Tag Archives: psychology

Anger Issues: Innies and Outies

Posted on by Shona Innes
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I love anger.  You’re probably not supposed to have a favourite feeling because all feelings are important, but I do love anger.  Anger has so many great functions.  It can energise us. If unleashed, our anger can help us run faster, bite harder, and throw, move and break bigger things than we can when we are not so angry.

If emotions are the human dashboard that guides us through our body’s journey through life, when someone’s anger flares, it’s a great warning sign.  Anger is a way our body and brain use to yell at us to pull over and make sure we pay attention to something that is not quite right.

Often, anger is behind us when we finally decide to do something about a problem that has been building or neglected for quite some time.  Anger can be useful to get stuff done.

However, anger can also be dangerous and debilitating.  When anger gets out of control, it can be the emotion behind hurtful and destructive behaviour.  Anger can give kids, and adults, a bad reputation and make others disinclined to want to spend time with them.

An important part of parenting or educating a child is helping them to know how to get the best of their anger – helping a child get the best of the motivating and problem solving aspects of anger without hurting someone, breaking something or making a rash decision.

Sometimes we need to consider is the anger a problem, or is the child’s situation the problem.  Some young people have plenty of legitimate things to be upset and angry about.

Managing anger is one of those Goldilocks kind of things.  It’s important that we get the balance “just right” – Expressing too much anger in the wrong kinds of ways at one end and holding anger in and letting it build on the other end.  When we consider anger, we need to consider the problems that might go with externalising anger (letting it out) as well as internalising anger (holding it in).  So, just like belly buttons,  anger problems in kids and adults are usually of two kinds – “outie” anger issues or “innie” anger issues.

“Outie” anger issues are probably those that usually come to mind when we think of anger problems – yelling, profanity, damage to property, verbal abuse, road rage and physically hurting others.  Typically we help people manage outwardly expressed anger by understanding the things that trigger them and learning to take alternative action to deal with the tension that rises in them – to take a slow breath, take other’s perspectives, think about consequences, take a “time out”, exercise or do some hard physical work and learn to problem solve.  There are also new programs emerging that assist those to manage their outwardly expressed anger by tuning into the part of themselves that is grateful for what they have and to be compassionate towards others.  These processes take time, but do work as long as they are modified for each individual’s age and circumstances.

“Innie” anger or anger that is held in or internalised is also a problem and can have big implications for mental health and interpersonal functioning.  Some will hold their anger in until they reach a point where the smallest of things will set them off.  For those watching from the outside, the reactions seem out of proportion with the trigger. That’s usually because the trigger may have little to do with all of the other problems that have been held in and not expressed or dealt with.  When this kind of anger erupts it can take everyone by surprise.  It can seem confusing and can be very hard for a person to control.

“Innie” anger can also be linked to experiences of shame or self loathing.  A young person may learn to respond to something that makes them angry by appearing cheerful for a range of reasons – they may not want to bother others or stand out, they may be told by people who are important to them not to be angry, they may feel that others won’t like them if they are angry or they may be punished for expressing anger.  Instead, they develop a strategy for dealing with things where the  outside part of them doesn’t match the inside.  They lose touch with their ability to feel and express healthy emotions and this can have substantial mental health consequences.

It’s important that we help young people to know, label and understand emotions in themselves and other and learn how to express them in ways that are healthy.

Properly expressed anger is a fine and powerful thing for everyone to have in their interpersonal armor and coping tool box.

To encourage young people to express their anger in useful and safe ways we need to:

  • Model appropriate anger – Speak up in appropriate ways, let people know when we are upset by things and take necessary, responsible action – join a protest, start a group, write a strongly-worded letter, articulate the problem and ask for what they would like to be done
  • If you are responding to a child’s anger, be sure to help them label the feelings and be clear that you want them to manage the feeling differently rather than to banish the feeling
  • Encourage the safe expression of individual opinion in your household or school
  • If someone hurts someone else with their anger outbursts, be sure to have them make some amends – again for the behaviour and not for the feeling
  • Encourage exercise, loud vocalisations (some, myself included, might call that singing) and asking for help.
  • Develop compassion for others and for ourselves by modelling kindness and recognising others needs and our own needs, too.

Anger can be awesome, ferocious, strong, protective and proud. Without anger we can be vulnerable and taken for granted.  Turned in, anger can fuel shame and sadness.  The key to anger is feeling it, knowing it, showing it in the right kinds or ways and then using it’s powers to get problems fixed.

How long has it been since you gave your anger some attention?

 

 

Not happy with how we look: Negative body image & Body Dysmorphic Disorder

Posted on by Shona Innes
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Can you imagine what is would be like to have your beautiful young son or daughter come to you with such hatred for their appearance that they are begging you to take them to a plastic surgeon?

I think from time to time we all check out our image in the mirror and make an evaluation of it.  Some people (young and old) make such critical evaluations of their appearance that they start to believe that they are unable to contribute to any sort of life because of their appearance.  When this becomes debilitating, we usually consider a diagnosis of Body Dysmorphic Disorder.

