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adhd testing

ADHD Testing

Testing for ADHD can be as brief as a school or pediatric screening; or, if a learning disability is suspected, it may be as comprehensive as a full psychoeducational evaluation or neuropsychological assessment. Typically, the protocol is somewhere in-between. At Brentwood Counseling, experienced psychologists and educational consultants help evaluate Attention Deficit Hyperactivity Disorder in children, adolescents and adults using the following protocol:

  • Parent Interview and Review of History
  • Parent Rating Scales (ADHD, Developmental History, Behavior/Psychological)
  • Teacher Rating Scales
  • Self-Rating Scales (older students and adults)
  • Consultation with referring therapist or physician (when appropriate)
  • Extensive Clinical Interview with child, adolescent, or adult (typically requires two sessions)
  • Observation of child in classroom (when appropriate)
  • Psychological Screening to help rule out other concerns (e.g., anxiety, depression, behavior disorder)
  • Written report
  • Feedback session with parents to review results and recommendations for treatment, etc.

It is important to remember that ADHD is not a binary (yes/no) diagnosis that a certain score on a specific test can identify.  Rather it is a continuum disorder that presents in varying degrees as a deficit in some aspect of self-regulation (attention, focus, hyperactivity, impulsivity).  An ADHD diagnosis requires concerns in childhood that continue to have a negative impact over time in more than one setting (e.g., school, relationships, family, work).  Even well-trained professionals can disagree as to causes of these problems with self-regulation, but basic symptoms are outlined in the Diagnostic of Statistical Manual (D.S.M.-5) and provide helpful guidelines for clinicians with the evaluation process. If a diagnosis is made, treatment options include behavioral/psychological interventions, environmental changes, parenting modifications, school accommodations, neurofeedback and, at times, medication.

 

If you are in need of ADHD testing, contact Brentwood Counseling Associates and connect with one of our experienced therapists.

 

 

nontraditional kind of loss

What Might Have Been: A Nontraditional, but Significant Kind of Loss

Ah, spring. The time of year when a sea of gold descends upon us here in Nashville. And no, allergy sufferers, it’s not just the pollen. It’s the jersey-clad, rally-towel-waving, banner-flying, Nashville Predators fandom that takes over the city during the NHL Stanley Cup playoffs. And it was never more rabid than during the team’s Cup Final run in the spring of 2017. For a couple of months that year, it was unlike anything Nashville had ever seen. And we believed that team could win it all. But suddenly one night in June, it was over. It wasn’t supposed to happen that way. Not to a team that had been the last to make the playoffs, a team whose players had suffered injuries galore, and still had somehow made it that far. And yet, it just wasn’t meant to be. If you were around that spring, or if you’ve ever rooted so long and so hard for something that didn’t come to pass, you’ve probably experienced the same kind of heartsick letdown that followed that Game 6 loss. To be clear, sports championships aren’t exactly the stuff of life and death. But they illustrate a type of loss that isn’t talked much about: the loss of what might have been.

When we hear that someone has experienced a loss, or is grieving or mourning, we usually make the assumption that they have lost a loved one or something vital to their happiness and well-being, such as their home. It’s long been that way in our culture, though more recently we’ve expanded our notions of loss to include experiences such as infertility, miscarriage, and the death of pets. However, just like in the hockey reference described above, what happens when something that we expected to happen, doesn’t? This type of loss often goes unrecognized because it doesn’t fit into our culture’s traditional definition of something that is “worth” mourning. And when we (or others) don’t recognize something as a loss, we don’t feel like we’re allowed to grieve. But when grief goes unresolved, it can morph into something else, like depression or anxiety. In fact, unresolved loss is often the “root” of the problems that bring people into therapy. Let’s take a look at some common nontraditional forms of loss around what might have been.

