New Developments on Autism and Asperger’s

Screen Shot 2013-08-07 at 10.53.38 PMThe Huffington Post’s staff writer, Bahar Gholipour reports on new research findings on the different brain patterns and connectivity of children with autism, in comparison to children with Asperger’s syndrome.

In Gholipour’s article: ‘Asperger’s And Autism: Researchers Find Brain Differences’, he reports that in a 400-participant study, researchers observed stronger connections between several regions in the left hemisphere of the brain in children with Asperger’s, in comparison to both children with autism and typically-developing children.

These research findings provide excitement, and provide new research avenues for future studies.  However, the study draws criticism to the recent DSM-V changes that merged Asperger’s syndrome into a general category of autism spectrum disorders (ASD).  What do these differences mean, and how will they influence future treatment for individuals with Asperger’s?

Questions like these, and many others are just the beginning for those in the mental health community.  To read more, you can find the full article here: http://www.huffingtonpost.com/2013/08/05/aspergers-autism-brain-differences_n_3707791.html

Reference:

Gholipour, B. (2013).  ‘Asperger’s and Autism: Researchers Find Brain Differences’. The Huffington Post. Retrieved from http://www.huffingtonpost.com/2013/08/05/aspergers-autism-brain-differences_n_3707791.html

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© Vanessa Lemminger, M.A. Marriage and Family Therapist 53937, 2013. Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Vanessa Lemminger, Marriage and Family Therapist 53937 with appropriate and specific direction to the original content.

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Expectations for Therapy

Expectations for Therapy

            Coming to therapy can often be intimidating.  The treatment you receive from a therapist is much different than going to an appointment at your family doctor or the dentist, but the treatment is just as important.  To get the best out of your experience, it is helpful to know what to expect from your therapist, and what not to expect as well.

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What you can expect:

Informed consent. The first thing your therapist should do is provide an informed consent form to review and sign.  This form details your participation in therapy, and covers areas such as confidentiality, reporting laws, and your fee agreement.  If you are not asked to sign an informed consent form, this should be a red-flag.

Review of confidentiality.  Every therapist should review the limits of confidentiality, and how it applies to you specifically.  There are different laws and ethical guidelines surrounding confidentiality that differ depending on whether the client is a child under the age of 12, a child 12 years of age or older, an adult, a couple, or a parent.  It is important to know how confidentiality works, and what the legal exceptions are.  If your therapist has not reviewed this with you, ask him/her to right away.

Clear understanding of fees and scheduling. The therapist should review and confirm with you their fees and scheduling policies.  It should be clear exactly what you are paying, how long the sessions last, the policy for going over the designated session time, and any cancellation or rescheduling policy.  It should also be clear as to what methods of payment are accepted, and if you are able to use your insurance.  Often times this information is listed in the informed consent form, but if you have any questions or are not clear on everything, do not hesitate to ask your therapist for more information.

Right to end treatment.  You should never feel forced to go to therapy or that you have to complete a certain number of sessions.  A therapist will certainly recommended a desired number of sessions that would be necessary to complete your specific treatment goals, but you are never obligated to, nor should be forced to complete a set number of sessions.  Each and every session is voluntary and you should never feel pressured to continue treatment if you are not comfortable.  The only exception to this is with court-mandated treatment or treatment of a minor.

Setting goals.  It is important to set goals at the beginning of therapy, and define what it is you want to work on.  Depending on the therapist’s theoretical orientation, goals may be more specific or more general.  If you have a preference as to how you would prefer to set goals and how you want your therapy experience to feel (more concrete and structured, versus more abstract and introspective), ask your therapist what his/her theoretical orientation is, and how that affects his work as a therapist.  Some therapists are more involved and work more as an agent of change, while other therapists take a more collaborative role, working side by side with the client.  This is also dictated by the therapist’s theoretical orientation.  Find out what type of therapist and theoretical approach you are more comfortable with or that matches your style.  Often therapists work from several theoretical approaches and have a more eclectic style.  Let your therapist know what works well for you, and they can use the theoretical approach that fits best with your style.

Support.  In the therapy room you can expect to find support through the challenges you are experiencing.  Coming to therapy can help reduce feelings of isolation.   Therapy goals almost always include increasing support systems as well, as it is important that the client receives support as they work through the challenges they face.

Empathy.  Therapy is also a place where you can expect to receive empathy.  Everyone experiences challenges and seeking help does not make you weak or damaged.  Therapy provides a non-judgmental space to address your challenges, while also providing feelings of validation and understanding through the process.

