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Covid-19 – talking with children in uncertain times

How do we contain our children’s anxiety in such uncertain times, when we too feel anxious and unsure ourselves?

When children are nervous we may notice them continually searching for reassurance – the usual advice would be to acknowledge this but keep reassurances to a minimum, modelling to them that fundamentally the adults in their life believe that the world is a safe place.

However, here we are – smack bang – in the middle of unprecedented times where it may be difficult for us, ‘the grown ups’, to keep level heads ourselves around our families health and economic future.

Our most important job is to manage our own anxiety whilst engaging with our children honestly and openly about the developing situation. Their worlds of home and school have been thrown into orbit; they had to say a hastened, brutal goodbye to friends and teachers not knowing when they would see them again.  The novelty of not being is school has now probably faded a little – time at home with parents is usually pleasurable but sometimes not.  Relationships can be put under extraordinary pressure when we are in lockdown with an unclear future.

Whilst we need to talk to children openly and find out their understanding of the pandemic, our responses should contain reassurances aplenty but we must to be careful not to give absolute guarantees.

It is within human nature to endeavour to provide an environment for our children in which they feel safe. Maybe we can begin to appreciate how these trying times can be viewed as an opportunity for us to model kindness, resilience and compassion.  We can hope that our children will remember these formative times as a period in which they learnt important life lessons along with resilience for their futures.

 

Sharon Spindler is an experienced Systemic Family Therapist with twelve years experience within the NHS and private practice.  Sharon is available at the Brighton & Hove Practice.

 

Further reading by Sharon Spindler –

Family Therapy for Beginners

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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.

 

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes Practice.

 

Blogs by Dr Laura Tinkl

Parenting Styles

‘Ghosts in the Nursery’ – The Power of Family Scripts

When praise becomes harmful to children

The role of ‘attunement’ in relationships with babies and young children

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Educational Psychotherapy: (1) supporting social-emotional development and learning

Educational Psychotherapy was developed by Irene Caspari in the 1970s, an Educational Psychologist working at the Tavistock Clinic in London.  She was interested in understanding learning difficulties from a psychoanalytic and attachment perspective. In order to address both learning needs and emotional difficulties together, she pioneered a method of blending structured (educational) tasks and free expression within a 50-minute weekly therapy session.  Treatment usually lasts 1-2 years but some work continues for longer or is adapted for shorter periods or extended assessments. Trainees are typically experienced teachers or learning support staff and undergo their own therapy during training. Many continue to work in schools and adapt their learning to therapeutic teaching and attachment-aware, trauma-informed practice.  

What follows is an anonymised, disguised case study which illustrates how Educational Psychotherapy can begin to support social-emotional development and learning.

11-year-old Sammy was referred for therapy by his key worker on account of difficulties he was having with relationships, expressing and understanding emotions and understanding the world. An earlier Educational Psychology assessment had suggested that high levels of anxiety were impacting on Sammy’s capacity to make full use of learning.  Therapy took place over 18 months.  

Sammy soon engaged with a variety of word, number and drawing games and activities, offered within the context of a supportive relationship.  Tasks which combined cognition, physical activity and relational connection proved an effective way to build trust, stimulate thought and enliven Sammy’s felt experience in the room.  Shared story writing and the free use of paint and clay facilitated expression and imagination. Conversation also had a significant place, at the point of checking in, within and around activities and, over time, for sustained periods.

Over the first 6 months of therapy, progress became evident in the following foundational areas:

Sense of self and reciprocal interaction
Sammy came to enjoy the process of co-creation with craft activities and solving problems together, including making up physical word and number games and negotiating the rules between us.  He became more comfortable with what he didn’t know  and embraced the opportunity to find things out, explore new skills and introduce me to new areas of learning.  Sammy also started to talk more about himself and grew comfortable with the routine of checking in at the start of a session, when he would share a happy achievement or discovery or an experience of frustration, disappointment or confusion.

Tasks and learning

Persevering at a challenging task requires the use of Executive Function skills, such as being able to monitor and evaluate where the difficulty lies, use problem solving skills to work out and plan the next steps, use working memory, inhibit distracting thoughts and so on.  Young people like Sammy, who have difficulties in these areas, require considerable “scaffolding” to help them develop and practice skills and tools for thinking. To begin with, Sammy found it hard to take instruction or support from me but as trust grew he became a little more comfortable with not knowing and clearly more curious.  My sense was that a space for thinking opened up in his mind which enabled him not to panic but to consider what was required next in order to proceed. 

Thinking about and talking about feelings

The development of a language for feelings was a significant area of development.  In early sessions, Sammy would habitually say that everything was “fine” or “normal”, almost seeming oblivious to the relevance of emotional experience or reflection.  After a time, Sammy disclosed that he had been getting into rages at home and taking out his feelings on objects which had sometimes become broken.  He acknowledged that this was confusing, upsetting and problematic for him and that he wanted help with it.  Activities like squeezing paint directly onto paper or working with clay enabled Sammy to express himself viscerally and then reflect on how he connected with the images created.  We also thought about activities Sammy could do at home to self-regulate.  

