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All posts for the month September, 2015

Having just returned from speaking at the Australian Summit on Bribery and Corruption, I was overwhelmed by the huge amounts of money large corporations commit to preventing bribery and corruption in their organisations and the huge amounts of time, money and resources government officials put into prosecuting offenders. It made me think about parallels between organisations and families. These large organisations, and indeed Governments, really want their employees and citizens to be honest and to be decently rewarded for good work. I think that is exactly what many parents want for their families, too – to raise children who are honest and decent people.

So how do we raise children to become honest citizens of the world?

Children go through different phases with good and evil. Let’s consider lying. To tell a lie, actually requires quite a bit of cognitive work. To tell a good and convincing lie requires a big lot of cognitive work. It requires thinking about what happened, predicting consequences, being able to predict what other people might do and being able to understand what other people might believe – lots of social skills are required to be clever about lying to others.

When we assess a child’s moral development, we note that they go through stages as their brains develop and their understanding broadens. In the middle of last century, Kohlberg had a theory that many who have studied child development will recognise. Kohlberg posed a range of dilemmas to children of certain ages and was interested, not so much in whether they got the answers right or wrong, but in the reasoning or justifications that were used to arrive at the answers. One of the more famous dilemmas involves a woman dying and needing treatment….

In Europe, a woman was near death from a special kind of cancer. There was one drug that the doctors thought might save her. It was a form of radium that a druggist in the same town had recently discovered. The drug was expensive to make, but the druggist was charging ten times what the drug cost him to make. He paid $400 for the radium and charged $4,000 for a small dose of the drug. The sick woman’s husband, Heinz, went to everyone he knew to borrow the money and tried every legal means, but he could only get together about $2,000, which is half of what it cost. He told the druggist that his wife was dying, and asked him to sell it cheaper or let him pay later. But the druggist said, “No, I discovered the drug and I’m going to make money from it.” So, having tried every legal means, Heinz gets desperate and considers breaking into the man’s store to steal the drug for his wife.

When asking children about these dilemmas, Mr Kohlberg believed that children developed through stages in regard to their responses. He suggested that children in their earliest phases of moral development believe that the right thing to do is the thing that won’t get you into trouble or the thing that avoids punishment. If you ask someone at this stage of development if it is okay to take a biscuit from the jar without asking they would say “no” because “you would get in trouble”. In the early years of child development, the wrong thing is defined as the thing you could be caught doing and then get in trouble for. If you are not caught, then there’s no trouble. (I know you are all thinking about adults you know who are still at this early stage of development).

As a child progresses through life and develops morally, the child starts to understand that there is a need for people to do the right thing because it keeps the world in order, makes life predictable and keeps society settled. There is more consideration of other people. Good people are “nice” and they do the “right thing” by others.

With still more development, a child begins to realise that people can have different views and experiences of the world and that these determine what the right thing to do might be. Rules and Laws are important, but children (normally teens by this time) can understand that there is a more universal “good” and that sometimes people try to change or oppose laws because there is a really important reason for doing so that might affect lots of people.

If you search the internet using any search engine to enquire about how to raise honest children you can really see the influence that culture and religion might have on parenting ideas.

One of the things that Kohlberg’s theory has been criticised for over the years is that it ignores the role that culture and experience have on a child’s developing sense of what is right and what is wrong. If you live in a third world country where food and shelter are scarce, there might be different opinions about what is right and wrong. We only have to look at how one culture can be divided about topics like gay marriage or asylum seekers to know that people’s lives are shaped by experiences that lead them to maintain certain beliefs about what is right or wrong. Views of what is “right” are influenced by opinions of their family, the opinions of their friends, workmates, the books they read (what really is “happily ever after”?), the information they regularly surf on the internet, or the things they have witnessed in their lives. Is it okay to offer someone more money to get that surgery faster?  Is it okay to go to jail for protesting about something you really believe in? There will always be some cultural influences on these answers, but it will depend on what the adults in the child’s life believe and how they act and respond to perceived injustices and wrong doings.

What will the child get in trouble for and what will they see others get in trouble for…or get away with?

The ability to understand right and wrong has implications beyond parenting. The ability to be able to tell right from wrong is really important in legal matters involving children. In our society, we recognise that children will differ from adults in their ability to know and understand right from wrong. Under the age of 10, a child cannot be convicted of a crime in Australia. Between 10 and 14 we enter a bit of a complex zone where Courts will usually require that a child can only be convicted of a crime if it was clear that they knew the difference between right and wrong at the time. For children 14 years to 17 or 18, a young person can be convicted of a crime, but we tend not to send then straight to custody and have a range of other options we as a society prefer to take as we recognise that they may not fully understand the wrongfulness of their actions. In some states in Australia, there are adult youth justice options for youth up to 21 years of age where more vulnerable offenders can be sentenced to Adult Youth Justice options and not to adult prisons.

