How the CFC Utilizes "Top Down" and "Bottom Up" Strategies to Promote Well-Being

By Tina Payne Bryson, LCSW, PhD

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At the Center for Connection, our interdisciplinary approach allows us to paint with a broad brush when working with clients and supporting them in their goals. For example, in a case where the client presents with ADHD and depression, a frequent recommendation might be to recommend Dialectical Behavior Therapy (DBT). However, at the CFC, we might view this client's needs differently and consider more “bottom up” and “top down” strategies.

Regulation vs. Dysregulation

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When we’re regulated and able to think and consider, we can use “top down” strategies like pausing before action, noticing and deciding, self-talk, talking about feelings, and problem-solving.

When we’re dysregulated, we can’t do those things well at all, so we need “bottom up” strategies that regulate our nervous systems to allow us to get back into an integrated brain where we can use "top down" strategies as well (such as DBT).

General Bottom Up Strategies

Some of the best "bottom up" strategies are:

• Co-Regulation (which is when someone is connecting with you to comfort and get you back to regulation through their presence)

• Sensory-Based or Body-Based approaches

  • For example, the “physiologic sigh” which is when your exhale is longer than your inhale and which is very powerful to down-regulate your nervous system.

• Sensory inputs that are regulating

• Movement

• Breathing in a specific way

• And more

General Top Down Strategies

General “top down” strategies can include teaching clients to use

• Dialectical Behavior Therapy (DBT)

• Cognitive Behavioral Therapy (CB)

• Mindful Noticing

• Naming Feelings

• Curiously becoming insightful about a behavior we might have

• Role playing how to handle situations better in the future

• And more

In these examples, we’re working with the brain’s plasticity and giving “reps” to the prefrontal cortex.

Therapeutic Bottom Up Strategies that Support Top Down Approaches

In therapy at the CFC, we do a lot of both.

• When we use top down strategies, we’re giving repeated opportunities for the prefrontal cortex to practice. And that part of the brain is built from lots of things, including development unfolding, but also through things we can support:

1. Through providing safe, positive, predictable relationships throughout development, (including that with the therapist); and,

2. through repeated experiences that flex and use that part of the brain.

In our example above, we know that kids with ADHD have a quick “gas” for emotional and behavioral impulsivity (without strong “breaks”) and need lots of reps to build this part of the brain.

• We also work with clients on bottom up strategies so that when they’re in intense emotional states, dysregulated, etc., they have strategies they can use to regulate their nervous systems so they can get back to pausing, making decisions, etc. This is especially important because while top down can prevent that “flipped-lid” state, once it’s there, top down strategies are inaccessible and our client needs to get in the reps on regulation from the bottom up, too.

• From there we can work toward what I wrote about with Dr. Dan Siegel in The Whole-Brain Child to create integration in the brain. This happens when bottom up and top down approaches to come together to help kids be more Flexible, Adaptive, Coherent (doing what makes sense), Energized (not depressed), and Stable.

A handy way to remember this is to think of the “FACES” of an Integrated Brain:

• We can also collaborate with other professionals, like psychiatrists where meds can support our client or by working with OTs to help turn the dial down on sensory processing, or focus on other pieces that are an important part of the picture.

Considering all of these tools and approaches, we can see that some of the depression (in our case study above) may be a result of the gap between what the child wants and what he’s able to do, given his challenges, followed by him then feeling bad and angry about/at himself. And when we use DBT, we know a lot of it is about reframing how you see things, so that “mindsight” and self-attunement may be helpful as well, and so are lots of other approaches.

When the Best Protection Is Connection

This article first appeared in Psychology Today and was written by our amazing Director of Mental Health, Christine Triano. Christine is a licensed clinical social worker (LCSW) and psychotherapist specializing in the treatment of adolescents, adults, families, and creative professionals.

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KEY POINTS

• As children grow older, the parent-child relationship naturally changes to meet the young person's need for autonomy.

• It's important to let go of the need to hold your child back and allow them to make mistakes and learn from them.

• Focus on connecting with your child, being a supportive presence, and listening more and talking less.

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A longtime client got on our video call this evening and let out a long exhale. Talking about the week’s events with her two teenagers, she summed things up like this, “I’m learning how to parent in a whole new way, and it’s really hard.”

What I sought to name in return is that “hard” doesn’t even begin to describe the job of parenting teens. I would add exhausting, challenging, disconcerting, and dysregulating to throw just a few more adjectives on the fire. But what I hope comes through when the smoke clears is so much more. I’m looking for words that reach deep inside the hearts and souls of tired, worried, uncertain parents. Words that express what a real human-to-human, parent-to-teen connection can be. Humbling. Inspiring. Rewarding. Worthwhile.

Here are a few guidelines I’ve learned not only from working with parents of teens but from road testing them with my own two kids, now 18 and 20:

The best tool you have to protect them is the strength of your connection.

You want to keep them from harm, shield them from mistakes, and generally reduce their pain and suffering. When they were little, that meant bumpers on the corners of the coffee table and keeping those tiny Legos out of their mouths. But now, guess what? Those ways no longer work. And the more you try to protect them by restricting what they do and where they go, the more creative they will become at finding a way to get their needs for novelty, exploration, and independence met.

Now, of course, I’m not talking about extremes, and in no way am I suggesting you can’t have rules and expectations. What I am saying is that as they seek greater autonomy, you may think you should hold them back. You might insist you drop them off instead of letting them ride a bike or take a train, or you might reflexively veto spontaneous plans because they didn’t let you know in advance.

These impulses are wired up from all of the parenting you’ve done to date, and with the onset of adolescence, it’s like your old parenting rulebook suddenly became outdated overnight. What’s so stress-inducing is that there is no Amazon delivery with an updated version. This is very much a DIY project about knowing who your child is and tailoring your plan to meet their evolving needs. Connection fosters communication—and communication keeps you informed and in the loop when your influence matters most.

Pay attention and give them some space, and you might be pleasantly surprised.

There’s a decent chance they can manage their schoolwork and schedule, anticipate and verbalize their needs, and plan and manage their social relationships. This is a good thing, parents—you actually get to give your prefrontal cortex a break, as most teens can pick up the bulk of the work of organizing and planning their own lives. Let them take the lead while you get another cup of coffee. They may not do everything the way you would or in a way that’s comfortable for you, but that’s on you.

It’s time to downshift from accomplishing tasks to offering presence. Your teenager very much wants and needs your attention. Being curious, open, and non-judgmental all help strengthen the infrastructure of your relationship. That’s the gold ring.

Focus on what you want, not what you don’t.

Ever notice how you get your kid in the car or have their attention over dinner, and a laundry list of all the things they are not doing right or could be doing better comes tripping off your tongue? It’s as if someone pressed play, and out it comes. Don’t stay up too late. Don’t forget to turn in your work. Don’t talk to your brother like that. Don’t stare at your phone. Don’t drink. Don’t smoke. Don’t forget to take out the trash. Don’t do any of the dumb things I did as a teenager. (Only this last one is usually more of a thought bubble than an actual statement.)

I’ve worked with many parents who come to me in distress, worried about the risks their teen might be taking or be tempted to take, or about the chance their teen might repeat mistakes that they’ve already made. I get this worry, but I can’t assure anyone their kid is not going to stumble or fall. What I can do is turn the conversation to what their child is doing well and what they’d like to see happen, as opposed to all the things they’d like to prevent or stop. Give your attention and support to where you want them to grow, and watch what happens. When all else fails, simply try saying less and listening more.

You are in new territory, but you’re not without tools. Your child’s brain is going through a period of spectacular development rivaled only by their toddler years. As they grow toward the young adults they will be in just a few years, you have an opportunity to let your relationship grow along with them. Build up your support network, and give yourself some credit. As my client said so well, learning new ways of parenting is hard—and also totally worth it.

Ready, Sense, Go!

Our two amazing clinicians, Olivia Martinez-Hauge, MA, OTR/L, and Christine Triano, LCSW, just published an article in Psychology Today called “Ready, Sense, Go! 12 sensory strategies to support your teen's distance learning.” Scroll down to view all 12 strategies and read the full article:

Many students are well into their fall semester online at this point, and what I hear from the teens I see regularly (also online!), is that they are tired. This is a different kind of tired than the usual adolescent exhaustion. It’s their nervous systems experiencing the toll of being immersed in an online environment up to six hours per day (or more) for classes and extracurricular meetings, followed by hours of homework… on their computers.

