Category: Parenting

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Pressures to Breastfeed Can Harm Maternal Mental Health

00Child Development, Decision-Making, Embarrassment, Featured news, Guilt, Mental Health, Parenting, Postpartum, Stress, Suicide January, 19

Source: sevenfloorsdown at DeviantArt, Creative Commons

Florence Leung of British Columbia, Canada went missing on October 25, 2016 while struggling with post-partum depression. Less than a month later, her family discovered that she had taken her own life, leaving behind a husband and infant son.

In an emotional public letter, Leung’s husband Kim Chen wrote an impassioned plea to new mothers asking them to seek help if they felt anxiety or depression. He also revealed that his wife’s difficulties with breastfeeding, and the resulting feelings of inadequacy, likely contributed to her condition. Urging women not to criticize themselves about an inability to breastfeed or a decision not to breastfeed, Chen wrote:

“Do not ever feel bad or guilty about not being able to exclusively breastfeed, even though you may feel the pressure to do so based on posters in maternity wards, brochures in prenatal classes, and teachings at breastfeeding classes.”

Speaking with the Trauma and Mental Health Report, Melissa (name changed) said that she was struck by Chen’s words, and recalled the scrutiny around breastfeeding she experienced with her first child:

“I was tired, sore, and the baby was cranky and constantly wanting to feed. It surprised me that, despite my vocal frustration and obvious difficulty breastfeeding, the nursing staff and lactation consultants were adamant that I continue to breastfeed exclusively.”

The frustration worsened once the couple returned home. The week that followed was exhausting, spent trying to calm a screaming newborn who constantly wanted to feed. The couple attended several breastfeeding clinics that reiterated the same message: breast is best. Melissa and her husband felt confused and defeated.

Shortly thereafter Melissa became completely overwhelmed:

“I began to get scared, and not trust myself. My inability to easily nurse and soothe my baby without intense discomfort led to feelings of failure. My emotions were overwhelming. I wasn’t sleeping because I was constantly pumping breastmilk or nursing.”

Within a week after giving birth, Melissa’s infant was suddenly much quieter and less agitated. Upon closer examination, she noticed that the baby looked pale, and was lethargic and dehydrated. A frantic trip to the emergency room (ER) revealed the newborn was not getting enough liquids and nourishment—despite the many scheduled feedings. Melissa said:

“When the ER doctor apologized for the miscommunication and advised us that supplementing with formula is not only okay, but sometimes necessary, I felt a mixture of relief and betrayal. Relief because I knew we would be okay, yet betrayed by some health professionals who put their personal agendas above our health and well-being.”

In an interview with the Trauma and Mental Health Report, Diane Philipp, a Child and Adolescent Psychiatrist at SickKids Centre for Community Mental Health in Toronto, shared that she meets many mothers suffering from stress, shame, and guilt associated with breastfeeding. Philipp explained that the judgements of others place unnecessary pressure on mothers:

“It’s important for mothers to have access to frank and open discussions that are safe and non-judgemental where they can seek out information and make the most knowledgeable decision that is best for their child and for themselves in terms of breastfeeding.”

Every woman’s situation is unique. Lifestyle habits, medication use, and medical and psychological history can complicate the post-partum experience. With this context in mind, the healthcare team should provide a comfortable environment—free of judgement—when discussing post-partum issues, including how to provide an infant’s nourishment.

For mothers who are unable to nurse, be it for medical, physical, or personal reasons, their decision can be supported and honoured in a way that promotes emotional well-being and encourages healthy parent-child bonding. Philipp said:

“For parents who can’t breastfeed for whatever reason, wonderful attachment bonds can still be made. Breast milk is not the only ingredient in a valuable, long-lasting relationship.”

Melissa, now a mother of two healthy school-age children, remains sensitive to others’ assumptions of breastfeeding:

“I felt so pressured to get it right, and so judged when I couldn’t provide for my child. Even when you come to terms with your decision not to breastfeed, people question your choice. Looking at my children today, I know I did the right thing.”

– Kimberley Moore, 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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What Can A Lizard Tell Us About Mental Health?