Our body image is different to an image of our body.  An image or photo of our body captures how it is at any point in time.  Our body image, though, is the representation we have of our own bodies.  It is essentially a judgement or series of judgements we make about how we think we appear.

When you ask people to tell you about their bodies, rather than give you facts , for example, on the colour of their hair or their measure height they usually give you judgemental words like plump, skinny, solid, pale….even ugly.  For most of us, this is not a problem, but for a few, the way their body image becomes central to their level of happiness.

When we determine our worth or happiness by our judgement of how we look, things can get pretty complex.

Body Dysmorphic Disorder or BDD is a diagnosis used when there is an intense preoccupation with a perceived flaw in physical appearance. (For most BDD it is with people’s own appearance, but BDD by proxy can mean that parents become obsessed about flaws in their children’s appearance).  Individuals with BDD often spend lots of time checking and worrying about a particular aspect of their appearance. They may spend a lot of time comparing their appearance with others, and engaging in behaviours designed to try to hide or conceal the area of concern or generally try to avoid being seen by others.

It is thought that BDD affects 1-2 percent of the population and it does not seem to vary with gender.

In the clients I have seen with Body Dysmorphic Disorder, they usually focus on one feature in particular – their teeth or the shape of their lips and sadly, if they do take steps to have these adjusted to their liking (people with BDD are often frequent customers of plastic surgeons), it does not always mean that their happiness improves and they will then go onto to target the next part of their body that they find the most displeasing.

The thinking if ultimately something like “if I can just change the way I look, my life will be wonderful”

BDD is  much more than just vanity or being dissatisfied with how they look, it can become obsessive and often co-morbid (or exists together with) with depression, anxiety (especially social anxiety) and I have seen it accompanied by self harm and suicidal ideas, too.  It can make it hard for a young person to leave the house, go to school or uni, or meet up with friends…or if they do, there needs to be much time trying to cover or adjust a certain aspect of their appearance.

This means BDD can interfere with living with others.  Those with BDD will often continually seek reassurance about their appearance or spend lengthy times in the family bathroom or be frequently late for work or school. There is often quite a deal of secrecy and shame associated with BDD and BDD can quite often be associated with financial difficulties, too, with money being spent on treatments or cover ups.

Oversimplifying it, but in an attempt to explain how BDD starts and is maintained we could consider it  going something like this example (although imagine it being much more complex/less staright forward):

  • Someone tells me I have a crocked nose
  • I believe that I have to look perfect to be liked by others
  • I spend hours trying to cover up my crooked nose with makeup, but that all gets too hard and the products I use have cause swelling and redness, so I start avoiding going out whether others will see me crooked nose. I keep checking with the people I love about my nose, but that doesn’t satisfy me for long.
  • I stop socialising, friendships drop away and I never get to test the idea that I have to look perfect for others to like me or want to be friends with me.

Where does BDD come from?

It is thought that most BDD starts in adolescence and that much goes untreated for many years.  Adolescence is a time of many body changes, and also for some, an increased risk for acne, but other times of life where the body changes can also be triggers – like the emergence of wrinkles or loss of hair with aging or new scarring after an accident or medical issue.

Those at risk of BDD or serious negative body image have often been teased or excluded and are also more likely to associate with peers or even family members who are very focused on appearance. Certain personality types may be more prone but also, social and cultural pressures are thought to contribute including social media. I have also seen BDD that began following a period of childhood and family trauma.

There are so many industries that depend on us being dissatisfied with our body image – Industries worth billions of dollars.  They flood the media with direct and indirect messages about happiness being derived from appearance.

How can we prevent it?

Sadly, at this stage, we don’t’ have any strategies that definitely prevent BDD.  I like to try to educate children about the powers of advertising and the tricks marketers pay to make us buy things.  However, the best the research can suggest is that people seek treatment early.

So, if you are a parent of a teen, it is usual for them to spend more time in the bathroom and in front of the mirror as they approach puberty, but if the checking is accompanied by frequent negative statements about their appearance, constant comparisons of themselves to others, regularly needing reassurance that they look okay, and avoiding socialising or leaving the house, you  should increase your level of concern.

The first point of call should be your GP or Mental Health professional.  A proper diagnosis is essential.BDD has some similarities to Eating Disorders in that it is also about body image, but the preoccupation is usually different, with eating disorders normally being about weight and shape and usually leads to a change of eating patterns.

Treatment can include medication and psychological intervention.  Psychological treatment is focused on tackling negative body image by building body acceptance and using techniques to help reduce the amount of time spent obsessing, checking or seeking reassurance about appearance.  Psychologists can also help with uncovering and challenging assumptions and negative predictions that link appearance with ideas of success and happiness.  Psychologists can also help a person to tackle their avoidance or behaviours that set up self fulfilling loops around unhelpful assumptions

There is some very useful information at the BDD Foundation website.