So… if we move from the big heavy stuff of crime and Courts and come back to day to day life in the average Australian home, where are we up to with lies? Is it okay to tell a lie if the truth might upset someone? Is there such a thing as a white lie? How does a secret or withholding the truth differ from a lie? What is sarcasm – how come someone can say one thing with their words but say something else with their tone and is this okay? It’s all very complex and it’s lucky that most children actually take it all on board with the cleverness of their developing brains and the guidance of their families and educators. These clever and developing brains are hungry for information and we should give it to them in regular bite-sized pieces that show them the similarities and differences that different ideas and cultures bring to people choices about what they do. The world is complex. There will always be dilemmas for which there are no clear answers. Meanwhile, though, it is perhaps always wise to check whether we, the grown-ups, are living in line with our values and how we demonstrate these to children in moment by moment ways.

Like all other aspects of parenting, your child’s moral development will depend on what they see and experience in their home life, school and surrounds. Parents need to be clear about what they value and parent to match the values that are important to them.

Meltdowns – We’ve all had them. Some of us have had them more recently than others. Some might live with someone (grown up or little) who frequently melts down.

In psychology, we understand that melt downs are the letting out of built up emotions – frustration, excitement, disappointment, anger, despair, grief….

Strong feelings usually let us know that we have a big problem, or sometimes an accumulation of smaller problems, that need solving. Unresolved problems, worries, fear and distress can build to panic or rage when the brain is overwhelmed at the work it needs to do to coordinate all the information it is getting to come up with an action that will satisfy and solve.   Melt downs are certainly a letting go and letting go can have its advantages. With our cortex back in control after an emotional outburst, we can often think things through more clearly.

However, melt downs can come at a cost. Often, when we let our emotions take the front seat in our brain, we can do and say things that can hurt others physically or emotionally. So, after a meltdown, we can end up with more problems in addition to those that triggered the explosion in the first place.

There are some factors that we know are linked to a higher likelihood of meltdowns.

  • The fight and flight (or freeze) response – Our body is naturally wired to defend itself. If it feels threatened, brain functioning in the cortex or the thinking part of the brain, is compromised or completely by-passed in order to make quicker, life-saving reactions. If someone regularly interprets a situation or a problem as a threat to their own well being or life (or to the life of someone they care about) melt downs are more likely. Sadly, if someone has lived through multiple life-threatening events, their fight and flight response can be, understandably, twitchy.
  • Someone’s temperament – Temperament is a stable pattern of responding that we are born with. Our temperaments are short lived and can be altered with time and parenting. Children who are born with a ‘touchy’ or ‘anxious’ temperament, are more likely to melt down. In adults, we more readily refer to stable character and coping traits as personality. Some people with certain personalities find it very hard to cope without meltdowns
  • Mental health – People who have troubles sustaining attention or who have a depression or anxiety disorder may be more prone melt down. Substance use, be it coffee, alcohol or illicit drugs, will also make a person more prone to melt downs because it alters the amount of stimulation the brain experiences.
  • Difficulties being able to see other peoples’ points of view or think abstractly to solve problems – Children of a certain age are more prone to melt downs because they have not yet developed the capacity to take another’s perspective or to solve problems. As we get older and learn more, we get cleverer and more creative about coming up with solutions to problems. If, however, our brain activity is compromised (by injury, Autism, dementia, stroke), melt downs can become more frequent.
  • Inflexibility – Some people are quite rigid with their ideas and they have trouble changing them, even when they are presented with new ideas or evidence contrary to their opinions. Inflexible people find it hard to imagine. Like the ability to think abstractly, inflexibility can be associated with Autism Spectrum concern, a head injury, a cognitive disability or dementia.

Of course, if you know someone well, you will understand their triggers and the early warning signs that things are going to get messy. Be sure to use this information for good and not evil. Avoid unessential triggers where the avoidance does not affect their quality of life, but we do not want people who have melt downs to have their lives limited by too much avoidance.

If you see warning signs, act to de-escalate. Different de-escalations will work for different people so it’s wise to review all your past attempts. De-escalation will involve different strategies for different ages. For toddlers, it might be a noise or a shiny object, for older children it might involve humour.

The idea of de-escalation is to get the brain to focus on what it can do and offer it some really basic tasks rather than suggest that it do something that might just inflame emotions further. I like to tell people about the Three Things Thing.