00Animal Behavior, Child Development, Epigenetics, Evolutionary Psychology, Featured news, Genetics, Mental Health, Parenting, Stress, Trauma December, 18

Source: Hayke Tjemmes at flickr, Creative Commons

A new study on lizards has found that, when exposed to stress, their responses can be passed down genetically. Scientists now believe there may be more to the process of heritability than once thought. This process is called “Transgenerational Stress Inheritance.”

As recently as 2011, most research did not examine the possibility that parental stress could affect sperm or egg cells. Since genes are transferred to offspring through these cells, anything that modifies them can have an impact on genetic expression in children. The idea that parents’ experiences prior to pregnancy can change gene expression and, therefore, affect offspring behaviour, is novel.

In the lizard study, researchers from Pennsylvania State University exposed young lizards to fire ants (a natural stressor) and compared stress levels to unexposed lizards. Interestingly, contact with the stressor did not affect the lizards’ behaviour later in life. But, their offspring had stronger stress reactions than offspring of lizards who had not been subjected to the ants.

Lead researcher Gail McCormick told PsyPost:

“Our work reveals that the stress experienced by an individual’s parents or ancestors may overshadow the stress that an individual faces within its lifetime. In this study, offspring of lizards from high-stress sites were more responsive to stress as adults, regardless of exposure to stress during their own lifetime.”

These findings suggest that, although early life stress may not manifest later in adulthood, the effects may be passed down to offspring, even if offspring are not directly exposed to the stressor.

A similar study involved researchers conditioning mice to associate the smell of cherries with a mild electric current. When the fragrance permeated the air, the mice were given a small electric shock. And so, the mice began to fear the scent even when the shock wasn’t administered. Even more fascinating was that offspring of these mice, as well as their offspring, experienced fear in the presence of the odor. The fear reaction occurred even though the later generations didn’t experience the conditioning process.

Of course, the question these studies pose is whether there is a similar effect in humans.

As recently reported in the Guardian newspaper, researchers from New York’s Mount Sinai School of Medicine compared the genes of direct descendants of Jews who were “interned in a Nazi concentration camp, witnessed or experienced torture or who had had to hide during the second world war” to the offspring of Jews living outside of Europe who were unharmed. The children of parents who experienced WWII trauma showed genetic changes and a greater risk of stress disorders. These were not present in the other children. The Guardian article stated:

“[The] new finding is [a] clear example in humans of the theory of epigenetic inheritance: the idea that environmental factors can affect the genes of your children.”

In other research, psychologist Margaret Keyes from the University of Minnesota and colleagues examined twins to determine if the behaviour of biological parents could affect offspring who were not raised by them. The study found that children of parents who smoked were more likely to be smokers, even if those children weren’t raised by the parents, and as such, did not have parental smoking behavior modeled to them. Scientists are still questioning, though, whether it’s parental behavior directly affecting these genes or a genetic predisposition to smoking being passed down for generations.

On the whole, these studies make the case that genetic changes can happen a lot faster than previously thought, within a few generations or even one generation. And, as reported in Science magazine, people can see evolution in real time:

“Now, thanks to the genomic revolution, researchers can actually track the population-level genetic shifts that mark evolution in action—and they’re doing this in humans. [Studies] show how our genomes have changed over centuries or decades…”

Research in this field is still new and is subject to several caveats. Perhaps the most important one is the complexity of human beings and their environments. Indeed, there may be too many variables that factor into the human experience for researchers to arrive at definitive conclusions.

But, these studies do suggest that individuals may be affected by the stress felt by ancestors in  before them. Further research is required to determine whether these findings are the result of transgenerational stress inheritance or an external factor that has yet to be considered.

– Andrei Nistor, 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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Man to Monster

00Ethics and Morality, Featured news, Grief, Parenting, Pornography, Trauma November, 18

Man to Monster

Source: intographics at pixabay, Creative Commons

Anatomy of Violence, a film directed by Deepa Mehta, takes viewers on an emotional journey, illustrating how we create perpetrators of violence against women.