If you have young children (preschool and early primary) and you are concerned about them developing a negative self image, perhaps you could share “You are Like You” with them to open up some conversations about their thoughts about themselves.

 

Meltdowns – How to help when they “absolutely can’t take it any more”

Posted on by Shona Innes
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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.

 

Why just Mothers’ Day? The importance of everyday self-care for Mums.

Posted on by Shona Innes
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Yes – it’s on! Mother’s day is upon us and so, too, the carefully crafted junk mail and television commercials – Images of blow-waved children bouncing onto a perfectly ruffled bed on a sun-streamed morning bringing breakfast on a delicately manicured tray while a handsome man with the just right amount of five o’clock shadow smiles on from the bedroom door. Ahhh! Motherhood!

We all know that motherhood is rarely perfect. But – how much leeway is there from “perfect” before it starts to have a detrimental effect on families?

It is very clear that family violence is a toxic influence on the lives of little ones and that violence needs to be avoided at all costs. However, the other sometimes hidden, toxic, risk factor for eroding well being of children is maternal (and parental) mental health problems.

When you look into the literature on risk factors for child mental health, there is one factor that repeatedly screams out – parental depression. Depression is more than stress or fatigue. To some extent, some stress and fatigue are very much a part of parenting. Depression, however, is the big player in family wellbeing. Even when families are challenged by children with special needs or complex behaviours, it is the presence of absence of parental depression that often determines the outcome for the child’s mental wellbeing.

Parental mental health is critical to positive child well being. A parent with poor mental health can have a huge impact on the entire family – the other parent/s, the children, the ability to work and earn income and the ability to stay socially engaged with friends and extended family. A mother needs to be “fit enough” to be able to:

  • provide affection
  • be responsive to her child’s needs
  • be encouraging
  • teach every day lessons in moment by moment situations
  • engage with the child and the world
  • discipline positively when it is called for
  • support her partner in co-parenting and encourage the partners healthy relationship with the child.

If a mother’s ability to do these things is affected for any lengthy period of time, then that’s when a child’s well being may be affected unless support is rallied. Some mothers have difficulty relying on others or being relied upon themselves. Often, this difficulty can be a sign that something has gone on in the mother’s early years that interfered with the attachment between her and her own parents.

While some parents have clearly defined mental health problems, many parents may suffer from what we refer to as “subclinical” mental health disorders. A subclinical disorder is one where a mother can still soldier on and get to work, feed the family and attend all of the after school sport and activities, but underneath she is just not coping and may be leaning heavily on alcohol, other substances, or over working in order to get by.

Some mothers soldier on through their non-coping periods. Sometimes they do this because they don’t want to be a burden or a nuisance to others, because they are “so lucky” compared to some of the things they see people go through on the news and because they think they just need to “snap out of it”. Some get a bit of a Super Mum complex and then become resentful when their mood takes a hit.

Mothers need to prioritise self care. This doesn’t mean selfishness. It means genuinely looking after the person who, if not travelling well, has the ability to disrupt the whole family.

Just like we should check in and service our motor vehicles, Mum’s need time to reflect and take stock. A mum who is “firing” on all of her mental health “cylinders” uses healthy ways to regulate her emotions and manage her stresses and seeks and provides support from, and to, others. She watches the signs on her own emotional “dashboard” and refills when her “fuel levels” are low. Driving herself by being clear about her signs optimises her mental health, helps her make decisions, keeps her stable in her work and for her family and helps her exercise some sharp parenting skills.

Promoting self care for mums should be more than Mothers’ Day marketing madness. It’s imperative that mothers are supported to have, and maintain, good mental health that stays well clear of subclinical levels of concern.

So, what does a mother need this mother’s day?  Self-care!  She needs to do some basic stuff really well and really consistently and not just on Mothers’ Day.

A mother (or any parent or carer) needs to look after herself every day.  She needs to know how to ask for and accept support. She needs time to check in and make sure that she has balance and that her coping skills are healthy – more laughter, exercise, fun and sharing and less lonely, hard-working, stoic resentment.   She needs to be curious about life, be open to meeting new people and to trying new things. If there is something that is getting in the way, whether it is from the past or in the present, she needs to work on shifting it.

Banish stoic, perfect super mums and their bouncy, sun-filled mother’s day breakfast expectations and bring on healthy, open, warm, vulnerable, human mothers who can give and receive cuddles and have them gladden their hearts without fear that snot or crumbs will mean that there will be even more work to do before she can relax and genuinely “be” with her favourite people.

Mum, do right by yourself and your children and if you feel that your mental health could be wobbly, take time to check in on yourself. Your partner, best friend or even your GP may be great people to start a check in with. You might be surprised at how much they can tell you about yourself and what it is like when you may not be coping.

“Boring!” – Tips to help kids manage boredom

Posted on by Shona Innes
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We’ve all felt the feeling of boredom. For some of us it might have been longer ago than others. Many of us have busy and full lives these days, but some children (and some adults) are more prone to experiencing boredom.

