“C”ommunicating with Our Teenagers

We cannot NOT communicate. – Ray Birdwhistell 

Everything we do communicates something. It has been estimated that between 67-94% of our communication is nonverbal. What is non-verbal communication, you ask? It is everything except the words. It could be a grunt, a smile, a sigh, our smell, our jewelry, our clothes, whistling, the way we comb our hair, tattoos, the way we cook our food, piercings or the lack thereof, our posture, the nuances and history of a relationship, a stare at our son, a gaze at a pretty girl, the way we walk, our mode of transportation, hand gestures, or making googly eyes and funny sounds at a baby. We may say something, but our true intentions frequently will leak through our nonverbal behavior.  

The tone, the attitude behind the words when you ask your son to do something, communicates a whole lot more than the words that you verbally say. It is the attitude that he will respond to, not merely the words. Everything communicates. That is why the “C” in the title of this article is so large. Everything communicates something. We cannot NOT communicate. 

Even a dead person communicates. They communicate deadness.  

It is what is not being said that we pay attention to; this is why sarcasm is so dangerous. With sarcasm, there is a contradiction between the verbal and the nonverbal. Sarcasm is typically cutting. In fact, the word means, “to tear flesh.” For children, sarcasm can be very confusing.  

If you were to attend a communication seminar on learning “Effective Communication Skills,” you might come away with skills such as: having good eye contact, sitting on the edge of your chair, nodding and other non-verbal behavior to indicate you are listening. You might also learn about the importance of reflective listening. All these skills are important, however, do you suppose it would be possible to perform all these behaviors and not really listen in a caring way? And, if a person didn’t really care, do you think other people will be able to tell?  

Of course they can. 

“There is something deeper than behavior that others can sense – something that, when wrong, undercuts the effectiveness of even the most outwardly ‘correct’ behavior.” i  This thing that is deeper than behavior is something philosophers have been talking about for centuries. Carl Rogers called it “Way of Being.”ii  

Martin Buber explains that there are two fundamental ways of being, two ways of seeing another person. The first way is as a ”Thou,” a person with hopes and dreams and struggles similar to your own.  The other way of seeing a person is as an “It.” This is where one objectifies a person. “If I see them at all, I see them as less than I am – less relevant, less important, and less real.”iii This is then also about you and your perspective. There is always a good chance that a person does not see things the way they really are; that person may be missing something. We must be willing to honestly look at ourselves and see what part of the problem is our own. “Might I be provoking the other person without even knowing it?” 

When we talk to our teenagers, we sometimes ask them questions.  We must understand that they do not merely answer our questions; they are answering a relationship. Our conversations don’t happen in a vacuum. They happen in the context of a historical relationship.  They are answering a person, and with that person, comes an accumulation and history of their interactions. They answer according to the quality of their recent and remote relationship. 

For example, you might ask your daughter, “Would you take the dog for a walk?” She could respond in a variety of ways. She could ignore you. She could say, “of course.” She could tell you to eat rocks, or yell out while leaving, “maybe later.” On the other hand, if your daughter’s best friend (having a different relationship) said, “Let’s take the dog for a walk?” Your daughter may happily agree to take the dog for a walk. The relationship determines the interaction. 

In his book ”7 Habits of Highly Effective People,”iv Stephen Covey speaks of an emotional bank account we each have with our children. We must have enough positive interactions, thus building the relationship in our “emotional bank account,” before we can safely make a withdrawal (correction/discipline) without damaging the relationship. After all, we do not want to bankrupt the relationship.  When the emotional bank account is healthy, your child can take correction, knowing that it is coming from a place of love. 

The quality of the relationship determines our ability to be effective parents  

and our teenager’s willingness to allow us to influence them. 

 The moment a parent has a nasty verbal exchange with their teenager is not the time to try to immediately solve the problem. There are too many hot emotions for anyone to think clearly. If the relationship is generally good, waiting for a few hours, or perhaps a day to address the problem is wise. Time allows the parents and teenager space to see the situation clearly without the corrupting influence of these distorted and self-justifying thoughts and emotions.  

If the relationship has been rocky, time is needed for the relationship to heal. Part of healing process is deliberately working on developing trust again; another topic for another day. 

Originally published on http://utvalleywellness.com/

 

 

Medication Management and Mental Health

In my career in healthcare, I have seen far too many patients who have been prescribed medication and continue to take that medication faithfully; Yet after a time, they are not really sure why they are taking that specific medication or if it is even helping with the diagnosed issue.  