Mehta made the film after hearing about the gang rape of Jyoti Singh in Delhi, India. The BBC news reported that an off-duty driver took his bus for a joyride with five friends. When Jyoti boarded the bus, believing it was on-duty public transportation, the men raped her and beat her with iron bars. She died of the injuries.

According to the BBC, a rape victim cannot be publicly named under Indian law to protect the family from shame. In defiance, Jyoti’s mother Asha Singh stated in a public gathering after the attack:

“I say this in front of you all that her name was Jyoti Singh.”

The significance of her actions cannot be overstated. Jyoti’s mother said she had no shame in being known as the mother of a rape victim—it was the perpetrators who should feel shame.

Jyoti’s death sparked outrage across India, and brought public attention to the false belief that women are to blame when assaulted. Although media coverage focused on the victim, filmmaker Mehta decided to analyse what led the men to do what they did.

In an interview with The Reel, Mehta explains:

“I was in Delhi when this horrific incident [the rape of Jyoti] took place, and since then, I have been curious about what made or turned these men into brutal animals.”

Mehta thinks the rapists were not born monsters, but became that way. In the film, she explores factors contributing to their violent behaviour. She also humanizes the men by portraying their day-to-day lives, similar to the lives of other Indian men. They worked, they cooked, they had families.

This approach was highlighted when she spoke to the CBC about the film:

“I really wanted to humanize [the rapists]. [It] doesn’t excuse what they did, but it helps start a conversation about why these things happen.”

Early in the film, Vikas, one of the perpetrators, is shown hiding under the bed when his uncle enters his room and sexually assaults him. By age eight, Vikas is homeless.

Another character Dinesh grew up in a family where women were treated badly. He always received what he wanted, while his sisters were forced to take care of him and do household chores. In one scene, Dinesh’s sister is reading a book. Dinesh yells that he wants the book. His sister is then threatened by their father with violence if she denies her brother’s request.

Researchers at Georgia State University found similar themes in the backgrounds of men who were self-confessed rapists. The researchers analysed an “ask a rapist” thread on Reddit that posed the question: “Reddit’s had a few threads about sexual assault victims, but are there any redditors from the other side of the story? What were your motivations? Do you regret it?”

Someone responded with:

“I was an extremely isolated youth who came from a broken home, and my escape was the Internet… Most of the material [internet pornography] was very sexually aggressive towards women.”

Much like the characters in the film, this individual sees his environment as contributing to his violent behavior.

The responses to the Reddit thread also showed themes of: blaming the victim or their biology, expressing hostility toward women, and objectifying women. More than one motivation was typically found to underlie a single rapist’s actions.

-Anika Rak, 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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The Making of a Murderer

00Child Development, Featured news, Genetics, Law and Crime, Parenting, Psychopathy July, 18

Source: sarahjgibson at DeviantArt, Creative Commons

In 1993, when Robert Thompson and Jon Venables from Liverpool, England were both 10 years of age, they killed a two-year-old boy. Thompson and Venables kidnapped the victim from a shopping centre, tortured him, and left him to die.

Stories like these raise many questions. Chief among them, how does something like this happen at all? Was it the result of bad parenting? The community certainly thought so, viewing the boys’ upbringing as the cause.

The trial had exposed evidence of domestic problems in both families. The judge stated that Thompson’s and Venable’s parents must take moral responsibility for their children’s actions. So members of the Thompson family had to assume new identities and go into hiding. They moved nine times to escape verbal and physical attacks. The Venables experienced similar threats.

In a recent interview with CNN, family therapist Tricia Ferrara put the onus on parents to understand when their child is in trouble. She said:

“All parents need a better understanding of child development so we can detect when the signals show a child may be moving in an anti-social direction.”

And a study conducted on the Columbine shootings, where two teenagers killed 12 students and a teacher at Columbine High School in Denver, suggested that the community saw parents as partly accountable for the murders.

There’s no doubt that parenting plays an enormous role in child development. Researchhas found that abuse, negative parenting, and prolonged malnutrition are linked to a proclivity toward physical violence.

