The Rules: Keep It Simple

When it comes to parenting, sometimes less is more.  While I'm certainly an advocate of intentional parenting, sometimes standing back and letting things go has it's merits.

Have you ever heard the term, "helicopter mom?"  Hovering leads to exhaustion, which leads to burn-out, and at the exhausted and burned out level, parenting is no longer enjoyable.  "Rules before relationship equals resistance."  Resistance is the level where the fun goes out of parenting.  If parenting becomes all about the routines and the rules, there is little time left to enjoy the relationships that made us all want to be parents to begin with.

A few ideas about keeping rules simple:

• Ask yourself if a rule is necessary for the situation.  Example:  No singing in the car.  That actually used to be a real rule at our house...until the rule became far more annoying than the singing.  The reason behind the rule:  We have a daughter who used to love to sing.  Her rule was to sing anytime, anywhere, the more singing the better.  But what's a girl to do when her brothers think singing is annoying?  Most of the time the answer was (to the brothers), "Go do something else."   Or if she'd been singing for a long time, she could go finish singing in her room.  But what about in the car?  The brothers couldn't get away, and the sister was only happy if she was singing...but since the brothers couldn't get away, the new rule was announced:  No singing in the car.  Then one day a song came on the radio that everyone but one family member wanted to sing.  The one family member whined the whole time that the rule was:  No singing in the car.  Get the picture?  As situations like that came up, it became apparent that the rule created more problems than it solved, and the rule was absolved in favor of lessons about courtesy and kindness.  It's working.  (Mostly.)
• Try the umbrella rule policy:  If one rule "covers" the others, try eliminating a few.  What do the following rules have in common?  1) Don't ride your bike without a helmet.  2)  Wear your seatbelt.  3) Don't leave toys on the stairs.  4) Don't throw things in the house.  See a common thread?  Hint:  They all have to do with safety.  Try the next list:  1)  Eat your vegetables.  2)  Wash your hands after using the bathroom.  3)  Brush your teeth morning and night.  4)  Clean your room.  What do they all have in common?  Hint:  The answer is health.  Imagine being able to replace those 8 rules (and numerous, numerous others) with two rules:  Be safe.  Be healthy.  Then when a child forgets to buckle up, or forgets to wash hands after using the bathroom, simply ask, "Was that safe?" or "Was that healthy?"  Umbrella rules tend to focus on "being" qualities rather than "doing" tasks.  Children gain judgement from learning to generalize a way of being across a variety of settings vs. applying a rule to a limited setting.  Rules like safety and health can encompass everything from cleaning up after yourself to not licking your fingers at the dinner table.  You can ask:  Is it safe to leave your toys on the stairs?  Is it healthy to lick your fingers while you're eating?  Qualities or characteristics important to your family become the new umbrella rules, and can eliminate tedious enforcement.
• Avoid black and white thinking:  In psychology black and white thinking refers to a specific type of thinking error where absolutes are the norm.  Black and white thinking reflects fear and uncertainty of anything unfamiliar.  In parenting it reflects a need for control, and leads to despair and resorting to extreme parenting when things don't go as planned.  Black and white thinking traps parents in a corner.  What is meant to limit and restrict paints rigid lines around a situation that don't allow for flexibility and growth...and certainly limits the quality of relationships.  Parents who engage in black and white thinking find themselves emotionally exhausted, with children ill-prepared to face the variety of life circumstances that only expand as they get older.  Such examples in parenting include:  We don't allow internet in our house.  If you don't like rules, that's tough.  Lying is bad.  All rock music is evil.  Somewhere between black and white lies grey.  If the horrible possibilities of the internet are frightening, try making a list of what you'd like your child to know in order to navigate the internet safely and sit with them while you learn how to navigate the internet together.  Could time limits instead of restrictions solve media problems?  What about lying?  Is it ok to lie if you're planning a surprise party, or talking about the Tooth Fairy?  If a child is lying to get out of trouble, it could be an opportunity to examine what in your relationship with them has them concerned about the rules and not feeling like they can come to you to work through difficult situations.  If lying is bad, does that make the child bad also?  Black and white thinking leads to generalizations about self-worth in children.  Try flexibility instead.

