EXPERIENCING GRIEF AND LOSS DURING THE COVID-19 PANDEMIC

Life hasn’t been the same, for anyone, since the COVID-19 pandemic took over our lives about six weeks ago. Schools and businesses closed, and we all went home for the foreseeable future. Many daily activities and simple pleasures, such as going to the coffee shop, have been put aside for now. As if life wasn’t hard enough with all of the suddenly imposed change, you lose a loved one. Then not only are you grieving the loss of life as you knew it, but you are grieving the loss of someone’s life. 

The statement that life will never be the same again takes on a special meaning for those of us who have lost a loved one during COVID-19. My mother was 80 years old, and she had chronic and long-term medical conditions that were always of great concern to my family. She had cancer, COPD, a stroke, and a heart condition, but she had survived it all with incredible strength and courage. So we did not expect her to pass away following a long infection for which she was being treated. We were certainly not expecting her to pass away during a pandemic, when we were unable to hold a proper memorial service. Extended family and close friends could not travel to pay their respects, nor could anyone easily send flowers, bring food, or do the other things people normally do to support those who are grieving. Of all the ways I thought my life would be altered by COVID-19, losing my mother and being unable to properly show respect for and celebrate her life was not what I had envisioned as one of the challenges.

How can mourners cope with the deeply felt loss during a time when others can only show limited forms of support? How can we access resources to help us grieve, when so many options are limited? I’ve asked this question both as a clinician and as someone grieving, and these are some strategies I have created.

1. Fully acknowledge the magnitude of your loss: For me, it would be easy to include the loss of my mother as an additional source of stress during an already stressful time. But losing a loved one, especially a parent, is devastating. It’s important to acknowledge how deep the loss is, rather than combining it with other stressful events happening concurrently. 

2. Make time for grief: As the days and weeks seem to run together during this time when we are almost always at home, be sure to carve out time for the emotional pain. Leave time for tears, reflection of fond memories, and processing emotions such as shock, sadness, and anger. The journey of grief is different for everyone, but it’s important to take the journey.

3. Give self-compassion: I’ve heard many people say they feel pressured to be more productive and creative right now because they have more time. I felt this way prior to my mom passing away. I am fighting against feeling it now. Self comparison is never a good idea, but when you are grieving, it is worse. Grieving the loss of loved ones demands emotional energy. We should not place expectations on ourselves or criticize ourselves for doing less and being less motivated. There is no way to anticipate how we will feel from one day to the next, so pressuring ourselves to accomplish certain things or feel certain ways can be harmful to our emotional adjustment.

4. Engage in simple pleasures: Let yourself find ways to experience temporary relief from your grief. Such as stepping outside for fresh air and sunlight, eating a favorite meal, taking a hot shower or bath, reading a good book, or doing whatever brings you some moments of joy. There are no “rules“ of grief that say you have to constantly feel pain. It’s okay to take time away from grieving.

5. Access good support: Identify trusted sources of support and encouragement, whether it’s personal friends and family members, mental health professionals, clergy, or all of these. We cannot be together right now in the ways that would be ideal during times of mourning. But we can reach out through phone calls, video chats, and group chats. If you aren’t feeling up to talking, let those closest to you know how they can best support you. It’s very easy and very tempting right now to isolate. But social distancing doesn’t mean emotional distancing. We still need connection with others, especially at times when we’ve lost someone so important to us. 

There’s no formula for grieving. Nor is there a time frame for getting over the loss. However, there are some things we can do to take good care of ourselves as we mourn. This is especially important during this time of great uncertainty. 

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HOW TO BUILD RESILIENCE DURING THE CORONAVIRUS PANDEMIC

Three weeks ago we were all doing life as usual. We were following our daily routines of work and school; going out to dinner with friends; planning vacations over spring break; and looking forward to the change in season. After all, the groundhog promised us an early spring.

Then, the news coverage began. Each day, there are new positive test results for COVID-19. Life as we know it quickly changed, and the prognosis for the near future became scary. Schools have closed, people are strongly encouraged to telework, and now restaurants and bars are rapidly changing their business hours or closing all together. It’s a lot of change to accommodate within a short period of time. 

