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Gratitude is a hot buzz word right now. Everywhere you go, you hear about being “in the moment” and being thankful for what you have. If you Google 'Gratitude', a million different definitions come up. I like the one from Psychology Today, which states  “Gratitude is an emotion expressing appreciation for what one has—as opposed to, for example, a consumer-driven emphasis on what one wants.” People who express gratitude, meaningfully and often, tend to experience more positive emotions, sleep better, are kinder, and have stronger immune systems. Gratitude does not just have to be shown after a big event, like a bar mitzvah or a promotion; it works best when integrated into our daily lives. Being thankful for every day, little things, helps us realized how blessed we are. When forming a habit, we’re told to practice at the same time every day, over a significant period of time. When we think about practicing gratitude, we are taught to notice new little things. If you say “I am thankful for my spouse and children”  all the time, you lose interest in gratitude. It just becomes a meaningless platitude. But if everyday we are able to find even one new things to be thankful for, we begin to look at our world differently. Studies have shown there are many different, healthy, and effective ways of displaying gratitude: you can write in a journal. Logging your thoughts for yourself helps keep you on track and reminds you of all the many things around you you are thankful for. You can also write a letter to those who have helped shape you into you. Letting people know how much they mean to you, what effect they have had on you, is immeasurable. You feel good saying something, and knowing that you are making someone happy. The other person is touched and honored, knowing that their comments, or actions, have made a difference, even to one person. Giving is another way to practice gratitude. Winston Churchill once said “We make a living by what we get. We make a life by what we give.” When we give money, even a small amount, to someone else, we feel more pleasure than if we were to spend that amount on ourselves. When we donate, Oxytocin, the “feel good” hormone, is released in our brains, which helps to lower our stress and increases our sense of connection to others. This oxytocin boost will cause people to give more generously and feel a greater sense of empathy towards others. This in turns causes people to want to pay it forward, to keep the loop going. A recent survey noted that people who donated to charity in the past month reported a greater sense of satisfaction. In fact, across 136 countries, donating to a charity that you believe in and are thankful for had a similar impact on happiness levels as doubling your household income. A little Thank You goes a long way. Not just for you, but for all those you meet.

I think the buzz-phrase for a while has been “self-care”. Recently we have been bombarded with messages of how we need to take care of ourselves; how important it is to make sure we don’t burn out; how if we aren’t ok, we won’t be able to take care of anyone else. I think in the current climate, the notion of “self-care” is more important than ever. We are being bombarded with news and feelings from all sides: our friends, our family, the news. Even our recent diversions don’t allow us to escape: Facebook and Twitter are rife with political and emotional messages. We need to stop. We need to take care of ourselves. Burnout has never been so close as it is now. We need to take care of bodies and our minds, because if we aren’t ok, we can’t be effective friends, spouses, parents. Here are my suggestions: Disconnect from all social media. Listen to audiobooks in the car. Meditate, color, knit, run. When you find yourself becoming upset, drawn in to a thought or argument that will raise your hackles and blood pressure, walk away. Think about your breath coming in and out of your body. Remember you don’t have to pay attention to those pesky notions running through your mind. The world has changed. But our role in it has not. We need to be there for those who rely on us.  We are the helpers and the healers. But this time, more than ever, it’s important to take care of ourselves.  We are worthy people, too. Self-care is more than just a buzz-phrase today. It’s a lifestyle.

