Friday, August 28, 2015

How to Get Back on Track When You’ve Lost Your Motivation

When your “get up and go” has “got up and left,” when there’s no more “pep” left in your step, sometimes the best thing you can do is just stop trying for a while.
Moving forward feels great, but movement takes energy. When’s the last time you took a break without feeling guilty?
If you dislike the idea of resting, it might help to know that it’s a productive and appropriate project that could help you get your groove back.
Having said that, maybe you don’t have the option of sitting around doing nothing. Somehow, you’ve got to find or create the motivation to get moving again, regardless of how stuck you feel.
That’s when it’s time to do two things.
The first is to remind yourself of your own agency. No matter how helpless you may feel at a time like this, no matter what challenges you face, you have control over the little things in your life.
You’re the only one who gets to decide whether to brush your teeth, rinse out that empty yogurt container, or sweep up that debris on the floor near the front door.
When life won’t give up its rewards to you, you can still reward yourself with clean hair, a timeout, or—here’s a novel idea—a carrot. (Make it a baby carrot with peanut butter; you need the nutrients.)
Losing motivation creates a sense of powerlessness, not to mention a lack of direction and purpose. It casts a spell that makes you forget your autonomy. But total powerlessness is most often an illusion.
Who else makes those moment-to-moment decisions about whether to wash a dish, darn a sock, or do a push-up?
When you feel paralyzed by obstacles like apathy, low energy, or indecision, taking small, unrelated actions can rev that idling engine.
The best activities are simple acts of grooming and household management.
Sprucing up your résumé and applying for jobs on the Internet is not a small action; don’t ask yourself to do that before you have some wins under your belt in the form of clipped nails, a tidy drawer, or a changed light bulb.
Once you inspire yourself by being proactive in smaller tasks, you’ll be better able to roll up your sleeves and do some heavy lifting on the bigger stuff.
The second thing to do if you’ve lost your mojo is to follow these three, simple words: Just start it. I remember an instructor in graduate school telling us that if you simply begin to do a task, motivation kicks in within 10 seconds.
You read that right: 10 seconds may be all it takes to shift from “I don’t want to do it” to “I’m already doing it, so I might as well continue.”
Let’s say, for example, you’re trying to get yourself to go to the gym. Get up right now and gather your workout clothes and/or shoes. Fill a water bottle or do whatever it takes to prep for a trip to the gym.
You’re far more likely to follow through and actually go if you start doing anything related to your goal.
Between these two tools—inspiring yourself through small actions or committing to just 10 seconds of activity—you’ll be able to make more progress than you would by sitting there berating yourself for being stuck.
Loss of motivation can be a symptom of depression. If your condition becomes entrenched, please consider speaking with a counselor or other mental health professional.

© Copyright 2015 by Tina Gilbertson, MA, LPC, therapist in Portland, OR. All Rights Reserved.
Originally posted on GoodTherapy.org.

What If Your Emotions Are In Fact Perfectly Rational?

