Mental health support made simple

Following the second edition release of Introducing Mental Health, authors Connor and Caroline Kinsella provide insight into taking a more global and simplified approach to mental health support in the fully revised and updated second edition.

Kinsella-IntroducingMentalHealth-C2W

We wrote the original Introducing Mental Health: A Practical Guide to make the very complicated seem a little bit simpler and to help front-line workers do what often seems like the impossible. It’s not an easy role at the best of times, but much has happened in the nine years between editions to make the job of mental health care even more difficult than it was in 2006.

As thoroughly well behaved and professional writers (ahem) we chose not to fill the book with a long list of all that is wrong with UK mental health services. After all, most of our British readers need no reminders of the savage cuts, dwindling resources and disappearing in-patient beds that are now a feature of UK mental health.

But while it’s all very well to moan incessantly about our own back yard, we looked to the developing world for inspiration to update the simple, straightforward approach to mental health care embodied in the first edition. We’re lucky enough to have as a close friend one Vikram Patel, the Foreword writer of both editions, who is also the director of the Centre for Global Mental health, London. Vikram has spearheaded the global mental health movement which has helped make mental health a priority issue in those parts of the planet where malnutrition, malaria and HIV have traditionally demanded resources that truly put our own budget cuts and resource slashing into perspective. He is now on Time Magazine’s ‘World’s 100 Most Influential People’ list and we met up with him just as he had been interviewed for BBC Radio Four’s excellent The Life Scientific series.

It was a little strange sitting in a London pub with an old friend who is now the psychiatric equivalent of Kim Kardashian, albeit with a rather more worthwhile contribution to the world. While western psychiatry remains bound by an ever increasing list of obscure diagnoses, pharmacological treatments and reliance on highly trained professionals, the global mental health approach is a means of delivering care and support to communities without the need for complex resources, vast infrastructures or highly qualified personnel. Under this guise, mental health support is largely delivered by local people who, to put it quite simply, work with people not symptoms. In a word, it’s a very, very simple model of mental health care. And it works.

Psychiatry is, after all, a relatively straightforward science. It doesn’t take a master’s degree to recognise  when someone is severely depressed or saying bizarre things or taking an hour to leave their house because all the windows and doors need checking several dozen times. But supporting people through mental ill health can be anything but straightforward, and with qualified professionals and NHS facilities becoming ever more scarce, we now rely on police and prison officers, accident and emergency staff, housing support workers and (increasingly) friends and relatives to deal with our most needy and distressed people.

And while the poorest parts of the world begin to develop simple low-tech support systems that make optimal use of professional expertise combined with common-sense and the local knowledge of communities, the global mental health approach starts to look a lot like the sort of system that in many ways we in the UK are adopting by default.

We’ve written Introducing Mental Health twice, in both editions reflecting the many different scenarios and types of worker with whom we have worked in both clinical practice and training. We haven’t ignored the huge advances in the science of genetic and biological origins of mental illness, and have tried to make the science accessible to all. After all, there aren’t many people who would guess how much their Chinese takeaway has in common with the latest explanation of psychotic illness*. But above all we’ve strived to learn from Professor Patel and global mental health how this is above all a social issue, and how all of us have a part to play in helping our community’s most distressed and vulnerable people. It’s really surprisingly simple.

* Sorry. You’ll have to read the book to find the answer.

 

Caroline Kinsella has been a registered nurse since 1980 and has specialised in working with offenders and individuals with severe mental health problems. She has a Master’s degree in Forensic Mental Health from St Georges Hospital Medical School and is currently working with the Dorset Inreach Team as a mental health nurse assessing and care co-ordinating the needs of offenders in several Dorset prisons. Both Connor and Caroline live in Dorset, UK.
Connor Kinsella trained as a mental health nurse and has considerable experience of working with mentally ill people in both in-patient and community environments. Since 1998 he has designed and facilitated training for a wide range of services in health and social care. He writes a well-regarded blog called The Stuff of Social Care and has contributed to The Guardian’s Social Care Network.

To learn more about Introducing Mental Health click here.