Expect to work.  Part of the therapeutic process involves making changes, and to do so requires work from both you and the therapist.  Reaching your goals is going to require you to make changes, put plans into action, and require you to step outside your comfort zone.  Some therapists, depending on their theoretical orientation, will also assign homework in addition to what is worked on in therapy.  This homework works in conjunction with what is done in session.

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What NOT to expect from therapy:

Answers. Unless your therapist takes a very direct and authoritarian-type position, you should not expect to get “answers” to your problems in therapy.  Your therapist is not going to tell you whether you should stay with your partner or separate, nor whether you should quit your job or not.  Therapy is a process that results in personal growth, something a Magic 8 Ball cannot do.

Quick fix. Therapy is not a quick fix either.   One or two “power sessions” are not going to work out your marriage conflict.  The minimum amount of sessions to expect for almost any goal is at least 4, and longer for more complex relationship concerns.  If you are not quite ready to make a commitment, consider attending a workshop.  Many therapists offer a wide variety of one- or two-day workshops that address a variety of different themes: communication, intimacy, confidence, etc.

Tips and tricks.  Often parents come to therapy looking for tips and tricks to fix their “problem child”, and they are often disappointed.  The “problem child’s” behavior is almost always the result of the entire family’s dysfunction.  A more realistic expectation for parenting concerns or behavior management in therapy would be developing positive parenting strategies and reducing family conflict.

Change your partner. Therapy is not a place to find an ally to take your side during arguments with your partner, nor is it a place to “change your partner.”   Coming to therapy will not “fix” your partner or make them “see it your way.”   A more realistic expectation for therapy would be to learn how to appropriately mediate arguments, improve communication, and clarify expectations for your relationship.

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Having a clear understanding of what therapy entails, what to expect from therapy, and what is not likely to happen in therapy, will make scheduling an appointment much less distressing.  Therapy is a place to feel relief from stress, experience empathy, and find support.  Having a clear understanding of the therapy process will help maximize those feelings and move you close towards your goals.

   nessa

    Vanessa Lemminger M.A., LMFT 53937
Marital and Family Therapist

 

© Vanessa Lemminger, M.A. Marriage and Family Therapist 53937, 2013. Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Vanessa Lemminger, Marriage and Family Therapist 53937 with appropriate and specific direction to the original content.

How to Make the Most of a Social Outing

How to Make the Most of a Social Outing

A child’s learning does not just stop at school or the therapy session.  Providing opportunities for your child to learn and practice their social skills is a great strategy for continued learning.  Setting up a play-date or social outing for your child is a great start, but there is more you can do to help facilitate appropriate social interaction and social skills while allowing the natural peer interaction to take place.

Children age 2-6

For parents with younger children, it is important to take time and observe the children’s play.  Children at this age can have unique styles of play, and do not always use logical play.  Instead of immediately joining the children in play, spend time observing first.  Watch how the rules of the play are established, and what the object or goal of the play is.  Study how they transition between play, and what themes they frequent (Do they always play some version of house, or do they lean more towards adventures?) Once you’ve taken some time to understand their style of play, join in, but let the kids take the lead.  Asking questions is a great way to engage more conversation in play while still leaving the control to the kids.  As an example:

Three kids are pretending to cook in the sand box, and you join.  Questions you can ask: “Can I play?” “Who can I pretend to be?” “What are you making?” “What should I make?” “Who is going to eat the food?” “Where should we take the food?” What do we cook next?”

Another great technique to naturally model appropriate social play is to think out loud.  Narrate everything you are doing while playing.

“Hmm… I want to dig a tunnel, but I need the blue shovel and Jared has the blue shovel.  Maybe I could ask him to take a turn with it.  Jared, can I take a turn with the blue shovel?”

“Oh no! I want to play on the swings, but everyone is playing in the sand.  I really wish I had someone to swing with.  Maybe I could ask someone to come play with me! Caleb, do you want to play on the swings with me?”

Remember, when working with kids, less is more.  The goal is to create natural social interaction, and it’s important not to over-pathologize your child’s behavior.  Children do not always say “thank you” after every single toy exchange, and do not compliment their peers on everything they do.  It is also typical for children at this age to play alone or have moments of parallel play (children playing adjacent to each other).  Don’t feel like you need to be maintaining constant dialog.  When the environment is relaxed a child will feel more comfortable going beyond their typical boundaries.

