anxiety – Lessons Learned

The SPED Classroom: COVID-19 Edition

As an academic, I find comfort in relying on the expertise of others. Facebook is filled with teachers, mothers, and therapists with wonderful, color-coded ideas. But, we are in crisis. I need more. I need high-level experts with a following that traverses over space and time. Right now, I’m looking to the muses:

Mr. Rogers, the social-emotional muse, is famous for his tagline: look for the helpers. That’s no help for me. I live with one who is a great help to the community as a paramedic but not the most helpful co-teacher for e-learning. What is helpful is the decrease of anxiety that comes from Mr. Rogers’s habits of greeting me at the door, changing his sweater and shoes, and starting the day.
Maria Montessori, the educational muse, created an entire system based on naturalistic learning.
Tim Gun, the creative muse, motivates amateur designers to tap into their creativity in order to figure out how to use the unconventional materials of plant fronds and chainmail with chiffon to make a red carpet look. His tagline: make it work!

Mommy Title Mash-Up

I have written a lot about being a working mom and having a special needs child to keep it interesting. When the days all run together, and my time at home is also my time at work, I need to find ways to have more impact while doing less. Here are some ideas that help satisfy SPED goals that relate to occupational therapy (OT), speech/language therapy, and social work.

Post-it Note schedules: you can get as colorful as you want. You can designate yellow for foods to eat, pink for outdoor activities, green for Daddy’s tasks, etc. The goal is for each family member to participate by writing words, phrases, or pictures of what needs to get done on a daily basis. Older kids can arrange their “sticky schedule” while grimacing through brightly colored additions parents include.

OT: writing/drawing, pulling off one post-it note for fine motor, rearranging post-its to cross the brain’s mid-line
speech: “wh-” conversations to understand what goes first? why? where does the post-it go? where should the schedule go? where should the work get done?
executive functioning: organizing the day, prioritizing activities

Jacob cleaning the kitchen floor at 3!!!

2. Household chores: anything that makes my back, neck, and shoulder ache is a great new task for Jacob. At an early age, we recognized the need to keep his engine running in a productive direction. He works the products in the Swifer family like an Olympic curling champ. He also learned to put clothes in the hamper, bring it down to the washing machine and load it. Now that Jacob is older, he helps unload the dishwasher and puts his clean clothes away. Frankly, little orphan Annie had it easier. I joked I was making him earn his keep, but it turns out I have been a closet Montessori teacher. The nice thing is how all of these chores target Jacob’s IEP goals in some way or another.

OT: pincer grip required to empty the dishwasher or pull one sock at a time from the washer builds the hand muscles needed for writing , cross the brain’s mid-line by requiring him to reach across his body to grab the silverware, forcing kids to put things away top left to top right and then progressing down mirrors how the motor plan for their eyes for reading
speech: more “wh-” conversations to understand what goes first? why? plus sequencing what to do first, sweep the floor before attaching the wet wipe to mop, is needed to develop skills for reading,
executive functioning: putting the silverware away categorizes the brain
social work: whose turn is it? how do you cope with the frustration of not being able to get your fingers and arms to do the right thing?

3. Dance! If you have read my blog before, you have come to understand that our mental health is rooted in relishing our childhoods while embarrassing our children. You have also read my growing fascination of neurobiology and how music does more “than save our mortal soul” (pause to love Don McClean’s “American Pie”). So many of our SPED kids get movement breaks in school, but we limit them to Cosmic Yoga or painstakingly slow breathing exercises. Moms, it’s time to break out the bar mitzvah videos and Electric Slide (boogie, woogie, oogie). Then, Cha-Cha Slide before you level up to the Cupid Shuffle and dare to judge your physical health to see if you can Tootsie Roll. (Reward yourself with many candies of the same name if you pull that off without pulling a muscle.)

OT: motor planning is key to all of these dance moves, plus they repeat giving kids a chance to practice a motor plan over and over
speech: a receptive speech challenge for sure, but with corresponding video or Mommy-model resources, kids are using a real life Boardmaker app.
social work: modeling it is okay to look and feel silly is key for our kids who struggle with nuanced emotions like embarrassed or uncomfortable

Spark Note Summary

The COVID crisis has given us more questions than answers. My goal is to let that discomfort be okay. The beauty of everything being different and new is everything HAS to be different and new, like a “make it work”moment with Tim Gunn. E-learning is not education. Shelter in place is not an opportunity to try being a stay-at-home mom, Pinterest mom, or mom who masters the work-life balance. Shelter in place means to accept YOUR place. Continue to do the best you can, with what you have, at any given time. I’ll follow Mr. Rogers in creating the habit of sending you ways to live and learn…

The Feral Children of Fortnite®

I confess. I’m a gamer. Not WAS a gamer…AM a gamer. I didn’t grow up this way (unless you include a stubborn determination to beat Mario Bros on Nintendo). In fact, it wasn’t until college that I fell deeply in love with computer games. Picture this: it’s a hot summer day in Chicago. My boyfriend, his crew, and I hit the sand beach volleyball courts of the North Shore park districts for hours. After a quick round of showers, we all gathered in an apartment lugging 90’s Apple computers, an ethernet hub, a duffel bag full of cords, and a 6-pack. That is where I was when the Bulls grabbed championship after championship, and I watched live coverage of the deaths of Princess Di and Mother Teresa. Needless to say, when families try to convince me that gaming is ruining their children, I work hard to remember I’m an objective professional. Fears of Grand Theft Auto® and Call of Duty® have come in and out of my practice without a mental note much less a blog. Fortnite® is different

Out of the Mouths of Babes…

My husband and I still sneak in some gaming time, but neither of us has ever played Fortnite®. So, I conducted some field research to learn about the basics of the game. Here is what I’ve learned from a 14-year old expert gamer and a 25-year old social gamer. Fortnite® resembles what children of the 80’s would call a Wrestlemania Battle Royal combined with the Hunger Games.

