Category: Parenting

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Parent Mental Illness Casts Long Shadow on Children

00Anxiety, Child Development, Depression, Featured news, Parenting, Suicide, Trauma June, 17

Source: stefanos papachristou on flickr, Creative Commons

“My aunt woke me to say that my mom sent a text to the family priest in the middle of the night, asking for prayers after taking a bunch of pills.”

Diagnosed with clinical depression, Keith Reid-Cleveland’s mother had a long, painful history of suicide attempts, feeling unhappy and tired much of the time. Like many children, he felt helpless and didn’t understand depression, thinking her fatigue was from hard work, and that his mother just needed sleep.

As Reid-Cleveland grew up, he began to take notice of his mother’s mood, making it his responsibility to try to make her smile:

“At first, this just entailed telling her ‘I love you’ every time I saw her. Eventually, it morphed into me acting as sort of a motivational life coach/stand-up comic.”

After his mother’s first hospitalization:

“I did Desi Arnaz impressions to make her laugh…”

He also gave her emotional support:

“I sat down and unpacked what was bothering her step-by-step, until she realized it wasn’t as devastating as she’d thought.”

The Canadian Mental Health Association (CMHA) estimates that 8% of adults will experience major depression at some point in their lives. About 4000 Canadians die each year by suicide, making it the second leading cause of death for those between ages 15 and 34.

Parental suicide and hospitalization have a tremendous impact on children.

To better understand this traumatic experience, researchers Hanna Van Parys and Peter Rober, from the University of Leuven in Belgium, conducted interviews with children between ages 7 and 14 who had a parent hospitalized for major depression.

Many children showed sensitivity to the parent’s distress. Like Reid-Cleveland, some reported awareness of parental fatigue or lack of energy. Others picked up on mood changes, such as when the parent was feeling angry or sad. And some reported feeling guilty for being a burden.

Eleven-year-old Yellow expressed to his father: “If you would like me to be somewhere else sometimes, just tell me.”

Others sought ways to convey to their parents that they were not affected by their mental health, attempting to elevate mom’s or dad’s mood. Van Parys and Rober consider this behaviour common for children seeing a parent in distress. In their study, a child named Kamiel was asked whether he would like to solve problems for his mother, to which he responded: “Yes, sometimes, if that would be possible,” while hugging her closely.

When his mother was first hospitalized for a suicide attempt, Reid-Cleveland’s loved ones decided he shouldn’t see her. Recalling similar situations of parental hospitalization, child interviewees reported much distress and worry about the parent. Many felt alone, powerless, unable to help.

One girl expressed existential fear, stating: “Then I think about when you will die, everything will be different when you die.” Seeing a parent in the hospital forces the child to imagine life without them.

Research shows that children of parents who attempt suicide are at higher risk to do the same. And in a study conducted at the Aarhus University in Denmark, researchers found an increased long-term risk of suicide in children who experienced parental death in childhood, increasing suicide risk for up to 25 years following the traumatic experience.

Like Reid-Cleveland, many children living with parent mental illness feel isolated and helpless. Van Parys and Rober note that prevention programs focusing on family communication are beneficial to enhance family resilience, and to lessen the burden on the child.

– Khadija Bint-Misbah, Contributing Writer, The Trauma and Mental Health Report.
– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.
 

This article was originally published on Psychology Today

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When Discipline Worsens Performance in Competitive Sports

00Child Development, Coaching, Featured news, Parenting, Self-Control, Sport and Competition, Trauma May, 17

Source: Petr Magera on flickr, Creative Commons

On December 19, 2015, former National Hockey League (NHL) player Patrick O’Sullivan revealed shocking details of sports-related childhood abuse. In a blog article on The Players Tribune, he disclosed that his father began abusing him at 5 years old when he got his first pair of hockey skates.

At the age of 10, it worsened:

“It would start as soon as we got in the car, and sometimes right out in the parking lot.”

He reveals that his father would put out cigarettes on his skin, choke him, and throw objects at him. At times, he endured whippings with a jump rope or an electrical cord.

“As twisted and insane as it sounds, in his mind, the abuse was justified. It was all going to make me a better hockey player—and eventually get me to the NHL.”

The more goals Patrick scored, the more the abuse intensified.