To find some ideas to help my clients alleviate this stress and better care for their minds and bodies, I turned to my colleague Olivia Martinez-Hauge, MA, OTR/L, a marriage and family therapist associate who, for the past 18 years, has worked within the private sector and public school systems as a pediatric occupational therapist.

“I think addressing a teen’s sensory health is so important and often overlooked because of their age and increasing independence,” shared Martinez-Hauge. “While your teen might be waving you out of their room and locking the door behind you, I think it is still important to set your teen up for success with easy tips and strategies to care for their sensory system.”

1. Play with the lighting. Sometimes an overhead light is too bright. Try a muted desk lamp, or move their work station closer to a window for some natural light.

2. Tired eyes. Try having your teen toggle with the accessibility features on their computer. Some computers dim to a blue light filter and most have a “high contrast” feature. Adjusting computer lighting and/or contrast can give the eyes a break.

3. Visual breaks. Encourage your teen to take frequent visual breaks. Have them relax their eyes into a “panoramic” view of their surroundings. By taking a break from using their focused vision, they can calm and downshift their brain.

4. Sound. Make sure your teen is not fighting to hear over external noise; headphones or earbuds are good ways to limit distracting noises (just monitor the volume). It can add an extra layer of exhaustion to continuously try to filter out unnecessary stimuli in order to attend to the important stuff.

5. Seating. Good seating is not only important for the body, but for keeping focused too. Different seating can give your student enough of a boost to stay engaged just a bit longer. Seating ideas include: swivel chair, ball chair, standing instead of sitting, stool, or a combination of all of these.

6. Laptop position. Invest in a computer stand or place the computer on top of a large ringed binder; this raises the screen closer to eye level and positions the keyboard in a better position for typing.

7. Movement. Regular movement helps prime the brain for learning. Encourage your teen to take regular movement breaks and, most importantly, to listen to their body and move when they need to move.

8. Snacks. Help your teen put together a snack basket to keep close by. Try packing it full of items that are chewy to give a lot of feedback that will wake up the nervous system. Some examples: jerky, granola bars, crackers, carrot sticks, gum, sour candies, nuts.

9. Fidgets. There are so many fidgets out there for the hands, but a small piece of putty and/or clay can work wonders for regulation. Also, fidgets are not just for the hands! Try putting a tennis ball, textured mat, or foam roller at your student’s feet to keep their bodies busy while keeping their hands free.

10. Furry friends. Consider letting your teen have the family pet nearby during distance learning. This can provide emotional support and a sensory break when brushing, holding, or attending to the pet.

11. Calm apps/websites. Encourage your teen to pick one or two favorite apps for breathing, moving their body, or calming their nervous system. Have your teen share the app with you and maybe both of you can start off your day with a guided meditation or some deep breathing.

12. Check-ins. Just because they roll their eyes and can do things on their own doesn’t mean they don’t need you. Check in with your teens from time to time to offer some co-regulation and remind them they are not alone. A tall glass of lemonade and a cookie can't hurt either.

I know I will be sharing these ideas with teens and parents in the coming weeks. One more thing to consider with teens is that they are so socially attuned at this age and stage that looking at the faces of all of their classmates at once can be quite intense. Knowing this, I encourage them to regularly take a moment to look away, to gaze out the window, and to surround their workspace with items like photos, drawings, or mementos that soothe and comfort them.

Lastly, I so appreciate Hauge-Martinez’s final point, as relationship and connection are the name of the game. Being there for your teen is always a great strategy to set them up for success.

Back to School, Back to Stress

Checking in at the end of the pandemic summer.

This article originally appeared in Psychology Today.

After the initial flurry of worries this past spring about the aimless summer our teens were facing, things seemed to largely settle down. It turned out that a healthy dose of unstructured time, more sleep, and even some boredom, was not so bad. Yes, a lot of carefully considered plans disappeared almost overnight, but as parents we shifted gears and found a way to soothe our anxious souls about the disappearance of the idea of what summer should be.

As for our teens, they too had to sit with disappointment. But then, they were largely fine. And by that I mean, they really were OK. Yes, they missed seeing friends in person as much as they would like. They may have even pushed to get out more than felt safe or possible. But the teen brain is nothing if not wired to seek connection with peers, and thanks to the range of virtual options available, for the most part they kept the channels open.

Now, in the seeming blink of an eye, here we are at back-to-school time. Just like those graphs charting COVID rates, I can’t help but notice the uptick in parental anxiety, no doubt fueled by the ongoing discussion of the limits and drawbacks of online learning and the chaotic experience many had at the end of the last school year. For those parents whose kids are back in person, there are other worries, but for the large part of the country sending their teens back to school online, it’s been a time for lots of deferred worries to come rolling back in. Here are a few I’ve been hearing:

I’m worried they’re going to fall behind. This one is persistent. My own son is entering his senior year and working on college applications. Grades matter right down to the moment he presses “submit.” To this refrain, I talk with parents about hitting pause and taking a overhead view for a moment. Our kids may in fact fall behind on the schedule of traditional academic benchmarks. But consider this: When all kids are “behind,” what does that even mean anymore?

Ask any teacher, and they will tell you kids fall behind all the time. After each summer break or winter vacation, there is always learning to recover. Our kids will eventually catch up on their academics. What I’m curious about is what are the opportunities to help them actually build skills and get ahead during this time?

Adolescence is such an important time in the growth and sculpting of our teen’s brains—and the experiences needed to set them up to successfully launch into young adulthood go way beyond school. A few ideas to practice include:

• Have your teen schedule their own doctor, dental, haircut, therapy or other appointments.

• Collaborate on making dinner one night a week with the goal of handing it over completely.

• Learning to drive and the basics of car maintenance.

• Build financial and budgeting basics. (My 19-year-old is looking to buy a car, which has opened the door to learning about loans, interest rates, credit scores and more.)

• Talk about how to shift more responsibility for their “stuff” to them. This means things like doing their own laundry, changing their linens and towels, cleaning their room, getting their own toiletries—basically anything related to their room and their self-care.

How do I know they are actually doing their work? Yes, sitting in front of a screen offers a chance to look at more screens. A motivated adolescent will figure out how to play Fornite during Algebra or chat with friends during French. To this, ask yourself, how would I feel if they were actually in school? Would you be worried about what they were doing in class? Would you be calling or texting them to see if they were following to the Powerpoint on factors? Most likely, not. Then do the same. They are in school, it’s just that you can see them now and that tends to push our parental worry buttons.

We can help them prepare to maximize their learning by talking about their set-up, their schedule, and by making sure they have what they need in their environment to help them stay focused and comfortable. But then, just like dropping them off at the curb, take a deep breath and walk away. We all know that teenagers pretty much never find motivation from our hovering or nagging.

I can’t get them interested in doing anything. It may be even harder to get your teen out of their room or away from their screens now that school has started. Again, think about what the first month or so of going back to school is usually like. It’s probably not unusual for your teen to be tired after school, or even need a nap, as they adjust to an earlier and more structured schedule. My high school student has shared how he misses coming home to an empty house, where he really enjoyed a couple of hours of downtime to himself before everyone else got home.

Give it a little time and try to engage where you can. Don’t suddenly make all conversations about school or homework or the need to do productive things. Instead, try exploring what it’s like for them to be going through this strange, new experience of the way school is happening. As always, you can't lose by keeping the focus on connection.

Your relationship with your teen is still one of the best predictors of their emotional well-being. They may appear to be pulling away, but they need your support as much as ever. By staying curious and open, by saying less and listening more, you have the tools to continue to invest in your evolving relationship with your teen, pandemic or not.

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About the Author

Christine Triano, LCSW, is a licensed clinical social worker and psychotherapist specializing in the treatment of adolescents, adults, families, and creative professionals. You can find her on Facebook and LinkedIn.

Back-to-School Support

Support for Parents & Educators

In this living blog, we will offer resources and tips to support parents and educators as they prepare for this unique and challenging school year. Updates will be posted to our Facebook and Instagram pages, as well as archived here for your ease of reference. Our hope is that together we can support the children we care about and support the health, safety, and well-being of our communities.

Helping Kids with Anxiety About Returning to School

In this video, Center for Connection Founder and Executive Director, Dr. Tina Payne Bryson (co-author of NY Times bestselling books, The Whole-Brain Child and No-Drama Discipline) talks about how parents can help kids experiencing anxiety about school. Also, parents might enjoy this read from the NY Times article on how to manage anxiety over back-to-school decisions.

