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Kids who self-injure tend to be particularly emotionally sensitive and vulnerable and suffer from what Dr. Hollander calls “emotional illiteracy.” They can’t name their feelings, let alone formulate a plan for managing and coping with them. Strategies that work with most kids, such as reassurance, minimizing the severity of difficulties, or offering to help them solve problems, can backfire with kids who self-injure.

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And now for something completely different

And now for something completely differentWhen my son was about two and half I no longer knew how to parent him. He went from toddling baby I knew and adored to a stomping, glaring preschooler I didn’t understand. My tried and true techniques quit working and more than once I carried his screaming self out of the store, the library and away from the park completely baffled by his behavior. I felt guilty for his behavior, I felt guilty because I didn’t know how to quit triggering his anger and I really felt guilty because I sure wasn’t liking him much.

It seemed like neither of us could do anything right.

“I’m a terrible parent,” I cried to my husband. “I don’t know what I’m doing and I’m ruining him.”

It was my first lesson in how developmental stages could hit both of us. I knew he was going to grow and change but I didn’t understand that I would have to grow and change with him. It was only when I was commiserating (i.e., crying on the phone) with a friend whose daughter was exactly one month younger that I realized that I’d become stagnant. I was still trying to parent a toddler and he was trying to grow into a kid.

Parenting is anything but stationary. Our kids are growing all of the time and sometimes it takes a crisis in the relationship for us to realize that it’s time to change things up. We can’t parent a preschooler like a toddler; we can’t parent a teen like a tween. Those parenting plateaus — where kids and parents are perfectly in sync — are temporary. They grow, we grow and then we all have to readjust to each other.

I have found in my own life and in the lives of the families I see that the greatest push-pull comes when kids are edging to greater independence and parents haven’t caught up with this new scenario. There are predictable developmental windows when it’s easy to lose track of each other — when toddlers learn that they’re separate from their parents; when teens start looking to peers instead of mom or dad. But it can happen in less volatile times, too. Maybe a child wants the training wheels off or wants to choose their own clothes or wants to be left alone with a project. What was welcomed as attentive parenting one day is all of a sudden perceived as overbearing and we don’t even know when we crossed the line.

I tell this story a lot so you may have heard it but right around this same time when my son and I were first knocking heads he got furious with me because I didn’t remember his dream. He was trying to tell me about it at breakfast and he was so angry that I couldn’t remember it for him. For me, that sums up those trying toddler-preschooler times; he wanted me to psychically keep track of his inner thoughts and feelings but he sure didn’t want to hold my hand when we were crossing the street. No wonder I was confused, right? This stuff is confusing.

It’s painful to grow up (and not just for kids). It’s hard to make sense of these mixed messages — the 13-year old who mouths off and rolls her eyes then tries to climb onto your lap, the teen who won’t let you into his room but who wants to tell you the entire plot of Homestuck and exactly what he thinks of it. How are we supposed to know?

The answer is that we can’t know until we run into that brick wall and realize that our parenting needs updating. Conflict is a sign that things need to change. Sometimes what needs to change is our parental expectation and behavior. Sometimes it’s our kids who are dragging us to the next stage while we’re still trying to hammer away at the way things used to be.

It’s hard. It’s frustrating. And it is often painful.

That first time was the worst. I really thought I’d broken him and that chaos and conflict were going to be a permanent reality. But we did work it out. I changed up my expectations, I built in more opportunities for him to feel independent and suddenly my sunshine son was back, both of us happy to be with each other again.

And after that I could recognize when the landscape was starting to change and knew to rewrite my map. Acclimating to the new terrain got a lot easier once I knew what to look for.

One of my most favorite things to do is help stuck parents because I’ve been there (boy howdy) and I know how hard it is. Hit me up if you’d like some support.

Somatic Symptoms of Child Anxiety

Somatic Symptoms of Child AnxietyLast night for the Parenting Kids with Anxiety group we discussed the way anxiety can affect our kids’ bodies.

Somatic symptoms are often mistaken for something else, which can get in the way of getting appropriate help.

