Food Issues with Teen

I received this call for advice last evening:
Our high energy middle school aged son only eats foods which have a specific consistency and texture.  He is resistant to trying new foods which aren't on his very short-list of acceptable ones. While we're familiar with picky eaters amongst children, his patterns seem to go above and beyond being picky about food.  We are concerned that he isn't getting adequate nutrition or calorie needs to keep up with his body's needs. On Thanksgiving day, when there were ten different dishes to choose from (including mashed potatoes, which we thought he might like), he ate nothing. 

We have tried a number of responses, including letting him choose the foods he'd like to try; involving him in the cooking and preparation of food; working with taste and touch and texture of food through occupational therapy as a young child; holding him while he is eating.  When he started school this year he said he wanted to try new foods, but then dissolved into tears when he couldn't eat the food he had chosen to try--a piece of chicken, a pancake or a piece of pizza.  We are very concerned that he has an eating disorder which may have long term effects on his physical, emotional and social well-being.  Generally, we give him the kinds of foods he wants as often as we can.  But there are many instances where this is not feasible, e.g. visiting friends at their houses, and other social contexts.  It limits him in different areas of his life, which he has acknowledged.

We think that he might need some additional professional help with this, and we could use some as well. We've run out of creative or responsive ideas which might help him along the way.  However, since he feels a great deal of shame about the issue, we suspect it won't be an easy road to get this needed help.  He was adopted at age 8 months, and spent that time in an orphanage where "feeding" was accomplished by putting balancing a bottle against a pillow for the babies in the orphanage.  There was no physical contact.  He refused to touch or play with food from a very early age, and would become enraged when he was given something new or different. 

Check out my facebook page:  Challenging Children for my reply to this family.

Loss, Abandonment, Grief, New Families, Newly Reunited Families

Holidays!  They conjure up many, many images and along with how those images are conjured up come memories.  For some, perhaps for many these are joyful and loving memories and for some, perhaps many these memories are painful and the images are triggers.  The memories conscious and unconscious that come along with sights, sounds, smells, touch are the triggers.  When you find your children, (bio, foster, adopted)  "acting out" their behavior is signaling that they are in distress.  And it isn't because they don't want a visit from Santa, or the Chanukah dreidel they are dysregulated and no amount of threatening, cajoling, consequenting will change their behavior in the long run.  They might shape up for a couple of minutes, hours or if you are lucky a whole day or two.  But, the outrageous, unacceptable behaviors will continue.

Here are some suggestions to make the holidays more peaceful for your family:

1.    Window of Tolerance

Be mindful of your own tolerance level for chaos, mess, unpredictability and just the overall stress of holiday spending, preparation, drain on your mental and physical energy.  Keep it in check by not overbooking, not overspending, and most of all keeping your expectations of yourself always in the forefront of your plans.

Consider your child’s window of tolerance and don’t overplan for him, don’t keep him up late, don’t use the “you’d better be good or…” routine because it will only increase the level of stress narrowing the window and almost guaranteeing a meltdown. 

2.    Time In

Instead of putting your child in time out, bring her into you.  Let her know it is all too much and you understand.  By bringing her next to you, instead of sending her off by herself to “think about what she has done” at a time when her brain is unable to thing, you will be helping her to calm.  You will be letting her know that you know it is all too much for her and you are helping to slow it all down.

3.    Be Proactive

Predict when your child might be about to lose it and scoop him up and suggest getting some air together, even if you are in the middle of a sing along; even if the turkey has just been brought to the table.  If there are three events planned for the celebration and by the second one, your child is whining and tattling (yes, even your 14 year old…remember when we stress, we regress) say that you are calling it a day.  Do not use this as a way of consequenting, but as a loving way of understanding that he just cannot tolerate another celebration.

4.    You Can’t Always Be There

Keep in mind that there will be times, that you can’t be where your child is when her window of tolerance begins to slam shut.  Know that she is doing the best that she can at that moment and so are you.

