2021 by BHP Leave a Comment

Executive Function (part 2): Ideas for Supporting Thinking Skills Development in Children

Referring back to my previous blog – Children and young people with Executive Functioning Difficulties need us to:

Accept that they have gaps and delays in these skills.

Learn, by spending time with them and observing, which Executive Function Skills need scaffolding and practice.

Support by being the air-traffic controller when a child can’t do this alone, building in steps like:

  • modify the environment – reduce noise/ remove other distractions, create comfort, provide easy access to resources, use visual aids/ prompts, movement/ sensory breaks.
  • simplify tasks – reduce language and instructions, keep tasks short and achievable.
  • support completion of tasks – help child get started and ensure he/ she understands and can access materials required – check in regularly; if needed, be alongside throughout a short task before child tries a similar one with less support.
  • Use memory cards – if child needs to wait for your support, write it down on a card for each of you – and if possible the approximate time you will return to the task with them.
  • build EF skills development through practice – carefully chosen activities/ games/ projects.

The best way to develop executive function skills is to do meaningful activities which require Executive Function (thinking) skills to be used. To be able to engage in these kinds of activities and draw on thinking skills, children need first to feel safe, regulated and connected – for this they need a regulated, consistent adult to support them. Children also need activities which interest them and which are achievable, matched to their emotional age and ability level or the level they could manage with support. The following ideas for activities and games are just a few of many which might help.

HOME-BASED ACTIVITIES
Many of these activities involve the use of working memory in order to plan, prioritize, and get organised. They may also require self-control to stay focused and flexibility to solve problems:

  • Build a bird box or bug hotel/ grow things/ make a wormery/ catch falling leaves/ watch birds
  • Bake/ plan and cook a meal/ make a rug/ make a puppet/ do a mosaic/ make fimo beads
  • upcycle furniture/ decorate a room/ mend a bike puncture/ junk modelling
  • start a collection/ invent games/ create hunts and trails for each other
  • do a jigsaw/ make lego models – either from the box or made up
  • make music or playlists/ make up dance routines/ do puppet shows/ role-play/ tell stories

MEMORY GAMES

  • Matching pairs (working memory, flexibility, self-control). Adapt this to suit attention span and memory skills by reducing the number of cards. Can be cooperative if you work as a team to see how many turns it takes you to find all the pairs.
  • I went to the shops (working memory). Take turns in a pair or group to add to a shopping list, repeating the full list each time – invent various (I went for a walk and I saw a …… ; I went exploring and I found a ……) – be as flexible as you need to be to keep child engaged – eg. give clues if they struggle to remember a word.

WORD GAMES

  • Word tennis (working memory, task initiation, attention, flexibility). Play cooperatively in pairs or a group. Take turns to pick a topic and see how many things you can name from that topic – pass a ball/ soft toy as you do it. Continue for as long as you can without repeating a word. If you wish, time how long you can all keep going for or count the number of words.
  • Cooperative Bananagrams (planning, prioritising, flexibility). For children not ready for the competitive version of this game, work altogether as a team to use all the letters to make lots of mini crosswords or one giant one. Adapt this for your child’s attention span by choosing how many letters you play with.

PICTURE / MOVEMENT GAMES

  • Jenga (self-control, flexibility, planning) – Adapt this game in any way that suits your child, eg. leave out the requirement to pile bricks on top, use a smaller stack, create a rule that when a brick is taken there are other actions to follow, which might be drawn from a pile of cards. Or, just use the bricks to create mini collaborative challenges. Eg. Let’s see how high we can make a staircase, What’s the tallest tower we can make? Can we make a domino rally in the shape of an S? Are there enough bricks to make an outline of both my arms?
  • Home-made Pictionary/ charades (flexibility, self-control) – Create your own bank of words/ pictures/ phrases to be drawn or acted out for others to guess – or use cards from published games. Avoid time limits if this creates stress. Play in pairs if this helps a child to participate – whisper together about how you’re going to draw or act out the word.
  • Freeze (focus, self control). Play music while everyone dances or moves in any way they want. Freeze when the music stops. Or everyone moves about and one person just shouts “Freeze!” Try holding your poses for a count of 5/10/ longer.
  • Dobble (focus, initiation, self-control) – a matching game done at speed – the twist is that matching pairs of images may be different in size and surprisingly hard to spot! There are different ways to play the game and various themed versions available.

STRATEGY GAMES

  • Forbidden Desert (planning, prioritising). This is designed as a cooperative game where participants work together to escape from a desert by finding pieces of a sun-powered flying-machine, whilst avoiding sandstorms and keeping water supplies topped up.
  • Quirkle (Planning, organisation, flexible thinking). A simple but original game based on matching colours and shapes on wooden painted blocks. Players need to think about where best to place their pieces for the maximum score. Work in teams if this suits your child best. And you could try using the blocks to make patterns – see what your child comes up with.
  • Rush Hour (Focus, flexible thinking, working memory, perseverance). This is the original version of a game which has been replicated on many apps. The real thing is a fun way of moving vehicles to enable an ice-cream van to leave a car park. There are 4 levels so it’s easily adapted.
  • Genius Square (Focus, flexible thinking, perseverance). This game can be played solo or against a partner/ other team. The task is to fit the blocks into the grid around where the dots are placed. There are always lots of possible solutions.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

 

Further resources and ideas are available at:

HARVARD Centre for the Developing Child website for activity ideas by age group –https://developingchild.harvard.edu/guide/a-guide-to-executive-function/

UNDERSTOOD website for ideas on supporting different areas of executive function.
https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/executive-functioning-issues-strategies-you-can-try-at-home?_ul=1*2sfyod*domain_userid*YW1wLVppUDNOQ3JWZXUwSTIzekQyall5N3c.

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families Tagged With: child therapy, Function Skills, Thinking Skills

February 15, 2021 by BHP Leave a Comment

Executive Function Skills (part 1) – What They Are And Why Some Children Struggle With Them.

Executive functions are the cognitive skills we use to control and regulate our thoughts, emotions and actions to achieve goals. These three main areas of executive function work together:

  • Self-control/ inhibition – the ability to resist doing something distracting/ tempting in order to do what’s needed to complete a given task, helping us to pay attention, act less impulsively and stay focused.
  • Working memory – the ability to hold information in mind and use it to make connections between ideas, make mental calculations and prioritize action.
  • Cognitive flexibility – the ability to think creatively, switch gears and be flexible to changing requests and situations, allowing us to use imagination and creativity to solve problems.

For example, all three areas are needed in social pretend play:

  • Child needs to hold their own role and those of others in mind (working memory)
  • Child needs to inhibit acting out of character (employ self-control), and
  • Child needs to flexibly adjust to twists and turns in the evolving plot (cognitive flexibility)

The joint forces of our executive function skills can be thought about as . . .

  • the conductor of an orchestra, organising multiple instruments to make one unified sound or
  • an air-traffic controller managing safe take-off and landing for hundreds of air-craft

Executive functions are controlled by the frontal lobes of the brain which are connected with and control the activities in many other regions of the brain.

Hot and Cool Executive Functions
Hot executive functions are the self-management skills we use in the heat of the moment when emotions run high – they require concerted conscious effort and help us give up short term gain for the sake of a more important goal. Examples include: resisting temptation; focusing on a boring task; breaking an old habit; and biting our lip when angry. Cool executive functions are the skills we use when emotions aren’t really a factor. Examples include: remembering a list of numbers and repeating them back in reverse order and following a simple recipe.

