I wanted to take some time to identify why clinicians are always talking about self esteem (maybe yours doesn’t), but I find it extremely helpful in determining a person’s experience with success which tells me about how they’ll respond to therapy and the speed in which progress is made.

There are lots of different tangents about self esteem as well. Types of self esteem, how to achieve higher self esteem, self esteem and it’s impact on relationships, and more! But for the purposes of this post, let’s just focus on what self esteem is, and the benefits of having a higher sense of self esteem in general.

First of all, self esteem and self confidence are often used interchangeably. However, self confidence is a measure of faith in your own abilities like in a sport, or making new friends. Self esteem is a measure of our own sense of self such as our worth and value in the varying situations. So, someone could have low self esteem and find themselves to be a burden, but have high self confidence in one or more abilities like art or athletics.

This can be confusing for parents of children, especially teenagers who appear to be thriving in school and in their extracurriculars, but express feeling sad, worthless, or burdensome. Remember that these things are separate and that innate self worth and value is internal. External validation can only help so much, and is often merely a starting point to address rational thoughts about the self.

But really, why is self esteem so important? In short, it affects how we think, speak, what we do in our lives (decisions), and how we respond in our relationships. It’s the backbone of our being and is a determinant for the level of motivation we have in taking care of ourselves and exploring our own potential. With healthy self esteem, we respect ourselves, and expect that same respect from others. That means that even if someone disagrees or we get something wrong, we don’t diminish our value in ourselves.

So you can see how much better our lives can be if we have healthy self esteem. Comparatively, if we have low self esteem, we experience ourselves and therefore the world in quite the opposite way. Often times, with lower self esteem, there is a lack of trust in personal values and opinions, which leads to a lot of doubt, self blame, shame, and criticism. If you feel this way about yourself, it is no wonder that life is not as enjoyable. An outside criticism feels more like a personal attack rather than a correction. Social cues can often be misinterpreted to support a negative belief about oneself. Lower self esteem leads to varying degrees and types of depression and anxiety.

As this relates to children and families, you can imagine if someone in the family does not value themselves as much. Or, like I previously mentioned, appears to have a surplus of confidence in a multitude of activities, but still feels as though they are not good enough. If a parent feels this way, certain behaviors may be modeled more frequently on handling typical life events like rejection and failure which can impact a growing child or teenager’s view on themselves.

Oh my goodness, so what do you do?!

Being aware of where your own self esteem is at is the first step to taking any kind of action to support or change it. Children and adults alike often describe general feelings, but there are always thoughts behind those feelings. Notice what those thoughts are first, and then you can decide if they are helpful for your self esteem or not. Learning how to cope with these feelings and thoughts rather than ignore them and allow them to circle your mind unconciously is a sure way to get your self esteem up to where it allows you to have more enjoyment in your life.

We’ll discuss more about self esteem, different types, and concrete steps and activities you can do for yourself and your child next week.

Before we dive into the types of attachment styles, it’s important to know what attachment is. At is basis it’s an emotional bond with another person. Taken from Psychology Today, attachment is the emotional bond between infant and caregiver and it is the means by which an infant gets their primary needs met.

Attachment theory is the idea that available primary caregivers that respond to an infant’s needs allow a child to develop a sense of security. If they don’t, a child will adapt and develop varying attachments to the caregivers and then later on as an adult to other adults they wish to have a relationship with (romantic and platonic).

There are two typical factors for determining types of attachment or attachment styles:

Understanding the four types of attachment styles can help you with your own child, but also in understanding some of your own concerns that arise within your own relationships.

1. Secure: This is the hope! Children who can depend on their caregivers show distress when they’re separated from their parents, and joy when they return. Children are upset about a caregiver leaving, but are assured they will return. They also feel comfortable seeking reassurance from caregivers whenever they feel frightened. As an adult, this person will trust in relationships and be able to tolerate difficulties and use coping skills to manage challenges.

2. Avoidant -Insecure: This is the style that occurs often when children grew up in environments where the caregiver was dismissive or consistently not present. (Remember, these things are not always intentional and there are numerous factors that play a role including the child’s own temperament. Dismissive does not automatically equal abuse or neglect.) Children will not rely on caregivers and will avoid them. They will show little to no preference for a caregiver or a stranger. They can appear very independent, but often their emotional needs go unmet. As adults, they will have a difficult time relying and getting close to others typically out of fear of being hurt. Because they have limited knowledge on how to get their own needs met, they also can come across as aloof or selfish because they cannot recognize when someone else may need support. Being vulnerable is extremely uncomfortable for this person and they will avoid becoming too emotionally close to another individual, seeming as though they always have their guard up.

