Back to the Rat Race

4/1/2013

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Many of us in Northern Virginia heard our alarm clocks for the first time in over a week this morning. After a slower paced spring break we are back to the school buses, packing lunches, homework and shuttling around from one practice to another.

It was so nice to let go of the schedule for a bit. We slowed down, slept in, travelled and played. The kids seemed lighter, slower and relaxed. Many parents that I know took the week off from work, or at least a couple of days. Throw in Passover and Easter to the mix and it's been one big party (well, mostly, unless you observe the Passover dietary rules which is an entirely different blog post).

Last night as we sat around the dining room table for the first time in over a week and ate a home cooked meal, we were laughing and being silly with an edge of "it's time to get back to normal". We had spent MANY hours together, in the car and at meals and in a hotel room, there had been little alone time and we just might have been starting to rub each other the wrong way. My big announcement was "in the morning, everyone is going to leave". One kid rolled his eyes dreading the school bell while another one was somewhat relieved to get back to school and his friends and the routine.

There is something to be said for routine. We depend on some sense of normalcy and patterns. Despite the monotony of it, our kids do thrive with a schedule. I work with a family whose father defied all routine. He wouldn't adhere to meal times, bed times or a homework schedule. The kids were suffering; they fell asleep in class and were struggling academically. With the help of many professionals, this dad began to implement some routine into his daughters' lives and they are doing much better. With a good night's sleep and a consistent schedule the girls (and all of us) perform better in our daily lives.

Flexibility is key; a night out once in a while or breakfast for dinner in front of the television on occasion, but overall, spring break or not, routine is a good thing. Our bodies crave it as do our minds and souls.

As we get back to the grind, keep this in mind while we are rubbing our eyes from lack of sleep and cursing the traffic, there is something to be said for getting back on that hamster wheel.

Balancing the Helping Hand

3/14/2013

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I met with three different women last week each of whom was concerned about her mother. One of my clients was in her mid twenties, another in her mid thirties and the third woman was in her early forties. Each of them are worried that their mothers aren't doing enough in their daily lives. They worry that their moms are isolated, don't get out and don't have peers or interests. Two of the moms have husbands that work during the day and the other mom is living alone. My clients each came to me with personal issues and struggles, but this one week they all happened to be discussing their moms.

I was thinking about how much each daughter should encourage, urge or interfere in her mom's lives. What is the right balance? One client was attending a workshop and her mom came along, another was joining her mom at worship services. The third has been an integral part in her mother's 'new normal' of adjusting to living alone. The one who was attending church with mom began to feel badly when she wanted to explore some other spiritual options; she was torn between meeting her own needs and meeting the needs of her mom.

As a therapist, this is an interesting dynamic to witness. My client is my interest; my job is to provide the tools for my client to feel better, achieve her goals and find calm and joy in her daily life. I hear about, in this case, their mothers and have new concerns and empathy. Would we call this a client 'once removed'? What happens when what is best for my client may be in conflict with what is best for the client once removed?

The twenty-something woman has recently moved into her first apartment after years of schooling. Her mom is struggling with her baby becoming an independent adult. My client feels torn between having dinners with her mom and taking care of her own social needs. I help my client with her boundaries; encourage her to take care of herself, live her new 'adult' life and nurture her independent relationships. Is it my client's role to fill her mother's emotional needs? Not necessarily. In a perfect world, the 'client once removed' would begin her own therapy to empower herself to make changes to become personally fulfilled without tugging at her daughter to feel complete.

Three weeks ago, the client in her early forties was so worried about her mom that she asked if she could bring mom in to her therapy session. After talking about the pros and cons and discussing all confidentiality needs, we agreed that this would be an appropriate move. The next week, they both came to the session. At almost eighty, mom was full of life; proud and in charge and chatty as could be (unless I asked her something that made her uncomfortable or was too close to a real feeling. She repeatedly told me that in her day one didn't go to therapy except for one person she knew who had a "breakdown"and was taken to the "sanitarium"). Mom insisted that she was happy, enjoyed her television shows and socializes when she gets her hair done and with the people at her favorite restaurant that she frequents up to three time a week. The following week my client/her daughter came back for her session. She said that she had "let go"; hearing her mom talk with me had convinced her that mom was going to call the shots. As much as my client would like for mom to get out more and have some friends, she was letting go, it wasn't her call to make.