Executive function skills are a vital part of learning. They help children to be in the right place at the right time with the right equipment, listen to the teacher, wait for a turn and not call out. They are also pivotal in managing frustration, getting started on a task, staying focused, accepting constructive criticism and asking for appropriate help. They enable children to notice and correct mistakes, prioritise, persevere and complete challenging activities, resist the urge to retaliate and feel more confident about managing in school.

Children with under-developed executive function skills may act without thinking, overreact to small problems, be upset by changes in plans, forget to hand in homework, delay starting effortful tasks, switch between tasks without finishing any, lose or misplace things, struggle to meet deadlines and set goals, and lack insight into their behaviour.

Factors which can make it harder to access our executive function include tiredness and sleep deprivation, dyslexia and more complex learning difficulties, neuro-developmental conditions like Autism and ADHD, environments which overwhelm our senses and create stress, one-off traumatic incidents and complex trauma as a result of Adverse Childhood Experiences.

Given their significance, difficulties with Executive Function can contribute to social, emotional and mental health difficulties if they are unsupported and children who are already vulnerable for any of the above reasons may experience a compounding of the challenges they face. It is therefore essential that we take time to understand what these issues look like for each individual and adjust parenting, schooling and community interventions accordingly.

Look out for my forthcoming blog –  Executive Function Skills (Part 2) for ideas on how to support children with these difficulties.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

 

Additional resources –

  • UNDERSTOOD website: https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/executive-functioning-issues/what-is-executive-function
  • The book  Why Can’t I Do That? A Book About Switches by Fi and Gail Newood is designed to help children understand what Executive Function skills are and how they link to everyday challenges.

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families, Parenting Tagged With: child therapy, childhood developmental trauma, Cognitive

January 18, 2021 by BHP Leave a Comment

The Pandemic and the Emerging Mental Health Epidemic

There is a lot of talk about how Covid-19 and the resulting lockdown cycles are causing a mental health crisis in the UK. This blog aims to unpack and list some of the reasons why the response to the pandemic is also causing a mental health epidemic amongst us.

This year has been very hard on most of us, personally and professionally. I don’t think I have come across anyone who has not been negatively impacted by the pandemic and resulting lockdown cycles since last March. The pandemic and deaths resulting from Covid-19 are only one aspect of this crisis. The efforts to avoid death and transmission, not overwhelm the health service, and its resulting policies, in conjunction with how the Covid narrative is portrayed in the media, is what is driving the mental health crisis.

Before the pandemic hit, we were already living and dealing with normal day to day challenges linked with work, relationships, raising children, making decisions, caring for relatives, ageing and death, etc, etc. As psychotherapists, we listen to and work with these challenges everyday. The pandemic has added another layer to pre-existing issues in society, exacerbating them for everyone through the fear of death, loss, survival and health anxieties, to name a few issues which are both specifically linked to the pandemic but also issues to do with being human.

It has even become difficult to distinguish whether some of the difficulties experienced are linked to Covid or not. For instance, relationship issues which were pre-existing became exacerbated during lockdown and having to work together to home school children. Or someone with an already high level of health anxiety becomes even more anxious about becoming infected with Covid and isolates themselves even further from others.

There was a big drive to bring more awareness to mental health issues in UK society before any of us even heard of Covid-19. A large number of people were already experiencing pressures on their mental health through a variety of factors, which have now become more exacerbated through the fear of death and transmission, confinement at home, business closures, lack of outlet with entertainment venues, cafes, leisure and restaurants closed.

We have lost a large proportion of our social connections due to not being able to meet socially and professionally as we used to. Even small daily exchanges which used to make us feel more socially connected have been taken away, such as a visit to a local shop or the hairdresser.

The list is endless: Professionals who derive their identity and social contacts through work and running their businesses and had to close them, the elderly who were already lonely and have now become even more isolated, workers in the gig economy who were already struggling to survive and are now out of work, parents who were already under pressure and now have to home school as well. The list goes on…

It is vital that enough mental health support is available. In my work as a therapist, I acknowledge the collective impact in society yet focus on how it affects people on an individual level. We are all fighting our own battles at the moment, each one is dealing with a separate set of challenges pertinent to their life circumstances. It is vital for us to acknowledge and talk about what is troubling us and not just “get through”.

To enquire about psychotherapy sessions with Sam Jahara, please contact her here, or to view our full clinical team, please click here.

Sam Jahara is a UKCP Registered Psychotherapist, Transactional Analyst and Supervisor with a special interest in working with issues linked to cultural identity and a sense of belonging. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Leaving the Family

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Families, Relationships, Sam Jahara Tagged With: anxiety, Covid-19, Relationships

January 11, 2021 by BHP Leave a Comment

Love and family

The family is our first social group. It is the crucible in which our passions are born and our capacities to love and to live are shaped – and misshaped. The family imbues its members with its own specific culture, habits and attitudes.

As an organism, it too is shaped by the cultural moment and the social environment, the hopes, fears and attitudes of the day. It is the bedrock of our most durable and intense emotions and the fertile soil of our satisfactions and discontents. The family reconfigures with each new life that enters and exits. Constantly changing, constantly staying the same it is both dynamic and flexible, coded and predictable. We are all indelibly touched, one way or another by its authority. We learn to love in the context of ‘family’, each in our own idiosyncratic way. Every family has its own cast of characters ((step)parents, grandparents, (step) siblings, aunts, uncles etc). All players in a unique drama. Family is a stage where universal themes are navigated, power, sex and money, hierarchy and democracy, passion and ambivalence, in all their dark, tumultuous, devastating and innocuous glory.

Universal themes

From Greek myth to Shakespearean tragedy, the depths and breadth of family relations provide a turbulent, brooding backdrop to moral, ethical and philosophical considerations of a universal scale. So often in these epic tales, we are reminded what an unruly emotion love is, indeed how uncomfortably close it resides to its shadowy counterpoint hate. Disowning his most beloved youngest daughter Cordelia, King Lear in a fit of vanity and rage is consumed by vengeful hate, abdicating love and reason in its wake he casts her out. Her failure to satisfy his insatiable need for flattery and primacy, to go against her own nature, disrupts their bond, unleashes chaos and eventual tragedy. This is an epic tale of family conflicts, of power, love and greed. Most family dramas do not play out on such a grand scale, but remain hidden in the shadows of secrecy, shame and trauma, creating a legacy that can trickle (or cascade) down through generations to come.

Changing Families

Whilst the major human themes endure in families across generations, the architecture of family life and living is continually changing with the socio-political and economic tides. Every generation spawns its own raft of experts on the family and its constituent members, from the institutions of religion, state, medical and social science and philosophy. The current moment, in particular, is one in which the couple is the central organising pillar upon which the success of the family depends. Bred in ever smaller numbers, the modern child is also a major focus of scrutiny and opinion. As the birth rate has decreased so children’s value has increased. Parents invest heavily in their offspring financially, emotionally, educationally etc. We dedicate ourselves to their health and happiness, often discounting our own in the process. As an antidote to our high tech fast-moving, demanding lives we create a utopia of childhood and perhaps (without knowing) locate many of our own unmet hopes and passions in our beloved and precious innocents.