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Child & Masks: Tips for Helping Kids Who Struggle with Wearing a Mask

In this video, you'll hear from our amazing pediatric occupational therapist, Dr. Jamie Chaves, as she talks about supporting kids in wearing masks. She'll talk about some of the key factors to consider when a child is having difficulty with wearing a mask, and how to approach it from an understanding of a child's state of regulation and their relationship with you, as well as from a sensory perception perspective. It's part of a two-part discussion and we hope it helps. We'll post more videos to support parents and educators during this unique back-to-school season.

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Child & Masks: Tips for Helping Kids Who Struggle with Wearing a Mask (continued)

In this video, pediatric occupational therapist, Dr. Jamie Chaves, will continue her discussion on supporting kids in wearing masks.

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Seven Ways to Cope with Uncertainty

Here is a wonderful article from Greater Good Magazine: Science-Based Insights for a Meaningful Life. In it, Christine Carter (author of The New Adolescence: Raising Happy and Successful Teens in an Age of Anxiety and Distraction and The Sweet Spot: How to Accomplish More by Doing Less ) shares that uncertainty is hard. She writes that “…human beings crave information about the future in the same way we crave food, sex, and other primary rewards. Our brains perceive ambiguity as a threat, and they try to protect us by diminishing our ability to focus on anything other than creating certainty.”

Click here to keep reading and to learn more about the coping strategies she recommends (don’t resist, invest in yourself, find healthy comfort items, don’t believe everything you think, pay attention to your internal experience, and resist looking to someone else to save you).

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Sending Your Teen to College During a Pandemic

In this video, Center for Connection Founder and Executive Director, Dr. Tina Payne Bryson (co-author of NY Times bestselling books, The Whole-Brain Child and No-Drama Discipline) talks about what parents can do to manage the feelings that come up when sending your kid to college in a pandemic.

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Want more tips and strategies? Check back often as we’ll update this page throughout the month.

Need additional support?

Visit our Getting Started page to schedule a virtual parenting consultation from one of our team members or learn about our other services (Occupational Therapy, Assessment, Educational Therapy, Psychotherapy, Play Therapy, Speech and Language Therapy, and more—tele-health services available for most services).

Talking to Kids (and Informing Ourselves) About Race, Racism, Prejudice, & the Protests

Many in our community are just waking up to the reality of the systemic racism that prevails in our nation. Others have been painfully aware of its existence throughout their lives. As we all seek to more fully understand these realities and find meaningful ways to respond and enact change, one of the best steps we can take is to continue to educate ourselves. And we want to find ways to talk to our children as well. You’ll find below a few starting places we can all use to more fully inform ourselves and talk to our kids about race and racism.

We know these conversations with our children won’t always be easy. But it’s so important. For some of us, this won't be our first experience of talking with our kids about prejudice. For others, it might be the first time we’re addressing the uncomfortable topics of race and privilege. In both cases, the CFC wants to support you in helping your kids understand how to recognize and combat various forms of racism, know what to do when they see it, talk about the images and headlines they might be seeing on the news and social media, and foster self-love and promote a healthy cultural identity. 

NY Times article on books to help parents explain racism and the current protests.

Wall Street Journal article on how to talk with children about the protests with advice from pediatricians, educators and other experts.

Kid-friendly movies to help teach kids about racism.

Anti-racism library resources by LeanIn.org.

In Support of Our Community

The Center for Connection stands in solidarity with the people of color in our communities and emphatically declares that Black Lives Matter. All of us at the CFC have been deeply affected by the deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery, and each of us is pained by the fact that this systemic pattern of violence against black individuals continues, seemingly unabated. Many of us are reflecting on old wounds from our own experiences with racial trauma. Others of us are questioning our understanding of the issues and our potential to enact change, while taking in information from various sources so we can better understand, and better show up as allies. ⠀
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Whether you feel grief, guilt, anger, shame, helplessness, anxiety, or fear, know that we are here for you. We are feeling this with you. Our team is ready to engage in difficult conversations with you and to sift through memory and meaning as we process this incredible injustice together. We're ready to listen and to do our part to show up, educate, advocate, empower, and bolster community resiliency. ⠀
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At the CFC, we prioritize human connection, which begins with the principle of equality and justice for all people. We cannot truly connect unless we truly see one another. ⠀
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Illustration/design by Quentin Monge (Instagram: @mongequentin).

Learn About the Online Brain Talk Curriculum

Encourage Stronger Executive Functioning & Emotional-Regulation Skills from the Comfort of Your Home

Now, more than ever, students need knowledge, tools and activities to manage the dysregulation that has come along with sudden schedule and social changes. In light of the Safer at Home order, you might be finding yourself at a loss for how to manage big feelings of worry, or struggling to help your children make sense of their emotions and reactions. To help, we are excited to partner with The Brain Talk Curriculum to give parents, teachers and therapists a wonderful resource to teach how the downstairs brain and upstairs brain communicate for stronger executive functioning* and emotional-regulation skills**.

In an effort to support our community, Brain Talk is offering a 50% discount now through April 3rd, 2020!

Use code: EF@HOME at checkout: https://www.braintalktherapy.com/subscribe.

WHAT IS THE BRAIN TALK CURRICULUM?

Brain Talk is an eight-unit curriculum that personifies key parts of the brain into relatable characters and explains how these parts of the brain communicate in order to mindfully respond instead of impulsively react. Explore videos and leveled activities to help students understand the conversation between their downstairs and upstairs brains when they feel impulses.

• Myg, or the amygdala, is the part of the brain that triggers avoid impulses. If the brain senses some kind of threat, even if it comes from being told, “No more ice cream!” it gives you a Myg Moment to fight, flee, or freeze.

• Buster, or the basal pleasure-and-reward circuit, is the part of the brain that triggers seek impulses. If the brain senses an opportunity, even if the perceived opportunity breaks the rules, it gives you a Buster Bam to grab-and-gulp the immediate reward.

• Ms. Hipp, or the hippocampus, is the brain’s personal memory librarian. It keeps track of past experiences to help determine how we should act in the future.

• The Professor, or the prefrontal cortex, is the brain’s goal-setter and plan-maker. It helps us pause impulses, come up with options for how to respond, and choose the best option in order to reach our goals.

Brain Talk pairs perfectly with mindfulness activities and social-emotional learning programs. It is a great resource for virtual or home-based learning, especially since it doesn’t require any prior brain background knowledge.

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 *Executive functioning is the use of critical thinking skills in the upstairs brain to engage in goal oriented, self-regulated behavior.

**Emotional-regulation involves awareness of your emotional state and the ability to respond mindfully even in the midst of big feelings.

Using a Brain-Based Approach to Maintaining Balance While Social Distancing

Blog article written by Melanie Dosen, LCSW

In the midst of the COVID-19 crisis, there has been an amazing outpouring of information, resources, and ideas on how we can safely physically distance ourselves and our kids at home while still attending to our academic, work, and daily needs.  Figuring out what to prioritize and when during the day can be an overwhelming task for us all! One way to maintain a healthy balance is to use the Healthy Mind Platter for Optimal Brain Matter as a guide in creating your and your child’s daily plan. 

The Healthy Mind Platter, created by Dr. Dan Sigel and David Rock, looks at 7 essential daily mental activities that promote healthy mental and emotional balance.  Here are the 7 essentially daily activities, along with some ideas on how you can integrate them into your social distancing daily life: 

Focus Time:

Helps us make deep connections in our brains.

• Remote education and daily school assignments certainly provide opportunity for focus time in your day!  Can you also incorporate engaging projects that center around your child’s interests, such as researching recipes for a baking project, or creating their own science experience or Rube Goldberg invention?  

• Creating a daily schedule can help ensure that everyone is getting the balance that they need. Websites such as Big Life Journal have helpful templates for making daily schedules and to-do lists.  But if our interest and focus aren’t sticking to our schedule, this is the perfect time to demonstrate flexibility and adaptiveness! Allow your kids to keep creating and discovering if they are immersed in something, even if the schedule suggests that you need to move on.   

Play Time:

Enjoying novel experiences enables us to make new connections in the brain.