While it is normal to feel bored from time to time, a low tolerance for the feeling of boredom has been associated with a number of concerning outcomes including depression and hostile aggression. Those who are boredom prone are also more likely to procrastinate, feel insecure and more likely value the end product of activity (eg payment for work) rather than extract joy and meaning from the activity itself. Boredom has also been cited as a factor in studies of substance use, internet addiction, dropping out of school and marital issues.

Like most things psychological, a child’s experience of boredom is usually a sum of parts. Some of the parts are outside of the child and have to do with a lack of stimulation in the environment. Other parts are within the child and have to do with tolerance, attention, impulsivity and an ability to create interesting activities for themselves.

When most people experience boredom, they feel it as an unpleasant experience that has low energy and describe it as “unexciting”, “tired” or “depressed”. A smaller number of people experience boredom as unpleasant, but in a high energy way. High energy boredom is usually described as “frustrating” and a precursor for anger.

Whether it’s the high energy or low energy type, boredom is an unpleasant feeling. Indeed, that feeling of unpleasantness could well be boredom’s biggest contribution to our lives. Boredom is a little emotional “blimp” to tell us that there is more that we need to be doing or adding to our lives.

If boredom’s function is to tell us there’s more we need to do, then perhaps we should be explaining boredom’s function to children rather than running around trying to “fix” or cater to their boredom. We need to provide opportunities and guidance to get children to use their boredom as a prompt to getting creative about action.

Different members of your family may have different tolerance to boredom. Also, there will be differences in what each member of your family perceives as being stimulating.   When you are busy, down time can be seen as a luxury.   For your children, however, especially if they have not learned how to manage down time, it might be quite under-stimulating.

Don’t expect a child to “free-range” if they haven’t had enough experience or practice at this before.

There is a growing movement around mindfulness and learning to “sit with” feelings, but don’t expect that your child will be able to sit with feelings if they haven’t had some guidance. Helping your child manage boredom will take a little coaching. Encourage children to recognise and label their boredom and then to decide whether they want to do something with it. Do they want to try to sit with that feeling or do something about it (maybe something other than just complaining to you about the feeling?)

So, some top tips to help children learn to manage or cope with boredom:

  • Provide a choice of activities – don’t give children too many options for what might be available nor give them a blank slate – just a list of viable options.
  • Invest some time in getting the children started on an activity. If it has been awhile since there has been time to fill, they may need help with some momentum. Then once they are rolling along, you can step aside.
  • Make sure you provide some adequate resources. These don’t have to be expensive, nor linked to the internet. Sometimes you need to just get children started on building a cubby out of old sheets, or starting a rock garden outside or cutting out pictures from junk mail to make a book mark. Try to mix up the activities so that your children have more than one source of entertainment in their boredom fighting tool box – try a game of “I Spy” rather than passing your mobile phone to the back seat of the car.
  • If the task that you need to do is inherently dull, provide meaning and make the goal of the activity clear. Be sure that you provide a reason why you want them to do a task that might be boring. “We need to pick up all of these things on the floor so that we have enough space for the next thing we might do”.
  • Also, if a task truly is boring, try to change it up. Try to see if you can turn a dull task into a game (pick up all the things on the floor in rainbow order – red first!) or make up a silly song to sing while you get the job done (ask my youngest about the teeth and shoes song). Boring tasks might earn a raffle ticket for a surprise treat – the more tickets you get in a raffle, the more chance you have to win. Better still, after a few coaching sessions, challenge your children to turn the task into a game or song themselves.
  • Be sure you are matching the activities available to your child to their level. This might be especially important if they are spending the school holidays in the care of someone who does not know them very well and might have too many “bubsy” activities lined up.

     

Boredom, like other feelings, is a sign from our body that something needs doing.  Without it, I wonder if anyone would have done anything creative or new???

Help your children to learn to use the feeling of boredom as a trigger to sit and watch the feeling or to get creative.

Kids and gaming: The all-new family battleground

Posted on by Shona Innes
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I’m sure if you have ever played a computer game or console game you know that they can be great fun and a handy distraction. Like anything fun in the history of humankind, though, there is the potential for life to get out of balance if too much of our time is dedicated to one source of enjoyment. Until they are old enough to curb urges and delay gratification (jobs linked to the brain’s cortex), children need parents to act as their cortex.  Until children fully develop a cortex of their own they need limits set on their exposure to all things that might compete with living a happy and healthy life – they need some limits on gaming time.

In all of the years I have been in clinical and forensic practice with young people, I have never seen a young offender who has been convicted of a violent crime solely because they played too many computer or console games.  Child development is much more complex than that! However there is perhaps a more frequent  or common concerning trend and that is where gaming starts to interrupt a happy, healthy and social life for the individual or their family.

The children I have seen who have developed problematic gaming patterns have usually done so because there’s something else that’s not-quite-right in their life.  Sadly, sometimes there are a many very-not-right things.

Among families who have presented to me with a child (primary, secondary school or uni student age) with gaming issues, there are some common themes.  The children usually declare that they are not being heard or getting a say and sometimes there is a lack of respect or the recognition of needs between family members.