In my experience, one of the most common nontraditional losses of this kind occurs in close relationships, when there is grief about what a relationship could have been. This type of loss can occur in friendships, relationships with siblings, and romantic relationships. But its impact seems to be felt most strongly when it happens in the parental relationship. Most mothers and fathers strive to parent in the most effective way possible, and don’t intentionally set out to hurt their children. But certain circumstances can lead to an ineffective, often outright hurtful parenting style. Those who struggle with alcoholism, for example, parent while under the influence, when they’re usually not at their best selves. Or those who grapple with severe depression parent while being unable to function at the most basic level, let alone at the level that healthy parenting requires. Regardless of the reason, parents do sometimes become unable to offer the unconditional love, support, and acceptance that their child needs. And just because a child reaches adulthood doesn’t mean that that need goes away. This is why most people with this kind of loss report that they continue to try to please their parent, despite having been met with rejection their whole lives. They’ve become tired of trying, yet may be reluctant to accept the loss of hope that their parent will ever truly approve of them. They often enter therapy when they just can’t try anymore. And the grief work done in therapy involves deciding whether to continue to expect anything from the parental relationship, and how to make peace with what it could have been.

Another “what might have been,” nontraditional form of loss occurs around career paths. This kind of loss can occur anytime during a person’s career. However, I’ve noticed it coming up so frequently among college and university students that I’ll use that population to illustrate it. Maybe more so than ever, students these days begin thinking about their career paths in high school, or even earlier, as they discover their talents and passions and start focusing on a particular educational track. Maybe they’ve got a knack for numbers, and they’re encouraged to pursue accounting. Maybe their talent lies in science, and they decide to shoot for medical school. Or maybe their athletic prowess has paved the way to a full scholarship and talk of professional play. But what happens when there’s a bump in the road and those plans don’t come to fruition? Consider the mathematically- or scientifically-minded student who runs up on some required classes he can’t pass. Or the star athlete who has a career-ending injury. Not only are these students left to redirect their course and find a new career path, but they’re left with the loss of what might have been. And if well-meaning parents, friends, and advisors emphasize the importance of finding that new path, the student can draw the conclusion that the loss wasn’t worth grieving. But when unresolved grief is suppressed, it can make it difficult for such students to move forward. College is stressful enough without also having to rewrite your life’s career path. But therapy can allow students to process the emotions surrounding the loss of their original career expectations, begin to heal the pain of that loss, and start writing their new career story.

Finally, let’s consider losses that alter a person’s lifestyle. These kinds of losses are often physical in nature, having to do with significant illness or other changes to the body or mind. For example, let’s say a person’s spouse develops early-onset dementia. Shifts must be made not only in the couple’s daily lifestyle, but in their expectations about the long-term. What happens to their plans of traveling abroad after they reach retirement age? Or to all those hopes and dreams they had about being grandparents together? There might also be regrets about not having gone after those hopes and dreams earlier. Or guilt about acknowledging the sadness and unfairness of the curveball life’s just thrown them – after all, the last thing the wife wants to do is blame her husband for getting sick. But it’s crucial that she give herself permission to mourn the loss of her old reality, as well as the loss of what might have been. If she doesn’t, it could complicate the grief she experiences when she faces the impending loss that will eventually come with the progression of her husband’s disease. Talking with a trusted professional in counseling can ensure that all the facets of loss, both traditional and nontraditional, are acknowledged and honored. And difficult though it is, doing the work of grief goes a long way in ensuring that it doesn’t shift into something more.

 

If you have experienced or are currently experiencing this kind of loss, and are struggling with the emotions associated with your grief, contact Brentwood Counseling Associates and connect with one of our experienced therapists.

 

 

Father and son on a hike can be a way to connect when parenting an ADHD adolescent.

Parenting ADHD Adolescents

Parenting teenagers is challenging enough, but when parenting ADHD adolescents is part of the equation, that challenge is almost always greater. As a psychologist who has tested, consulted and counseled for many years with ADHD teenagers and their parents, here are some thoughts, tips and encouragements (some light-hearted, some not so much). A general principal that runs through these suggestions is that neither adolescence nor ADHD are to be “fixed” or cured, but more to be experienced, processed and managed with understanding, support…and a healthy sense of humor.