• We all need time to be creative and playful in our day!  Science has shown that play helps children build new connections in their brains, express their ideas, and process big emotions.  Integrate play time into your day together by going on scavenger hunts at home or in the neighborhood, or setting up a family art mural space to create a cityscape on butcher paper or a white board.  Free play time with toys is always a great idea, too!  

• Need ideas on what to do during play time?  Make a fortune teller with various games and activities listed inside: How to Make Paper Fortune Tellers : 10 Steps (with Pictures)

Connecting Time:

We activate the brain’s relational circuitry when we connect with other people and take time to appreciate our connection to the natural world. 

• During this time of world-wide social distancing, finding creative and innovative ways to connect with our loved ones, friends, and peers is crucial to maintaining our well-being.  FaceTime or video chats with friends are a great way to check in, and writing letters or making cards for family members can also help us feel connected. 

• You can also connect to our natural world while at home by streaming live animal cams, from the Monterey Bay Aquarium to Pandas in Sichuan, China. 

Physical Time:

When we move our bodies, we strengthen our brains.

• Let’s make sure to get those movement breaks in!  Set up daily “PE” time in your schedule--walks, hikes, or bike rides are still allowed, as long as we’re keeping a safe distance from each other.  Dance parties, workout videos, or family yoga sessions are great indoor options.  

• Some fitness apps, such as Down Dog, are offering free subscriptions to teachers and students into the summer! 

Down Time:

When we are non-focused and let our minds wander and relax, we help the brain recharge.

• This is the time to give ourselves permission to let go.  It’s so restorative for our brains to turn off the productivity switch and allow ourselves an opportunity to be open and relax.  Not only are we letting our brains recharge when we give ourselves down time, but we’re also allowing our own creativity, ingenuity, and imaginations freely flow.  Provide your child and yourself time to sit and be.  

• This may be a good time to pick up a book or write stories in a journal; you can also sit quietly and draw, paint, and color together.  Find printouts of Mandalas or coloring pages to illustrate during this time of rest and recharge. 

Time In:

When we quietly reflect internally, we help to better integrate the brain.

• Maintaining our mental health and well-being is important now more than ever.  Prioritizing reflection and mindfulness time, as well as time when we can express our fears, doubts, disappointments, and frustrations, will better equip us to handle the challenges that we’re facing.  

• Set time aside for writing in a gratitude journal; practice mindfulness together by doing breathing practices or going on a Rainbow walk as a family.  

• If you or your child is feeling overwhelmed during this time, many therapy practices are offering on-line telehealth services or parenting groups to provide support and help.  Click here to see what on-line services The Center for Connection is offering now.   

Sleep Time:

When we give the brain the rest it needs, we consolidate learning and recover from the experiences of the day.

• A consistent sleep schedule will not only help our bodies stay healthy, but also help solidify all of the amazing efforts we put into integrating balance for our brains during the day.  As best you can, maintain a sleep schedule for yourself and your child--the more routines and predictability we can integrate into our day, the easier it will be to adjust to this “new normal” of social distancing.  

• To help get to sleep at night, practice calming meditation before bed.  Bedtime can also be a wonderful opportunity to connect, reflect on the day, and practice gratitude together.

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Maintaining balance for ourselves and our children during a global health crisis is no easy task.  The Healthy Mind Platter is not about striking a perfectly balanced schedule for yourself and your children, but rather a way to create space for you to get all that you need. Be sure to check back in for more 7 essential mental activity ideas.  Be safe, and be well! 

[Repost from The Washington Post]: For queer families, back-to-school time is especially fraught

The following article is from The Washington Post and includes quotes from Center for Connection clinician, Robyn Park.

Article written by David Minerva Clover

Published on August 29

We all know how stressful back-to-school season can be. In addition to acquiring supplies, dealing with school clothing drama, and meeting teachers, there’s the task of helping nervous or reluctant kids manage their feelings about a new school year and all the changes ahead.

But members of LGBTQ+ families, whether they are children or adults, face particular challenges when entering the educational system. That means back-to-school time is especially loaded and especially stressful.

As a visibly queer and transgender parent myself, when we began to look into schooling for our 4-year-old, I found myself overcome with anxiety. Parents in same-sex partnerships often have to deal with outdated forms and administrations that assume all children have a mother and a father. Transgender children may be concerned about bathroom access and whether they’ll get to use their correct name and pronouns in the classroom. And LGBTQ+ families are often concerned about bullying and the fact that even if the rules are on your side, other parents may still be against your family.

I’ve found that interacting with school administrators has included a lot of emails to explain my family’s names, pronouns and relationships, and I’ve had to staple extra sheets to documents when our information doesn’t fit on the provided forms, making me feel like an outsider before the year even begins.

My family is not alone.

After moving from Oakland, Calif., to Pittsburgh, Andrea Cipriani, a lesbian mother, had to cross out the word “father” and write in “mother” on her son’s kindergarten enrollment paperwork. The paperwork issues make her “question how much the district accepts same-sex parents and makes me wonder what issues will come up in the future,” she said. And while she doesn’t want to assume the school won’t be welcoming, she is worried about that possibility.

Robyn Park, a marriage and family therapist who specializes in adoption issues and LGBTQ+ families at the Center for Connection in Pasadena, Calif., says the added stressors weigh on families. They “experience greater vigilance” in trying to make sure their children are safe, she said. “LGBTQ+ parents ... oftentimes have to work harder than other parents to ensure safe and effective learning environments for their children."

So what’s a parent to do? “We were just very mindful from the beginning,” said Amber Leventry, a queer and non-binary writer and advocate and staff writer for the website Scary Mommy. Leventry, who uses they/them pronouns and has three children, one of whom is transgender, emphasized the importance of surrounding their family with potential allies within school and daycare systems. Entering the schools as a volunteer, and an advocate for all kids, has helped, Leventry said. “I don’t want my family to be used as the example; it’s just too much emotional labor. But since you’re not doing it, let me come in as an advocate."

Leventry believes that doing this work has helped protect their kids from carrying the anxiety themselves. They also acknowledged that not every LGBTQ+ parent is up for that level of advocacy: “I understand that I’m good at it, I have the energy for it."

Park, the family therapist, said the key to helping children calm big emotions is to talk about it or, as she says, “name it to tame it... By helping children name different emotions ... you are able to help tame them.” She also added that parents should “remember safety is nonnegotiable. You have every right to speak up and to be heard."

Of course, parents aren’t the only ones responsible for making the school year a success for kids and families. Schools, administrators, and the teachers themselves, also have a lot of work to do. As more and more LGBTQ+ families enter the school system, it’s in everyone’s best interests for those schools to be prepared. “My whole thing is you might be accepting, but how inclusive are you? Throw a rainbow or trans flag in the pencil cup,” Leventry says. “I remember the first time I saw that upside-down pink triangle in my school. Kids are looking for that, and if they don’t see it, they think something is wrong with them.”

Pam Strong, an equity and inclusive education resource teacher with the Peel District School Board in Mississauga, Ontario, thinks that schools are often too gendered and heteronormative and that those norms, among others such as whiteness, are often “reinforced in our curriculum, the books we read, and the conversations that we have or don’t have.” She believes it is important for schools not to wait until they have a student or a family identify as LGBTQ+ before they prepare for them.

Such preparation requires teachers to make an ongoing commitment to learning and unlearning what they think they know about identity.

Strong suggests having educators walk through the school assuming a particular identity to see what problems they encounter. Her district also uses safe space stickers, and she advocates, much like Leventry, for putting up rainbow flags or other symbols that show kids they are welcome. “Comprehensive safe school policies are incredibly important and can help address bullying and harassment issues in school,” she says.

With steps like these, hopefully families like mine will feel more welcome and safe as they begin the school year.

David Minerva Clover is a queer and trans writer, covering everything from parenting to dinosaurs. He lives in Detroit with his partner, his child and an embarrassing amount of animals.

25 Back-to-School Tips from Our Team to Make Your Transition Back-to-School Easier

The following introduction was previously published in The Quarterly magazine’s Fall 2019 edition:

“As much as I loved summer as a kid—and I loved summer—I also got excited about going back to school each fall. I couldn’t wait to get the back-to-school clothes, see my friends again, have a routine, learn new things, and I really got into the restocked school supplies. My sister, on the other hand, never liked going back to school. She rebelled against the schedule, homework, and not getting to wear a swimsuit all day. And for our mom, there were summers she was counting days until school started, as well as summers where she grieved that her long, open-ended days with her girls were over until June.