But, there is also important research pointing to the role biology plays in predisposing some individuals to psychopathy, including violence. The BBC reported that neuroscientist Adrian Raine discovered a decrease in activity of the pre-frontal cortex in the brains of murderers, suggesting a genetic predisposition.

And, research by Elizabeth Cauffman and colleagues from the University of California found that good parenting doesn’t always lead to the outcomes we imagine. In fact, anti-social encouragement by a romantic partner was correlated with the highest level of offending in youth, even when warm relationships endured with parents.

In a TVO documentary Genetic Me, professor Daniel Nettle claimed that personality is stable throughout a person’s life. Individuals have tendencies for some things and not others. Nettle suggests that people are born with predispositions for certain personality traits. He adds, though, that the environment has some effect on bringing out theses inclinations, and that people can fight against them.

NPR reported that there are additional factors that play into a person’s development, perhaps explaining why not all children raised by the same parents are violent. Children in the same families have distinct personalities and varied interests that elicit different parenting. Plus, children experience independent social environments outside the home.

Perhaps the complexity of the matter is described best by neurobiologist James Fallon, who studies the brains of psychopathic killers. He explained in a TED Talk that an interaction occurs between environment and genetics. When presented with a particular brain image, he noted it was clearly a psychopath’s brain. What was most shocking—it was his own brain. Fallon, though, is not a killer, and had a happy upbringing. But, he has a family history of homicide. The first documented murder of a mother by a son was committed by a member of his family, several generations back.

Fallon said that, although some individuals, mostly male, have genes or brain damage that make them more susceptible to becoming murderers, their childhood experiences can make all the difference. For instance, the MAOA gene in particular can give rise to a violent individual if the gene is combined with experiences of brutality.

Where do murderers come from? Like all the big questions in mental health, an either-or perspective leaves little room for complexity. In the great genetics versus environment debate, the making of murderers—indeed, the making of us—requires that we look somewhere in-between.

–Anika Rak, 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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Feeling Like a Fraud in the Face of Success

00Anxiety, Confidence, Featured news, Parenting, Self-Esteem, Stress, Work June, 18

Source: Kynan Tait at flickr, Creative Commons

More common than once thought, from new fathers to high-level executives, many of us experience impostor syndrome. Defined in the Harvard Business Review, it’s:

“A collection of feelings of inadequacy that persist despite evident success. ‘Impostors’ suffer from chronic self-doubt and a sense of intellectual fraudulence that override any feelings of success or external proof of their competence.”

For fathers, these beliefs can result from observing the immediate bond between mother and infant (fathers may take up to two months to have a similar connection). Physician Liji Thomas explained to News Medical:

“Fathers bond to their babies over a longer period… During this time, they may feel ‘out of it’, especially when they observe the special bond between their spouses and the new baby.”

And many mothers think they’re impostors too. Blogger Michelle Grant posted a piece in the Huffington Post titled “The Parenthood Impostor Syndrome,” where she said:

“It’s a feeling of uncertainty, of anxiousness and for me, it was the very real idea of being a fraud in those early weeks of motherhood… ‘Everyone else is better at this than me,’ I told myself.”

New parents can’t get direct feedback, so it can be difficult to know if they’re doing things correctly for the infant. Grant continued:

“When we first become parents, we are expected to carry out a role we’ve not been trained for—and we get no feedback from our babies on how well we’re doing. So, it’s no wonder if we feel out of our depth and like an impostor.”

The impostor phenomenon is not a psychological disorder, but rather a reaction to a situation where individuals struggle to settle into a role and feel as though they’re faking ownership of it. And, feeling like an impostor isn’t limited to parents.

In a research review, psychologists Jaruwan Sakulku and James Alexander reported that as many as 70% of people experience impostor syndrome at least once during their lives—exposing the magnitude of the problem. In fact, many successful professionals face impostor syndrome.

It was first identified by psychologists Pauline Clance and Suzanne Imes in 1978 when it was used to describe many high-achieving women who didn’t recognize their personal success despite exceptional academic and professional accomplishments. These perceptions may be related to whether or not women attribute their success to luck or to ability.