Disruptive Student/s

Yesterday, I posted on my Challenging Children Facebook page, this question posed by a teacher: "what am I to do with a student who is not on task, causing other children to be off task, and taking my attention from those who want to learn?"  here are 2 interventions that will, in most cases, elicit positive responses from the disruptive child as well as the other students in the class.  #1.  Develop the daily practice of greeting each child, as they enter your classroom, every day.  This means that you, the teacher will be at the door, not as a hallway monitor, but as a "greeter".  Personally address each child and make a mental note of the student's mood.  #2.  Pay particular attention to that child or children who seem a bit off that day.  When this student or students appear off task, wander over to his desk during your lecture or during a seat assignment and gently touch the student's shoulder (unless of course you know that this is a student who will react negatively to this gesture).  If you are uncomfortable touching a student, lean down and give a quiet, encouraging word. And #3: (Yes, I know I was only giving two interventions, but this one is an expansion of #2) Use #2 for amy child who appears off task or unfocused, even if he appeared just fine when you greeted her at the beginning of the class.

YOU ARE NOT THE BOSS OF ME!!!!!

"You can't tell me what to do; you are not the boss of me!"  "No, I don't want to do______, I'm not going to do it and you stop talking!"   These words come from a 4 year old...and with the words come the aggressive behaviors of kicking, spitting, and hitting.  What does this behavior mean?  I keep telling folks to look beneath the behaviors...this child has had to develop survival skills in the face of trauma....and in this survival mode he will fight whatever and whomever is in his way.  He has got to have control, he has got to be in charge.  And until he is able to feel a sense of true safety, he will be trying to control in the fight mode.    Should he be punished for his aggressive behaviors?  No, though these behaviors do need to be addressed.  They do not need to be punished.  Match is feeling, tell him you know he wants to have____, that he wants to go and do_____.  And he will be able to have____later, or he can do____later.  You know he wants it, you understand that he feels like he will never get it or never be able to do it, but he will.  Not now because_____(make it a short explanation), but later.  And for now he is safe, you are safe and he is okay.  You don't want him to hit you, it does hurt you when he hits.  But nothing is going to happen to him...he is okay, he is safe.  Match his tone if you can without the anger behind it...he may need to know that you hear him...tell him you hear how very upset he is.  Hold his hands when he tries to punch you, let him know it is not okay to spit...you aren't angry with him, but you don't want to be punched and you don't want to be spit at.

"Gary, Indiana; Gary Indiana...

my home sweet home.”  I am usually able to begin a blog with the title.   Tonight was different:  I wanted the title to reflect how adults assume that children are naïve, clueless and without sensory perceptions.   And so now it occurs to me that I will title this blog with the beginning lyrics from the Music Man. The school administration  has decided that a large majority of our school children in Gary, Indiana will now be walking to school. And of course such a new adventure  will be met with youthful abandon;  parents and guardians will be reminded of their carefree days of being able to walk to school.  And my intention, as I sat down, was to write about the effects of trauma.  And how sometimes the very fabric of our children's lives is rooted in trauma.  Many families are experiencing poverty and unemployment, severe illness, separation, alcoholism, not to mention that they themselves may be victims of abuse or neglect.  Because you see, our city is no longer the idyllic community that Meredith Wilson made famous.  Instead we have a poverty rate over 28%, we have a 13% unemployment rate; a fifth of all of our housing, churches, school buildings and other structures are vacant and boarded up.  And our children live amidst this poverty, in this blighted community, on blocks where violent and not so violent crime occurs on a daily basis.  "The wheels on the bus go round and round..." but those elementary school children who live within a mile of their school will be walking this school year, and those middle and high school students who live within two miles of their school will be walking as well.  Because of budget cuts,  our school system can only run 50plus buses, last year they ran 150plus buses.  What's trauma got to do with it?  Many of the children in our community experience the effects of our blighted and crime ridden neighborhoods on a daily basis.  It effects them, it effects their relationship with their friends, their family and it causes them stress...stress that they don't understand, stress that they can't process because they can't name it.  It causes them fear...fear about when the next robbery may occur in their neighborhood, when the next person may get shot, whether that next person will be their neighbor, or their cousin, or their auntie.  And now each day, before they get to school many will walk through their neighborhood and the adjoining neighborhood to get to school and they will see what, of course, they have seen everyday.  But it will be different...they will experience it, inhale it, kick at it...and they will arrive at school more stressed out than they are after a rowdy bus ride.  After all, the buses are clean; after all, the buses were not a recent crime scene.  Are our school staffs prepared?  Has anyone thought about the effects, of that not so healthy walk, on the psyche of our children?  My guess is that they haven't; my guess is it will take months, if not the entire school year to figure out why so many kids are having a hard time focusing early in the day and perhaps again in the afternoon as they prepare themselves for the return trip home with the scents of despair that will accompany them on their walk.