Love them or hate them (and indeed it is within our families that we learn about both) idealise or reject them it is within the context of the family that we learn about the social world and our place in it. It is in this original grouping that we have our first experience of grief and loss, it is where we learn to trust (or not) and to express (or inhibit) our desires. Family life is fraught with misunderstandings and pain and is the vessel in which our virtues are forged, kindness, loyalty generosity and fortitude. Interestingly, even when we grow up and leave them we will most often seek out another with whom we wish to form a family. At this very particular COVID moment, we are all forced to reconsider what family means to us.

 

To enquire about psychotherapy sessions with Gerry Gilmartin, please contact her here, or to view our full clinical team, please click here.

 

Gerry Gilmartin is an accredited, registered and experienced psychotherapeutic counsellor. She currently works with individuals (young people/adults) and couples in private practice. Gerry is available at our Brighton and Hove Practice.

 

Further reading by Gerry Gilmartin

Understanding sexual fantasy

Fear and hope in the time of Covid

Relationships, networks and connections

Paying attention to stress

Face to Face and Online Therapy Help Available Now

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Filed Under: Families, Gerry Gilmartin, Parenting Tagged With: Family, family therapy, Parenting

December 21, 2020 by BHP Leave a Comment

What shapes us?

We all have key figures in our lives, people who either held or hold great importance because of their positive impact on our professional and personal lives. They may have been people who we are either personally or professionally connected to, such as parents, siblings, friends, family members, or teachers, bosses, coaches, therapists and work colleagues, to name a few.

These people become so important to us because we internalise their qualities and also their positive messages to us, whether they were implicit or explicit, verbal or non-verbal.

Therapists are keenly aware that some key elements need to be present in our work in order for a positive relationship to form. We know that many who come to therapy do so because of breakdown or absence of relationship early on, which we can also understand as a scarcity or total absence of some key elements listed below:

Interest and Curiosity

To feel seen, heard and to perceive sense of curiosity towards oneself from another, which is engaged, honest and encourages mutual trust. Delight, enjoyment and even surprise in the exchanges that take place.

Attunement

Usually used in the context of a parent-child relationship, but the word is also used in other contexts. Attunement is a quality where the other person ‘tunes in’ to another, almost as if trying to absorb and understand what the other is communicating on a deeper level. Attuning entails putting oneself aside to hear how the other views and experiences the world.

Consistency

Consistent love and care is something children need in order to feel emotionally and psychologically safe. This continues to be the case for adults, albeit in a different way. The consistency in the care of others is what gives us a sense of belonging and therefore a sense of safety in the world.

Commitment

To feel the commitment of another to a relationship is another form of consistency, but also one that affirms that “I am here for you” or “You can count on me”. This doesn’t not mean that the other won’t disappoint at times or will always be available. But they let you know that you can rely on their commitment to you as a friend, partner or in an ongoing professional relationship, such as the regular long-term commitment of psychotherapy, for instance.

Time

Related to the two above in that there needs to be a consistent time commitment in order for any relationship to work. The gift of time cannot be underestimated, especially in today’s world. With time, important conversations take place, people get to know one another and things are allowed to unfold. We feel valued and important when others make time to be with us.

Connection

Of course this can’t be forced. We either feel connected or we don’t. However, all of the qualities above are conducive to developing a connection with another. Some people are better than others at connecting, both to themselves and therefore to other people. But there are times when the chemistry between individuals exists in a way in which can’t be explained. Some of these formed connections stay with us for a very long time, if not forever.

What are other qualities that you see as essential to forming a positive bond with someone? I look forward to your thoughts.

 

To enquire about psychotherapy sessions with Sam Jahara, please contact her here, or to view our full clinical team, please click here.

Sam Jahara is a UKCP Registered Psychotherapist with a special interest in working with issues linked to cultural identity and a sense of belonging. She works with individuals and couples in Hove and Lewes.

 

Further reading by Sam Jahara

How Psychotherapy can Help Shape a Better World

Getting the most of your online therapy sessions

How Psychotherapy will be vital in helping people through the Covid-19 crisis

Leaving the Family

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Families, Relationships, Sam Jahara Tagged With: Mental Health, Relationships, therapeutic relationship

Online Bereavement Therapy

Grieving is an emotional, psychological and physical response to losing someone we’re close to. It can be an unsettling experience and many people feel as though something is wrong or missing from their life. Elizabeth Kubler-Ross’ Five Stages of Grief outline the core emotions as denial, anger, bargaining, depression and acceptance. But there are countless other emotions you may feel as a result of losing someone, which can make it confusing to comprehend.

What is Online Bereavement Therapy?

Online bereavement therapy can be beneficial in helping you cope with your loss and come to accept what has happened. You’ll speak with a trained counsellor who has experience in helping people grieve and the issues that surround bereavement.

Since grief is often accompanied by feelings that are similar to depression, it can be all too easy to rely on anti-depressants to heal you. But this can often mask the impact of grief and delay the grieving process, causing more harm than good.

Online therapy will enable you to work through what has happened and come to terms with it. A counsellor can also help you understand that grieving is not a neat process and even after you’ve accepted your loss, you may still have difficult periods occur in the future. Your therapy may last several months or even longer – it all depends on the individual and how they process such events.

How Can Bereavement Therapy Help Me?

Some people find comfort in talking about how they feel, while others may find it difficult to talk about their emotions and withdraw from those around them. Grieving is incredibly tough, but you don’t need to feel as though you’re on your own. Offloading your worries and feelings onto someone else can be beneficial and help you work through the stages of grief.

Online bereavement therapy can help you during this mourning process – you’ll have the support of a trained professional and everything you discuss with them will remain completely confidential. It can help to discuss your loss and identify the emotions you’re feeling, whether it’s sadness, anger, guilt or helplessness.

Your counsellor can also help you in learning to live without the person you’ve lost, something that can be daunting. With the support of a counsellor, you’ll soon realise just how common and natural your responses to grief are which can make these emotions easier to deal with.

If you want to talk to our team, contact us today or take a look at our practitioners.

All the content on this page has been reviewed and vetted by Mark Vahrmeyer UKCP Registered Psychotherapist, Supervisor and Co-Founder of Brighton and Hove Psychotherapy. For any questions or more information about the subjects discussed on this page please contact us.


October 26, 2020 by BHP Leave a Comment

Helping children to ride the waves of big emotions

Quite a few people this week have asked me about tips for supporting children at times of high emotional stress (e.g. anger, rage or anxiety). For this reason, I thought I would share with you some generic pointers for parents that I use in clinic, but which could apply to most children. These are predominantly drawn from the principles of Dialectical Behaviour Therapy (DBT) and Dyadic Developmental Psychotherapy (DDP), which you may have heard of.

1. When a child is calm, help them to understand that emotions (of any kind) are a bit like waves… they rise, they peak and they fall. They come and they go, but they DO eventually end.

2. When a child (or their parent) notices that they are starting to become distressed (or to ‘fall out of their window of optimum arousal’), they can be supported to try the TIPP approach:

T = TEMPERATURE
Helping a child to change their body temperature (e.g. by splashing the face with cold water or eating or drinking something cold) can help them calm, as the body naturally gets hotter when distressed or aroused.

I = INTENSE EXERCISE
Engaging in intense exercise to match the level of emotional arousal (e.g. star jumps or running) provides a healthy outlet for anxious tension. – Ideally this should be a rhythmic exercise as it is more likely to activate a child’s earliest neural pathways of feeling soothed from when they were rocked as babies.

P = PACED BREATHING
Slow breathing, concentrating on their breath and (importantly) breathing out for longer than they breathe in, helps children to regulate the bodies. This is because longer exhalation naturally slows their heart rate and activates the Parasympathetic Nervous System (PNS), which in turn helps the body to calm.