Certainly, rules are an individual parenting decision.  Families need rules to function, but children need flexibility and guidance to grow into human beings that can handle a variety of situations rather than limiting behaviors in a few isolated settings.  Sometimes less really is more.

Finding Mental Healthcare Treatment

Brag time:  Recently a private pay option offered by Solutions Counseling and Consulting was recognized in a local news story titled "Finding Mental Health Services For the Uninsured."

For me, offering this option to clients is a no-brainer.  In an email response to the reporter who wrote the report, I said, "When I don't have to bill insurance companies, I pass the savings on to clients."

As it turns out, offering treatment alternatives to clients pays off in a win/win scenario.  Over the past few months as I have seen the private pay portion of my practice grow, it is apparent that this alternative to traditional mental health treatment is catching on.  Surprisingly, many clients with insurance are also choosing this method of payment.  Here are some of the reasons this private pay plan is a good option for consumers of mental health services:

1. Consumers have limited or no mental health benefits.  Although mental health parody was included as part of an economic bailout in 2008, a large portion of our population remains without benefits.  Those who do have benefits are finding that employers are cutting both traditional health benefits and mental health benefits in response to the current economic crisis, making out of pocket costs higher across the board.
2. Diagnoses that can be billed to private insurance companies are limited.  In other words, having insurance coverage does not guarantee payment.  Here's a direct quote from a common provider of health insurance concerning things which aren't covered:  Treatment for conduct and impulse control disorders*, personality disorders, paraphilias and other Mental Illnesses that will not substantially improve beyond the current level of functioning, or that are not subject to favorable modification or management according to prevailing national standards of clinical practice, as reasonably determined by the Mental Health/Substance Abuse Designee.  And another:  Mental Health Services and Substance Abuse Services that extend beyond the period necessary for short-term evaluation, diagnosis, treatment or crisis intervention.  In spite of laws addressing mental health parody, we obviously still have a long way to go.  Can you imagine an insurance company saying that health insurance could not extend beyond short-term treatment, or that conditions that aren't subject to substantially improve won't be covered? Diabetes?  Cancer?  Heart conditions?  High blood pressure?  You'd be out of luck.  (*Conduct and impulse control disorders include, but are not limited to:  ADHD, Asperger's, and Autism, all common mental health disorders that are not covered by insurance.)  
3. Other treatments not commonly covered by insurance:  marriage/couples counseling, family counseling, and grief counseling (unless the consumer has a diagnosable condition).  At that point you have to ask:  Do I want myself or my child to be diagnosed with a mental illness in order to receive counseling?  Many times counseling can benefit individuals and families going through temporary life crises without needing to receive a mental health diagnosis.
4. Terms surrounding treatment of pre-existing conditions:  For many people, when benefits change due to changes in employment or coverage offered by employers, pre-existing conditions are questioned or not covered.  Another point about pre-existing conditions:  In order to bill insurance for treatment of diagnoses not covered by insurance (see above), providers often bill treatment under a co-morbid or duel diagnosis, with the secondary diagnosis being listed as the primary diagnosis.  (For example, a client with ADHD could receive counseling under a diagnosis of depression or anxiety, provided they meet minimal diagnostic criteria.)
5. Some problems don't require mental health treatment.  I have also recently updated consulting services offered on my website as a way to address parent and family needs for access to information and resources that often prevent the need for costly mental health treatment later on.  Families who access these services typically meet with me once or twice to discuss concerns and get ideas about handling problems that can lead to much greater concerns later on.  It is not uncommon for parents to struggle with questions and concerns about parenting, development, sleep, rules, and relationships and want sound information and ideas that would help them to help their families.  We live in a difficult world where children are often the target of environmental assaults such as internet addictions, gaming addictions, pornographic material, bullying, discrimination, etc.  These difficult circumstances make parenting difficult, and guidance through difficult behavioral and discipline issues can be helpful.  Why seek mental health treatment and diagnosis for common problems associated with keeping families safe and healthy?