While adjusting the way that we work and learn is doable with today’s technology, adjusting to the social isolation and the complete halt of our typical activities can feel overwhelming. This is especially true given that we don’t know how long this will last. Initially, activities were getting canceled and things were closing for the next 2 to 3 weeks. But recent press releases in the last few days have indicated that it could be up to eight weeks, or longer, before life returns to normal. Adding in the risk of contracting a virus that we still don’t know much about, and we have the recipe for fear, anxiety, and hopelessness

Though it may not seem possible to maintain a positive attitude right now, we must not lose hope. We must focus on what we can control and do our best to modify our environment in ways that are not only tolerable, but enjoyable. Hopefully, this blog can suggest some ways to make the best of life and continue to build resilience during what may be an extremely tough few months. 

1. READ AND LISTEN TO RELIABLE SOURCES OF INFORMATION: to manage anxiety around the spread of the virus, as well as its impact on the world around us, visit credible websites with up-to-date data. These include the CDC, WHO, and your county government website for local data. Select the quality and quantity of your news coverage carefully: be cautious about reading many different sources of information that aren’t directly related to facts and recommended behaviors. Sometimes, you really can have too much information. 

2. KEEP AS MUCH STRUCTURE IN YOUR DAY AS POSSIBLE: if you are working from home, taking classes, or simply hanging out at home much more than usual, it’s important to maintain structure. Start your day with some physical activity or mindfulness meditation, schedule times to speak with others, and set a timer to do work if necessary. This will prevent the days and weeks from running together and will increase your sense of accomplishment.   

3. STAY CONNECTED VIRTUALLY TO FRIENDS AND FAMILY: regardless of your work or living situation, schedule times to talk with friends and family. Be intentional about making connections and engaging with your support network.    

4. GET CREATIVE, LITERALLY: Explore your creative brain in whatever fashion peaks your interest. Cooking, drawing, painting, writing stories or poetry, playing a musical instrument, writing songs, or simply rearranging your furniture. Find your inner creativity and explore a side of yourself that you don’t usually give time to.

5. EXPRESS GRATITUDE: This might be hard right now with so many things put on hold and so many typical pleasures lost temporarily. But it’s not as hard as you may think to find reasons to be thankful. Each day, think of at least a couple of items that you can be grateful for, whether it’s physical health, stabile finances, the ability to work online, the opportunity for simpler living for a time, or the relationships that you cherish. Being grateful allows us to remember that life is not as grim as it may seem.

6. EMBRACE NATURE: even those who are not athletes can embrace nature with a simple walk in the neighborhood. It’s now spring, and there’s plenty to enjoy, whether it’s cherry blossoms, flowers in your garden, or a bright sunny sky. Enjoying nature can be emotionally rewarding and physically restorative. 

These are challenging times for us all. But using these strategies can help make the best of a difficult situation. Right now try not to worry about or predict the future. We really have to just take life one day at a time.                           

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Should You Fire Your Therapist?

In my October blog post, “Good Therapy Is an Art and a Science,” I explained what quality therapy looks like. The post below offers additional insights into therapy by providing tips to help you determine whether or not your therapist is a good fit.

You’ve been going to therapy for two months. You have to leave work early to get there on time. You’re paying out of pocket because you couldn’t find anyone who takes your insurance. You’re thinking about stopping therapy because you should feel better by now, right? I mean, after all, you’re paying good money for therapy. That means that it should work right away, and two months is long enough to wait. 

If you’ve ever felt this way, let’s talk about therapy. There are indeed legitimate reasons to stop going or to find a new therapist. Your feelings about wanting to benefit from therapy and understand how you are benefiting are valid. Of course you need to feel like you are improving. Therapy is a commitment, so it is true that you want to make sure it’s worth your time and money. Caring and competent therapists agree, wholeheartedly, that clients should feel their time and money are valuable, and that they will get a return on their investment.