 Children age 7-12

Parents with middle-aged children should focus on building self-esteem and competency during social outings.  This is the age where children develop of sense of self, which makes modeling appropriate social behavior important. A great way to do this is to be overly socially appropriate yourself.  For most, social skills come naturally so we do not even realize the different social behaviors we are exhibiting.  As a parent modeling appropriate social behavior, the goal is to expand these interactions and amplify them.  To provide an example:

Two individuals, John and Gary are at a bowling alley.  John sees Gary pick up his ball and start walking towards the lane.  This triggers John to think, “Oh, it must be Gary’s turn.”  John then glances up at the screen to confirm his thought that it was, in fact, Gary’s turn.  After Gary sends his last ball down the lane, he casually tosses a hand up, which John meets with his own.  Without checking the screen, John walks up to the lane for his turn.

A child with ASD may not see all these subtle social interactions that take place, and deciphering when it is okay to approach the lane, who’s turn it is, or what to say to a friend may not be so obvious.  This short interaction can be amplified and expanded by being curious, asking questions, and making observations.  For example, to prompt a child to look at whose turn it is or stay focused on a game, a parent could ask the child, “Whose turn is it? Do you know whose turn it is, Molly?” A child at this age will be more receptive to the former approach versus, “Molly, it is your turn.  Make sure to pay attention to the game.”  Using observational statements also helps narrate some of these interactional patterns.  A parent could say, “Wow, Molly! Sarah hit 2 pins on her first try, and 6 pins on her second try.  She did a great job. I’m going to give her a high-five!”  Expanding your language beyond “Good job!”, “Great work!”, and “Nice try!” is also helpful.  Try to compliment and appreciate a child’s specific behavior and achievements.  Some example of this phrasing include:

“Andrew, you put your lunch box away by yourself!”

“When you put toys away, that helps Ms. Smith.  She appreciates your help!”

“Carissa, thank you for giving Ella an extra turn.  That was showing great sportsman ship!”

Children at this age also like to have a sense of control and independence.  It’s important for all parents to establish boundaries, but allowing your child to choose some of the rules and boundaries for play will give them a sense of control and create a less restriction environment.   When feeling in control and relaxed, a child will feel more comfortable opening up and exercising their social skills.  Giving children some control of their environment and boundaries will also lead to less resistance or less focus on the “rules”, which will allow the child to be more productive during their social play.  Language and approach makes all the difference when talking to children.  For example, which of the following phrases sounds [approachable?]:

“Well, we could play [game X] or we could also play [game Y].  What do you both want to do?”

“Well, that is not an option.  You can pick [A] or [B].  Which one?”

The words “could”, “also”, and “want” provide a softer approach that appears to be giving all the choice to the child, when in fact you as the parent set the parameters.

Teens 13-18

Working on appropriate social skills with teens during play-dates or outings can be tricky.  First off, it is probably best if you refrain from using the word “play-date” with your teen.  Instead, use “hanging out”.  All teens have an increased self-awareness and are very sensitive to being embarrassed.  Working with your teen is all about being natural and playing it cool.  No teen is going to want their mom or dad lurching around them while their hanging out with their friends, and especially not if they are going to point out things they are doing wrong.  The first key to working with your teen in social situations is to blend in.   As much as you despise that video game with exploding zombie heads, act like you love it! Maybe they are playing a game that makes absolutely no sense at all to you: act excited to learn how to play! Every teen has liked something absolutely silly at that age, but if you are not receptive to their interests, they are not going to be receptive to yours (working on the social skills).  Try your best at refraining from saying as many “Eww!”s or “What?!”s as possible (if you are really brave, try using some “Cool!”s and “Awesome!”s), and instead ask questions about the game or activity they’re playing.  You can ask what the rules are, how to play, what happens if someone does X or does Y, and the object of the game.  Remember to ask in an excited voice and not with a concerned tone. This will not only clue you in on the parameters of their play, but also show that you are interested in their world.  Once you have established this common ground, you can start modeling appropriate social interactions.

When modeling social skills with your teen, it’s important not to draw attention to him/her or single them/their behavior out.  You can still provide correct social responses without having to point out the error.

As an example: Your son/daughter walks in the kitchen, with his friend following behind.  Your son/daughter grabs a soda from the fridge, shuts the door, and starts to leave without offering his friend one. Don’t: “Benny, you need to ask your friend if he wants a soda too. That was rude.” DO: “Chris, would you like a soda as well? If Johnny is thirsty, I’m sure you are too!”