I have a healthy concern for many people’s view of emotion. This view suggests that emotion means being irrational, negative, out of control, subject to the whims of others who “make” us feel things, and holds that being emotional is generally a sign of weakness or abnormality.
Being a professional counselor affords me a unique position from which to view the dangerous byproducts of this view. I’d like to start the process of reframing emotion and putting it into a healthier context that allows us to learn and grow.
What I’ll tackle first is the eons-old disparagement that emotions are irrational and therefore inferior to intellect. This argument states that emotions have no reason within them at all and that, because of this, an emotional person loses control. Furthermore, the thinking goes, the way to regain one’s composure and control is to push away or get rid of emotions as fast as possible.
Suffice it to say this belief stems from a practice of demonizing the body and our baser instincts. What this view does get right is that our bodies are storehouses for powerful energies. Left unchecked and ignored, these energies can turn into juggernauts that can destroy and create chaos. The key point to recognize here is that these powerful energies get built up through a willful practice of emotional self-denial and from not realizing the true sources of our emotions.
Seen from a healthier vantage point, we begin to see the truth that emotions come from and are energetic expressions of our beliefs. Although it can take considerable time and effort to discover this truth, effective counseling or psychotherapy and meditative techniques are designed for just this sort of discovery. Myriad techniques work toward helping us create space between our thoughts and our reactions to them.
An example helps here. Let’s say you react strongly to people who frown at you. Every time you notice someone frowning around you, you assume it means he or she doesn’t like you or disapproves of something you did or said. This, in turn, causes you to feel ashamed or anxious. Notice that the belief you have creates your emotions. Because of your possible (if not probable) misinterpretation of the other person’s behavior, you stay in a semi-constant emotional state of anxiety and shame.
Now imagine that, rather than personalizing other people’s facial expressions, you develop an attitude of curiosity. With this curiosity, you can do many things. One thing you might do is, much like bird watching, set a goal of noticing as many frowning faces as you can. What would you feel now? Perhaps interest, perhaps amusement, perhaps even happiness if you beat yesterday’s record.
Taking this curiosity one step further, imagine you generally wanted to know why the person is frowning. Instead of anxiously staying in your head, mind-reading and creating a story that may not be true, you become inquisitive and talk to the person. You discover that he or she lost a job, forgot where he or she parked, or something else that has absolutely nothing to do with you. Because you let go of the perspective that everyone is judging you and embraced curiosity instead, you connect with someone. Now you feel close, empathetic, and connected.
Emotions are actually very rational, as they spawn directly from our belief systems and attitudes. Put differently, emotions are logical and reasonable extensions of our beliefs. The issue lies in not being mindful of our beliefs. When we aren’t being mindful of our beliefs, the emotions seem to pop from out of nowhere or seem to be caused from the outside. Knowing that our thinking creates emotion puts us on a path toward taking control of our lives.
© Copyright 2015 by Joshua Nash, LPC-S, therapist in Austin, TX. All Rights Reserved.

Originally posted on GoodTherapy.org.

The Expectation Trap: How Wanting Is Making You Angry

In my articles on anger management, I frequently talk about how anger gets disguised as another emotion. Conversely, I also emphasize the reverse: other emotions left unnoticed and unacknowledged can turn into anger. In this article, I offer no disguises, no cover-ups. Witness instead a direct creator and perpetrator of anger.
I expect things. So do you, and so does everyone else. These expectations encompass virtually everything we conceive. We expect things about our bodies and minds, other people (along with their bodies and minds), our jobs, our pets, the sun and moon. If I sound a bit hyperbolic, it’s because I mean to emphasize this: the vast majority of the thoughts we have throughout any given day are comprised of expectations. And with these expectations—every single one of them—we create frustration, irritation, and anger.
An expectation, put in the simplest of terms, is a thought about the way we want something to be. Expectations can range from the obvious form of “I really want to get that job” to more subtle expressions that hardly go noticed, like heavy sighing or rolling one’s eyes. Regardless of what form an expectation takes, it ushers in personalized judgment about the way we think the world should be.
Expectations trap us when we cannot see past them. When we lead with them and then meet up with something very different from our particular desire, anger is typically the result. At its core, anger expresses dissatisfaction with reality. All the different words for anger apply here: irritation, frustration, annoyance, being “miffed,” etc. The intensity of our anger is often directly correlated to the level of attachment we have to our expectations of reality.
It might seem as if I’ve made expectations out to be truly heinous. Usually at this point, a person I’m working with in therapy might say something like, “Well, then, I suppose I should have no expectations at all? Just have no standards?” On the contrary! Standards dictate our commitment, connection, and drive for excellence. What I shop here isn’t an end to expectations, but a renegotiation with them.
Expectations in and of themselves are actually harmless. They can be viewed from the perspective of expressing personal tastes and preferences. Expectations get the better of us only when they become rigid barriers keeping us from flexibly working with what life hands us. Toward a more functional use of expectations, I offer the use of what I call basic requirements.
Basic requirements express the base-level necessities that must be met for us to continue cultivating a relationship with another person, a job, a lifestyle, etc. Whereas expectations get used as billy clubs to bash over the head of a reality that doesn’t meet our desires, basic requirements take a more open stance. They state that certain things will need to be in place in order for the relationship to continue—for example, respect and trust in a committed romantic relationship. If for some reason the basic requirement isn’t met, both parties may move on.
The reason expectations so often create anger is we stubbornly keep insisting that the thing in question be different, be what we want. Basic requirements free us from this trap. Instead of staying locked in a constant struggle to get an experience from someone or something that just can’t supply it, we take our basic requirements elsewhere. We relieve ourselves of the need to be constantly angry, because we no longer resist the truth that X can’t give us Y.
Notice that attachment is the real culprit here. Basic requirements express how we want the world to be. Attachment keeps us locked in struggle. Freeing ourselves from chronic anger becomes easier and easier when we let ourselves move on from no-win situations.
© Copyright 2015 by Joshua Nash, LPC-S, therapist in Austin, TX. All Rights Reserved.

