SIMILARITIES BETWEEN YOUNG CHILDREN AND DOGS

I have been seeing similarities between young children and dogs.  This started after I had a number of patients talk about the benefits of owning dogs and how their dogs help them to feel calm and peaceful.  Some of my patients have used their dogs as "comfort" animals [like a "service" dog] and they tell me that their dogs are able to detect if they [the owners] are experiencing stress. One patient believes that her dog can detect when she starts to dissociate as a way of coping with stress. There are also reports of dogs helping people to overcome their depressive and anxiety symptoms by being with them and not judging them and requiring help to be fed and walked, etc.  

A lot of these attributes also apply to children.  Children are loving and caring as well as being non-judgmental.  I have patients who report that their children are alert to their [the patient's] stress level and can help them to stop their stress reaction by calling attention to the onset of stress and their parent's withdrawal.  I have witnessed young children be very tuned in to their parent's stress and will distract their parent so that their parent will stop their stress response and attend to their child, who keeps them in the present moment.  

Maybe children know mindfulness and meditative practices intuitively?  What do you think? Dogs too?

PARENTING MADE EASY?

I have previously blogged about how the two year old child of a mother who sees me started to ask "where are we?" and this question seemed related to when his mother was starting to cope with a percieved threat by removing her awareness from the situation as if she were not there.  This coping mechanism is called "dissociation."  Her son was very sensitive to this happening and his question would then bring his mother back to the present and to being aware of her son and others who were there.  Young children seem especially good at being present and don't seem to get stuck in the past or future.  

Since children seem to be sensitive to whether or not their parents are with them in the present, it might mean that they can help us to be present with them and this will help us to be present more of the time in other parts of our lives. So, what is this "presence?"  Eckart Tolle suggests tha it is an alert, attentiveness to what is happening now.  He contrasts this with interactions when we are telling our children what to do or not to do.  I know that at times in the past, that dominated my interactions with my children. It is necessary some of the time but I also recognize now that I would often tell my children to do something that they were able to handle for themselves without my reminding them.  Being present with our children which supports them making decisions for themselves seems important as we strive as parents to help our children to gain self-confidence so that they will make decisions for themselves and take on the task of becoming independent, responsible people.  

So it seems that if we allow our children to help us to be present with them, they will be more likely to be happy, independent adults and we will become much better at being with people and enjoying them without having to feel responsible for them...eg having to tell them what to do.  Now, does any of this make any sense?  I am hoping that it does and I am reminded that every time someone who comes to see me has asked that question, the answer has always been yes, it does make sense.

BULLYING AND PHYSICAL COMPLAINTS

Children who are being bullied are more than twice as likely to have psychosomatic [physical complaints caused by stress] complaints compared to children who are not being bullied.  This was reported in a study in Pediatrics by G. Gini, Ph.D. and T. Pozzoli, Ph.D.  They did a meta-analysis of 30 studies involving more than 219,000 children who had psychosomatic symptoms.  Some of the children had been bullied.  The study determined that any repeated and/or unexplained somatic [physical] symptoms are a warning sign of the possibility that the child is being bullied. The somatic complaints can include: recurrent headaches. breathing problems, poor appetite, sleeping problems, etc.  

So, if your child has somatic complaints with no reason for them besides stress [psychosomatic] then it is very important to check for bullying as one of the causes of the stress. 

TF-CBT [TRAUMA FOCUSED COGNITIVE BEHAVIORAL THERAPY] FOR CHILDREN WHO HAVE BEEN AFFECTED BY SEXUAL ABUSE OR OTHER TRAUMATIC EXPERIENCES