Similar to adults with internet and gaming issues, children can retreat to the gaming sphere to avoid unpleasant feelings or happenings in their lives.

Children retreating to games might be avoiding family conflict or other strong feelings like grief, loneliness, family separation or hurt from bullying, troubles with learning, or lacking a sense of achievement (at school or with friends).

Then, there are the children who just find it hard to comply with requests to turn the game off.  Children will always find it difficult to move from an activity they are enjoying to a less-preferred activity.  Playing a game is way more fun than cleaning your teeth and getting ready for bed.

Some children who are more oppositional will always find it tough and may need additional incentives to keep the household gaming rules and limits.

It is rare (in fact it has never happened in any of my clients) that a child complains about having too much time for gaming. I am loathe to suggest a set dosage rate for gaming time, but I’m happy to suggest it should be negotiated. When talking about limits to gaming, tell the child how their time on the computer affects you and other people.  Depending upon the age of your child, it’s important to assist them to understand their priorities (school work, music, chores, pets, siblings, friends, sleep) and help them to make a balanced decision about how much time would be a healthy amount of time and which days might be best.  Sometimes it can be handy to draw up a simple calendar and purchase a timer.  Younger children may need a timer set – with a five minute warning so they have time to save their advances.

Once you impose restrictions, don’t cave in or make threats – just follow through with regard to the times you have set. There will be most resistance at the start of the limits while they are being tested to see how wobbly they might be.  You will likely here how “unfair” it is, how they are the “only” child who has those limits in their class and how “bored” they will be.  Stick to your plan.  Indeed, think about having, at least, one day free of gaming each week or times where, maybe on holiday, there is a longer computer-game-free zone.

When you are limiting gaming time for your children, be sure you also limit it for the adults in the household as well.  Make sure that when you are with your child, that you are with your child and not just sitting next to them while you play or check messages on your phone or other portable device.

Be firm about computer and console game time and content limits, but be interested in the themes, characters and goals of their games.

Try to find out what it is they love about the game.

Many of the primary aged children I see would love for their parents to play on the games with them or at least to know some of the characters so that they understand why they are excited or disappointed after having played on a game for a time.  Also, if you know what games most interest a child, it becomes easier to suggest a real world equivalent way of pursuing this interest.

Encourage and help children to:
  • build up alternative recreation options
  • meet up with friends face to face
  • share meals – maybe even help to cook
  • get to bed at a good hour
  • take part in family life
  • explore art, books, music or even homework

Computer or console gaming is just one way of millions that everyone can enjoy their free time, but it is no fun when issues about accessing computer and console games become a battleground.  All children need limits and everyone needs balance. Keeping an eye out for things that might be making a child seek out more than usual game time, modelling negotiation and problem solving around accessing games provide the best chance for peaceful solutions.

Shona’s tips

Keep an eye out for the next Big Hug book, “The Internet is Like A Puddle”.  It will be available in Australia from early January 2015. Ask your favourite bookstore.

Parents and Carers  – While it is tempting to use computer games as baby sitters, it is really important that someone responsible looks over the child’s shoulder from time to time while they play.  Set up gaming devices in a more public area in your home.  This also lets you check whether your child is playing “on line”, with strangers or with people that you know.

Teachers – Keep an eye out if a child looks repeatedly sleepy in class or if the content of all of their writing and socialising seems game-themed.   Whilst gaming may often be one of the limited interest sets of a student who has an autism spectrum concerns, if you see a change in the child over time, be sure to feedback what you have noticed to the student’s parents or carers.  Encourage children to spend time in groups that do not necessarily share a gaming interest and encourage their development and involvement in non-gaming activities and themes.

Psychologists and Helpers – It is often the parents who will present a child with internet addiction issues.  It is rare for the young person to acknowledge any problems the first time they are dragged along for a treatment session. Keep an eye out for depression, impulsivity, sensation seeking, social anxiety and attention issues as well as getting a good sense of the family and friendship dynamics.  Kimberly Young and Cristiano Nabuco de Abreu have edited a fabulous book titled “Internet Addiction:  A Handbook Guide to Evaluation and Treatment”  (published by Wiley in 2011) and if you are regularly seeing children or adults with internet or gaming issues, this is a great resource.

Kids – While it is fun to spend lots of time playing games on the computer or console, when people tell you to stop playing, there usually have very good reasons.  Sometimes, it doesn’t feel like you are being listened to when someone tells you that you can’t have anymore of something that you love.  Stay cool.  See if you can make a deal with the adults and then be very careful to keep your side of the deal.  When kids get stuck or bogged on just one area of fun, it can start to take over their lives.  Make sure you exercise all of your “fun muscles”, not just the gaming ones.

How do you know if your child needs psychological help?

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“Your child needs help” they said. “Something is not right with him” they said. “Maybe you should take her to see someone”. That’s all very easy for other people to say, but how do they know? How do you know if your child has a problem and if your child does have a problem? How do you find the best person to help them? Surely it takes more than just “seeing someone”?