Originally posted on GoodTherapy.org.

After Divorce: When Children Resist Seeing One Parent

Amid or following divorce or separation, some families face the issue of one or more children refusing to be in contact with one of the parents. While the dynamics of any family experiencing this can be quite complicated, children may behave in this way for a variety of reasons.
Here are some examples (for the purposes of this article, one parent is referred to as the preferred parent, the other the resisted parent):
  • There may be conflict between the parents, and the child does not want to remain caught in the middle.
  • The child may have been closer to one parent than the other when everyone lived together.
  • The child may be in a developmental phase where alignment with one parent over the other is age- and/or gender-related.
  • One parent may be involved with a new partner before the child is ready and/or comfortable with the situation.
  • The preferred parent is more financially secure or otherwise stable than the resisted parent.
  • The child chooses who he or she believes most needs to be taken care of based on the circumstances.
  • There is ongoing litigation (even if the children do not know the details, they often see the effects of the stress).
  • Both the preferred parent and the child believe the resisted parent is not safe.
In these situations, it is often the favored parent’s belief that the resisted parent caused the resistance; meanwhile, the resisted parent often believes that the favored parent is responsible for the child’s refusal to see him or her. While either of these scenarios can certainly be the case, families are complicated systems in which many behaviors and relationships impact what everyone experiences.
There are two important options, which are not mutually exclusive, to consider here: (1) Improve both the favored and resisted parents’ relationships with the child, or (2) improve the co-parenting relationship. As complicated as the family system may be, individual relationships within the system can be addressed. Both parents have responsibility for their part in the family dynamic, including the favored parent.
The favored parent may have a difficult time seeing or appreciating how he or she responded when the child did not want to see the other parent. When a child tells you about something negative that happened with the other parent, for example, it can feel natural to sympathize with the child and build a case against or undermine the connection between the child and the resisted parent. This isn’t fair to the other parent or the child. When a child provides negative information, contacting the other parent and asking what he or she knows about it is a good place to start. Secondly, it’s important to help your child understand that he or she can talk to the other parent about it and not have you be his or her voice.
The resisted parent, of course, has an important role to play in the relationship with the child and in behaving in a way that is inviting. Children who resist a parent sometimes feel the expression of affection, for example, as intrusive. It can be expressed, however, without the expectation of reciprocation. This gives the child room to make a choice. It sometimes happens, with time, that the child begins to respond. It is important that the resisted parent let the child know he or she is loved, without conditions.
There are many more ways for both the resisted parent and the preferred parent to alter their behaviors with the goal of improving the relationships between children and parents. The most important is to improve the co-parenting relationship. When children can see their parents having civil and respectful interactions and making it a mutual priority to offer safety, this often leads to a relaxation of the need to push one parent away.
If a child in your family is resistant toward one parent and your co-parenting strategies have been ineffective, contact a therapist in your area for help.
© Copyright 2015 by Shendl Tuchman, PsyD, therapist in San Ramon, CA. All Rights Reserved.

Originally posted on GoodTherapy.org.