The correct response here allows you to demonstrate to your teen that if he is thirsty, others may feel the same as well.  It provides an example on how to be polite, without making the child feel like he is being scolded in front of his friend.  You can also redirect the focus from your teen by focusing instead on the emotion present.  As an example:

You and your teen are at the beach with a friend and his/her teen.  Your teen skips up to you, unknowingly knocking over their friends sand creation in the process.  DO: “Chris (the friend), you look upset because your castle got knocked over.  You were working hard on that, and I can tell you are upset. Maybe we can help you rebuild it!”

In this example, the emotional context is still being addressed, an appropriate action is still being offered, but there is no blame or focus on someone’s mishap.  Using “we” when offering to help rebuild the castle also allows for another opportunity to work as a team together, and shifts the focus from a blame (“you need to fix his castle”) to working together on the solution.

Lastly, parents can practice their social skills at home.  Practicing with partners or relatives can be very effective modeling.  They are many instances when adults use very subtle cues to express what they are feeling, that may be missed by a teen with ASD.  Compare these examples:

Example 1:

Mom: “Dan, we are almost out of milk, eggs, and we don’t have anything for lunches this week.” Dad/Dan shrugs his shoulders.  Mom: “Well, Dan, I got the groceries last time, and the time before that”.  Mom then stares at Dan/Dad with her hands on her hip and a scornful look on her face.  Dad/Dan is silent for a moment.  Dad/Dan: “I’ll go tonight …” with a huff.   

Example 2:

Mom: “Dan, I’m feeling frustrated that I have to get groceries every time, and I think it would be fair if we took turns and shared the responsibility.” Dan/Dad: “I’m sorry that you’re frustrated and I apologize for not helping out more.  We should be taking turns and sharing the responsibility.  I will go get groceries tonight since you got them the last few times.”

Example 1 uses a lot of emotional cues, body signals, and gestures that may not picked up, where as Example 2 provides a narrative that better describes what each partner is feeling and what the appropriate social rules are.  Of course this change in language is hard to do all the time, and that is not expected.  But recognizing the more subtle emotional language used, and taking time to expand it to provide more clarification can provide great modeling examples for your teen when at home or with family.

Final Note:

On a final note, if you need more help knowing what to do, reach out to your child’s therapist, or behavioral interventionist.  What techniques do they use? What patterns have they seen? What are they currently working on in regards to social skills.  You can even ask to shadow a session.  Working on the same goals and using the same approach will help create consistency, which helps both your child and the therapist or interventionist working with them!

Vanessa (16)

    Vanessa Lemminger M.A. LMFT 53937
Marital and Family Therapist


    


© Vanessa Lemminger, M.A. Marriage and Family Therapist 53937, 2013. Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Vanessa Lemminger, Marriage and Family Therapist 53937 with appropriate and specific direction to the original content.

Featured on Xcite Steps: “Making the Most of a Social Outing”

Head on over to Xcite Step’s website to read my latest article on making the most of a social outing, for parents of children with ASD!

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Vanessa Lemminger, M.A., LMFT 53937
Marriage and Family Therapist

 

Autism: Support for an Entire Family

Time magazine posted a great article online by Barbara Cain titled, ‘Autism’s Invisible Victims: The Siblings’.  Cain speaks about the taxing role of being a sibling to a child with autism, and the endurance siblings need to cope with such a complex disorder.  Although Cain highlights the role of sibling can lead to positive outcomes as well, she emphasizes the importance in recognizing that autism is not just an individual condition, but a condition that effects an entire family.  The entire family deals with autism, and the entire family needs support.

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I would like to reiterate how important it is for parents to find support for themselves as well.  Parents of children with multiple barriers are the most self-sacrificing individuals, and because of this they are likely to disregard their own needs for support, for the needs of their children.  It is important for parents to remember that their needs for support and self-care are essential for providing the best care for their children.  Think about this: When are you more likely to get irritated and yell at your child?  When you are tired? Or when you are feeling refreshed? I am guessing this is an easy answer.  How you feel and the care you take for yourself will reflect in the relationship and care you provide your child.  Whether it means taking an hour out of your day to do something you enjoy, like reading a book or going for a walk, or spending an hour talking to a supportive friend, self-care should not be neglected.

Vanessa Lemminger, M.A., LMFT 53937
Marriage and Family Therapist

 

25 De-stressing Mini-tips

25 De-stressing Mini-Tips

Are you under stress?