 What is missing for these patients? Medication management 

Medication management is the process of following up with the healthcare provider on a regular basis to assess the effectiveness of the prescribed medication therapy, discuss any side effects that may go along with the medication, and make adjustments in order to achieve proper dosing. In some cases, the follow-up may be to change the prescribed medication therapy, if it is not providing the desired outcomes. Medication management should be an ongoing process. It should include open dialogue between the patient and provider about the effects of the medication combined with any other therapies or treatments that may be in place. This is to ensure useful data is being collected, so decisions can be made based on the whole picture; not just the medication piece. 

When it comes to psychiatric and mental health services, the importance of quality medication management cannot be overemphasized. Not all people who seek psychiatric help will require medication. In some cases, amino acid therapy may be appropriate or continued therapy and counseling with regular psychiatric follow-up is warranted. If medication is prescribed, the patient should plan to see the psychiatric provider within 2 weeks (in most cases) for the first medication management visit.  Continued follow-up visits should be scheduled monthly, or as needed depending on the individual case. 

During these visits, the patient should plan on communicating openly with the psychiatric provider about their use of the medication, any side effects that they may be noticing, and any changes they are feeling in relation to their mental health diagnosis. At times, genetic testing can be used to pinpoint what medications are more likely to work for each individual patient. This testing can be used not only for patients who are just beginning psychiatric treatment but also for patients who have been prescribed medication therapies that aren’t working. The patient should also plan to consult with the psychiatric provider before taking any other medications. They should inform the provider of other mental health therapies being used or medical complications that may arise during treatment. The patient should expect the provider to ask questions that will direct and lead the conversation, so time is well spent and modifications can be made with confidence. 

Ultimately, the key to effective psychiatric medication management is open and continual communication between the patient and provider. At the Center for Couples and Families, our psychiatric providers strive to provide thorough psychiatric assessment, follow-up, and medication management. 

Originally published on http://utvalleywellness.com/

 

Self Care When Experiencing Parental Alienation

Though almost half of marriages in the US end in divorce, most people who divorce successfully transition to their new life within two years. However, about 15% of divorces experience continued litigation. These cases exhibit a high degree of hostility and distrust between the spouses, making it difficult for them to communicate about the care of their children without involving the court. Often in high conflict divorce, it only takes one high conflict person to keep the dispute from resolving. If one spouse is noncompliant with the parenting plan and unwarrantedly denies the other parent access to the children, it compels the blocked parent to fight to not only see their children, but often to defend themselves against false allegations of abuse. The accused parent has two choices: either engage in conflict, or be separated from their precious children. 

If you are experiencing denied visitations and an unwarranted campaign of denigration, you are most likely going through parental alienation. Those who have experienced it say it is one of the hardest things they have ever gone through. It requires developing advanced skills in order to cope. Parents who have been successful in dealing with parental alienation have developed the following skills: 

  1. They sought knowledge. They read about parental alienation in order to understand why it happens, and what they could do to make it less difficult for their children. “Intellectually understanding parental alienation provides an emotional anchor to help make good decisions for yourself and your children.”1
  2. Reframe the meaning of your child’s behavior. For example, based on your current situation you may constantly tell yourself, “My child doesn’t love me anymore and never wants to see me again.” Try altering that statement to, “My child still loves me and wants to see me, but he is painted into a corner and is doing what he thinks he has to do in order to survive an experience that is as painful for him as it is for me.”2
  3. Stay even-tempered and never retaliate. “A person who reacts in anger is proving the alienator’s point that he or she is unstable.”3 Avoid falling into this trap.
  4. Don’t live a victim’s life. Although you are experiencing victimization, don’t live asif you have no power or worth.Deliberately take care of yourself. Eat healthy foods, stay socially connected, do something spiritual daily, exercise and get out in nature. Do things that you enjoy and that rejuvenate you. 
  5. Be proactive. Always show up to pick up your kids even if you know they won’t be there. Keep a journal, and document what happens.
  6. Take a parenting class. Learn how to understand your children developmentally and respond empathetically.Develop superior parenting skills. 
  7. Reduce your children’s anxiety. Find ways to reduce their anxiety when they are with you by picking your battles and not engaging in conflict. 
  8. Never talk bad about your ex to your children.This forces them to align with the other parent against you, and paints you in a bad light. 
  9. Try to make what little time you have with them positive and fun. It is through having fun that you gain connection and preserve your attachment. 
  10. Find an alienation-aware therapist, and get the appropriate support and treatment you need.

Each time you board a plane you are reminded that if the oxygen masks drop, you need to put the mask on yourself first, before helping others. The same is true of parental alienation. You must deliberately take good care of yourself first if you are going to survive emotionally. 