When Your Partner’s Opposites Aren’t So Attractive Anymore

There’s a reason you and your partner can’t agree. It’s because you started out as opposites. And opposites attract. So annoying, right? But you are in excellent company because opposites attracted long before the human species got here.
It turns out that Einstein’s theory of relativity is built on it, and if you remember your high school science, electrons and protons whoosh right into each other. In the animal kingdom, opposite-ness has the survival value of creating a diverse set of genes.
But among humans, the problem gets a bit complex when the very qualities that attracted us in the first place are the ones we now find highly irritating.
In the world of corporate America, it is well known that people work well together when they are similar in outlook and disposition. If we merely choose people we can get along with, we tend to choose similar ones. But if we choose those we are attracted to, then our unconscious tends to kick in and lead us down paths we probably wouldn’t take if only we knew (consciously) we were doing it. Often, those paths lead to our opposites.
Then again, attraction is hardwired into the animal kingdom, so it must have a positive purpose. What could that possibly be? Back in 1967, Henry V. Dicks had a theory about this (Whitehouse, 1981). According to his view, we are attracted to someone who has a quality we don’t have because that quality was a part of our personality when we were children. At some point, it was attacked or rejected by our parents. So we also rejected it, but at the same time missed it.
Because the quality was put down, we don’t care for it. But because the quality was a part of us at one time, it is still attractive. So, we now have ambivalence about that quality. In a 1981 study of 30 people, it turned out that the annoying quality was an exaggeration of the very quality the person was originally attracted to, supporting Dicks’ theory.
So, for example, if a person was attracted to someone who was outgoing, years later the complaint might be that the object of attraction socializes too much and doesn’t pay enough attention to the person.
This is an interesting psychoanalytic approach. Here’s mine: We are here on Earth to learn and grow. We reach for the stars. That is hardwired into us. That part of us that wants to expand our horizons naturally would be attracted to people who have qualities we don’t have. Yet, we of course get along best with people whose outlook and style are more similar to ours. We are pulled in both directions. I think it’s as simple as that.
What if you find yourself in exactly that situation right now? You are in a relationship with someone who seems to be your polar opposite. You are a saver; the other person is a spender. You like to travel; your soulmate likes to stay home. You feel that a comfortable home is a tidy one; your significant other feels home is where it’s most relaxed. You prefer time alone together; your mate wants to socialize. What do you do? How do you resolve these sorts of things without giving up who you are?

Step 1: Get the Magic Back

Without the magic you once had, all the discussions in the world may be of no avail. There was a time when you counted the minutes to being together. There was a time when the list of things above would have been petty in your eyes.
Do something fun, exciting, romantic, and then do something else that’s wild and happy.
The magic comes when you put the whole person into perspective. You used to love something deep and undefinable about that person; now it’s time to reach for that something again.

Step 2: Take a Look Inside

Use the ideas presented above to look at yourself. What is it that you wanted in this other person? What is it about you that is missing that thing? How did that happen? How did you come to find it attractive in your partner?
A little soul searching may help you remember that you had a reason—a good reason—to be attracted to this person. There was, indeed, something about him or her that completed you, even if you were not consciously aware of it at the time.

Step 3: Cherish That Quality

You were once attracted to that quality, so now is not the time to reject it. Cherish it.
True, it may need some refining. We were all put here to grow, and that includes not only you but your friends and relatives as well. By being in contact with one another, each of us can grow.
But the best possible climate for growth comes from acceptance, not rejection. If Dicks’ theory is correct, then plainly we see that rejection by our parents did not help us grow. Take responsibility for the fact you chose this partner.

Step 4: Say What You Need

If you have done all of this introspection and recognize where the attraction came from for this now-annoying quality, and it is still intolerable, speak up! But do it with love.
So many people think that being assertive is the same as being harsh, demanding, and autocratic. That’s the furthest thing from the truth. The reality is that an assertive response is one that doesn’t beat around the bush but doesn’t say it with anger, either. Although you may be annoyed, do some deep breathing and let go of the bad feelings.

Step 5: Figure Out a Solution Together

The beauty of relationships is that so much can be accomplished by putting your head together with someone else’s. Almost every problem really does have a solution. Enjoy the teamwork and the renewed sense of closeness it fosters.
And if you need a little nudge or guidance in the right direction, contact a qualified therapist.
Reference:
Whitehouse, J. (1981). The role of the initial attracting quality in marriage: Virtues and vices. Journal of Marital and Family Therapy7(1), 61-67.
© Copyright 2015 by Deb Hirschhorn, PhD, therapist in Far Rockaway, NY. All Rights Reserved.

Originally posted on GoodTherapy.org.