Here is the harder truth to reconcile, though: Your expectations of therapy will affect the outcome. So, before you decide to fire your therapist, here are some factors to consider: 

1. How many times have you gone to therapy? If you have gone a handful of times, now is the perfect opportunity for you to tell your therapist you don’t feel that it’s helpful. This will allow them to work with you on goal setting and troubleshoot why you feel like you’re not benefiting. Don’t drop out of treatment until you have had this conversation.

2. Do you know what your goals are in therapy? If your goal is to increase your self-awareness, you need a therapist who can help you identify behavioral patterns that you’ve developed over time. If your goal is to overcome your fear of spiders, you need a therapist who can teach you specific strategies to manage that anxiety. Being specific about what you want to accomplish or overcome in therapy will help you choose your therapist. It will also help you decide whether your therapist is a good fit.

3. Have you done work on your therapy goals outside of your session? If not, this could be an important part of the reason that you aren’t making progress or are feeling dissatisfied with therapy. Therapy is not a one hour a week experience. It requires reflection, self analysis, and intentional action during the rest of the week. If your therapist hasn’t clearly communicated this to you, talk with them about it. Issues discussed and strategies learned during the sessions are the food for thought that you act on, and chew on, in between appointments.

4. Have you communicated with your therapist about your lack of progress and dissatisfaction with their work? Some therapists will be direct, and they will ask you how things are going. Other therapists will wait for you to tell them. It’s a matter of personal style and theoretical orientation. But you can always choose to tell your therapist that you don’t think you’re making progress. Most good therapists will receive this and can adjust or adapt their approach. 

5. Do you believe that your therapist cares about your progress? If you have gone to therapy more than a handful of times, and you do not believe that your therapist is invested in helping you, it may be time to find someone new. However, if your therapist asks you how you think things are going, expresses an interest in setting goals with you, and tells you that they care about you, they probably do. An uncaring therapist is likely not the reason that you aren’t making progress.

The key in deciding whether to persist with your current therapist or find a replacement is honesty. Be honest with yourself about how much effort you are making in the process. Be honest with your therapist in sharing information, identifying goals, and giving them feedback. Don’t decide to leave therapy or your therapist without first communicating your concerns and giving the therapist, and the process of therapy, a genuine opportunity to work.

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BEING PRESENT: The one New Year’s resolution you should make

Happy New Year! The year 2020 is now in full swing. New Year’s resolutions have begun to surface all over social media. I must admit there are some good ones: get in better shape, declutter, eat healthier. The quest to have a healthier, more prosperous year and to improve the quality of one’s life is certainly admirable.

The problem with New Year’s resolutions is that they can often be difficult to achieve; either because there isn’t a plan to implement them, or because the person doesn’t think carefully through the tools and resources needed to be successful. But there is one New Year’s resolution we can all make that does not require significant planning, financial resources, or other means that can be hard to obtain or sustain. This resolution will undoubtedly improve our mental health and well-being; improve our relationships, and perhaps even improve aspects of our physical health. This year, resolve to be present.

What does it mean to be present? It means that you focus your energy on what’s in front of you. This may sound simple, but it requires a shift in thought process and emotions that takes effort. 

To check how often you are focusing on the present, reflect on your typical daily activity. How much time do you spend thinking about the future? Do you experience anxiety about a list of things that you have yet to complete? Now, think about how much time you spend in the moment. Do you take time each day to be grateful for aspects of your life that are going well, for things you have, or for the people in your life? Do you notice things around you, such as natural beauty or a new coffee shop or restaurant that has opened recently? These are examples of being present: getting outside of your head and into your life to notice, enjoy, and attend to what’s happening right now. It’s a shift from outcome oriented living to process oriented living.

You can practice being present by making small changes to your daily life. Sit down and have a meal with your family, and leave your phone in another room. This allows you to focus on conversation and hear how other people’s day went. Then, you can answer emails or texts. Look at your to do list, and instead of feeling overwhelmed by the number of items on it, start at the top of the list and conquer the first task. While completing this task, focus on doing your best and making the most of it, rather than continuing to think about what you have to do next or by the end of the day. After a long day of work or school, set aside time to spend with your family, your significant other, your friends, or even some alone time. You can make a conscious decision to put a time limit on being busy to have some relaxing space. These are examples of being present.