 

Self-Help for Adults on the Autism Spectrum

In another blog post for Mental Health Awareness Week award winning JKP author Dr. Lee A. Wilkinson discusses some of the challenges facing adults on the autism spectrum—

The dramatic increase in the prevalence of autism spectrum conditions among children and adolescents and the correspondingly large number of youth transitioning into adulthood has created an urgent need to address the problems faced by many adults on the autism spectrum. Nearly a half million youth with autism will enter adulthood over the next decade and most will continue to require some level of support. In addition, there is a large and diverse group of adults whose autistic traits were not identified in childhood and have not received the appropriate interventions and services. Although autism symptoms may improve with age, co-occurring mental health issues may worsen in adolescence or adulthood. As a result, there are a significant number of adults on the spectrum who are now seeking help to deal with feelings of social isolation, interpersonal difficulties, anxiety, depressed mood, and coping problems. Unfortunately, mental health problems such as anxiety and depression and even the diagnosis of an autism spectrum condition itself often go unrecognized. Although the rate of co-occurring mental health issues for adults on the spectrum is high, accessing services to address these symptoms is frequently difficult and the extent of the problem will only increase as more and more youth transition to adulthood.

Evidence is beginning to emerge for interventions addressing the mental health needs of this growing and underserved group of adults, including cognitive-behavioral therapy (CBT). CBT has direct applicability to adults on the autism spectrum who often have difficulty understanding, managing, and expressing emotions. It has been shown to be effective in changing the way a person thinks about and responds to feelings such as anxiety and depression. With CBT, the individual learns skills to modify thoughts and beliefs through a variety of strategies which improve interaction with others in helpful and appropriate ways, thereby promoting self-regulation and mental health. It is a goal oriented approach and primarily emphasizes here-and-now problems, regardless of one’s past history, traits, or diagnosis. CBT also provides a more structured approach than other types of psychotherapy, relies less on insight and judgment than other models, and focuses on practical problem-solving. Moreover, because individuals learn self-help in treatment they are often able to maintain their improvement after therapy has been completed. Evidence-based CBT holds considerable promise as an effective intervention for improving the quality of life and psychological well-being of adults on the autism spectrum.

Despite the availability of effective psychological treatments for anxiety and depression, a substantial number of adults on the autism spectrum do not seek professional help. Common obstacles to mental health care access include limited availability and affordability of services, confidentiality issues, lack of insurance coverage, frequent delays and long waiting periods, and social stigma. Likewise, many service providers do not have the experience or expertise to work with individuals on the autism spectrum, particularly those with co-occurring mental health issues. Self-help interventions represent an increasingly popular alternative to therapist-delivered psychological therapies, offering the potential of increased access to cost-effective treatment for a range of different mental health issues. They provide an opportunity for the individual to gain some useful insights and begin to work through their problems with limited guidance from a therapist or mental health professional. Research has clearly shown that self-help strategies are effective, practical, and acceptable for many individuals in reducing mental health problems such as mild to moderate anxiety and depression, often alone or with other forms of treatment. Self-help interventions have the potential to play an important role in providing effective treatment to the large proportion of adults on the spectrum who are experiencing mental health issues.

While there is no shortage of books describing the controversies and challenges related to the diagnosis and treatment of autism spectrum conditions, there is a need for a practical resource for adults on the spectrum that promotes self-understanding and directly teaches effective ways of coping with their emotional challenges. Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT presents strategies derived from cognitive-behavioral therapy (CBT), adapted specifically for adults with autism, to help them overcome anxiety and depression, and improve their psychological well-being. The author takes the best of CBT therapeutic techniques to facilitate greater self-understanding, self-advocacy, and better decision-making in life-span activities such as employment and interpersonal relationships. This self-help guide provides evidence-based tools that can be used to learn new ways of thinking, feeling, and doing. It includes questionnaires, forms/worksheets, and exercises to help the reader:

  • Evaluate his or her autistic traits and discover their cognitive style.
  • Identify and modify the thoughts and beliefs that underlie and maintain the cycles of anxiety, depression, and anger.
  • Apply therapeutic techniques such as mindfulness, positive self-talk, guided imagery, and problem solving.
  • Accept the past and achieve unconditional self-acceptance.
  • Deal effectively with perfectionism and low frustration tolerance.
  • Avoid procrastination and learn to maintain positive changes to their progress

Used alone or in combination with therapy, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT is an essential self-help book for adults across the spectrum looking for ways to understand and cope with their emotional challenges and improve their psychological well-being.