PAIRED MUSCLE RELAXATION
Supporting a child to tense and then relax parts of their body, supports muscles to release tension. Relaxed muscles require less oxygen, so heart rate and breathing naturally start to slow down.

3. Having a calm box – Supporting a child to develop a pre-prepared box of all their favourite textures, smells, photos, games, sensory toys, etc., can be a lovely way to start to talk about emotions with a child and help them to feel a sense of self-efficacy in managing their own emotions. As time goes on, a child might start to ask for their box before becoming overly distressed.

4. Parental matching of the affect – When a child’s brain is distressed, it regresses to a much earlier developmental form of itself, whereby it does not register language or logic in the same ways. For this reason, a parent needs to ‘match’ the emotional intensity of the child in their non-verbal behaviours (e.g. when a child is shouting: using a loud (but not angry) voice, using BIG physical gestures, maintaining intense eye contact, etc.). The very act of ‘mirroring’ a child to themselves helps them to feel held and contained. The parent can then gradually lower their voice and soften their gestures, which the child will match in turn. I think of this as ’emotional hand holding’.

5. Having a cuddle – Following an emotional outburst, close physical connection instigated by a safe adult, is one of the most soothing and regulatory activities to do with a child to bring them back into a state of optimum arousal. It also enables them to learn that no matter what they have done or said, they are still loved, which is so important for developing a secure and healthy attachment. Once they are physically and emotionally calm, you might then want to talk about the actual behaviour if this needs to be addressed, however, the key is…’Connection before Correction!’!

I hope that you find some of these tools helpful. It is of course important to note, however, that what causes (and maintains) emotional distress in children can vary hugely from child to child. It is also important to note that for some children, what causes and maintains their distress can be very hard to determine. In such cases, parents should feel empowered to seek professional advice regarding a targeted assessment of their children’s specific needs.

Happy surfing everyone…!

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Child Development, Families Tagged With: child therapy, childhood developmental trauma, family therapy

October 12, 2020 by BHP Leave a Comment

Helping Children With Loss Through Story Books

Children, like all of us, encounter loss in their lives, temporary and permanent. They may lose a treasured possession, a loved one who dies, a parent who leaves or is imprisoned, a friend who moves away, or a valued teacher in the transition between year groups or schools. Some are unlucky enough to lose their health or abilities they once took for granted. Others lose their home or their country and there are those who lose their innocence through exploitation and with it perhaps their sense of self and any respect and trust they had for the world.

With loss comes associated feelings, held in the conscious or unconscious mind or both. Support in processing losses may or may not be available and the degree to which children show lasting difficulties will vary accordingly. Stories are just one tool which can help children connect with and work through internal emotional conflicts associated with experience of loss.

Like art, stories help us to take new perspectives and understand ourselves, others and the world differently. They can offer comfort or challenge, enliven or unsettle us. By engaging the imagination, not only can stories transport us to another time and place but they can also open up a rich emotional landscape which might otherwise be off limits to the defended conscious mind.

Most children speak and understand the language of play and they live stories, in their everyday playful interactions with food, sounds, textures, objects, animals and people. And, of course most are introduced to and love books, from a young age. Well-told children’s stories tap into a child’s thirst for make-believe, for adventure and for powerful emotive themes such as love and hate, despair and hope, failure and redemption.

For this blog, I have selected 6 story picture books which I will briefly summarise:

Amos And Boris by William Steig (1971)
This beautifully written tale of enduring friendship focuses on the unlikely alliance of a mouse (Amos) and a whale (Boris), who become acquainted when Amos falls off the boat he has made (which is sadly lost forever) and Boris rescues him. The two travel together, learn about their differences, survive a falling-out, share ideas and develop “a deep admiration for one another”, becoming “the closest possible friends”. Coming one from land, one from sea, the time comes for them to separate: “. . . we can’t be together . . . I’ll never forget you though.” Years later, Boris is beached by a hurricane and Amos, aided by elephants, is then able to save his life. The wrench of what may be
their final parting is sad and tender yet secure in the knowledge that each will continue to be remembered in the other’s heart and mind.

Badgers Parting Gifts by Susan Varley (1984)
This story opens with the inevitability of the ageing Badger’s death and his awareness of the loss his friends will feel after he’s gone. When he dies, Badger is sorely missed by all the animals but especially Mole, who feels “lost, alone and desperately unhappy.” The friends’ sadness is intensified by Badger’s absence, as it was he who had always been there for them in times of trouble. And in missing him, they start to come together and share memories. This, in turn, highlights to them the gifts which Badger has left behind, skills he taught each of them when he was alive which they can now remember him by and use to support each other. Gradually, sadness gives way to a comforting and emboldening remembrance and gratitude.

The Red Tree by Shaun Tan (2001)
This story tells of a girl who loses her sense of purpose and place in the world, and with it any sense of hope. Through unique, extraordinary, incredibly crafted images, and condensed, graphic text, we travel into the girl’s mind, inhabited by surreal, exaggerated and often frightening forms and scenes which overwhelm her. She is not seen, heard or understood and oscillates between these worlds of chaos and a relentless nothingness. A happy, colourful life is out of reach and all seems doomed and irresolvable. She has lost everything and become lost herself. And then, suddenly, life returns (thankfully!) and with it hope and joy. This speaks to the immense value there is in sitting alongside and fully taking in the realities of another person’s bleak experience. As the reader, we witness the
girl’s pain, perhaps helping her to mourn her losses and then re-discover herself.

The Day The Sea Went Out And Never Came Back by Margot Sunderland (2006)
Eric the sand dragon lives on a beach and adores the beautiful sea beyond, which in its daily rhythm comes and goes predictably, with the tides. One day the sea goes out and does not return. This is devastating for Eric who waits and longs for the sea to come back and is then overwhelmed with the pain of his loss. He becomes trapped and isolated inside himself. Eventually, attracted to the vulnerability of a dying wild flower, which he then saves, Eric is drawn back into life himself. He saves more flowers and a rock pool garden is created. Eric starts to feel safe enough to fully mourn his loss and in so doing discovers that remembering his beloved sea builds a treasure store in his mind which
he can keep forever.

The Lonely Tree by Nicholas Halliday (2006)
Set in the New Forest, this original book uses the seasons to chart the forest life-cycle through the friendship between an old, story-telling oak tree and a young, curious evergreen. As the oaks sleep for the winter, the evergreen becomes acutely lonely and, when spring finally comes, all hope is cruelly crushed when his oak-tree friend fails to wake up, his long life ended. The evergreen cannot comprehend what has happened but holds onto his cherished memories, through the sadness. Hope returns as a fallen acorn germinates and a new oak is born, destined to form a new friendship with the evergreen. Stories of the forest are retold and, as they are, the trees’ roots go “deeper and
deeper into the ground”, reminding us that with companionship we can endure and process the pain of loss and live a more enriched life.

The Heart And The Bottle by Oliver Jeffries (2010)
Beautiful illustrations alongside a concise narrative makes for great dramatic effect, telling the story of a delightfully curious and creative little girl who experiences the apparently abrupt and unexplained loss of an adored grandparent, with whom she had discovered and shared many wonders. She puts her heart into a bottle for safe keeping but as she grows up becomes limited and encumbered by its seclusion, which she finds she is unable to reverse. It is only through connecting with her own daughter’s zest for life that she allows her heart to be freed and re-discovers treasured memories of her beloved grandparent who she can now enjoy remembering. Her inner-child, in league with her actual child become the unwitting healers.

