strategic communication march 2014 - childwise.org · be childwise: effective parenting of...

Be ChildWise:Effective parenting of distressed children

Kate Cremer-Vogel,

MS, LCPC

Elizabeth Kohlstaedt,

Ph.D.

© Copyright Intermountain 2014

The source:


Overview

• Traditional parenting vs therapeutic parenting.

• Understand and practice the skills of therapeutic parenting

• On the journey to therapeutic parenting:

– Know yourself.

– Know your child.

– Interventions that keep you in relationship even when distressed.


Barry and his family


Barry’s journey

• Barry came to live with the Susan and Doug Smith at age 5.

• He seemed restless and difficult to soothe even from a young age.

• His parents, Susan and Doug have an older daughter, Sarah, who is 3 years older than Barry.

• Susan and Doug felt that they could contribute their loving family to a child in need, and that it would be good for Sarah to have a brother.


Susan and Doug

• Susan and Doug met in college and have good jobs.

• They live in a middle class neighborhood and are proud of their lovely home.

• School district is well respected for academics and sports.

• They have a strong connection to their faith community.

• They have one older daughter and consciously decided to adopt.


Susan

• Susan lived in a trailer with peeling paint in a sketchy part of town growing up.

• Her parents loved her, but they were distant and consumed with providing a living and gambling.

• Susan was left on her own a lot, and subject to her physically aggressive older brother.

• Susan put herself through college and met Doug there.


Doug

• Doug grew up in a middle class family.

• His parents had a bitter divorce when he was 7, with fighting over possessions and over the children.

• His mother was very connected with his little sister and not very much with him.

• Doug ended up living with his mother until his teen years and then moved in with father who left him pretty much alone.


Barry

• Barry was born to a meth-addicted mother. Father was physically assaultive of mother and is in prison for PFMA. He has never claimed Barry.

• Barry was removed at about 6 months and went between foster care and mom’s temporary sobriety several times before age 3.

• From 3-5, he was in a good foster home with other children until he came to live with Susan, Doug and Sarah.


Traditional parenting


Traditional parenting

• The child wants to please the parent.

– The child knows he belongs and is loved.

• Parent withdraws empathy to correct misbehaviors

• Parental disapproval makes the child uncomfortable.

• Child does better to get back into parental approval.

• We parent as we were parented. Unconscious repetition of parenting style.


Therapeutic parenting

• The child doesn’t believe he can please the parent.

– He doesn’t have a relationship, doesn’t feel he belongs and doesn’t feel love for the parent or that the parent loves him.

• Parental disapproval taps into the child’s shame and fear. He expects anger and reacts with anger.

• Child becomes increasingly angry at parent and angry behavior increases.


Therapeutic parenting

• Parent must MOVE IN, sustain empathy when the child struggles and create a new relationship and new narrative for this child within this family.

• We consciously become the parent WE WANT TO BE, not necessarily as we were parented.


The balance changes


The map

• You are the agent of change in your child’s life.

MotivationsChildhoodRole modelsTolerances

TemperamentHistoryDev ageAge of trauma/loss


“We don’t see things as they are;

we see things as WE are”

• Our sense of ourselves formed through the earliest experiences of relationship.

• The best predictor of a securely attached relationship is the adult’s ability to look within (Siegel & Hartzell, 2004).

• Start with understanding of motivations, then move on to understanding our backgrounds and who we want to be.


Motivations

• Often it is our noblest of motivations that trip us up when the child doesn’t conform to what we want.

• Motivations bloom into expectations, and expectations can get in the way of knowing your child.

• What was your motivation to become a parent? A teacher? A therapist?

• What would trip you up about that motivation if the child didn’t conform to your expectations?


Motivations

• Page 13 in text:

– I want to make a difference in the world.

– I see taking in a hurt child as a religious obligation.

– This child needs a good home and we can provide one.

– I will feel good about myself if I contribute to ease the suffering of an unwanted child.