Surprisingly, learning to be present can actually help us achieve other goals. Changing the pace of our lives and shifting our focus from the outcome to the process increases our commitment to all that we do. We become more intentional in our actions, and our motivation is more genuine. We can make decisions more thoughtfully because we are more aware of what we want, how we think, and the impact that our actions have on us and others. 

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HAVE AN ANXIOUS AND A MELANCHOLY NEW YEAR: Feel All Your Feelings This Holiday Season

We had just returned from visiting my parents for Thanksgiving. I looked forward to relaxing and watching Elf — one of my favorite holiday films. I felt peaceful and happy, as I planned decorating and other festivities. Then, the commercial began. A family looking through holiday video clips came upon a memory of their grandma, who apparently had passed away since last year. Cue the music from the movie Up, and my tear ducts started freely flowing. I couldn’t stop for ten minutes. The commercial stirred in me memories of Christmases past with loved ones no longer with us. It also stirred grief in anticipation of future Christmases without my parents. This was not the relaxing experience I had anticipated.

Although the commercial triggered emotions that were inconvenient for what I had planned, I recovered and the evening resumed. In fact, I felt a comforting release after the tears. But left to my own devices, I would have chosen to avoid uncomfortable feelings. We all engage in emotional avoidance sometimes, because we want everything to feel ok. We make black-and-white statements about how situations should feel. Relaxation shouldn’t be interrupted with negative feelings, we say. The holidays are supposed to be happy. It is the most wonderful time of the year, we hear everywhere during the holiday season.

The reality is that, most of the time, we experience mixed feelings. Circumstances can and do evoke several different emotions at once. We may feel happy on our wedding day, but a tinge of sadness that some family aren’t in attendance. It’s the same on holidays. We may feel joyful in celebrating the season with loved ones as we look forward to our favorite traditions. But we also feel heartbroken as we grieve those who are no longer with us.

Give yourself the gift of feeling everything this season. Rather than working hard to avoid negative feelings and expending a great deal of energy doing so, consider accepting all of the emotions that surface. Rather than setting high expectations for how extraordinary everything should be and how much joy it should bring, wait to see how you feel. Acknowledge the joy and the pain of this holiday season. Reflect on and be grateful for all of your experiences. The memories that trigger tears can then be cherished, instead of avoided. The anxiety that you accept and power through will bring you relief and build resilience.

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HOW THERAPY FOR CHILDREN WORKS BEST: IMPORTANT THINGS TO CONSIDER

I hear similar stories from parents. Their child is having stomachaches unexplained by a medical condition. Maybe the child is having difficulty at school either academically or behaviorally. Their child’s pediatrician or teacher has recommended therapy. But, many parents tell me, therapy doesn’t sound like something that would be appropriate for a child. The decision to take your child or teen to therapy is fraught with questions and concerns. What will they talk about? How will we know when they are making progress? What does therapy look like for a child or teenager?

These are all valid questions. Knowing some of the answers before you choose a therapist and get started with the process can make a big difference as to whether or not therapy will be helpful. The fact is that therapy for children and teens can be very effective in addressing emotional problems, school problems, and problems at home. It is also true that the earlier children receive therapy and other mental health support, the better their outcome. Early intervention can make all the difference in how children grow and develop emotionally if they start having problems at a young age.

But the reality is that many parents take their kids to therapy and feel like it goes nowhere: it just lasted a long time, and they had no clear evidence of positive results. Thus, the purpose of this blog is to educate parents about child therapy. Below are some guidelines about how to look for a therapist, how to get the most out of your child’s therapy, and what to expect in terms of the outcome. 

1. Determining Qualities of a Good Therapist: A therapist who specializes in children and adolescents is the best fit. Even though more generalized practices can work, a therapist who has training and expertise in child development, attachment, and parenting will provide more knowledge and insight specific to the child’s needs. This may seem like common sense, but many people may not be aware that there are therapists who actually specialize in working with children and families. These therapists will also know the best therapeutic approaches to take with a younger person. Talk therapy alone, with a lot of questions, generally does not yield a productive therapy session with a child.

