Mommy, my brain is hungry!

goldfish_crackers

Young kids tell you what they want. The iPad. Angry Birds. Skylanders and Lego Ninjago. American girl dolls and My Little Ponies.  A pop tart. A fruit rollup. Goldfish. Noodles with butter. Sound familiar?

If only they knew what their brains wanted to help regulate their physical and emotional states. Their pleas might then sound like this: “Mommy, my brain is hungry!  I gotta have some protein to focus. I need some avocado to think of something else before I hit my brother!”

 

The brain/nutrition link is elementary. The brain runs on neurotransmitters. Neurotransmitters are made from food, specifically protein. Neurotransmitters are carried on the superhighways between cells that are coated with fat. [Fat, you say? Good fats.] And sugars provide glucose for brain energy.  Complex carbohydrates supply sustained, long-lasting energy; simple, quick burning carbs only give rapid, short-lasting energy, leading to “zoom and crash.”

A parent might as well say,

“Blood sugar, go to your room!”

 

An after-school tantrum can reflect low blood sugar.  Classroom distraction can reflect inadequate intake of quality protein. Poor impulse control can reflect deficiencies and DHA and EPA.  I am no longer content to blame behavioral problems on “psychological” issues when the body may be the problem, or at least part of it. How silly that distinction even sounds… the distinction between mind and body is history.

Parents bring kids to psychologists to help change how their minds work … when it’s children’s bodies that often get them into trouble. The unspoken assumption is that the child mind can control his body, given the proper “tools.” But it’s more and more clear to me ~ we often have to help the body and brain first before I can do much with the mind.

Nothing is more proximal to your child ~ closer to his interior being ~ than what’s in his cells at any given moment.  

… closer than your hug, your touch, your loving words or threatened punishment … closer than therapy interventions. 

 

walnuts-health-benefits_1-1024x683

Knowing children’s brains are hungry, I now routinely recommend a nutritional consultation at the commencement of care.  Sometimes, I advise parents at the intake to return in 30 days after  implementing nutritional changes.  No longer can I accept parents’ money and take their time if I believe a child’s body needs help before her mind can respond. How would I know this?


Over the past 4 years of my practice, my referrals for child psychiatry consults have plummeted.
 Why? Because parents are trying nutrition first with profound results. Many kids accept new food routines and even request specific foods at key times. They quickly recognize how different ~ and better ~ they feel.  These children actually start to say, “Mom, I need some protein…” My colleague Jan Katzen, former Montessori teacher and Certified Nutritionist, often says, “I have yet to meet a brain that does not respond to better nutrition.”  Jan is one of my most valued referral sources. Learn more about her at http://www.NutritionforLearning.com.


Do I lose business with all my nutrition referrals?
 
 Sort of! Some kids improve by eating differently and no longer need my services.  But more often, kids come back after a nutritional boost. Then therapy is more efficient and effective. That’s because a child’s brain chemistry and blood sugar is working with me.


Findable, affordable foods could potentially transform your child’s brain and body from dysregulation to balance.
 
Changing the timing and composition of snacks and meals can make all the difference. Canned black beans, apples with almond butter, stone-ground tortillas, walnuts and cage free eggs can turn around brains and behavior. Not being a nutritionist, I’ll stop there and leave it to the experts.  Picky eater?  Nutritionists of often have sneaky ideas for helping gradually change your child’s palate.


Does changing your child’s diet take some time and money? Yes. So does therapy. Try one, and you may not need the other.

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Child nutrition a module in Dr. Onufrak’s ChildSightTools® parent seminar series, delivered live in small-groups through out the year in her Phoenix, AZ office.

What Every Parent Wants

 

Parents want lots of things for their kids.

But when they call me, there is astounding similarity in what they want. Parents arrive, hope in hand. They sit on my couch and describe children of different ages, issues, gender, and problem settings. Yet every parent wants the same thing. Improbable, but true.  How can this be?

 

paris girls chalk

 

CONNECT

Parents yearn for their young children to connect better —  with them at home, and with others outside the home.  They pray for smoother interactions between their child and other kids, between their child and other adults.  They wish their child could …

Get through a play date without a knock down/drag out, friend-goes-home-early;

Feel brave enough to say hello on the playground;

Handle teacher correction without feeling she’s “mean;”

Be able to tell a teacher what one feels and needs;

Have as many loving moments at home as challenging ones;

Enjoy mutually satisfying parent-child interactions.