Last month a friend's mother had surgery. This morning she was sharing with me how her mom had been doing. My friend was hands-on during the initial time of surgery and recuperation. She has since backed off; "my mom (who is eighty) is very independent and doesn't need me to be hovering". Just recently she told her mom to drive over to her house, she told me "I had to push her for fear that she would be too afraid to resume driving."

As she talked, I had an "aha" moment about this half-written post. There is a time for a dinner with mom and extra visits after surgery, but there is also a time and a need for boundaries. It can be very complicated to set those boundaries for fear of hurting "mom's" (or anyone's) feelings. Taking care of one's self is not selfish, it is self-care. When my clients are giving all of their time and energy over to their moms, they rarely have anything left for themselves. The more they learn in therapy how to take care of themselves, the more balanced and healthy energy they will have to give back to their moms and others in their lives.

Growing Moms

2/13/2013

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I am sitting in the waiting room of my gynecologist (tmi? who of you hasn't sat in that waiting room?). Driving in to the big parking lot that I thankfully hadn't entered since my last appointment a year ago, I recalled the years when I was coming here once a month then once a week. I spent more time at this office during my child bearing years than I did in my own dining room.

As I entered the way too full that is going to keep me here for way too long waiting room I realized that I am the only one in here past the childbearing years (much to my daughter's dismay when she regularly asks for a baby sister). There are about seven women in the room, two with toddlers and one with a 4 week old precious little boy. Two women are doing the three hour glucose test, remember that nasty stuff, killing the morning on their iPads that have replaced the outdated People magazine that I read back in the day. Each time the door opens I am hoping that the nurse will finally call me in for the joy of the stirrups, but instead another huge belly comes out attached to a tired and expectant mom.

The chatter in the room is about sleeping, or not sleeping, the size of babies and how cute baby 'gas' is. I had to open my mouth (shocked?) and share that my oldest is getting ready to go to college, and it was just 5 minutes ago that I was sitting here making a birth plan (which included LOTS of drugs).

One couple is sitting here, so cute, the only man in the room. Young love, coming to support his newly pregnant wife - yes, that was us. Do I dare share what is to come? And, I don't mean the sleepless nights and boxes and boxes of diapers. We all know that, "What to Expect When You're Expecting" drummed it into our heads on EVERY.SINGLE.PAGE. I'm thinking more about sharing about when the nanny quits (or doesn't show up), or when Teacher Work Days fall on MY work days. What about every single band concert, or broken braces bracket or argument about taking a shower? Nah, I won't share. I had a neighbor whose kids were a few years older than mine that used to say "you'll see". Yes, I did see, but I saw through my own eyes on my own time.

But, I might want to share about the first tooth lost, or the adorable jazz recital costume, the fantastic soccer tournament or the thrill of the college acceptance letter. Nah, I'll let the new moms have that joy on their own as well.

The roller coaster ride of parenting.The highs and the lows, the ups and the downs; truly a mind game, and I wouldn't trade it.

As part of my clinical practice, one of the parts that I really enjoy is working with parents. I often see them when they are at their wit's end: their son is skipping school and using drugs, a daughter is depressed, suicidal and won't leave the house, or the newly turned teenager is defiant and refusing to do anything asked of him or her. My role is two-fold; one of education and support. I support the exhausted and frightened, yet well-meaning parent. I ask them for their input reminding them that they know their child better than anyone else (something they have forgotten while enduring the feelings of Failure at Parenting 101). I try to normalize the situation explaining that so much of what they are witnessing is common, yet painful, teenage behavior.

The education piece is to re-teach these parents, who may have lost their authority in the tumult, that they are, in fact, the parents. They are in charge and they have authority and the final say. The over hormoned, self-involved teenager often misses that memo, preferring to operate instead via whatever is entering his mind via the all-too-important ear buds. Parents need to enforce firm limits and stick to rules and consequences. This can all be done with love, and support, but it needs to be done to make it effective.

I will spare the pregnant mommies that last bit. How could they possibly imagine that their little bundles of joy will transform into big, smelly, obnoxious, yet hysterical, smart and loving teenagers? I certainly never knew!