 

About the Author

Lee A. Wilkinson, PhD, NCSP, CPsychol, AFBPsS is a licensed and nationally certified school psychologist, chartered psychologist, registered psychologist, and certified cognitive-behavioral therapist. He has published widely on the topic of autism spectrum disorders both in the US and internationally. Dr. Wilkinson is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools, also published by Jessica Kingsley Publishers and editor of a recent volume in the American Psychological Association (APA) School Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools.

Talking to children about schizophrenia

In a special blog post for Mental Health Awareness Week, we’ve asked Alice Hoyle, author of Pretend Friends, to share her thoughts on therapeutic storybooks for children. 

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I always wanted to be a writer or a teacher. Since teaching was more likely to pay my bills I went down the route of educating the masses, whilst still scribbling down the odd poem or story when the mood took me (mainly when suffering avoidance stress from a major deadline!).  I wrote my first published story Pretend Friends whilst doing some Masters research into inclusive storybooks.  It was then that I realised there were very few story books to support discussions about serious mental illness with young children. There were a few books about depression but nothing to help explain about symptoms of psychosis such as hearing voices.  So I decided to write my own story (partly in a spectacular effort of procrastination from said Masters!).

The idea for using the concept of ‘pretend friends’ as an analogy for schizophrenia came to me when spending time with my children and someone close to our family who has experienced psychosis.  My eldest was talking about her imaginary friend Hector and the adventures they were going to go on. It struck me we are not concerned when children have imaginary friends but when adults hear voices it is a different matter. Pretend friends is an analogy children can relate to which simplifies some of the complexities of experiencing psychosis or living with schizophrenia to a level children can understand.

The key messages outlined in the book  are gentle, non-scary, age-appropriate explanations about what it might be like to live with hearing voices or experiencing things that other people don’t experience.  The story explores the adventures of Little Bea and her imaginary friend Nye-Nye, and compares them with the experiences of Big Jay and his pretend friends (the voices he hears).  The story asks for people to be kind to people like Big Jay and to “love them just as they are”.

Another important message to include was to make sure that the main character, Little Bea, was absolved of any big responsibility to make Big Jay better, and that ways of supporting Big Jay in his recovery were explained.  I didn’t want a child to feel worried or upset or that they needed to take on caring responsibilities if they found out someone close to their family was hearing voices. That should be a grown-up’s job!

I am so pleased that this book has been published as I think it is vitally important to start talking about mental health from a young age. This way children can learn to look after their own mental health, and to support their peers if they are experiencing issues of their own.  I decided to donate all my royalties to the charity Rethink Mental Illness as writing this book wasn’t about making money, but about supporting families like my own with a tool that can help them have conversations about serious mental illness.  After all, as a parent, I want my children to grow up to be kind and accept people for who they are, and not to worry or be scared of people who are different from them. As a health educator I want the same for all children.  I truly believe that supporting children to understand mental illness, will help our society to become more inclusive, supportive and kind.

Alice Hoyle works as an Associate Advisory Teacher of Personal, Social, Health & Economic (PSHE) Education for the PSHE Association.  Alice lives in Bath with her husband, two daughters and a plethora of pretend friends including Elfie, Li-Li, Ariella and Micub. Alice would love to hear from you if the story of Pretend Friends helps your family in some way, you can find her on Twitter as @AliceHoylePSHE.

Call for Comic and Graphic novel submissions

Jessica Kingsley Publishers and Singing Dragon (an imprint of JKP) have recently started developing an exciting new line of comics and graphics novels and we are now open for submissions.

At JKP we are committed to publishing books that make a difference. Our range of subjects includes autism, dementia, social work, art therapies, mental health, counselling, palliative care and practical theology. Have a look on www.jkp.com for our full range of titles.

Singing Dragon publishes authoritative books on all aspects of Chinese medicine, yoga therapy, aromatherapy, massage, Qigong and complementary and alternative health more generally, as well as Oriental martial arts. Find out more on www.singingdragon.com

If you have an idea that you think would work well as a graphic book, or are an artist interested in working with us, here is what we are looking for:

Graphic novel or comic – Long form

We are looking for book proposals that are between 100 and 200 pages, black and white or colour, and explore the topics listed above or another subject that would fit into the JKP/Singing Dragon list. Specifically we are hoping to develop more personal autobiographical stories.

Here are the guidelines for submission:

  1. A one-page written synopsis detailing the plot/outline of the book, as well as short bios of all the creators involved.
  2. Character sketches of the main characters with descriptions.
  3. Solo artist/writers or writer and artist teams should submit 5 to 10 completed pages to allow us to get a sense of the pace, art style and writing.
  4. Solo writers will need to submit 10 to 20 pages of script as well as the one-page synopsis from point 1.

