Jedi Mindfulness Trick

You hear the word all the time: Mindfulness. "Be mindful" to reduce stress, improve relationships, treat that Borderline Personality disorder, etc. What does it really mean?

mind·ful·nessˈmīn(d)f(ə)lnəs/ noun1.
the quality or state of being conscious or aware of something.
"their mindfulness of the wider cinematic tradition"
2.
a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations, used as a therapeutic technique.

Aahh, now you get it... blog entry done. No, not really.

Some of you may recognize the Star Wars reference in the title. If you will recall Yoda, (Empire Strikes Back) telling Luke, that he was impatient, that he never had his mind on the tasks at hand, instead his mind always wandered into his fantasy of becoming a pilot "like his father." Now, I have issues with the Jedi philosophy, because they teach that emotions are a hindrance and should be repressed. I think that if Anikin had been allowed to grieve the loss of his mother when he left her to train, he might have turned out better. But getting back to the point. When we meet Rae, whose parentage has yet to be revealed, she is a scavenger. She spends all of her days picking off parts of grounded Imperial Star Cruisers on her desert planet, washes them in, trades them for food. At night, she waits to be rescued. When her powers are awakened, it takes her very little time to connect to them, her mind is clear, she can focus, and she wins. 

She can do this through mindfulness. Yes she has a fantasy life, but it doesn't interfere in her daily life. She can put it all aside until the right time. 

I have been listening to meditation recordings on the Calm app. The voice of the guide is pleasant, which is important to me. The message is that constant thought about everything all the time is exhausting and can make us sick, physically or mentally. It helps you learn to clear your mind and not judge yourself when thoughts peek their heads into your brain. But to just go back to the clear, open blue sky. Thoughts are little, white, puffy clouds that float away. There are YouTube channels as well that offer guided meditation, body scans etc as well, just so I don't plug the one thing I like particularly. 

If you do this a little every day on a scheduled basis, you can do this during times of stress. You can do this during times you need to focus. You can be present in your life instead of being distracted by the noise either around you or in your head. You might even get some good sleep! 

What would it be like to have a conversation with someone you care about where you were completely attuned to them? Or you were sitting on the grass under the tree and felt the breeze, heard the leaves rustle, smelled the flowers on the air? Just present? Not thinking tomorrow is Monday and there are 100 things waiting for me to do... Thoughts and anxiety are ever present, but they don't have to control you. So even if you think what you are doing is mundane, being focused on that mundane thing can translate into other parts of your life when you just might need to save the world!

GOALS

One of the most common sources for anxiety in people who want to achieve anything is how to set a goal. We tend to see the final result and we have no idea how to get there. To get to the magic coast, we have to hike through the desert, climb the mountain, battle the troll under the bridge, avoid the enchanted forest... these are the steps involved. There are always more than we realize.

I often hear, "I want to start my own business," or "I want to move out into my own place and be independent," and are overwhelmed by the task. The reason is: it's just too big. So how does a goal oriented person begin? 

There are several options:

SMART goals. The accepted way to write a goal is the SMART format. And yes, if I am your therapist, I will have you write it down someplace. A journal, a white board, the bathroom mirror - if that is where you will see it. 

S: Specific. What are you trying to achieve. The result of your efforts. 

M: Measurable. How are you going to quantify your success and progress? In terms of money? Lowering or increasing scores on a test? 

A: Achievable. If your goal is to grow wings and fly away then you're just setting yourself up. 

R: Realistic. You aren't going to play professional basketball if you are only 5' tall. But you may have other options for your talents. 

T: Time limited. What time frame are we looking at? What date are you aiming for?

So here is an example based on the above breakdown: (GOAL) Start a business

 (Tasks/action steps)

Write a business plan and submit to a loan officer for a business loan. 

Criteria will include type of business, current earnings, market research, etc

Use skills obtained in business school and enlist experts on subjects of xyz to consult/be on board of directors, etc

Due date for plan: (set dates for 1st, 2nd and final draft) Submit to Bank: (set date). 

There are probably many other tasks in starting a business but the idea is that you break down your lofty hopes and dreams into workable parts. 

If you have many hopes and dreams, then listing those in a grid format can also help break them down and prioritize. What do you want to / or have to get done in the next 30 days? 6 months? 1 year and 3 years? You're making 4 boxes and sometimes the tasks and goals will be moved up or moved farther out depending on what is going on in your life. 

I have one client who is using an app called "Epic Win" to record goals. What makes this app different is that it is based on role playing games (RPG). You are a character, and the more you meet your goal deadlines the more your character gains points that are applied to looks, charisma, etc. For younger people who play RPGs regularly this can be especially appealing. The app isn't free but it's not expensive. It's certainly a creative way to achieve!