Each year, kids and parents have a whole host of reactions to summer ending and school starting, but regardless, it’s definitely a transition that can be taxing for all. It can be a challenge, wondering who the new teacher and classmates will be and experiencing the change of schedule. It’s typical for many kids and teens to experience anticipatory worries that feel exhausting or especially difficult as they shift from summer to school. Fortunately, there are all kinds of steps we can take to help them prepare for and navigate this time of year successfully.

Several year ago, I founded The Center for Connection (CFC), an interdisciplinary clinical practice in Pasadena. We’ve collected a whole team of experts who are good at helping children and families not just to survive, but thrive in the various areas of their lives—including the transition back to school. I asked some of our experts to suggest strategies and tools for helping out kids succeed as they transition back to the classroom.”

Back-to-School Tips from our team

1. Courtesy of Dr. Tina Payne Bryson, Center for Connection Founder & Executive Director): Make school a fun place to go.

Give your child some time to make positive associations between fun and school. Go 10-15 minutes early to school and do fun things with them in order to help them make these associations. Play on the swings, play a game of Uno or Eye Spy, or some other silly game.

2. Courtesy of Tami Millard, Center for Connection Learning Specialist: Sleep.

Sleep is essential for our child’s ability to weather stress in positive ways and be resilient. The frontal lobe, which helps us regulate our emotions and bodies, make good decisions, be flexible, problem-solve, and more can’t function optimally without good sleep. “Establishing the sleeping/waking routine a few weeks before school is helpful to make the schedule transition minimal.”

3. Courtesy of Christine Triano, Center for Connection Psychotherapist and Director of Mental Health: Create a peaceful morning routine.

Sit down with your kid and create a checklist of what needs to happen to get out in the morning and make a plan to minimize stress. So, things like, pack your backpack and put it by the door at night, shoes and jacket by the front door, fill your water bottle and put it in the fridge, clean out the lunchbox after school and put in snacks for the next day. Based on age, I like shifting the responsibility to the child.

4. Courtesy of Hanna Bogen Novak, Center for Connection Speech and Language Pathologist: Take a seat.

Try using visualization to build strong executive functioning, which is critical to all learning: Encourage your child to make a mind movie of their return to school by using the tool: Take a S.E.A.T. and picture It.

a. Space: Where will you be on your first day back? A new classroom with a new teacher? In a new school? Help your child think about what it looks like to navigate their new learning space.

b. Emotion: How will you feel on your first day? Nervous? Excited? Shy? All of your child's feelings are valid, and sometimes they might be feeling lots of emotions at once. Remind your child that feelings can change minute-to-minute, and day to day, and that's OK.

c. Actions: What will you do on your first day back? Help your child remember that oftentimes the first day of school is all about becoming familiar with new routines, and that it's always OK to ask for help.

d. Time: When do you go back to school and how long will you be there? For children who struggle with certain subjects at school, help them remember that less-preferred activities don't last forever.

You can encourage taking a mindful moment to breathe as you initially take a S.E.A.T. (ideally while actually pausing and sitting), exploring the child's emotions.

5. Courtesy of Dr. Joy Malik-Hasbrook, Clinical Psychologist and Director of Psychoeducational Assessment: Involve the child.

Include the child in finding the solution, respecting her understanding of herself, depending on her age. We can ask the child “What will help you feel brave for this new school year?” and “What do you need?”

6. Courtesy of Tami Millard, Center for Connection Learning Specialist: Build Balance.

Create habits that will serve your children well through each transition ahead, year after year. “Starting in elementary school, through college, invite them to contribute to a family conversation about creating a schedule for a well-balanced life that includes school and activity management, along with physical activity, family time, sleep, down time, and other valued activities.

7. Courtesy of Janel Umfress, Center for Connection Educational Therapist and Learning Specialist): Make playdates.

Setting up times to play and interact with peers who will be in their class helps with those first day connections and desires to get to school. Janel Umfress

8. Courtesy of Dr. Tina Payne Bryson, Center for Connection Founder & Executive Director): Bravery symbol.

Give them a temporary tattoo and when you put it on tell them “this is your bravery tattoo.” A simple bracelet works as well. Find the language that works best for them—you might use the words “peace” or “calm” or “courage.”

9. Courtesy of Christine Triano, LCSW, Center for Connection Psychotherapist and Director of Mental Health: See the week.

As for overall time management and communication, use a kitchen whiteboard with a weekly calendar. Fill it in together on Sunday nights, use different color markers for different kids. List appointments, afterschool activities, big due dates, or important family events. Kids like to know what to expect and it builds a sense of agency over their time to start to plan their own calendar. It’s important for them to add things that matter to them too!

10. Courtesy of Hanna Bogen Novak, Center for Connection Speech and Language Pathologist: Teach wonder questions.

So much of the dysregulation about returning to school stems from the nebulous worry about re-integrating into the social dynamic of the classroom” “Use ‘wonder questions’ to show peers you're wondering about them: ‘I wonder what you brought for lunch today.’ Hopefully they’ll get asked a question in return and have a sense that people wonder and care them in return.

11. Courtesy of Dr. Joy Malik-Hasbrook, Clinical Psychologist and Director of Psychoeducational Assessment: Play to practice.

In order to process and create a feeling of familiarity, try different avenues of play--imaginative (play school together), create art about school, write a story about it.

12. Courtesy of Tami Millard, Center for Connection Learning Specialist: Talk about it.

Older kids have social concerns too and if they haven't seen their friends over the summer, they can be angsty about what the social scene will look like moving forward.” Ask them how they’re feeling about this and how they plan to navigate it.

13. Courtesy of Janel Umfress, Center for Connection Educational Therapist and Learning Specialist): Use a conversation starter.

Find books about going back to school and read with your child. Parents can show photos of themselves at the age of their children and reminiscing about their experiences with honest emotions.

14. Courtesy of Dr. Tina Payne Bryson, Center for Connection Founder & Executive Director): Fake it till you make it.

When you move your body into different positions, you activate emotions, thoughts, and feelings associated with that posture. Add playfulness while doing this! Ask them to show you what their bodies look like when they feel brave — have them actually strike a physical pose. Standing brave helps us feel brave or take 2-3 minutes to assume a floppy noodle posture, or an octopus, or any other posture that is super floppy and relaxed. Hold it for a couple of minutes.

15. Courtesy of Dr. Joy Malik-Hasbrook, Clinical Psychologist and Director of Psychoeducational Assessment: Start with yourself.

Children are skilled at picking up on our feelings about our child going back to school, so it’s important that we work through and get clear on our own worries or concerns or on triggers from our own school experiences that may be leaking out. Modeling calm confidence, inner compassion, and respect can show our kids that we trust they will do well.

16. Courtesy of Janel Umfress, Center for Connection Educational Therapist and Learning Specialist): Emphasize curiosity as a social skill.

It can be really helpful to give our children tools that assist them in navigating their relationships. Worries are often related to open-ended times, such as recess and lunch, rather than what is happening in the classroom. By emphasizing curiosity as a social skill, we're teaching children about how to enter into a group, and most importantly, how to ask questions. The question can be about permission to enter into play or sit with a group during lunch ("May I?"), but more importantly, we want to teach children to be curious about others by initiating a conversation and keeping the topic and conversation going. When children return from their first day of school having played with a new or old friend, or connecting with someone at lunch, their experience tends to be reported as so much more positive.

17. Courtesy of Christine Triano, LCSW, Center for Connection Psychotherapist and Director of Mental Health: Make mornings fun.

Make a morning playlist for the house or car. Choose songs that boost energy, are fun to sing or dance to or create a less stressed morning.

18. Courtesy of Hanna Bogen Novak, Center for Connection Speech and Language Pathologist: Gratitude.

Calling upon recent research, focusing on and feeling grateful for the more preferred aspects of school can even change the chemistry of the brain in the moment, helping your child feel more regulated.

19. Courtesy of Olivia Martinez-Hauge, Center for Connection Mental Health Therapist:

Our kids are not the only ones who deserve compassion as we venture into a new school year. Back to school is a time of transition for everyone - kids and parents alike. Take a moment and breathe. It really is going to be okay.

Now that you feel better, let's talk homework. Does homework time end in tears? Yours or your child’s? Here are some tips to flip the script on homework time.