These books, like many others, model that feelings are okay, they are a normal response to loss and are to be expected. This is an important message to our children, particularly given that many of us are still filtering cultural and familial influences in our own lives which would have us discount feelings in order not to rock the boat or blow other people’s stiff-upper-lip cover. Children are expert at tuning into our sensitive pressure points and while they may push our anger buttons quite readily, they may avoid talking about sadness if they sense we may be uncomfortable and find it hard to hear and hold them. In turn, to avoid burdening others or being alone with pain, their own natural defences against connecting with sadness can become strengthened and entrenched.

A story book can serve as a helpful third party, a neutral but enriching messenger, able to venture into forbidden territory within the safety of metaphor. Connection with characters breeds understanding and empathy for one’s own pain. We can read the story exactly as it is or go off piste, filling in blanks with a child, co-creating a personalised narrative, re-writing the ending and reflecting all the while. Repetition can work wonders, enabling a child to use pictures as prompts and retell the story from memory. Each retelling can add meaning and a layer of digestion for the child, outside of his/her awareness, whether or not any overt life parallels are drawn.

All 5 of these books also convey a sense of hope, always integrated into the experience of loss. Again, this is a powerful lesson in a world which all too often splits artificially the good from the bad. We might not long for loss or wish it upon anyone else, but when it comes we, alongside our children, can do what we can to to feel it, to know it, to share it and to find new life somewhere within it.

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families, Parenting Tagged With: child therapy, childhood developmental trauma, family therapy

August 24, 2020 by BHP Leave a Comment

Communication, communication, communication

Of all the problems presented by clients when they first attend therapy as a couple, communication difficulties are often to be found as the most pressing. However, our difficulties with communication is not just an issue within a relationship: it touches every aspect of our lives – which makes the effort of finding out how we communicate well worth the effort.

Our style of communication is based on how we learned to communicate in our families, culture, society, and with our peers.  It is important to understand that communication is a learned skill:  when we are born, we will be neither good nor bad communicators. However, since it is a learned skill, it means we can unlearn things that make communication a problem, and we can learn new ways to be more effective in the way we relate our ideas, opinions, thoughts and feelings.

What is your style of communication?

Read through a brief description of the four main types of communication and think through which style would be a best fit for you.

  1. Passive Communication       

Passive communicators fail to communicate to others what they think, want or need.  Sometimes they don’t even admit it to themselves. Passive communicators might believe that they are protecting others from their feelings, but in fact more often they are protecting themselves from potential conflict and/or rejection.

Example:

Your partner or friend asks you to do something you do not really want to do. You may feel you are under time pressure, already have too much to do, or already had something else planned for that time.

Passive response:

Agree to do what the partner/ friend asks (what feelings are involved here?)

Say, “Okay”

Pretend not to hear request

Passive communication includes:

  • Avoiding situations which might be uncomfortable
  • Avoiding conflict
  • Avoiding situations that feel emotionally risky
  • Not expressing feelings, thoughts or needs
  • Ignoring our own rights in a situation
  • Lying or making excuses in uncomfortable situations
  • Being apologetic or putting down self
  • Letting others make decisions for us

Feelings might include:

  • Relief (avoided conflict)
  • Resentment (of others for making decisions, having power)
  • Annoyed with self (didn’t say what felt/needed)

2. Aggressive Communication                

Aggressive communicators say what they think without taking into account the other person’s feelings, thoughts or needs.  Aggressive communication includes shouting, intimidating body language, sarcasm and violence. This form of communication aims to hurt, and is often a projection of the hurt and anger the person is feeling.

Example:

Your partner or friend asks you to do something you would rather not do.

Aggressive response:

Laughs at person and storms out of room. (note the ‘acting out’)

“Of course I can’t/ won’t do it!  What an idiotic suggestion.  Why would I want to do that now?  It’s stupid.”

“Yeah, right”

“You always do this.  Don’t you ever do things yourself?  Why me?  You never do things yourself: it is always left to someone else.”

“Why the xxxx did you ever become my partner/ friend?”

Aggressive communication includes:

  • Expression of feelings, needs and ideas at expense of others
  • Violating others’ feelings or rights
  • Dominating and belittling behaviour
  • Having a sense of power or control in the situation
  • Saying what you think without thinking about the outcome
  • Sarcastic remarks

Feelings might include:

  • Sense of power
  • Justified in what you have said
  • Pleased to get your way in the situation
  • May feel isolated (aggressive communication can distance people)
  • Frustration
  • Bitterness

3. Passive Aggressive Communication

People who use a passive aggressive communication style, indirectly say what they think or mean.  It often leaves the person receiving the remark feeling confused, as they have not been clear about what they really think or feel. Although the person speaking might believe they are being polite in communicating this way, both they and the recipient can often be left with unresolved feelings that linger.

Example:

Your partner/friend asks you to do something that is inconvenient for you.

Passive-aggressive response:

“Sure, no problem”…Then seeks out confidante and says, “I just talked to X, who asked me to do this. Can you believe it? He never does things himself, he’s so lazy… How did I get into a relationship with him.”

“I guess I can do that.  I am a bit busy, but I’ll probably be able to do it.  I missed something important the last time, but obviously you need me to do this so I will.”

“Whatever”

“I suppose that is one way to organise your life – getting others to do the work for you. Sure, I’ll do it.

Passive aggressive communication includes:

  • Being indirectly aggressive
  • Trying to control the situation while being ‘nice’
  • Manipulative behaviour
  • Being unclear about how you are truly feeling
  • Denying your feelings about a situation, when you are clearly aware of them
  • Making others feel guilty
  • Avoiding rejection and hurt
  • Getting what you want without facing conflict

Feelings might include:

  • Low self-esteem
  • Isolated because of distancing and confusing communication
  • Angry at self
  • Relief because person has made their point whilst avoiding conflict.

4. Assertive Communication    

People who communicate assertively, are clear and say what they mean. They accept their feelings, thoughts and ideas without judgement and express these in such a way that they don’t put the other person down.  When being assertive, they take into consideration timing, situation, feelings and thoughts.

Example:

A partner/ friend asks you to do something at short notice, when you have deadlines of your own.

Assertive response:

“I am unable to do this as I need to finish x by y.”

“I am unable to do this now, but I could do it by x.’

“I cannot do this now, but I would like to help. How about we meet at x and we can do it together?”

Assertive communication includes:

  • Expressing your feelings, needs and ideas, while maintaining respect for the other person
  • Knowing what you feel so that you can express it clearly
  • Standing up for your rights: saying “yes” or “no” when you mean it
  • Being honest with yourself and others
  • Saying what you mean (with persistence—sometimes you have to repeat yourself when being assertive)
  • Making own choices
  • Taking risks in communication
  • Facing potential conflict

Feelings might include:

  • Feeling good about self
  • Increased confidence
  • Increased self-esteem
  • Relief

Communicating assertively can make us feel anxious, but it often leaves us feeling empowered. It takes practice, but it can become habit. Think about your needs and feelings – and then consider the best way of articulating them.

It is also odd to think that to make ourselves assertive, we need to make ourselves vulnerable (by being honest and open about how we feel). If we fail to do this, and continue to communicate without the connection with feeling, we are likely to continue to ‘act out’ various defensive communication styles learned in our early family units.