Mentoring

1/31/2013

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I belong to this great group called DC Therapist Moms. It is pretty clear who they are: therapists who are moms that live in the DC Metropolitan area. Their main function is to host a listserve where therapists post on a daily basis about anything and everything. Questions about specific clinical topics, looking for referrals for their clients, suggestions on business practices or inquiries about books or conferences including off topic posts like 'in search of a nanny'. It is a wonderful resource and has truly changed my professional life.

They have a mentoring program that I used last year when I began my private practice. I met with a wonderful woman who had been in private practice a little longer than I had and I picked her brain about EVERYTHING. It was so nice to be able to ask every last question that was swimming through my brain. She has since become a friend and is part of my wonderful peer supervision group.

This week it was my turn to be the mentor. I met with a therapist who is starting her private practice. She is a decade plus younger than me and has a toddler and a baby on the way; talk about different life stages.

It was a really nice meeting; we shared our work histories, that we both went to the same graduate program (of course, she was in diapers when I was there) and various other war stories from the social work field. I processed about a difficult client that I had sat with the day before since it was somewhat close to her area of expertise and I shared with her my special interest in the area of adoption. She hadn't worked with adopted clients so it was fun to be able to answer her questions and reflect on my experience with that population.

We also talked about our kids, day care challenges and balancing it all.

I heard some really fascinating things from this young mom that I hadn't expected. She was interested to hear that I hadn't gone into private practice until recently. I explained that I wasn't ready until my kids were older and I could put more energy into building a business. She appreciated how hard it was to balance the daycare, sick kid and early school release days with a busy practice. I told her that when I had a fixed schedule working for an agency it worked better with day care and now that the kids were older and more self-sufficient, it was easier for me to come and go and have a more random schedule.

As she processed my journey, I was able to see it in an objective way. I hadn't really planned my career path or thought it out, it kind of just happened that way (I tend to live that way, uber planner, I am not). And yet, as I recollected my process with my colleague, I realized that it made sense. My professional career has worked very well with our family life.

I have always been very grateful that since my oldest son was born, I have had the opportunity to work part-time. As I sat in playgroups with other moms of babies and toddlers and we ranted on about family-work balance, I truly believed that I had the best of both worlds. My Tuesdays and Thursdays have forever been my work days; that was when I would put on grown-up clothes, interact with other adults, and continue to learn and practice my profession. The other days were filled with diapers, playgroups, laundry and nap time. I wouldn't have traded that lifestyle for anything.

As I set out for our meeting at Starbucks the other morning, I certainly had no idea that these thoughts would have been generated. I am glad that this young mom-therapist was able to send me on a little tour of memory lane. It doesn't help that we are about to have our basement painted and this morning I removed all of the artwork from pre-school from the old chipped painted walls.

Ah, the journey of life, hop aboard, it is a fast moving and crazy ride.

Teenage Depression and Suicide

1/21/2013

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How many of you loyal readers remember this post about a presentation that I was being trained to give about teen suicide and depression? The presentation was last week at my synagogue and it went really well.

There were about sixteen high school kids ranging from ninth to eleventh grades that met with the Religious School Director and another volunteer therapist from our congregation. Ivy Weitzner, our liaison from Jewish Social Services of Northern Virginia and I met with their parents, about 19 in all (some of the kids had both parents present).

Ivy and I met with the parents in the sanctuary. It was a calm and serene setting for our presentation and discussion. We shared some scary statistics about teenage suicide such that suicide is the third leading cause of death for those ages 10-24, children and particularly adolescents who suffer from depression are at much greater risk of dying by suicide than are children without depression (U.S. Department of Health and Human Services, 1999), and children who first become depressed before puberty are at risk for some form of mental disorder in adulthood. Five years ago, 1 in 25 teenagers were making suicidal attempts, today 1 in 12 teens are attempting suicide.

We talked about some common risk factors for teenage suicide:

• previous suicide attempt(s)

• History of mental disorders, particularly depression

• History of alcohol and substance abuse

• Family history of suicide or child abuse

• Feelings of hopelessness or isolation

• Loss or interpersonal conflict (problems with school or the law)

• Physical illness

and some of the warning signs that demand immediate attention:

• Talking or writing about suicide or death

• Giving direct verbal cues "I wish I were dead" or less direct verbal cues "You will be better off without me"

• Expressing that life is meaningless and/or isolating from family and friends

• Giving away prized possessions

• Neglecting appearance or hygiene

• Dropping out of school or other activities or groups

• Obtaining weapons (gun, knives, sharp objects) or prescription medication

• Exhibiting a sudden and unexplained improvement in mood after being depressed or withdrawn (this often signifies that the person has made the decision to end their life. Once the decision is made, the weight is lifted and the person feels a sense of relief which can translate into an unexpected euphoria)

We then talked about indicators that could help prevent suicidal behavior such as supportive family relationships, good social skills and knowing where to seek help when difficulties arise. Additional protective features are connection to extra curricula activities and having good relationships with 'other' adults that were not necessarily the teen's parent.