Parenting Softly

My husband and I watched from our deck this morning as a friend walked by and in hand with his two young children.  We knew they were probably off for a morning walk on the beach.  They greeted us and commented on the purple flowers growing on a trellis by the street.  The daughter who is about 6, was wearing a lovely long white dress (a "nylony" looking garment) and bright pink sparkly flats.  The little guy who is probably about 4, stooped down to probably scoop up some of the rocks near the trellis.  Our friend, very quietly reminded him that those were not his rocks and he should leave them where they were.  He used the same tone to his voice that he used when commenting on the flowers.  And his son indeed let thee rocks tumble out of his hand, they said goodbye to us, resumed holding hands and indeed walking down the street and up the beach path.  Did I mention that our friend's daughter was dressed in a long white dress with pink sparkly shoes?  My husband commented on how very cool it was that she was able to wear whatever she wanted to walk in the sand and perhaps even dip her feet (and therefore her dress, because it reached to her feet) in the lake.

Observing our friend, I immediately thought of the term "parenting softly".  On this morning, my friend embodied that kind of parenting.

Can We Give What We Haven't Gotten?

The question that this blog is responding to is whether it is possible for a parent to help their child heal from the wounds of trauma if they themselves have never processed and understood their own trauma? My answer is that it is very, very difficult to parent a child who exhibits the often extreme behaviors of a child who has experienced developmental trauma.  It is difficult for the parent who themselves have been raised in a loving, nurturing, caring, empathetic family.  If as a parent, you have experienced the trauma of abuse, neglect, emotional abuse, prenatal trauma, unprocessed loss, etc. until you have processed and understood that trauma you will react to your child's behavior and be unable to respond in a loving, nurturing, empathetic way.  There are several reasons why this is so and much of it has to do with what happens in the brain when we are stressed and have emotions that have been submerged and often denied.  When we are triggered through stress, our short term thinking is suppressed and we don't have access to the cognitive part of our brain.  So what happens is that we meet our child at the exact same place they are...overwhelmed and incapable of thinking through our words and actions.

My faithful reader who posed this question did not ask the follow up to "can we give what we haven't gotten?" and that is can we get it.  And the answer is yes, but it takes looking at our own history, our own baggage which can be childhood history and baggage or more recent adult relationship history.  When the child who is talking back to us and not listening reminds us of a  boss or a spouse who demeaned, maligned, and ultimately dismissed us we need to step back and see that, and understand it for what it is.  Even, yes even seek help for ourselves so that we do the necessary healing to be available to help our child heal.  Otherwise, we will experience a clash of wills that could become physically and/or emotionally abusive and re-traumatize our child.

The Power of Oxytocin

I wrote on my Facebook page:  Challenging Children that our 7 year old grandson used his powers this morning to calm a very agitated possum who had been trapped unwittingly in the trap set for a groundhog.  He was pacing the perimeter of the cage like a trapped animal...which of course, he was.  Our young grandson went out to get a closer view of him and as he stood just a foot away from the cage he began to talk to the possum in a soft voice.  He told the possum that he was safe, his Papa would take him out to the woods and release him.  His Papa would never hurt him.  He kept talking to him in this soothing way and soon the possum quieted down and laid down in the cage.  About 20 minutes later, a mole came up trying to get under the cage and that started the possum moving again around and around the cage.  This time, our young grandson simply walked over to the cage where the possum could see him and just quietly stood...and again the possum settled down.  What was happening here was what happens in relationships between humans and also other animals.  If one approaches another in a loving, attentive, calm manner a hormone in the brain called oxytocin is triggered in the receiving party.  In this case, our young grandson did not want the animal harmed and he didn't want him to be stressed...in order to "reach" the possum, he quietly and repetitively told him (who by the way he named, "Speedy" when they released him into the woods) he was okay, he was safe.  Animals are neurobioogically wired to be in relationship; relationship that is attentive and caring.  And when we are in relationship with another our brains naturally release this calming hormone.

