Thursday, September 27, 2012

Feel

I operate from the assumption (hard-won lesson) that all feelings are normal and natural.  They deserve to be noticed, not judged.

When I share my thoughts and feelings, lay myself bare, I just wanna be heard, understood and accepted (feel felt).

It means I have the ovaries to be real - no pretense, not trying to be cool (because I am cool - got nothing to prove).

I don't wanna be judged, questioned/interrogated, fixed, dismissed, minimized, pathologized, told that I'm wrong, lectured, etc.

Feelings are ephemeral, they too shall pass.  So I acknowledge them.

When we don't acknowledge our feelings or the feelings of others, it signals to me that somewhere, somehow we learned to stuff, deny, ignore, intellectualize them, see them as weak, steamroll over them.

I've worked really hard to stop doing that.  I wanna be seen, understood and accepted.  I start by doing this for myself.

Rumi's poem the The Guest House says it all...

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they're a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.

Be grateful for whatever comes,
because each has been sent
as a guide from beyond.

Care & Let Go

It's not that I don't care, it's that I have no control over it, so I let it go.

Tuesday, September 25, 2012

The Relationship between Maternal Acceptance, Community Violence & Child Outcomes

Increasing levels of community violence victimization were significantly associated with PTSD symptoms, and even after controlling for being a victim of violence, simply witnessing community violence was significantly related to stress symptoms.

Additionally, as hypothesized, the relations between community violence exposure and mother's report of internalizing and externalizing problems were moderated by the child's perception of maternal acceptance.

Moderate and high levels of maternal acceptance acted as a buffer, protecting children exposed to community violence from developing emotional and behavioral problems.

Bailey, B.N., Hannigan, J.H., Delaney-Black, V., Covington, C, Sokol, R.J. (2006).  The Role of Maternal Acceptance in the Relation Between Community Violence Exposure and Child Functioning.  Journal of Abnormal Child Psychology, 34(1), 57-70.


Monday, September 24, 2012

De-escalating a Fight in Family Therapy

Mother and daughter clearly wanted to fight, but it would have been a mistake to allow them to.  Carl extended his hand toward them, as if to block the current between them.  His voice was firm.  "Let me stop you two.  Because I really do want to wait for Don."  They looked away from each other, and the moment passed.


From The Family Crucible: The Intense Experience of Family Therapy by Augustus Y. Napier with Carl Whitaker

A Moment of Conflict in Family Therapy

"What we are talking about is the prospect of the family as a whole changing.  And to start that process with one fifth of the family absent would be unfair to Don (sibling) and I think unfair to you.  He's part of the family, and we need him here if the family as a whole is going to change." There was an edge of toughness in my voice. 
Mrs. Brice didn't give in easily.  "But Don isn't the problem.  The problem has to do with Claudia."  Her voice was chilly, too.  We were definitely having a fight. 
Nor was I giving in.  "But you see, that's your initial definition of the problem.  We assume that the problem is much more complex and much more extensive than Claudia.  And the whole family just has to be involved."  I hesitated, gazing with level intensity at the mother.  I realized that pushing the family might mean losing them, but I knew that it had to be done.  "Now, maybe you guys aren't up to this kind of major job that we're talking about.  We really can't decide that for you.  But it's clear that we need the whole family."  A very large and imposing silence.


From The Family Crucible: The Intense Experience of Family Therapy by Augustus Y. Napier with Carl Whitaker

Moments in Family Therapy

"Claudia (teenage identified patient in family therapy) seems pretty alive to me," I said.  "I like the fact that she's angry and fighting with her parents rather than taking the anger out on herself.  I feel that Claudia is very stressed, but that suicide right now is an option that she keeps open rather than an obsession.  As a fantasy, it seems very much a part of her battle with her parents."  I summarized.  "She doesn't feel suicidal to me."  Claudia seemed to brighten with the words.
From The Family Crucible:  The Intense Experience of Family Therapy by Augustus Y. Napier with Carl Whitaker

Sunday, September 23, 2012

What if?

What if my study yields no significant findings or my hypotheses are not supported? 
I will still have learned the research process and completed my final requirement for the doctorate.

What if no man will ever love and cherish me again?
I will love and cherish myself.

What if people judge me for my choices?   
Ni modo (Fuck it).

What if people find out about my missteps?
I proudly own all my experiences.

What if people think I'm too this or too that? 
Not my problem.

What if people try to punish me (by shunning me) for not being a "good girl," in other words, not doing what they want me to do? 
Fuck it, it's not my problem.  They lose more than me in that shunning thing.  Thanks for walking out, meanies.

Who the fuck do you think you are playing against type, busting through glass ceilings, bending traditional gender roles, breaking with tradition, doing what you want, being happy, having fun?
Exactly.

What do they call the doctoral student with the lowest gpa at graduation?
Dr.

Risky

When I was younger, I took a lot of risks because I didn't know enough to be scared.

Now that I'm older, I take even more risks because my faith has grown bigger than my fears.

Where are you on the continuum and where do you wanna be?