General Survival Tips for Parenting ADHD Adolescent

  • Buy more liability insurance
  • Invest in the stock of your teen’s ADHD medication
  • Recommit to a life of prayer and regular church attendance
  • Have brochures of military schools on coffee table
  • Build your airline miles for parent trips only
  • Get over ethical concerns about bribing teachers

What To Expect from an ADHD Adolescent

  • Hormones and ADHD create confusing mix
  • Hyperactivity will likely diminish; inattention and impulsivity…not so much
  • Likely twists and turns on medications
  • Even more academic inconsistency
  • Higher risk for acting out behaviors including alcohol, drugs, sex
  • Lots of “knucklehead”moments
  • Entertainment, creativity, surprises
  • ADHD “spillovers” (emotional, social)

What To Try

  • Let go of control/power
  • Focus on influence that comes from relationship
  • Insist on physical activity
  • Pick fewer battles but hold forth on the few
  • Seriously reduce lecture, nagging, debating
  • Set clear expectations, limits and predictable consequences
  • Lose the emotional drama (yours, not theirs!)
  • Shorten list of things worth the battle
  • Work on your marriage
  • Don’t lose your own life/identity
  • Break negative cycle of behavior/response
  • Be open to creative options (with school, sports, activities)
  • Be intentional about finding “good news”
  • Help them find their gifts and talents

What To Remember

  • This is a season of life, not the rest of life
  • Adolescence for our kids recycles our teenage years
  • Goal is for them to leave home
  • Often parent/teen conflict is a good thing
  • Bridge to adulthood requires many travelers
  • Most likely, all will survive

If you’re parenting an ADHD adolescent, and you’d like to explore the ways you can better prepare for the associated challenges, contact Brentwood Counseling Associates and connect with one of our experienced therapists.

Resources

ADHD in Adolescence, Robin and Barkley

Driven to Distraction & Delivered from Distraction, Hallowell, Ratey

Surviving Your Adolescent, Phelan;

Smart but Scattered Teens, Guare et al

Taking Charge of ADHD, Barkley

depression counseling

Managing Holiday Depression

“’Tis the season…” You probably know the rest. It seems there’s a general expectation that this last month of the year will be merry and bright. But those who struggle with depression know that it doesn’t go away just because it’s “the most wonderful time of the year.” In fact, all those good tidings of joy might actually worsen existing symptoms. After all, depression is a hard enough battle without society sending the message that there’s something wrong with you if you don’t feel the holiday joy. If you’re finding it even more difficult than usual to manage your depressive symptoms this holiday season, read on for some tips on self-care as well as advice on when to seek depression counseling.

Set realistic expectations

When depression sets in, it can take more energy than normal to do the things you need to do to get through the day. Daily activities like going to work, taking care of your kids, grocery shopping, and cleaning the house suddenly become exhausting chores. And sometimes some of them don’t even get done. That can make the added tasks of the holidays seem particularly daunting. It’s crucial, then, for those who are managing depression during this season to prioritize. Don’t expect yourself to do it all this year. Talk with your family about realistic expectations around all the holiday extras such as card-writing, decorating, gift-preparation, baking, and attending parties and other holiday events. Decide which are most meaningful to you and your family, and figure out where you can trim or even delegate some of the responsibility. The extra time you’ll have and the reduced stress you’ll feel will go a long way toward keeping depressive symptoms from worsening during this hectic season.