The DVD that I talked about in detail in the original post was viewed (I tactically suggested we cut out the cheesy dramatizations and instead focus on the people that shared their real life experiences. I was even thanked by one of the parent participants for sparing her the cheese factor).

The discussion that ensued was beautiful. There were tears and fear and honesty. Parents shared about their personal experiences, their experiences with their kids and various stories about what their kids had endured be it depression, the loss of a friend or exposure to cutting (an important note that cutting is not necessarily a suicidal attempt, it can be, but it can also be an unhealthy way that one deals with emotional pain).

It was lovely to see how the group respected one another and offered compassion, or in some cases a tissue. One parent shared that he and his daughter had read the book, Willow by Julia Hoban about a girl who coped with a tragedy via cutting. Others (myself included) copied down the book information as a resource for our kids. The group felt safe, they asked amazing questions and allowed for a rich and thoughtful dialogue about such a scary and poignant topic.

The review from the teen group was that it went equally as well. I polled a couple of teens on their way out and they gave me a thumb's up. The leaders of the teens were impressed with their maturity with this difficult subject and with much of the discussion and candid responses that were shared.

One of the parents shared with me in an email that "the best part (for me) was the discussion it provoked in the car on the way home with my 16 year old daughter. Having had separate but similar sessions we were able to compare them, and this led to us talking without awkwardness. I shared about my post-natal depression, and she discussed her stress at school (nothing rising to the level of depression, thank goodness), but we both felt reassured that the door was always open between us, and that is a very valuable outcome"

We will be repeating this program at another synagogue at the end of the month. I feel honored to have the opportunity to spread such a powerful message and hopefully make a difference for those that are struggling with these mental health challenges.

As always, if there is EVER a question about someone's safety or risk of suicide the National Suicide Hotlines are available 24 hours/day 7 days/week.

1-800-SUICIDE (1-800-784-2433

All kinds of nourishment at Costco

1/4/2013

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I just left Costco and am proud to say that I spent under $200!! Woo hoo!! I only bought food that we needed, it was mostly healthy and things that we will enjoy and nourish our bodies (frozen pizza and those flat pretzel thingies included). What I saw when perusing the aisles during a mid-morning weekday was what looked like many moms stocking up their carts for their families. Yogurt, milk, juice, fruits and vegetables and the all too common granola bar of one form or another. Why this struck me, I am not sure. I snickered thinking about the moms in America loading up their carts in this huge wear house to feed their families. I went so far as to imagine moms in other countries trekking to the village to grab many of the same items from local markets also to feed and nourish their families.

That is what we do; we nourish our families physically, emotionally and spiritually. I was listening to a really good podcast today during a walk prior to the Costco adventure. The guest on the podcast, Elyse Resch, was talking about intuitive eating for kids. One of the things that most resonated with me was to create a healthy relationship with food for our kids, we need to first address our own relationship with food. I heard her talk about nourishing ourselves both physically and emotionally in order to be present and grounded to nourish our kids.

I have worked with many women who forget that second piece: the self-care. These are the women that are at Costco and Target, they volunteer at school, make the cookies for the teacher back-to-school lunch and many of them also work. When I ask what they do for themselves the common response is "there is no time for me".

My friends, we have to make time for ourselves, or we aren't any good for those that we love. I have used the metaphor of blowing up a balloon; that is how we inflate ourselves so that we aren't saggy and enervated.

By filling ourselves up in the form of yoga, a good book, a movie date or a girl's night out we can become bouncy and buoyant and playful. I always find that I am more available to help my family and clients when I have filled up myself.