How can Therapy Help?

Therapy will help you to understand your feelings better, which in turn will lead to a better understanding of your needs and the needs of those around you. You can then begin to make choices about how you wish to communicate those feelings and needs with clarity.

 

Kevin Collins is a UKCP registered Psychotherapeutic Counsellor with an academic background in the field of literature and linguistics. He worked for many years in education – in schools and university. Kevin is available at our Lewes Practice.

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Filed Under: Brighton and Hove Psychotherapy, Families, Mental Health, Relationships, Work Tagged With: communication, couple counselling, Relationships

June 29, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Why behavioural approaches do not work for all children

One of the most frequently asked questions put to me in clinic, is why some children do not respond to traditional reward/punishment based behavioural strategies. The answer is simple – because, contrary to popular opinion, these strategies do not work for all children in all situations.

This is because the ability to make a mental link between a behaviour and a punishment, and to then be to be subsequently less motivated to use that behaviour again, actually involves quite sophisticated cognitive processes. It also requires specific parts of the brain to be functioning well. Difficulties with this may apply to children with learning disabilities or neurological conditions. It may also apply to children who are anxious, fearful or traumatised. This is because anxious or fearful children are often operating from a very primitive part of their brain that physically impedes their ability to access more developed parts of their brains. This in turn makes it harder for them to make cause and effect links, to generalise, to suppress their impulses, to make rational decisions, to maintain empathy for others and, in some cases, even to trust in the motivations of others. Punishing these children without supporting them to understand what is happening for them, therefore, is actually more likely to increase their fearful behaviours and further undermine their trust in those around them. For some children, it can also exacerbate feelings of shame.

A second concern with an overly heavy reliance on behaviourist principles when applied to children, is the theoretical and research origins upon which these principles are based. Behaviourism was largely developed in the 1950s and 1960s in laboratories with small mammals such as dogs, cats and rats – animals with significantly less developed brains than our own. Whilst these experiments can teach us a lot about how to shape behaviour in its purist sense therefore (i.e. classical and operant conditioning), they offer nothing in terms of how we build children’s self-esteem, build their intrinsic motivation, or even how to protect their attachment relationships. For instance, classically conditioning young babies to sleep by ignoring their attachment-seeking behaviours, can have detrimental effects on a child’s subsequent relational security and internal regulation skills. Similarly, a heavy reliance on operantly conditioning ‘good behaviour’ in young children with external motivators (e.g. star charts) has been shown to undermine a child’s natural desire to problem solve, be creative and to keep building on their successes when these external motivators are later removed.

Whilst some behavioural principles within a parenting repertoire can undoubtedly be helpful, therefore, when used to excess, and particularly when used in the absence of a broader context of sensitive, loving and developmentally appropriate care, they can quickly become damaging. This is because human children have brains that require so much more from the parent-carer relationship than simple behavioural conditioning.

Part of my role as a Clinical Psychologist, therefore, is to help parents, carers and professionals, to find new and more effective ways of supporting children to reach their full potential.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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Filed Under: Child Development, Families, Parenting Tagged With: anxiety, child therapy, childhood developmental trauma

May 6, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Educational Psychotherapy (2) – developing empathy, mind-mindedness and self-discovery

In Educational Psychotherapy (1), I explain how Educational Psychotherapy first evolved and how, as an approach, it can help promote social and emotional development as well as the thinking skills required for learning.  This was illustrated through the aspects of a child’s first six months in therapy. Here, I highlight three areas of further progress over the next 12 months of work with the same child. Again, this account is disguised and anonymised.

Empathy and feeling understood

One of the most exciting benefits of Sammy’s becoming more emotionally literate was the opening it allowed for me to make connections between his experiences with family and friends and his feelings and then providing empathy for Sammy’s felt experience.  This enabled Sammy both to feel held and understood by me at an emotional level and to experience his feelings as making sense. Over time, Sammy came to welcome this and it seemed to encourage him to actively seek openings to make further connections between his experiences past and present and his thoughts, feelings and behaviours.

Mind-mindedness and social connection

Early on in the therapy, Sammy found it difficult to engage in wondering about his own mind or about others’ minds, in either imaginary or real contexts.  There were times when he seemed to think I should have already known what he was thinking. Things began to shift when trust developed and Sammy allowed himself to become more openly curious about me, what my life might be like and how I might perceive him.  He grew increasingly accepting of the idea that I had a mind separate to his and that learning about each other involved a shared process. He started to wonder about my own mental state and thoughts, perhaps partly in response to my modelling of a mentalising approach with him.  This capacity to be “mind-minded” was also reflected in Sammy’s accounts of social interactions at school when he openly wondered about various students’ motivations for particular actions and how they might have been feeling about a situation.  This included an understanding that people might have mixed feelings at times.

Therapeutic journey

It was Sammy’s journey of mental-emotional-social self-discovery which came to shape the bulk of our sessions and it was an encouraging and rewarding journey to be a part of.  The significance to Sammy of this work became increasingly evident as I began to talk about the sessions coming to an end several months before the final session.  Sammy found this very hard and would avoid or deny the subject in various ways.  However, in time, we were able to talk more about what this avoidance meant and Sammy moved into a period of some weeks when, unprompted, he became highly reflective about what the sessions had meant to him, bringing in memories of particular activities and commenting on changes which he felt had taken place within himself.  He also made reference to ways in which our working relationship had changed.  He spoke with confidence and resilience and a certain assurance that his memory would remain in my mind after our sessions had come to an end – and it has!

 

Brighton and Hove Psychotherapy is a collective of experienced psychotherapists, psychologists and counsellors working with a range of client groups, including fellow therapists and health professionals. If you would like more information, or an informal discussion please get in touch with us by telephone or email. Online therapy is available.

Face to Face and Online Therapy Help Available Now

Click Here to Enquire

Filed Under: Child Development, Families, Society Tagged With: adolescent psychotherapy, child therapy, family therapy

April 20, 2020 by Brighton and Hove Psychotherapy Leave a Comment

Tips for talking to young children about their behaviour

When talking to young children, most people know that ‘open’ as opposed to ‘closed’ questions are helpful. That is, questions that cannot easily be answered with a simple “yes” or “no” answer and invite the child to give more information. These questions typically start with “who..?”, “where…?”, “what…?” and “how…?”. What many people don’t realise, however, is that the most frequently used open-question starter – “why…?”, can be hugely counterproductive to conversations with young children.

This is because young children can easily experience the word “why” as threatening. A “why” question implies that the child should have (and the adult expects them to have) a level of insight about their behaviour that they genuinely might not have at this stage. For some children it can cause them to close down by becoming silent or simply saying “I don’t know”, which can feel infuriating to parents. Other children may feel the pressure to just give an answer – any answer – which might not even make sense (e.g. “I did it because my tummy was hurting”). This is because they just feel the pressure to say SOMETHING, which can also feel upsetting to parents. (Incidentally, when a child says that their tummy is hurting, that actually can be a sign of anxiety).

Much better, is to side-step the “why” question altogether with young children (e.g. “what made you do that?” or “when you did that, what did you think might happen?”) These kinds of questions keep the dialogue flowing and importantly, help the child to start to understand for themselves what their thoughts, feelings and motivations were when they used a particular behaviour.