2. Attending an Initial Consultation: Once you have chosen a therapist, I recommend setting up an initial consultation without your child. This allows you to meet the therapist, ask questions, and determine if you think you would trust this person with your child’s therapy. Choosing a therapist is different from choosing a pediatrician or another health professional. Your child is about to develop an ongoing relationship with this person for an extended period of time.

3. Telling Your Child About Therapy: Meet the therapist, then tell your child that you have made an appointment. Do not tell your child the therapist is a “friend.” Your child then wonders why they’ve never heard of this person or met them before. The therapist is also not a teacher. They see teachers all day at school. Be honest. The child likely knows they are struggling with anxiety, fear, sadness, grief, or nightmares. Let them know that you love them so much that you want to take them to a specialist who knows how to help them with these challenges. This will facilitate a smoother introduction with less fear. If they think they are going to see someone who can help them, they will be motivated to go and find out what therapy is all about.

4. Learning About Child Therapy: As your child attends therapy, you can also learn about child therapy. Schedule some time on your own with your child’s therapist if there is not time during the session to talk. Therapists handle their relationships with parents differently. Many of us prefer to have separate time with the parents, so that we can focus on answering their questions without the child nearby anxiously waiting. Use this time to ask the therapist about the goals in therapy, and work with them to come up with a plan of action. For instance, if your child is struggling with anxiety, the therapist is likely teaching your child coping skills to manage anxiety. Thus, you want to learn those skills as well, so that you can apply them with your child at home. Many therapists will also recommend books, apps, or other resources for parents, so they can help children outside of the sessions. An ongoing dialogue with the therapist is always best, so that you feel comfortable with the work that is getting done in therapy.

5. Collaborating with Other Professionals: It’s important for the therapist to talk to other professionals involved in the child’s care: the therapist gets a broader view of the child’s functioning in other settings. This may include a pediatrician, teachers, speech therapists, or occupational therapists. Parents should facilitate these professional interactions.

6. Waiting Patiently for Progress: No one wants to hear that therapy takes time. However — depending on the seriousness of the issues, the ability of the therapist and the child to establish rapport, and many other factors that are not in our control — it could take a matter of weeks or months before you notice positive change. While following the advice in this blog can make therapy more productive, there is no one answer as to how long therapy takes to work. Defining clear goals early on can make a big difference because the therapist and the parent know what progress will look like.

Deciding to pursue therapy for a child will result in less stress if parents are educated about what therapy for children involves. It can be an enriching, positive experience for children when the expectations are clear and when communication between the therapist and parents is consistent and strong. For more resources regarding child psychotherapy, check out www.drcarlamessenger.com

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GOOD THERAPY IS AN ART AND A SCIENCE

I recently attended a presentation by one of my colleagues called “The Art of Psychotherapy in Integrative Practice.” The presentation, and the conversation afterwards, was thought-provoking because it provided new insight that complements my own clinical background. While my doctoral training emphasized the importance of evidence-based practices, which represent a scientific approach to conducting psychotherapy, I believe that conducting psychotherapy is both an art and a science. That is the approach that I prefer to use, and the one that is most valuable to my clients. This blog is intended to educate potential clients, and anyone else interested in therapy, as to how psychotherapy functions as both an art and a science. Understanding therapy in this way will make it a more valuable and enriching experience.           

