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. 

 

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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.

A Radio Show … For Real

Pretending to host a radio show is my favorite Play Therapy technique. And now I have the chance to do it for real.

reel to reelIt started in 1970 with my father’s reel-to-reel tape recorder.  The thrill of that device was intoxicating and addictive … surpassing by far the allure of any toy. From the living room floor, I’d “broadcast” countless hours of shows. Commenting upon momentary whims, meditating on the arrival of my grandparents, singing self-authored songs, interviewing  family members. Beseeching my grandfather to record a bedtime story, preserved for posterity.

And along the way I grew up,  preserving detailed recollections of my development ~ emotional, social, physical and cognitive. Those recollections keep me close to the child mind, fostering insights that assist me today as a Clinical Child Psychologist and Play Therapist.

A Play Therapist must be a flexible, creative creature with a diverse collection of tools. The top of one’s head is often a rich source of inspiration. And one day, from that very location, an idea struck me ~ an impulse rooted in my own childhood play.

A reticent sensitive young boy on the Autistic spectrum was having a hard time settling into in therapy. Until I handed him a microphone.

microphoneIt was not a real microphone – but it was real enough to him. He took the wooden ruler in his hand and began to disclose the observations of his mind and yearnings of his heart to an imaginary audience. “Callers” ~ kids and adults, in as many accents as I could devise ~ requested his sage advice. The “Dr. Beth Show” became our therapy modality as I witnessed his coping efforts advance with grace and confidence. “The Show” became a dependable play therapy tool which has helped many child clients since.

So, when the VoiceAmerica.com Talk Tadio Network contacted me, I was incapacitated by laughter. Soon thereafter, incredulity morphed into musings ~ and musings into a clear vision. I began to imagine a child psychology program that could inform and support parents of young children wherever they are.  With delight, I accepted invitation to host a weekly radio show.

voiceamerica

Child Psych Central: Discover the KidBrain will launch December 11th at 10AM PST on VoiceAmerica.com. 

The show will feature my discussions with child mental health experts, local, national and international. We’ll cover issues that cross my desk weekly in my clinical practice.  My guests and I will explore early childhood conditions, issues and services to inform parents in an in-depth, accessible way.  I will ask my expert guests questions I believe parents would ask if they were in studio with me.

Find it on the Health & Wellness channel. Podcasts will be available on  iTunes and social media outlets. My Facebook and Twitter feed will feature guests and links to every episode. This blog will also feature guests and show topics to help you find resources for your family.

Please join me for the launch of Child Psych Central: Discover the KidBrain! Catch it on December 11th at 10AM Pacific on VoiceAmerica.com. Pretending was great fun – but I know this will be even more.  Hearty thanks to my colleagues, friends and client families for their advance support. Tune in – this time, for real!

 

 

 

 

 

 


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

Tuesday 3:58 pm ~ The Moment Before Play

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Tuesday 3:58
Every play therapist knows this moment,
right before the child bursts in – 
we send up a few intentions,
something like these … 
 

Away papers, away email, away almighty phone.
HE IS HERE, all peals and squeals, with a cheek-breaking smile,
awash in giggles deep and rippling,
body bursting with the joy of movement.  

The intersection of adultworld and childland.
It is time to cross the street.
A path clears, a space opens;
Every pull and press of the day sweeps aside.
An empty desktop am I, ready for work and only this work.

Farewell, logic; I have no need of you this hour.
You will only impede my path,
a puppy at my ankles.  Sit.

Agenda, hold your horses; 
I may use or abandon you.
If this child brings something else I must follow, then follow I will.

Patience, hover near
 and help me.
Long moments may linger before the curtains part.
Keep me attentive, unhurried, alert, and present
lest I miss the moment.

Child, take my hand
, take my brain.
Take me back, I cannot get there without sweet you.
Show me how, show me why;
Show me the missing puzzle piece, right before my eyes.

Make me soft enough to trust
, real enough to tell.
May this space provide enough places in which to hide,
enough corners from which to reveal oneself.
Let me recognize The Invitation and accept it gently
if it arrives.

– Beth Onufrak

The photo above was taken in my office playroom on a sunny Phoenix winter afternoon.
The child’s white board drawing of a flower and heart is labeled, “You can bloom.” 
#Playtherapy

“You’re Taking Your Child to a Shrink?”

You’ve wondered and waited ~ with your worries and wishes.  You’ve hoped this was “just a phase” in your young child’s life. Time after time, you’ve reassured yourself, “He’ll outgrow this; he’s young” or “she has so much time.”  In talks with your partner, you’ve raised your concerns … and talked yourself out of them as the weeks and months (or years) passed. There have been periods when he blossomed and was doing just fine. Times when those problems seemed far behind her.

Then the difficult days return … An event occurs, a moment arrives when it’s all too clear – you cannot manage this yourself. You are out of ideas. You begin to ask around, look online, make some calls. Make an appointment with dread and hope, shaky nerves and eager heart. Nearly every parent who seeks child treatment describes these phases. Now that you’ve made that call, you wonder what (or whether) to tell family & friends. The reactions of others can be a gnawing concern:

what

“I’m not even mentioning this to my mother, she’d have a cow.”

“I can just hear my dad now … ‘MY grandson is not crazy!’ ”  

“We’re not telling our friends, they wouldn’t get it – she’s an angel at other people’s houses.”  