Players are randomly placed on a map with resources. These resources can be cool, high powered guns, or lame, pile of wood.As the timer signifying the outer layer of the world disappearing ticks down, the player must gather resources to survive. Resources can only fill 5 slots of a player’s cache. Concurrently, a player can erect structures or barriers while trying to kill their way to the center. Confused, yet? I’ll give you the cheat sheet: poor randomized placement on board? DEAD; poor randomized gift of starting resources? DEAD; poor strategy balancing defense and offense? DEAD. This is how our children are having fun.

Out of the Mouth of a Family Therapist

The mental health profession studies the effects of gaming constantly. But, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is used by mental health professionals to diagnose mental disorders, DID NOT add gaming to its latest version in 2013. Research continues investigate whether excessive video gaming has the same effect on developing brains and neurotransmitters as substance abuse (making gaming an addiction) or obsessive compulsive behaviors (making gaming an anxiety disorder). When the experts’ research comes in, therapists will know how to help families navigate this modern maladaptive behavior. Let’s not wait for them.

What Gets Lost When Your Kids Try to Win

I mentioned some basic ways a player’s game can be cut short in Fortnite®. Here is what MAY be happening to your player when that happens.

Self-efficacy: Sometimes used synonymously with self-esteem, self-efficacy is the belief that you are a powerful individual who can solve problems and accomplish tasks. It is also the best way to combat anxiety and depression. The random placement of player and allocation of resources work in direct opposition to healthy development of a strong sense of “I can do it!”
The final straw…

This randomness also feeds the “It’s not fair” button vital to moral development.Children playing Fortnite® cannot be talked out of their honest assessment that falling off the shrinking map after the game placed them on a board with no good resources making fighting to stay alive harder than peers is unfair. They are right! It is unfair. But, providing more examples of how the world (fictional or real) is designed against them sends the message that tweens and teens are powerless.
Empathy: Despite the amount of hits on Google, Empathy Deficit Disorder, is not a real, psychological condition. Empathy is a learned skill. It is developed over time organically, as the brain branches out, and behaviorally, as you increase your social interactions. (This would be a great transition to a rant about social media or acceptable amount of screen time for children, but that’s for a different blog.) What makes Fortnite® dangerous, is it’s design that attributes tremendous amount of value to everything..and nothing. Let me explain. A player starts the game with some level of advantage or disadvantage of location and resource randomly. There is no skill or strategy, no concrete or intrinsic value, from the moment the game starts. Trying to win means determining how to blend building defensive structures while attacking other players. The immediacy of conjuring a wall or detachment of killing an opponent make it impossible to build value into using those methods to win.
Emotional regulation: Do you know why you can’t explain to your child why to accept the loss that came in 4 minutes when they lasted 4 hours in the game yesterday? You are talking to a feral animal. Yes, they know nobody is really dead. Their brains, however, do not develop the ability to put things into perspective until they are in their college years. (Talk about unfair!) Their brains are being fed stimuli from the game that trigger survival responses. “Hurry or you will die!” is the message of the game. Are you surprised when your sweet little boy or girl cannot interact like a human after gaming? Their brains are still on high alert! You may be offering to cook dinner, but their primal brain is thinking you ARE dinner. When Katniss won the first Hunger Games, she got to live in a fancy house away from the poor village. That wasn’t because she was a winner. It’s because even in fictional worlds, survivalists aren’t expected to return to normal life.

Spark Note Summary

The treatment plan for Pervasive Fortnite® Personality Disorder (not a real psychological disorder…unless my colleagues use it for future research), is ironically what makes the game so dangerous, TIME MANAGEMENT. Help your tween and teen transition back into the real world by giving them tasks that are designed to be routine and control breathing. Chores like setting the table, activities like jigsaw puzzles, or completing their reading minutes for school will bring the humanity back to your home.

You Don’t Need a New You for the New Year

If you have been frustrated that “Lessons Learned” is not loading fast enough on your iPhone, it’s not my fault. The Uber Powerful Wizards of Technology, see also Apple, recently confessed they were deliberately slowing down our “old” iPhones. This announcement seems tonally appropriate for the time of year where we all take a harsh look at who we are and what we did over the past 365 days to make resolutions to be a newer, better, smarter version of ourselves when the clock strikes midnight on December 31. Umm…why?

