Tuesday, April 16, 2013

Talking to children about terrorism

Parents should be honest, in an age appropriate manner.
First ask them what they already know and what they think about what happened. Then ask for their feelings and questions. Then proceed by answering their questions and responding to their fears. It's okay to say you don't know and not to have all the answers. Reassure your kids that they are safe and there are far, far more good than bad people in the world. Of all the billions of people on the planet, there might be 5 really bad people (probably a few more, but keep the numbers small to be relatable). Show them pictures of a crowded stadium and say if we had 100 stadiums, you probably wouldn't find one person who will make a bomb, that's how few people are out to get good people. Kids often understand better with visuals. Check back with your kids to find out what their friends are saying. Kids sometimes compare notes and fill in details they don't understand. If you notice changes in sleeping or eating, this can be a sign that anxiety is atypical. If this lasts more than a few weeks, you might want to take your child to her pediatrician.

Friday, December 14, 2012


Another week, another couple mass shootings. This time, an elementary school including a class full of kindergarten 20+ children are dead.

Here are some tips for helping your children cope with this tragedy.

1- Adults need to process their own feelings and fears with other adults, not with their kids. At this time children need to see their parents as strong and confident that their kids are safe in this world. If not, children will be afraid and suffer needlessly.

2-Listen, Listen, listen. Then listen some more. You'll naturally want to jump in and reassure, express what you think your child needs, but what kids need isn't a one size fits all response.

3- Answer questions honestly, at an age appropriate level. The key is honesty, because kids of all ages have great BS meters. If they don't think they're hearing straight answers, they'll be more fearful. It's okay to say you don't know, when they ask "why". Ask for their thoughts before providing your own. Nobody knows for sure, but the police are investigating to make sure this doesn't happen again. "Will this happen to me?" Your child has a better chance of winning the lottery or being struck by lightning is far greater. There are 7 billion people in the world. 27 people were killed. That's a much smaller chance than reaching into a box of Cheerios and picking out one specific piece of cereal.

4- Reassure your kids they are safe and that most adults protect children.

5- Some children will experience PTSD symptoms like nightmares, problems with eating, school phobia. If these symptoms occur for longer than a week or two, seek professional help. Schools may have extra counselor's available, but if your child is suffering in a more acute manner or for a more extended period of time than her peers, seek additional therapy outside school.

6- Keep the lines of communication open. Your child may be helped by doing something active like drawing a picture for the school or making a sympathy card. Sending such an expression can be extremely therapeutic.

7- Take care if your own feelings by talking to other adults and parents.

8- Keep normal routines and bedtimes. Routines create a sense of safety.

Saturday, November 24, 2012


Dr. Amy,
Our parenting style is very different from my in-laws (including sister and brother in law who have children the same age as ours.) I find it very stressful to be with them over the holidays. We talk things out a lot, use time outs infrequently, and generally have a "let's work together as a family" approach. They tend to ask for instant obedience and follow up with punishment (including corporal, though I've never seen anything I'd classify as abusive.) My own children get upset when their aunt and uncle speak sharply, yell, or hit their kids and I'm stuck trying to explain how they are still good people. My husband gets anxious that ours won't behave perfectly and validate our form of parenting in front of his parents. Any ideas for making this a more peaceful visit? (other than keeping it short -- which my husband resists because he likes his family. The are nice people, just a little harsh with their kids in my opinion.)


Dear K,

Discipline teaches children how to control themselves. Conversely, punishment involves controlling children and they learn to behave to avoid of repercussions, rather than internalize healthy values.

I can certainly understand why your children are confused, especially if their friends' parents also have healthier discipline styles, such as your own.  Your kids sound like they've developed a sensitivity toward the discomfort of others, I don't doubt your parenting has attributed to that. 

Disciplining in a way that instills fear causes anxiety in children and creates thought processes that can lead to unhealthy adult relationships-- ones based on intimidation rather than mutual respect.

If you prepare your children ahead of time by reminding them that sometimes Uncle Joe and Aunt Betty raise their voices, you can help decrease the apprehension your kids feel during these holiday visits. 