Comic – Short form

We have some shorter comic projects underway and are looking to expand the range of topics covered. These books can run from 20 to 40 pages, black and white or colour, with dimensions of 170x230mm. We are mainly looking for comics that provide ideas and information for both professionals and general readers.

For example, the first in this series, published by Singing Dragon, is a book exploring the latest developments in chronic pain research.

Here are the guidelines for submission:

  1. A one-page written synopsis detailing the narrative style and subject matter to be explored in the book. Also include short bios of all the creators involved.
  2. Solo artist/writers or writer and artist teams should submit 3 to 5 completed pages to allow us to get a sense of the pace, art style and writing.
  3. Solo writers will need to submit 5 to 10 pages of script as well as the one-page synopsis from point 1.

When submitting please provide low-res images and send them, along with everything else, to Mike Medaglia at mike.medaglia@jkp.com

If you have any other ideas that don’t directly relate to the subjects described above but you feel might still fit into the JKP or Singing Dragon list, please feel free to get in touch with ideas and enquiries on the email above.

On the value of writing with traumatised young people – with Marion Baraitser

Baraitser_Reading-and-Exp_978-1-84905-384-6_colourjpg-printMarion Baraitser demonstrates the power of writing with traumatised children and young people. Marion’s book ‘Reading and Expressive Writing with Traumatised Children, Young Refugees and Asylum Seekers: Unpack My Heart With Words’ is available now from the JKP website.

On the value of writing with traumatised young people:
When disturbed young people have read aloud together a strong text, talked about it with a practiced facilitator in a roomful of trusted community members, discussing characters and subjects that concern their own lives, and then written about it, it can transform their idea of themselves and of their future lives. They are better able to externalize self-hood so they can exist in the world, feeling that their internal being has connected to the outside world through books, in some profound way, a form of ‘being-in-development’, a process of growing and changing the many selves they can uncover by this process. The facilitator brings energy, optimism, warmth and responsiveness, even inspiration, or at least motivation or affirmation, to each session.
Here is Amina on the value of writing in helping her to heal:
Writing is helping me to put down memories, different perspectives, to try to find the line… Talking doesn’t do this. When I write I am having a relationship with my journal. Writing is like having a conversation with yourself. I tend to be more honest… pick up on things that lie deeper. I love myself, in writing… I am lucky to be here… I am lucky to be alive… You must keep going and finding yourself, at the same time staying true to yourself… even though you cannot forget where you started from.

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How reading great books together can change lives:
The Nigerian writer Ben Okri, who holds childhood memories of civil war in Nigeria, of his schooling in Lagos 400 miles from his family and of how, on reaching England, he lived rough, by his wits, homeless and miserable. He went to London because of Dickens and Shakespeare, but he also loved African writers like Chinua Achebe and Wole Soyinka. ‘Literature doesn’t have a country. Shakespeare is an African writer… Dickens’ characters are Nigerians.’ (Okri, 1992) As the young people read aloud in the company of a facilitator and a like-minded group, they become the writer, they are taken out of themselves, and if the writer is worth his salt, that encompasses a whole new set of dimensions that can change the way they regard life and their place in it.

Marion’s book ‘Reading and Expressive Writing with Traumatised Children, Young Refugees and Asylum Seekers: Unpack My Heart With Words’ is available now from the JKP website.

 

 

 

Why Neuroscience for Counsellors?

Rachal Zara Wilson is a counsellor, social worker and author of the new Neuroscience for CounsellorsWe caught up with her for a quick chat about the book and why she wanted to write about such a complex topic. 

1.  Who do you think would benefit from reading this book?

Definitely counsellors, but also any other therapists as well.  The book is designed so that it has sections where the neuroscience is explained, and separate sections for counsellors and other therapists with suggestions on how to use this knowledge for the benefit of their clients in the session room.

Families of people who are experiencing mental health dysfunction may also be interested in the knowledge contained in this book, and also in the implications for how they can support their loved ones.

2.  Why did you write this book? Wilson_Neuroscience-fo_978-1-84905-488-1_colourjpg-print

I’ve always been interested in neuroscience; the brain is so fascinating and amazing, and capable of so much more than we’ve always been led to believe.  And of course, as a counsellor working with people, how the brain works has always been top of my mind.  The final motivator was having a child who was experiencing problems with their mental health, and I guess I just hoped to find something that would help him and others in a similar situation during the course of my research.