Tune out some of the holiday “noise”

It’s inescapable this time of the year: the holiday music playing in all the stores, the movies showing on all the cable channels, and the endless ads on TV, the radio, and in print. It’s hard to ignore, and bright and merry as it is, it reinforces the belief that it’s a happy time of the year for everyone. But if you’re struggling with depression, it simply may not feel that way. Because depression can lead to increased feelings of guilt, anyway, why should you also feel guilty that you’re not as happy as you should be this season? You have control over how many of these holiday messages you take in, so why not consider limiting them? Be a critical consumer of all the seasonal “noise” that’s thrown your way this season. If the holiday music or movies lift your mood, immerse yourself in them. If, on the other hand, the store ads leave you feeling guilty about lacking the energy to do all the shopping this year, watch commercial-free movies instead. If you’re struggling with depression, you know that your baseline mood on most days is lower than normal. Give it a little extra TLC this season by structuring your holiday media intake with that in mind.

Seek depression counseling

So far, we’ve identified a couple of self-care techniques to manage depression this holiday season. They both involve setting limits in order to lift your mood and allow more time for the self-care that is so vital to staving off depressive symptoms. And if you’ve grappled with depression for any length of time, you probably already have other self-care habits in place that help. But if you find that it’s particularly difficult to continue managing it on your own, think about depression counseling as an additional option. Find a professional you feel comfortable with, whether it’s a psychologist, counselor, social worker, or clergy member, and let them share in your efforts to combat depression. Proper depression counseling can supplement the hard work you do every day to keep those depressive symptoms in check. And counselors’ understanding can help you normalize the challenges of finding the holiday joy when depression rears its head.

holiday anxiety counseling brentwood tn

Holiday Anxiety

They’re baaaaaack! It’s hard to ignore the holidays when we’re constantly reminded of them by the music, ads, and store displays all around us. But this season of gratitude, togetherness, and joy can also be a hectic and stressful one. For some, that stress is felt as an increase in anxiety, ranging from stress headaches or muscle tension to problems sleeping at night. Read on to learn more about what drives that holiday anxiety, and some tips for managing it.

Unrealistic Expectations

For some, it starts with the holiday cards. Family photos must be taken while the trees are still green and the sun hot enough to make you sweat in your holiday best. But that’s only the beginning. There’s the Thanksgiving meal to plan, the travel arrangements to be made, and the holiday decorating to do. And don’t forget all the holiday parties and those can’t-miss family entertainment options that only come along once a year! There’s an awful lot to pack in to these few weeks, and there’s a lot of pressure to pull it all off without a hitch. If you’re stressed out by the demands of creating the perfect holiday:

  • Make it YOUR holiday. Find out what’s most important to you and your family by talking about favorite holiday memories. This will reveal your “must-do’s,” and help you prioritize the most important things. Pour your heart into those few things instead of spreading yourself too thinly over many.
  • Be a critical consumer of social media and advertising. Remember that those scenes of holiday perfection aren’t so often found in real life. But if you still feel like your holiday doesn’t measure up, consider limiting time spent on social media, or taking a break from it altogether.
  • Practice gratitude. If you are on social media, you’ve probably noticed a recent trend in the month of November where folks share one thing each day that they’re thankful for. The candid nature of these posts is quite refreshing: one day the writer might be thankful for veterans who risked their lives for our country, and the next for dinner delivery kits that make life easier on busy weeknights. Such an everyday expression of gratitude, whether for things great or small, can ground us to what’s really important in life.
  • Give back. Never are volunteer opportunities more plentiful than during the holidays. Whether it’s sponsoring a less-fortunate family during the season, volunteering at a homeless shelter, or spending time talking with the elderly at an assisted living facility, seeing beyond our “first-world” holiday expectations can keep things in perspective.

Stressful Family Situations

“My family is not normal.” I’ve heard this from clients countless times over the years. And family relationships marked by a history of maltreatment or even outright abuse should never be considered normal. But many families simply have longstanding strain that, having gone unaddressed for so long, creates tension when everyone’s together. Throw the stress of the season into the mix, and you’ve got a recipe for one awkward, uncomfortable holiday. Consider these tips when you’re just about ready to walk out on your family celebration:

  • Have a game plan for awkward family discussions. Unfinished business between family members has a way of rearing its head when everyone’s together. Or someone might bring up a hot topic such as the recent election, or politics in general. Regardless, it’s worth giving some forethought to how and what you want to say should these delicate issues come up.
  • It’s also not a bad idea to plan a few escapes from too much family interaction. Locate a quiet place you can retreat when conversation goes south. Or plan an activity to do together instead of just sitting around the house talking. Unresolved family issues will still be there to work on after the holidays.