Another creative option is the vision board. There are many many tutorials online about these. If you are unclear of what direction you want to go it, doing one of these may assist you in determining a course of action. It's also a wonderful way to procrastinate!

Are you ready to get started? I am including a handout on SMART goals and a goal grid here. 

Set those goals and smash them!

Animals in Therapy

The vast majority of people love animals – a cat, a dog, bird, lizard, rabbit, horse or even a mouse. They show us love as much as we show them, and it’s completely unconditional. Almost any domesticated animal can be a comfort animal or have therapeutic benefits – there is no certification for this but it helps to have a therapist write an official letter indicated a child or adult needs their companion to address mental health symptoms. Often therapists are asked to do this so a family can move into a new apartment with strict rules about pets. There is an enormous amount of research already on the books about how animal contact can improve post surgery outcomes, improve social contact in older adults, increase walking times and distances for dog owners, experience a generally higher sense of well-being through their pets.

So why would someone need a therapy animal? All you have to do is adopt a pet and all your troubles are gone, right? I am writing this because I have an amazing dog, a 6 year old black Labrador retriever named Rocky. He’s calm, intuitive, quiet, completely harmless to kids and older adults. I do not have any certifications at this time in doing any “real” therapy work with him but often kids or adults ask me to bring him in. I let everyone know that while he’s healthy, has all his shots, but I am not covered to use him officially. They don’t care; and I am not worried that he’ll hurt anyone. I’ve seen toddlers manhandle him and all he does is lie down and get comfortable. When you stop patting him, he’ll nudge you or put his paw on your knee to remind you that he’s still there. I have a security system because frankly he would just lick a robber to death.

To use an animal for therapy, you need a therapist. The animal can’t go to school for that. The animal should pass a screening for the right behavioral attributes and have basic training for obedience. Many therapists have their own pets – horses at a ranch, dogs, cats, goats. People who are anxious benefit from talking while petting the soft fur – that tactile stimulation can help ground people in the present moment, and help them connect back to their body (see my NARM post) as so often people will disassociate when stressed. Children who have impulsive behaviors learn more empathy so see that their rough treatment might not be the right way to get the animal to “make friends” with them.

The animal therapy has specific goals for treatment. It is the primary intervention for the client. The other type is animal-assisted therapy (AAT) where the animal’s presence is secondary to the therapy going on. An animal can get a reticent child into the office, or motivate a teen to engage, or be a surrogate face to talk to when in distress.

My favorite example of Animal therapy is from the first book written by abduction survivor, Jaycee Dugard. She wrote that for her first session she was handed a saddle and assigned to saddle a horse (something she had never done before). Her two daughters did fine. She could not do it, after many failed attempts. Her therapist then asked her why she did not ask for help? This then spurred a discussion and realization that for years she could have asked for help while living with her captors. Everyone brings something different to therapy, and animals can offer something different and unique to each situation either as the therapy or as a jumping off point. 

FIX MY KID

I see a fair number of adolescents in my practice. I enjoy them a lot because when I was in High School I was in therapy and it damn near saved my life. Not because I was suicidal, but because I was able to process out all of the stupid, silly, stressful and annoying parts of being a teenager and decide what was right for myself. I mentioned before that the therapist wasn’t perfect but he did his best and sent me out into the world a little better than I was before.

I wanted to go to counseling – I asked to go. It meant my mom spending a little money on me every week but I babysat a lot and I often paid for my own luxuries that way so why not? I could walk to the office on my own, and I was a good client – only missing one or two appointments. Parents now ask for counseling for their kids – and they should. I always ask if the teenager wants to come, and usually they do. I explain that I am not the snitch for the parents – in front of them both. The kid needs to be able to tell me things without the parent hearing ALL. But the parents also need to be involved to a degree, so they know what progress is taking place and any changes that need to happen so they can support their budding adult.

I cannot “fix” anyone’s kid. There are times, when the teens behaviors are direct result/rebellion of their parents’ behavior. In those cases, I help that teen learn healthy ways to deal with their parents so they can move out someday and lead a healthy life. These are very difficult situations from my point of view. But when it works, the parent sees “improvement” because the teen stops butting heads with the parent as much. They see the end date ahead – college and independence. Often teens don’t realize until you point it out, that they WILL grow up and they CAN live somewhere else. The ability to imagine the future is located in the pre-frontal cortex of the brain, which is not yet fully developed until we become adults. But we can give them a little nudge.