When my son was diagnosed with ADHD, I thought, as a psychologist, I was prepared for the continuing challenges of parenting. But I was wrong. All my knowledge went out the window as I attempted to plead, cajole, beg, bribe, yell my way through parenting my son.  Those early childhood years of his life were increasingly tough. There were many moments I wished that there could have been a support group, a therapist, someone, who knew what I was going through. So that all of these increasingly difficult behaviors weren’t on mine and my husband’s shoulders alone. We were very lucky. We had friends and family, and a WONDERFUL therapist who helped us through it all. And even with all the support, we felt isolated from our parent-peers.  There are many parents out there who don’t have the support base we had. And it’s not just parents of children with ADHD that experience this burn out. One population of parents in particular has an exceptionally high rate of anxiety and depression. Parents and primary caregivers of children with Autism Spectrum Disorder (ASD) have significantly high rates of depression and anxiety (50% and 40% respectively).  Despite this, very few seek treatment for themselves. We know that if treatment is received, we can decrease these rates of anxiety and depression, thereby increasing satisfaction and effective parenting techniques, and decreasing alienation and loneliness. A recent study by Lushin and O’Brien (2016) has found that using the Early Intervention Program to provide treatment to parents, either in a home-based or clinic-based setting (where their child receives services) helps reduce the symptoms and severity of the depression and anxiety related to parenting s child with ASD. Receiving treatment for their depression and anxiety helps them parent effectively, which in turn helps their children. The Early Intervention Program seems like a perfect vehicle to provide these services. And we know that the early the effective services are provided to the child (and that includes appropriate parenting), the better the child is in the long term. And the better we all are. Lushin, V., & O’Brien, K.H. (2016) Parental Mental Health: Addressing the unmet needs of caregivers for children with autism spectrum disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 1013-1015. http://dx.doi.org/10.1016/j.jaac.2016.09.507

What happens when being sad doesn’t go away? Or, what does it mean when a young child is jumpy, unfocused, sad, and angry, more often than not? When young children are diagnosed with Major Depressive Disorder (MDD) often medication and/or therapy are prescribed. Many times, despite our best efforts, children with MDD often relapse. A new study looked at children prescribed fluoxetine (Prozac) as well as relapse prevention cognitive behavioral therapy (CBT). Interestingly, regardless of whether children received relapse prevention treatment, 80% of them experienced remission; that means that 80% of children in the study got better! But there was a group of children who relapsed. Children in the fluoxetine and CBT relapse prevention group stayed mentally healthy more than three months longer than those just receiving medication. Booster CBT relapse prevention therapy, along with appropriate medication management, has been shown to be effective in helping children diagnosed with MDD. Reviewing mastered skills, before they are needed, can help prevent further relapse, and quicker recovery, so that kids can get back to being kids. Emslie, G.J., Kennard, B.D., Mayes, T.L., Nakonezny, P.A., Moore, J., Jones, J.M., … King, J. (2015). Continued effectiveness of relapse prevention cognitive-behavioral therapy following fluoxetine treatment in youth with major depressive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54, 991-998. http://dx.doi.org/10.1016/j.jaac.2015.09.014

In my various roles as a mother, a friend, a psychologist, president and a board member of a psychological association, I meet a variety of people with different outlooks on life. Most people have their own opinions on how to do things. However, if I were to take everyone’s opinions as fact, I would be befuddled, and confused, and sometimes, paralyzed. To help me deal with several different perspectives, I need my own set of tools to help filter the information I receive. That way, I can analyze any given puzzle to find the solution that best works for me. In a nutshell, that is what cognitive behavioral therapy is. It provides tools to help one look at the world in a certain perspective. Cognitive behavioral therapy strives to adjust one’s thoughts, feelings and actions, so as to help one function in the world better. A trained cognitive behavioral therapist can help your child see the world differently from how he or she is accustomed to seeing it. We work on helping children recognize their thoughts as separate and apart from themselves; we work on talking back to those thoughts. Moreover, we work on knowing when something can’t be changed and how to accept that. A cognitive behavioral therapist teaches children how to be responsible for their own actions, and not those of others. When you change how you act, you can change other people’s actions and reactions as well. And when we change our thoughts and actions, our feelings change, too. In the end, it’s not the only way to view the world. But it’s about helping your child grasp the way that might make sense to him or her. And if it does, then it’s the best way to effect change.