I honestly had no idea where this post was headed after seeing the carts at Costco, but on the way home it started writing itself in my head. I must have sensed that one of the moms orbiting around the grapes and bananas seemed overwhelmed. I saw signs of a saggy balloon and wanted to give her a big burst of self-care

Happy 2013

1/1/2013

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Welcome to 2013!

I am not one for New Year's resolutions; I try to live one day at a time in a mindful way. I like to think about my daily intentions be they personal, for my family and friends or professionally. Believe me, not all days are thought out and purposeful, but that would be my goal in a perfect world (enter those days of 7 clients, kids with multiple practices and no dinner on the table; purposeful is out the window). All this talk about resolutions feels like a marketing ploy in my mind; it is the gym's way to get more business.

I do find that the beginning of new year can be a time for reflection. How did things go over the past twelve months and what is in store for the next twelve. I know many people that sit down with their partners and map out the calendar year: vacations, summer plans, budgets, doctor's appointments. I tend to live on the other end of that spectrum "what, Spring Break is next week? WHAT ARE WE GOING TO DO?" There is no right or wrong, it is what works best for you individually and for your family.

There are those that decide they want to make inner changes as they reflect on where they have been and where they are going. Some have struggled with depression and are ready to take that first step to walk away from the heaviness, others may find that they are ready to face their anxiety and be rid of that beast for good and then some may be assessing negative relationships and considering opportunities to feel more positive and free.

Whatever your struggle, please remember that you deserve to feel joy. If you are stuck in the muck, treat yourself to whatever help it is that you think you need to be free from the demons; we all deserve to have joy and peace.

Happy New Year, let's make it a great one!!

Laurie

The Bags we Carry

12/26/2012

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I have yet to meet a person or a family that is free of baggage. Big bags, duffel bags, backpacks or Coach bags, you name it, we all have baggage.

As we are coming off of the season of the holidays, aka family gatherings and such, I might venture to guess that some of our bags may be heavier than usual as our family of origin often pushes a button or two on our already overflowing bags.

This doesn’t mean we are all walking around in a sea of depression (although, sadly there are many who are), but it is rare to find someone who doesn’t have a story; a story laden with some emotional baggage. I recently met a new client. This man is successful, handsome and has a lovely family. He shared his story with me, which was quite heavy. As he walked out of my office slipping into a snazzy leather jacket, it dawned on me that anyone that saw him walking around town would not think that this is a guy carrying around such a hefty duffle bag filled with pain, conflict and sadness .

I work with teenagers who frequently talk about the “popular” kids at school. One girl labelled the spot in her high school where the popular kids hang out as the "benches" (it was "Jock Corner" at my high school); she talks about the well-dressed girls who always look like they are happy and have it together. I am forever trying to imprint in their brains (and mine) that we compare “our insides with others' outsides”. Many teenagers feel lonely or inadequate and see the perky girl who bounces through the halls as seemingly baggage-free. That bouncy girl that looks happy may be depressed, suicidal, abused or struggling with an eating disorder. We all have baggage; whether it is apparent on our outsides or not.

One of my biggest challenges as a therapist is to help people embrace the idea of learning to love and accept themselves. I try to help my clients see that healing their insides can boost their perception of their outsides. The teenagers especially hyper-focus on what is wrong with their skin, hair, body or teeth. I, on the other hand, urge them to shift that attention onto their inner strengths: how are they kind, when do they support their friends, who do they make laugh and who can they trust?

One seventeen year client old is constantly trying to climb the rungs of the popular group despite the fact that these girls can be catty and exclusive. I asked her what it would be like to have a really good friend; someone who is kind, fun, funny and trusting. She said that would feel nice. I asked her what it would be like if this friend was not popular; if you enjoyed being with this friend, trusted her and she made you laugh until your stomach hurt, but she lacked the popularity sash across her front?

I challenged my client to observe the people in her classes. Think about the important qualities in a friend and if she thought there might be someone that she would consider being friends with despite their place in the popularity hierarchy. For the record, my client is beautiful; she has long cascading blonde hair, a beautiful figure and stunning features, but sadly she does not recognize this beauty in herself, but she has reported to talking to a few nice girls in one of her classes.

We all have baggage; the popular kids, the beautiful people, the intact families and the super wealthy. It can be a little wristlet or an oversized trunk, but we all struggle at some point because no one has a perfect existence, it's part of this game we call life. The next time you think that your neighbor continues to skate through everything unscathed, remember that they have bags in their attic as well.

