Michael A. Jones, LCSW

Adult Attachment Styles

2010-08-05T16:28:00.000-07:00

Parents often find themselves overwhelmed by the responsibilities of caring for their children, particularly when the child has behavioral, developmental, medical or mental health challenges. The child seems to be pushing our "buttons". Sometimes it feels intentional and purposeful. We often blame the child. However, while children may find and push our buttons, they did not install them. Our parents did. That is, as a result of our own childhood experiences, each of us has developed an attachment style that affects our ability to develop all kinds of relationships; with friends, co-workers, spouses, and especially with our children. A securely attached adult has made sense of his or her childhood and has the ability to deal with a child's behavior without taking it personally. The dismissing adult has difficulty identifying with a child's struggles because to do so means he may have to take another look at a possibly painful past. The preoccupied adult has open childhood wounds and feels hurt and rejected by her child and others. The adult with a disorganized attachment style is a dangerous parent. Taking another look at our childhoods can help us develop "earned security". Then we can help our children develop more secure attachments to us, thus setting them up for more successful relationships.

Toward More Powerful Parenting

2010-04-13T17:39:00.000-07:00

Traditional parenting focuses on fear and force to gain compliance for the purpose of controlling behavior in the present without regard to future repercussions. It leads to insecure parent-child relationships and children with low self esteem and shame who grow up to be angry adults who are more likely to use power and control with their children. By contrast, powerful parenting means effective parenting; real adults who are aware of themselves and their children in a way that results in long lasting life lessons and secure relationships with children who have healthy self esteem who become well rounded and effective parents themselves. Effective parenting splits the two parts of parenting in two. First, joining and attuning with a child in such a way that the child feels acknowledged and understood despite his/her behavior, mistake or success. Then, second, and only when necessary, and separated by time and space, the thoughful application of a teaching consequence that is commensurate with the mistake or lesson to be learned, a value added experience that builds self esteem and self efficacy. The second without the first will not be effective and can be damaging. The first, with or without the second, is essential to maintaining and improving the parent-child relationship and may teach as much.

Therapeutic Parenting

2010-04-06T10:04:00.000-07:00

Therapeutic parenting is purposeful parenting with the intent of helping a traumatized child heal through the relationship. The trauma may have happened because of previous parents, an event or serious of events, or as a result of typical changes in family life like divorce, moving, or birth of siblings. The healing parent first needs to understand themselves, their own childhood hurts, their thoughts and feelings about children and parenting, and develop an awareness of their strengths and weaknesses. Much like flying, put the oxygen mask on yourself and then put it on your child. The therapeutic parent is the change agent; the number one tool of change is empathy; and the medium through which change happens is the relationship. We develop, improve, and repair a parent-child relationship in which the child can feel felt and heard, understood and accepted. From this safe base, the parent (with a therapist or not) helps the child explore the traumatic material so that its stressful impacts on behavior and functioning no longer have the same effects. Healing parents use affection and play to build and repair the relationship and structure and supervision to reduce anxiety. It splits the parts of parenting in two; joining with the child as a nurturing consultant then providing teaching lessons that last.

Ages and Stages

2009-08-16T18:20:00.000-07:00

We humans develop in stages from pre-birth to death. There is a series of steps we take both literally and figuratively that lay the foundation for future growth and learning. These are neuro-bio-psycho-social steps that lead us to cognitive, emotional, physical, and social functioning. Erik Erikson and Jean Piaget are among the theorists who named the essential conflicts we must resolve before moving on to the next challenge of life. Our experiences with parents and others help us achieve these developmental milestones. However, conditions and events like illness and trauma can interfere with this process resulting in uneven developmental progress. In reality none of us is cognitively, emotional, physically, and socially the same age or stage. A child of 15, for example, may look his or her age or older, but have the brain functioning of a 12 year old, the social skills of a five year old, and the emotionally reactivity of a two year old. This child needs different and extra experiences to catch up, and parenting her or him like a typical 15 year old will not be successful. In my work, then, I teach "investigative parents" to target the developmental stage and not the chronological age of their child, easier said than done, until the puzzle pieces begin to fit together.