Women are particularly vulnerable to impostor syndrome when they believe their achievements are the result of chance. And when they engage in occupations historically held by men, such as being a university professor or member of law enforcement, women may feel they are not truly meant to be there.

Further research, though, has demonstrated that both men and women in high-earning positions or positions that are characteristically respected are susceptible to the impostor phenomenon. A Forbes article mentioned that partners at accounting firms and famous celebrities alike have felt like frauds in their positions, as though they would be uncovered for being an impostor. Actor Don Cheadle said:

“All I can see is everything I’m doing wrong that is a sham and a fraud.”

In another example, renowned author Maya Angelou recounted:

“I have written eleven books, but each time I think, ‘uh oh, they’re going to find out now. I’ve run a game on everybody, and they’re going to find me out.’”

A number of causes can  contribute to impostor syndrome. These range from perfectionist personality traits, to family pressures to succeed, to minority status. A cover story in gradPSYCH magazine of the American Psychological Association stated:

“Differing in any way from the majority of your peers—whether by race, gender, sexual orientation or some other characteristic—can fuel the sense of being a fraud.”

There are some ways to combat impostor syndrome for those struggling with its challenges. Psychiatrists Andreea Seritan and Michelle Mehta suggest that “accepting compliments graciously” and “keeping a record of positive feedback” are important to minimize its effects.

For parents who are suffering with self-doubt, the CBT Institute of Southern California advises that acknowledging the fallibility of being human is helpful to overcoming impostor syndrome, and to enjoying the positives and pitfalls of parenthood.

–Andrei Nistor, 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

Robert T Muller - Toronto Psychologist

Parkinson’s Takes its Toll on Family Caregivers

20Caregiving, Family Dynamics, Featured news, Mental Health, Neuroscience, Parenting, Stress January, 18
Source: Lesia Szyca, Trauma and Mental Health Report Artist, used with permission

Her hands and legs trembled, she could no longer drive. Cognitively, she declined. Her balance was affected, and she often fell. My grandmother Anna (name changed) had Parkinson’s Disease. It took over her life.

As a vibrant and independent woman, Anna had always been eager to help her family. Then, as the disease progressed, roles began to shift, and younger family members had to care for her.

Anna battled Parkinson’s Disease (PD) for more than 15 years. A degenerative neurocognitive condition, it is caused by a gradual loss of dopamine producing cells in the brain that worsens over time leading to tremors, cognitive impairment, and emotional changes.

To date, there is no cure, so a combination of medication and therapy is the only treatment. Anna battled this debilitating illness with no chance of recovery.

As she declined, so did her capacity to be self-sufficient. Her motor abilities drastically decreased, and her memory continued to diminish. She required supervision the majority of the day, and was unable to perform her favorite activities, such as baking, making crafts, sewing, and gardening.

Before Anna was admitted to a long-term facility in 2015, caring for her became a full-time job shared by my mother, my sisters, and grandfather. For my mother Charlotte (name changed), seeing her mother’s deterioration was particularly difficult. Unexpectedly shouldering the role of primary caregiver took a toll:

“At times on my own, I would go in the shower and cry. At other times too, the circumstances made me short and impatient with people. I would be intolerant and lose my temper due to the frustration.”

A study by Laurence Solberg and colleagues examined the emotional and mental health of adult children who are primary caregivers to ill parents. In administering a survey to identify stress levels, the researchers found that caregivers had heightened levels of negative feelings, such as anxiety, while caring for a parent. They found that being a caregiver of an elderly, sick parent adversely affected personal health. However, caregivers balancing the needs of an ill parent with those of their own children did not experience elevated stress compared to individuals without children.

But my own mother’s experience was different. She found it demanding to balance caring for an ill parent and caring for her own children.

“If you only have to balance an elderly parent and a job, it’s much easier than if you also have a family. With children, there’s additional responsibility. Anna required some priority, but I couldn’t lose focus on my children.”