Labels, Diagnoses, Medications...

Having spent the last few days talking with parents and fellow professionals about children with behaviors that are considered disruptive, challenging, unacceptable to adults, etc., I am bereft at how little attention seems to be paid to what is underneath these behaviors.  And parents seek out professionals for help and in return they get labels, diagnoses, medications and sometimes dire predictions about what the future holds for these children.  I am left tonight with the thought that has been ongoing for me over the past 7 years:  Caseworkers, therapists, physicians, teachers, and parents continue to focus on behavior and how to eradicate inappropriate and disruptive behavior.  The majority of folks involved with these children want the children to change.  They want the behaviors gone.  And they want it gone...now!  The hard truth is that these behaviors did not emerge overnight; nor do they come out of a child's desire too be difficult, to anger his parents, to confound and irritate his teachers, these behaviors come from an unconscious place.  These behaviors are driven by stress.  And guess what, one cannot diagnose and medicate stress and expect any kind of long term result.  Yes, you can bandaid the behavior with behavior modification based on the label and diagnoses; and you can medicate to calm the acting out.  And indeed, I have come to believe that these remedies are the duct tape for inappropriate, disruptive behaviors.  One could probably even color code the palliatives:  red for Oppositional Defiant Disorder; blue for Major Depressive Disorder; green for Attention Deficit Hyperactive Disorder; etc.  Problem is when you remove the tape...the behavior is lurking underneath.

Where can one find the cure?  Once we have exhausted all the labels/diagnoses (because after all, don't many of the diagnoses have the same behavioral indicators) and prescribed various combinations and permutations of medications, how often are disruptive behaviors still evident?  The answer, in my professional opinion, is yes...yes the problem is still there at a very cellular level.  The "cure" is healing and what we now know, is there is this connection between the mind and body (and yes, the spirit).  And it is only when our children can heal from the trauma that lurks in the brain (aka mind) that the behavior will diminish.  And the source of healing is not, I believe in the diagnoses/label and not in the pill bottle but rather in relationship.  Healing is in relationship that shows patience, empathy, acceptance, compassion, and encouragement.  And within the safety net of relationship healing can and will occur.

Stealing to Self-Soothe

Today, on the Facebook page:  Challenging Children, I published a question put to me by a parent who son has been in and out of residential placement for the past 6 plus years.  She was asking why her 17 year old son, Jake would take the family Wii and deny taking it.  (Note: no one saw him take it).  Stealing is an external manifestation of internal turmoil...Jake was in a state of stress presumably for several days prior.  He was not thinking when he "stole" the Wii; he was stressed to his very core (oftentimes, he has been sent away to placement when he has had an incident at school that was aggression toward a staff member and indeed he had been removed from an alternative school placement before the end of the school year.  And this was the first time it would have been heard by the court).  And we know, from brain research,  that when we are in a state of stress, short term memory is suppressed.  Stealing can become an addictive behavior because it produces a high that calms the system down.  Of course, it is an unacceptable means of regulating stress and causes more problems in the long run.  But remember, Jake was STRESSED and unable to think through his behavior.

How should his parents respond?  Obviously, they were in a state of stress believing that Jake had stolen from his own family, once again (this was a previous pattern) and they have worked so hard to be able to help him heal from past trauma.  And they feel they have come so far in being able to regulate themselves and be responsive to him.  And now he seems to just be resorting to old behaviors.
What will be most helpful to Jake is if his parents can sit down with him and let him know that at first they were very angry...and could feel in the pit of their stomachs or the tension in their neck the anger.  They have talked about it together and realize that they should have picked up on how much stress he was feeling about Court.  And they should have talked with him and let him know that it really was going to be okay because there was now a plan for next school year and they would let the judge know that they want him to stay at home.  They should tell him they love him and want to work very hard to help him and they want him to know that when he is feeling stressed, he can come to them and they will listen.  They will try very hard not to talk...not to tell him that he should see things such and such a way, but rather they will just listen.  And if he doesn't want to talk, but just wants to hang out...they will be there.  And let him know that they are sorry, they didn't get it and that he felt like he couldn't talk to them.  They realize that he sometimes acts without thinking to make himself feel better...