1,2 Http://www.womansdivorce.com/alienated-parent.html 

3 http://www.majorfamilyservices.com/parents-who-have-successfully-fought-parental-alienation-syndrome-by-jayne-a-major-phd.html 

Shared Parenting Myths: Woozles and Zombies

Custody and parent-time decisions are usually made by using what is called “The Best Interest of the Child” standard. This standard is intended to guard children from conflict and abuse, and to promote stability, but because it is vague, and not based on empirical evidence, it is susceptible to influences of what Edward Kruk, a social work researcher, describes as “judicial biases and preferences, professional self-interest, gender politics, the desire of a parent to remove the other parent from the child’s life, and the wishes of a parent who is found to be a danger to the child.”He argues that “a more child-focused approach to child custody determination is needed to reduce harm to children in the divorce transition and ensure their well-being.”2

What does the research show about the well-being of children of divorce? That shared physical parenting is the best custody determination for children. (This excludes cases of abuse, neglect, and parents with no prior relationship.) So why isn’t this the norm in most cases? It is because of Woozles and ZombiesWoozles are myths and misrepresentations of research that are not supported by evidence, but because they keep being repeated, they are believed to be true.3  Linda Nielsen, psychologist, and expert on shared parenting, explains,

To summarize briefly, the words “woozling” and “woozles” come from the children’s story, “Winnie the Pooh.” In the story the little bear, Winnie, dupes himself and his friends into believing that they are being followed by a scary beast – a beast he calls a woozle. Although they never actually see the woozle, they convince themselves it exists because they see its footprints next to theirs as they walk in circles around a tree. The footprints are, of course, their own. But Pooh and his friends are confident that they are onto something really big. Their foolish behavior is based on faulty “data” – and a woozle is born.4

Nielsen continues, “Nobel Prize-winning economist and New York Times columnist Paul Krugman (2014) wrote about a similar concept that he called a ‘zombie,’—a belief that ‘everyone important knows must be true, because everyone they know says it’s true. It’s a prime example of a zombie idea—an idea that should have been killed by evidence, but refuses to die. And it does a lot of harm.’”5

Some common Woozles and Zombies of shared parenting, followed by what research actually shows, include:

 

  1. Children want to live with only one parent and to have one home. Shared parenting is not worth the hassle.

When adult children of divorce were asked, they said having a relationship with both parents was worth any hassle they experienced in moving between homes.6

  1. Young children have one primary attachment figure, the mother, with whom they bond more strongly. Given this, it is hurtful for infants to spend any overnights with the other parent in the first year of life.7

The truth is that infants form different, but strong attachments to both parents and that “there is no evidence to support postponing the introduction of regular and frequent involvement, including overnights, of both parents with their babies and toddlers.”8  

  1. Where there is high conflict between the parents, children do better with sole custody. Shared parenting only increases the conflict and puts the children in the middle.9

Conflict remains higher in sole- than in shared-custody families. Most children are not exposed to more conflict in shared-parenting families. Maintaining strong relationships with both parents helps diminish the negative impact of the parents’ conflict.10

  1. Shared parenting only works with those who agree to it, and is only successful for a small, cooperative group of parents who have little conflict.

The research shows that even if shared parenting was originally mandated, it leads to better adjustment for the children and less long-term conflict between the parents.11

Sadly, Woozles and Zombies can distort the facts about best practices for custody arrangements,  but the research evidence is clear and irrefutable that a shared parenting model is truly optimal for families and “traditional visiting patterns . . . are . . . outdated, unnecessarily rigid, and restrictive, and fail in both the short and long term to address [the child’s] best interests (Kelly 2007).”12

1,2,12 Kruk, E. (2012). Arguments for an Equal Parental Responsibility Presumption in Contested Child Custody. The American Journal of Family Therapy, 40(1), 33-55.  DOI:10.1080/01926187.2011.575344 

 5 Nielsen, L. (2015). Pop Goes the Woozle: Being Misled by Research on Child Custody and Parenting Plans, Journal of Divorce & Remarriage, 56:8, 595-633, DOI: 10.1080/10502556.2015.1092349    

 3, 4,8,10 Nielsen, L. (2015). Shared Physical Custody: Does It Benefit Most Children? Journal of the American Academy of Matrimonial Lawyers, 28, 79-138. 