The reasons for considering alternatives to traditional mental health treatment are many.  As a practitioner, I've enjoyed expanding services and offering treatment alternatives to clients which I feel puts them in the driver's seat of their own health care.  As a culture, we may be making strides in the treatment of mental health disorders, but meanwhile, it feels good to be addressing a few of the holes in our current system.

If you or someone you know is considering counseling, or alternatives to counseling, contact Mary for more information.

Mothers of Special Needs Children

In a few days it will be Mother's Day.  Moms:  May your day be filled sticky hugs, sloppy kisses, and a refrigerator front filled with hand-made cards and neatly scrawled sentiments about mothers.

Do you know a mother of a special needs child?  Are you the mother of a child with special needs?

The job of mothering is a difficult one at best.  It is filled with sacrifices, battles, and thankless tasks that never seem to end.  Whether you're married or single, rich or poor, domestic diva or kitchen klutz; whether you're a stay-at-home mom or you work outside the home, or whether you're a mom to children by birth or adoption...or simply by nurturing and loving all the children you meet...  No matter your individual circumstances as a mother, you know that mothering is one of the most difficult and challenging tasks women share.

Add to that the task of parenting a child with special needs, and the task becomes exceptionally difficult and challenging.  I realize that special needs is a broad category.  It can include (to name just a few) parenting children with behavioral and mental health challenges, children with complicated medical histories, children who suffer trauma and abuse, children who are adopted, children who struggle to learn, children who struggle to make friends, children with any range of developmental delays, children  who struggle with physical limitations and disabilities, and many many other possible combinations of complications parents face raising children.

In my mental health practice, I help parents and children deal with a variety of the issues mentioned above, and almost always, by the time I see them, they've tried multiple interventions, been to doctor appointments of multiple specialties, struggled in school, and struggled at home.  They're frequently the object of comments from others, sometimes well-meaning, and sometimes just mean.

One of the first things I find myself discussing with parents in this situation is their own mental health, self-care, and support systems in dealing with the complications of raising a child with special needs.  I want them to know more than anything that it is not bad parenting that causes psychiatric, behavioral, or developmental disorders, but it takes an exceptional parent to dig down deep into reservoirs of untapped strength to raise this child.

That said, the risk of burn-out to parents of children with special needs is high.  Elizabeth Blackburn (winner of Nobel Prize for Psychology or Medicine 2009) studied mothers who raised special needs children over the course of ten years.  She found that mothers of special needs children experienced a shortening of telomeres (protective end of chromosomes).  This process could cause an average of 9-12 years decrease in life expectancy of these mothers.  This is a biological condition similar to what is experienced by combat soldiers.  Increases in other hormones associated with stress also contribute to autoimmune disorders, diabetes, and other chronic health problems.  Certainly, constant stressors of that level go beyond those experienced by other mothers.

It is not only a good idea, but a necessary one, for mothers of children with special needs to seek support and care for themselves.  Here are some ideas of how that can be accomplished.