Patrick’s father assumed that these harsh disciplinary practices would enhance his abilities and success, but experts say otherwise. The scars of childhood abuse have a lasting negative impact.

John O’Sullivan (no relation to Patrick), a former soccer player, coach, and founder of the Changing the Game Project, says this parenting behaviour burdens the child, hindering performance.

In an article on the Changing the Game Project website, John writes:

“If a child believes that a parent’s love is tied to the expectation of winning, and he does not win, he may believe that he is less loved or valued. This creates anxiety and inhibits performance.”

Childhood maltreatment leads to decreased mental and physical health, even decades after the abuse. Rutgers sociology professor Kristen Springer and colleagues reported that, in their population based survey, physical symptoms and illnesses, like hypertension and cardiac problems, were present in those who experienced childhood abuse years earlier. And childhood maltreatment is also associated with increased anxiety, anger, and depression—symptoms that can be heavily detrimental to an athlete’s performance.

Some studies also show that early childhood maltreatment, such as the abuse endured by Patrick, shape aspects of socio-emotional development in adolescence and adulthood. A study conducted by Pan Chen and colleagues at the University of Chicago supported the relationship between childhood abuse and aggressive behaviour in adulthood. The researchers note that early trauma may increase impulsive behaviour and lashing out in abuse survivors.

But some, like Patrick, seek help. He says in an interview with ESPN, “…I have put the money and time into my own health.”

He acknowledges that not everyone has the opportunity to find the help they need—especially as an athlete:

“Players don’t feel like they can say anything because it’s a huge red flag. You say you need to see a psychologist and you’ll get a call from your agent saying he spoke to the General Manager of the team and wants to know what your ‘problem’ is.”

In addition to how isolating the experience of abuse can be for professional athletes and adults, Patrick emphasizes how helpless and frightening it can be for a child. He describes his own feelings of disempowerment, at the age of ten: “I just tried to survive. Each morning, I’d wake up and think: Here we go again. Just get through it.”

It didn’t help that others turned a blind eye. Patrick says that parents and coaches would catch a glimpse of the abuse, but no one stepped in. Bystanders may feel hesitant to intervene, out of fear of being wrong. But he counters, “If you are wrong, that’s the absolute best case scenario.” He hopes his story will raise awareness about childhood abuse in young athletes.

As for parents, soccer coach John O’Sullivan says that empowerment may be key to promoting competitive success, instead of harsh discipline and criticism. “The best players play with freedom, they play without fear and they are not afraid of making errors, they can play up to their potential,” he says in an interview with Kids in The House.

He shares that “I love watching you play” are the best five words you can say to a child after a game. “Because when you tell your kids, after a game, that ‘I love watching you play’, what you do is you free them from the burden of being responsible for your happiness as a parent”.

–Khadija Bint Misbah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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When the Expectation is for Parents to Hover

00Attachment, Attention, Child Development, Featured news, Identity, Parenting December, 16

Source: Dennis Skley on Flickr, Creative Commons

In September 2015, the Supreme Court of British Columbia, Canada, ruled that a mother, known only as ‘B.R.’, could no longer leave her eight-year old son home alone for two hours after school. As reported in a Vancouver Sun article by Brian Morton, this court decision implies that children under the age of ten cannot be left unsupervised under any circumstance.

The implications of this case reach far beyond B.R.’s personal story, and may have serious consequences, raising questions around babysitting, and even whether parents can leave children alone in the house to fetch something from the backyard or to have a conversation with the neighbours.

The ruling is seen by some as reflecting a shift toward helicopter parenting, where parents “hover”, rarely leaving children alone or allowing them to make their own decisions. This consistent interference may in fact hinder a child’s development.

Kathleen Vinson, a professor at Suffolk University, views parental hovering as preventing children from gaining a sense of independence and privacy, which in turn can impede a child’s ability to mature into a healthy, responsible adult later in life. In her research, Vinson found that:

“…the impact of having helicopter parents may have resulted in children’s under-involvement in decision-making; reduced ability to cope; and lack of experience with self-advocacy, self-reliance, or managing personal time.”

Vinson’s research highlights a helplessness and lack of control that many of these children feel. As they move through adolescence to enter university and an increasingly competitive job market, these young adults may find it difficult to juggle the stress brought on by sudden autonomy.