3.  So what’s so exciting about what you learned?

Probably the most exciting thing would be the brain’s capacity to change itself, known as brain plasticity.  The brain isn’t static, it’s more like a dynamic organ that is constantly changing for better or worse.  And what we do plays a huge part in how it changes.  How much stress we’re under, what we eat, the quality of our sleep, whether we exercise and how much, our living environments, and the presence or absence of early trauma in our lives are some of the things that contribute to the way our brain functions, and to its capacity for change, or plasticity.  I guess the most exciting thing is that we have control over this plasticity to a large degree, and we can therefore improve the quality of our brain function, our health and our lives.

4. Why don’t we know this stuff already?

Because neuroscience is a field in its infancy.  There’s a lot of learning coming through, but much of it’s wrapped up in scientific jargon, making it inaccessible to those of us who are not scientists.  And because there’s lots of different levels of looking at the brain, (both micro and macro,) different neuroscience specialties do not always integrate their specialist knowledge.  I think the benefit of this book is that it integrates the neuroscience into an overall big picture, while also drawing on this resource to come up with practical ways for integrating it into therapy.  It hasn’t been done before because it’s new, because it’s complex, and because integrating neuroscience with counselling and other therapies requires a knowledge of both fields.  I believe that in the future, all practitioners providing talking therapies are going to need to understand what neuroscience offers our professions, or risk becoming irrelevant.

5.  Why put it in a book?

This knowledge is meant to be shared.  All counsellors and therapeutic practitioners want best outcomes for their clients, and the more knowledge we have that can help people make positive change in their lives, the better.

6.  Is it complicated?

The neuroscience is complex, but the book is designed so that people who just want to know what it means for their practice can just read those sections, while those who want to understand how it all works can read up on the explanations for how all the scientific evidence fits together.  The book is written in the plainest English possible, and there is a glossary and diagrams at the back to help you fit it all together.

You can find out more about the book, read reviews and order your copy here.

Browse our latest collection of new and bestselling titles in counselling and psychotherapy

Here are our new and bestselling titles in counselling and psychotherapy. For more information on any of the books inside, simply click the title or cover image to view the full book page.

Starving our Anxiety Gremlins

Kate Collins-Donnelly; therapist, consultant, and author of Starving the Anxiety Gremlin, talks about the rise of anxiety in children. In this article, Kate discusses what can be done to help young people struggling with anxieties and shares a letter from one of the young people she has worked with on her experiences of overcoming problems caused by anxiety.

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Anxiety is one of the most common mental health disorders in the UK and worldwide. The UK ONS Child and Adolescent Mental Health Survey published in 2004[1] estimated that 290,000 children and young people nationally had an anxiety disorder, which equated to 2.2% of 5 to 10 year olds and 4.4% of 11-16 year olds. Leading anxiety charity, Anxiety UK, estimate that one in six 16-24 year olds have suffered from an anxiety disorder and five pupils in an average school class will have experienced anxiety[2]. And results form an NSPCC survey published in 2004[3] revealed that 34% of the young people studied felt that they were always worrying about something, with 11% feeling extremely worried.

We still don’t know the true prevalence rates amongst national and global populations as, like many other mental health disorders, anxiety disorders remain under-reported and under-diagnosed. However, what is clear is that anxiety is a common cause of distress for children and young people today.

Just like for adults, anxiety can come in different shapes and sizes for children and young people too – with some children and young people getting anxious about a variety of things and others only experiencing anxiety in response to very specific situations. Common worries for children and young people include school work, exams, friendships, family circumstances, health, death, bullying, body image, and much more. And children and young people can experience anything from normal occasional worries, fears and nerves to long-lasting and severe anxiety disorders that include generalised anxiety disorder, simple and complex phobias, panic disorder, separation anxiety, obsessive compulsive disorder and health anxiety.

Not only is anxiety common and varied, it also has the potential to be debilitating, especially when experienced on a frequent basis. This is partly because anxiety can bring such a wide range of cognitive, physical, emotional and behavioural symptoms with it, including concentration problems, obsessive thoughts, headaches, racing heartbeat, panic attacks, loss of confidence, avoidance of situations and procrastination to name a few. And it is important to remember that these symptoms can vary from young person to young person. It is also because anxiety can have impacts on all aspects of a young person’s life, including their studies, work, relationships, physical health, mental health and emotional wellbeing, future prospects, motivation and much more.