How do you know when your child might need help?

Yes, there are some days when we could all use someone to talk to about our worries, fears or problems and children are no exception! In terms of taking your child to see a psychologist, there is a general rule of thumb that can assist. If your child’s problem has persisted for some time and is starting to get in the way of them having a happy and regular life, then it might be time to consider getting them (and you) some extra help.

For a child, a happy and regular life usually means that they sleep, eat, go to kinder/school, have fun with friends, maybe they are involved with a class or group outside of school and generally do what they are told (most of the time). Things that might indicate that something is not right could include trouble regularly attending school, taking far too long and far too many companion toys and glasses of water before going to sleep at night, melting down at the idea of a sleep-over or school camp or suddenly they are not meeting the expected targets with their school work or their behaviour takes a change for the worse. If a child is in danger because of how they feel or what they are doing, your priority should be to get them help straight away.

What does a psychologist do?

A psychologist’s job is to help with emotions, learning and behaviour. Psychologists use scientific research to understand how people think, feel and behave and to help them fix personal problems. They can help to diagnose and treat mental health problems, learning issues or challenging behaviours and relationships. Psychologists can work in hospitals, community health centre, for welfare agencies and in private practice.

To help a child with a problem, a psychologist needs to get to know a lot about the child, their experiences and the situation. They need to ask personal information and keep it confidential. In essence, the practice of good psychology is all much easier to do if the psychologist can make your child feel comfortable and retain professionalism. You and your child and maybe even your child’s school, need to be able to form a good working relationship.

So, how do you find the psychologist who is right for you?

The Australian Health Practitioner Regulations Agency (AHPRA) is responsible for regulating many health professionals in Australia. The Psychology Board of Australia assists AHPRA to regulate the practice of psychology and protect the community by making sure practice guidelines are kept by registered psychologists. Psychologists must be registered with the Psychology Board of Australia to practice psychology (by practice I mean to engage in the art and science of applying the theories of behavioural science to a person’s problem – I don’t mean that they are still working on trying to get it right). If someone is not registered with AHPRA/PBA, then they are not legally allowed to practice psychology in Australia. You can check a psychologist’s registration status, their qualifications and their endorsements (additional qualifications and supervised practice in a certain type of psychology) on the AHPRA website.

Like many professions, psychologists in Australian have a professional body that represents its members’ interests. The Australian Psychological Society (APS) is a group that psychologist can join to help them stay abreast on what is happening in psychology in the country, to assist with keeping up to date with new findings and to lobby the government or other authorities about psychological issues. Members of the APS pay an annual membership.   Membership of the APS is voluntary and psychologists don’t have to be a member of the APS In order to practice psychology in Australia. The APS has a “Find a psychologist” service, but members also have to pay to use this service and there are many psychologists who choose not to use it. The “Find a psychologist” service is largely for private practitioners so it does not tell you about all the psychologist in your area who might be working in a hospital, community health centre or in a school.

Your general practitioner may know the psychologists in your area. Paediatricians and psychiatrists usually have a good idea about the psychologists who work with young people in their area. I always like to think that people could ask their doctor, paediatrician, psychiatrist, school principal or teacher…“If it was your child, which psychologist would you want them to see? “

Better still, call a few psychologists in your area and have a talk with them about what they do and how they do it. You will need to ask about the costs of meeting with a psychologist. Your doctor should be able to tell you whether any rebates apply to psychology fees.

You might also want to ask the psychologist about their qualifications. The qualifications and requirements for being a registered psychologist have changed a bit over the years. There are psychologists who have doctoral or masters level degrees from universities and some psychologists who have gained some of their qualifications from university and from learning in the field. Some psychologists will have additional qualifications and experience in certain areas.

Psychology is a growing profession and the research and information about the most helpful ways to assist others and it is important that a psychologist stay up to date. AHPRA/PBA keeps track of psychologists’ additional qualifications and they also check whether psychologists are keeping their skills up to date.

Shona’s tips

Parents and Carers – Don’t be frightened or put off by suggestions that your child get some help. You know your child. Listen and watch them and spend time with them in the places or at the times when the issues seem to be biggest. If you do decide to see a psychologist for your child, you may want to see the psychologist on your own first. (You’ll need to check whether a session without the child is eligible for any rebates because this is sometimes a tricky area with funding bodies). Seeing the psychologist alone can mean you can talk without little ears hearing your worries. Alternatively, ask the psychologist if you can have some brief time alone with them before the child joins you for each session. If you are still not sure about the type of help that would be best, you can always call Parentline or its equivalent in your State.

Teachers – It helps to encourage a family to engage with a psychologist if you can tactfully explain what you are seeing that concerns you. It can help if you find out a few psychologists in your area that may be able to assist so that the family has less leg work to do to engage with a psychologist.