In time, thinking about feelings became an area that Sammy would actively seek.  He talked about experiencing fear and how this had caused him to adopt particular behaviours as an avoidance mechanism.  It seemed that the naming of these fears was enough to create some distance and enable Sammy to make a choice about how he wanted to act.  Sammy also talked about sadness and acknowledged that he had grown used to keeping his feelings to himself.  He started to voluntarily make links between his expressive material in artwork and his own thoughts and feelings inside.  

 

In part, these conversations involved psycho-education, helping Sammy to understand more about how feelings work, that it is normal to experience a wide range of feelings and that it can help to be self-aware and to share some of what we feel with trusted others.  At times, we were able to do this through playing board games or through role-play with miniatures.  Sammy showed that he could recognise the difference between actions held in mind and actions lived and that he could think hypothetically about possible future consequences of taking a particular course of action.  

This phase of the work paved the way for more profound developments which were to follow.  Sammy was now ready to take more risks. (Read more about this in Educational Psychotherapy (2) – article will be published shortly).

 

Michael Reeves is a Psychotherapist working with children and young people aged 4-18 and/or their parents/carers. He is available as a clinical supervisor for training or practising therapists and counsellors, whose work is primarily focused on children/ families/ parents. He is available at our Lewes Practice.

 

Further reading by Michael Reeves –

Curiosity: how can children’s behaviour help us understand what they need from us?

Acceptance – What does it have to do with managing children’s difficult behaviour?

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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 behavioral 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

 

Dr Laura Tinkl is a Senior Chartered Clinical Psychologist, professionally accredited by both the Health and Social Care Professions Council (HCPC) and The British Psychological Society (BPS). Appointments can be made in the Lewes Practice.

 

Further reading by Dr Laura Tinkl –

‘Ghosts in the Nursery’ – The Power of Family Scripts

When praise becomes harmful to children

The role of ‘attunement’ in relationships with babies and young children

What is ‘Blocked Care’ as it applies to parenting?

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Leaving the Family

Long-term Psychotherapy is all about leaving the family – not literally – but in the psychological sense.

This is a much more complex process than it sounds. Why? Because it takes years of back and forth, and it is a journey which although slow, in my view essential for psychological health.

If you were lucky enough to have had a secure attachment relationship to your main carers – meaning an upbringing with parents who were secure in enough themselves to support your natural development throughout life – even if you experienced challenges or significant losses, you will feel enough security (real security, not an inflated one) in yourself to navigate life’s challenges.

For the rest of us, probably the majority – we will probably need to come to terms with the reality and aftermath of growing up in dysfunctional families, with parents or carers who were at best unskilled, and at worst abusive.

Leaving the family in the psychological sense can result in leaving in the physical sense too – such as choosing to have limited or no contact with an abusive or toxic family member.

This can be a difficult and painful decision to reach because of feelings of guilt, and expectations/ ideas of what a family should look like. For example, in some cultures it is taboo to cut contact with close family members (especially parents). Also, the person who is choosing to not have contact is usually accused of being difficult, making up stories, etc. Putting the blame on one family member (usually a child) is also a way of denying systemic dysfunction within the family.

Status Quo

Being in Psychotherapy can be risky because of what can get uncovered. Ideas about family which were not true, love which wasn’t there, destructive behaviour which was condoned or kept secret, etc. It is often painful to come to terms with reality. However, it is much more painful to live in denial.

Things which are denied or suppressed, remain unaddressed. What remains unaddressed affects us anyway because we can’t make links between our experience (past and present), feelings and behaviour. This is confusing and can cause a lot of unnecessary suffering.

As children we may have tried hard to keep our family together, because we depended on them for survival. And whilst some families are held together by love, compassion and humanity, other family relationships are held together by denial of serious dysfunction and/ or secrecy around abuse. This is not to say that love isn’t possible in dysfunctional families. There are degrees of how much harm dysfunction in families will cause.

Short Cuts

The reality is that there aren’t any short cuts for this type of work. Many people come into psychotherapy having tried to bypass their pain through short-term fixes, and shallow pursuits. Maybe after a string of failed relationships or a life that feels empty. Unaddressed, long-standing issues can also manifest as chronic depression or anxiety.

Of course, there needs to be a certain readiness and willingness for this type of work to take place. Maybe a certain level of maturity even (not usually related to age).

Aims and goals

The destination is unknown because it depends on each unique individual’s circumstances and hoped for outcomes.

The aim could be to finally become an adult in an emotional and psychological sense. This means to take more ownership of one’s feelings, thoughts and decisions. To be more present in one’s body. To have more fulfilling relationships and a more meaningful life.

Who wouldn’t want this?

Sam Jahara is UKCP Registered, CTA, PTSTA and is one of the Brighton & Hove Psychotherapy Co-founders.  She is an experienced Transactional Analysis Psychotherapist. Her special interests include culture, identity, belonging, sustainability and environmental issues. Sam is available at our Lewes and Brighton & Hove Practices.

 

Further reading by Sam Jahara –

Psychotherapy can change your life – but you may not want it to

On rushing towards answers

How do Psychotherapists work with anxiety? Trio of Blogs – Part 3

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