Similar views are expressed by Lenore Skenazy, author of the blog Free Range Kids.With tongue-in-cheek, this self-proclaimed “world’s worst mom” speaks out against tactics such as GPS-tracking one’s children. She supports the idea that it is normal for both parents and children to make mistakes. According to Skenazy, these experiences are an opportunity for a child to develop and mature:

Childhood is not a crime. Down time is not dangerous. In fact, it’s the fertile soil where creativity takes root. Do you wish you’d grown up with your mom tracking your every move? If not, don’t do it to your own kid.” 

But parents often believe they are doing the right thing. Over-attentiveness may come from a place of genuine concern, and the consequences of leaving one’s children unattended.

A Parents Magazine article explains that for many, even the smallest failure or accident can seem disastrous, especially if parental involvement could have prevented it.

And parental involvement is a crucial aspect of a child’s mental health and development. In their textbook, Home and School Relations, University of North Dakota professors Glenn Olsen and Mary Lou Fuller examine the impact of parental participation in children’s education. The authors found that children whose parents showed more interest and involvement in their growth tended to excel academically across multiple domains, including classroom performance and standardized testing—a trend that continued well into higher education.

Still, problems arise when parent involvement extends too far, leaving young adults helpless in trying to find their footing, impeding normal development and failing to foster independence.

For such competencies are necessary to cope with the trials and tribulations of adult life.

–Andrei Nestor, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Divorce an Unreliable Predictor of Aggressiveness

00Anger, Child Development, Divorce, Emotion Regulation, Family Dynamics, Featured news, Parenting, Self-Control August, 16

by Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

“Tomorrow is the day of retribution, the day in which I will have my retribution against humanity, against all of you.”

Elliot Rodger spoke these words in a video he recorded before stabbing and shooting fellow students at the University of California, Santa Barbara (UCSB) in May 2014. After killing six and injuring 14 others, Rodger took his own life.

In a 140-page manifesto called “My Twisted World,” Rodger explained that he was seeking revenge for being a virgin at 22 years of age. Tormented by loneliness and rejection, he detailed many painful experiences that helped push him over the edge. In a final video, he threatened the life of every female student in UCSB’s most popular sorority house and anyone else he saw on the streets of Isla Vista.

Rodger sent this manifesto to his parents and therapist before the killing spree, blaming them for his sexual frustrations. His father, Peter Rodger, later explained that his son began dealing with mental health problems at a young age, following his parents’ divorce. In an interview with Barbara Walters on ABC’s 20/20, Rodger’s father spoke about Elliot’s fear of interaction with other children in high school:

“He felt the inability to get along with them. And this is when we realized that he had a real fear of other human beings, of other kids his age.”

Stories like those of Elliot Rodger lead us to seek explanations. We try to understand how something like this can occur. In the 20/20 interview, one explanation advanced was the idea that Rodger’s life changed when his parents divorced.

Source: Yuliya Evstratenko/Shutterstock

The idea of divorce being profoundly damaging to children offers a compelling explanation when it is otherwise difficult to understand certain individual actions. Research shows that children who experience divorce at a young age may develop separation anxiety and dependency. When they do not receive equal attention from both parents, they may become sensitized to rejection and react strongly to this same type of rejection in social situations. Over time, they may develop lower self-esteem and negative expectations regarding intimate relationships.

But even among this small fraction of children, severe aggression is rare. In fact, most children of divorce are able to cope relatively successfully with their situation and go on to develop close relationships, experiencing few behavioral problems. Yet it remains common to view divorce as being destructive for children.

Janine Bernard of Purdue University and Sally Nesbitt of the Counseling and Psychological Services Center in Texas both found no significant differences in levels of anger, aggression, and passive-aggressiveness between children of divorced or disrupted families and children of intact families. In their two-part study, they found that while all children are affected by the quality of their parents’ relationship, environmental and sociocultural factors are just as important in determining individuals’ temperament. Similarly, internal levels of maturity, personal coping styles, and other relationships can and often do counterbalance the negative impacts of divorce.

Bernard and Nesbitt note:

“For generations couples have been disillusioned by the marriage myth, which promised life happily ever after. The more recent divorce myth is equally dogmatic and suggests that divorce has inordinate powers to hurt people regardless of the mental health and maturity of the adults and children involved.”