I remember the first time a parent said to me “Your son is too violent. I hope you understand. I don’t want my son to get hurt. I can’t let him play with your son.” I remember being devastated and feeling so alone. If you’ve ever been in a similar situation, I bet you’ve asked yourself questions like, ‘how do you find yourself again? How do you find a group, who loves you and understand you AND your child?’ Here are four tips to help you navigate through this difficult time. 1. Smile. Through the tears, through the feelings of sadness, hurt and anger. Just smile. When you look happy, you are more approachable to other people. And when your child looks back at you and sees you smile, they will be more assured and calmer. 2. Go out. Put yourself out there. No one is going to come to your door and making you leave your bed, house or den. That might mean going to a coffee shop, a painting night, joining a book club or any other fun event. The point is, to get yourself out there and connect with others. 3. Take an exercise class. It’ll have a dual effect of pumping your endorphins and making you feel better and meeting people who are also happy. You will be involved in a group activity that gives you a common goal, and a common topic to talk about and do together. 4. Find your “like”. Join a support group. There are other parents out there who have children similar to yours and they will have a wealth of understanding for you and your child. It’s tough now, it feels unfair, unjustified, not right, but your child will grow up. While you’re on your journey of raising your child, put yourself out there and you will find people who understand that your child’s behavior is not your own, they will see that you’re doing your very best and they will be a blessing to you and your child just like you will be a blessing to them.

In our minds, summer is usually the time to break loose. Our kids get excited about having no more rules, no more books, riding around the neighborhood with their friends. However, let’s take the time to imagine if summer wasn’t that carefree. Our kids know the rules in school, they know where to sit, who to talk to and how to play. Yet, in the summer those rules don’t apply. It’s as though they are thrust into a world they aren’t yet ready for. They have a bundle of energy, they want to play but they don’t know how. For a child encountering these feelings, summer can be really stressful for them. Enter summer camp! It provides a structured environment that is wholly centered on fun. Like school, it clearly defines how to have fun, when to have fun and with whom. The right camp provides a structured, active environment that can help your child blossom and learn to have fun with their friends, whether they have ADHD or not. Now that we’ve established camp can be a lifesaver for you and your child, here are some tips on choosing the right summer camp for your little one(s). 1. Ask. The most important thing you can do is, ask your child. They go to school and try to listen/follow the rules all year long. This is the time to listen and find out what activities they enjoy? Do they want to meet new people or go to camp with familiar faces? If they are involved in the process of choosing a camp, they are more likely to enjoy their summer. Ask their teachers and school staff as well. They know your child and have a different opinion on how they interact with others at school. Remember to keep this information in mind when you are choosing a summer program. 2. Staff. There are a few important things you want to look for in a camp. The smaller the camper the counselor ratio, the more supervision there will be. Imagine everyone is off playing basketball and your child doesn’t want to. A small camper to counselor ratio will allow someone to take a walk with your child, cool them off, and maybe even tutor them on the game while sitting on the sidelines. This approach is wonderful because it doesn’t stress out the rest of the group or embarrass your child. This experience really happened with my son and it was the best solution possible!
You also want to know the age of the counselors and their training. You might choose to pay more for a camp where every counselor is a teacher, as opposed to a teenager but you know they have more patience and training to work with your particular child. You also want to know how many nurses are on staff. This is important if your child is going to be receiving medication. It’s reassuring to know that someone is on staff that can either administer the medicine or keep a trained eye on your child to make sure no adverse reactions occur in the hot sun while they are running around. 3. Activities. In this day and age, many kids want to spend the summer glued to an electronic device. Don’t let them. The more physical activities they are involved in, the better and happier they will be. This is true of all children, but especially those with ADHD. There’s something to be said about being outside, running around in the fresh air. There are tons of studies that say that one of the most effective treatments for ADHD. Outdoor exercise is highly beneficial, so look for a camp that provides outside activities, shade and access to water and hydration. On the flip side, you want to know that if it rains the fun doesn’t stop. A good camp will have an organized rainy day plan. 4. Types of Camp. There are camps that specialize in working with children who have been diagnosed with ADHD, learning disabilities, or Tourette’s Syndrome etc. These may be a great option for you. However, don’t rule out the local programs either. They may be just what your child needs. Remember, each camp is different, and each child is different. It may take some investigating, but there is a program out there to help your child have the best summer of their lives.