1. Teamwork. Align with your child and make them feel that you are tackling homework together. Working with your child during homework time is insurance for a “read to learn” brain. A child who is regulated is scientifically more capable of reviewing and practicing the subject at hand, as well as soaking up your wisdom.

2. Plan. Take a week and experiment with different times to start homework. Then ask your child what time felt best for them and develop a plan together to incorporate homework into the daily schedule.

3. Place. Experiment with different places to do homework in order to optimize your child’s attention and focus. Some kids need music in the background, while others need it quiet. Allow your child to move, stand, or lay on the floor on their stomachs to keep their brains awake and regulated.

Rest assured, you will not be tested on this information.

20. Courtesy of Janel Umfress, Center for Connection Educational Therapist and Learning Specialist): Partner with the Teacher.

If the child has intense worries and fears, identified learning challenges, or if there are parental concerns, it’s important to share the information with the child's teacher so he/she understands how best to support the child from the start.

21. Courtesy of Tami Millard, Center for Connection Learning Specialist: For older kids, Tami Millard:

In thinking about our older kids (middle/high school), it’s important to create habits that will serve them well through each transition ahead, year after year. Invite them to contribute to a family conversation about creating a schedule for a well-balanced life that includes school and activity management, along with physical activity, family time, sufficient sleep, and down time (also known as "fallow time", a period in which you do nothing. To learn about the important of having fallow time, check out this article: You Are Doing Something Important When You Aren't Doing Anything-NY Times).

22. Courtesy of Allie Bowne-Schreiner, Center for Connection Mental Health Therapist: Build in some extra "special time" to connect with each child after the day.

Even 10 minutes of uninterrupted, tech-free, focused time where you follow their lead and connect will do wonders to help them feel seen and important. The after school/evenings can get hectic, but pushing pause to prioritize this focused, quality time puts lots of deposits in our children's emotional buckets.

23. Courtesy of Olivia Martinez-Hauge, Center for Connection Mental Health Therapist: “How was your day?”

I’ve asked my son this question many times. The response I receive is routinely dissatisfying - “good.”

I want more, but how do I help my son open up to me? Here are some tips that have worked for me.

1) Love them first. Sometimes our kids have difficulty downshifting from school to home so this is disarming, less demanding, and makes a soothing connection with them. Starting with “hey I missed you today,” or “I am glad you are home,” can help your child regulate during the transition home.

2) Model for them. Give them a brief run-down of your day. Use new descriptive words and don’t leave out the negative ones. It is helpful for our kids to know emotions – positive and negative and everything in between – are normal.

3) Guide them. Use focused questions instead of open-ended questions. “What was the best part of your day? “What was the hardest part of your day?” “Who did you play with today?” Talking with your child about their day might be best during bath-time, dinner time, or even bed time. Or more simply, whenever the moment presents itself.

4) Involve everyone. Asking everyone in the family about their day promotes connection and further models communicative engagement. It might even be fun to speculate with your child what the family dog did today as a conversation starter.

Note: If your child’s behavior is carefully monitored at school steer away from asking your child if he/she had a good or bad day. Chances are your child has some shame surrounding their behaviors and focusing on positive questions can encourage them to share with you what is happening at school.

24. Courtesy of Dr. Tina Payne Bryson, Center for Connection Founder & Executive Director): Name it to tame it.

Create a book with your child by taking photos of your child’s school — classroom, playground, drop-off spot, cafeteria. Print photos out and while assembling them into book form, do the following three things:

1) Facts: Ask your child what she/he does during the day, be specific,

2) Feelings: What is she/he actually feeling during their school day, again be specific; use their words, and

3) Tools/Strategy: Help them come up with ways to manage these feelings. It might be a favorite song that your child could hum or sing to herself when she’s feeling scared. Or, it could be a hug that they could give themselves. Be creative, whatever will help them manage these feelings.

4) And, lastly, say “if you need help, your teacher will help take care of you.”

25. Courtesy of Dr. Tina Payne Bryson, Center for Connection Founder & Executive Director): Ask for help.

It’s important to note that, for any age, some kids might need some additional support from a professional. Observe the timing and intensity of your child’s anxiety or reactivity, and be curious about why and what is leading to these feelings. It may be that the demands of the environment are outside of your child’s capacity or that something else is causing a stress response. If what your child is experiencing seems outside of the typical developmental response seek professional help sooner rather than later so that whatever is causing the distress can be looked at more closely.

Center for Connection Launches Invited Speaker Series

We are pleased to invite you to join us for a series of professional workshops, featuring expert speakers on a range of topics we feel are unique, highly relevant, and intrinsic to the work of mental health practitioners and related disciplines who share our desire to stay current and integrate interdisciplinary practice with the latest research in neuroscience. You'll also have the opportunity to learn more about what we do and meet many of the wonderful clinicians on our Team during a lunch time Meet and Greet with the Center for Connection. Light refreshments and coffee will be provided throughout the training experience, but lunch will be on your own, so please plan accordingly. Several local eateries are close by to grab a quick bite, or you may decide to bring lunch with you to make the most of the mid-day networking event. 

Learn About Our Upcoming Program

The Many Faces of Grief: A Clinician's Toolbox to Facilitate Emotional Regulation Through the Grief Experience (6.0 CE Workshop)

Friday, May 10, 2019, 9:00am – 4:30pm

Losing a loved one is perhaps one of the greatest pains we experience in life. Long-term illness, accident, health crisis, addictive substance or suicide will influence the grieving process and may produce unique psychological consequences. For clinicians who work with children and adults grieving different types of loss, it is imperative to understand the physical, psychological and behavioral repercussions that often occur and implications for treatment. In this highly experiential 6.0 CE workshop, you'll develop a toolbox of clinical skills to help clients through mourning losses and facilitate growth after grief.

Learning Objectives: After the workshop participants will be able to:

1. Identify different forms of grief: traumatic/complicated, disenfranchised, anticipatory, delayed, cumulative and compounded grief.

2. Understand DSM differential diagnoses between grief, depression, traumatic grief, prolonged grief and complicated bereavement.

3. Explain how the grief experience differs for children, teens and adults and for survivors of sudden versus prolonged death.

4. Understand the major theories and tasks utilized in grief therapy.

5. Develop awareness of evidence-based treatments used with different forms of grief.

6. Describe major constructs within Post Traumatic Growth in grief therapy.

Contact us for more information if you have questions about registration, or if you wish to inquire about sharing your own area of expertise and joining our series as a future invited speaker.

Hear Annalise Kordell & Other Experts at the 2019 Kidskintha Parenting Consciousness Conference

Save the Date: February 15 - 18, 2019

Register now and get 48-hours of FREE access to over 28 interviews with experts from the fields of neurology, psychology, mental health coaching, teaching, and educational entrepreneurship (including the Center for Connection’s very own Clinical Director, Annalise Kordell, who will speak on “How to Build Coping Mechanisms for Unprocessed and Frightening Big Feelings through a Child’s Changing Years”). Click here to watch a quick excerpt.

Watch these Trailers to Learn More

Click the button above to register now for FREE. You will receive an email at the start of the conference, and will have 48 hours to watch the various keynote addresses. Topic focuses include:

1. Practicing child-centered, connection-based parenting

2. Beating Parenting Overwhelm

3. Raising children with self-awareness

4. Making sense of their rapidly changing bodies and minds

5. Raising Future-Ready kids

6. Raising strong and resilient children

7. Setting children up for academic success. 

Hear Dan Siegel, Olivia Martinez-Hauge, & Other Experts at this Year's Bright & Quirky Conference!

Are you raising a bright and quirky child? Looking for answers in helping your child thrive, even with focus, learning, social, emotional or behavioral challenges?  Wanting to find a community of experts and parents who ‘get’ a twice exceptional child who is both bright and struggling?

Join Licensed Marriage and Family Therapist Debbie Steinberg Kuntz for The FREE Bright & Quirky Child Online Summit starting January 28, 2019. The 30 speakers include Dr. Ross Greene, Dr. Temple Grandin, Dr. Dan Siegel, Dr. Ned Hallowell, Dr. Laura Kastner, Michelle Garcia Winner, Dr. Barry Prizant, Dr. Denise Pope, Dr. Dan Peters, and Dr. Laura Markham.