The calendar gives us several excuses to create a brand new you: the Jewish New Year, birthdays, or my favorite, the beginning of the school year. Somehow New Year’s Eve cornered the market with the invention of New Year’s Eve resolutions. But, it is just a gimmick capitalized upon by gyms, weight loss programs, the vitamin and supplement industry, and well-intentioned Jewish mothers. Resolutions are a premium form of self-shaming. You spend valuable psychological and emotional energy asking yourself, “What did I do wrong that I need to change RIGHT NOW?” Save your energy for dealing with your kids who are STILL on winter vacation. If someone could make up resolutions, I thought I would invent my own New Year’s term, “the resolution cycle”.

It’s a Vicious Cycle

A perfect example of the “resolution cycle”

The “resolution cycle” starts with a time period of emotional self-flogging, harshly judging yourself for a series of decisions you have made. Then, a boost of optimism! This year will get different! With a tweak of your attitude here and some changes to your outward appearance there, you will be much happier in the days to come. It all ends when life does its thing and lands you on a chute instead of a ladder causing you to run back to the old you who knows how to survive those events. This cycle is the reason I prefer not to see clients this time of year when they seemingly need help the most. Who wants to shake up your coping mechanisms, your survival skills, when you are about to spend the next few weeks back in the family jungle that made them necessary?

Good For You, Good “To-Do”
It is easy to beat yourself up regardless of the time of year. The new year should be about celebrating you and setting goals. 2018 will be your best year ever by remembering what you did in the past and setting a path for the future.

No task is too small to applaud: There must have been days this year when you finished the laundry without several cycles of wrinkle release. (I can’t think of those days, myself, but I have much more faith in you, my dear readers.) How about the other small victories: getting your child to complete homework without a fight, getting praise for a project completed at work, getting to enjoy a date night with your partner. These events are all worthy of a celebration. You need to remember these magical confluences of events were actually possible because of you! You figured out a new way to prioritize your time or tapped into a new source of patience. Your 2017 self had some great moments! It is that YOU, not some holiday imposed version of a new you, that will get you through the next 12 months. So, when 2018 bites you in the butt or slaps you in the face, you have the skills necessary to react like a setback is more of a tickle than a trauma.
Vegetables aren’t the only things to finish: Our parents never had to succumb to hiding vegetables in desserts. They simply gave us a choice, eat your vegetables or you don’t get your reward (dessert). While rewinding your internal home videos to applaud yourself, make a note about things that you started but didn’t finish. I’m not talking about things you never started, like past years’ resolutions that are on your internal “Empty and Broken Promises” shelf.
I love Reader’s Digest! This gem is entitled, “I will be happy next year if I can…”

I mean the books you started to categorize and alphabetize but didn’t make it past the first cube in your bookshelf. (Come on, that can’t just be me…) I mean the photos you started to organize in your computer and send to Walgreens or Shutterfly to print but still have your son’s diaper free lap around the kitchen amidst his first day of kindergarten picture. Then, choose which one or two to complete in the upcoming year. Like our beloved iPhone batteries that are drained by background apps, we are drained by the anxiety produced by unfinished tasks. (It’s also a great cheat for next year’s “‘Atta Girl” list.)

Spark Note Summary

We know we should say, “I Love You” as often as possible instead of waiting for Valentine’s Day. Well, we don’t need to wait until New Year’s for healthy introspection. Like switching lanes in traffic, change is never easy and not always good. Change needs to start from a place of strength and proceed in baby steps. Sometimes that even means looking back in order to plan how to move forward. You know, just like how I’m going to have make sure to back up my old iPhone before giving into my husband’s resolution to get the new one.

A Monster Calls: Let Our Kids Answer

Young adult literature is my guilty pleasure. (OK, one of them. I’m a sucker for the Real Housewives of Wherever You Are.) When I worked in a bookstore, I got the same questions as when I was an English teacher: What do you recommend for a young person who is a good reader? When that girl was me, I was “forced” to read the classics, Little Women, or adult fiction, like the Clive Cussler series. The good news is the stories we love in the movies originated from young adult books. The bad news is the content is not something that is emotionally or psychologically friendly for tweens and teens to read alone. I’m here to help.

From Cover to Cover

Click here for the link to Amazon to read reviews.

Our fears are ignited with the first sentence of the book, “The monster showed up just after midnight” (1). In a little more than 200 pages, Conor found out how to stop the monster and free himself, “And by doing so, he could finally let her go” (205).

On the surface, a monster born from a yew tree, taunts Conor during the nights after the cancer killing his mother tortures him all day. Conor isn’t as afraid of the monster as much as he is the nightmare that wakes him nightly. A Monster Calls by Patrick Ness teaches parents what Conor learned in school: “Don’t think you haven’t lived long enough to have a story to tell” (23). Conor’s true fear is one we all share, regardless of age: having the courage to speak YOUR truth aloud without shame.

Who? Conor is dealing with getting beat up by bullies in middle school while his mother is getting beat up, again, by cancer. He gets help getting back and forth to school from his grandmother and less-than-helpful advice from his estranged father.