People with such views tend to expect children from divorced families to become socially isolated and develop behavioral problems. Bernard and Nesbitt explain that this is a common hypothesis among researchers conducting divorce studies. The bias may impact their judgment and cause stilted reporting of results, with more focus on a child’s negative behavior and less on their positive qualities.

Eva Bennett on flickr

Source: Eva Bennett on flickr

Elliot Rodger is an example of one individual who was psychologically disturbed and viewed his parents as responsible for his suffering. But he is certainly not a typical example of a child of divorced parents.

His social isolation may have felt unbearable to him, and he and his family sought an explanation for his violent actions, just as we all do when we hear about tragic stories like this. But our best explanations can be misguided. Reliably predicting violent behavior is still difficult to do.

Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Postpartum Depression Underdiagnosed in Men

00Depression, Featured news, Parenting, Post-Partum, Pregnancy June, 16

Source: John Hann on flickr

After his son Jaden was born, Jason Maharaj felt depressed, exhausted, and stressed. Following complications during the pregnancy, Jason’s wife was diagnosed with postpartum depression, and he had to look after both his son and his wife while continuing to work.

But Jason soon realized that his mood was unusual and he spoke to a clinician about his feelings. The clinician responded: “Now is not the time for you. Now is the time to take care of your wife.” Only after he reached his tipping point—snapping at his son and bursting into tears—did Jason receive a diagnosis of his own.

Postpartum depression is most commonly diagnosed in new mothers within 12 months of childbirth. However, 1 in 4 new fathers also experience symptoms of the disorder during this period.

The symptoms include depressed mood, little interest in regular activities, feelings of worthlessness, and loss of energy.

Fearing that an open discussion of their feelings would result in dismissal or stigmatization, many men experience symptoms but resist seeking help.

In a study conducted by Jane Iles, Pauline Slade, and Helen Spiby at the University of Sheffield in the UK, couples completed questionnaires about their stress levels at different times following childbirth—after 7 days, 6 weeks, and 3 months. Results showed that symptoms of postpartum depression were similar among men and women. Men’s acute symptoms often followed their partner’s or occurred simultaneously. In both men and women, higher levels of postpartum depression and posttraumatic stress were related to inadequate partner support.

Sherri Melrose, assistant professor at the Centre for Nursing and Health Studies at Alberta’s Athabasca University, believes that healthcare professionals could help families best by addressing the needs of both parents. She explains that men often respond to their depression by socially isolating themselves or by expressing aggressive and pessimistic mood patterns.

Jason Maharaj showed frustration toward his son, who was craving attention. “I jumped up and turned around and yelled at him,” he recalls.

Unlike many women who are more comfortable expressing sadness, men often react to their depression with anxiety and anger. Melrose notes that some men may turn to substance abuse, avoidance of familial responsibilities, or extra-marital affairs to cope.

But like women suffering with postpartum depression, a father’s reaction to the disorder depends heavily on the social support they receive, especially from partners. In the same study by Iles, Slade, and Spiby, the authors found that men who feel attached to their partners and receive support are less likely to withdraw, react violently, or cheat.

Melrose recommends that healthcare practitioners be taught to recognize not only the existence of postpartum depression in men as well as women, but also the different ways it can manifest.

Commonly, women are administered the 10-question Edinburgh Postnatal Depression Scale to determine signs of postpartum depression. But Melrose questions the validity of this scale for use with men, as it cites frequent crying as a major symptom, which is far less common in men.

The more recent Gotland Scale for Assessing Male Depression uses 10 questions specifically designed to assess masculine expression of depression, using phrases such as “stressed out” or “burned out” rather than “I have been so unhappy that I have been crying.” Melrose believes the Gotland Male Depression Scale may be more suitable to test postpartum depression in new fathers, but suggests further testing to confirm the scale’s reliability and validity.

Because postpartum depression in men is highly stigmatized, hospitals, outpatient clinics, daycares and other organizations serving parents and children should consider their role in educating new parents about its possible manifestation in men. Psychologists and physicians should also ensure they take the feelings of both parents seriously.

Until they do, it is unlikely the stigma surrounding the condition will dissipate.

– Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Russian Adoption Laws Leave Children Warehoused and Unwanted

00Attachment, Child Development, Ethics and Morality, Featured news, Health, Law and Crime, Parenting June, 16

Source: John Manuel Sommerfeld on Flickr

It is a life of deafening silence, colourless walls, and empty corridors, a life of intense longing and disappointment. For over 600,000 children living in Russian orphanages waiting to be adopted, it is the only life they know.

In 2013, Russia passed a law to ban the adoption of orphaned children by American citizens, in part because of tense political relations between the two countries. In 2014, Russia also banned the adoption of orphans into any country that acknowledges same-sex marriage in order to “protect children’s psyche from the undesirable effects of exposure to unconventional sexual relationships.”

With these measures in place, finding homes for orphans outside the country has become very difficult.

Meanwhile, adoption within the borders of Russia faces its own set of barriers. Cultural prejudice against adoption perpetuates feelings of rejection among orphaned children and contributes to fears amongst potential adoptive parents that orphans have inherited undesirable traits and tendencies from their biological parents.

As one adoptive parent, Vera Dobrinskaya, stated in a BBC interview, many orphanage staff members discourage adoption when meeting with prospective parents. She quoted a nurse as saying to her, “Their parents abandoned them, and you want to take care of them?”

Unlike orphans in other countries, 95% of Russian orphans have at least one living parent. Often, they are taken forcibly into state custody because of family illness, disability, or poverty.

While institutions manage to provide for children’s basic physical needs, most Russian orphanages fail to take mental health into consideration. Research has shown that mass institutionalization and the absence of regular adoption practices harm children’s health and development.

To make matters worse, the interaction of staff members and children in these facilities is minimal and conducted in a formal manner, with little warmth or emotion. Daily activities like waking up, showering, dressing, and feeding are carried out in a militaristic way.

As the BBC explains, the problem of Russian orphanages is mainly in their self-identification as warehouses for unwanted children.

Georgette Mulheir, an advocate in the movement to end child abuse, explains why mental health neglect is a problem for these children in a recent TED Talk. While visiting a Russian orphanage, Mulheir reported seeing rooms lined with rows of barred beds, with children quietly gazing up at the ceiling. Newborns also lay in silence, often wearing soiled diapers but not crying, unfamiliar with the help that comes from attentive caregiving. And the head nurse proudly told Mulheir, “You see, our children are very well-behaved.”

Lacking proper stimulation and without secure attachment, many children develop odd and often self-injurious behaviours, such as rocking back and forth or banging their heads into walls. Just as healthy attachment between children and caregivers provides a sense of security for psychological, emotional, and physical development, lacking appropriate caregiving can seriously damage mental health.

As Stephen Bavolek, in the field of child abuse suggests, some of the problems these children can expect as they grow up include poor impulse control, impaired foresight, and a lack of trust in and affection for others.

Several months after the Russian adoption bans were implemented, the United Nations held a meeting to develop alternate childcare programs. Local governments within Russia were instructed to begin transferring children from orphanages to foster families.

This process, however, has encountered resistance from the institutional staff. As child rights protection activist, Maria Ostrovskaya, explains, “Institutions reject sending children into families, as state funding brings jobs and paychecks.”

The situation remains unresolved while many thousands of children wait for politicians to decide their fate. The stakes are high, as many of the children grow up with a risk of being sold into slavery, committing crimes, entering prostitution, or taking their own lives.

– Sara Benceković, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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RUSH Prevention Program Helping Children of Bipolar Parents

00Bipolar Disorder, Emotion Regulation, Environment, Featured news, Health, Parenting, Stress, Therapy May, 16

Source: Rolands Lakis on Flickr

“It was just kind of not knowing what you were going to get every time. Emotionally when I was younger, I always cared about her. She was my mom. As I grew up, I kind of became disconnected because I didn’t know the real her. I only knew her from her diagnosis. I only knew her emotions. I didn’t know the real her.”

– Steven, child of a bipolar mother.

In 2004, the World Health Organization named Bipolar Disorder (BD) the seventh-leading cause of ‘disease burden’ for women between 15 and 44, a measure that combines years of life lost to early death and years lost to living in subpar health. Public Health Agency of Canada reports that BD occurs in one percent of Canadians, and their reported mortality rates are two to three times greater than the general population.