Just Say No? A Guide to Setting Limits with Your Child

It’s a commonly held belief that while our parents’ generation failed to pay enough attention to our thoughts and feelings as children, our generation cares too much about our children’s thoughts and feelings. While this is certainly an over-generalization, I believe it reflects an important reality: Parents today have difficulty setting limits and saying “no” to their kids.
This does not mean we should stop listening to our children. Rather, the key to effective limit setting is finding a balance between being firm, on the one hand, and giving our children some control on the other. If we can identify what our children are capable of, hold onto the limits we know to be important, compromise on those we don’t, and include our children in the process when appropriate, the limit setting process can be (if not exactly fun) quite manageable.
To illustrate this point, I would like to start by describing some limit setting dilemmas a few parents with whom I have worked have faced, and a parenting moment of my own (lest anyone think I am suggesting this limit setting stuff is easy). I have changed the names and details for confidentiality purposes.
Sleepless Sally: Dan and Mary attended a limit setting workshop I gave because their 2-year-old, Sally, was not listening to them. When I asked Dan and Mary about their approach to limit setting, they explained that they never used the word “no” with Sally because it was too negative. Instead, they would try to explain the reason for the limit in a more positive tone. For example, when Sally refused to get ready for bed (a frequent occurrence), they would tell her, “You need your sleep. Aren’t you tired yet? It’s important to get enough sleep.” When I asked them what they would do if Sally started to run into the street by herself, they responded, “Sally, why don’t you stay with Mommy and Daddy?” They knew their approach wasn’t working, but did not know how to fix it.
Trampoline Thomas: Another parent, Karen, who consulted with me about her 5-year-old son, Thomas, explained that Thomas did not respect the limits she tried to set. Karen was particularly upset over a recent visit to a friend’s house. Her friend had a trampoline, which Thomas absolutely loved. Thomas loved it so much, in fact, that he refused to stay at the kitchen table during dinner, instead leaving the table to go on the trampoline. Karen tried to dissuade Thomas from going to the trampoline during dinner, but couldn’t seem to figure out how to get him to stay. After a few nights of unsuccessfully trying, Karen decided to set a consequence for Thomas: If he got up from the table and went to the trampoline during dinner, he could not play on the trampoline at all the next day. Despite Karen’s warning, at the next dinner Thomas got up and went to the trampoline. The next day, Thomas was not allowed on the trampoline, but that night at dinner, he did the same thing again. When I heard this story, I was surprised; I would have thought a day without the trampoline would have been enough to get Thomas to change his tune. As I inquired more about the consequence and its implementation, however, Karen sheepishly admitted that not only had Thomas been prohibited from using the trampoline, but everyone had been disallowed from using it, lest Thomas feel badly about being left out!
Reserved Rachel: While my daughter, Rachel, had always been rather reserved, it wasn’t until she was 9 years old that my husband and I really took in the fact she was not saying hello to anyone in our building (or in public), even if they greeted her first. Pointing out to Rachel that this was rude or that others might not like her did not seem to help, nor did setting consequences or rewards. We were really at a loss.
I recount these stories not to show how lousy these parents and I are at parenting. We aren’t. In fact, we are all loving, caring parents who really just want to figure out how best to support and help our children. Frankly, all parents try things with their kids that don’t work. Rather, I want to use these stories to highlight how complicated limit setting can be and to point out some of the important questions we need to ask ourselves as we go about the job of figuring out how to set limits with our kids. These questions include:
  1. Why are limits important?
  2. How do I know when limits are appropriate?
  3. How do I enforce limits?
  4. When and how should I use consequences?
  5. When and how should I use incentives?