The Three Things Thing involves asking the person to tell you three things that they can see right now, then three things that they can feel with their skin right now and then three different sounds that they can hear in their space right now. If they are a little calmer, but need more, try for another two of each thing, then another one. Your aim is to get their brains to a point where they no longer feel that they are out of control. Focusing on the very basic senses in the here and now can help. Try it with your friends and family! You can almost feel your brain changing down a few gears. Bonus points if you can get them to try to slow their breathing down, too!

Longer term, we need to help the person to prevent more meltdowns. This may include planning to gradually introduce a watered-down version of a troubling scenario, a step at a time, and help the person to stay relaxed and celebrate as they tolerate a little bit more of a feared or distressing situation at a time.   However, living or spending time with people who have meltdowns can be very wearying and you may wish to get some extra help

You as a parent, partner, teacher, case-manager or friend might have some really useful information, but a visit to a psychologist can help you and your partner-in-melt-downs to work on a comprehensive plan tailor made for their temperament/personality, mental health, history, triggers, thinking patterns and behaviours. The plan should also involve teaching the person other ways for dealing with strong emotions or new ways of thinking about problems.

 

When we are helping little ones (or grown-ups) to learn to regulate their emotions, we are teaching them to label and safely express how they feel. We aim to help them to match their behaviour to certain situations, to turn their energy levels up and down – a little like we might adjust the volume of a stereo or the temperature of an oven.

Sometimes we need to build our energy up – like when we need to get going for the day or when we are about to play sport. Sometimes we need to turn it down, like when we are getting ready for bed or ready to concentrate and learn at school or at work.

We can adjust our feelings output levels and intensity using a range of techniques like changing our breathing, changing what we “say” to ourselves internally or by doing different exercises. Music can also help us to turn the volume up and down on certain feelings. We can immerse ourselves in a particular emotion by adding a certain background sound track to a moment.

Some music works for us emotionally because our reactions to it leave us feeling a certain way. Researchers know that we are very likely to select the music we play so that it is congruent or feels the same as our mood. We can also use music to help us move from one emotional state to another.

Just like emotions, music can be high or low energy and it can have a pleasant vibe or a more unpleasant edge to it. We can change our mood and our energy levels by exposing ourselves to certain music. Up beat, happy music can energise us. Quiet, lilting, melodic, perhaps classical music, can lower our energy and can calm us.

Researchers have also reported that music that is classified as “extreme” can make you feel calmer. Punk or heavy metal music can help people connect and share an emotion. People can connect with the anger or the rage that is being expressed in the beat and in the lyrics. They can relate to it, then release.

Music and songs can also help immerse us in memories. It can take us back in time to happier, sad or rebellious phases of our life. Familiarity and repetition can soothe us, so it is not surprising that we often go back through our music collections looking for a certain track from a certain point in our life to immerse ourselves in a certain feeling. However, musical memories can also leave us with an annoying advertising jingle stuck in the recesses of our minds for days.

Movie makers have known about the power of music to effect emotions for a long time. In a movie soundtrack, music is used to play with your emotion. Music can help to build suspense and even to add fright to a scene.

Music can help you build your emotions and then perhaps release them when the beat drops. Dance and techno music often uses a rising beat, then a pause, and then “the drop” where all of the tension is released. A dance can be a physical and emotional work out and the repetition of certain movements can be soothing. Humans tend to pace, jiggle or rock when agitated and this can help them soothe themselves.

So, if you are dealing with someone who has trouble regulating their emotions, or who is still learning to regulate emotions, think about the ways that music can be used to help them.

For instance, if you are driving along and in need of manipulating the mood in the back seat of the vehicle, perhaps you can try to play a certain track in the car. Many parents will attest to reaching a destination with nursery rhymes ringing in their ears and minds for the day, but somehow feeling a little more sane or less stressed. Please be aware, though, that changing the music should not be excuse to push beyond stress levels that are affecting the driver’s concentration. Oh, and at the risk of sounding patronising but needing to be safe, you should always pull over to change the music if you are driving a vehicle – we don’t want anyone getting in a situation that requires emergency sirens in the sound track.

You can also use music choice as another way of talking to children about feelings. “I feel a bit uptight – let’s choose something a bit soothing”. “I feel happy – let’s choose something up beat and celebrate”. As you watch films together, you can highlight that you expect something scary is about to happen because the music is changing and explain that movie makers do that on purpose. Perhaps, you can all have a go at making some emotional music, too. Crack out the instruments, or even the pots and pans from the kitchen.

Just like all things in life, expose your child to a variety of music genres and cultures so they can sample what works for them. Perhaps the repetition and the movement associates with learning to play an instrument can introduce them to a way to soothe or regulate their emotional selves for years to come?