The most common somatic symptoms of child anxiety are these:

  • Restlessness (inability to sit still, fidgeting with clothes or objects, chewing on fingernails, etc.)
  • Stomach problems (butterflies, pain, nausea, a need to go to the bathroom)
  • Blushing
  • Heart palpitations (also panting, wheezing)
  • Muscle tension (headaches, other aches & pains)
  • Sweating
  • Shaking

Behavior problems are common in anxious kids for several reasons including the somatic symptoms. Kids who are too tense and fidgety to sit still may be reprimanded in school, which may increase their anxiety. Anxiety is sometimes misdiagnosed as ADD/ADHD because it can make it so hard for kids to focus. However children with ADD/ADHD can also have anxiety and it may be missed because observers assume it’s part of the child’s attention problems.

Kids who are anxious may act irritable, mouthy, weepy and generally difficult. Part of this has to do with the somatic response; most of us act yucky when we feel yucky.

The physical symptoms of anxiety are real — they’re part of the Fight/Flight/Freeze fear reaction. In other words kids aren’t making them up or making themselves sick to get out of the things that make them anxious.

When we are afraid, our bodies go into protective mode. Our muscles get tight so that we’re ready to react. Our adrenaline kicks up, which makes us get sweaty and makes our heart and breathing come faster. The cascade of chemical reactions in our bodies can also wreak havoc on our tummies. This physical response not only prepares us to stay safe, it also tells us that we need to be afraid. In other words, anxiety happens on a self-perpetuating loop.

Imagine a 9-year old who wakes up worried about a report she has to give later that day in front of her class. As she’s getting dressed, thinking about the report, her stomach starts to hurt. She heads down to the kitchen only to find that she can’t eat breakfast. She starts to worry about throwing up in front of the whole class and this makes her stomach hurt even more. She can’t stop picturing how awful it will be to humiliate herself and she finds herself worrying even more about the report she spent all last evening getting just right. Her thoughts are worried. Her emotions are worried. Her body is worried, too.

As parents we need to help our kids spot the loop and interrupt it. This takes practice and attention.

For somatic symptoms, parents can help their children identify their physical response to anxiety. In the kids’ groups we’ve taken outlines (like Gingerbread Men) and drawn in where we feel our worries. Kids are often surprised and relieved to find out that symptoms like sweaty hands or shakiness are common. Knowing what’s happening can help children feel more in control of their anxiety response.

Interrupting the physical part of the anxiety loop means addressing the physical symptoms. Deep breathing, hugs, rocking, and taking a time-out can all help children get their bodies and minds calm. Taking a cool drink of water or splashing cold water on one’s face or wrists can help decrease sweaty symptoms or decrease blushing.

I also really like a set of muscle relaxation exercises created for children with autism who need to prepare for blood draws. They’re simple and easy to remember even for very young children. Some of them are unobtrusive enough that kids can do them under their desks at school or in the car before heading off to an event. You can find them in this PDF, Taking the Work Out of Blood Work, on pages 11 to 13.

The exercises take practice to get good at them and parents can do them with their kids before bed since that’s a great time to practice getting calm. That way when children do start to feel anxious, they’ll be prepared with familiar exercises they already know how to do.

If you’d like to come to the next group, just sign up for an email reminder at the Parenting Kids with Anxiety web page.

Remembering those tired years

But in fact at the time she took those photographs Rebecca had just been tired, tired in that way a woman with a child and a husband and a house and a job and a life gets tired, so that it feels like a mild chronic illness.

from Still Life with Bread Crumbs by Anna Quindlen

This lady looks better groomed than I did when I was that tired. Look, her hair is even brushed!

This lady looks better groomed than I did when I was that tired. Look, her hair is even brushed! And hoop earrings! Who does that with a toddler around?

I’m enjoying this novel but I really loved this line because it rings so true. I remember being that tired with both of my children (although the first time around I didn’t have a job but I did have a boy who did not sleep through the night for the first three years of his life). I see that tired in my clients, moms with babies or young children or trying to juggle too much.