– My spouse really wants to adopt a child, so I’ll go along with the idea.


What is the trap?

• I want to make a difference in the world

– This requires that the child change because I took care of him. What if he doesn’t?

• I see this as a religious obligation.

– What if the child humiliates you in front of your congregation by acting out. Who are you now? Do you cast out the religion or the child?

• I will feel good about myself if I ease the suffering of a hurt child.

– What if the suffering increases – yours and his? Do you get rid of the child to ease your pain?


Now it’s your turn

• The child needs a good home and we can provide one.

– ?

• My spouse really wants to adopt a child, so I’ll go along with the idea.

• ?


And back to Susan, Doug, Sarah

and Barry

• Susan and Doug have an older daughter, Sarah, who is 3 years older than Barry.

• Susan and Doug felt that they could contribute their loving family to a child in need, and that it would be good for Sarah to have a brother.


Susan






Doug






Susan and Doug

• What is the family’s motivation for adopting Barry?

• What is Susan’s individual motivation (possibly)?

• What is Doug’s possible motivation?

• And now, what would be the hidden traps with each?


How to get out of the trap

• The motivations are excellent, noble.

• But all of them require the child to do something to achieve your motivation.

• The opposite is true: The adult must be someone for the child; not do something to him.

• So, who are you and who do you want to be?


Who you are for the child

• Later this morning, Kate will lead you through some exercises that help you determine what your attachment style.

• Knowing yourself is the best key to becoming the parent you want to be.


Let’s start with some basic

questions

• Who was my most important role model as a parenting figure? Mom, dad, neighbor, teacher, grandmother?

• How was that person someone for me?

• Who do I want to be for this child?


Who is your child?


Brain Development for Safe World

Brain Development for Dangerous World

BRAIN

Hormones, chemicals &

cellular systems prepare for

anticipated world

OUTCOMEIndividual & species survive the worst conditions

INDIVIDUAL•Edgy•Single focus•No Social Cues•Quick to act•Hyper vigilant•Hyper reactive•Numb•Detatched

TOXIC STRESS

OUTCOMEIndividual & species survive in good times; vulnerable in poor conditions

INDIVIDUAL•Laid back•Relationship-

oriented•Thinks things

through•“Process over

power”•Multi-Focus

Hardwired for Anticipated World

Normal Biological Response Bumps Up

Against Social Expectations

Adapted from the research of Martin Teicher, MD, Ph.D

By Washington Family Policy Council

Biological pre-

disposition

Attachment


The beginning

• Temperament:

– Influenced genetically – easy, difficult, slow to warm up.

• Predisposition to major mental illness, including antisocial behavior.

• Influenced by prenatal environment:

– If mother highly stressed, infant’s nervous system in highly stressed.

– Mother rejection of the child in utero increases fetal distress and “tunes up” nervous system.

– Drug and alcohol abuse.


Child Development

• Seven developmental domains (Chapter 4, p. 56):

– Relational

– Cognitive

– Psychosocial

– Emotional

– Physical

– Sexual

– Moral


Why look at development?

• Children understand and take meaning from events based on their relational, cognitive, emotional, etc. stage at the time of the event.

• Watching for clues of developmental age can help you understand the meaning of current behaviors and the need beneath them.


Cognitive development (p. 70)• Birth – 2

– Self from other.

– Object permanence (does someone exist when I don’t see her?).

– Object constancy (is the other person still the same person independent of my feelings about her?)

– Frustration tolerance begins.

• 2-6

– Egocentric

– Intuitive

– Need for sameness


Cognitive• 2-6

– Understands changes along one dimension

– Trying to regulate emotions – jealousy, anger.

• 7-14

– Sees differences along concrete lines (skin color, clothes, height, weight).

– Rational judgments but along concrete lines.

• 14 and up (with normal cognitive development)

– Thinks abstractly .

– Concerned with hypothetical, future and ideological problems.