THE SCIENCE OF THERAPY: 

While popular culture is still determining whether or not psychology and its practice is technically a science, I would present the case that it is indeed a science if the therapist chooses to utilize its scientific virtues. Research continuously provides evidence in support of cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), cognitive processing therapy for trauma (CPT), and exposure and response prevention (ERP) for phobias and obsessive-compulsive disorder (OCD). When therapists have obtained proper training in any of these techniques, and clients are motivated and cooperative, the research validates their success. Not only does science support their effectiveness, but clients feel relief from their symptoms. This is very encouraging, especially after months or even years of suffering with emotional challenges that can be debilitating. Clients who seek treatment with therapists who utilize these strategies are more likely to return to therapy later if the challenges return. They find hope in their newly acquired emotional stability and higher level of functioning.*

However, as freeing as it feels for clients to experience a reduction in their anxiety, depression, and other emotional symptoms, implementing scientific strategies in therapy alone is not enough to result in long-term, positive mental health outcomes. People want to feel relief from their symptoms, that is true. But the manner in which those strategies are developed, and the relationship and sense of trust necessary for clients to engage in therapy, is even more important.

THE ART OF THERAPY: 

Effective long-term therapy requires more than scientific training and being a good teacher of strategies. Crafting a relationship with a complete stranger where they develop trust in you as their therapist is indeed an art form. Not only do they trust you to give advice and to guide them in the process of healing, but they also trust you with long held fears, embarrassing details, and other secrets. If the therapist asks too many questions, too quickly, it may invoke greater fear and anxiety. If a therapist makes suggestions that are taken, and they backfire, this may compromise trust. Thus, the timing in therapy is one aspect that represents the art of conducting a meaningful session. When adding individual touches like humor into a therapy session, you have to take into account the individual preferences of each client. The therapist must know the client well before engaging in advice-giving, humor, or other personal touches. This is the hardest work for the therapist to achieve.

Finding ways to connect, emotionally, with a range of individuals and maintaining a rapport that prevents sessions from becoming stale and unproductive are factors that you can’t learn by reading a book or even entirely through graduate training. Truthfully, there are therapists much more gifted the art of psychotherapy, and others who are well-versed in the scientific discipline of evidence-based approaches to treatment. I believe that clients are in need of both the scientific and the artistic aspects of psychotherapy. Integrating the art of building a relationship with the use of practical strategies is the approach that my clients deserve. This is the kind of therapy that grows the integrity of the mental health profession and the one that will result in the promotion of long-term mental health and well-being.  

*If you’re interested in learning more about evidence-based therapy, check the Resources section on my website: http://www.drcarlamessenger.com/resources .   

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High-Functioning Autism: A Clinician’s Perspective

Formerly referred to by the mental health field as “Asperger’s Syndrome,” High-Functioning Autism is characterized by challenges in an individual’s social and emotional functioning that can affect the quality of their interpersonal relationships. In addition, such individuals may have difficulty communicating with others, exhibit rigid thought patterns, and restrict their interests to certain topics or hobbies. They often misperceive social cues and, as a result, do not know how to comfortably interact in social situations. 

While these behaviors do characterize High-Functioning Autistic individuals, beyond the social awkwardness, they are wonderfully unique, highly misunderstood, and complex. Traditional neuropsychological evaluations do not always capture the nuances of their personality, their strengths, or their potential. It’s a process to fully understand an individual who meets the criteria for High-Functioning Autism.

The following characteristics can make it rewarding to work with these individuals. 

1. They cannot help being honest about what they think. You always know where you stand. When my goal is to help these clients achieve healthy and joyful relationships, their honesty is refreshing, especially in a metro area where diplomacy can often feel superficial or fake.

2. They desire friendships and to belong in community. They may lack the social skills to be positively received by others much of the time, but this often leaves them feeling sad and lonely. It is untrue that most individuals prefer not to have relationships. If they expressed this sentiment, it is more likely because of the social discomfort, rejection, or alienation they have experienced. No one would want to continue pursuing something that has such negative and painful results.

3. They often possess a wealth of knowledge in areas of their interest. While they do not always pause to listen or allow others to interject as they disseminate their knowledge, I can often learn fascinating and valuable information.

4. They have the capacity for empathy. I have heard it said that individuals on the autism spectrum are incapable of empathy. It is often not true that they lack the capacity all together; rather, it's a muscle they must build. While it can be difficult for them to see the perspectives of others, it’s possible to raise their awareness.

It’s important for clinicians who decide to work with this population to understand these complexities. If there’s anything I can say with certainty from my clinical experience, it’s that working with these individuals is more of an art form than a science. 