You are not alone if this story sounds like yours. In fact, you are entirely typical. You may feel wary of following your plan while anticipating disapproval from others. It is hard to seek outside help. So hard that many families put it off a little longer. A good number of parents arrive moist-eyed and shake my hand confessing, “We should have been here two years ago. We knew things were getting bad, but we just weren’t ready.”  

How do you know when it’s time?  The following benchmarks may tell you: When you have tried countless strategies, but the problem keeps worsening; when you’re starting to worry about the safety of your child and those she plays with;  when the problem is hampering friendships, school, and family life; when your child doesn’t seem to enjoy “being a child;” when there are more “bad” days than good and his or her self-esteem appears to be suffering.

How do you select a child mental health provider? At local community mental health centers, staff assign a therapist to match your needs.  If you select a health insurance provider or elect to private pay, your choice will be more personalized.

checklist

    • Ask trusted people.  You’d be surprised how many parents have struggled behind the scenes just like you. Many have a favorite provider they count upon.
    • Look online.  More and more providers have websites and social media presence.  How do they describe their practices? Check out their Facebook business page posts. What do they Tweet?  How do you like  their material?
    • Call for an initial inquiry.  Do you feel comfortable interacting with the office staff?
    • Understand medication vs. therapy.  Medication is prescribed by psychiatrists, physicians & nurse practitioners. Therapy is provided by psychologists, counselors, & social workers
    • Ask if a parent-only intake is possible.  Not all providers can offer this. However, such an intake allows coverage of sensitive topics you don’t wish to discuss in front of your child.

O.K., so you’ve made an appointment. Or you’ve begun the process and feel ready to tell people.What do you say?  I offer these suggestions:

We’ve found a provider who specializes in young children.

We need “new ideas” to address a big problem that just isn’t going away.  

We want to help our child now before the problem grows so we can have “better days” together. 

After meeting your therapist, assess how you feel. Provider-family “fit” is very important! But a degree of unease is natural until you all settle in. Be open to sharing information. Providers cannot truly help your child or family without the “full picture.” Know that any personal information you share is entirely in service of your child. Also, be ready to change yourself! Providers help young children by giving their grown-ups “new ideas.”

Seeking help for your young child is a step of courage.  And it can make a world of difference! Intervention with young children sweeps stones off the path of development before they become boulders. Begin early so the only thing weighing upon his young shoulders is sunshine. happy20sun


“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


Big Upsets? The Three C’s of Calming Down

I have a child in mind … crying and wailing, stomping and screaming. How can we help young ones calm down? The secret lies with us.  Grown-ups’ reactions can determine the course of a meltdown. The ball is largely in our court.

It doesn’t really seem fair … child meltdowns inconvenience the adult agenda, right?  Then why must the adult orchestrate the calm-down? Many parents bring children to therapy to acquire emotional “tools.”  But equipping the child is only half the work.

Within the child, a meltdown is a cataclysmic force.  Like a “volcano tsunami,” an articulate 2nd-grader explained. (Now that he has such words!)  Reasoning goes off-line like the internet in a downpour.  Parents say: “There’s no talking to her when she gets like that.”   “He gets this glazed look and I can’t reach him.”  If parental agitation escalates, the child perceives a Grand Canyon-sized gulf between one’s anguished self and the adult whose help he needs.

In the young years, calming down is a two-player game.  Adult frustration can generate auto-responses, such as “Quit acting like a baby,” or “Stop it, you are just fine!  But telling a distressed child she’s “fine” is like ordering rain back up into the clouds. Calming down is a complex, full-body skill to be learned.  And no one can be embarrassed or disciplined into a learning a new skill.

To assist parents, I created a quick, portable tool: THE THREE C’s for Helping a Child Calm Down.  The work of two psychology heroes of mine, Drs. Dan Siegel and Becky Bailey (see below), inspires this approach.

  1. CONNECT with your child through empathy. Stand in her shoes. Describe your compassionate grasp of her feelings  (“Oh, this is so hard for you / You really wanted that …”).  Don’t know what’s wrong? Say, “Ohh, tell me all about it.” Empathy calms the brain’s limbic system enabling the cortex to problem solve.  This is Step One, because nothing positive can happen until your child feels “felt” by you.   The Message: “I notice and care about your feelings.”
  2. COOL DOWN yourself first (count to 10, say a mantra “we can do this”), then cool down your child.  Guide and join him in body-calming strategies – watch his reactions and adjust your moves (hug him, stroke his back, say “Let’s breathe together,” “Let’s shake out our hands …”)  The Message: “We can cool you down together – I’m with you.”
  3. COACH your child in a guiding spirit.  Start the ball rolling, point her in the right direction, let her carry the ball across the finish line.  Think of yourself as a sports coach instructing others’ children – teaching a skill.  The Message: “Together we can get through this moment.”  Coaching may look like:
    • “You be the picker – this arm first, or that one” [through a sleeve]
    • Let’s give your brain a break for a minute, and think about something happy – like HoneyBear”
    • “I  wonder if you try that [puzzle] piece over in this area …”

While not a panacea, the Three C’s form a component of my interventions across a wide diversity of child conditions, including ones that bring severe impairment.  Try the Three C’s – your child’s meltdowns may have a lot less lava!

Literature of interestParenting From the Inside Out – Daniel Siegel & Mary Hartzell / Easy to Love, Difficult to Discipline – Becky Bailey.

#parenting #child #meltdowns