catholicism, attachment theory, and the mental health of our students catholic association of...
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Catholicism, Attachment theory, and the
Mental Health of our Students
Catholic Association of Religious and Family Life Educators Ontario
Dr. Phil CarneyMay 12, 2011
CARFLEO!
“How does our Catholic faith tradition inform our understanding of and approach to the mental health issues of youth?”
Email from Bronek Korczynski, January 20, 2011
Dear Ruben:
allexperts.com/q/Catholics-955/2009/3/Mental-Illness-Deliverance.htm
I am sorry to hear about your and your son's affliction. We will pray for your and your son. You can know that God accepts your offering of your suffering and that suffering is redemptive because God and the Church teaches that....
While it is technically possible that a person can be afflicted with a demon that causes some symptoms of mental illness, there will be more than that usually to indicate a demonic involvement.
Mental illness is usually caused by brain chemistry issues. Also, mental illness tends to run in families.
Beautiful documentCould quote from every paragraph
APOSTOLIC LETTERSALVIFICI DOLORIS
JOHN PAUL II
ON THE CHRISTIAN MEANINGOF HUMAN SUFFERING
Story of Job – problem of evil
Christ’s sufferings – redemptive, and we are not defeated
Good Samaritan
Beautiful documentCould quote from every paragraph
The parable of the Good Samaritan belongs to the Gospel of suffering. For it indicates what the
relationship of each of us must be towards our suffering neighbour. We are not allowed to "pass by
on the other side" indifferently; we must "stop" beside him. Everyone who stops beside the
suffering of another person, whatever form it may take, is a Good Samaritan. This stopping does not
mean curiosity but availability. It is like the opening of a certain interior disposition of the heart, which
also has an emotional expression of its own.
A template, perhaps?Catholic Psychotherapy Association
“As a long time therapist with a re-awakening of my
faith, I was keenly aware of how (important )
Christ’s love is to the healing of the human heart.
I felt incredibly alone with my desire to put this
into the therapy I was doing, especially working
within a Catholic Church.”
Sandra McKay, President
Reported in Denver Catholic Register, April, 2009
Let’s get our bearings......
ROLE OF CATHOLIC EDUCATION
“In our own time, we hear a great deal about work
being done in Ontario’s schools to create ‘schools of
character.’ Society can only benefit from such efforts.
At the same time, however, Catholic schools must
continue to be schools of transformation,
transforming not only students but society as a
whole, into the image of Christ.”
Catholic District school Board of Eastern Ontario
“If you have a strong commitment to Catholic education........”Let’s get our bearings......
THE CHALLENGE FOR CATHOLIC SCHOOLSDennis Murphy
The challenge is to announce anew and in
contemporary fashion the Christian and Catholic
answer to the perennial search for our souls ....
(Note: ie, there are others out there doing the
searching. We better have answers! We have better
answers!)
The goal here this evening
- The Catholic ‘brand’ and the brand loyalty challenge
- Locate mental health issues as developmental issues, which are in turn Attachment issues
- Show how you can intervene most effectively on mental health issues through your Attachment relationships with your kids
- To show how our Catholic faith tradition brings Attachment theory to life in a way the
clinical world cannot
Here’s the challenge. Catholics in every profession live in culture
of THE AGE OF ENTITLEMENT
See in parish context. Selective self-exemption from ....
-Catholic Mission Statements (hospitals, school boards, etc)
-Church teachings
-Practice of the faith
-Specific needs of the kids (ie, passing by on the other side’)
Not alone with the temptation
Shoeless Joe Jackson
President of Ford Motors
”SAY IT AIN’T SO, JOE!!”White Sox lost the 1919 World Series to the Cincinnati
Reds
How long was that Lexus in the parking spot of the President of Ford Canada?
What if a Catholic teacher worked with kids in an environment committed to
“..transforming ... students... In the image of Christ”
but
Quietly was loyal to a different team – or no team
Chose not to display the brand
Teaching in a Catholic school does not make you a Catholic teacher.
- Just saying.
National Institute of Mental Health (U.S.)
Research shows that half of all lifetime cases of
mental illness begin by age 14.1 Scientists are
discovering that changes in the body leading to
mental illness may start much earlier, before any
symptoms appear.
http://www.nimh.nih.gov/
Mental heath issues - data Centre for Addiction and Mental Health 2006
About 1 in 5 children and adolescents in the US, symptoms
mental health disorder, in given year, and about 5 in 100,
serious emotional disturbance with functional impairment.
Canadian children and adolescents: prevalence of a mental
health problem ranges from 18 to 22 per cent, and is about
25% among young adults.
Suicide, third leading cause of death, Canadian/ US
adolescents (after mva and other accident deaths).