With Fathers’ Day upon us this weekend, perhaps it’s time to think about what fathers need – not in the underwear, socks, and new fishing gear department, but more in terms of what really makes them happy. What do fathers need to be happy, mentally healthy and to be well?

Proudly, a lot of recent useful research into the mental health of our Dads has been completed here in Australia. When we go searching through the research on psychology and Dads there are a few themes that emerge:

  • Dads are subject to different gender and parenting norms
  • Dads experience mental illness differently to women
  • Men use different strategies to manage their health problems
  • Men may be more reluctant than women to seek help for health and welfare concerns.

I have had the privilege of working with lots of fathers, but on reflection, this is usually because they have been made to see me because their child is at risk, their parenting is being reviewed by a welfare agency or because they are under some sort of Court Order to get some help. Sadly, there is a subsection of fathers who are mandated to receive mental health treatment because they have come to the attention of authorities in relation to concerns about their parenting or because they may have broken the Law.

It’s really important to recognise, though, that while a very small minority of men (just like some women) with mental illness do pose a risk to their families, the majority do not. It’s stigma that stops many good men receiving the mental health support that they need.

Fathers can come to the attention of mental health professionals:

  • Because they have a mental health concern and they are seeking help
  • Because they have just become a father and may have issues with peri-natal adjustment or
  • Because their children or partner have mental health concerns

Across the world, men are less likely to present with symptoms of depression, but more likely to present with issues related to substance abuse, especially alcohol. When we take a closer look at men who abuse alcohol, we often find co-existing depression and anxiety.

Researchers have tried to better understand the difference between fathers who seek help and fathers who do not. It appears to come down to weighing up the pros and cons of “coming out” about their mental health. Some fathers feel that coming out about their mental illness gives them greater support and less worry about being “found out”. Sadly, some have experienced stigma and wished that they had not told others. Clearly, when a Dad speaks about having mental health issues, we need to do more to make them feel supported and to keep them engaged in treatment so that they can return to a happy quality of life.

It is also clear that we need more work done on educating the community about mental health issues for men. We need to think carefully about the way we give information to fathers. While it has for a long time been thought that men are less help seeking than women, we do now know that men prefer to get information through lay advice. The challenge for professionals is to support lay people or easily available avenues of support to have the best professional and scientific advice that can be offered. Beyond Blue have some great resources for men.

We need to keep an eye on new Dads. When parents become parents for the first time or for each subsequent new baby, there is a risk that the changes that occur around the new bub can throw coping systems into a spin. While we have been aware for some time now that mothers need support around a new bub, we now know that fathers can also be vulnerable at this point in time.

Interestingly, Fathers have different risk factors around post-natal health than mothers. With fathers, the researchers[i] have now established that there are some specific factors around Dad that will predict how he goes post-natally. Dads are at higher risk of post natal mental health issues if they are have poor job quality, poor relationship quality, if their child’s mother is psychologically distressed, if they have a partner in a more prestigious occupation and if they have low parental self efficacy.

Another time that fathers come to the attention of mental health clinicians is when a father is parenting a child (or adult child) who has a mental illness or disability. Fathers of children with mental health concerns often report feeling powerlessness and a sense that things are “a constant struggle”. It is thought that fathers are more likely than mothers to cope by keeping themselves distracted or busy, or want to find logical and rational answers – this can sometimes leave mum to cope with all of the feelings stuff. However, those who are working with fathers need to know that they will be more inclined to require and take on board practical information with regard to their child and they should make this available.

Generally speaking, Dad’s are happier when they have a job that values them, an intimate partnership that is healthy, when they have active involvement with their children and when they feel good about their capacity to parent.

When Dad’s mental health does get wobbly, mental health services need to provide family friendly services, they need to specifically ask after dad’s mental health and ask whether Dad is happy with his parenting or would like some help to learn to have more efficacy in their parenting.

So, my wish for fathers this fathers’ day is:

  • Workplaces that consider flexible arrangements for dads (as well as mums)
  • A supportive partner, family, mates and community
  • More available services for fathers themselves but also services for children that are father-inclusive
  • More available advice around mental health that is professional and scientific but that looks like it’s “mate’s” or “lay” advice as Dad’s seem to find information easier to digest in this way.

Have a happy Fathers’ Day, Dads!

 

[i] Giallo, R., D’Esposito, F., Christensen, D., Mensah, F., Cooklin  AR., Wade, C., Lucas, N., Canterford, L., Nicholson, J.M (2012). Father mental health during the early parenting period: Results of an Australian population based longitudinal study. Social Psychiatry and Psychiatric Epidemiology, 47(12):1907-1916. doi: 10.1007/s00127-012-0510-0.