Sex Ed and Sexual Abuse

2009-08-08T07:43:00.000-07:00

Sex is the one topic that parents generation after generation have the most difficulty teaching their children. Sexual development is part of human development but the subject is infused with so much cultural meaning including fear and shame that we often avoid the issue. Most people pass on the job of sex education because they are not sure of the facts and don't know what to say. Think about how you learned about sex from your own parents, or rather from peers on the playground. This is particularly difficult and dangerous when we are trying to protect our children from sexual abuse. One in four women and one in five men is the victim of child sexual abuse. Children as early as three or four need to know about "indoor" and "outdoor" plumbing, vaginas and penises and what they do and what they are for, how babies are made and how they are born, and how it feels and how to manage sexual development through adulthood. What is normal is same age sexual exploration like "playing doctor" and "show and tell", and yes, masturbation. What is not normal is sexual knowledge and language beyond age level and coercion, compulsion, and secrecy. These are red flags for sexual abuse. Perpetrator may have been victim and both need intervention. The Child Welfare League of America has some great resources including articles and books for children and parents and links to local treatment options. Sexually abused children can grow up to be healthy, happy adults. Start today.

Attachment Basics

2009-08-06T07:46:00.000-07:00

The relationship with the parent is the template for all future relationships. This attachment is essential for survival. Without it an infant dies. The attachment is directional, from child to parent. It is driven by the parent's commitment to meet the basic needs of the child. And, because it is a one-to-one relationship, it develops differently with each parent and primary caregiver. We have a different relationship with our mother than our father. Each one is unique, and there is no competition. A person can and does have many attachments over a lifetime. The child's role in attachment is to make his or her needs known. When a parent meets those basic needs; for food, comfort, touch, or soothes the distressed child, the attachment grows stronger. The prime time for attachment is pre-birth to the first three to four years of life. The attachment relationship is brain based. When a parent meets a child's needs, he or she is building brain cells. Baby cries, mother holds, and a brain connection forms. In the same way, if an infant cries but a parent does not respond, a different brain connection is made. The child either feels powerful or powerless. So, attachment contributes to self esteem, identify, and behavior. A child who is securely attached to a parent can make friends, get along with employers, maintain an adult relationship, and facilitate secure attachment of their own child.

Depression in Children

2009-07-25T08:48:00.000-07:00

Whether we are therapists, psychiatrists, pediatricians, family therapists, or parents we should all be concerned about childhood depression and the accompanying risk of suicide, especially given the spate of recent suicides by pre-adolescents. As I told San Diego News Network, among a therapist’s first actions is to screen for mental illness including depression and suicide risk. In addition, I make a referral to or consult with the child’s doctor to rule out medical conditions that may cause, contribute, or appear as mental health issues. If depression is the issue, I refer the parent to a child psychiatrist for a medication evaluation. The combination of therapy and medication is the accepted treatment for depression. Screening children means we can start earlier to address hereditary depression as well as depression caused by environmental factors. The key for parents and providers is that depression looks different in children and is easy to miss or attribute to behavior and developmental issues. In addition to changes in eating and sleeping and mood, children with depression often appear agitated, irritable, or angry. Parents and teachers can miss it or minimize it. So, short simple screenings with the Beck Depression Inventory or the Child Depression Inventory are tools for doctors and therapists to use. At the least we will educate about depression. If it means saving a child’s life, then we are using safety contracts with parents and children and accessing psychiatric services up to and including hospitalization. However, the earlier we can treat depression the more success we can have in helping children not only enjoy their childhoods but also grow up to be well adjusted adults.