The yew tree in Conor’s backyard becomes the monster.
The monster is the character who provides the best guidance for navigating the anger, fear, and powerlessness that Conor faces as the cancer steals his mother.
What? Jewish folklore explains the reason Jewish people tell so many stories (guilty) is because nobody knew the true name of G-d, so their stories were prayers that granted miracles. The monster explains he will disappear after three stories are told: the monster will narrate the first two stories, and Conor must tell the third story, his nightmare, to the monster. Conor learns some lessons about the human condition to help his relationship with his grandmother and father. Rather than his grandmother being good or evil, we all learn with Conor that the world is gray. Our judgement of others as good or evil reflect our morals. The monster’s second story follows the lesson of “The Hangman,” doing the right thing when you are not personally affected.
When? Traditionally, developmental psychologists only address common markers in life, births, deaths, weddings, and graduations. But, since late in the first decade of the new millennium, we are starting to understand that the life span has markers in adulthood, too. By the time we meet Conor and his mom, we are beyond learning about life before and after cancer. The line is drawn between before and after the “little talk”. BEFORE Conor was being bullied and stopped being friends with Lily, he didn’t need to think about processing his mother telling him she may not survive the latest experimental treatments. AFTER their “little talk”, Conor had no privacy because everyone knew he was going to lose his mother.
Where? A Monster Calls lives where children do, at home and in school. It doesn’t take long for the monster to wreak violence in both settings. He destroys parts of Conor’s grandmother’s house. He beats up Harry, the school bully, who has been punching and kicking Conor for weeks. The more Conor tries to be invisible, to live nowhere, the more the monster causes destruction everywhere.
Why? There is a purity in children because they do not understand nuance. Asking “why” isn’t annoying repetition. It’s taking a firm stance in what you know to be the truth. Some parents use a child’s insistence of understanding to reminisce ye olden days where children were seen and not heard. Conor’s nightmare, the story he tells the monster, the story he needs to tell in order to accept his mother’s death, is the perfect example of the damage of silencing children. Conor tries to get control of his heart and home to help his ailing mother which summons the monster. Conor tries to be perfect, tries to be invisible, which causes the monster to destroy places and people. Conor acts out to earn punishments worthy of the guilt he feels in his nightmare. But, being visible is not the solution to being invisible; for Conor, the nightmares became more frequent. Telling the monster his nightmare, sharing HIS truth aloud, chased the monster away.

…And How?

Patrick Ness finished this novel for another author, Siobhan Dowd, who died before she could decide where her characters would go. Ironically, the poetry of a story about disappearing due to death reminds us to make sure our children don’t feel invisible. We need to indulge in their passionate arguments about why a purple sky makes sense in their 6 year old drawings and why they are certain they are in love in their 16 year old relationships. Our insistence on teaching them “the truth”, will create monsters that will stop them from sharing their truth.

On the Road to Change With Father Time and Gandhi

When I was in college, I got really bored with how my room looked. Changing the colors of my comforter or posters was not enough to make my restlessness go away. So, I rearranged my 3 pieces of furniture each quarter. This is a bigger deal than you think. As a smart control freak, I prepared for each move by cutting Post-It notes to represent each piece of furniture and placed it on a graph paper blueprint that I had drawn to scale. (No, I’m not kidding.) I have repeated that behavior in the 7 places and 6 classrooms I’ve lived in since then.

But, that doesn’t mean I’m good at accepting change or easily ready to make changes to myself. Anxiety and depression are characterized by the overwhelming feeling of being stuck, being unable to change how things are now in order to make things better later. Change is not easy. Maybe that is why there are just as many steps to change as there are to grief.

Cracking Open the Window to Leap Through

Grad school provided me with two memorable frameworks with which to approach counseling. My homeroom-esque class with the best professor and mentor a loud, know-it-all needed (shout out to the one and only Dr. Victoria Junior) came with an introduction to Johari’s Window. In my practice, it is common for clients to reach out for help for problems that border panes 1 and 2. My clients know there is something not right but just can’t quite articulate the problem. In order to crack that window wide open, we work to crawl, walk, run, retreat, and regroup through the stages of change. (The names of the stages are mine, not the clinical terms.)

Substance abuse and addiction training required the ultimate textbook for understanding all change. This is literally the textbook on the stages of change.

Problem? What Problem? There are not enough examples, videos, PowerPoint presentations, or tantrums to get you to see there is a problem. The bad news? Your loved ones must continue to beat their heads against the wall and fill the air with their voices despite its apparent lack of efficacy. The good news? Something is getting through at a subconscious level that is prepping you to proceed to stage two.
Oh, That Problem? It’s Not a Problem. Deaf ears are now more like selective hearing. You have gotten the message that there is something in your lives getting in the way of an angst-free existence. But, at this stage, the problem is YOURS; your loved one believes it is manageable.
OK, My Problem is a Problem. Time to buy colored pencils, Post-It notes, and erasers.
Hiro from Heroes when he learned to stop time

Lots of erasers. You are ready to put a plan in place. We have one stage left before the plan is put into action, but we have a plan!
I Did It! Despite the fact that change has been working, albeit at an uncomfortably slow pace, it is clear to everyone that you are making new choices. New behaviors are obvious and should be applauded by all onlookers. Don’t be surprised if physical exhaustion accompanies all of this psychological and emotional change.
That Worked..Kinda. Although change may vastly improve your physical and mental health, it is not always easy to maintain. People need to meet the NEW YOU. You need to see how the new you interacts with your old friends and family. An occasional appearance from your stage 1, 2, 3, or 4 self is to be expected, not shamed.