Do you feel like you have no spare time to relax?

Well, this article is for you.  Here are 25 de-stressing mini-tips that you can use in the quick five minutes between meetings, or the half-hour you have on your lunch break.  These tips are great ways to collect yourself when stress is high and time is limited.  Some of these tips may work well for you, and others may not.  You will have to figure out which helpful tips work best for you, and work best with your schedule.

1. Go for a walk.  Whether it is just for five minutes to get out of the house or office, or a longer ten-minute walk, some mild exercise and fresh air does wonders when we are under stress.

2. Chocolate! Chocolate’s link to PEA (Phenylethylamine) and endorphin release (check it out here: http://www.allchocolate.com/health/basics/brain.aspx) make it a great option for a quick 5-minute fix.  But here’s the catch: this is not an excuse to eat an entire pint of chocolate ice cream as a “snack”.  The yummy benefits of chocolate come from the actual cacao bean, and dark chocolate has a higher concentration of cacao than milk chocolate, so you will be able to reap better rewards if you stick to the more potent and healthier chocolate.  Also, moderation is key.  There is no point in eating chocolate to relieve stress, if one is just going to over-indulge to the point of causing more stress (“great, now I have to add ‘working out’ to my giant to-do list today.”) Try planning out your chocolate fix.  Look at your schedule, and find your most stressful points of the day.  Are there two, or three? Maybe even five?  Pick out three times in your day where you feel the most stressed, and then pack three bite-size pieces of dark chocolate in your bag.  This will keep you from eating the entire bag, or caving at the snack cart and buying the Snickers bar instead of the healthier dark chocolate.  The idea is to keep your quick-fix a stress reliever and not a stress producer!

3. Eat a healthy meal.  What we put into our body is what we get out in return, and fueling up with a nutritious meal will not only make you feel good, but give you more energy as well!

4. Make yourself a warm drink.  A soothing cup of de-caf tea, or even just an apple cider will do the trick!

5. Get cozy and read a book!

6. Sing your favorite song! We all have a favorite song.  Not just any favorite song, but the song that puts you in a good mood no matter what is going on around you.  (You know, the song that you stop and dance to no matter where you – even if that means dancing down aisle five at the grocery store)  Turn the song on and blast it as high as it goes (or as high as you can get away with where ever you happen to be), and sing away!

7. Laugh! Watch a funny movie, read a great joke, or listen to a comedian.  Do whatever it takes to get yourself to laugh!

8. Make a de-stressing CD or playlist for your Ipod.  Gather some songs, even if it is just a few, that make you feel relaxed.  Take advantage of the five minutes before a meeting or doctor appointment by popping in some ear buds and listening to a calming track, or take advantage of a commute from work and pop in the CD.

9. Write. Using the word “journaling”, always produces some cringes, as the next thought is usually “Dear Diary …”, but wash that image out of your brain.  Pick up a sketchbook from the store.  You can usually find basic ones for about $4.  Sketchbooks work the best for this because they allow more flexibility and creativity.  You don’t have to have a purpose for why you are writing, or even a set format.  Just write.  Maybe you can’t find the words? Draw instead.  Possibly you have seen a picture in a magazine, book, or a picture of your own that reflects what you are feeling – tape it inside the sketchbook.  Quotes are another great starting point for those who are hesitant.  Don’t worry about what you are writing about, and just let the words flow from your hand.

10. Tear up your stress! Think about what is bothering you the most, or what has been on your mind, and write it down on a piece of paper.  Then, tear the paper into shreds!

11.  Do you have too many things on your mind? Are your thoughts racing? Write them down.  Cut a few strips of paper, find a bowl (a fish bowl or mason jar would be fine), and keep them in a handy spot.  When you feel that you can’t focus your thoughts, write down each thought that is causing stress on a piece of paper, fold it up tightly, and place it in the jar.  You can always go back into the jar when you are feeling less anxious and address the things you put in.  By doing this, you allow yourself to completely let go of the thought until you feel better able to tackle it.

12. Cardio: get your heart pumping with some cardio.  Challenge yourself to see how fast you can go on the treadmill, or try something new and learn how to kick-box.  Getting your heart rate up and releasing energy through physical activity is a great way to let go of stress.