That level of exhaustion is isolating. It’s hard to get out of the house and it’s hard to be present with friends when you get there. Sometimes, I remember, you feel like you must be doing it wrong to be that tired but that’s just how some stages of parenting are. Other people may wear it better or have golden kids who actually sleep or who are more comfortable with chaos. But that doesn’t make the rest of us — the yawning, forgetting, scatter-brained and exhausted rest of us — inadequate. We’re just tired.

Personally I am not one of those women who love the baby stage. I like them better when they start to talk (and even better when they start to talk back) so the hardest time for me is having a baby in arms or a baby lolling around on the floor while I try to keep my eyes open lying next to them bored out of my mind but ready to smile when they glance to make sure I’m there, ready to coo back, ready to pick them up and turn them around so they can make their way like inchworms away from the bookshelf or towards the squeaky toy.

Both my kids get mobile early — scootching off the baby blanket by four months, cruising by six, first steps before nine months (my daughter) and just after (my son). This meant I was trapped next to them on the floor for most of my days since neither had any tolerance for places you prop babies so a person can do things like run to the bathroom or eat a piece of toast in peace without the baby wailing.

I know I did things like cook, clean, drive the bigger kid elsewhere, and — during my daughter’s infancy — write the things people were paying me to write. But what I remember is feeling caged in by babyness, caged in by that full-blown, heady and drunken exhausted devotion. Short-tempered and love-addled, forgetting where I put down my coffee, forgetting to eat lunch, forgetting to shower because I was so busy attending to the cut-in-half grapes, the tushie wiping, the Raffi songs, the dusty chew toy that somehow rolled under the couch and all the minutiae, the nauseatingly tiny, demanding details of parenting small children. And oh boy, were there days I resented them and felt guilty for my resentment so that everything felt worse and even more exhausting.

When I see that reflected in the faces of my clients I tell them it will get better (because it will) and sometimes they believe me but sometimes  they don’t or they are too exhausted to summon up belief. But parenting does get easier (and harder but not so physically hard, which makes the other parts easier). That time that engulfed me, I realize now, was such a short line on the map of my parenting career. But I’ll never forget it, never stop empathizing with the tired mom pushing a stroller or trying to coax a toddler into a carseat or trying to reign in a bouncing preschooler (or several) while she tries to grocery shop.

Parenting is hard. But it gets easier. Hang in there.


Because it’s not the media or skinny, out-of-proportion Barbie dolls or even peer pressure that is the No. 1 cause of body issues for young girls.

It’s their mothers.

“Moms are probably the most important influence on a daughter’s body image,” said Dr. Leslie Sim, clinical director of Mayo Clinic’s eating disorders program and a child psychologist. “Even if a mom says to the daughter, ‘You look so beautiful, but I’m so fat,’ it can be detrimental.”

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The truth about manipulative kids

manipulative kidsFirst of all I want to be clear that manipulative kids are not bad kids. They are children who have learned inappropriate behavior to get the things that they want and need.

I just plugged “manipulate” into Google and the defintion I got was this:

1. handle or control (a tool, mechanism, etc.), typically in a skillful manner. “he manipulated the dials of the set” synonyms: operate, work;
2. control or influence (a person or situation) cleverly, unfairly, or unscrupulously. “the masses were deceived and manipulated by a tiny group” synonyms: control, influence, use/turn to one’s advantage, exploit, maneuver, engineer, steer, direct, gerrymander; twist someone around one’s little finger “the government tried to manipulate the situation”

All behavior serves a purpose. All behavior is a means to an end. We do things because we want things and because we need things. We need understanding. We need love. We need to express understanding and love. We also might want stuff like toys and new clothes and later bedtimes. As we get older, we become (one hopes) more skillful in using our ability to communicate and so less manipulative according to definition number two.

However getting to definition number one (handling in a skillful manner) necessitates a developmental trek through definition number two (turn to one’s advantange).

When I was 13 I started babysitting a little girl who was 2-years old. She used to cry when things didn’t go her way and I suspected she was making herself cry deliberately. So one day I asked her if she could make herself cry. Yes, she said and she proceeded to show me exactly how she did it.