3. Ambivalent – Insecure: This is a child who becomes very distressed if the parent leaves. This style usually results from a caregiver being unavailable or extremely inconsistent in meeting a child’s physical and emotional needs. These children are typically very anxious. As they get older, they may be overly attuned to their partner or people in their social circle and overanalyze small changes in a persons demeanor or expression. This person will also find it difficult to trust a partner and because of their own insecurities often push people away. At the same time, they will also use these insecurities to pull a person back.

4. Disorganized – Insecure: This is often brought on due to inconsistent and confusing expectations by a caregiver. Caregivers may be extremely kind, loving, and supportive, and at times terrifying, cruel, and neglectful. Behaviors are often confusing in this child as some things one day can be comforting, and other days the child may seem distant or aggressive. The range is extreme and varied. Adults with this type of attachment style have difficulty with most relationships in life. They have a lot of difficulty with coping skills and often rely on others to soothe them. They struggle to understand other’s point of view or why someone may need them. Their coping skills are lacking and they tend to rely on their partner or their close circle to help regulate emotions for them. Because of this, physical and psychological violence often occurs.

In most circumstances, nobody will fit into one category perfectly. There are certain characteristics that a person may hold from each. Improving your own strength in self awareness means that we can look at ourselves and identify if we are reacting to a person, or merely the situation. When we speak to children, and notice their styles of attachment, our reaction can be based on the level and type of insecurity they’re dealing with.

Relationships with others can heal us, but only when we can accept and respect the relationship we have with ourselves.

One of the biggest issues I come across as a clinician involves communication between adults and children. This often comes up because caregivers have expectations of their children, but they aren’t always expressed until the last minute. Meanwhile, children and teenagers develop their own expectations for a certain situation or reaction. When they come together, arguments ensue and overall stress and strain on the family occurs.

“Say what you mean, but don’t say it mean.” – Andrew Watcher

With school approaching, stress is high for everyone which diminishes our rational thinking. However, for many, there are new and more expectations for kids when they are home doing school work that may not have occurred before. Children have expectations of their parents about being able to help them. The behaviors and activities that were once allowable at home are shifting to include typical school behavioral expectations.

Regardless of the situation, there are a few simple things to keep in mind when trying to improve communication and setting expectations.

3 Tips to Setting Expectations

1. Make them about your child and not your own needs and want: Each child is unique and different. You may want your child to excel in math, but it is more difficult for them. Make your expectation something that is achievable and doesn’t diminish their sense of self. When it comes to behaviors, identify your own family values such as kindness and respect. Set your expectations so that they are aligned with those values.
2. Be clear and consistent: Prepare your child in the moment and out of it. When you are going to the store and expect your child to leave without having a tantrum for wanting a candy bar, let them know what you expect them to say when you answer. Practice with them. Repeat this every time you go out and when you’re home. The more often you practice, the more likely it is that your child will react in the way that is most appropriate and expected. Reinforce with little celebrations and verbal acknowledgement of how well they behaved. This also reinforces that they are successful and can meet the expectations that have been set which is important for self motivation and self esteem.
3. Forget the “all or nothing” attitude: There will be instances where the expectation was high and the child didn’t meet it. Reach for high expectations and standards, but when they aren’t met, acknowledge the difficulty and any small success that was obtained. Maybe they only asked a few times to get that candy bar, but eventually said okay. If you criticize your child or reinforce with a negative consequence, you run the risk of lower self esteem and perfectionist qualities from children. Reiterate that mistakes are okay, and that any small progress is worth recognizing and celebrating!

Anxiety manifests in a multitude of ways depending on the unique experiences of an individual.

We can expect for younger children (typically under 4) to feel nervous or more scared facing new experiences without their caretakers beside them. But, children with an insecure attachment often have more difficulty with their confidence in experiencing new situations. This can come from a number of negative experiences, but also from positive ones. For instance, due to COVID-19, many children have not been required to build upon their confidences in being separated from their caretakers. Children may have a tendency to be more dependent on their caregivers, simply because they have not been required to practice their independence. 

The following are the criteria for a child (or adult) to have Separation Anxiety Disorder based on the Diagnostics Statistics Manual V. 