13. Try some mindful meditation or breathing exercises. When we exhale, we turn on our parasympathetic nervous system, slowing our body down, which is why many forms of meditation involve extended exhalations.  (Sapolsky, 2004, p. 48)  Are you new to mindfulness or lacking some good breathing exercises? For an introduction to mindfulness and meditation, I would recommend The Miracle of Mindfulness: An Introduction to the Practice of Meditation by Thich Nhat Hanh, which is available on Amazon.com for under $6.  For practical application, I would recommend The Mindful Path to Self-Compassion: Freeing Yourself from Destructive Thoughts and Emotions by Christopher K. Germer, PhD.  Germer’s book covers self-compassion, practicing loving-kindness, and customizing your self-compassion, with practical breathing and meditation exercises weaved into each chapter.  This book can also be found on Amazon.com for as little as $9.

14. Try yoga.  Yoga incorporates breathing and meditation with exercise to treat both our physical and mental self.  There are many different types, or teachings, of yoga, making it easy to find a style that is most fitting to your own.  Yoga is a great practical way to incorporate meditation and breathing exercises for those who are more active/need more of a physical release.

15.  Remind yourself of something that you admire about yourself.  Better yet, make a list of all the things you admire about yourself.

16. Call a friend.  That’s what they are there for!

17. Flex your creative muscles.  Whether is it dancing, painting, drawing, composing, creating, or even a DIY project – just let the energy flow out of your body and create something.  Creativity allows for a flexible release of energy!

18.  Take a short, 30 minutes nap.  Sometimes a little rest can turn a day around.

19.  Get more sleep! This is probably a no-brainer, but one that almost everyone is guilty of neglecting.  There are a million excuses for not going to bed early, but it is better to go to bed early and tackle unfinished projects in the morning when our minds our well rested, as we are better able to concentrate and are actually more productive (despite the fact that we swear we are not a morning person!) Are you a night owl? Start small and head to bed fifteen minutes earlier than you normally would.  The next week set your goal for 30 minutes earlier.

20. Take 30-minutes to yourself each morning.  Don’t do what you have to do, or what you should do, but do what you want to do.  We often spend most of our day doing things for others, and when there is finally time at the end of the day for ourselves, we are often too tired to take it.  Reverse this pattern and make the first thing you do in the day for you.

21. Plan your day.  Take a few minutes to plan out your busy day.  When you are prepared, things go much smoother and you are better prepared to deal with natural bumps that occur.

22.  Treat yourself to a massage.  Only have a couple of minutes, or are trying to save money? Even little, self-administered massages are great.  Try gently massaging your temples, nose, or scalp when you are under stress.  A scalp massage would also go great with a nice hot shower, recommended in #24.

23. Immerse yourself in nature.  There is something about our natural environment that brings a sense of relaxation and grounds us.  When you are stressed, surround yourself with nature.  If you only have five minutes at work or with the kids, go for a brief walk outside, eat your lunch on the grass, or just enjoy the breeze from an open window (We rely on our air conditioning systems way too often!).  Do you have more time? Go on hike, enjoy a lake, or head to the ocean.  In my opinion, nature’s most calming element is rain.  Next time it rains, take five or ten minutes to enjoy it in its entirety.  Open the window (you can lay down a towel to protect the window sill or floor), and smell the scent of fresh rain.  Feel the cool, humid air rush in.  If you’re really brave, sit outside when it rains and feel the raindrops bounce off your body.

24.  Take a nice, long, hot bath or shower.  Not the kind of shower that you take to do the everyday scrub down.  Take a shower just to feel warm water run over your skin, and focus on how your muscles relax as you feel the beads of water drip down.

25. Create a new space.  This depends on the space and the amount of freedom you have, but try changing the space you are in.  Re-arrange the furniture, reorganize, or change the décor.  If you really have a lot of flexibility, be bold and repaint the room.  Changing the space you are in will also change the energy and feel that accompanies the room. If you are questioning this one, think about the advertising business.  There is a whole industry built around creating different feelings and messages by creative placement.

Do you have any other great suggestions that I missed? Please, let me know! Pass along what great de-stressing mini-tips you may have as well!

Reference:
Sapolsky, R. M. (2004).  Why zebras don’t get ulcers.  New York, NY: Henry Holt and Company, LLC.

Vanessa Lemminger, M.A., LMFT 53937
Marriage and Family Therapist

© Vanessa Lemminger, M.A. Marriage and Family Therapist 53937, 2013. Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Vanessa Lemminger, Marriage and Family Therapist 53937 with appropriate and specific direction to the original content.

What Is Loss?