COPE

What else do they want? Without exception, every parent who comes to my office wants “coping skills for my child.” After many years, I noticed this word mentioned in EVERY intake — not just many or most. Parents yearn for their child to acquire skills that can be remembered, applied and activated in troubling times. For their children to learn to handle a situation without aggression, withdrawal, meltdown, a freak out, or “bad choices.”

THRIVE

My new patient paperwork concludes with this question:

“Say you run into someone six months from now, someone who knows your family well but hasn’t seen you in a while. Somehow, things have gotten better. What would you like to be able to say?”

In the hopeful answers to this question, the same word keeps cropping up: THRIVE. “He is just thriving” or “She’s thriving now in every way …” Parents want their child to feel success, joy, light, achievement and resilient self-esteem – to thrive on every level of development.

So, parents want their children to connect and cope better, so ultimately they can thrive.  Over my 20 years as a child psychologist, I see those aspirations as intertwined. But perhaps not as you’d expect.

 

With preschool & primary graders,

child coping is a joint venture between adult & child.

They learn and practice these skills with YOU

and apply them in the world.

 

Wait … don’t kids learn to cope in the therapy room?

They learn it in every room. Young children are developing their “coping systems” – a complex blend of neurological, physiological and emotional and social mechanisms for reacting and responding to challenge. Part temperament and genetics, part modeling, part impulse control, part emotional regulation. A tall order for the young ones I see.   Very hard to do alone.  We adults actually help or hinder children’s coping through our interactions with them.

Adult-child interactions literally build kids’ brains, fortifying the neural groundwork for either calm, confident problem solving or alarmist, defensive/offensive or escapist problem solving.  What’s the difference? Asking for help versus throwing a chair; greeting an unfamiliar child versus hiding behind your leg; expressing the thought “This is too hard” versus running out of the classroom.

 

To help children connect, cope & thrive,

I teach adults to facilitate their child’s coping

through brain-building interactions styles.

 

At some point in the process of child therapy  most parents mention to me, “It kind of seems like you’re training us …”   Down the road, many parents also share a common disclosure, admitting somewhat sheepishly but with deep pride: “I noticed he really started to change when I started to change. I had no idea ….”

Child therapy is composed of direct child intervention AND parent guidance.   Parent workshops go straight to parent guidance.   Workshops pump parents full of information that lower the temperature of child problems.

For instance, parents learn why yelling never works.  We think the louder we yell, the more kids will remember the lesson next time. Right? Wrong. Yelling activates the threat center in the limbic system in the brain, taking blood and oxygen away from the thinking cortex. Yelling literally incapacitates the child’s cortex from problem solving. Thinking goes off line. Good coping doesn’t get rolling like that.

You can learn to help your child Connect, Cope & Thrive via child therapy or a parent workshop.  Or, you try to apply these few concepts and see if things improve:

Child coping starts at home in every interaction you share.

Your own calm coping is the best model for your child’s coping.

If your child’s “upset elevator” goes up, keep yours down.

 

Promote your child’s coping through calm connection that models the cool you want them to achieve. Remember, you are building his or her brain in these early years.  Parents are the most important part of child therapy.

 

Dr. Beth’s Parent Workshops & Saturday Seminars resume September 2014 including:  Savvy Solutions for Your Challenging Young Child; You & Your Anxious Child; and The Child-Sight Model: Change Your View and What You Think, Say and Do. Visit DrBethKids.com for details. 
 
Photo credit: by Beth Onufrak

What’s Wrong with “Wh” Questions? 5 Things and The 5-Word Fix

 

Your child is falling apart. Another volcanic meltdown, drowning in a tsunami of tears, siren-like screams. If you knew what specifically was wrong, you’d know what specifically could help. So you resort to the strategy that helps you the most in adult life:  specific questions.

what-why-how2What are you upset about?
What happened?
When did this happen?
Where were you?
Why are you so upset?
How did this happen?

Who? What? When? Where? Why? How?
Wh-wh-wh …

It truly is unfair that the style of inquiry that helps us function in the adult world incapacitates us when trying to help a young child.  Specific questions can even prolong and impede the process, while emotions spiral further out of control like a tornado on the plains.   Why? (oops!)

In 20 years of being a child psychologist, and the years of training before, I learned the cardinal lesson: “Wh” questions shut a child up faster then you can say ice cream sandwich.