Prevalence of mental health problems among young people
may be increasing (Adlaf et al., 2002).
The Mental Health Foundation:mentally healthy individual is one who can:
-Develop emotionally, creatively, intellectually and
spiritually;
-Initiate, develop and sustain mutually satisfying personal
relationships;
-Face problems, resolve them and learn from them;
-Be confident and assertive;
-Be aware of others and empathise with them;
-Use and enjoy solitude;
-Play and have fun;
-Laugh, both at themselves and at the world.
MHS Evidence Jan 2011
Quick tour through some of the diagnoses you will deal with, and that compromise
child developmentDepression
Persistent sad mood; Loss of interest or pleasure; Restlessness, irritability, or excessive crying; Feelings of guilt, worthlessness, helplessness, hopelessness, pessimism; Sleeping too much or too little; Appetite change; Decreased energy; Thoughts of death or suicide, or suicide attempts; Difficulty concentrating; Persistent physical symptoms that do not respond to treatment.
While adults may experience depressed mood, children and adolescents may display more irritable than depressed mood. An adult who is depressed may experience weight loss. Children, however, may not gain the expected amount of weight for their age.
All About Depression.com May 2002
Quick tour.....
Childhood Anxiety Disorders
-Anxiety disorders: most common form of psychopathology in children with an overall prevalence rate of 8–10% .
-Generalized anxiety disorder, separation anxiety disorder, and simple phobia are among the most frequently diagnosed (3,24).
-Childhood anxiety disorders are often associated with other childhood anxiety disorders and with depression. It is extremely important ... to be aware of these.
Susan Jo Perlmutter, M.D. 2000
Quick tour.....Childhood Anxiety Disorders
Susan Jo Perlmutter, M.D. 2000
BEHAVIORAL INHIBITION -tendency to withdraw when exposed to unfamiliar situations ;
SEPARATION ANXIETY DISORDER -become extremely distressed when separated from a parent;
PANIC DISORDER -recurrent and unexpected panic attacks - discrete period of intense fear or discomfort
SELECTIVE MUTISM -manifestation of a shy and inhibited temperament and may be a variant of social phobia.
OBSESSIVE-COMPULSIVE DISORDER -recurrent obsessions or compulsions that are time consuming or cause marked distress or impairment.
Quick tour.....
Not a diagnosis, but a condition you will see a lot of:
ANXIOUSNESS
The child or youth is unsure of him/ herself,Is defensive, won’t admit to things,
Everything is a justice issue,Takes things personally,
Reluctant to try new or hard stuff,Makes fun of other people,
Reluctant to join inFile under: Attachment issues
Quick tour..... Bipolar Disorder What Distinguishes Bipolar Disorder from A.D.H.D. and
O.D.D.?
Research has shown that approximately 7% of
children attended by physicians at psychiatric
facilities can be categorized as bipolar. According
to the American Academy of Child and Adolescent
Psychiatry, up to 30% of the 3.4 million children
and adolescents with depression in the United
States may actually be experiencing early onset of
Bipolar Mania.
HelpYourChildWithAnger.com 2008
Quick tour..... Bipolar Disorder What Distinguishes Bipolar Disorder from A.D.H.D. and
O.D.D.?
While hyperactivity may exist in all three conditions, intense mood swings are more indicative of manic-depressive syndromes. Bipolar children seem to be in a chronic state of alternation between abnormal behavior and normalcy. This kind of mood and behavior changes is not present in other behavioral issues.
Another difference is a decreased need for sleep in bipolar children.They are usually insomniacs requiring fewer than 5 hours of sleep. They also do not seem to suffer from consequences of sleep deprivation. When manic, their energy level seems unquenchable.
A third difference is the presence of manic elation which often takes the form of uncontrollable and hysterical laughter for no apparent reason. Episodes of elation can also appear as unusually risky behavior undertaken because of a grandiose concept of an invincible self.
A fourth presiding symptom is rapid and incessant talking without listening to what others have to say.
Quick tour..... Personality disorders
Personality traits are enduring patterns of perceiving, relating to, and thinking about the environment and oneself. When significantly maladaptive and causing serious functional impairment or subjective distress, they constitute a personality disorder.
Personality disorders are not formally diagnosed in patients younger than 18 years because of the ongoing developmental changes.
Medscape Updated April 8, 2011
Quick tour .....Conduct Disorder has been associated with:
Child abuse, Family conflicts, Genetic defects
Parental drug addiction or alcoholism, Poverty
More common among boys.
Prevalence? Qualities necessary to make the diagnosis (such as "defiance" and "rule breaking") can be hard to define. Behavior must be far more extreme than simple adolescent rebellion or boyish exuberance.