Spark Note Summary

Just because you seek out doing things differently, doesn’t mean you are ready for a change. Anxiety and depression don’t start overnight or disappear in the daylight. There is a process to learning how to see your problems even before you start to address them. Your best friend on this journey is time. Just ask Gandhi, “Live as if you were to die tomorrow. Learn as if you were to live forever.”

Summer Is Not the Only Thing Hot

As a proud sci-fi geek, I have watched every superhero movie. In the first Avengers movie, the good guys are fighting enemies from outer space while battling inner demons. (More real life than sci-fi.) The Hulk is known for having incredible anger issues and admits that his secret to controlling his Hulk-bearing anger is that he “is always angry.” He is not alone; anger is always lurking in all of us. Being full time parents, employees, spouses, friends (just writing the list is making my Hulk side wake up) spreads our resources too thin to stay calm. Anger may be unladylike, but it is common and lurking (not far) below the surface of every woman I know. We are running too fast, giving too much, and getting too little. So, our Hulk comes out as a matter of survival.

Your Brain on (Organic) Drugs

There are a flurry of chemicals generated in your body at all times. That is why all of our well-named mental illnesses used to be under the umbrella of “chemical imbalance”. Chronic mental illnesses, like depression, anxiety, and bi-polar disorder, are diseases where your body naturally does not produce the neurotransmitters or hormones necessary to live a healthy, productive, focused life without medication to restore the natural balance. But, we are immensely powerful. We can change our body chemistry and trip ourselves into these conditions. Anger is one of the strongest catalysts for this problem. But, before I discuss how to treat anger, and prevent mental illness, it is important to have a quick rundown on these important chemicals.

Dopamine is your natural high. It motivates you to get to the gym because of the impending reward of a piece of cake on a cheat day. It moderates your euphoria into more acceptable happiness.
Oxytocin is your natural love potion. It is the neurotransmitter that fills your body when you first kissed “the one” and when you first saw the baby you loved from the inside out (literally) for 40 weeks. It helps you heart things on Facebook based on empathy.
Epinephrine lets you lift a car off your loved one and run away at Flash-esque speed when you feel threatened. The reason this hormone is the life-saver for those who suffer from fatal allergies is because it triggers your fight/flight response by providing a surge of adrenaline.

Anger Is An Alarm

It means the dopamine and oxytocin are running low and being replaced by epinephrine. Or, in more common terms, you’re are being overrun by the need to survive. Your emotional boundaries have been triggered by one, or a combination, of the following emotions:

Selflessness: Women are driven by the dream of “having it all”. In trying to pursue that dream, we forgot to read the fine print: YOU are the first one to get nothing. There is a limited amount of emotional and psychological resources in every one. Once you red-line on that fuel, anger will let you know that there is nothing left for your partner, children, or employer before you do something wonderfully indulgent (think double-digit minutes in the bathroom with the door closed, for example) to start.
Loneliness: The last time I saw my closest friends, my crew, was at a wedding almost one year ago. Before that, we got together to mourn the loss of a parent. We have been friends for more than 20 years, so our bond is solid. But, it is ludicrous that we can only find time to connect when a milestone is reached. It is hard to maintain your identity separate from your roles in work and home. Feeling like you are alone will easily wake up the Hulk, the original spokesman of anger.
Exhaustion: When you wake up at 5 am and run around until 11 pm, there are precious few minutes to stop your brain and fall asleep. Sleep deprivation can cause a myriad of physical health problems. The effects on mental health are glaringly missing from the everyday conversation. Your brain needs 25 years to be fully grown. The last area of growth, the forebrain, is where your executive functioning thrives, the ability to multi-task, prioritize, and organize. See also: the Mom-brain. That quarter-century of development can be undernourished if you don’t get enough oxygen/sleep/relaxation.

Spark Note Summary

Doctors get sick. Lawyers get sued. And, moms need to be “mommied.” Mommy shame is pervasive in social circles. It is also a bellowing megaphone in our own heads: we have internalized the message that we MUST be the best, achieve the best, and raise the best without applause or affirmation. Trying to win that impossible trifecta would make anyone gear up for survival. So, the choice is to admit you are human or continue to be Mrs. Hulk.

The Long Goodbye

This is the first time I have stolen a title for my blog. But, I’m in good company. Patti Reagan “stole” this title for her 2004 memoir about her father, President Reagan. Her mother, Nancy Reagan, coined the term “long goodbye” in 2002 to describe the last years with Alzheimer’s sufferer, President Ronald Reagan. I first saw this term as the title for an episode of The West Wing, my favorite political drama. The episode aired in 2003 and focused on the relationship between the White House Press Secretary and her father, who was diagnosed with Alzheimer’s Disease.

Television’s allows America to show us who we are so we question if that mirror is accurate. I haven’t seen or heard of any show that has committed itself to exploring the diseases associated with aging. I’m sad to say that our treatment of loved ones aging is accurately mirrored in pop culture; it doesn’t exist. The Alzheimer’s Association advocates for the more than 5 million Americans living with the disease. I’m hoping this post helps their caregivers who provide 18.2 billion hours of unpaid assistance to their loved ones.