 “Wh” questions can be unhelpful, even anti-helpful, because they:
    1. Shut down a child’s own narration and conception of the problem
    2. Block a child’s sharing of the salient details to him
    3. Pigeonhole a child’s thinking into your categories of thought
    4. Build a child’s frustration with us adults
    5. Make a child more upset from the communication gap

May I suggest an alternative ~ my 5-word Fix: “Tell me all about it.” It may sound similar to asking …  but this approach to inquiry is completely different. How so?

Consider the last time your computer displayed a cryptic, terrifying error message before going blank, toying with your life. In consultation with the  IT person, it may be very hard for you to explain the problem.  The IT person might ask you specific “wh” questions, such as: What did the error message say?  What were you doing right before this happened? What gobbledygook thingy is your thingamajig?

But you’re upset and you don’t have computer language. It may be doggone difficult to answer those “wh” questions. You might even grow more frustrated in this process. You might wish the IT person would simply say, “Tell me all about it.”  At that point, you could begin with the language you have to describe the problem at the level you are capable of.

When a child hears “Tell me all about it,”  it feels like “Just give it to me, however it’s going through your head right now, with whatever words you got … and I will just listen.”

“Tell me all about it” also opens up your child to tell you a detail you’d NEVER have asked for.  Because you couldn’t have thought of that.  Because you’re weren’t there … and you’re an adult.

haystack
Relying on “wh” questions in a meltdown is like trying to find a specific needle in your child’s haystack.  It’s like asking, repeatedly:   Is this the needle? Is this the needle?  Is THIS the needle? You would get infinitely farther, infinitely faster by just saying “Tell me about this haystack you got here.”

Naturally, you have to ask “wh” questions at some point. Probably several, to get the clarity you need. But starting out with nine “wh” questions will create more problems than progress.  “Tell me all about it” may be the most productive start.

You can add “I’m so sorry you’re so upset.”  When you’re lost, interject, “Help me understand; tell me some more about this, honey.” (Hint:  forget about solving this problem right now; her brain needs empathy too cool the limbic system down.) 

“Wh” questions are like putting your hand on a specific door knob and asking, “Is it this door?” Saying, “Tell me all about it” opens doors you didn’t even know were there.  Try it and you will see.

Parents: Why a Workshop?


question marksSo, you’ve been concerned about your young child
for quite some time. You’re not sure if you need a child psychologist … maybe, maybe not. Starting therapy is not like signing him up for soccer! It’s a larger decision. Some friends say get help now; others say, “it’s just a phase.” You and your spouse may not even be on the same page about your child.

A few new good ideas would be soooo nice. So you read articles, blogs, posts, tweets … but none seem to address the specific issues in your life with your child. You’d love specific parenting advice, some face-time with an expert, and the support of other struggling parents like you. A safe place where you wouldn’t have to worry about judgment. And it would be great to “test drive” a therapist before signing up for care.

That’s when a workshop may be “just what the doctor ordered.”

people link

Workshops are one of my favorite clinical activities. For one, I can talk with grownups and don’t have to sit criss-cross applesauce on the carpet! More importantly, they serves my deep need to help more than one child per hour. Workshops serve my growing drive to get basic, customized, high-quality information to parents of young kids in a cost-effective format.

And these days, cost-effective things are more needed than ever! Workshops extend child psychology services in an affordable, comfortable, helpful way so people don’t have to forestall something this important. That being, helping your child connect, cope, and thrive.

For many years – 13 to be exact – I resisted the notion of holding parent workshops. How could I ever help children I’ve never met … especially when each child is so unique? Then it hit me. Week after week, along with the customized advice I dispense, a set of core principles and “prescriptions” kept coming in handy.

For any given child & family, about 50% of my interventions are singular and customized; the other 50% come from foundational elements of pediatric mental health & balanced parenting. These common elements are pervasively, predictably helpful across a wide range of diagnostic conditions, family circumstances and child problems. From these elements, the content of my Parent Workshops was born.

In the hot Phoenix summer of 2013, I launched my first workshops. Feedback from the initial sessions revealed what parents really need. In addition to facts, approaches & strategies, they craved something else as well. They needed the opportunity to …

    • step away from their busy lives
    • reflect deeply about their children
    • absorb new ideas while out of the house, and
    • receive laughs, tissues & high-fives from other parents.