Household Guests & Changes to Routine

No, you’re not just old and set in your ways. We all benefit from structure, and the holidays are prime routine-disruptors, particularly if you’re hosting houseguests or are one yourself. Whether it’s college students returning home for an extended break or out-of-town guests just staying a couple of nights, most people bring their own preferences and routines right along with their luggage. To avoid extra stress from attempting to accommodate everybody’s needs:

  • Don’t be afraid to discuss some general house rules and expectations up front. College students, for example, frequently have later curfews than they did when they still lived at home. On the other hand, small children staying with you may need quiet for bedtime a lot earlier than you’re used to. Upon arrival, talk with your guests about their needs, as well as yours, to avoid after-the-fact misunderstandings and hurt feelings.
  • To maintain some sense of normalcy within your bustling holiday inn, pick one or two pieces of your daily routine that you’re not willing to part with. Maybe it’s your daily workout, meditation, or devotional. Or maybe it’s your bedtime. What do you do normally that grounds you, relaxes you, or rejuvenates you? The holidays are no reason to give those things up, and in fact, may actually call for a little more of them.

These are just a few ways you can reduce some of the inherent stress at this time of the year. But if you find that your anxiety seems to be out-of-proportion, or if it lasts beyond the holidays or interferes with your functioning at home or on the job, reach out to a trusted professional for more support. We at Brentwood Counseling Associates are ready to help.

marriage counseling in Brentwood, TN

Marriage Counseling: More Than Just a Last Resort

Marriage counseling. What do those words bring to mind? Impending divorce? A last-ditch effort? Couples often do seek marital therapy when the relationship doesn’t seem like it can possibly continue. But marriage counseling can also serve to strengthen healthy relationships that have simply gotten off-track somewhere along the way. Every marriage is different, and many different relationship dynamics create tension or outright conflict between spouses. But couples fall into lots of common traps that, with some understanding, don’t necessarily have to mean the end of the road for the marriage.

Different marriage templates

Think about the kind of relationship dynamics you witnessed between your parents. Were they outwardly affectionate with each other? Did they argue in a healthy way? Did they nurture their marriage with date nights or getaways without the kids? The kinds of patterns you observed as a child all contributed to your understanding of what marriage looks like. Healthy or not, their relationship became your template for marriage. After all, how many others did you observe so closely for so many years?

When couples marry with very different examples of what a marriage is, they bring with them assumptions about what the role of “spouse” entails. And often, those assumptions don’t mesh. For example, let’s say one spouse came from a family where the parents spoke several times by phone during the day. And let’s say the other spouse had a parent who traveled for work and only called home once during those week-long trips. If expectations about frequency of communication are not discussed, misunderstandings and hurt feelings can result. This is just one way that different marriage templates can create conflict. But understanding them can open up a couple’s discussion and negotiation about what they want from each other and the marriage.

Differences in problem-solving styles

Problem-solving is another area in marriages where interpersonal differences often go unnoticed. Think about what you need the most when you have a problem. Some of us get a lot out of simply being heard and having our feelings validated. But others only feel better after they’ve arrived at a solution. Understandably, a spouse who just needs to “vent” about a problem may feel frustrated by their partner’s suggestions about how to “fix” it. But if each had known the other’s needs up front, that frustration could have been avoided.

But what about when the problem is between the spouses? Differences in conflict-resolution styles can make problem-solving even harder. For example, one spouse might discuss problems calmly and rationally, whereas the other might bring heated emotions into the mix. Or one might prefer to address only the current concern, with the other bringing up similar concerns from the past. Identifying a couple’s differences in problem-solving styles can keep conflict from escalating into something beyond the original issue.