It is natural to disassociate ourselves from thoughts of loved ones dying, one of our nation’s biggest fears. Fear puts us in survival mode. We are ready to run, fight, or freeze. We just want to be left alone. But, the consequences of asking your aging parent to deal with this part of life alone are profound. (Consider this: the worst penalty that can be imposed on a criminal short of death is the same technique used in torture, isolation.) It is hard to talk about the end of a wonderful journey. It is hard to get in the car and spend time with someone who may or may not know who you are. But, you can use these tips to increase your chances of smiling when you make the effort.

Connect Four

The key to maintaining a meaningful relationship with a loved one who memories are slipping away is to personalize each minute. I love how A Dignified Life introduces the concept for caring for loved ones with dementia and Alzheimer’s, a Best Friend. Best Friends are the living photo album, memory book, and memorial candle who can bring about meaningful moments with someone who is just beyond reality.

Folly: Gathering intel is fun but requires a level of dissociation from the detective. You cannot presume to know what is important to your aging parent based on what was prioritized in your home. Religious observances, for example, may have just been a marital compromise. My grandparents were very observant Jews. They walked to temple, had separate dishes for meat and dairy, and even a separate kitchen for holidays that required cooking in a separate oven. But, my grandmother used to sneak me out of the house to share pork-filled wontons and other Chinese foods. Additionally, getting older ironically awakens the young, mischievous sides of us. In fact, based on the shrinking brain and decreased efficacy of neural pathways, the elderly act just as impulsively as adolescents. Stories like this one of mischief and mayhem are great ways to wake up a sleeping brain.
Triggers: I love fires. I went to overnight camp since I was 5 years old. My husband and I expressed our love in front of a fireplace. Whereas most of my friends share the warmth and comfort of a fire, it would be a mistake to think everyone has positive memories or impressions of huddling around a campfire. My father-in-law was badly burned as a child when trying to stamp out an innocent fire in the alley behind his apartment. It may make sense to share this story of how his son fell in love as a way to remember who I am or enjoy the shared experiences of finding love. Except, sharing the intimacy of the memory would nearly guarantee a traumatic response from my father-in-law. Taking the time to learn which memories are painful is just as important as learning which memories are pleasurable.
Labels: My father loved to create nicknames for us. I loved to create nicknames for my students. Uncovering nicknames (not teasing, shameful name-calling) from childhood are helpful to grab your loved one out of their isolating zone. My father-in-law used his legal name, Harvey, all through school. But, he used his middle name, Scott, as an adult. This piece of family history is helpful insomuch a using the childhood name is more likely to create bonding moments.Aging works in reverse chronological order, the newer memories are the first ones to go. Our favorite possessions also have their own fond names. My mom and I had sequential license plates starting with the letters “LF” when I got my first car. We used them as proud monikers for the “lead foot” bestowed upon us by HER father, the man who urged everyone with a new car to open up the engine early to train it in case a need ever arose.
Visitors: Grandchildren are a gift. My mother insists that being a grandmother
Jacob listening to Papa’s wise words (Papa, 96, Jacob, 7 mos)

is intensely different and deeper than being a mother. Unfortunately, grandchildren and aging parents do not match. The increased energy of the child in combination with the quiz questions, “Who is this?” or “Don’t you know who this is?”, make someone in the throes of Alzheimer’s or dementia angry, sad, and frustrated. In fact, mislabeling a child, calling your daughter by your name, is a common source of agitation for caregivers. Correcting your loved one becomes a common source of agitation for the aging. Where your mother may have missed a generation, she still knew the child was family. It is best to agree with your mom and chat about a memory you have shared. More often than not, she will recognize your daughter before the story is over. It’s also not a time to find beautiful albums or frames for those little ones. Memory-related disease does not necessarily mean there are other health problems. But, poor eyesight is a given for all who age. It can be frustrating to be surrounded by pictures you cannot see.

Spark Note Summary

We have become a generation of avoiders and hoarders. We want to hold onto to our loved ones as long as possible…over there. Those years do not have to be wrought with anguish, for the loving or loved. Take the decades before diseases of aging rob you of your loved ones to learn how special their lives have been. That way, the “hello” has much more impact than the “goodbye”.

Learn How to Scrawl: A Book Review

Welcome to the first book review from Lessons Learned! From time to time, we need a brain break, a way to escape the facts of our life by exploring fiction. Books can be a great way to learn some lessons while relaxing. My first recommendation is Scrawl by Mark Shulman. Before you raise your eyebrows, or close the blog, let me prove how a book marketed to tweens and teens has a few lessons for all of us to learn.

From Cover to Cover

As we read the first line in the novel, we read the first journal entry of Tod’s detention journal: “Think about a pair of glasses for a second.” 230 pages later, Tod’s journal ends with an exchange between himself and the guidance counselor who has been reading and commenting in his journal for the 5 weeks he was in detention: ” ‘Was that all that kept us from getting kicked out of school?’ And you smiled back at me. ‘Yes.’ ” What we learned between the first and last pages, is how we all judge without knowing, watch without seeing, and speak without listening.