Hopefully you don't have to stay in the same home as your in-laws during these visits, so that you can keep a safe boundary for your children. If you see situations begin to become loud, you can take your family back to the hotel, or at least out for walk or drive, then have a discussion about what's been witnessed.

Getting into a good vs. bad person discussion with your children isn't necessary or helpful. You can emphasize that in your family, you solve conflict through communication. You can say that not all parents know how to work out problems quietly, and that you also feel sad when Mary and Johnny are yelled at or hit.

I understand that your husband wishes for perfect behavior to prove your values. This isn't uncommon, whether the issue is discipline, grades or expectations for performance at Little League games. I would not be surprised if your told me your mother and father-in-law are critical about what they perceive to be "leniency".  If this is the cause of your husband's worry, it's proof that the overbearing approach hasn't helped his confidence. 

You have the right to speak to your in-laws and set boundaries about what you will and will not allow your children to be exposed, although sometimes the conflict this causes isn't worth the discussion. You have the absolute responsibility to define the boundaries in which your in-laws treat your children, including forbidding yelling.

If you have the family celebrations at your house, you can establish the boundaries of no corporal punishment or voice raising before the visit. Your in-laws might not appreciate these limits, although as long as you know they are not unreasonable or unhealthy.

Good luck!

Sunday, November 11, 2012


Dr Amy, I have 2 adult children and have patterned some unhealthy conflict resolution behaviors. When I see my daughter struggling with her boyfriend to resolve a disagreement it pains me. Do you know of any good tools or resources for young couples?


Dear JH,

I'd like to personally welcome you to the modeling unhealthy behavior club. Membership is very exclusive, and includes every parent who ever walked the planet.
Children are sponges, especially when we wish they weren't. Even when they're babies, and haven't yet developed the cognitive function to absorb their surroundings, or the words to make sense of conversations, they use their senses to absorb the moods and stress levels of their environments and primary caregivers. Fortunately, parents don't realize to what extent, or they'd never get a moment of rest!

I believe preverbal messages are strongest, since they are imprinted on young minds **blank slates** without context or a cognitive framework to understand.
Luckily, children are resilient and adaptive. They can learn from their own mistakes and the errors of others and develop healthier ways of interacting.
You don't say what "unhealthy conflict resolutions" your daughter and her bf have. Communication is often at the root of conflict. We come to this through generations of habit. For many kids, family is the primary source of understanding the world. Our family "rules", spoken and unspoken, are the laws of the universe to younh minds, and were particularly so in generations before daycare and preschool.

Does our family treat and speak to each other with respect, even when differing?
Do we lose our tempers and say things we wish we hadn't?
Do we apologize when we've been wrong?
Are we violent and do we scare each other?
Do we leave when we're mad or do we shut the other person out?
Are we kitchen sink arguers? (Do we fight not only about the issue, but throw in every conflict we've ever had including the kitchen sink?)
Are we passive-aggressive?
Do we refuse to admit our mistakes?
Are we abusive?
Do we hold grudges?
Do we blame others for our problems?
Do we shame?
Do we never fight and sue press our conflicts, allowing them to fester unspoken?
Do we avoid conflict?
Are we destructive or self-destructive?
Are we manipulative?

With the above list, one might believe healthy conflict to be impossible.

The most important, first step you can take to help your daughter is to make sure, in no uncertain terms, that she knows how to define abusive **physical, emotional, sexual, monetary, mental** behavior. Her safety in all of these realms is most important.

The following links are for teenage relationships. I listed them because the basics are important for adults and minors. There are elderly people who don't recognize unhealthy or abusive relationships, so the basics are the same regardless of age.




If your daughter can identify more specific areas where her relationships, please write back.

Dr Amy PsyD, LSW

Wednesday, November 7, 2012


My friend Molly's son Jackson breathes baseball. He spends hours in his back yard practicing his pitching, catching, and batting skills. He idolizes his softball-prodigy big sister and thinks the Bryce Howard can do no wrong.