Difficulty adjusting the marriage to the season of life

Another trap that healthy marriages often fall into is failing to keep up with life-cycle transitions. This is a very common concern, and is often what brings couples into therapy. Dating and marriage take place during one snapshot of a couple’s life. And when their individual or joint life circumstances change, they often forget to reassess how the marriage will also shift. These transitions are often related to children, careers, or finances. Change any of these things, and most likely there will need to be adjustments to the day-to-day workings of the marriage. We’ve all heard of empty-nesters who wake up one day and realize that they devoted so many years to raising a family that they scarcely know one another anymore. But think about other life-cycle transitions. Previously-childless couples who now have an infant must reevaluate how to maintain relationship-nurturing habits like date nights and sexual intimacy. Or a new job that requires lots of travel will probably mean a renegotiation of household and childcare duties. The constantly-changing nature of life demands marriages to keep up, and when this doesn’t happen, there can be bumps in the road.

The good news is that all of these concerns can be worked through with the help of a trusted professional. Sometimes it just takes an unbiased third party to facilitate discussion and negotiation, and to enhance communication skills. Contact us to find out more about how the therapists at Brentwood Counseling Associates can assist in getting your marriage back on track. A bump in the road doesn’t have to mean the end of it.

surface relationships

Finding Deep Connection in the Age of Surface Relationships

by Stephanie Inkso

It’s all so easy. Swipe, like, love, share. All with the touch of a finger. We make quick judgments of current and potential friends and intimate partners based on one post or photo. And when we’re on the other side, we have the luxury of presenting our best selves to the world. Sure, these virtual interactions ensure much less risk of being rejected. But that risk is a natural component of human relationships, and by removing it, we have also robbed ourselves of the richness that deep interpersonal connection can provide.

In my work with teens and young adults over the past few years, I’ve heard over and over about the longing for a true relationship, including all the ups and downs, the good times and the bad. Clients talk about “surface” friendships, in which accomplishments are shared, but not missteps. It’s as though the online presentation of the perfect self is playing out in real life. Intimate relationships are being kept “surface,” too, but in name only. These no-strings-attached relationships have all the components of a committed dating relationship, but without the actual label. This trend is leaving many young adults hurt and confused, and unfortunately, often less likely to want to go down that path again. But with so many young adults wishing for more meaningful connections with others, what’s keeping them from doing so?

Sure, it’s truly easier to interact with others virtually instead of in reality. But I would argue that it actually makes it harder and harder over time to start using those one-on-one, in-person skills again. Think about a depiction of two older gentlemen sitting in rocking chairs passing the time of day. What in the world do they have to talk about? And how do they stand to sit in silence, should there be a lull in the conversation? I wonder if we’ve lost the ability to be comfortable in the presence of others without the distraction of technology to occupy our minds? Are we using our phones as protection from the potentially difficult feelings that are an inevitable part of true interpersonal connection?

Further, we can gain so much from the nonverbal interactions that occur when we spend time being present with others. Shared smiles and laughs. Eye contact. Facial expressions and body language that indicate being in sync with each other, or that something is wrong. These experiences all have so much more depth and meaning when experienced in person rather than through emojis. Sure, being truly present with another person opens us up to potential criticism, and even rejection. We see more in each other than the best selves that we usually present online. But the practice of being real with each other increases our comfort with the vulnerability that leads to deeper connection.

If you’re tired of surface relationships, counseling is a good place to start. You can examine the fears that hold you back, and practice being vulnerable with a trusted professional in a supportive space. One of us here at BCA would be more than happy to join you in this process. Sometimes we even offer interpersonal process groups, in which you can practice that newfound vulnerability with others who are also looking to deepen connections. Give us a call if there’s any way we can help.