This is an important foundation step towards impulse control and emotional regulation.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families, Parenting Tagged With: anxiety, child therapy, childhood developmental trauma

February 3, 2020 by Brighton & Hove Psychotherapy Leave a Comment

Parenting Styles

Since the early 1960s, psychologists have been interested in the relationship between parenting and the emotional, social and behavioural development of children. 

Of particular significance to this field of study, is the early work of psychologist Diana Baumrind and colleagues, who conducted the first longitudinal study of more than 100 preschoolers through to their adolescence, specifically examining the impact of their parents approaches towards them on their subsequent development (Baumrind & Black, 1967). This study, which used a combination of naturalist observations and parental interviews, identified four ‘dimensions’ of parenting – (a) disciplinary strategies, (b) warmth and nurturance, (c) communication and (d) expectations of maturity and control. More than this, however, this influential study identified three ‘parenting styles’ which have since stood up to considerable empirical scrutiny. 

The first of the parenting styles identified by Baumrind is now more commonly referred to ‘authoritarian parenting’. This an approach to parenting which is generically low in warmth but high in control. Parents who fall into this category, typically hold very high expectations for their children’s behaviour and develop strict, non-negotiable rules for which they must live by. They are described as “obedience and status-orientated and expect their orders to be obeyed without explanation” (Baumrind, 1991). Failure to abide by their rules, or to meet their behavioural expectations, is typically met with punishment rather than with empathy or understanding. This type of parenting is often seen in adults who they themselves were raised by parents with a similar style of parenting [see my earlier blog on ‘family scripts’] and who therefore hold an authoritarian working model or ‘blueprint’ of what it is to be a parent. This style can also sometimes be seen in anxious parents, who respond to a fear of losing control of their children by exerting total control. The implications for their children, however, is that they are often left feeling angry, confused or upset internally, but have no capacity to process or make sense of these emotional experiences as they develop. Their children are also often limited in their opportunities for free play and exploration of the world, which is equally important for healthy emotional and social development. 

The second parenting style identified by Baumrind is that of ‘permissive parenting’. This style can be broken down into two further parenting styles – ‘permissive-indulgent’ and ‘permissive-indifferent’. A ‘permissive-indulgent’ parent is broadly defined as a parent who is very high in warmth, but very low in control. In direct contrast to their authoritarian counterparts therefore, permissive-indulgent parents make very few demands on their children, rarely discipline them and typically seek to avoid confrontation. They are described as “generally nurturing and often take on the status of a friend more than that of a parent” (Baumrind, 1991). The implications for their children, however, is that whilst their internal worlds are largely attended to (although negative emotions can still be feared), they lack the developmentally appropriate structure, boundaries and expectations that they need in order to develop into healthy, socially-adept adults. ‘Permissive-indifferent’ parents on the other hand, present as very low in control AND in warmth. These parents offer neither structure and boundaries nor warmth and affection for their children. They are what we typically consider to be emotionally neglectful parents, who in extreme cases, may actively reject their children, leading to inevitable attachment difficulties as their child develops.  

The third parenting style initially identified by Baumrind’s study is known as an ‘authoritative’ parenting style. This style bridges the gap between authoritarian and permissive parenting styles and is known in research circles as the ‘gold standard’ for child development. This is because parents who are able to approach caring for their children with this style of parenting are able to establish developmentally appropriate rules and boundaries, but can at the same time, remain responsive to and curious about their children’s internal worlds. This means that they can be open to trying to understand a child’s internal world (e.g. their thoughts, feelings, motivations, perceptions, beliefs, etc.) even if they do not accept their behaviour. Indeed, when their children fail to meet their expectations, an authoritative parent is more likely to respond with forgiveness, nurture and find structured opportunities for new learning, rather than with punishment. Similarly, they can remain democratically open to questions and challenges from their children about their rules. They are defined as being able to “monitor and impart clear standards for their children’s conduct. They are assertive, but not intrusive and restrictive. Their disciplinary methods are supportive, rather than punitive. They want their children to be assertive as well as socially responsible, and self-regulated as well as cooperative” (Baumrind, 1991). The benefits for children raised with this type of parenting style is clearly evidenced in their later performance on a broad range of emotional, social and behavioural indices. These include social responsibility, the ability to cooperate with peers and adults, independence, assertiveness, problem solving and high self-esteem. Support for this ‘middle ground’ approach to parenting is also offered by recent research which has identified that children with a history of severe developmental trauma and attachment disruption, respond most effectively to an ‘authoritative ++’ approach to nurture whilst in care – a specific type of parenting approach which is very high in both control AND warmth and nurture – also known as the ‘two handed’ approach to parenting (Hughes, Golding & Hudson, 2019). 

As alluded to earlier, the type of parent we become will be influenced in part by our own experiences of being parented. Whilst we can adapt this to a degree, however, when we are under stress, it is likely that we will move closer towards our ‘blueprint’ of what a parent is. For this reason, it is extremely important that as parents, we take the time to notice for ourselves when we are starting to a more extreme type of parenting style (authoritarian or permissive) as an indicator or ‘red flag’ that we need to take some time out to recharge in order to be the parents that we want to be, and which our children need us to be. If you are co-parenting, it can also be helpful to think about where you and your partner each naturally fall on the continuum between high warmth and high control as parents, and to spend some time thinking about the strengths and weaknesses of these respective similarities or differences in your parenting styles, as well as the impact that the combination of your parenting styles has on your child. When challenges or parenting styles feel unhelpful or entrenched, however, it can be worth seeking professional help. 

References – 

Baumrind, D. (1991). The influence of parenting style on adolescent competence and substance use. Journal of Early Adolescence, 11(1), 56­95. 

Baumrind, D., & Black, A.E. (1967). Socialization practices associated with dimensions of competence in preschool boys and girls. Child Development, 38, 291­327.

Hughes, D., Golding, K. & Hudson, J. (2019). Healing Relational Trauma with Attachment-Focused Interventions: Dyadic developmental psychotherapy with children and families. Norton

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families, Parenting, Relationships Tagged With: Family, Parenting, parents

November 4, 2019 by Brighton & Hove Psychotherapy Leave a Comment

Post Natal Depression in Mothers & Fathers

In this blog, I want to write about post-natal depression, revisiting and summarising a classic paper by Lawrence Blum, an American Psychiatrist and Psychotherapist. The paper was written originally in relation to postnatal depression in mothers, however, because it essentially explores the conflicts aroused in becoming a parent and caregiver, particularly in relation to our own experiences of caregiving.  I think it applies also to fathers and to same-sex couples and heterosexual couples where the caring of the infant is more equally shared.

Blum’s paper, titled the “Psychodynamics of Postpartum depression”, is available on the web.

The paper draws a distinction between baby blues which he defines as the hormonally induced depression resulting from pregnancy and childbirth, and post-natal depression, which has typical features of depression, – ‘sadness, crying, insomnia, or excessive sleep, low mood, low energy, loss of appetite, agitation and self-critical thinking.’ 

He describes the external factors that can contribute, such as prior anxieties and depressions, low external support, difficult relationships, difficulty conceiving, stressful life events, etc. He summarises the studies at the time into the results of different therapies and concludes that supportive counselling, CBT and Psychodynamic Psychotherapy were all superior to the control and that Psychodynamic therapy had the biggest impact on depression, as defined by the DSM 111. 

The focus is then on the possible  ‘psychodynamics’ of the depression and these are what I shall briefly outline here as these are what can really be usefully explored and alleviated by Psychotherapy. Three principle emotional conflicts are outlined; Dependency conflicts, Anger conflicts and Parent conflicts. 