Bouncing Back from the Darkness

12/19/2012

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I wrote this last week before the tragedy in Newtown, CT. I have struggled to write or post anything unrelated to to the horrors that occurred because I don't want to detract from their experience. Sadly, as I re-read this post, I saw that it could be applicable. I do hope that if anyone is feeling stuck in the depths of darkness or struggling with any thoughts of suicide that they will reach out to me, another practitioner or use the resources listed below. Warmly, Laurie

A few weeks ago my son was rejected from a college. This was the first he had heard from any college and it was a lousy way to begin the process. He was devastated, as was I. It wasn't his first choice school, but that "rejection" be it in your mailbox, or these days on your computer, is one loaded word. My son is a sensitive kid with a sick sense of humor. I share this because in the midst of his anger/fury/sadness/fear he announced that he was going to "drink a bottle of bleach". Although he was kidding, the therapist in me NEVER takes any suicidal talk lightly.

Twenty-four hours later, he was notified that he was accepted into his safety school. Ahhh....relief! He would not be spending the next 4 years in my basement, he has somewhere to go. He was elated, proud and just darn happy.

A week later, he was then notified that he was accepted to the first school, yes, the one that originally rejected him. What? It turns out that he had accidentally made two accounts when filling out his application online. He had called the school and asked them to delete the first account which, unbeknownst to us, they failed to do. His first account with incomplete application was rejected, his second and proper account was accepted. Relief and sanity ensued.

And, yesterday, he was accepted to his first choice school! Joy, joy and all joy! (except for enormous tuition payments).

Back to the bleach. In our lowest moments, some of us resort to "all or nothing thinking". A devastation occurs, a heartbreak, a financial crisis or something equally as traumatic and many teens and/or adults contemplate suicide, some attempt it and tragically, others succeed.

I have tried to make the "bleach" conversation a teachable moment. In one's darkest hours it is sometimes impossible to see that something positive could happen, in my son's case within twenty-four hours. I saw a client a few weeks ago for her first appointment. She was very depressed and felt lost and "stuck". She shared her story with me and I tried to give her some relief from the heaviness that she carried. Later that day on a whim I sent her an email. She responded very positively and said that she had wanted to email me, but hadn't wanted to seem to "needy". We had a few more exchanges and I sent her an exercise to practice until we next met. I kid you not, for her second session the following week, she bounced into my office. She said that she was feeling "motivated" and had taken several concrete steps with her renewed energy to help lift her spirits.

What a gift to be able to witness such a transformation. Not all clients experience change as quickly, but many do get their bounce back and find joy and calm after doing the necessary work to address the heaviness and move forward.

I beg you to know that joy can be had. If you or someone you know is in that very dark place, please get help. Twenty-four hours, a week or a few months can feel like eternity, but the darkness can lift and joy is attainable.

See these resources for immediate help:

Suicide Hotline

Kristin Brooks Hope Center

No Words

12/15/2012

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That was my FB status a bit after I learned about what happened in Newtown, CT: no words. I could not put words to what I was feeling, to what had happened, to the idea of someone going into an elementary school, like the one where my daughter attends and opening fire on small children; children that use words like "bad guys" referring to a character from Batman, not a man in their school.

A blogger friend of mine just wrote that as a blogger, she was feeling a desire to post about the tragedy, "write something profound...and yet (she) can only...pray for the families that have been traumatized". That friend inspired me to open my Wordpress account and click "New Post".

I have just returned from a dear friend's home with several other dear friends and their families. We lit the last candle on the menorah and as a group of 15 sang the Hebrew prayers blessing the Chanukah lights. We were celebrating a young man returning from his first semester of college, my son's acceptance to college as well as being together as a "family" and being blessed with health, safety and peace. I suggested that we also sing the Shehecheyanu which is a prayer that is said during special occasions; when one is thankful for special experiences. It was so beautiful that it brought tears to my eyes.

I think of the lights that are being lit at the vigils for the victims of Sandy Hook. I think of the lights that were lit tonight in my town at a vigil to stop gun violence. And, I think about all of the candles that were lit in homes all over on this last night of Chanukah. There were some Jewish children that were killed in the massacre; their Chanukah lights were not lit. I pray that our lights somehow shone on their memory.

May all of their memories be a blessin