The disorder is marked by alternating periods of manic euphoria and intense depression. In a manic state, people experience elevated moods, racing thoughts, and sleeplessness, in addition to overspending and engaging in risky sex. The depressive phases make for overwhelming feelings of sadness, withdrawal, and thoughts of death and suicide.

Research has related BD to aggressive behaviour, substance abuse, hypersexuality, and suicide. But more recently, studies have been showing the kinds of challenges faced by children of those diagnosed with the disorder.

The Pittsburgh Bipolar Offspring Study reports that children of bipolar parents are 14 times more likely to develop bipolar spectrum disorder. Children of two bipolar parents are at an even higher risk.

And these children are also more vulnerable to psychosocial problems. A study by Mark Ellenbogen at Concordia University finds them at greater risk for problems with emotional regulation and behavioral control.

Ellenbogen and colleagues have explained how stressful home environments can alter biology to influence mood disorders in adolescents and adults.

In an interview with the Trauma and Mental Health Report, Ellenbogen stated that OBD individuals (that is, offspring of parents with bipolar disorder) show higher levels of daytime cortisol, a hormone that is released during times of stress. OBD are psychologically more sensitive to stresses in their natural environments.

“We have found that high cortisol levels in offspring may represent a biomarker of risk for affective disorders, particularly in vulnerable populations like the OBD. We believe that these changes in cortisol levels can be linked to stress, inconsistent parenting practices and disorganization in the family environment.”

Reducing the stressors in early childhood may help decrease elevated levels of cortisol, and ward off the development of BD and other problems.

Recognizing the need for early intervention, Ellenbogen initiated a pilot prevention program, Reducing Unwanted Stress in the Home (RUSH), which targets bipolar parents and their vulnerable children between six and eleven.

An assessment measures salivary cortisol, looks at the family environment, and evaluates the child’s behaviour. Then parents and children participate in weekly sessions.

With parents, the focus is on improving communication and problem-solving skills, and increasing structure and consistency in the home. With children, they teach skills for understanding and coping with stress through age–appropriate exercises and educational games.

“The goal of the RUSH program is to prevent the development of affective disorders and other mental disorders by intervening in families well before these serious mental disorders begin. That is, this is a prevention program for children at high risk of developing debilitating mental disorders.”

To date, children and parents have been responding well, but the research is ongoing.

Programs like RUSH aim to prevent the development of mental illness in vulnerable youth. And an ounce of prevention can mean a whole lot to quality of life down the road.

– Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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When Adolescents Claim the Right to Refuse Treatment

00Child Development, Decision-Making, Family Dynamics, Featured news, Parenting, Therapy April, 16

Source: UnitedNotions Film, Used with permission

In a personal essay in the Hartford Courant, 17-year old Cassandra C. recalls her legal battle when she refused to undergo chemotherapy after being diagnosed with Hodgkin Lymphoma, a cancer of the lymphatic system.

The Connecticut Superior Court ruled that as a minor, Cassandra did not understand the severity of her condition. She was taken to Connecticut Children’s Medical Center in Hartford, where she was forced to undergo chemotherapy.

In her essay, Cassandra wrote:

“I should have had the right to say no, but I didn’t. I was strapped to a bed by my wrists and ankles and sedated. I woke up in the recovery room with a port surgically placed in my chest. I was outraged and felt completely violated.”

When Cassandra’s mother did not bring her to medical appointments, the Department of Children and Families took Cassandra into custody. She was medically examined and placed into foster care.

A month later, Cassandra was allowed to return home once she agreed to continue chemotherapy. After reluctantly undergoing two days of treatment, Cassandra claimed that it was beginning to take a toll. Feeling trapped, she decided to run away to evade treatment, only returning home out of fear her disappearance would land her mother in jail.

It is common for cancer patients to experience adverse side effects while undergoing chemotherapy. In addition to physical side effects, patients often experience a range of psychopathologies, including depression, fear, anxiety, and hopelessness.

In court, Cassandra argued that she cared more about the quality of her life than the duration. Yet she was told that undergoing chemotherapy would increase her chance of survival by 85 percent. Without it, doctors said there would be a near certainty of death within two years. Although Cassandra acknowledged this risk, she maintained that she had the right to make decisions about her own life and body.