Diagnostic Criteria for Separation and Anxiety Disorder

The criteria for diagnosis of separation and anxiety disorder include the following:

1. Developing inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:

• Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.
• Persistent and excessive worry about losing major attachment figures or about possible harm to them, such as illness, injury, disasters or death.
• Persistent and excessive worry about experiencing an untoward event (eg. Getting lost, being kidnapped, having an accident, becoming ill) that causes separation from a major attachment figure.
• Persistent reluctance or refusal to go out, be away from home, go to school, go to work, or elsewhere because of fear of separation.
• Persistent and excessive fear or reluctance about being alone or without major attachment figures at home or In other settings.
• Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
• Repeated nightmares involving the theme of separation.
• Repeated complaints of physical symptoms (eg.headaches, stomach aches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.

2. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.
3. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning.
4. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism spectrum disorder; delusions or hallucinations concerning separation in psychotic disorders; refusal to go outside without a trusted companion in agoraphobia; worries about ill health or other harm befalling significant others in generalized anxiety disorder; or concerns about having an illness in illness anxiety disorder.

Luckily, there are some very simple ways to treat separation anxiety and increase independence and confidence. 

Therapy is often the first stop, although not always necessary. A therapist will likely use CBT and exposure therapy to help your child learn to manage their feelings and distress by identifying the irrational thoughts and replacing with real true thoughts based on their experiences. Exposure therapy involves gradually increasing times of separation so that the child can tolerate more and more distance and time from the person they are attached to. 

5 Ways to help your child with their Separation Anxiety without the use of Therapy or Medication

1. Make and Practice a Goodbye Ritual: The practice part is the most important here. Without helping to rewire the brain when a person is calm, there is little likelihood that the person could access that coping skill when they are anxious. The ritual should be brief and can include things like a giant hug, a couple kisses, and a phrase (Love you lots, goodbye and see you later etc). Stick to it and practice at every opportunity presented. 
2. Intentional Practice: When you know there will be a less usual time to say goodbye, practice the entire event first. This could include going to the school, dropping off at a friends house, or even a grandparents’ or babysitters. If you’re able, drive to the location and practice your goodbye ritual. The more familiar with the events, the better!
3. Use a Transitional Object: This is something that is used to instill feelings of safety and comfort like a blanket, or a picture. Bring it out and make it a part of the goodbye ritual to initiate feelings of security and to feel loved and connected even though you are apart. 
4. Validate Feelings and Get Excited: When you notice that your child is anxious by means of being clingy, crying, or avoiding, validate that you know that is how they are feeling, rather than immediately jumping to words of encouragement. When your child is able to successfully say goodbye for any length of time (30 seconds or 10 minutes), make sure to give plenty of positive praise and reinforcement in the way of excitement and happiness. 

5. Model a Positive Goodbye: It can be very helpful to make the goodbye ritual universal for a time so that the child who is anxious can see that it is expected for all family members, or those that are in the home. Seeing how another person says goodbye can encourage a child to be successful and replicate the same thing. 

Be patient. The harder a child is pushed, the more difficult the process can be. It may take longer than ideal, but it is well worth it in the end for you and your child. 

Just as kids have their typical anxious worries, so do parents. If your child is going to school for the first time you wonder if they’ll be okay without you. Will the teacher be kind or strict? Will your child make friends? Will they be scared? 

And once they go to school, you’ll engage in whatever routine you have. Going to work, engaging in your own hobbies, taking care of the house, and attending to other things. 

But this year, it’s 100% different. In my last post, I spoke about some of the homeschooling/virtual learning/social distancing at school plans. Some kids are back full time, some are alternating or rotating days. Whatever the plan is, there are also new rules. You may have more than one child and have to figure out the schedules of multiple schools. You can’t necessarily plan for a scheduled two days to be home that change every week, so now child care is an issue. The result for parents:

STRESS!!!!!

So whatever your childs’ “back to school” plan is, here are a few tips to take care of YOU and support your child. 