Dependency Conflicts

In order to care for a baby, there is a need to be utterly depended upon, this is tiring and emotional and benefits from support. If there is a conflict about receiving support, self-denial of the caregiver’s own needs, they can seek to repress their own essential vulnerability and needs and get depressed.

Often people manage this part by becoming carers and end up in caring roles, such as therapists (a good reason as any why therapists need their own therapy!) This counter-dependent strategy can work until it doesn’t. Someone who seems to be managing everything well, suddenly finds the balance has tipped too far. A baby can stir up the caregivers previously unconscious or sleeping wishes to be cared for, hidden by a display of independence.

Anger Conflicts

A conflict with feelings of anger, which can feel counter to the role of the caregiver. Parents can feel they don’t have a right to be angry, feel guilty about it or frightened of it, yet may have experiences and histories, which have left them feeling angry. Anger can be felt towards the baby, either as a projection of past hurts or for the very real things it has done to the parents lives; tuned them upside down, deprived them of sleep, money, jobs, sex, etc, while carrying on with its incessant demands obliviously. The danger apart from depression in all of this, is that these feelings are denied and controlled and ‘loss of control can follow from over control as internal pressure builds up”, and has to be released, either threatening the relationship with the baby or more commonly being displaced onto partners.

Feeling the anger, tolerating it, and judiciously putting it into words, easy for the clinician to say, is the difficult and essential task for the person who is looking after the baby.

Parenthood conflicts

Caring for a baby can stir up unresolved and unprocessed feelings about the caregiver’s own experiences of being cared for, whether a mum or a dad by a mum or a dad. Although a negative experience of being cared for can positively inform the ways in which the caregiver feels they don’t want to be, it doesn’t necessarily translate into clear ideas of how or what to be. In addition, the caregiver, giving the baby what it didn’t receive, can be gratifying but can also stir up the wounds of what they, the caregiver, didn’t receive. 

I would like to finish with Donald Winnicott,’s, (a British paediatrician and Psychotherapist), funny but true reasons why a mother, (or father or caregiver), hates their baby, with the intention in which they were written, to provide relief from the day to day conflicts, that can be felt in the rewarding, important but by no means easy job of nurturing an infant:-

  1. The baby is not her own (mental) conception. 
  2. The baby is not the one of childhood play, father’s child, brother’s child, etc. 
  3. The baby is not magically produced. 
  4. The baby is a danger to her body in pregnancy and at birth. 
  5. The baby is interference with her private life, a challenge to preoccupation. 
  6. To a greater or lesser extent, a mother feels that her own mother demands a baby so that her baby is produced to placate her mother. 
  7. The baby hurts her nipples even by suckling, which is at first a chewing activity. 
  8. He is ruthless, treats her as scum, an unpaid servant, a slave. 
  9. She has to love him, excretions and all, at any rate at the beginning, till he has doubts about himself. 
  10. He tries to hurt her, periodically bites her, all in love. 
  11. He shows disillusionment about her. 
  12. His exciting love is cupboard love so that having got what he wants he throws her away like orange peel. 
  13. The baby at first must dominate, he must be protected from coincidences, life must unfold at the baby’s rate and all this needs his mother’s continuous and detailed study. For instance, she must not be anxious when holding him, etc. 
  14. At first, he does not know at all what she does or what she sacrifices for him. Especially he cannot allow for her hate. 
  15. He is suspicious, refuses her good food, and makes her doubt herself, but eats well with his aunt.
  16. After an awful morning with him she goes out, and he smiles at a stranger, who says: ‘Isn’t he sweet!’ 
  17. If she fails him at the start she knows he will pay her out forever.
  18. He excites her but frustrates—she mustn’t eat him or trade-in sex with him. 

Winnicott, D.W. (1949). Hate in the Counter-Transference. Int. J. Psycho-Anal., 30:69-74. 

 

Paul Salvage is a Psychodynamic Psychotherapist trained to work with adolescents from 16-25 and adults across a wide range of specialisms including depression, anxiety, family issues, self-awareness and relationship difficulties. He currently works with individuals in our private practice in Hove.

 

Further reading by Paul Salvage –

The Therapeutic Relationship and the Unconscious

A Nation Divided

Adolescence: the trials and tribulations

Face to Face and Online Therapy Help Available Now

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Filed Under: Child Development, Families, Parenting, Paul Salvage, Relationships Tagged With: anxiety, Depression, family therapy

October 7, 2019 by Brighton & Hove Psychotherapy Leave a Comment

“Ghosts in the Nursery” – The Power of Family Scripts

 

 

As much as we might fight it, our own experiences of being parented, create within us blueprints or ‘internal working models’ of what it is to be a parent. These models only become fully activated when we become parents ourselves, and often take us by surprise. For instance, we may find ourselves ‘turning into’ our parents in ways we hadn’t intended. Similarly, memories from our past can be unexpectedly invoked in us when our own children reach the same age. 

Selma Fraiberg (1987) emotively referred to this phenomenon as “ghosts in the nursery” – the idea that without conscious effort to alter entrenched family patterns, family life can essentially become a ‘rehearsal’ for the next generation. More commonly, we refer to this phenomenon as the enactment of ‘family scripts’. John Byng-Hall (1985) proposed three ways in which these family scripts may manifest – 

  1. REPLICATIVE SCRIPTS: 

These scripts are a direct replication of the parenting that we received ourselves. They can include replication of positive scripts (e.g. family rituals, ways of nurturing children, ways of enforcing boundaries, certain sayings, etc.). They can also include replicating negative (unresolved) scripts, which may be consciously replicated (e.g. “smacking never did me any harm”) or unconsciously replicated (e.g. needing to hide one’s sad or angry feelings from a parent can make it harder for these children to later recognise or respond to these feelings in their own children).

  1. CORRECTIVE SCRIPTS:

These family scripts are a conscious decision to offer our children a different experience of being parented to what we received ourselves. The danger for this type of script, however, is that because they are driven from an emotional response to our past, there is a risk that we will go too far the other way (e.g. feeling hard done by as an older child, so favouring our own eldest child).

  1. IMPROVISED SCRIPTS: 

These family scripts relate to the ability to flexibly and creatively amalgamate what we most value from our own experiences of being parented, with what we now value and learn from new relationships, education, culture, etc. We generally consider that the most resilient and healthy families adopt this form of script. 

Difficulties can arise when damaging or unhealthy replicative family scripts cannot be consciously thought about by parents. In extreme cases, these can negatively impact upon a parent’s relationship with their child and therefore, their child’s subsequent emotional well-being. For the most part, however, activation of family scripts is normal, inevitable, and actually helps children to become embedded within the familial and social context to which they belong. Indeed, almost all the parents that I meet in my work (myself included), offer a fascinating mix of all three of the above scripts to their children.

References:

Byng-Hall, J. (1985). The family script: A useful bridge between theory and practice. Journal of Family Therapy, 7, 301-305

Fraiberg, S., Adelson, E. & Shapiro, V. (1980). Ghosts in the nursery: A psychoanalytic approach to the problem of impaired infant-mother relationships. Journal of the American Academy of Child Psychiatry, 14, 3.

 

Please follow the links to find out more about about our therapists and the types of therapy services we offer.  We have practices in Hove and Lewes.  Online therapy is also available.

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Filed Under: Brighton and Hove Psychotherapy, Child Development, Families, Parenting Tagged With: child therapy, family therapy, Parenting

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