Jackson and The Threshers had planned to win their Little League Championships, but The Storm had plans of their own and beat The Threshers in the semi-finals.

Jackson was despondent. His seven-year-old brain hadn't envisioned a scenario with less than a first place finish. At first Molly wished for away to take away his pain thinking if only The Threshers had won. But, then she saw the loss as a teachable moment and what followed was an extraordinary opportunity for Jackson to show more character than most adults would after suffering a loss.
Using baseball as an analogy, Molly reminded him that Bryce's Nationals hadn't made the World Series, and in fact, many great players would never play in a World Series, let alone win a ring. Jackson, who has as uncanny knack for knowing and understanding the stats of his favorite players, was able to recognize Bryce struck out more times than he hit the ball, and even the best hitters in the history of the sport failed to hit as often as they succeeded.
Even Molly couldn't have predicted what happened next. Jackson decided that The Storm played a better game and deserved to win. He wanted to cheer The Storm in the championships the next day. As if she wasn't proud enough, the next morning Jackson announced he wanted to bring cupcakes to his former rivals.
The Storm won and Jackson congratulated the team. His chest swelled with confidence when The Storm's coach acknowledged the good deed and praised Jackson's playing from the previous day.
Jackson learned more from losing that game than he ever would have had The Threshers won. He would not have had the opportunity to reach within himself to show such character. Molly was proud of Jackson, even though his team lost on Saturday, as most parents would have been. On Sunday her pride reached levels she never knew possible. On Wednesday, after the Presidential election, she wondered why her seven-year-old was a more graceful loser than many adults.

Good luck in 2013 Jackson and The Threshers! And more importantly have fun playing. Karma is definitely rooting for you.

Monday, November 5, 2012

Hurricane Sandy: Rethinking Childhood Hunger


   Watching the ravages of hurricane Sandy, and hearing, not surprisingly, that the wealthiest families have more resources to survive and recover from nature’s fury, I’ve taken pause to look at poverty from the perspective of children and the most important fundamentals for their success.
   The neediest children are not necessarily those without iPods or the latest fashion trends. When thinking about poverty, images of children without basic resources come to mind. We imagine kids who come to school wearing torn, ill-fitting clothing, holes in their shoes, without winter coats to protect from the elements. Perhaps these children reside in homeless shelters or foster homes, or maybe their parents are simply inadequate. We may even tell ourselves these would never be our kids. Those children receiving welfare, food stamps, eligible for free lunch programs have parents—if they even have parents—who aren’t providing for their basic needs.
   Sometimes the best dressed kids with the biggest houses and newest electronic gadgets are the neediest of all. Especially if they are lacking in one of the most essential ingredients for growing healthy children—unconditional love and positive regard. The first months and years of an infants’ lives are framed within the context of attachment to consistent, loving, available primary caregivers. Babies feel safe when they can rely on their basic needs being met. If they are fed with hungry, changed when wet, comforted when afraid, they learn to feel secure in the world. Developmental psychologist Jean Piaget called this first stage of life, on which the rest of a child’s cognitive development is built, Basic Trust vs. Mistrust. Think of this stage as the straw foundation of one Little Pig’s house vs. another built of brick that can withstand the huffs and puffs of life. While the outside of the straw house may look more majestic, wealthier even, without bulletproof strength, beauty is a mere illusion. Trust does not develop through perfect parenting or and mistrust does not develop because a baby’s cry is sometimes unheard. In fact,  D W Winnicott’s concept of the “good enough mother” tells us that infants are resilient and they do not need flawless parents in order to thrive.
   The richest children, are in fact, those who are protected by unconditional love and knowing that impenetrable regard of their worthiness withstands mistakes and failures. Whether a child hits a home run or strikes out for the fiftieth time in a row, she is loved equally. Her parents are proud of her persistence as much as they are her success. That’s not to say her self esteem is based on getting a trophy for waking up in the morning or that she deserves a medal for failing a test for which she did not study—only that the love she receives is not contingent on performance. Her parents will not like or approve of every choice she makes, because if they do she is not testing her independence or autonomy. Her parents will love her regardless of those choices. Unconditional regard does not mean she escapes consequences for poor decisions or that she is prevented from failing or learning from those failures. It means she has a safe place to fall, into the endless love she has built from the security of those first attachments.
As therapists, we sometimes see the materially wealthiest children living in a dearth of self-esteem because they lack the security of feeling loved. While this does not mean an absence of love or even unconditional love, it does mean that kids do not always feel the presence of this positive regard. Sometimes parents mistake being good providers or meeting their children’s material wishes to be the same as giving them the security of impermeable emotional safety. Despite what naysayers believe, this does not create egocentric, narcissistic children, but children who are confident enough to allow that the success of their peers does not mean their own failure or inadequacy as human beings.
So, as we pledge $10 with our smart phones, or call in donations to the Red Cross for hurricane survivors, we cannot forget the cheapest and most important resource that some kids lack, whether sleeping in a mansion or disaster shelter.