Friday, September 14, 2012

Assembling a Dissertation Proposal



I'm not a great cook, but I can assemble a great salad.

Writing, on the other hand, is totally my thing.  However, writing a dissertation proposal (about 75 pages) was starting to get unwieldy and overwhelming, especially with the naive ambition of my ideas.

So I have decided to change the way I think about it and bank on my strengths.  Now, I am in the process of assembling my dissertation proposal.

The proposal has the following sections:  Introduction, Statement of Problem, Literature Review, Theoretical Framework, Research Questions and Hypotheses, Methodology, Abstract and Timeline.

I have butcher paper representing each section gracing every bare wall space in my dining room (my art work is resting temporarily on the ground).  I will post pics soon - it's quite lovely in a colorful, creative and organized way.

As I read through articles (from the sweet spot of my venn diagram - the intersection between low-income urban families, parent-child communication and posttraumatic resilience), I am posting ideas about research questions and methods that are recommended in the discussion section of these articles.  I am also posting information for the lit review.  Index cards, post-it notes and sharpie pens (in lots of cool colors) are my best friend right now.

Also, I had to completely re-write the discussion section of my publishable paper - I didn't really know what I was doing the first time and tried to fake it.  I decided to learn how to write it by doing what painters do - copy the experts.  So I literally wrote out - sentence by sentence - the discussion section of about a dozen articles (the very ones I am using for my dissertation proposal - a two-fer) to crack the code and find the pattern:  (1) study finding, (2) how it is consistent or contradicts with existing research, and (3) interpretation(s) of finding, (4) repeat as necessary.


Surprisingly, it meant I could read and internalize what I was reading no matter where I was reading (cafe with great music, cafe with cute men everywhere, on the couch with the TV tuned to So You Think You Can Dance or Top Chef or Project Runway, etc., or 11pm at my dining room table).  Now I can skim through those sentences - and the inevitable stars and notes I wrote in response - in order to post them on a corresponding butcher paper.  I am actually EXCITED about going through all the articles to mine them for ideas for my proposal.  I am a nerd and I like it. 

Who said research can't be creative and fun?  That's precisely why I do it.




Thursday, September 13, 2012

Just Check It Out

"Sometimes we can put up road blocks in our head when they are not really there, and it is always better to just check it out."
I stole this line from progress notes that I was signing off on.  I love being a fly on the wall in the sessions of clinicians I am supposed to be supervising.

Wednesday, September 12, 2012

Relationships and Resilience

The finding that child emotional regulation skill was a weaker protective factor than the caregiver-child relationship, or other levels of the child's ecology, is an important one and challenges the notion that resilience is a quality that "resides" in a person.
Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004). Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor. Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487. 

Our relationships make us who we are, they make us stronger, they are the reason we overcome.  Relationships.

Stop the Violence

At the highest levels of violence exposure, youth with good ability to regulate their emotions were equally likely as youth with poor emotional regulation skill to have symptoms of depression and anxiety.
Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004). Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor. Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487. 

Even the most skillful among us has a breaking point.  There is just so much we can learn about coping.  We also need to work on preventing the violence.

Families and Urban Youth

Gorman-Smith, Tolan, Henry, and Florsheim (2000) also found that exceptionally functioning families protected inner-city African American and Mexican American boys from adjustment difficulties.

Recent work by O'Neal (2001) found that family characteristics were stronger than individual characteristics in protecting junior high age youth from the effects of community violence.
Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004). Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor. Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487.  

Let's aim to work with families - instead of relying primarily on individual counseling with youth.  

If you have not been adequately trained to work with families, please figure out how to learn and practice often.

If you are scared to work with families, then ask for help.


If you had a mixed experience with your own family, you are not alone.  Welcome to the club.


If you don't believe that working with families will make a difference or if you believe that families will refuse to work with you, then you are right.


If you believe that working with families is one of the most effective things you can do and you believe that families want to get along better because they love each other, then you are right.


What do you choose to believe?
"A belief is only a thought you continue to think.  A belief is nothing more than a chronic pattern of thought, and you have the ability - if you try even a little bit - to begin a new pattern, to tell a new story, to achieve a different vibration, to change your point of attraction." --Esther Hicks

Felt Acceptance

The quality of the caregiver-child relationship, particularly felt acceptance from the caregiver, was the strongest protective factor in this study.
Felt acceptance had a strong, inverse relationship with both internalizing and externalizing symptoms (a main protective effect) and interacted with violence exposure to influence internalizing symptoms.

Internalizing symptoms were high and stable at low levels of felt acceptance; with increasing levels of violence exposure, adjustment problems increased for youth with high levels of felt acceptance.

Interestingly, violence exposure was negatively related to felt acceptance, such that children who experienced, witnessed or heard about high levels of violence felt less accepted by their caregivers.

These findings are consistent with those of Weist el al. (1995), who found that family cohesion protected inner-city boys from the effects of stress.

Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004). Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor. Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487.  

Families matter.  Children need the support from their families.  In what ways can we strengthen and promote these powerful relationships, no matter where they are right, right now?