5 Tips for Parents when your child “goes back” to school:

1. Take care of yourself: I’m sure you’ve heard things like you can’t pour from an empty cup. Your kids come first, but don’t forget to do some intentional care for yourself. There is probably a lot to balance, but it’s so important to do the tiniest things that make you feel relaxed and happy. Light a candle when you go to shower, buy yourself a new book, go to sleep, and take a break from your phone. Anything that can give you the slightest boost in your mood. Because when you feel better, you’re able to better support your kids.  
2. Be aware of your tone: Your words matter, but your tone matters more. When we are stressed and overtired, we tend to be shorter and clipped with our words. When others hear us, they hear annoyance and more often than not, they become defensive or cranky themselves and give it right back. Eliminate the bickering and fights by noticing your own tone of voice and how you feel. Takes a tad more effort on your part, but a few minutes resetting vs. 30 minutes arguing is a win in my book.
3. Write it down: With changing days, times, and schedules, you’ll need a way to keep it straight. Whatever method you choose, make sure you have access to it all the time. Staying organized will help you feel more in control of a very out of your control situation. This helps put things swirling in your head down on paper which is a relief for stress. 
4. Talk to someone: Remember that there are so many other parents going through the same if not very similar situation. In a time when we feel really alone, make sure to reach out, connect, and get validation that if you’re overwhelmed, sad, frustrated, and exhausted, you’re not the only one. If you really feel your mood taking a turn for the worst, please don’t hesitate to reach out for professional help. There’s no shame in asking for help. (Number on the main page)
5. Be gentle with yourself: It’s okay to cope in not the “healthiest” of ways. Having an extra glass of wine, not getting all the household chores done and being as “organized” as you can, eating your comfort foods, or zoning during a scroll through facebook. Don’t beat yourself for forgetting things, not being “on top of it” or crying it out in the shower. Just be mindful to take care of yourself in all the good ways too. 

Breathing is natural, right- Something that your body does automatically without you even
having to think about? Sometimes our own breath can work against us.

When you’re feeling anxious or stressed, you tend to take quicker, shallower breaths that come
more from your chest. This can create a physical response within your body- including dizziness,
increased muscle tension, and feeling as though you’re not getting enough air into your lungs.
Changing the way you are breathing allows you to ground yourself; to take control of your body
and your mind in a moment where you are feeling out of control and maybe even panicked.

Below you can find an extremely simple breathing exercise to utilize in these moments. The
technique can even be used as just as a way to check in with yourself throughout the day. This
exercise can be done sitting, standing, or laying down.

• Inhale slowly and deeply through your nose. Fill your abdomen up with air, feeling it expand. Keep your shoulders and hands relaxed. Think of only your breath.
• Exhale slowly through your mouth while pursing your lips. You should hear a “whoosh as you exhale. Feel your abdomen relax.
• Repeat. Do it as many times as it takes to feel yourself become more centered and calm. Your heart rate should come down. Your muscles should relax.

As you practice this exercise, you can learn to utilize it in different ways. The practice may
evolve into being used to expel negative thoughts or a way to cope with a bad day. When you
inhale, focus on that negative thought; that negative energy. As you exhale, feel it leave your
body. Force it out and into the air, free from your lungs, your body, and mind. This practice is
used oftentimes during mindfulness activities and even during yoga sessions.

Next we will explore a technique called alternate nostril breathing…

Welcome to the first installment of a series of posts that will be focused on coping skills. In this
first post, I’d like to focus on two things- what exactly are coping skills and why do we need
them?

Oftentimes, when we experience any sort of change in life it can lead to experiencing
psychological stress. Psychological stress refers to a person’s emotional, behavioral, and
biological response to a “perceived threat” in their environment. This type of response activates
what is called the Sympathetic Nervous System in our bodies. The SNS regulates blood pressure,
heart rate, and affects the immune system. High rates of stress lead to a compromised body,
physically. Mentally and emotionally, psychosocial stressors often prompt reactions of
depression, anxiety, impaired concentration and decision making capabilities, a feeling of
disconnect from the environment and those around you, and intrusive/negative thoughts.

Psychological stressors can in all shapes and forms. Events that are perceived to be both positive
and negative can prompt a stress response. Some examples include a break-up, getting a new job,
moving to a new city, experiencing the loss of a family member, and so on. As a response to
stress and the side effects that accompany it, the body and the mind will search for a way to cope
in an effort to battle the body’s reactions and try to maintain stable mental health and emotional
wellbeing.

Developing coping skills can help you tolerate, minimize, and deal with stressful or
uncomfortable situations in life. Of course, a person can develop both healthy and unhealthy
coping skills. For example, a negative coping skill would be utilizing excessive amounts of
alcohol in order to deal getting fired from a job. Within this series, we will be exploring a new
healthy coping skill each week.

Learning and honing an array of coping skills will allow you to not only be able to tackle any
major stressors that may be currently affecting your life at this moment, but will give you the
chance to better deal with events that occur in the future. Not every person finds the same
success in each coping skill, so remember to keep at it and find the strategies that work for you!

In the next post, we will be exploring the use of breathing exercises…