Anxiety and Depression in Teens

Anxiety and Depression in Teens and Young Adults: When is it Time to Talk to a Professional?

by Stephanie Insko

You may have heard about the alarming increase in anxiety and depression among college students. I have seen this concerning trend firsthand in the couple of decades since my first job in a university counseling center. Sure, I worked with a lot of students who were dealing with depression and anxiety back then. But the majority of the students seeking counseling were simply struggling to adjust to the newfound responsibilities, decisions, and relationship dynamics that came with college life. In other words, they were in the thick of the learning curve of becoming adults.

The challenges of adjusting to adulthood have not gone away in those nearly 20 years. But they are inherently more difficult for the average young person to navigate while also struggling with untreated anxiety and depression. Therefore, it’s more crucial than ever that young folks address any mental health concerns before they’re on their own, trying to perform in college or on the job. But how do you know when it’s time to seek the help of a mental health professional?

Clinical anxiety and depression can sneak up on us, and may go unnoticed until functioning is affected. In teens and young adults, this often shows up as a decline in school or work performance. There might be a lack of interest or motivation to improve, and problems concentrating might make it nearly impossible to do so. Social functioning might change, too, with increased isolation from friends. A loss of interest in previously-loved activities is another warning sign. Other signals that this is more than a “rough patch” include changes in appetite, sleep, and overall energy levels.

If you’ve noticed any of these signs, it might be time to consult a therapist. Anxiety and depression in teens are manageable concerns, and therapy is a collaborative effort to develop a plan to do so. Maybe you’re a parent noticing some signs that worry you as you send your child off to college. Or maybe you’re a young adult struggling to balance depression or anxiety with the demands of school or a job. Whatever the age or stage, a good relationship with a therapist can help you figure out how to manage it all.

Self-Acceptance

Self-Acceptance: The Cornerstone of Maturity

by Jim Kelly

The following is an excerpt on the significance of self-acceptance drawn from the book, How to Be the Adult in the Room, authored by one of our therapists, Jim Kelly. You can purchase this book through Amazon. This book is also available for purchase in our office.


In the privacy of my office, even highly successful people regularly admit deep insecurities, which rob them of peace and happiness. In fact, in many cases their achievements are driven by the desire to prove themselves. Yet, their achievements never satisfy the deeper need to feel whole for just being who they are.

When I work on the issue of self-acceptance with clients, I help them identify and validate aspects of who they are in the following areas:

  • Inherent personality traits
  • Natural abilities
  • True interests
  • True values and principles
  • Honest thoughts and feelings
  • Direction and purpose

Deborah was in her late twenties and struggled with chronic anxiety and anorexia—a very complex issue. In my experience, anorexia is usually symptomatic of a few predicable themes—perfectionism, achievement, and control, though what I typically find at the heart of the problem is an undeveloped sense of self. This young woman, who was a nurse, exhibited these patterns. Her compliant personality oriented her as a child to take her cues from other people and to try to please them. Her parents divorced when she was young, and she lost close contact with her father. She grew up longing to feel closer and more loved by her father, which undermined her self-worth.

Deborah’s personality also predisposed her to strive to be in control. As she grew up, these factors coalesced to work against her. Along the way, she became deeply insecure, and her maladaptive response was to try to be perfect to win outside approval and validation. She always made straight A-s in school and graduated at the top of her nursing class. Yet, she never felt good enough. She was an excellent nurse, but constantly compared herself to peers and would look for evidence to find herself lacking. On the outside, she appeared to have it all together. On the inside, she was a train wreck. This is where anorexia came in. Like many women in our culture who feel insecure with themselves and out of control internally, she focused on controlling and perfecting her body to gain a sense of self-worth and control. The psychological reward gained by achieving this essentially unhealthy thinness is, of course, fleeting, illusory, and never satisfying.