1. Why Are Limits Important?

Sometimes, amid the battle of limit setting, we feel like giving up and giving in. At these times, it can be helpful to remind ourselves why we need to stick with it. And here’s why:
Limits help children feel safe, physically and emotionally: It may seem like our children hate us when we tell them what (not) to do, but unconsciously (and sometimes even consciously), children often have their fingers crossed that we will take charge. Why? Because they don’t have total control over themselves and this is scary for them! Until they learn self-control, which happens slowly over the years, our children rely on us to provide that structure and control. In fact, it is partly how they learn self-control, by internalizing the structures and limits we provide them. It is how they feel safe.
For example, if a 2-year-old is doing something dangerous (like running out into the street), the parent must act quickly (“No!” is great for dangerous situations). Two-year-olds do not have the impulse control or reasoning skills to assess danger on their own. They need to be taught to be cautious and wary of certain situations.
Limits teach children how to regulate their different needs (hunger, tiredness, transitions, etc.):Children need to learn how to listen to their bodies and respond appropriately. This is not something that comes easily or quickly. By having routines and limits for our children, we are helping to regulate our children in ways they are not yet capable of. We are also modeling for them the importance of listening to one’s body and needs.
Perhaps because of our determination not to make the same mistakes our parents made with us and/or because of all the research showing us how smart and capable our children are from very young, parents today often assume that our children are able to regulate their needs on their own, much as adults do. However, this is typically not the case. Learning to self-regulate is a process that happens over many years; it is a developmental task that can’t be rushed. At any given moment in time, we need to figure out what our children are capable of and not ask more from them.
For example, understanding the importance of sleep and being able to choose one’s bedtime is something that Sally, at 2, is simply not capable of. She does not have the cognitive capacity to understand the importance of sleep, delay gratification, or regulate her tiredness and activity level.
Limits teach children important social skills (turn taking, being polite): I am a big believer in allowing children to feel whatever it is they feel, no matter how difficult it may be for them or their parents to handle. However, feeling something and acting on it are two very different things. While a 1-year-old may not be capable of distinguishing between the two, a 5-year-old certainly is.
Thomas, for example, is probably capable of sitting at the dinner table for a reasonable amount of time, assuming he is developmentally more or less on track. At some point, trying to understand why Thomas has trouble sitting at the table will be helpful, but understanding is not a substitute for setting the limit.
Rachel, after much discussion, agreed to work on greetings through role-playing with my husband and me. Rachel also suggested that she would try to make eye contact and smile and/or wave to people so that they would not think she was rude. We all agreed on a system for carrying this out. Carried out with starts and fits over time, these solutions helped Rachel feel more comfortable interacting with the outside world.
Parents are one of the primary carriers of culture for our children in these early years. It is our responsibility to teach our children how to be in the world in a way that won’t annoy everyone else. Introducing some of the social graces—sitting at the dinner table, taking turns, greetings, thank yous, etc.—and limiting the no-nos—hitting, biting, grabbing, etc.—is an important part of that job.
Limits help children build self-esteem: When children are able to predict and meet our expectations, they feel more competent. As children learn through our limits how to regulate their needs, handle their feelings, and function effectively in the outside word, they become more confident. However, when we expect too much of them, the opposite can happen; kids can become very frustrated and disappointed in themselves. This brings us to our next question …

2. How Do I Know When Limits Are Appropriate?

I would argue that limits are appropriate when they reflect an understanding of what your child is capable of developmentally, reflect an understanding of your child’s unique needs, and take your (the parents’) needs and preferences into consideration.
One of the problems that Dan and Mary faced with Sally was that they didn’t seem confident about how much sleep she needed. Although it can be hard to know how much sleep an individual child needs, there is a range that is commonly accepted (which you can readily find online). After we discussed this range together, Dan and Mary, through trial and error over a few weeks, were able to figure out how much sleep Sally needed. Feeling more confident about how much sleep Sally needed then made it easier for Dan and Mary to enforce her bedtime. Having a consistent bedtime helped Sally get the sleep her body needed and helped her begin to learn how to self-regulate her own tiredness.
Another reason setting limits is important is that it helps you take care of yourself. For example, having a consistent, reasonably timed bedtime for your child usually gives you some much-needed down time—time to relax, catch up with your partner, and recharge a bit before you face another day of parenting. This benefits not only you, but your child as well. A parent who takes care of himself or herself is generally a happier, more patient parent.
Lastly, when deciding which limits to set, try not to sweat the small stuff. If allowing your child to watch an additional 15 minutes of television gives him or her a sense of agency and you a much-needed break, why not? As long as the 15 minutes doesn’t turn into two hours, being flexible within your structure gives your child the message that you are willing to take his or her wants and needs into consideration, but that when you set a firm limit, there is a reason for it. My experience is that children tend to respect limits more when there is some flexibility on the stuff that is not as important.