There are so many things we want to pass along to our kids: love of music, love of sports, good work ethics, beautiful curls or blue eyes. Sometimes, our genetics adds little “bonuses” with our gifts, like ADHD. Or Celiac. Or any number of other genetic blips. It’s hard to parent a child in general, but adding the guilt on top of that makes it even more gut wrenching. I remember feeling terribly guilty that my son had ADHD. It’s because my husband has difficulty starting a project without being asked many times. It’s because I was bouncy and combative as a child. Maybe if we didn’t have so many kids. Maybe if we didn’t send him to school so early, or to camp. Maybe if I didn’t work. If I did ‘x’ differently, maybe then he’d be able to listen, and sit, and keep his hands to himself. I’m here to tell you that almost everyone feels some level of guilt. It’s normal to second guess yourself and your choices. But don’t let that overwhelm you or your ability to parent. It’s not anyone’s “fault”. It is what it is. It’s also important to know if you are consumed with guilt, or any sort of overwhelming emotion for that matter, you can’t parent effectively. Let’s play devils advocate. Let’s imagine, for example, that it is totally your fault. As in, you hand-picked these genetics to give to your child. You can get upset that you shouldn’t have done that and that you made a mistake. You want to wish it away but you can’t. Your child has green eyes and that’s it. However, if your child has diabetes or autism, your job changes; it gets more interesting.
How do you teach your children not to rail against their nature, but to embrace their strengths, their idiosyncrasies? It’s a tough job but you start with the fact that everyone has something that they come up against in life. It’s not that they have this, but how they handle it that makes them the person that they are. Who they are isn’t bad; each little negative has a flip side, a positive. Our job as parents is to find the positive and help them shine, even if our children can’t figure out how to do it for themselves yet. Feeling guilty comes with being a parent. You don’t want to hurt or disappoint your child, but no, they can’t have the $300 toy car. They will cry about it and you might feel bad. What makes you a good parent is the ability to know what is within your control, and what isn’t. The genes that are passed along to your child are not within your control, but how you love and live with your child is. That is what makes all the difference.

I remember the first time someone said they didn’t want their son playing with mine. They were both about 5 years old, and the mom said my son was “just too rough.” She didn’t want her son getting hurt. This was someone I considered a friend. The kids played well together often, I had thought. So when mom said this, I was absolutely taken aback. I spent the next few days just listening; watching how other parents and kids interacted with my son. I know he had issues, but I wondered how others dealt with him. To be honest, when kids are that young, parents aren’t often cruel. There is usually an expectation of “Oh, he’s a five-year-old boy”. However, when they get older society expects children to grow up and sometimes our kids don’t get that memo. They may not mature as quickly as their peers or act as other kids expect them to and then the hurtful words come. In addition to that, there are the sly glances and the avoidance. How you handle that as a parent effects how your children will handle these social games as well. Here are some tips that I hope will help you handle these difficult situations with aplomb. 1. Don’t worry so much about what other people think. This is true in general, but especially when it comes to your child. You are the expert on your child. Other people are merely consultants. This will also help you to be less hurt and upset by what they say. 2. Smile. A lot. It’s a great habit to get into. When you are angry, or upset at someone else, just smile at them. They get confused and don’t know what to do with that. And it keeps the tension of the moment off of you and yours. Imagine if that’s a skill your child could emulate? It’s such a great gift you can give to them! 3. Hug your Child. They are loved, and they need to know that. We may think they don’t hear the comments or see the glances, but they do. They need to know that you, their rock, their support, still loves them unconditionally. 4. If you must reply, be calm. See number 2. Yelling and getting emotional just makes everything a tangled mess. When you are calm and in control, you can control the situation. Whether you are stopping someone else from disciplining your child, or you are correcting a misperception, it should only be done when you can take a calm breath and maintain that mood. If you yell and scream, you lower yourself to their level. And now there are many children fighting, even ones that are really big and should know better. 5. If all else fails, walk away. That old adage is true: if you have nothing nice to say, don’t say anything. Some people aren’t happy and some people think pointing out other peoples flaws make them look better. You don’t have to be part of that. Leave. You and your child deserve better. Everyone is going through something, it’s just that sometimes those “things” are more obvious. Remember that you love your child, regardless of what other feel and that is what’s really important.