Tip of the Iceberg or What Do Consequences Have To Do With It?

Imagine an enormous iceberg, what you see on the surface is only a tiny percentage compared to what is underneath. To continue to focus on behavior is like chipping away at all of the ice that is visible. Just as you get one chunk of ice removed, more just bobs up from what is below the surface. We cannot reach the bottom by chipping away at the top. If we chip away at behavior by using consequences and control without addressing the emotions under the surface...all we're going to get is more negative behaviors bobbing up. And if we keep doing what we've always done, we will keep getting what we've always gotten.

Limits

"What do we do when our child who has had a history of separation and loss, perhaps neglect, perhaps abuse, cries and tantrums when she doesn't get her way? She tells me that I'm not her boss and I can't tell her what to do and I can't yell at her. She will kick me and scream at me whether we are at home or out at a store or a park or wherever." This question from a very well meaning parent screams to me...I feel guilty and I am so exhausted. This parent goes on to tell me that she will give in to her child so that the child will calm down and then says to me...I know I'm not suppose to consequent her because she will feel threatened, and I am only trying to control her. At this point I say to this mom, stop and breathe. Yes, your child has had awful things happen to her, some unimaginable to us...she feels like she has no control and is not safe. You as the parent, will not help this if you let her have her way. You can help her without taking away privileges, without giving her time out, without depriving her of anything. And you need to in order for her to ever get regulated, in order for her to ever feel safe. Let her know that no, she can't go outside, she can't have more candy, she can't watch another DVD...let her know the limits. And then accept her rage...don't feel guilty about all she's been through. Let her know that she will be able to go outside again, when it isn't raining or when you can keep an eye on her. Let her know there will be more candy another time. But...not now and it is okay for her to be disappointed, it is okay for her to express her disappointment. Hold her if she will let you...walk away if you need to...wrestle her playfully to the ground if she'll let you and tell her it is okay...she is okay.

To Medicate or Not to Medicate...

that is a question that many parents and professionals struggle with when working with children who have challenging behaviors, their families and, let's face it, the many systems they come in contact with. I realize that for many, it is not an easy question to answer. Unfortunately, mental health practitioners and even the courts (in cases where children are a part of the social services system), are almost backed into a corner to say yes, let's at least try medication. And the age of children who are put on medication is younger and younger. And this is probably particularly true for children who are in "the system". A young child, age 4 who is "all over the place" in preschool, has difficulty keeping her hands to herself and at times has been know to be aggressive with other children, will be put on medication to help her be "more manageable" for a foster parent and the preschool. A nine year old boy, also in "the system" was said by the evaluating psychologist: that his behavior can is now able to be managed thanks to several medications that appear to keep him in a drowsy state all day and thereby dull his behavioral and emotional responsiveness to the extent that he is not able to act out even if he wanted to...in time, however, the evaluator states "these medications will require adjustments in his pre-teen years or earlier"...and then "he may not be as pliable as he is now."

Unconditional Positive Regard

Unconditional positive regard, a phrase and philosophy of relationship termed by Carl Rogers, is the "basic acceptance and support of a person regardless of what the person says or does." On my facebook page, Challenging Children, today I mention a book entitled: "Mommy, I Wish I Could Tell You What They Did To Me In School Today". And it is subtitled: "Everyday Atrocities Faced by Special Needs Children". The book is about, the real life tales of physically handicapped, special needs students. My particular experiences with challenging children in schools have been with those who are determined to have an "emotional disability" or even a "behaivor disorder". Those of you who follow this blog know that I've written in the past about both unconditional positive regard and Special Education. I have not particularly dealt with the two together. Unconditional positive regard was written about primarily in relationship to parenting. Today, I want to talk about it in relationship to schools and teaching challenging children.