What is Loss?

Death.  It’s one of the most taboo subjects.  If you ever want to end a conversation, start talking about death.  Death and the sadness that occurs afterward, are often met by friends and loved ones with attempts to return to happiness as fast as possible, instead of attempting to understand how to cope with the experience.  Avoidance is even found in graduate-level counseling programs, where grief/loss is completely removed from the required coursework.  Despite all of our avoiding, death and loss surround us and occur more often than we realize.

Loss can be camouflaged, but it lies in almost everything we experience.  Loss of identity is a common hidden loss.  This can occur for many reasons.  For example, after a divorce, many people experience a loss of identity as they transition from a married couple to a single individual.  It grows increasingly difficult the longer a marriage lasts, since the longer someone has held an identity, the harder it becomes to transition to a new identity.  Loss of identity can also be seen in children during divorces.  For some children, the change that occurs may mean taking a new role in the family, transitioning from son to “man of the household.”  This switch can cause stress, conflict, and confusion for the family member who is forced to take on a role they are not normally accustomed to.  Losing a job can also cause identity loss, particularly with men.  Society has labeled men with the social role of “provider.”  Working and providing for a family is an identity for many men, and when that is taken away via job loss, men sometimes have a difficult time adjusting to a new role as dependent.

Another common but hidden loss is the relocation of a home.  This loss is probably more common today as many families are forced to move because of the inability to afford their current bills, job relocation, or foreclosure due to a poor economy.  For many families, the home symbolizes much more than just a roof and four walls; it can hold history, memories, and an ongoing restructuring project and result of hard work.  Losing a home or being forced to move can be devastating and leave one with feelings of intense loss.   Our homes are also our place of comfort.  Do you remember your first move? How long did it take you to make your new place feel like “home”? This feeling of comfort is often grieved as well when losing a home.

Loss of ability is another example that can occur for people with chronic or terminal medical conditions.  For instance, some diseases like Multiple Sclerosis (MS), which results in loss of muscle control, slowly strips away many abilities that a person once had.  Just one month after diagnosis, an individual may lose their ability to sleep comfortably.  Months later, they may lose their ability to walk without assistance.  Next goes the ability to walk at all, being bound to a wheel chair.  Loss of vision, the ability to control bowel movements, and the strength to feed oneself can also occur.  Each of these different stages in the disease results in a loss, and those individuals experience grief during each individual stage.  [I would like to note that this is a generalized example based on a severe course of MS.  Not all individuals with MS will experience these symptoms, and not all courses of MS follow the same path.]  Sudden loss due to either disease or tragic event is also a loss that requires grieving.

As one can see, there are many types of losses that are not the actual loss of a human life.  People experience these losses many times over, but often confuse the experience with other emotions.  Are we really mad that the staircase in the new house is placed in such an awkward place, or are we just grieving the loss of what was once our place of comfort and security? Are you really upset that your partner took on more hours at work, leaving no time to help you around the house? Or are you having a hard time transitioning out of the role in the family as “provider”?

One may answer, “What does it matter? Regardless of how I got there, I’m left feeling mad!” One cannot begin grieving something they have not yet acknowledged has been lost.  Appropriately defining these moments as a loss ― whether it be a divorce, losing a job or a house, gaining a new identity as a single, taking on a new role in the family, or declining physical abilities due to a chronic medical condition ― will help one gain a clearer understanding of what they are experiencing, and help one to better cope with the feelings they are having.

It is also important to recognize the actual loss to allow for the time and space to grieve.  Although it may not be seen by others as an “actual” loss, what was experienced is, in fact, a loss and can leave one with the exact same feelings.  Taking care of oneself during this difficult time is not only important, but essential.

Vanessa Lemminger M.A., LMFT 53937
Marriage and Family Therapist

Check out my blog post featured on the R.A.R.E. Project site!

http://rareproject.org/2012/04/16/what-is-loss/

© Vanessa Lemminger, M.A. Marriage and Family Therapist 53937, 2013. Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Vanessa Lemminger, Marriage and Family Therapist 53937 with appropriate and specific direction to the original content.