This online summit includes over 19 hours of free expertise from experts working with bright kids with focus, learning, social, emotional, and behavioral challenges. The Bright & Quirky Child Online Summit runs for 7 days, beginning January 28th. Content will be FREE to the public each day for 24 hours. There will be approximately 4-5 talks per day. A membership to the Bright & Quirky IdeaLab is available for purchase for those who would like to watch the series at their own pace, do Q&A with the experts, and get parent support. Amazing lineup of speakers!

Here’s an Overview of Each Day:

• Day 1 - Jan. 28: Understand your bright & quirky child

• Day 2 - Jan. 29: Manage emotional intensity, meltdowns & behavior

• Day 3 - Jan. 30: Navigate school and learning challenges

• Day 4 - Jan. 31: Manage social challenges and build community

• Day 5 - Feb. 1: Increase focus, motivation and executive function

• Day 6 - Feb. 2: Calm stress, anxiety and perfectionism

• Day 7 - Feb. 3: Parent complex bright & quirky kids — interviews from Dan Siegel and our own Olivia Martinez-Hauge will air on this day!

Click to register:https://brightandquirky.com/summitreg/

The Impact of Traumatic Separation on a Child’s Developing Brain:

A Brief Discussion Given Current Events

Written by:  Joy Malik-Hasbrook, PsyD PSY22923 Licensed Clinical Psychologist

Many years of research have shown us how important the caregiver/attachment relationship is on a child’s development and resulting adult functioning.   “Development may be conceptualized as the transformation of external into internal regulation” (Shore, 2001, p. 205). Thus, the child internalizes the external experience of the parental relationship to develop many areas including regulating mechanisms of internal feelings and states, inner calming, managing fear and stress, connection with others, and perception of the world.

A child’s brain is continually developing based on her external environment.  Subsequently, research has shown that the brain can be significantly impacted when the child endures a traumatic experience.  Trauma can be defined by an experience where the individual is so frightened and/or helpless that it overwhelms the capacity to cope.  When a child experiences a loss of the caregiver relationship, this can be especially traumatic because children are dependent on their caregivers for survival and safety.  The child will likely be in a constant state of helplessness and vigilance, which is overwhelming for the brain and body. 

Research shows trauma impacts the child’s developing brain in many ways.  The brain adapts to this constant fear and focuses more on survival.  Subsequently, the brain overly develops the systems that anticipate and respond to a threat, instead of other expected areas of maturation.  The limbic system (amygdala and hippocampus), midbrain, and brainstem, which play key roles in regulating our responses to a potential threat, fear, and states of overwhelm show increased sensitivity.  Additionally, the cortex and frontal lobes have reduced functioning, which are structures connected to problem-solving, planning, and learning. 

When a trauma occurs outside of the home, the child can heal and integrate this difficult experience with the support of her loving and safe parent.  The parent’s protection and processing of the trauma support the integration as the child is able to internalize the healing experience from the parent.  Therefore, when a child experiences a distressing parental loss or separation it is traumatizing in multiple ways.  The current political decision that separated families is extremely dangerous to the families’ ongoing health and development.  It is one of the most dangerous experiences a child can have because not only has she experienced something traumatic, the loss of her parent, but she also do NOT have the safety, love, connection, and regulation of the attachment relationship to heal and integrate the traumatic experience.

It is also important to note the shared experience of overwhelming toxic stress among all of us living in the United States.  Given our interconnectedness as humans, we are all impacted by the helplessness and distress our society is feeling. 

We must also remember that our brains, bodies, and minds have an amazing capacity for healing. Research in neuroscience has taught us about neuroplasticity, that the brain, even in adulthood, can change.  We can provide the mental health support for both the children and their caregivers to heal and integrate this trauma. We can also teach mindfulness and compassion practices, which studies have shown support the healing of the brain and body after experiencing a trauma.

References:

Schore, A. (2001) The Effects of Early Relational Trauma on Right Brain Development, Affect Regulation, and Infant Mental Health.  Infant Mental Health Journal, 22(1–2), 201–269.

van der Kolk, B (2003) The Neurobiology of Childhood Trauma and Abuse. Child and Adolescent Psychiatry Clinics 12, 293-317.

College or Bust? Understanding your college student’s mental health

An interview with Christine Triano, LCSW

By Olivia Martinez-Hauge, M.A. OTR/L, AMFT 

After months of preparation and the college essentials are jammed in the back of car, your high school grad is off to their first year of college.  You might be experiencing the swirl of emotions and expectations typical of a parent sending their child off on their first step toward adulthood. But what happens when your student doesn’t make it through their first year or even semester? According to some sources, 35 percent of first year college students will drop out during their first year.  The Bill and Melinda Gates foundation reports that a majority of these students drop out due to the cost of going to school. But what about the mental health of our first-year college students? According to the National Alliance on Mental Health, 50% of college students reported their mental health as below average or poor.

There is no doubt that the transition from high school to college is a difficult one. As therapists we are seeing clients who are struggling to make this transition. We work with others who have returned home experiencing feelings of shame and guilt for not performing to the real or perceived expectations of their family and friends. Students are left asking questions of themselves and working through the feelings on their own. Many times, parents are left with questions about how to help their children who are in uncharted college territory. I have turned to a seasoned colleague who has years of experience working with this exact population. Christine Triano is a licensed clinical social worker and the Director of Mental Health at the Center for Connection in Pasadena. Here is a question and answer session vis-à-vis parents of college-age students.

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Christine, how can we know if our student is really struggling with mental health issues or if it’s just laziness or homesickness? 

Homesickness is a normal part of the college experience, and likely a feeling your child has already experienced at summer camp or travel away from family. It’s a hard feeling, but one that is also tolerable and should resolve with time and engagement with others and by participating in enjoyable activities.  

A mental health issue does not simply pass, but rather continues to come up and, untreated, likely worsen. One way to look at any issue is to ask, is this significantly impairing my child’s ability to function? Questions to assess this might include: Are they making it to class? Getting their work done on time? Maintaining a regular schedule? Getting enough sleep? Spending time with peers? How’s their self-care (e.g. hygiene, nutrition, personal chores)? Major challenges in any of these areas may signal that there is a mental health issue at play.

How do I prepare my student for the independence of college life?

There are two fundamental forms of preparedness for leaving home. The first is cultivating the skills necessary for independent living. I can’t tell you how many freshmen I met while working as a college mental health counselor who had never grocery shopped or done a load of laundry. Think about leaving home for the first time to live away from your family in a totally new setting, surrounded by strangers, including one or more you have to share a room with. Then add the academic pressures and logistical demands of mastering a college schedule. It’s a lot. Now, add the fact that you need to put money on your laundry card, make sure you have a bottle of Tide, and separate your whites from your colors. It is a small task that can become that one extra drop that makes a student’s bucket overflow. 

So, how to help your teen be better prepared in this regard? This one is relatively simple, but means starting now (or yesterday!). I strongly believe all kids should have chores. Even a 5-year-old can help set the table, or put their clothes in the hamper. Beginning in high school, I often share with parents that they are not helping their child grow by doing things for them they are capable of doing themselves. My own children, both teens themselves, have heard this time and again. Of course, there are exceptions. When my recent high school graduate was studying for finals, I happily threw in a couple of loads of laundry for him. But, in general, I think it’s great to look at this as adding tools to their self-care toolkit. This includes tasks like: laundry, changing their sheets, cleaning the bathroom, preparing some simple meals, and making a basic grocery store run. For older teens, making their own appointments for haircuts or the doctor is also great practice. If they drive, I would add basic car maintenance too. 

The second form of preparedness is more about emotional readiness. A Harris Poll of college freshmen found that a full 60% stated they wished they had gotten more help with emotional preparation for college, defined as “the ability to take care of oneself, adapt to new environments, control negative emotions or behavior and build positive relationships.”  Studies have shown us that such preparedness is a major factor for students’ success during their first year at college. I would also add that play and balance are major contributing factors for cultivating resilience.

At the Center for Connection, we often talk about the foundation for this kind of resilience in terms of having the ability to self-regulate. Anxiety, depression, panic, stress, isolation, or withdrawal, by contrast, are all forms of being in a state of dysregulation. One way to approach this is by asking yourself if you are scaffolding your child up toward greater resilience. This may mean encouraging them to email a teacher or to set up a meeting at school on their own, allowing them to plan how to spend their time when there are competing social and academic demands, and generally letting them experiment with taking risks (within reason) and possibly failing. In general, if you can standby with support and empathy, rather than intervening or otherwise performing those amazing contortions of body and spirit designed to prevent your child from experiencing disappointment, loss, or discomfort, then you are on the right path.