Tuesday, September 11, 2012

Violence Prevention and Supporting Parents

Parents, community leaders, and policymakers need to take the lead in lessening the violence that children see, hear about and experience...work with parents to improve their coping and emotion regulation capacities and the quality of their relationships with their children. 
A high-quality parent-child relationship, as this study has shown, has a strong potential to affect children's adjustment. 
A first step in getting there is to attend to the mental health needs of parents, many of whom are suffering from depression or PTSD. 
Once parents are treated for their own adjustment problems and are coping more effectively, they are better able to be available and supportive to their children.
Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004). Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor. Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487. 

Protective factors can only go so far.  At high levels of violence exposure, even the best families will suffer. In addition to promoting protective factors, we need to work together to reduce all types of violence exposure among our children.

Families matter.  Parents and children are inextricably linked.  Let's respect and nurture that relationship, no matter how tenuous it appears.

Child therapy is family therapy.  Children exist in a system called a family, not in isolation.  What happens to one family member affects the whole.  Stabilizing the family will go a long way toward stabilizing the child.

Instead of becoming a substitute caregiver for a child, I wanna support the parent in their care-giving role.  Then I can watch happily as parent and child reach for each other for love and support.

Talking About It

Feeling accepted by caregivers, having easy communication, and feeling accepted by and assertive with peers may help children "talk through" and cognitively process feelings aroused by experiencing, witnessing or hearing about violence, thus reducing symptoms of depression and anxiety. 
However, such coping resources may not be adequate to affect aggressive behavior. 
Caregiver's regulation of anger was the only protective factor for children's aggressive behavior.
Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004). Violence Exposure and Adjustment in Inner-City Youth: Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor. Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487. 

Talking about it helps, no matter how hard it can be - it keeps the sad and scary feelings from sticking around forever.

But talking about it may not be enough to manage or contain a child's out-of-control behavior.

How a parent manages their own anger seems to make a difference.  We learn by example.


Violence Exposure Interferes with Important Relationships

...violence exposure was negatively related to felt acceptance, such that children who experienced, witnessed, or heard about high levels of violence felt less accepted by their caregivers.
Kliewer, W., Cunningham, J.N., Diehl, R., Parrish, K.A., Walker, J.M., Atiyeh, C., Neace, B., Duncan, L., Taylor, K. & Mejia, R. (2004).  Violence Exposure and Adjustment in Inner-City Youth:  Child and Caregiver Emotion Regulation Skill, Caregiver-Child Relationship Quality, and Neighborhood Cohesion as Protective Factor.  Journal of Clinical Child & Adolescent Psychology, 33(3), 477-487.

How does the impact of high levels of violence - at any level - interfere with our most important relationships?

Friday, September 7, 2012

Codependency vs. Self-Care

Maybe the reason that self-care is so difficult for social workers and other helping professionals to prioritize is our penchant for codependency. 

The opposite of co-dependence is self-care.


Thursday, September 6, 2012

Nurturing Ourselves

"We develop a way of life that embraces and blends the concepts of self-nurturing and self-discipline.  We love ourselves in all the ways we need and deserve to be loved; we discipline ourselves in ways that will be in our own best interests.  We become our own best friend and parent.
...Nurturing is an attitude toward ourselves - one of unconditional love and acceptance.  I'm talking about loving ourselves so much and so hard the good stuff gets right into the core of us, then spills over into our lives and our relationships.  I'm talking about loving ourselves no matter what happens or where we go. 
In the morning and throughout our day, we lovingly and gently ask ourselves what we can do for ourselves that would feel good.  We ask ourselves what we need to do to take care of ourselves.  When we hurt, we ask what would help us feel better.  We give ourselves encouragement and support.  We tell ourselves we can do it, we can do it good enough, and things will work out.  When we make a mistake, we tell ourselves that's okay.  We wait a moment, until we get our balance back, and then we ask ourselves if there's something we can learn from our mistake, or if there's some way we can improve our conduct in the future, or if there's an amend we need to make. 
We tell ourselves we love and accept ourselves...We make ourselves feel safe and loved." 

Beyond Codependency:  and getting better all the time by Melody Beattie

Sex for Money?

I had a friend in college who liked to call dates: "free food & free entertainment."

I just heard a woman complain that her 18-year old daughter is living with a young man and having sex with him but he is not giving her any money.  Sex for money - isn't that called prostitution?  Or is that a relationship?  The woman was appalled that her daughter's boyfriend responded to her daughter's request for money for a dress with: "Get a job."  Isn't that what a feminist would say?

Some women expect to be wined and dined in order to get laid.  Again, is that prostitution or a relationship?

What is the state of relationship politics these days?  Does a man always pay for dinner?  When is it okay to go dutch?  Is it ever okay for a woman to pay?

If a woman makes her own money, then can she have sex with whomever she wants - free dinner or not?

I had lunch with a woman who had been married for a very long time and was back on the dating scene.  She asked a mutual friend about the who-pays-for-dinner protocol.  The mutual friend was an attractive woman who said, "I've never paid for dinner."

I'm not sure what the underlying assumptions are and where they come from?

What are the modern rules and what is the modern rationale?