Who? The book is formatted as a journal written by Tod, a bully, who is serving detention under the supervision of Mrs. Woodrow, a guidance counselor. But, the more you read, the more you question what you know about bullies. For example, Tod explains his environment to Mrs. Woodrow by explaining, “Every neighborhood downtown has its own violent Neanderthal troglodyte hell-raisers” (8). He also plays euchre at lunch with his friends. Euchre, not poker. And, helps his blind lab partner. Questioning your facts on bullies, yet?
What? Punishment. The journal is a punishment for getting caught. (You don’t learn what he got caught doing until the near-last page…and I’m not spoiling that for you.) Tod’s friends are outside completing their more typical, juvenile delinquent punishment of picking up trash under the supervision of the head custodian. But, who hasn’t inflicted punishments upon themselves? True story: my mother accidentally ran a red light. (It was one of those that is only for a small strip mall.) When I pointed this out to her, she literally pulled HERSELF over! This is not a serious example, but it is a serious issue. Instead of listening to me, listen to Tod: “The more important you treat yourself, the more you’re worth” (41).
When? Let me be a typical therapist, here, and answer a question with a question: Which events in your life mark the difference between then and now? There are the usual markers in life, births, deaths, weddings, and graduations. Traditionally, developmental psychologist have stopped there. But, since late in the first decade of the new millennium, we are starting to understand that the life span has markers in adulthood, too. We see Tod accidentally enter the spelling bee only to come in second when a teacher cheats, and we question what we know about bullies. We admire the large statue created by Luz, and we question what we know about the goth/artist. How long does it take, how old do we have to be, for stereotypes to be broken? Changed?
Where? The longer you read Scrawl, the more it reminds me of a house of mirrors where each turn reveals a different, exaggerated version of yourself and surprises you each time. You realize that Tod is more complex than the school bully. You see what he is like at home, a not-surprisingly poor house where he wears layers of clothes to sleep in order to combat the lack of insulation in his “bedroom.” Tod surprises us in the auditorium as he becomes a reluctant accomplice in creating the costumes for the original play written by the stereotypical school freak. In detention, Tod writes much more than is required and is more honest than is expected. reflection.
Why? It is surprising that, as a therapist, I loathe this question word. After reading Scrawl, are we supposed to long for after school specials? Do the readers labeled as bullies feel vindicated? Do we donate more to the Salvation Army in case a ne’er-do-gooder needs to help a friend? Sure, why not. Or, maybe we just needed some perspective on how far we have come. Or, maybe we just needed a way to talk to our children about how to treat others.

…And How?

How do you take the lessons learned from Scrawl and use them to make yourself stronger? First, let go of the memories of high school that have flooded you for 238 pages. Second, make an impromptu book club with your kids (ages 10 and up are fine) to discuss how they feel about the characters and if anything is similar in their lives. Third, it’s never to late to start a journal. It is infinitely more healthy to get any thought or feeling out than to “suck it up.” Last, start now to be who you want to be regardless of who you were then or who others think you are now. Like scrawling, life can be messy, unconventional, and unpredictable. Enjoy!

LeVar Burton, Accidental Therapist Extraordinaire

Click here to bask in the nostalgia of the theme song!

Before the costume designers of Star Trek: The Next Generation chose an 80s banana clip for a futuristic visor, LaVar Burton was the host of Reading Rainbow. Each episode had a theme similar to ones that my son has in his pre-K class…space, animals, transportation, etc. Books were read to us by famous celebrities like Kermit the Frog. LeVar Burton took us on “field trips” to a fire house or farm. But, the best part of each episode was at the very end. A child just like me, a cute, book-loving precocious child, would tell us all about a favorite book. These were heartfelt testimonials that always ended with the phrase, “But, you don’t have to take my word for it.” No? But, I do! You love books…I love books! We are virtual book club buddies!

Bibliotherapy

Bibliotherapy is a real, accepted modality for treatment of some mental health issues. It started with the turn of the century when soldiers were given medical books to learn about their injuries. In the 1960s, bibliotherapy became an official modality under the American Library Association, and psychotherapists mainstreamed the practice as an additional tool during more traditional therapeutic treatment. As Lessons Learned begins adding an occasional book review, it is important to understand the mental health benefits of reading.

Pacing: Shakespeare wrote in poetry, iambic pentameter, for his audience to get caught up in the music of his words. Before you twitch into a mess of