Psychologists and Helpers – Make sure you take time to welcome young people to your service with an age appropriate greeting. Don’t try too hard to be “hip and jiggy with it”. Children can tell when you are faking it or trying too hard and this can be off-putting. Make sure you have some age-appropriate reading material in the waiting area and also that you have some “things and stuff” to visually demonstrate concepts. Children don’t usually sit down opposite a grown up to talk. Be prepared to take some time to play or engage and explain what is going to happen.

Kids – Seeing a psychologist doesn’t mean that you are looney or crazy. You would probably be surprised to know how many of your friends have seen someone else outside family and school to help them with different problems. You may never know which of your friends is already seeing a psychologist because psychologists are good at keeping that information to themselves. It’s not something they want to blab about. You can find out more about what it might be like to see a psychologist by visiting http://kidshealth.org/kid/feeling/emotion/going_to_therapist.html.

Teenage Girls: Things you should “totally” know

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A biopsychosocial look at mental health during the adolescent years including: Brain development, Identity formation, Risk taking – substance use, self harm, Relationships, Socialising and social media, Counselling, parenting and support. A framework for understanding what might be going on for her.
Shona Innes, Senior Clinical & Forensic Psychologist 499 Hargreaves Street (Corner Myrtle & Hargreaves Sts) Daytime: Saturday 23rd August 11-12.30 or Evening: Wednesday 20th August 6.30-8. Cost: $45. Limited places available. Phone Irene or Alicia 5443 2284 or email admin@bendigopsychology.com.au to secure your place with a payment.

Talking to your child about media coverage of tragedy

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The world is not always a predictable place. Sometimes it can be just cruel and awful. This week, the incident involving the Malaysian Airlines passengers flying above the Ukraine has been a terrible example of the unexpected side of the people of our world. Our special wishes need to be extended to all of those who are some way involved or related to those who lost their lives in the tragedy.

News of such a tragedy usually starts to flood our heads and our homes via screens or over the sound waves.  Often, the updates are accompanied by graphic pictures on the television and in the papers.  Special updates interrupting normal viewing or listening habits. Our conversations and our tones of voice change. So, it is important that we are mindful of our children’s responses to these kinds of events. The way that we react can affect the way that they react and how they learn about the world and coping when tragedies occur.

If your child seems to be upset about it, how do you explain or counsel them when it is truly an atrocity?

Depending on your child’s age and understanding, you may want to explain the known circumstances. For a late primary school child, if they have questions, you may like to get out a map and just briefly (and age appropriately) explain the goings on in the Ukraine – “a place where people are fighting about who should run and make decisions about their country”. The newspapers have some handy diagrams you can use to explain the areas of the world that are involved. Look for reliable and sensible information and screen it first before showing your child.

It might also be handy to explain to your child that whenever their is an awful event, some people who are sad will sometimes get angry or want to blame someone.  You might see or hear some of these people in the news. Sometimes  sad people want answers to their questions.  Some questions have no easy answer or the right answers can take time to get.  it is understandable that people might be upset.  More anger usually doesn’t fix things, but if your child feels angry, help them to express it. They might like to write a letter to someone they think is important or who they think could make thing better in the future.
If your child is sad, in a grieving kind of way, they might like to write about their feelings, draw a picture, light a candle or plant a flower or shrub in the garden. They may need a little extra time at bedtime and a few more hugs.  It is perfectly okay to feel upset by upsetting events.

If your child is anxious, it can be helpful to reassure them about the things that you know. Be sure to explain about the role of news broadcasts in our lives. I like to tell children that the reason news is called “news” is because it’s not something that happens every day. If it was something that happened every day, it would not really be “news”.   We might even have to call it “olds”.  “CHARLIE EATS BREAKFAST” is not a common headline. Charlie eats breakfast every day. It’s not a “news” thing.  It happens everyday. The news reporters like to talk about things that don’t happen very often. The reason these event are news is because it is something that happens, thankfully, very rarely. The chances of it happening are usually very small. While this horrible situation did actually happen, it would be silly and sad to spend time ruining our life with worry about something that happened so rarely.  I also usually say that

“if worry really could help, then I would tell everyone to worry their hearts out”

but worry just tends to make us uptight and upset and we are better to spend that thought space being kind to others and doing nice things.
If your child is truly distressed, it is a really important time to try to make life as predictable as it can be. Try to make bedtimes and meal time’s routine. Do whatever you might normally do. It can be tricky when normal television programming is replaced with scenes of a traumatic incident. If that is happening a lot at your place, maybe switch off the news channels.  It might be a good time to get out a packet of cards or a board game and have a family games night instead of watching the “tele”.

If your child starts to change their behaviour (more fearful, clingy, challenging than usual) over a lengthy period of time they may need some extra help.  Be sure to let your child’s teachers and other carers know that they are not quite themselves.  Talking to your GP is a good place to start.  Your doctor can help you workout if further psychological intervention might be needed.