1. Build Social Supports:  Although difficult to build and maintain, support systems are life-saving.  Social supports are often the only source of much-needed respite.  Many parents of children with special needs say that as they try to build social supports through traditional means (church, school, neighborhood, work), their special needs children create too much stress for friends and other parents to understand and their support systems disappear.  This can be a huge barrier to finding social support, and many parents give up.  Consider social support in tiers with community support being the outer tier, a layer which many families don't have to access frequently.  Children with special needs often have access to community or school programs and resources that other children don't have.  Start with those groups and make friends with like-minded people who can share in child-care and other ideas for respite.  As you do, the outer tier of support becomes an inner, more natural support system.  Also consider looking for funding for respite care provided by trained caregivers.  There are also support groups for parents of children with special needs where it is possible to connect with other parents and build support systems.  Family is another source of built-in support.  If you have children with special needs and live far away from family, ask yourself:  Who lives locally who can give me the same support?  Do you have friends or community groups who have become like family to you?  If not, is it a possibility to move closer to family?  (I work with one family who recently relocated from another state for that very reason and it has made a huge difference in the couple's marriage to have additional support.)  And just a caution:  While internet groups can be helpful and provide sources of contact and information, they lack the human touch that will decrease stress hormones and provide hands on care and support that parents of children with special needs will require.
2. Take Care of You:  Moms of children with special needs will frequently say they don't have time for themselves.  I ran a group for parents of children with special needs for several years, and I was persistent at getting parents to identify things they did for themselves each week during our group check-in.  At first there weren't many responses, but after the question had been out there for several weeks, I started to get answers:  I started taking vitamins...  I went to the doctor...  My mom watched my son while I got a pedicure...  I went out to dinner with my sister...  I painted my bedroom...  I started taking walks with my son...  I went back to bed after my child went to school...  Moms in the group even started sharing ideas of where they could get low-cost haircuts, nails, massages, etc.  All the little things you do for yourself add up to decreased stress and improved health.  If the well is empty, you can't give what your child needs most.
3. Accept Things As They Are:  It's difficult to know when to be a mom warrior (required for mothers of children with special needs) and when to let it go.  If you're starting to feel like you're fighting just to fight...for something...anything...that could help your child, then do a quick assessment of your efforts.  How much time are you putting in?  What are the results?  Are the difficult lifestyle and dietary changes making a difference or are they complicating life in hopes of making a difference?  Are you spending hundreds of dollars a month on supplements and procedures that promise hope and don't deliver?  What would you do with that time and money if you didn't have to make those efforts?  Certainly health is important, but truly assess the progress of your child under each intervention.  Interventions should produce progress, and if they don't, consider different approaches.  Seeking healing and improvement is certainly a necessary part of treatment, but also consider the long-term effects of constantly trying to change or improve the disability vs. enjoying the unique abilities of that child or your family.  Also consider the needs of other family members and the impact of interventions on their sense of normalcy.  Family life is important also.  Interventions are excessive if they take away from every day human interactions (which by the way, are very healing).
4. Don't Forget to Live:  Most likely, the challenges of special needs aren't going away.  As stated above, expend a reasonable amount of effort into the care of your child, but don't forget to live.  Do you enjoy life?  Do you enjoy relationships?  Do you enjoy your children (even the ones with special needs)?  Do you have hobbies and interests outside your children?  Do you and your spouse share a relationship that isn't focused on parenting and medical or therapy visits?  I know one family raising a child with autism who leaves him with family while they go on vacation.  He hates vacations anyway.  It took them years to get to that point, but they enjoy their other children in a different way and notice that their bonding and interactions with their other children improve during those times.  They say that when they look at family vacation pictures, there is always a little pang of sadness that their child with autism isn't a part of those memories, but they celebrate a life they now enjoy when managing his melt-downs no longer controls their lifestyle, and their child with autism is much, much happier in his own home under the watchful care of relatives who are willing to provide that support.  That may not be the answer for everyone, but it is an example of adaptations that work.

The task of parenting special needs children is a difficult one.

Remember:  It takes an exceptional parent to dig down deep into reservoirs of untapped strengths to raise this child.

The honest truth is this:  If the reservoirs aren't there, the unique things you have to offer aren't available either...  Your experience is uniquely your own.

Don't forget to live!

(If you know a  with a special needs child, consider watching their child, or taking them out to lunch...    Celebrate their experience in motherhood.  Help them build their circle of support.)