Image by Dmitri Posudin from Pixabay

Five Hard Truths Divorced Parents Must Accept

Since I began practicing in 2007, I have worked with many families in which the parents were going through a divorce. I have been subpoenaed to testify in Family Court over two dozen times. While occasionally it’s necessary for me to testify to advocate for the well-being of a child, I am saddened by the frequency of these requests. Psychologists are often subpoenaed to serve parents, but it does not protect the children. Children’s therapists should not routinely testify because it often compromises the child’s therapeutic relationship. If the motive for taking the child to therapy is to engage their provider in court testimony against a former spouse, parents must ask whether they are serving their child’s best interest or their own. 

In this post, I want to address parents going through divorce and encourage them to reach out to mental health professionals who can help them and their children navigate this difficult time. Therefore, I want to give them some tools to support their children and effectively manage their own emotions.

Here are some factors to consider before making your child’s mental health treatment about court testimony and some recommendations that might help as you navigate custody and visitation challenges:

1. Your child’s mental health challenges are not your ex-spouse’s fault. It certainly is true that divorce is hard on everyone. It is also absolutely true that your child will be affected by the divorce. Your child may be sad, angry, and scared. Children often worry that the divorce was their fault. Or they may develop separation anxiety from their parents when one of the parents moves out of the home. Your child will grieve the loss of the family as it once was, even if there was conflict. In many cases, children need to see a counselor to support their adjustments, and they can also benefit from a support group. However, it is misleading to identify the divorce as the central cause of any mental health problems. Many children would have had mental health challenges anyway. There are many reasons why children become depressed, anxious, or have school related problems. The reality is that there are complex reasons why children struggle emotionally, and divorce is definitely a factor. But neither parent causes the mental health challenges of their children in the context of divorce. Neither parent is solely to blame for the child’s mental health problems. Furthermore, the solution, even in cases where the parents bear some responsibility, is not to remove the parent from the child’s life.

2. Your parent-child relationship may be negatively affected by attempting to remove the other parent from your child’s life. Parents who engage in ugly court battles, continuously make derogatory statements about their ex’s acts in front of their children, or attempt to alienate the child from the other parent may ultimately do more damage to their own relationship with their child. Sometimes, they initially have success. I have seen many children who have formed negative opinions of a parent. They begin to not want to spend time with that parent. But I’ve also seen many cases where the child later turns against the alienating parent. Or, in the worst case scenario, the child becomes estranged from both parents as an adult. Parents who are considering removing their ex from the child’s life for any reason must consider the risks involved in doing so.

3. You can’t dictate how your ex raises the children. You may be a good parent: you have figured out how to discipline, how to support their education, how to love them well, and how to shape them into wonderful human beings. Part of the reason that you divorced may be due to differences in parenting preferences. But now that you are divorced, you have even less power over how they will be parented by your ex partner. Coparenting — continuing to work together to effectively parent even after the marriage has ended — has mixed success. Most of the families with whom I have worked have not had much success with it. This is largely due to the level of conflict between the couple. It can be successfully executed with two cooperating parents whose first priority is their children. But even in the best coparenting scenarios, you cannot control what the other parent does. When the children are in the care of one parent, that person can decide how much screen time they get, what they eat, what they do, and when they go to bed. This may not be congruent with your choices.

   My advice is to focus on your own parenting. Give them good meals when they are with you, limit screen time as advised, help them develop healthy sleep routines, and teach them good self-care. As they grow older, they will develop the healthy habits that you taught them. Obviously, there are circumstances that warrant concern. Suspicion of abuse or other maltreatment should be investigated. However, in the majority of cases that I’ve seen, while one parent makes better choices, the other parent can still be capable of having custody.  When negotiating shared custody following a divorce, both parents have to pick their battles carefully: the more time spent in court, the less time parents spend with their children.