Often associated with attention-deficit disorder. Both carry major risk for alcohol and/or other drug dependence.
Can be an early sign of depression or bipolar disorder
Children with conduct disorder tend to be impulsive, difficult to control, and unconcerned about the feelings of others.
Medline Plus January 2009
Quick tour ...Oppositional Defiant Disorder (ODD)
All children are oppositional from time to time. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out.
Oppositional Defiant Disorder (ODD), ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning.
American Academy Child and Adolescent Psychiatry June 2009
Quick tour ....Oppositional Defiant Disorder (ODD)
Symptoms of ODD may include:
Frequent temper tantrums
Excessive arguing with adults
Often questioning rules
Active defiance, refusal to comply with adult requests and rules
Deliberate attempts to annoy or upset people
Blaming others for his or her mistakes or misbehavior
Often being touchy or easily annoyed by others
Frequent anger and resentment
Mean and hateful talking when upset
Spiteful attitude and revenge seeking
American Academy Child and Adolescent Psychiatry June 2009
Quick tour ....Aftermath
So what is it we are supposed to do then?
Be therapists?
Love them to death?
Cut them a lot of slack?
Read up on all the disorders – or at least the most frequent ones?
Pray for them?
Use our relationship with them?
Tremendous Resource #1Dr. Gordon Neufeld
Dr. Gabor Mate
Tremendous Resource #2Dr. Gordon Neufeld
Attachment therapyGordon Neufeld - Introduction
Names and descriptions of syndromes of behaviour
and learning problems have multiplied (eg, ODD,
CD, bipolar, ADHD).
They present a problem in that they tend to
describe, not explain. They do not help us make
sense of the child from the inside out.
Consequently we are left to deal with what we see.
Attachment therapyGordon Neufeld - Introduction
“Are there really all kinds of separate learning and
behaviour problems or is there an underlying
cause or common denominator? I am increasingly
convinced that underlying (it all) is a singular
condition. Like the immune system dysfunction
that underlies a myriad of medical symptoms,
syndromes, and sicknesses, there is also a
psychological condition that underlies a diverse
array of learning and behaviour problems. ……
Attachment therapyGordon Neufeld - Introduction
“ ………In a nutshell, the problem is one of
developmental arrest or psychological immaturity,
what I shall refer to more simply as stuckness.”
All kids qualify for ADHD, bipolar, ODD, CD. These
patterns initially have to do with their immaturity.
When the kids do not grow out of their
developmental deficits, then they are at risk.
Attachment therapyGordon Neufeld - Introduction
“Not everyone who gets older grows up….. Those
kids who are stuck are also prone to an
assortment of problems and disorders which in
turn distract us from the root problem.
Attachment therapyGordon Neufeld - Introduction
If there is a common denominator, then there is a
singular approach. And that is to understand and work
with the relationship context
Attachment is the default approach for developmental
immaturities. Most handicaps can be at least
mitigated by an attachment approach.
In all species, the more significant the handicap, the
more attachment is implicated in the answer. No meds
or pills will help a kid grow up. Rather meds help kids
avoid blowing apart their primary attachment.
Concise History Attachment Theory
Journal of Consulting and Clinical Psychology 1996
London family psychiatrist John Bowlby: attachment
behavioral system having primary and immediate
responsibility for regulating infant safety and survival ....
This system is ..... equal in import to systems guiding
feeding and reproduction and as leading the infant to
(a)continually monitor the accessibility of one or a few
protective, older "attachment figures" (usually but not
necessarily biological relatives) and to
(b)flee to these individuals as a haven of safety in times of
alarm.
Allan Schore: Attachment in context of brain development
The baby’s brain growth literally requires brain-brain
interaction which occurs in the context of a positive
affective relationship between mother and infant
(Trevarthen)
The child is using the output of his mother’s right
cortex as a template for the hard wiring of circuits
in his own right cortex that will come to mediate his
expanding cognitive- affective capacities
The right hemisphere is dominant in human infants,
and indeed for the first three years of life
ATTACHMENT
Attachment empowers by facilitating dependence
Attachment and vulnerability go hand in hand. A
child cannot attach without becoming capable of
being hurt and wounded – especially by
experiences of separation.
Allan Schore: Attachment in context of brain development
The loss of the ability to regulate the intensity of feelings is
the most far-reaching effect of early trauma and neglect
(van der Kolk)
The infant’s transactions with an emotionally misattuned
and unresponsive caregiver are stored in the infant’s
developing corticolimbic circuitries as imagistic, visceral,
and nonverbal procedural memories. They act as
severely dysfunctional templates for how the word
works.