In discussing this with some colleagues, after being “fired” from a teen I had a nice rapport with, because her symptoms weren’t gone after 2 months, we came up with a few ground rules:

1.       The above rule – I’m not your snitch

2.       I can’t fix your child. Therapy is a process and it takes time to dive deep under the surface. Some symptoms are serious and debilitating and your teen may need at least a year of work.

3.       Therapy isn’t forever – my goal is to get the parents to learn to be the supportive adult in the teen’s life. You should grow alongside your child. You are forever.

4.       If your child is being treated for trauma – their “bad” behaviors in school or at home are often a direct result of the trauma. Punishing them for their trauma responses is counter-productive. Setting limits is good. A good resource on this topic is Heather Talbot Forbes’ Beyond Consequences.

5.       Check in and participate once a month at a minimum. Ask questions about how you can help support your child grow into an adult.

Unfortunately, a little “getting over” on parents is part of growing up, and very common. Be patient with your teen. They’ll make mistakes and they’ll learn from them. It won’t usually ruin their whole lives. You can warn them but they’ll still insist on finding some things out the “hard way.” Listen to them, ask questions, repeat back what they say and ask if you are understanding them right. “What do you think about that,” and “Hum, interesting,” will go a long way. And I am here to help!

Finding a Good Therapist

After you have decided to find a therapist, and you meet them and you begin. How do you know you have a good therapist? How do you know that what you need from them is going to be met?

Therapists are human beings, and they make mistakes. They say something too deep too quickly, or make an assumption, or look a little glazed over for a moment… This can happen from time to time. But the experience of being in therapy is much bigger than these little moments between you.

Your therapist should be open to your questions about their practice. What is your therapist’s theoretical framework? What is your therapist’s approach to helping people with your particular concerns? Where did the therapist get their training? If you get a sense that the therapist doesn’t want to answer or is impatient with you, keep looking, especially if it bothers you.

Your therapist should have an idea how long treatment should take, ideally.

Your therapist should check in with you about how treatment is going, on a regular basis.

Your therapist should, at least on the surface, appear to be organized and grounded, as a person. As I said before, they are humans, they’ve had bad experiences, they have problems too, but their problems should not spill into your therapy.

Your therapist should seem like an individual person, rather than a textbook. You should be able to get a sense of their personality in sessions. They use themselves in sessions.

Your therapist is not dominating the conversation with anecdotes about their own lives. They should spend most of their time listening and encouraging you to speak, explore and process.

Your therapist should adhere to ethical rules and guidelines. They don’t invite you to parties, or accept your invitations to barbecues or make uncomfortable suggestions. In Colorado, it is illegal to have a dual relationship with your therapist, including dating and sexual relations. They are in a position of power in your life and it would be exploitative and abusive to engage you in non-therapeutic activities.

Your therapist should inform you prior to the start of treatment of the above, to make sure you are going to be a good fit to work together. Your therapist should be confident enough to say, “we might not be a good fit, I can help you find someone who is.”

If you think I am a good fit for you – give me a call and put me to the test! www.aliceriley.net

Book Report

I have been reading and listening to Healing Developmental Trauma by Drs. Heller and LaPierre that is mostly about the Neuro Affective Relational Model (NARM) of working with people (adults) who have experienced early trauma. What is interesting about it is that it is about more than "shock trauma" which is what most of us think of - child abuse, neglect, a severe accident. They define Developmental Trauma as much more encompassing, even pre-natal insults like a surgery, or a depressed mother. I thought right away, if that is the case then we all have some kind of trauma, and a lot of it makes us different from one another. I used to think that "bad things" happening (and subsequent survival) make us just that more interesting as people. Most of us go on from there, to survive and thrive.