When researchers Caroline Kenny and colleagues examined the experiences of family caregivers, many expressed distress over feeling unprepared for the role. My mother felt the same:

“We didn’t know how to properly care for Anna. We didn’t know how to lift her correctly, or how to deal with her frustration. On top of having the responsibility of caring for her, we had the added stress of not knowing how to handle her properly.”

And finding time for herself was not easy for my mother either. Solberg’s research supports this predicament: three quarters of caregivers reported decreased time for personal hobbies and interests. Charlotte said:

“I do think these responsibilities cause you to neglect your usual pastimes. I went from work to Anna’s home to my home. There wasn’t time for myself.”

In a study by Vasiliki Orgeta and colleagues, published in the International Psychogeriatrics Journal, the authors reported on the importance of social support for coping with the strain of becoming a caregiver.

For me, it was painful to see my grandmother’s decline alongside my own mother’s struggle to care for her. But consistent with Orgeta’s findings, I’ve found that relying on friends and family, and my social support system, has helped alleviate the anxiety of seeing my family in distress.

No one’s experience is the same; people cope in their own ways. For my mother, the situation has been heartbreaking:

“Seeing a person who is loving and vibrant, such a nurturing mother, become a person who is not nurturing anymore, not strong, whether emotionally or physically, is agonizing. It’s a part of life, but it’s hard to accept.”

–Alyssa Carvajal, 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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Parkinson's Takes its Toll on Family Caregivers

00Caregiving, Family Dynamics, Featured news, Neuroscience, Parenting, Stress January, 18
Source: Lesia Szyca, Trauma and Mental Health Report Artist, used with permission

Her hands and legs trembled, she could no longer drive. Cognitively, she declined. Her balance was affected, and she often fell. My grandmother Anna (name changed) had Parkinson’s Disease. It took over her life.

As a vibrant and independent woman, Anna had always been eager to help her family. Then, as the disease progressed, roles began to shift, and younger family members had to care for her.

Anna battled Parkinson’s Disease (PD) for more than 15 years. A degenerative neurocognitive condition, it is caused by a gradual loss of dopamine-producing cells in the brain that worsens over time leading to tremors, cognitive impairment, and emotional changes.

To date, there is no cure, so a combination of medication and therapy is the only treatment. Anna battled this debilitating illness with no chance of recovery.

As she declined, so did her capacity to be self-sufficient. Her motor abilities drastically decreased, and her memory continued to diminish. She required supervision the majority of the day, and was unable to perform her favorite activities, such as baking, making crafts, sewing, and gardening.

Before Anna was admitted to a long-term facility in 2015, caring for her became a full-time job shared by my mother, my sisters, and grandfather. For my mother Charlotte (name changed), seeing her mother’s deterioration was particularly difficult. Unexpectedly shouldering the role of primary caregiver took a toll:

“At times on my own, I would go in the shower and cry. At other times too, the circumstances made me short and impatient with people. I would be intolerant and lose my temper due to the frustration.”

A study by Laurence Solberg and colleagues examined the emotional and mental health of adult children who are primary caregivers to ill parents. In administering a survey to identify stress levels, the researchers found that caregivers had heightened levels of negative feelings, such as anxiety, while caring for a parent. They found that being a caregiver of an elderly, sick parent adversely affected personal health. However, caregivers balancing the needs of an ill parent with those of their own children did not experience elevated stress compared to individuals without children.

But my own mother’s experience was different. She found it demanding to balance caring for an ill parent and caring for her own children.

“If you only have to balance an elderly parent and a job, it’s much easier than if you also have a family. With children, there’s additional responsibility. Anna required some priority, but I couldn’t lose focus on my children.”

When researchers Caroline Kenny and colleagues examined the experiences of family caregivers, many expressed distress over feeling unprepared for the role. My mother felt the same:

“We didn’t know how to properly care for Anna. We didn’t know how to lift her correctly, or how to deal with her frustration. On top of having the responsibility of caring for her, we had the added stress of not knowing how to handle her properly.”