4. Your ex will likely never agree with you. This one may seem like common sense, but I have worked with enough divorced parents that I think it’s worth saying anyway. The question all divorced parents must ask continuously is “who is my top priority?” You may be extremely angry with your ex, and you may be very well justified. The reality is that even a family court judge can’t make your ex agree with you. If revenge is what you are seeking, or simply “I told you so,” is it worth risking your relationship with your children? Do you respond to your anger by fighting in court? Or, is it a wiser choice to get your own therapy, so you can work through your anger.

5. Your child’s therapist is not your advocate. The child is not only the client of record, but also the priority of their therapist. It is important for the therapist to guide both parents in better understanding their child’s problems and needs. But it is not appropriate for the therapist to see only the viewpoint of one parent or to begin advocating for the removal of custody from one of the parents. It is not the therapist’s role to focus on either parent, but instead to treat the child’s mental health challenges. The exception would be in cases of known abuse, but even then, it’s not the therapist’s decision. Therapists are mandated to report suspicion of abuse to child protective services, but their focus then returns to providing supportive care and interventions to the child in the family. There have been times when it was necessary for me to give testimony that was not favorable toward a parent. On these occasions, there were grave concerns regarding the children’s well-being and safety.

If your divorce and custody situation needs professional consultation to determine who is more fit to have custody, a custody evaluation is a better choice than using the child’s therapist as your witness. There are psychologists who conduct comprehensive custody evaluations for parents in contentious custody battles. This is the route to take if you believe your ex is abusing your child or putting them in direct danger. However, in most cases, children’s mental health outcomes are far more positive when parents work together and seek a holistic approach to address their child’s emotional and psychological functioning.

Photo by Juliane Liebermann on Unsplash

MILLENNIALS: are they the therapy generation?

A recent article in The Wall Street Journal, “Millennials Are the Therapy Generation” by Peggy Drexler, discusses millennials’ increased interest in therapy and new therapeutic strategies for engaging their generation. While I agree that millennials are open minded about therapy, what are their expectations? They often enter therapy prepared to be open about the challenges they are having, but are they open to feedback? I think it is necessary to explore what they perceive therapy to be, as well as what good therapy looks like. We need to engage millennials in therapy in ways that they can receive, but what people want from therapy is not always aligned with the best approach to personal growth and self-improvement. In this article, I want to encourage millennials interested in mental health treatment to adopt realistic expectations, so they can get the most out of their therapy. 

If you are a millennial seeking treatment, you must ask yourself, “am I up for the journey?” Many millennials perceive therapy as helpful, and they come in with high hopes about its efficacy. Their expectations of how quickly therapy is going to cure them, though, can be unrealistic. They typically want advice and practical solutions early in treatment. The desire for solutions is genuinely good, but the process of finding the best solutions for them is a harder and longer journey. Getting them to stay past a handful of sessions can be a challenge. Some of them stick it out. Some of them work through the difficult emotions and dig deeper into the underlying reasons for their stress. 

Whether or not someone chooses to go on the journey in therapy depends on many factors. Among the most important, especially for this generation, is the individual’s willingness to explore their decisions, mistakes, and failures. For a generation whose parents largely provided positive feedback and praise, this can be difficult to undertake. Many of them have never had to question themselves because their parents stepped in and solved some of their problems. So, now, they may be looking for their therapist to help them do the same. But it isn’t that simple. We must understand our choices and take responsibility for them before we can grow in our insight of how to make different ones. Acknowledging that sometimes we will do our best and still make a decision that we regret is part of the growth process. Thus, therapy involves growing out of avoidance and into personal responsibility. 

This kind of journey can be hard for many people, not only millennials. But many millennials find it intolerable and not worth doing. They want therapy that’s quick, effective, and that reinforces their ideal self. Good therapy, insightful therapy teaches people to accept their choices, learn from them, and incorporate them into their development of identity. This kind of growth can be uncomfortable. You have to sit with it. That means you come back to therapy once a week, and it’s not always something you gleefully anticipate. You will leave some sessions feeling worse than when you started. You have painful questions to ponder sometimes. But as you progress through the journey, you notice changes in yourself and an understanding of yourself that you have gained through the process.

Photo by Samantha Gades on Unsplash