– Egocentric but with a twist.


The thinking of a 3 year old

• Video will be provided


The thinking of a 10 year old

• Video will be provided


Understanding cognitive age to

understand the need• The 10 year old girl whines that she

doesn’t get enough attention. Can’t recall or experience what mom has given her.

• Cognitive age?

• Need?

• An 8 year old boy suddenly notices that his skin color is different from the other kids and gets angry with friends.

– Cognitive age?

– Need?


Back to Barry





Barry

• Given his parentage: what are some possible temperament issues?

• Given what happened to Barry, where do you anticipate his struggles to be?

• When were his primary losses?

• What do you think he’ll have most trouble with?


So now what do we do?

• Understand the meaning of your child’s behavior.

– Be curious; be a student of your child – read through his cues.

– Look at what developmental level he is expressing.

– Bring him close and meet the need.

• If you can’t do it immediately, come back and repair.

• The 30% rule.


Five basic feelings

• Most of the feelings fall into 5 basic cagetories: Look at the hand on page 120.

– Scared

– Sad

– Mad

– Glad

– Ashamed

• They can be broken down, but let’s start with these.


Helping create the narrative

• Your child may not be able to name the feeling.

• Can you put together the feeling based on the behavior?

• Children from impoverished or harsh backgrounds don’t reflect, they act.

• You may need to teach the child.


Some frequent underlying feelings

(p. 112)• I’m afraid.

• I don’t trust anyone else – only myself.

• I feel powerless.

• I need so much, but that might scare you, so I won’t ask.

• Nobody understands me or really wants me.

• I can’t do it. (I honestly can’t or I might fail if I try )


Other feelings

• When you leave me, I’m afraid you’ll never come back (or when I leave home, I’m afraid I’ll never get back.)

• When are you going to get rid of me?

• I can’t tolerate frustration.

• I’m a nobody – I don’t fit – I look different and am different.


Moving in once we know (p. 121)

• Move from reaction to response. Move toward not away.

• Your child typically doesn’t understand his own reactions. It is a journey together that builds the relationship.

• Find the connection between the event and the emotion.

• Sit with the child and co-create the story of what this might mean.

• Be curious and use the language of hope.


Let’s take the deep dive into Barry

• Barry is now 8. Sister Sarah is now 11.

• Barry hates school and rips up his homework rather than doing it.

• He is mean to Sarah; makes fun of her and punches and pinches her.

• Barry has been seen to harm the family dog. He denies it, but the dog is terrified of him.

• Whenever Susan goes away, Barry destroys things and is wildly aggressive to Doug.


Looking for the triggers in Susan,

Doug and Barry


Susan






Doug






Barry





Who are the parents and what are

their triggers• What behaviors would cause Susan to

react instead of respond?

• What behaviors would cause Doug to react instead of respond?

• What motivations might get in the way of them fulling including Barry into their family?

• What role do you think Sarah plays in this?


Understanding the child

• What might Barry’s temperament be?

• What was the impact of mom’s addiction on Barry’s security of life?

• What might be some central issues for Barry? What will his triggers be?

• What developmental age might he regress to and what would it look like?


What might Barry be feeling?

• What do you think his primary underlying feelings are?

– When Susan leaves?

– About Sarah?

– About the dog?

– When he is alone with Doug?

– About school? About his classmates?


Back to your own story…

• What are your personal motivations for being a parent, a teacher, a therapist?

• Is there a way that they might get in the way for being someone for the children you are trying to help?


Understanding your child

• Think of the child whose name you wrote down.

• What is his temperament? What do you think happened to him?

• What would his underlying sense of self be?

• What are the conflicts that he might hold?


Conclusions

• The critical points in parenting children who have been harmed is:

Understanding yourself

Understanding your child

Intervening in ways that build and strengthen the relationship.


Questions?

strategic communication march 2014 - childwise.org · be childwise: effective parenting of...

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