Click here to hear modern day iambic pentameter.
horrible memories of school, it may help to understand that iambic pentameter is exactly the same cadence as the theme song from Gilligan’s Island. Prose also has an intentional rhythm. Short, choppy fragments mirror the mood of the character. Endlessly long sentences (see anything Faulkner wrote) drone you into a lull; “what did I just read in those two pages that were three sentences long?” Mental health practices of mindfulness and meditation help suffers of anxiety and PTSD, for example, use careful control of breath as a self-healing tool. Being whisked away into an author’s linguistic pacing can have the same benefits.
Guided imagery: All of my students will tell you I have a hard and fast rule about movie adaptations of books. I refuse to watch a movie in which I’ve read the book. I refuse to read the book if I’ve seen the movie. Case in point: I’ve seen all 8 Harry Potter movies without cracking the spine on any of the 7 novels on which they are based. My snobbery is based on protecting myself from dashed expectations. As I read any book, I imagine what the characters look like, how they speak, how they dress, etc. I like to use my internal CAD programming to design their homes and neighborhoods. Getting lost in the story is why reading a book with Fabio on the cover can be more healing than one with Dr. Phil on the cover. One of the most preeminent medical facilities, the Cleveland Clinic, has concluded: “Imagery can stimulate changes in bodily functions such as heart rate, blood pressure and respiratory patterns. It can help you tab inner strengths to find hope, courage and other qualities that can help you cope with a variety of conditions.”
Empathy: One of the major impacts of bibliotherapy is to see yourself, including your challenges, in a character. It is also extremely cathartic reading how someone just like you works on fighting mental illness without stigma or despite of it. This process, forming a bond with a character that reminds you of yourself, builds empathy. It also allows you to have empathy, not sympathy or pity, for yourself. Now that you are starting down the path of empathy for yourself, you have made the most difficult step in self-care: appreciating who you are without apology. Not sure what the difference is between empathy and sympathy? Watch this remarkable animated short.Spark Note Summary

Bibliotherapists are most often English majors with a depth of knowledge about “who” and “what”. Therapists are most often psychology majors with a depth of knowledge about “how” and “why”. As a woman with a bachelor degree in English Education and a master’s degree in psychology, I am your unicorn. As this blog takes on an occasional book review, have some faith in the magic of some more of the lessons I have learned.

Fly Your Geek Flag High

Let’s start with a riddle:

If you see one, it is safe to assume there are dozens you cannot see.
They can subsist on garbage yet grow to amazing heights and weights.
The minute you outsmart them, they find four more ways around you.

The answer: Mice? Vermin? Pestilence?….TEENAGERS!!!

There is some form of instinctual survival skills that causes adults to cross the street, or hallways in the mall, when a gaggle of teenagers looms closer. I have spent more than 20 years as the Jane Goodall of teenagers. I have been accepted in their tribe. I have learned to adapt to their unusual language patterns and ever-changing forms of communication. I have studied their behavior in the hopes of sharing this vital information with others.

Your Teenage to Adult Translation Guide

Every once in a while, I feel validated when a prestigious, well-researched journal documents their years of research only to conclude something my work in the trenches has already learned. Recently, there was an article in an academic publication that revealed the key strategies for working with teenagers in a therapeutic setting. I am admittedly “borrowing” the organization of the article (Holliman, Ryan P. and Foster, Ryan. (2016). Emodying and Communicating Authenticity in Adolescent Counseling. Journal of Child and Adolescent Counseling, 2:1. 61-76). These experts list 7 strategies for creating an authentic relationship with an adolescent client. I’m going to shorten the list and give you my usual, humorous, everyday insights to help you manage the teenagers in your life. Warning: most of the experts cited in this blog will be directly from the real voices of my favorite fictional geeks.

Personal confidence: It is a teenagers job to win at “gotcha”. They look for inconsistency between what you say and what you do as justification for not trusting you. Your job as a counselor, or even a parent, teacher, or any role model for a teenager, is to demonstrate the strength in being yourself. Nobody explains this better than Mr. Stand By Me, Wesley Crusher actor and nerd king, Wil Wheaton.
Modifying language and speech: You can easily make the mistake of zigging or zagging. This is not the time to throw out slang you’ve heard on TV. (Zig.) Please don’t answer the question, “What did you do last night?” with, “Netflix and chill.” You haven’t created a bond with your client; you have either revealed an intimate detail about your private life or your desperation to be liked and accepted. This is also not the time to demonstrate your expert vocabulary or practice your parenting tone. (Zag.) Conversation is the start of communication. An effective counselor is using these conversations to model healthy word choice. Start building your client’s emotional IQ by working together to properly identify emotions. This is an exceptional way of feeding into the natural tendency of teens to correct all of us ignorant, out of touch people who were birthed as adults.
Dissipating tension: Teenagers are similar to dogs and babies; they can smell fear. Maybe because they are fueled by trying to make sure nobody else detects their own fear. It is helpful to remember that teenagers are still children. Engaging their bodies will loosen their lips. I often play cards (which may or may not resemble Vegas tables) in my first session. The ease of the activity helps build what person-centered therapists call congruence, an overly academic way to explain that a therapist should be a person, not a caricature. Whether it’s board games, card games, or drawing, the activity that releases the tension is also the best to return to when therapeutic gains are released. Remember: the best salve for growing pains is childhood fun.
Investment in the process: Teenagers grant access to their thoughts and their feelings to very few people. Even then, the time you have access is limited.
“You see just seeds, but I see the trees.” Photo by jeffzeleya.com

Therefore, the role of a counselor is to plant a seed. Create a relationship that serves as a fond memory for a healthy, trusting relationship with healthy boundaries. Make it easy for the next coach, life or sports, to continue the work you begin.

Spark Note Summary

Being authentic simply means being yourself. What is not so simple is embracing that self. When counseling, parenting, or mentoring a teenager, it is essential to have worked out your adolescent issues FIRST. We want our teenagers to LOVE who they are, not SHAME who they are. Especially if they grow up to be sci-fi fanatics who use sarcasm and wit to educate others about some lessons learned.