Obviously, my focus in my work is on the adults (and kids) who experience the shock trauma. But as simply as I can explain NARM, here it goes. Our bodies are regulated by our mothers, at first, through gestation, and then through the bonding period. Our parents hold us, feed us, sleep by us and we learn to feel safe and calm and "regulated" neurologically. We become organized and our brain and endocrine systems function optimally. We enjoy good nutrition, health and connected relationships to others assuming that love continues throughout our childhoods.
When that bonding and meeting of needs is disrupted, both early on and throughout our development, our bodies become disorganized and dis-regulated. We learn adaptations to survive the abuse or neglect. Humans (and animals) have three autonomic responses to danger: Fight, Flight, or Freeze. An infant can only do one of these things: Freeze. They will stop crying and disassociate from the body to ignore hunger, a wet diaper, pain. Babies and children will cease to recognize needs and have needs to preserve the minimal bit of relationship with the parent that they can get. As they get older they continue to protect the parent relationship by appearing compliant and good. They are not however, connected to themselves or others, they are not developing their own identity or knowing what they need from the environment. They do not recognize that the failure was in the environment. Instead they just know they "feel bad" and later they simply "are bad."
I wanted to cry listening to and reading this, for the babies out there who are enraged when they even have to "cry it out" as some professionals propose. There are many people who are now adults who experienced this, and just this lack of responding can create lifelong effects. Frequent disassociation, anxiety, panic attacks, health problems, relationship issues. I feel vindicated as I recall my own parenting - I held them, responded to them, bonded to them and I still strive to meet their needs as they grow.
There are five adaptive styles/organizing principles that can become survival mechanisms that go on into adulthood. I can list them but going into all of the traits and treatment here is way beyond my blog scope: Connection, Attunement, Trust, Autonomy and Love/Sexuality. Surviving as a baby or child is one thing, the problem arises as adults because we're not babies anymore. We were abandoned, but no longer. We were harmed, but no longer. Yet people are going through life as if the trauma is still happening and they often can't even put their finger on WHY they still feel bad. NARM does not focus on repeating the past traumas, it focuses on helping people remember without re-experience of it through connecting back to the body and learning to regulate their own biological systems. Developing identity and the ability to deeply connect to another person.
The use of this model in treatment is complex and requires a lot of study, practice and supervision. One of my goals is to do the 12-18 month program. For now I have to say that just having this understanding of the brain's development has made a difference in my practice. I do have a fair number of clients (in person and online) who seem to have one of the Adaptive Survival Styles and trying to do this kind of work online while completely DIS-Connected to them is potentially disastrous. I am ambivalent about continuing as an online therapist for this reason. After all, connection and relationship is what therapy is about, and then sending clients back into the world to try to connect and build relationships with others. It is important to continue learning, be humble, genuine, self aware, regulated and Connected.

Does My Child Need a Therapist?

                 I see a lot of posts, memes, blogs about parenting, about how our kids “drive us crazy” or got into trouble at school for some mischief or even for bullying another child. I have friends ask me often if they should take their child to counseling for sometimes “normal” things related to the child’s particular temperament, and sometimes for what is a good catch on the part of the parent. How would you know if your child is having issues beyond what you, as a parent, can help?

                The critical question I am going to ask is, “does the child’s behavior or mood prevail across two or more environments?” If a child is struggling to concentrate in school, misbehaves, can’t stay in their seat and blurts out in class, but is quiet and pleasant at home, sits and reads, then I would think there is some school anxiety vs ADHD (attention deficit hyperactivity disorder). If a child is moving and off task at home and at school, and in a museum and a grocery store, then we might be looking at ADHD. Confused already? That’s why getting answers from a person and not your Google search is important. There is a lot to consider and asking is perfectly reasonable. Children with ADHD don’t always need a therapist, unless some of their adaptive behaviors have become habits and they need help with social skills and parents may need help adapting their own skills to the child who needs a lot of patience. Kids can usually be easily treated with medication that the pediatrician can prescribe (a simple questionnaire should be given to the teacher and an EKG is usually completed first). Be sure to ask a lot of questions – parents need to know everything they can.

                Similarly, the behavior is not only taking place in multiple environments, but is interfering with normal daily tasks. A child who is developing OCD (obsessive-compulsive disorder) will eventually forego pleasurable activities to complete the compulsive behavior they “need” to complete to resolve the worry in their mind. Most people have a superstition or two, but if a child cannot get dressed before going through several perfect renditions of their task, (flipping the light switch, a chant, touching objects in a certain order) there is a problem.

                If you have answered “yes” to either or both of the above questions (2+ environments, interfering with fun), you may need a professional consultation. It does not mean something is “wrong” with your child, or your parenting. Imagine if your child needed a life-saving medical service, and you decided, “no, it’ll be okay without the intervention?” You wouldn’t likely do that, would you? You’d take your child for the appointments until they were cured. Letting an emerging mental illness go untreated is a threat to the child’s future, so it’s better to get help now while their brains are workable. Yes, many of these illnesses also come out as adults, and we can’t always predict it, but kids can learn valuable coping skills to handle stress throughout their lives. And parents don’t always know the best way to manage childhood anxiety, depression, OCD, ADHD. When you love someone as much as you love your child, your emotions get mixed in all too easily.

                Ask your child if they are worried about anything. Tell them you can find someone who can help them feel better. It might not even take very long for relief. A good child therapist can help bring out issues through drawing, through games and help the child identify and verbalize what is worrying them. The therapist can help parents respond more effectively to their child and teach them skills to self-regulate, communicate and listen. Call a therapist, ask the questions, and make the appointment. A wonderful adulthood awaits your child.
ARileyLCSW@live.com.