3. How Do I Enforce Limits?

When setting limits, I recommend keeping the following in mind:
  • Be clear (with yourself and child) about why you are setting this limit.
  • Be clear with how you are setting this limit.
  • Be firm; don’t turn back!
  • Less is more.
  • Separate feelings from behaviors.
Before setting a limit, you need to be confident about why you are setting it. Kids of all ages pick up on doubt. If you start to waver, you are going to have a much harder time setting the limit. When explaining a limit, less is definitely more. With Sally, age 2, “it is time for sleep” is about all she can handle. Said with confidence, Sally will understand the importance of this limit, even if she goes to bed kicking and screaming.
With a child like Thomas, age 5, a longer explanation can be offered, preferably ahead of time rather than in the moment, something in the realm of, “During dinner, you need to sit at the table with everyone else.” “You are not allowed on the trampoline during dinner; it is not safe.” “If you leave the table tonight, you will not be able to use the trampoline at all tomorrow,” or some variation thereof. If your child has questions about the limit you’re setting, feel free to explore, but when it starts to feel repetitive and unproductive, I would suggest ending the conversation with something like, “I’m sorry you feel that way, but this is how it is going to be.”
With Thomas, it might even be possible to discuss what is going on for him, what he is feeling, and why he doesn’t want to sit at the dinner table. Perhaps there is something specific that is bothering him. More generally, in setting limits with a 5-year-old, it is often a good idea to ask him or her which limits he/she thinks are appropriate. Interestingly, children often come up with harsher limits than we do and are more likely to follow limits that they have helped set. Of course, if it feels like your child is playing a game of what-I-can-get-away-with, this is not the route to go.
With Rachel, age 9, I believe that one of the reasons she was able to follow through on the agreed-upon strategy was that she had helped come up with the alternatives (eye contact, smile, and waving) herself. Children tend to respond better to limits when they feel like they have some control, no matter how small that control is.
Of course, once you’ve set your limit, you need to enforce it. If you are not able to follow through, it obviously gets harder to enforce. However, even if you have had difficulty in the past, it is never too late to start to enforce a limit. A quick heads-up to your child about the change may be useful in advance. “I know I have been letting you get up from the dinner table the past few nights, but tonight is going to be different …” Your child may very well test you for a few nights, but if you are firm, you should be able to get back on track relatively quickly.
Checking in with yourself as to why you are having difficulty enforcing the limit is a good place to start. One reason some parents have difficulty enforcing their limits is because of what I call the “empathy trap.” When our children are upset, we feel badly for them and want to empathize with them, and it is important that we do. But when their being upset is connected with a misbehavior or refusal to comply with a limit, we need to be able to separate our children’s behavior from their feelings so that we can effectively set the necessary limit. I generally recommend a simple statement of empathy followed by a limit. With Sally, it might mean a sympathetic, “Aww, I know it’s hard,” as you carry her off to bed. With Thomas leaving the table, I might say something like, “I know it is hard for you to sit at the table, but dinner is not over yet.” With Rachel it was, “I know how hard it is for you to greet people in our building, but it is important that you not appear rude.”
Later, when the limit setting moment has passed, you might talk to your child about his or her feelings connected with the (mis)behavior, either through direct conversation (as with Thomas or Rachel) or, for younger children such as Sally, through reading a relevant, age-appropriate book (e.g. on bedtime) or through making a simple observation such as, “Sometimes children get angry at their mommy and daddy when they make them go to bed.” We want to validate all our children’s feelings, but not all their behaviors.

4. When and How Should I Use Consequences?

Sometimes you can set a limit and not have to give consequences. Phew! For those times when limits alone seem not to be working, however, consequences can be very effective. Of course, setting consequences is not always easy. One of the difficulties parents face in setting consequences is that they worry that they will have to keep enforcing the consequence over and over again, which can feel too punishing and depriving, or feel like too much work. However, if consequences are chosen wisely, enforcing them just a few times is often enough to deter the continuation of the misbehavior without being overly punitive.
The key to effective consequences is finding ones that are realistic in terms of age-appropriateness and practicality, relevant to the behavior you are limiting, and are something you have the means and wherewithal to follow through on. In the example with Thomas, Karen was able to pick a consequence that was realistic insofar as it was developmentally appropriate and seemingly practical and relevant insofar as it involved the trampoline, but she didn’t seem to have the wherewithal or confidence to follow through. She simply could not tolerate the idea of Thomas being left out.
One consequence that is particularly controversial among parents and parenting experts is the timeout. There are probably as many opinions about timeouts as there are parents and experts, so my opinion should be taken as just that, an opinion. It is my belief that timeouts should primarily be used for when a child is in some way out of control—temper tantrums, disrupting a gathering, biting, hitting, or threatening another, etc. The main point of a timeout should be to help the child feel more in control of his or her behavior. In this view, timeouts are less about punishment and more about removing the child from a troublesome or volatile situation.
Regardless of why you give your child timeouts, however, it is important that you do so in a way that is effective. Ideally, your child would be able to be in his or her room or crib until he or she calms down or for however long you have designated the timeout. Depending on the situation, you might choose to be right outside the door to let him or her know you are there (without a lot of discussion or engagement), but this does not mean being in the room with your child. That is called having Mommy or Daddy to myself. Sometimes parents have their child sit on a chair quietly for a few minutes. This is fine as long as the child experiences it as in some ways calming or, if you are using it as a punishment, somewhat negative. The goal with timeouts, like other consequences, is to motivate the child to not do the behavior again and/or to help the child regroup and calm down.