I love being a mom. I love that my five-year-old daughter says “Good morning Sunshine!” when I wake her up (even after she’s called me from the other room yelling, “WAKE ME UP, MOMMY!!!!”) I love that my almost 9 year old wants to share with me all the gruesome ways people have died while wearing Disney costumes (don’t believe everything you see on the internet, kid). I love how my 11-year-old son asks me how to make shakes in the morning, and to find out whether the ‘Farm to Table Restaurant’ is available for a special lunch, just for the two of us. I love my 12-year-old son as well. It’s just harder to remember that when he’s yelling at me to shut up and saying how untrustworthy I am, when he’s chosen to sneak on the computer to play games at some ridiculous hour in the morning. As I am so gently reminded by my husband, sometimes, I need to take my own advice. So here it is for my benefit and yours: some tips on living with an Oppositional (Pre) Teenager. 1. You love them. Sometimes it’s hard to remember this was the tiny infant you held until they fell asleep. Or played with on the swings for hours. But it’s the same kid. They are just buried in there under a tremendous amount of hormones. We need to remember that these kids are sometimes even harder to parent than typical teenagers because of their O.D.D. Remember, after the storm come the calm. Hang in there; it’s going to get better. 2. Tell them. When confronted, these kids will count the numerous ways they have been wronged, persecuted, maligned etc. Ignore it. Calmly tell them what they did wrong and walk away. Sometimes, it feels like they don’t hear you, but they are soaking in everything you say and do to incorporate into their adult repertoire. By telling them what they did wrong, in a calm manner, you are showing them that you are in control. Don’t take anything they say while they are in the midst of a “fit” seriously. They will say anything, and I do mean anything, to get your goat. Don’t respond. Stick to the topic at hand. Be short and sweet; then walk away. 3. Don’t fight, discuss sparingly. Even though they fight us every step of the way, we need to remember that these kids need boundaries. When we engage in fighting with them, those boundaries get loosened, and they get scared. Think of it this way: I’m going fight with you to push back against those boundaries (that’s what O.D.D. kids do), but if you fight back with me, those boundaries that I’m testing aren’t as secure as I need them to be, and now I’m lost. If you need to discuss something, or you think it’s a topic worth exploring, wait until both of you are calm and have a back and forth conversation. Always remain calmly in charge, and when you feel yourself getting tense, gracefully excuse yourself and walk away. 4. Let it go. I can hear Disney playing in the background…. But seriously, some things aren’t worth fighting over. Listening to a 12 year old interrupting, while a five year old sings “we don’t interrupt”, and an 11 year old continually trying to speak over him, and a 9 year old egging everyone on, trust me, I was tempted to walk in there and start yelling in order to gain control of the situation. You know what though, in two minutes, it all calmed down, and I didn’t have do a thing. It wasn’t worth me getting involved; they needed to figure this out on their own. My take away from this is, my 12 year old needs to learn from life, not from mom consistently stepping in and telling him what to do. 5. In Vivo learning. That’s fancy talk for learning from experience. Sometimes we want to tell our kids what to do, we want to reintroduce the rules AGAIN for the millionth time. Don’t. It’s more effective coming from someone who’s not you. You don’t want to sound like the teacher from Peanuts “wah wah wah”. Our kids learn so much quicker from real life experience. We can tell them if they play basketball in the rain, they are going to get sick, be cold, fall and get hurt. However, if we let them just do it, and they come in cold and wet and battling a sniffle, or if they fall and hurt their hand, they will think twice about playing in the next rainstorm. Kids learn so much more effectively from personal experience. Just as with neurotypical teens, it’s time to let our older kids experience things on their own. That’s not to say let them engage in unsafe behaviors or let them put themselves in dangerous situations. We still need to parent, but pick your battles and allow let them learn some important life lessons. 6. Take care of yourself. This is so important. I know I’ve mentioned this in other posts, but it’s so important to remember that if you are happy, you are more likely to be calm. The calmer you are, the less they will fight. (Not that they won’t fight, it’ll just be less intense and not last as long.) They will also feel safer when you are calmer, and you’ll be happier and able to deal with these adverse situations much better. Good luck. I promise you, it’s going to get better.