Attachment therapyGordon Neufeld - Introduction
The human brain is pre-programmed for:
Becoming viable as a separate being (Emergent process);
Becoming resilient and resourceful (Adaptive process);
Becoming capable of civilized and considerate relating
(Integrative process)
No child is born with these characteristics: they need to
be developed.
Attachment therapyGordon Neufeld - Introduction
Goal of the Emergent process is viability as a separate entity.
Sense of self is here!
– be full of own ideas, initiative, interests, etc. Able to take
responsibility, evaluate own efforts
The essence of Adaptibility is the registration of futility.,
The secret in the maze is NOT in knowing the way through,
but in recognizing blind alleys – something coming to an
end before a new pathway opens up.
Attachment therapyGordon Neufeld – Introduction
Everyone is born with potential to become civilized,
cooperative, patient, fair, balanced, etc
No-one is born with these attributes, but are rather
uncivilized, inconsiderate, impulsive, unstable,
lacking self-control, etc etc
We cannot command the attributes into existence, nor
can they be assumed at will. They develop in the
attachment context.
Remember? Want to notice the connection between development and mental health.A mentally healthy individual is one who
can:-Develop emotionally, creatively, intellectually and
spiritually;
-Initiate, develop and sustain mutually satisfying personal
relationships;
-Face problems, resolve them and learn from them;
-Be confident and assertive;
-Be aware of others and empathise with them;
-Use and enjoy solitude;
-Play and have fun;
-Laugh, both at themselves and at the world.
MHS Evidence Jan 2011
Emergent processThe non-emergent have a tough time with ownership!
Have not achieved a sense of self that can monitor, and take responsibility.
Adaptive processThe non-adaptive have a tough time with frustration! Do
not get to ‘futility’ and ability to move on to new direction.
Integrative processThe non-integrative have a tough time seeing other points
of view!
EMERGENT, ADAPTIVE, INTEGRATIVE
EMERGENT, ADAPTIVE, INTEGRATIVE
EMERGENT, ADAPTIVE, INTEGRATIVE
Working with Stuck KidsThree-pronged approach for creating a context of
attachment: Collect the kids; Protect the relationship; Create a village of attachment.
Engage the attachment instinct (their dependence on you) by
COLLECTING the child:
1. Get in the child’s face or space) in a friendly way, collecting the
eyes, smiles and nods (the ‘greeting ritual’);
2. Provide a ‘touch of proximity’ for the child to hold on to (in the
palm for infant, warm, soothing tone);
3. Invite the child to depend upon you, NOT pushing them away.
(Independence emerges from dependence);
4. Act as the child’s compass point (act as their guide, point
things out, help orient them. We all have instinct to stay close
to our guide).
Working with Stuck KidsThree-pronged approach for creating a context of
attachment: Collect the kids; Protect the relationship; Create a village of attachment.
When you Engage the attachment instinct by COLLECTING
You let them know the relationship with you is a safe place
You let them know everything about them matters to you
You calm their anxiousness (root, many mental health issues)
You are able to focus on relationship-friendly consequences,
not punishments
You create a trusting environment in which they follow you
and become teachable
You facilitate Emergence, Adaptability, Integration
Canadian Mental Health Assoc Mental Health and High School Curriculum Guide
Goals are to help teachers and staff to:
-Promote students’ awareness of mental health issues
and reduce the stigma associated with mental illness;
-Provide a safe and supportive environment in which
all students can maximize their learning;
-Remain accessible and responsive to students’ needs;
-Help students develop their abilities to cope with
challenges and stress;
-Identify those students in particular need of
assistance or support.
NOT COLLECTING
NOT COLLECTING
NOT COLLECTING
COLLECTING
NOT COLLECTING
COLLECTING
COLLECTING
COLLECTING(Eyes, touch of proximity)
-What can our Catholic faith contribute to this understanding of preventing and treating mental health issues?
-Wouldn’t you know, our God got to collecting long before we thought of it ............
Teachers, People Of God This is the model for our collecting
There are no bad days for our God who collects us. God is there today, God will be there tomorrow.
We do not have to wonder whether we will be heard, whether we will be loved, whether we will be held.
We just will be. Burdens become lighter even as we approach, since we are so confident this is true.
This love is about our growth, our healing, on this life. It is a taste of what we have to look forward to in the next.
When you Collect your kids, you not only prevent and healmental health issues,
You bring your children God. They will know that one day, and remember it was you who did that for them.
Teachers’ Context: People Of God Challenges!!
Teachers before you have passed the Catholic flame to you.
But conditions are not the same. Kids are not going home to prayer, Sunday Mass, or even just plain being held.
Still yours is the Catholic educational heritage.
In this and any other heritage, the first thing kids see is you. Pretending is not possible
Because the kids see right through you.
They need to hear you tell of this heritage of faith,
see you show this heritage,
experience you living it.