5. When and How Do I Use Incentives?

Sometimes there are behaviors that don’t seem consequence-worthy but need limits, such as getting ready in the morning, getting ready for bed, cleaning your room, etc. In his wonderful book on limit setting, 1-2-3 Magic, Dr. Thomas Phelan calls these behaviors “start behaviors.” These are behaviors that you want your child to do (rather than not do) and generally require more participation from your child than “stop” behaviors.
One of the techniques that Dr. Phelan recommends for incentivizing these behaviors is “positive reinforcement” (or as some of us prefer to call them, “bribes”). Stickers, treats, etc., are great for these behaviors and help get you and your child out of battle mode. Just be sure to pick a reward that is age-appropriate (a 2-year-old simply cannot wait a whole week for her reward) and is sustainable over the medium- to long term—e.g. a few graham crackers versus a lollipop every day.
Again, as much as possible, involve your child. Even a 2-year-old can decide whether she wants graham crackers or Goldfish for her reward; she will feel more in control and is more likely to comply with your limits. Some parents lament that they will end up having to bribe their child indefinitely, but it is my experience that for most behaviors, once the behavior becomes routine, the reward is less important and eventually can be discontinued or modified if you so choose.

Conclusion

Limit setting is not for the fainthearted (though neither is having children!), and a lot of figuring out what works is through trial and error and being open to considering other approaches. If you maintain an open attitude to learning about your child’s capabilities and needs and set limits that are realistic, age-appropriate, and that allow for some input from your child when warranted, you will most likely find that the job of limit setting gets easier and easier as time goes by (well, at least until your child turns 13—EEK!).
© Copyright 2015 by Ruth Wyatt, MA, LCSW, therapist in New York, NY. All Rights Reserved.
Originally posted on GoodTherapy.org.

Tuesday, August 18, 2015

5 Common Misconceptions About Marriage and Family Therapists

#1 We Only Work With Marriages and Families

This is not true. Marriage and family therapists have unique training and conceptualize problems in a relational context or, in other words, they consider your significant relationships. Marriage and family therapists are qualified to treat individuals, couples, families, children, groups, etc. We just treat them from a family systems perspective.

#2 MFTs Only Work in Private Practices

False! Marriage and family therapists work in many different settings including:
  • Business consulting
  • Churches
  • Community mental health centers
  • Courts
  • Employee assistance programs
  • Hospitals
  • Inpatient facilities
  • Prisons
  • Private practice
  • Research centers
  • Schools
  • Social service agencies
  • Universities
I am sure there are even more out there. Marriage and family therapists practice in a wide range of environments.

#3 Marriage and Family Therapy is Just a Specialization

This one is not true either. According to the American Association of Marriage and Family Therapists, the US Federal government considers marriage and family therapy to be one of the five core mental health professions. The others are psychiatry, psychology, social work, and psychiatric nursing. Each is considered to be a separate field with a unique treatment approach.

#4 Anyone Who Works with Couples or Families is a MFT

Wrong again. There are many different approaches to working with families and other mental health professions treat families, too. A social worker may do a wonderful job with a family in counseling, but this does not make them a marriage and family therapist.

#5 MFTs Cannot Treat Mental Illness

Not even close. Research suggests that marriage and family therapists are effective in treating a full range of mental and emotional disorders and health problems (Sprenkle, 2003). Addiction, drug abuse, anxiety, depression, alcoholism, eating disorders, and marital problems are only a few examples of problems treated by marriage and family therapists.
I am not offended when people have these misconceptions about marriage and family therapy.  However, I do feel that it is a significant part of my professional identity.  I am very proud of the life changing training that I have received and I want it to be acknowledged correctly as a part of who I am.


 References

  1.  Sprenkle, D. H. (2003), effectiveness research in marriage and family therapy: introduction. Journal of Marital and Family Therapy, 29, 85–96.