It has become very clear how damaging chronic stress is for our bodies and our minds.  It is also becoming clearer how many children are traumatized by different types of events and suffer from chronic stress.  TF-CBT was developed to specifically treat symptoms of chronic stress [Post Traumatic Stress Disorder (PTSD)].  This has been adapted for use with children and recent studies have demonstrated it's effectiveness.  To review some of these studies you can go to: The California Evidence-Based Clearinghouse For Child Welfare (2011) at http-//www.cebc4cw.org; or SAMHSA Model Programs: National Registry of Evidence-Based Programs and Practices at http://ncrepp.samhsa.gov. There have also been studies showing benefit for children who have witnessed violence, see Cohen, Mannarin, & Lyengar, 2011 and also benefiting parents. Children who have experienced abuse often experience: feelings of guilt for what they see as their role in the abuse; anger toward their parents for not knowing about the abuse and for not protecting them; feelings of being powerless; feeling that they are "damaged goods"; and fears that they will be treated differently because of the abuse. They also may demonstrate negative behaviors, have other mental health problems such as depression and have PTSD symptoms that include: intrusive and traumatic thoughts of the abuse; avoidance of reminders of the abuse; emotional numbing; irritability; trouble with sleep and concentration; and physical and emotional hyperarousal with sudden and more extreme emotional reactions than is indicated for different situations. 

Benefits of TF-CBT for abused children include: reduced symptoms of PTSD and depression and also reduced behavioral problems while providing support and positive coping skills for non-offending parents.  TF-CBT components are described using the word PRACTICE.  P = psychoeducation and parenting skills. R = relaxation techniques. A= affective expression and regulation.  C= cognitive coping and processing.  T= trauma narrative and processing.  I= in vivo exposure.  C= conjoint parent and child sessions.  E= enhancing personal safety and future growth.   The therapy involves individual and parent and child sessions.  In our hospital based treatment program at the Copestone Child and Adolescent Inpatient Programs at Mission Hospital, we have found that a group therapy focus can more rapidly help children and adolescents to feel less stressed about their problems and to learn positive coping skills as they support each other in talking about their problems and learning better coping skills. 

Hopefully, more children who have been abused will be identified and referred to therapists who have been trained in TF-CBT.  It is important to note that some children or adolescents who have been running away, cutting themselves or are actively suicidal should be stabilized first using DBT [dialectical behavioral therapy] before TF-CBT is used.  For more information on TF-CBT you can go to the Child Welfare Information Gateway at http://www.childwelfare.gov/pubs/trauma.

BEING BULLIED IN CHILDHOOD AND SELF-HARM BEHAVIOR AS AN ADOLESCENT

Earlier, I wrote about the impact of being bullied and being a bully, ten years later.  One study showed that children who were bullied were at significantly inreased risk for anxiety and depressive disorders while males were also more likely to be suicidal and girls to have agoraphobia [fear of public spaces and crowds]. The bullies had an increased risk of antisocial personality disorder.  I felt that the bullied children were also at increased risk for post traumatic stress disorder.

Another study by S.T. Lereya, Ph.D., et al, in the June, 2013 issue of the Journal of the Academy of Child and Adolescent Psychiatry reported on the impact of being bullied in childhood on adolescent self-harm [cutting and suicidal] behavior. They controlled for a number of other variables that also can lead to self-harm behavior and found that about 20% of the total self-harm behavior was caused by the bullying.  This is a very large effect from the bullying. 

It is a critical problem, especially as children [and adolescents] very often suffer in silence and do not tell their parents or teachers.  They also tend to  hold their feelings in so it is not easy to detect depressive symptoms.  Frequently they will complain of a number of different nonspecific symptoms that include headaches, stomach aches, backaches, dizziness, sleep problems and they may resist going to school and be withdrawn. When they do tell an adult they often feel that it doesn't help as they expect the adult to get the bullies to stop.  It would seem that a focus on helping the victims of bullies to cope with this stress so that they are no longer feeling overwelmed and can ignore the bullies more successfully.  Another focus, of course, would be to stop bullying from occuring in the first place.  Zero tolerance for violence or the threat of violence, so why not zeo tolerance for bullying?  I wonder if educating children and adolescents on the impact of bullying and the different forms it takes and then how to resist being part of bullying, wouldn't help reduce bullying significantly.  I am interested in your thoughts about how to prevent or at least reduce significantly, the bullying of our children and adolescents. 

Of course, it happens with adults, too.