And finding time for herself was not easy for my mother either. Solberg’s research supports this predicament: three-quarters of caregivers reported decreased time for personal hobbies and interests. Charlotte said:

“I do think these responsibilities cause you to neglect your usual pastimes. I went from work to Anna’s home to my home. There wasn’t time for myself.”

In a study by Vasiliki Orgeta and colleagues, published in the International Psychogeriatrics Journal, the authors reported on the importance of social support for coping with the strain of becoming a caregiver.

For me, it was painful to see my grandmother’s decline alongside my own mother’s struggle to care for her. But consistent with Orgeta’s findings, I’ve found that relying on friends and family, and my social support system, has helped alleviate the anxiety of seeing my family in distress.

No one’s experience is the same; people cope in their own ways. For my mother, the situation has been heartbreaking:

“Seeing a person who is loving and vibrant, such a nurturing mother, become a person who is not nurturing anymore, not strong, whether emotionally or physically, is agonizing. It’s a part of life, but it’s hard to accept.” 

–Alyssa Carvajal, Contributing Writer, The Trauma and Mental Health Report. 

This article was originally published on Psychology Today

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Conversation Cards Help Therapists Dig Deeper

20Child Development, Education, Featured news, Parenting, Trauma, Trauma Psychotherapy June, 17

Source: Michael on flickr, Creative Commons

As a counselor, social worker, or therapist, how do you begin conversations with your clients? What are the best ways to break the ice and generate meaningful discussions? These are questions that Jane Evans, trauma, parenting and behaviour expert, found to be common among her colleagues in the field.

Evans is a therapist and member of NEYTCO, the National Early Years Trainers and Consultants Organization, located in the UK. She has spent over 20 years working with parents and children who experience difficulty in relationships.

In an interview with the Trauma and Mental Health Report, Evans explains:

“I find that many practitioners don’t entirely understand childhood trauma and they struggle to talk to parents about it.”

To facilitate more open dialogue, Evans created Fink Cards—a conversation tool that provides structure to therapy sessions and helps therapists and clients engage in meaningful discussions. The Cards list questions to help parents who have trouble communicating and forming a good relationship with their children. And the Cards help parents and families who have encountered trauma in the past.

Since Evans sees trauma as a major factor in difficult parent-child relationships, she directly addresses this issue with the Fink Cards. They ask questions like “what does the word trauma make you think about?” to open the door to therapy work. The Cards support the counselor in facilitating discussion, and assist clients.

Evans found, while working with families, that parents are not always aware of how their own actions, as well as their interactions with the child, may in fact perpetuate problem behaviours. She says:

“Most parents see the child as the problem; they’re always aiming to fix the child. However, these cards invite them on a different journey. Parents consider what has happened early in their own lives or in their child’s early years and how that impacts their child’s behaviour now.”

Questions like “who was in charge of discipline when you were a child?” and “who notices when you are worried or anxious?” help parents reflect on how their early experiences and current support systems shape their parenting practices, as well as any negative impact these may be having on the child. As parents consider how these events impact their parenting choices, the therapist is able to work with them to implement more effective methods of communication and alternative coping strategies.

Research has shown that conversation cards can help patients become more open about their feelings. In a study conducted by researchers at Stratheden Hospital in the UK, 6D cards were used to facilitate holistic, patient-led communication. 6D cards are a type of conversation card developed to help physicians and nurses ensure a meaningful consultation with female patients in a gynecology clinic. They contain six categories, or dimensions, of health, including healthcare, emotions, lifestyle, interpersonal relationships, symptoms, and life events. The purpose of these cards is to allow the patients to lead the conversation.

Another study, conducted by the Design Council of the UK and the Bolton Primary Care Trust, focused on creating stronger methods of communication and management for diabetic patients with the use of Agent Cards, which are similar to both the 6D and Fink Cards. Agent Card statements encourage patient-led conversations with practitioners. Results of the study showed that using the cards helped facilitate more open discussion.

With Evans’ Fink Cards, clients have the freedom to choose questions from four categories during sessions: the parent’s early childhood and upbringing; the parent’s relationship with his or her child; the parent and child’s worries and anxieties; and how early trauma may have affected the child.