In an interview with the New York Times, Cassandra’s mother supported her daughter’s decision to refuse chemotherapy:

“She knows the long-term effects of having chemo, what it does to your organs, what it does to your body. She may not be able to have children after this because it affects everything in your body, it not only kills cancer, it kills everything in your body.”

Both Cassandra and her mother denied that Cassandra’s decision was anyone’s but her own. But there is some concern that Cassandra’s opinion on medical treatment could have been influenced by her parents. This issue is especially important given the far greater chance of survival offered by treatment.

A study by psychiatrist Paola Carbone in the Journal of Child Psychotherapy describes how young cancer patients may have trouble accepting treatment because of its severe effects on their developing bodies. Adolescent girls often express dissatisfaction with their bodies and lower self-esteem. The side effects of chemotherapy, such as weight loss, may negatively affect their fragile self-confidence.

The right to independent decision-making at this age is also a factor. In her essay, Cassandra writes:

“I am a human—I should be able to decide if I do or don’t want chemotherapy, whether I live 17 years or 100 years should not be anyone’s choice but mine.”

Researchers, Coralie Wilson and Frank Deane, suggest that it is important to teach adolescents’ that part of being more independent and autonomous is being aware of when and how to seek the support of others.

An extreme need for independence can result in self-imposed isolation, which is why Carbone maintains that adolescents are particularly in need of familial support. Other studies have also found that family involvement in discussions about the side effects of chemotherapy improves social support and decision making, lowers physical and mental distress, and increases emotional wellbeing.

Carbone explains:

“Chemotherapy refusal by adolescent patients should not be considered an obstacle to be eliminated at all costs, but rather a message to be welcomed and worked on.”

Cassandra was discharged from hospital last April, after completing treatment. Prior to being released, she wrote on Facebook, “I have less than 48 hours left in this hospital and I couldn’t be happier!”

She reported that she was grateful that she responded positively to the drugs and was predicted to survive cancer-free. But she also added:

“I stood up and fought for my rights, and I don’t regret it.”

– Khadija Bint Misbah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Overpraising May Reduce Self-Esteem in Children

Overpraising May Reduce Self-Esteem in Children

10Confidence, Family Dynamics, Featured news, Parenting, Personality, Self-Esteem December, 15

Source: Vinicius Zeronian Mattoso on Flickr

Spend five minutes at a park, and soon you’ll hear enthusiastic parents reinforcing their kids with, “you did so amazing” and other statements as a means of encouragement.  To the nurturing parent or guardian, praising a child for performance seems like a no-brainer.

But recent research suggests that overpraising may not be such a confidence booster for some children, particularly those with low self-esteem.

Developmental psychology researcher Eddie Brummelman at Ohio State University says that using inflated praise can actually backfire.  In his research, children were asked to draw a famous painting, Wild Rose by Vincent van Gough.  One group of children received inflated praise such as “you made an incredibly beautiful drawing,” while a second group received non-inflated praise like “you made a beautiful drawing,” and a third group received no praise.

In a later task, children were asked to copy a picture of their own choice.  For example, they could choose to copy a simple picture, where the child would likely make few errors, or a difficult picture with more detail.

The results showed that children with low esteem were more likely to choose easier drawing tasks after receiving inflated statements of admiration.  In an interview with Research and Innovation Communications at Ohio State University, Brummelman said, “if you tell a child with low self-esteem that they did incredibly well, they may think they always need to do incredibly well.  They may worry about meeting those high standards and decide not to take on any new challenges.”

Children with low self-esteem may interpret high praise as expectation, making them afraid of failure and disappointment, and consequently, afraid to take on novel tasks.

Elizabeth Gunderson and colleagues at the University of Chicago found that parents who praised with a focus on the child’s personal characteristics (e.g. “you’re so smart”) implied to the child that their ability was fixed and unchangeable, resulting in a lack of motivation to tackle challenging tasks.  But when parents highlighted their child’s efforts (e.g. “you worked hard”), children often used positive approaches for problem solving, and believed that their abilities could be improved with effort.

Researchers often refer to this constructive encouragement as process praise.