The only real solution was for Deborah to decide that who she was had little to do with her body, her achievements, and the approval of others. While she was gaining an awareness of the elements of who she was, she had to learn how to accept, listen to, validate, be guided by , and trust her true self—not a simple process. She had to completely re-orient herself from taking cues from others to finding and trusting her own center. As she developed a more authentic sense of her own identity and learned to trust and accept herself, she began to feel more secure internally. This internal sense of control allowed her to start shedding, little by little, the need to be perfect. She began to accept her own flawed, limited, imperfect human nature, including her body. Her anxiety began to resolve as she was able to validate her own competency, stop comparing herself to the other nurses, and enjoy her work. Deborah must continue to practice this higher consciousness, but she’s clearly on the path.

parenting adhd kids

Parenting ADHD Kids and Teens

by David Elkins

To Understand

ADHD is not just an immature, overly active child; a passive, defiant middle schooler; or an unmotivated, lazy teenager.  ADHD is a neurobiological condition that presents with deficits in self-regulation (attention, focus, over-activity, or impulsivity) starting in early childhood and at times may create impairment in school, relationships, or daily activities.

ADHD is a continuum disorder, not yes/no or black/white.  The Executive Functioning area of the brain (prefrontal cortex) is not fully developed until mid 20’s.  The “ADHD brain” often lags several years behind.

ADHD often co-exists with other behavioral, learning, and psychological concerns (e.g., learning disability, cognitive processing deficit, anxiety, depression, substance abuse, low self-esteem).

ADHD is a lifelong challenge with Age/Stage Implications.  ADHD kids and teens often

  • Take the scenic route
  • Display “quick twitch”
  • Act like “knuckleheads”
  • Act clueless and don’t make connections
  • Are high maintenance, high risk, and high reward

…and where do you think this comes from?  (Whose family tree gets “credit”?)

To Remember

  1. The system is the solution (develop a program-e.g., points for positive behavior)
  2. Surprise is not your friend (plan ahead and tell them about the plan)
  3. Kiss the third request goodbye (one or two is enough)
  4. Being right is highly over-rated (power struggles miss the point and will not work)
  5. Keep your mental illness to yourself (control your emotions and language)
  6. If it is not written, down, it doesn’t exist (lists, notes, charts, technology)

To Try

Behavioral/Psychological – Environmental/Life Style

While there is no magical parenting formula, parenting ADHD kids and teens needs to be more proactive, more intentional, and more thoughtful in their approaches.  These strategies apply to parenting all children; however, they are especially helpful with children who have issues of inattention, impulsivity, and over-activity.

  1. First, get their attention (eye contact, prompts)
  2. Structure, structure, and more structure (routines, consistency)
  3. Catch them being good #1 (to reinforce positive behaviors)
  4. Talk and fuss less, behave more (clear expectations, clear consequences)
  5. Run for your life! (or walk, swim, kick, jump, climb, move, exercise)
  6. Teach “executive functioning” skills (study strategies, organization)
  7. Catch them being good #2 (to build confidence, self-esteem)
  8. Find the best school fit, then advocate (504, IEP, Learning Services)
  9. Offer academic tutoring (to build basic skills)
  10. Seek counseling or coaching (for you and your child)
  11. Catch them being good #3 (to shape your behavior)
  12. Teach emotional self-control (don’t assume it)
  13. Don’t over-schedule (to provide down time, rest, and sleep)
  14. Catch them being good #4 (to help break the negative cycle of behavior, punishment, anger, avoidance, loss in self-esteem, depression, acting out)

And finally…

  1. CELEBRATE THE GOOD NEWS OF ADHD (intelligence, creativity, independence, out-of-the-box thinking, “quick twitch” athleticism, sense of humor, energy, enthusiasm)

Books

  • Taking Charge of ADHD, Taking Charge of Adult ADHD, 3rd Edition, Barkley
  • ADHD Workbook for Parents, Parker
  • Spark, Ratey
  • The Gift of ADHD, Honos-Webb
  • ADHD in Adolescence, Robin & Barkley
  • Smart But Scattered, Dawson & Guare, and Smart But Scattered Teens, Guare, Dawson & Guare
  • Give your ADD Teen a Chance, Weiss

Websites

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ADHD Testing

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