Workshop attendees found encouragement through another week of tantrums. And cheers after sharing a breakthrough. Some of the best moments occurred as I listened in the circle. And whadya know … I actually helped children I had never even met. Several, in fact, in a few hours time. As Mr. Rogers used to sing, “It’s such a good feeling …”

Workshops resume next month.
Dr-copy.Beth-Kite-Story-3-PRINTSavvy Solutions for Your Challenging Young Child will run Wed. nites, March 5th thru April 2nd and Thurs. mornings, March 6th thru April 3rd.

Workshops in development include: My Child & Me and ADHD and You & Your Anxious Child.

For details and registration, visit the Workshops tab on my website at DrBethKids.com. If you’re a Phoenix local in the Valley of the Sun, take a look or tell a friend. If you live elsewhere, look into parent workshops near you – for facts and friendship, solutions and support.


“You can tell me anything, I’m a puppet!” Why Play Therapy Works

Criss-cross applesauce, a spunky boy sits on the whimsical playroom carpet, eyes wide, mouth agape. He’s listening to my impulsive puppet Freddy exclaim, “I get so mad, I want to kick him in the leg!”  Freddy elaborates: “Why won’t he just play my game, my way, every time?”  It’s no longer any surprise. Nine times out of ten the amazed child replies, with visible relief, “THAT’S JUST HOW I FEEL!”


The child I have in mind speaks to the puppet, and he’s not alone.  Freed by genuine understanding and clear acceptance, the child opens his heart. He pours out his own troubles to the boy, girl, dragon, wolf, octopus, skunk, or chipmunk on my hand.  “I know, last night I kicked my brother,”  he offers, commiserating with the puppet.  “I hate time out.”  Another child reveals, “I did that in school and got sent to the principal. It was the worst day EVER.”

Now, I have a nice degree on the wall, with all the rights and privileges thereunto appertaining.  But puppets are my co-therapists and their credentials seem to surpass mine.  Children tell the puppets far more than they tell me alone.  Why is this?

The answer is simple: Puppets give safe distance.   No child wants to see a therapist who fixates on her problems, nor feel there’s something wrong with herself. In my playroom, it’s the puppet who has the problem. And to a much greater extent than the child.  That’s the secret.  If a child is here for anxiety, Puppet Miranda has hilarious, unreasonable terrors.  The boy here for anger meets puppet Pedro, who mentions unmentionable aggressive thoughts … the very thoughts children harbor and sometimes enact.  The boy can hardly believe Pedro feels the same way.  And before he knows it, we are talking.  Other puppets join us, supportive “voices of reason.”  Four-way conversations ensue between the troubled puppet, the helper puppet, the child … and oh yeah, me.

Puppets help bring the child’s problem comfortably into the room. They often speak for the child, making her feel not so alone and not so BAD.  Puppets are but one of many play therapy tools. But for me and many child providers, they open the door.  Puppets are exceptional delivery vehicles for Cognitive Behavioral Play Therapy, described above.  CBPT helps children try on new thoughts and rehearse new behaviors.  And guess who models those — yes, the puppets.

There are many models of play therapy, including directive (didactic in style), non-directive (following in style), and familial (incorporating parents).  One expressive mode is Sand Tray therapy, using miniature toys children select and arrange in sand.  Sand Tray helps children heal from trauma, abuse, and emotional damage too painful to speak aloud.  Regardless of the mode, play therapy provides stand-in symbols (toys, materials) to represent feelings and people, events and things, wishes and fears.  The child’s imagination creates a buffer and a flexible “space” to explore tough stuff.  Therapeutic play allows the freedom to approach and retreat from uncomfortable ideas, memories, and feelings.  Children open up about burdens such as obsessions and compulsions, low self esteem, wishes that one was “never born,” despair, rage and shame.  Play gets inner feelings “out on the table” so we can deal with them together.

So puppets are one tool of the play therapist.  The puppet-child connection is unsurpassed in early childhood psychotherapy. Children often bond with their puppets friends, proudly believing they themselves are the helpers. One child brought a nugget of puppy chow to nurture a chronically anxious puppet. “Worry Wolf,”  she entreated, “you have GOT to get hold of yourself!”  She then rattled off an expert list of self-calming tips for emotional regulation.  Well-remembered and expertly modeled.  Parents bring their children for follow-up visits, amazed with progress. In a hush, they whisper, “He’s been talking about Freddy nonstop for two weeks.”

Good.  Freddy sends a tangible and memorable message out the door – long outlasting the single hour with me.  I ought to put him on the payroll.

#parenting  #playtherapy  #puppets  #self-regulation  #angermanagement #child psychology