Psychology professor, Lisa Marie Tully, from the University of California states that process praise might be especially beneficial for children who are generally more motivated and persistent.  Those children are more likely to ask for help when faced with experiences of failure after attempting challenging tasks.

Interestingly, Gunderson also found that the amount of praise that the child received from the parent had no apparent effect on motivation or self-esteem.

Consistent with these findings, Michigan State University Extension (MSUE) suggests ways to give constructive encouragement to children, to promote self-confidence and competence.

MSUE advises that supporting the child’s effort, whether or not they are successful in accomplishing a task, is important.  So instead of using personal and exaggerated praise in an attempt to boost esteem, let the child know that you recognize their determination.

Letting the child know exactly what they are doing well and noticing the detail of their work is critical.  Trading ambiguous praise for detail-oriented questions lets the child know that their work is interest-worthy.  When children are explicitly told what they are doing right (e.g. “good job at cleaning up the blocks”), it’s more effective in changing future behaviours and promoting improved effort.

– Khadija Bint-Misbah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Parental Pressure Takes a Toll on Young Athletes

Parental Pressure Takes a Toll on Young Athletes

00Child Development, Family Dynamics, Featured news, Parenting, Resilience, Self-Esteem November, 15

Source: Jim Larrison on Flickr

Two young Jiu Jitsu fighters battle for position, and all I hear are the parents, “Ref, you missed those last two points!” “Jeffery, you’re doing it wrong!” Jeffery gets caught in a dangerous hold, and I end the match to spare him risk of a broken arm.  Afterward the parents approach me, angry I ended it so soon.

As a Brazilian Jiu Jitsu referee, many parents appreciate my concern for the welfare of trainees, but all too often, I’m forced to address those parents who try to motivate their children through put downs.  They call them names, yell, compare them to others, and stress the importance of being number one.  The pressure has a detrimental effect on child health, and leaves them feeling distressed and deflated.

According to Frank Smoll, Professor of Psychology at the University of Washington, parents play a pivotal role in determining whether sport is a fun learning experience or a nightmare. Smoll calls it frustrated jock-syndrome for parents who attempt to re-live their own past successes.

Smoll’s research found that children respond most favourably, not to coaches and parents who punish undesirable behaviours, but to those who sincerely reinforce behaviours that are desirable. For example, instead of yelling at a child for fumbling a ball, a parent or coach should congratulate the young athlete for the assist they made earlier in the game.  This encourages the child to try their best.

The money that parents spend can be a factor too.  Financial investment in sport has been associated with parental expectations. Travis Dorsche, a Utah State University professor and former football player, recently told The Wall Street Journal that “when parental sport spending goes up, it increases the likelihood that either the child will feel more pressure or the parent will exert it.”

As parents spend more on private coaching, equipment and travel expenses, the sport becomes less enjoyable for the child, and the child’s sense of personal ownership over their athletic career weakens.

Parent support is necessary for child success, but there is a fine line between supportiveness and pushiness.

Long term negative effects of overbearing sports parents are seen in two of the most successful athletes of all time, tennis player Andre Agassi, and baseball player Mickey Mantle.  In his international best seller, Open: An Autobiography, Agassi writes that he hates tennis with a “dark and secret passion” because of his overbearing father, and that when he won his first Grand Slam title, his father responded with, “You had no business losing that fourth set.”

Throughout their professional careers, both Agassi and Mantle developed problems with substance abuse.

Agassi turned to methamphetamine because it “swept away every negative thought in [his] head.”  Mantle, who had also been under intense pressure from his father, struggled with alcoholism and contemplated suicide.

According to Northern Illinois’ department of education, pressuring children too much in athletics can result in low self-esteem. These children are also at risk for physical injury, often pushed to perform regardless of pain complaints; they return to the field before fully healing.

For parents with children who play sports, about.com suggests encouraging your child to play the sport he or she enjoys, and supporting your child’s desire not to play a particular sport. Paediatrician and youth sports medicine specialist, Paul Stricker, argues that emphasis should be placed on a child’s effort.  Additionally, this should be modeled by parents and coaches, so children can learn the positivity of competition and effort, regardless of winning or losing.

As a coach and referee, safety is imperative.  Standing by my decisions and explaining that I’m not willing to risk safety may help some parents realize that there are things more important than being number one.

– Andrew McColl, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today