It is an everyday occurrence to hear teachers yelling at students in school, to hear security officers yelling at students, to hear principals yelling at students. For the student who is "well put together" and from fairly normal life circumstances, the response will be for that student to "shape up" and stop doing whatever she/he was doing to provoke the ire of the adults in the school setting. And most likely the teacher will also respond in the next moment when the student 'shapes up" in a calm manner. Rewind the scenario and yell at a student who comes from less than ideal circumstances...perhaps even a student labeled as "special" because of an emotionally handicapped label...and the student blares back at the teacher and perhaps even uses an expletive not deleted. The teacher reacts...note reacts and does not respond...there is more yelling back and forth, the student is marched to the office or perhaps the office is called and someone of more authority comes for the student...any of you who has spent time in school recently can describe, most likely, the "rest of the story".

Now, had the teacher responded to the errant behavior of the student rather than reacted, the story would not have ended with the student being taken to the office and further punitive measures no doubt taken. Had the teacher accepted and supported his student, rather than reacted from a place of stress (and yes, fear), that teacher would have used an intervention that was quite different. And that intervention could have been to go to the student, try to find out why the student was having difficulty with a school policy/rule whatever...the teacher would have done this by listening to the student and learning what was going on. And the "incident" would have had a much different ending.

Unconditional Love and Unacceptable Behavior

I was going to write on this today and when I went to the blog, saw that I had written on unconditional love in February...it must be a recurring theme in my work. Here is what Bryan Post had to say this morning: "Acceptance between parents and children is the unspoken agreement that within their relationship all is okay for now and forever. Acceptance does not imply that what you have done is okay but rather who you are. I accept you. There are things you may do or ways in which you behave that I disagree but underneath it all I accept you. You are my child. We will make it through. Once you accept, then you can truly love. Remember that unconditional love is love such that there is nothing that a child can do to earn it, nor is there anything a child can do to loose it."

How very powerful is this definition of unconditional love...there is nothing, nothing you, my child can do that will change my love for you. No matter how many mistakes you make, no matter how others look upon your behavior (whether that be your teachers, your grandparents, the neighbors and yes...even the authorities) I will love you and together we will get through whatever it is that is facing us. We say to our children what you are doing is not acceptable and I will help you to find another way of expressing yourself, another way of interacting, another way of communicating. Yes, I will teach you more acceptable ways...and I will do that in a loving, caring, accepting way.

Unconditional Love

I use the following quote from Heather Forbes as a jump off point for this blog entry: When you learn how to put unconditional love into action, you have the power to change any family situation. Parenting through power and authority over our children comes from fear and ultimately undermines a child's ability to trust and relate to both themselves and others. Conversely, parenting through unconditional love and relationship equips our children to develop their own internal sense of control and empowers them to enter the world with a strong sense of self, well-developed love for self, and an ability to relate to others through tolerance, patience, and understanding. It simply starts by asking the right question, "What is driving my child's behavior?"

Unconditional love and unconditional positive regard are not easy things to give to our children. We think it is because afterall they are our children and we "love" them in spite of what they do. But...do we really show them love or do we try to control them and change their unacceptable behaviors. I believe that most parents, teachers, caregiver try to change behaviors through exercising authority and control. And most of us do this because of our own fears and stress...the fear of what if , what if we don't nip this behavior in the bud by letting our child/children know that this is unacceptable behavior. And we do this through using our authority to threaten in one way or another so they will see the error of their ways...OR ELSE. Or else what??? Or else we really will show them who is boss and will remove something from them...their toys, their privileges, our attention...

2012

Welcome 2012!!! And Happy New Year to all who come regularly to this blog or even sometimes. And in this day of making oh so many resolutions that we have seemingly made before and some we've kept and they bear repeating and some are still on a "to do" list somewhere, I am resolving to communicate more often with all of you. I resolve to communicate only what seems relevant to me and to do it from a place of loving responsibility. I know that I often react to something that I have seen or read or heard about and do it from a place of judgment which is just another one of those words that are based in fear. The rantings that one makes (okay that I make) come from a place of fear...fear that it is imperative that everyone "get it", everyone understand how reacting to children and to one another from a place of fear only gets a defensive reaction...fear-based. I resolve to first of all understand where adults behaviors are coming from...and respond from that understanding; validate that the reactions of adults come from some previous experience and that the best way to interrupt cycles is to teach...not to preach.