But thankfully, by learning a range of cognitive behavioural strategies and techniques, children and young people can learn to manage their anxiety and bring it under control. And that is why I wrote Starving the Anxiety Gremlin to highlight to children and young people that by learning how to think and act differently they could starve their Anxiety Gremlins for good! You see, if we all starve our Anxiety Gremlins of their favourite food – our anxiety – they’ll shrink and shrivel away!

And here is a letter from one young person that I worked with to show starving our Anxiety Gremlins really is possible! Well done Chloe! You are an inspiration!

Dear Reader,

When I was six I developed a worry.  At my birthday party I was quite badly sick and from then on I was terrified of vomiting. My worry caused panic attacks, which made me shake and cry; and gave me a runny tummy and nausea, which made me even more anxious. I thought that there was no escape from my worry. I wasn’t even sure what life would be like without it. I found it difficult to be left alone at school. I didn’t like to leave the house because I was scared of being sick or needing the toilet and not knowing where it was.  My worry was taking over my life. I didn’t know how to make it stop and my family didn’t know how to help me.

We went to see the doctor and then some people who are trained to help children with worries.   At first trying to get over my fear of sickness felt like an impossible task but slowly I found ways of fighting my worry. I learned to breathe slowly when I felt panicky and to turn my scary thoughts into sensible ones. Keeping a worry diary and telling my family and friends when I was having a particularly bad day helped too. Unfortunately none of this works over night, but if you follow the steps in Starving the Anxiety Gremlin you will learn to manage your worries. With help, I began to have less panic attacks and suddenly life didn’t feel like this huge burden. One day, it will feel like that for you too.

When I was little I didn’t know of anyone else who was going through similar things so I felt very alone. I thought I was weird. But I wasn’t weird and I definitely wasn’t alone. Lots of people have a worry; just like me, just like you. I know it may feel like there is no way out but one day things will seem a lot easier and life will seem fun again. Never forget that you are strong enough to cope with your worry and that you have the most fantastic brain to help you overcome it.

I am now 17. I still worry sometimes because everyone does but I don’t worry a lot about being sick anymore and I’ve stopped having panic attacks. If you are feeling worried and scared it is really important that you tell people how you are feeling so they can help you. I promise it gets better. Remember that you are not alone in how you feel, you aren’t weird and that most of all you are incredibly brave!

Love from your fellow worrier,

Chloe xxx 

You can give Kate’s CBT techniques a try for yourself by downloading free evaluation sheets from her workbooks Starving the Anxiety GremlinStarving the Stress Gremlin and Starving the Anger Gremlin. Download the free evaluation sheets here.
You might also want to try these free activities on building a positive body image, taken from Kate’s book Banish Your Body Image Thief, and encouraging healthy self esteem, taken from Banish Your Self-Esteem Thief.
Starving the Anxiety Gremlin has been shortlisted for the School Library Association Information Book Award 2014. Voting commences on June 18th 2014. If you’d like to find out more about the awards or request a pack for your school, visit the website here.


[1] Green, H., McGinnity, A., Meltzer, H., Ford, T. and Goodman, R. (2005) Mental Health of Children and Young People in Great Britain 2004. London: Office

[2] Anxiety UK, Children and Young People With Anxiety: A Guide for Parents and Carers, available at: www.anxietyuk.org.uk

[3] NSPCC (2004) Someone to Turn To? Who Can Children and Young People Trust

When They are Worried and Need to Talk? London: NSPCC.

Adopting a balanced view

Child and family psychologist and JKP author of the bestselling A Short Introduction to Attachment and Attachment Disorder, Colby Pearce, on maintaining a balanced view when caring for children who have experienced trauma in their early lives.
This article first appeared on The Adoption Social‘s guest blog. 

I was born in January, which is the height of summer here in Adelaide, Australia. As such, I have always thought of myself as a “summer baby” and considered that this is why I enjoy the warmer months as opposed to the cooler months. I have a lifelong aversion to feeling cold and for many, many years I felt below my best during winter. I have questioned many people about this and have discovered that most people prefer either the warmer months or the cooler months. Many of them are just not happy until their preferred season returns.