“These cards are a way of having difficult conversations, but it’s not just me putting the questions to the patient and saying ‘you have a problem,’” Evans explains.

While the effectiveness of Fink Cards does require more research, they have already made their way into the marketplace, and look to be a promising resource in clinical settings. Sometimes building rapport or discussing sensitive topics with a client can be difficult, but Fink Cards may go a long way in helping therapists and clients ease into healthy conversations in an educational and comfortable way.

–Afifa Mahboob, 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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Conversation Cards Help Therapists Dig Deeper

00Child Development, Education, Featured news, Parenting, Trauma, Trauma Psychotherapy June, 17

Source: Michael on flickr, Creative Commons

As a counselor, social worker, or therapist, how do you begin conversations with your clients? What are the best ways to break the ice and generate meaningful discussions? These are questions that Jane Evans, trauma, parenting and behaviour expert, found to be common among her colleagues in the field.

Evans is a therapist and member of NEYTCO, the National Early Years Trainers and Consultants Organization, located in the UK. She has spent over 20 years working with parents and children who experience difficulty in relationships.

In an interview with the Trauma and Mental Health Report, Evans explains:

“I find that many practitioners don’t entirely understand childhood trauma and they struggle to talk to parents about it.”

To facilitate more open dialogue, Evans created Fink Cards—a conversation tool that provides structure to therapy sessions and helps therapists and clients engage in meaningful discussions. The Cards list questions to help parents who have trouble communicating and forming a good relationship with their children. And the Cards help parents and families who have encountered trauma in the past.

Since Evans sees trauma as a major factor in difficult parent-child relationships, she directly addresses this issue with the Fink Cards. They ask questions like “what does the word trauma make you think about?” to open the door to therapy work. The Cards support the counselor in facilitating discussion, and assist clients.

Evans found, while working with families, that parents are not always aware of how their own actions, as well as their interactions with the child, may in fact perpetuate problem behaviours. She says:

“Most parents see the child as the problem; they’re always aiming to fix the child. However, these cards invite them on a different journey. Parents consider what has happened early in their own lives or in their child’s early years and how that impacts their child’s behaviour now.”

Questions like “who was in charge of discipline when you were a child?” and “who notices when you are worried or anxious?” help parents reflect on how their early experiences and current support systems shape their parenting practices, as well as any negative impact these may be having on the child. As parents consider how these events impact their parenting choices, the therapist is able to work with them to implement more effective methods of communication and alternative coping strategies.

Research has shown that conversation cards can help patients become more open about their feelings. In a study conducted by researchers at Stratheden Hospital in the UK, 6D cards were used to facilitate holistic, patient-led communication. 6D cards are a type of conversation card developed to help physicians and nurses ensure a meaningful consultation with female patients in a gynecology clinic. They contain six categories, or dimensions, of health, including healthcare, emotions, lifestyle, interpersonal relationships, symptoms, and life events. The purpose of these cards is to allow the patients to lead the conversation.

Another study, conducted by the Design Council of the UK and the Bolton Primary Care Trust, focused on creating stronger methods of communication and management for diabetic patients with the use of Agent Cards, which are similar to both the 6D and Fink Cards. Agent Card statements encourage patient-led conversations with practitioners. Results of the study showed that using the cards helped facilitate more open discussion.

With Evans’ Fink Cards, clients have the freedom to choose questions from four categories during sessions: the parent’s early childhood and upbringing; the parent’s relationship with his or her child; the parent and child’s worries and anxieties; and how early trauma may have affected the child.

“These cards are a way of having difficult conversations, but it’s not just me putting the questions to the patient and saying ‘you have a problem,’” Evans explains.

While the effectiveness of Fink Cards does require more research, they have already made their way into the marketplace, and look to be a promising resource in clinical settings. Sometimes building rapport or discussing sensitive topics with a client can be difficult, but Fink Cards may go a long way in helping therapists and clients ease into healthy conversations in an educational and comfortable way.

–Afifa Mahboob, 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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Parent Mental Illness Casts Long Shadow on Children

40Anxiety, 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