I know my student has mental health issues, what can I do to ensure he/she is safe and healthy at school?

College campuses are acutely aware that students are experiencing record-levels of mental health challenges, with counseling centers facing increasing, and in some settings, overwhelming demand for services. The fact is, almost one thirdof students meet criteria for an anxiety or depressive illness during their college experience and many do not get or seek the help they need. It’s important not to be afraid to explore what’s really going on. It’s not unusual for a young adult to try and work things out on their own, or to be reluctant to worry parents back home.  If you have concerns or a sense that your child is really struggling, start with some open-ended questions or maybe be sharing a memory of your own college experience when things were hard. Let them know that their well-being is more important than their GPA and that you are there to offer support, without judgment. If you suspect they feel overwhelmed, you may want to gently offer to investigate options on campus, such as “I know the counseling center is available to all students, would it be helpful if I checked into how you go about making an appointment?” Keeping your own fears and concerns in check is important here. Even with college-age students, as parents our emotional state still has a big impact on our kids. We can help by being mindful that our own worries don’t amplify our child’s distress.

My student just told me they want to take a year off, what should I do?

First, breathe. Then, investigate, without leaping to assumptions. If your child is coming to you with such a pronouncement, it very likely was not arrived at lightly or easy to share. Maybe they are just feeling overwhelmed and need to vent. In that case, it may be more a question of exploring what kinds of support they need that they may be lacking. If it’s more serious, the first step should be to assess whether your child is in crisis. If so, it’s always important to seek help immediately. There are lots of reasons students decide to take a break. In many other parts of the world, it’s common for young people to take a gap year before heading off to four-years of college. The reasons for this are many, including gaining life skills, seeing new places, discovering what they’re interested in, volunteering, earning some money, and learning more about themselves. 

I have worked with students who muscled through their first year or two of school, despite the growing burden of untreated, or undertreated, anxiety, depression, trauma or other mental health issues. In my experience of working with such young people, there is also often an element of confusion about their identity rooted in not having a sense of their authentic self. Teens today face enormous pressure, oftentimes internalized, to be “perfect.” I am regularly impressed by the drive I see in high-schoolers, juggling AP classes, sports, extra-curriculars and schedules that make me tired just to hear about. The one thing that can be missed in this drive to get into a good college or university, however, can be time to reflect on their true values, hopes, dreams, and passions. Once away at school, it can make it even harder to form meaningful connections with others when it’s hard to be yourself, or if you’re not even quite sure who that self is. 

All of these factors can lead to that call where the idea of taking a year off is proposed. Getting to the degree is important, but so is arriving at college graduation with the mental and emotional well-being, life skills, and maturity to succeed after college. Would your student benefit from a year to focus on cultivating these qualities? What are the options for your family, and how can you come to an agreement about what the year will look like? I’ve worked with students home for a semester or a year, some of whom have done intensive therapy for most of that time, others who combined treatment with getting a job or taking classes nearby, and yet others who created plans involving travel and volunteerism after a restorative period home. All schools have a procedure for requesting medical leave, which applies to mental as well as physical health. There are some details to work out, but with a simple request and sometimes a letter from a mental health professional, the process can be initiated to give your student the time they need to get well. 

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Christine, you gave the readers great words of wisdom, anecdotes, and practical advice we can implement tonight! In some cases, the decision to go to college is expected and the discussion around the kitchen table usually focuses on tuition, deciding on a major, and where to live.  While bedding and books are essential parts of going to college, you can equip your child with a tool belt stocked with resilience, self-care, and self-advocacy tools to ease their transition into Independence University.  Experiment with giving your child space to be responsible for making an appointment, completing a chore, or advocating for themselves, and except some speed bumps along the way; mistakes and failures are moments of learning. By the way, the loads of laundry they bring home on the weekends are their way of saying, “I still need you.” — OMH

Introducing the Play Strong Institute...

The Center is excited to announce that we've expanded. Our new venture, The Play Strong Institute, will be run by Managing Director Georgie Wisen-Vicent and will open its doors September 1, 2018. 

Located at 1021 E. Walnut in Pasadena, California, the Institute is dedicated to providing continuing education and training to a new generation of play therapists, advancing study and research in play therapy and neuroscience, and enriching the lives of children and families through counseling that is highly integrated with the science of interpersonal neurobiology, trauma-informed care, play and the expressive arts. 

A MESSAGE FROM THE PLAY STRONG INSTITUTE

Our mission is to promote best practices in Child-Centered Play Therapy training with a focus on the brain and relationships for graduate students, pre-licensed and licensed professionals in counseling, psychology, social work, family therapy, and integrative mental health. We always incorporate the latest research on the developing mind, brain, and relationships working from a neurobiology framework in play therapy to better understand the needs of children who experience stress, anxiety, and trauma and help develop stronger emotional resilience. 

Because children are better at expressing emotions through their actions, the distinct advantage of play therapy is that children express their ideas and feelings through creativity and hands-on innovation. Research shows that our brains develop and get connected from the bottom up, so we begin with body movement and sensory experiences and allow children to make a natural progression to complex thinking, emotional awareness, and mature communication. In play therapy, children can share their life stories, form new connections and build confidence around previous challenges that have been difficult, uncomfortable, worrisome, confusing, or chaotic. A creatively attuned play therapist responds skillfully and effectively to clarify their needs, help them express their emotions, find new solutions, practice new skills, and rewire healthy brain connections in a way that feels most natural, comfortable, and yes, even fun and enjoyable to children!

Improving quality play therapy education and training for prospective play therapists and building competence in the neurorelational framework that respects the individual differences of children, teens and young adults are of particular importance to us. Our team of therapists, supervisors, and instructors has spent many years studying and practicing evidence-based, research-supported approaches in play therapy guided by the science of interpersonal neurobiology. We are very proud to share our knowledge, experience, and enthusiasm for teaching and working holistically with children and families. Join us in the movement to create stronger, healthier, more resilient kids through play!

Learn more!

Visit the Play Therapy Institute's website to learn more: https://www.thecenterforconnection.org/playstrong/

We have a new home for our interdisciplinary team!

We are very excited to have all of our brilliant CFC clinicians together under one roof! Our new office is located near the 210 freeway, right off the Madre Street exit, and we'll be open on Monday, July 23rd, 2018!

Our new offices will feature plenty of on-site parking, 6,000 square feet of office space, gorgeous mountain views, updated facilities, and more! It's also conveniently located near the Post Office, multiple restaurants, Target, and other shops.

We will close our California location by the end of July, and each team member's move-out date will vary. Our Walnut location will become a hub for play therapy. We will keep you updated as additional details become available! 

3030 E Colorado Blvd, Pasadena, CA 91107

CFC Clinician Dr. Chon Featured on MotherSquad.com

Check out this powerful blog from CFC clinician, Dr. Esther Chon, which was featured on Mother Squad.com. Dr. Chon is a mom and a clinical psychologist with a specialty in Infant Mental Health and Maternal Mental Health. 

To quote Mother Squad, "Dr. Chon writes about the experience of having a picture in your head of what your baby will be like versus what the "real" baby is actually like. This process of grieving, accepting, and loving repeats itself throughout motherhood. Dr. Chon draws from her own experiences as a mom." 

We Now Offer the Safe and Sound Protocol

We are proud to announce that we now offer the Safe and Sound Protocol at the Center for Connection for kids who need help with regulating their emotions.

Based on years of research by Dr. Stephen Porges, the Safe and Sound Protocol is a 5-day therapeutic listening program designed to help increase the social engagement system in children and adults while simultaneously calming the nervous system. We must be regulated and organized in order to understand language and engage socially with one another!

SSP is a great way to help children and adults move through major transitions (such as starting school, starting a new job, going on vacation) and prepare for participation in other therapeutic interventions. Visit the Integrated Listening System (iLs) website for more information.

Dr. Jamie Chaves, OTD, OTR/L, SWC at the Center for Connection, can now administer the SSP, which can only be done by a professional who has participated in the training. Interested participants will commit to five (5) consecutive days of listening to the 60-minute sessions (which can be broken up into two 30-minute sessions with a short break in between, if necessary). The cost of the 5-day intervention is $1,000.

Please contact Dr. Chaves directly for more information or to participate in the program.

Note that this intervention is not meant to replace other forms of therapy--it is designed to be used in an adjunctive manner.