“Do you ever make yourself cry to get cookies?” I asked. She affirmed that yes indeed she did. Aha! Busted! Only she wasn’t being sneaky at all; she was just doing what made sense to get cookies.

Kids are learning how the world works. They are not born with an instinctive understanding of subtle expectations and so they must learn our rules by trying them out and running up against them. We teach kids to say “please” to get cookies and they obediently say “please.” Sometimes, without meaning to, we also teach them to cry to get cookies and they obediently cry.

The 2-year old in my charge understood that crying got attention, which is a terrific and important developmental milestone and next she needed to learn the more subtle art of communicating appropriately. She didn’t know that crying — in the adult or the teen babysitter mind — is a last resort, a desperate measure. She didn’t know that we expected her to start using her words and to accept our limits. She was just beginning to learn that.

To learn that she needed to learn two things:

  • Limits. We caregivers had to start sticking to “no” even in the face of her adorable, heart-melting tears.
  • Empathy. She had to start the long journey of understanding that her needs and wants weren’t always going to take precedence.

If she didn’t understand those things, why would she stop? To her, crying — false or not — got her needs met. Why shouldn’t she want to get her needs met? Just as she happily said “please” so she happily scrunched up her face and sobbed. Both worked. How was she supposed to know that we really only approved of one?

So limits are super important.

But empathy is super important, too.

No child can put other people’s feelings above his own until he trusts that his needs will get met and until he believes that other people’s needs are just as important — and sometimes more important — than his own.

Those are really big lessons. Those are really hard lessons.

Some kids take longer to learn them because they have hard beginnings where lying outright or by omission was necessary for survival. Other kids just don’t have the developmental capacity yet. (Remember, child development follows a predictable path but every child’s path is her own, and sometimes their development can be uneven.) Finally some kids may not have learned it because their parents haven’t taught it to them yet. Or at least not taught it to them in a consistent manner that they can understand.

As long as it works, kids will keep on fake crying or telling fibs to get what they want. This is not because they’re awful people; it’s because they haven’t been taught that other people’s feelings matter as much as their own. This is also not because they’re parents are awful people; it’s because this is all really hard stuff and it’s harder for some kids than others and it’s harder for some parents than others.

Let’s talk about the parent piece a little bit. A parent who is very sensitive to their child’s feelings or a parent who has had trouble getting his or her own needs met or a parent who is feeling overwhelmed because of other life situations may be especially vulnerable to this struggle.

Let’s take Hansel and Gretel for example (you know I like to use fairy tales in my examples). When Hansel grows up, he may have trouble saying no to his kids. His own experience of being hungry and abandoned may color his empathetic response to his kids. If his daughter says, “But Daddy, don’t you love me?” He might have an especially hard time sticking to his limits. So she learns to whine and cajole and he grows increasingly frustrated with her. She whines harder, cries louder and he gets more distressed and hollers then gives in. So the cycle continues.

This is why there is no better mirror to our own unaddressed struggles than parenting; it’s the ultimate trigger.

I am not blaming parents here, remember I think worrying about who created the problem is a useless exercise. I’m saying that sometimes you get this child and that parent and together there is conflict. Such is the dance of parenting. Such is the dance of childhood. And such is the dance of counseling since seeing a child means that of course, you are also seeing the family.

When a parent uses the term “manipulative” to describe their child to me I know that this means that they’re getting frustrated, angry and discouraged. Manipulative is such a negative term that parents generally don’t use it with me until they’re at their wit’s end. Without needing to hear anything else I know this family needs help. I know the child needs help to build those empathy skills and I know the parent needs help feeling understood and supported.

Meanwhile, for those parents who are struggling to set and keep limits, I advise them to read How to Talk So Kids Will Listen, the best and most useful parenting book ever written. (That’s not hyperbole. I’m dead serious.) It’s got great instructions on extricating yourself from the arguments so that you can maintain limits and on building your child’s empathy as you set those limits.

I’m working on putting my parenting classes online and this is the kind of thing we would talk about more in depth so stay tuned. I’m aiming for fall but we shall see.