About three years ago, and with the emergence of joint aches and pains during the colder months, I had the thought that it was a bit of nonsense really to consider myself a “summer baby” and defer happiness until it was warm again. I have always been a keen gardener and have a large hills garden. Looking after my garden is an act of looking after my self. Water is an issue as it is scarce and expensive, my garden is large and summer is hot (As I write this it is the fifth consecutive day of over 40C). So, I bought some rainwater tanks and now I pray for as much ‘bad’ weather as possible during the cooler months. I check the weather radar each day and feel let down if forecast wet and wintry weather blows south or north. I still have my aches and pains and look forward to the warmer months when they trouble me less, but I also look forward to cooler, wetter months now as it is a boon for my efforts to maintain a magnificent garden. And the garden? Well, with the additional water supply it has never looked better.

Strong FoundationsWhat has all this got to do with looking after children; particularly those children who experienced significant adversity in the first days, weeks, months and years of their precious lives? Well, it has to do with how we perceive them and the effects of this; both in terms of our own experience of caring for them and their experience of being cared for by us.
I am particularly interested in the idea of “self-­fulfilling ­prophecies”. In Psychology, these take the following form. I have a thought. My thought induces an emotion. My emotion activates a behavioural response. My behavioural response precipitates a reaction in others. The reaction of others often confirms my original thought.

Let’s try one. Thought: “nobody loves me”. A common feeling associated with this thought: hostility. Common behavioural responses to feelings of hostility: withdrawal and/or aggression. A common reaction to withdrawal and aggression: admonishments. An inevitable result: confirmation of the original thought.
Lets try another. He is damaged by his early experiences. I feel badly for him. I try to heal him. He keeps pushing me away. He is obviously damaged.
And, another: He is such a good artist. I am so proud of him. I support and encourage his interest in art. His skills develop and he is often affirmed for his artistic achievements. He is such a good artist!

Children who have experienced significant adversity at the beginning of their life are commonly referred to as “traumatised”. There is much literature about how early trauma impacts the developing child, including their acquisition of skills and abilities, their emotions, their relationships with others and even their brain. This literature focuses on the damage early trauma does and there is a risk that we, their caregivers, see these children as damaged.

One of my favourite allegories is the one that the author Paulo Coelho tells in his book, The Zahir. Coelho tells the story of two fire­fighters who take a break from fire fighting. One has a clean face and the other has a dirty, sooty face. As they are resting beside a stream, one of the fire­fighters washes his face. The question is posed as to which of the fire­fighters washed his face. The answer is the one whose face was clean, because he looked at the other and thought he was dirty.

The idea of the looking-­glass ­self (Cooley, 1902), whereby a person’s self-­concept is tied to their experience of how others view them, has pervaded my life and my practice since I stumbled across the concept as a university student. Empirical studies have shown that the self-­concept of children, in particular, is shaped by their experience of how others view them. In my work, this has created a tension between acknowledging the ill ­effects of early trauma and encouraging a more helpful focus among those who interact with so ­called ‘traumatised children’ in a caregiving role.

I am just as fallible as the next person, and I do not have all the answers. But as a professional who interacts with these children and their caregivers on a daily basis I strive to find a balance between acknowledging and addressing the ill­effects of early trauma and promoting a more helpful perception of these children. I strive to present opportunities to these children for them to experience themselves as good, lovable and capable; to experience me and other adults in their lives as interested in them, as caring towards them and as delighting in their company; as well as experiences that the world is a safe place where their needs are satisfied. I strive to enhance their experience of living and relating, rather than dwelling on repairing the damage that was done to them.

Most of all, I see precious little humans whose potential is still yet to be discovered. eyes

Eyes are mirrors for a child’s soul. What do children see in your eyes?

References
Coelho, P (2005), The Zahir. London. Harper Collins Cooley, C.H. (1902). Human Nature and the Social Order. New York. NY: Scribner
Publishers

Prepared for The Adoption Social by Colby Pearce (Clinical Psychologist and Author), ©2014
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Assessing emotional awareness after trauma

Grasso_Clinical-Exerci_978-1-84905-949-7_colourjpg-webThis extract taken from Clinical Exercises for Treating Traumatic Stress in Children and Adolescents by Damion J. Grasso gives practical guidance to assessing and enhancing a child’s emotional awareness and vocabulary prior to therapeutic exposure.
‘These skills are essential for fully engaging in the therapeutic exposure and for processing the emotional content of the trauma memory.’

Read the extract here