Coping when Tragedy Strikes

In a world of “How To, For Dummies”, Web MD, and the ease of Google search,  we are accustomed to finding fast solutions to problems we encounter.  With a quick search on You Tube, one can find tutorials on everything from “how to create perfect curls” to “how to pick a lock”.  There are books that range from “How to Run a Successful Business” to “How to Find Inner Peace”.  Information, guidance, and insight are at the tip of our fingers in our fast paced, highly connected society.  When tragedy strikes, we often have the same urge to find a solution, some guidance, or at least some insight into what steps we should take next.  Working in the field of therapy, this is something I see often.  “What should I do?” “How long will this feeling last?” “How long does it take to recover?” “Will things ever feel normal?” “What do other parents do?” “Am I taking the right steps?”

My answer is never a simple one, and never a popular one.  In fact, that actual thought of one person having an “answer” to such problems, is ridiculous.  My reaction, instead, is this: If there was a “How To” book on what to do and how to cope when tragedy strikes, everyone would read it front to back, ten times over.  The book would be an instant best seller, but unfortunately, such a book does not exist.

There is no easy way to cope when tragedy strikes, and there is no easy answer on how to react.  What I can suggest, however, is helpful hints on how to make coping easier, and how to find solace in your own way.

Don’t panic:

Whether you have just been given a life-altering diagnosis, or experiencing another relapse through the course of a current condition, it is important not to panic.  It is easy to let our thoughts run wild, and sometimes when we are delivered what seems like unimaginable, out-of-this world news, our thoughts tend to drift into the unimaginable as well.  It is easy to instantly think of the worst that can happen, and get lost in a tumbling avalanche of fear and panic.

Although it is important not to panic, this does not mean you shouldn’t be experiencing feelings of sadness, shock, and fear.  All those reactions and emotions are normal to experience.

Give yourself time to cope:

This is a continuation of what I said above under “don’t panic”.  Disbelief, depression, anger, fear, and even euphoria are all emotions that can occur when tragedy arrives.  The different emotional states can occur in any order, and occur many times, or some not at all.   No matter what card you just been dealt, life continues to move at its normal lightening-fast speed.  It’s important to put take some time to yourself.   Put the breaks on when needed, and make sure to give yourself plenty of time during the day to just, simply, breathe.  Once you allow yourself to experience these emotions, you can start to reflect on the deeper meaning behind what is going on.

Educate yourself:

Don’t let shock and disbelief leave you helpless.  Educate yourself the best you can on what you are dealing with.  Information can help empower, thus leaving us to make better decisions that will lead us to more positive outcomes for ourselves.  Our bodies and our lives are as intricate as the ecosystem.  Making small, minor adjustments can create surprisingly large changes in how we feel.

Education can help us better understand the course of a disease, what the future may look like, common symptoms, and helpful ways to lessen or deal with side effects.  Education can tell us about what treatment is available, what treatment is not available, and what others in our position have encountered.

Education is similar to solving a Sudoku puzzle.  The more numbers that are available, the easier the puzzle is to solve.  Granted, this is a very simple metaphor, and “solve” is a very concrete and loaded word when dealing with tragedy, the point is to emphasize the importance of knowledge.  The more you know, the more control you can gain on the situation.

Now, here is the catch: it is also important not to obsess over information.  Moderation is key here.  Have you ever made a list for a list? (Guilty here.) Make sure that this stays helpful, and doesn’t lead to more stress.  Determine what would be helpful to know, and what you are content about leaving alone.

Self-reflection: What does this mean for you?

Find some time for self-reflection, grab a soothing cup of tea (or any thing that helps you relax), grab a notebook, and find a comfortable spot in your favorite room.

Take some time to think about these questions, how you would answer them, and actually jot them down in a notebook.  Physically writing down your answers will help give these answers weight.

1. How is this event going to change my life?

2.  How have these changes altered my identify?

3. How did I define myself prior to this event, and how do I define myself now?

4. What does this situation mean to me?

Whether you are experiencing an actual loss, or experiencing the loss of ability or lifestyle, these losses can be disorienting and alter our sense of identity.  Finding meaning in who we are and understanding how the changes in our life will redefine us will aid in the coping process.  It may take a while to feel content about our answers.  It is the process that is important.

Vanessa Lemminger, M.A., LMFT 53937

Marriage and Family Therapist

This article can also be found on the R.A.R.E. Project’s blog! Check out link and learn more about the R.A.R.E. project!

http://rareproject.org/2012/04/03/coping-when-tragedy-strikes/

© Vanessa Lemminger, M.A. Marriage and Family Therapist 53937, 2013. Unauthorized use and/or duplication of this material without express and written permission from this author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Vanessa Lemminger, Marriage and Family Therapist 53937 with appropriate and specific direction to the original content.