“Tell Me About Your Childhood”

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Why psychologists want to know and the implications for healthy child development

As the amazing human brain develops, it moves from a pretty primitive state of jumbled up nerve networks, through to a very complex series of coordinated networks over the years. The first networks that come on board start to link our senses to our brains – we can start to see and hear. As we age, our biology and our growing experiences connect pathways and we are able to do things that are more complex – so complex that some of our brains can even master algebra, fly fishing or a baking a sponge cake.

Our brains also start to become more efficient. We start to prune back the pathways we don’t need so that we can become more efficient at what we do. At about age 25, the pathways in our brain are covered in an insulating substance called myelin, which essentially stops messages leaking out on their journey along the pathways and we get even more efficient at the things we practice. Some things even become automatic.
So, as we journey through life, we are taking information into our brain and trying to work out where it should fit. In essence we make a set of rules, core beliefs or schemas upon which we build up our bank of ideas about how the world works and what is going to work best for us. The rules that govern our thoughts, feelings, and behaviours are buried deep within our brain. Each of us has a unique bank of rules because we all started with varying biology and then from the very get go, we all began to experience the world differently.

The things we experience in childhood, and while our brain is still developing, may be pivotal to the ways we choose to cope when a problem comes along.

As we develop through life, we take in new information and either decide to keep the rules we have, alter them, or get rid of the rule completely. If I see a man and make a friendly comment to him one day and he turns away, the way I make sense of his behaviour is likely linked to what I have experienced before. If I have experienced a lot of rejection, then I may not think much of his reaction. If I have had lots of acceptance before, then I might find his reaction odd. If the man is wearing a hearing aide, I might decide that he may not have understood me and I might try again. The ways I interpret the other person’s reaction will depend on my past experiences of other people in similar situations. What I do, think and feel next will also be determined by how I have automatically interpreted his behaviour in my brain.

This is just one little scenario – imagine a lifetime of scenarios built up in our brains!

If we face a problem and we do, think or feel something that takes that problem away or makes it more bearable, then we will remember what works and keep it for next time. If a rule is never tested, then it’s likely that it never gets adjusted to fit our new circumstances. If I was frightened by a dog once and then avoid dogs for many, many years then it’s likely that my rule that “dogs are frightening” will stay because it has never been tested.

The other problem we might face is that we come across a situation where we have become quite set in our ways. Sometimes, we get a problem and none of our past rules seem to work, but we might still keep on using them anyway. It could be that we are lonely and we have a rule that tells us not to approach new friends because we worry that they will be mean to us. Making change takes effort and insight. If we keep doing something that doesn’t work, then there’s usually a reason behind that, too – it may not be obvious but it might be buried in our pile of rules way down deep.
So, when a psychologist wants to know a little bit about your past, the psychologist is looking for some of the most important events that occurred in your life as these are the ones that will likely have left you with your strongest core beliefs. If your core beliefs and the automatic thoughts they lead you to generate are working for you, then life should be sweet. Some of the rules we laid down very early in our childhood may not have been tested for some time. If you have some core beliefs that are built on some faulty or out-dated logic, then it might be time to run a system’s upgrade.

Problems can be great opportunities to consider our core rules, think about an update for our beliefs, readjust our networks, and learn.

As parents, carers, teachers and therapists, it’s important that when a child has problems, we encourage them to problem solve, to think about the advantages and disadvantages of what has worked or not worked before. Some children will do this automatically and some, for various reasons of biology and experience, may need more help. There are very few absolutes in life, so we need to be sure that we promote flexible thinking in children. What we model and say, the things we celebrate, and the kinds of achievements we praise can all assist a more flexible and adaptive system of responding to the inevitable ups and downs life brings us.

Shona’s tips

Parents and Carers – Listen to your own thoughts and see what beliefs you keep telling yourself. Be especially vigilant when you feel a strong emotion rise in your belly – this is usually a sure sign that a core belief has been activated deep inside your brain. Some of the core thoughts might relate to your parenting and why you come down so hard on your children for some things, but turn a blind eye to others. You might find this worksheet by CCI a handy reference for identifying and working on your more troublesome thoughts.

Teachers – Keep an ear out for the core beliefs that children may have with respect to their learning. You might hear them out loud when you suggest a new task or give them feedback on a test. Some students may be stuck in a faulty belief system that tells them that they are not a good learner – “I suck at maths” or “I’m no good at sport”. Encourage children to gently test their beliefs with safe and well-thought-through challenges to their automatic thinking.

Psychologists and Helpers – Some of you may have some core beliefs that stop you from being as helpful as you might be. If you think you have some thoughts interrupting your process of therapy with a client, be sure to speak about them the next time you have supervision or a peer consultation. You may need to work on a plan to make sure that any faulty thoughts that you have about yourself as a clinician or helper are highlighted for some gentle work.

Kids – When you get a strong feeling in your body, check in with what your brain is saying. You might want to write it down, draw it or share it with someone. Don’t worry if you can’t do it at first – it’s a little bit like trying to chase a butterfly. Sometimes thoughts just flit in and out really quickly, but the important ones tend to hang around for awhile.