 6,7,9,11 Nielsen, L. (2013, Jan. & feb.). Parenting Time & Shared Residential Custody: Ten Common Myths.  https://issuu.com/nebraskabar/docs/janfeb_2013/1 

WRITTEN BY MICHELLE JONES, LCSW

Michelle is the director of Concordia Families – a treatment center offering services for reunification, court involved therapy, parent education classes, treatment needs assessments and professional education seminars and classes.

Originally published in Utah Valley Wellness Magazine

The Multiple Sides of Child Abuse

Each branch of the mental health profession, including psychologists, marriage and family therapists, and social workers, has a code of ethics which outlines the values and standards which should guide the treatment they offer. For example, according to the Social Work Code of Ethics, “social workers pursue social change, particularly with and on behalf of vulnerable and oppressed individuals and groups of people (Code of Ethics, 2017).”1 Further, most exceptions to confidentiality are also based on the values of protecting the vulnerable in the population, meaning children and the elderly.  

Within the arena of high-conflict divorce, there are children who are truly being subject to physical, sexual, and emotional/psychological abuse, and at the same time, there are also parents who make false allegations of child abuse in order to gain an advantage in court. When a professional becomes involved with these families, they need to explore multiple possibilities, and see the bigger picture of protecting the children against all forms of abuse.  Reflexively denying contact between a parent and child in order to err on the “safe” side is not always the “safe” thing to do. Unnecessarily disrupting a healthy parent-child relationship actually enables psychological abuse.  

First of all, therapists should take all claims of abuse seriously. Their obligation is to report it to the Division of Child and Family Services (DCFS). This agency will determine whether an investigation will be made, based on an assessment of risk factors.  DCFS should be able to determine if the claim should be substantiated, whether it is a chronic problem or a one-time incident, or whether there is no evidence for the claim at all.   

But when a parent makes false claims of abuse and unwarrantedly induces symptoms of anxiety or hatred in the child in order to destroy the child’s relationship with the ex-spouse, this is also an abuse known as parental alienation. It has been recognized as a form of psychological abuse, and is severely damaging to the child. A research article published in 2014, called, “Unseen Wounds: The Contribution of Psychological Maltreatment to Child and Adolescent Mental Health and Risk Outcomes,”2 examined the effects of psychological abuse. The lead author, Joseph Spinazzola, Ph.D., of The Trauma Center at Justice Resource Institute, Brookline, Massachusetts stated, 

“Given the prevalence of childhood psychological abuse and the severity of harm to young victims, it should be at the forefront of mental health and social service training,” (APA, 2014).3 

The American Professional Society on the Abuse of Children (APSAC)4 defines psychological abuse as five parental behaviors, as measured by the PMM and CAPM-CV scales: 

  1. Spurning(In parental alienation, a parent withdraws love from the child to punish them when they connect to the other parent.) 
  2. Terrorizing(In parental alienation, one parent induces fear of the other parent in the child.) 
  3. Isolating(In parental alienation the child is cut off from the other parent and most likely the whole side of the family.) 
  4. Corrupting/Exploiting(In parental alienation the child is encouraged to engage in behaviors that are cruel, disrespectful, and immoral in order to benefit the “favored” parent.) 
  5. Denying Emotional Responsiveness(In parental alienation, the child is punished for accepting love from the other parent.) 

In the latest version of the Diagnostic and Statistical manual, psychological abuse is defined as:  

“…non-accidental verbal or symbolic acts by a child’s parent or caregiver that result, or have reasonable potential to result, in significant psychological harm to the child.” (DSM 5, pg 719)5 

If our fundamental value is to truly protect children, who are the most vulnerable in the population, then we need to raise the level of therapeutic competency through education and training, and do assessments which consider all forms of abuse, including parental alienation.  Children should never be weaponized, and intervening systems should never enable it.  

 

  1. 1.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

2 Spinazzola, J., Hodgdon, H., Liang, L., Ford, J. D., Layne, C. M., Pynoos, R., . . . Kisiel, C. (2014). Unseen wounds: The contribution of psychological maltreatment to child and adolescent mental health and risk outcomes. Psychological Trauma: Theory, Research, Practice, and Policy,6(Suppl 1), S18-S28. doi:10.1037/a0037766 

3 Childhood Psychological Abuse as Harmful as Sexual or Physical Abuse. (n.d.). Retrieved March 25, 2018, from http://www.apa.org/news/press/releases/2014/10/psychological-abuse.aspx 

4American Professional Society Abuse Children | APSAC. (n.d.). Retrieved March 25, 2018, from https://www.apsac.org/ 

5Diagnostic and statistical manual of mental disorders DSM-5. (2013). Washington: American Psychiatric Publ. 

 

Originally published in Utah Valley Wellness Magazine

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