Friday, November 18, 2011

GOOD TOUCH/BAD TOUCH- Conversations about Boundaries and Beyond

If you begin having periodic conversations about good touch/bad touch when your children are toddlers, you'll develop an ease discussing boundaries that will carry throughout their teens. 

  • When talking with younger children, keep these discussions brief and age appropriate to avoid overwhelming kids with information beyond their capacity to comprehend.  Tell your kids if someone touches them or wants them to do something that feels uncomfortable, they should tell someone right away. If you aren't around, another adult until they can inform you--store clerks, teachers, and police officers are usually safe people.

father: You know, your body is special.
daughter: Because I'm special.
father: That's right, you're very special. Where are your private parts?
daughter: Under my bathing suit.
father: Yes. What do you know about your private parts?
daughter: Ummm...
father: No one is allowed...
daughter: No one is allowed to touch my private parts!
father: And if someone tries to touch you?
daughter: I tell you or Mom.

  • Teach children to attract attention and scare the perpetrator into retreat. Child molesters usually choose children who can be easily intimidated and manipulated into silence. They count on silence to continue their abuse.

mother: If someone tries to touch you in a bad way, I want you to yell very loudly, "STOP! You aren't allowed to touch my private parts." Can you do that for me?
daughter: Stop. Don't touch my privates.
mother: Louder. Remember you're trying to get people to hear you. "STOP! You aren't allowed to touch my private parts."
daughter: Stop! Not allowed to touch me.
mother: Louder.
mother: Excellent!

  • Include asking, whether your child has been violated. Query in a nonchalant manner and validate the response.

mother: Has anyone touched you in a way that feels uncomfortable?
son: I don't like when Grandma hugs me too tight.
mother: I'm glad you told me that. Grandma loves you and she would want to know her hugs make you uncomfortable. What should we do about this?
son: Maybe you could tell her.
mother: What if we talk to her together on Sunday when she comes for dinner?

In this scenario the mom validates her son's concerns. She empowers him by through inclusion in problem solving; and will model assertiveness and in the discussion with the grandmother. When children have the opportunity to practice establishing boundaries with family members, they are better equipped to respond if they encounter less safe situations. If kids can't assert limits with their loved ones, they won't be able to do so with unsafe people. You can start teaching these important skills with toddlers. Teach your extended family and friends to ask for hugs and kisses, rather than demanding affection. 

  • School age children are able to comprehend that "bad guys" don't look like big scary monsters, they can look like neighbors, doctors, or teachers. You can uses these conversations to discuss bullying and treating others with respect and kindness--another form of boundaries. Role playing remains an excellent means of helping kids understand these concept so they can practice setting limits in a save environment.

  • Tweens can begin to understand respect in boy/girl relationships--not to push others into doing things they don't want to do, not to do anything they feel is uncomfortable, and not to do to anything because they think "everyone" is doing so. Since you've been having regular talks about boundaries, you've already established a basis for conversing about more mature topics.