Silence is Golden

2009-05-16T20:55:00.000-07:00

In the days of "children should be seen and not heard", parents used to preach that "silence is golden". Sometimes, they would even give the misbehaving child "the silent treatment". These days we understand that silence can be golden as a treatment for children who seem "out of control". Children traumatized by abuse, neglect, chaos, or loss often have difficulty soothing themselves. The normal primitive fight/flight response that protects us from danger goes into overdrive. Everyday events, like homework, chores, or being told no drive the child into something close to a post traumatic stress response. They live with so much stress that even small annoyances send them over the edge. Bruce Perry, M.D. and Daniel Siegel, M.D. describe this neurological disregulation. That is, when faced with perceived threat, we "lose our minds". The parts of our brain that logically process information, the cerebral cortex and neocortex, turn off. Some children become disregulated faster and stay disregulated longer. You are right! They are not listening. They cannot hear us trying to explain, reason, or lecture them. They hear Charlie Brown's teacher, "Wah, wah, wah." Like a child with a temperature we cannot talk them down. They need comfort, care, and calm. The powerful parent using this "silent treatment" stays present, lending his or her self control by silently soothing to help the child regulate. The less said, the better. There will be time to teach a lesson to a brain that's on.

Parallel Process

2009-01-19T18:16:00.000-08:00

Clinical supervisors call it parallel process. It's the process by which the supervisor models with the supervisee how the supervisee may interact with the client. And, in return the supervisee often re-enacts with the supervisor how the client has acted with the supervisee. This process can be used consciously for learning and teaching purposes if both parties can be aware of it. This kind of interaction is also present for clinicians working with parents and their children. The therapist attempts to model with the parent how the parent might interact with the child. In return, the parent often re-enacts with the therapist how the child is behaving with the parent. If the main tool of attachment parenting is empathy, it is incumbent upon the therapist to use empathy with the parent. If the therapist misses the mark, the parent is likely to have difficulty hitting the mark with the child. Central to these interactions are also the concepts of transference and countertransference. The client transfers to the therapist feelings he or she has about children like joy or frustration. The therapist counters with feelings that can help him or her understand the client if the interaction is managed. It's the therapist's job to know how.

Where is your family?

2008-12-16T13:06:00.000-08:00

I have been visiting a group home for the last three weeks, ostensibly to provide therapy for several of the teenage boys who live there. I came away sad, angry, and amazed. These boys are some of the four thousand children currently in foster care in San Diego County. They are dependents of the court. But unlike seventy-five percent of the rest of those children who will likely be reunited with their parents, these boys spend the rest of their growing up years in the system. Except, they will not because when they turn eighteen they will be turned out on their own with a lot more growing up to do. Like many system children they have lived in many foster homes before the families gave up on them, they gave up on family life, or their own families gave up on them. To be sure, they have mothers and fathers, aunts and uncles, siblings and grandparents out there. Sometimes they have contact and know where they are, and sometimes they do not. But no one is really trying to get these boys back home. The court calls it a permanent plan, but for these children reunification, adoption, and guardianship were not permanent. They live in limbo. Sometimes their parents do not want them back. The boys find it easier to live in a "home" with staff instead of parents. They have reason not to trust any adults, including a new therapist, let alone teachers, employers, or partners. And yet, these boys learn to live with one another, some making plans for college while others lose hope and drift. They are all but forgotten except that we will meet them again as the parents of children we will remove and attempt to raise in the future in the village in which you are really on your own.

Ties that Bind

2008-11-30T19:25:00.000-08:00

The accepted evidenced-based treatment for most mental health problems is cognitive-behavioral therapy. Focusing on thinking and doing works well for issues like anxiety, depression, stress and trauma. But it misses the mark with most children and even some couples. Now there is growing awareness of the impact of attachment on the functioning of children as well as adult relationships. Attachment is that brain-based connection we make with our parent that forms the template for all future relationships. The parent drives this process by consistently meeting the basic needs of the child particularly in the first three years of life. Commitment to this one-to-one relationship leaves the child with basic trust that transfers to others and forms the basis for healthy self esteem and pro-social behavior. Because children are completely dependent on their parents they cannot be expected to make changes toward healing on their own. This is particularly the case when the relationship is new, strained, or damaged. Then the focus of healing is on the relationship itself. The repair work returns to the building blocks of attachment in nurturing and play. And so it is with adult couples when the roots of distrust are in childhood and partners meet each others needs.

Happy Parent = Happy Child

2008-11-23T16:19:00.000-08:00

The flight attendant says, "If the cabin should lose pressure, put the oxygen mask on yourself first and then place one on your child." And, so it is with parenting. Parents need time to themselves, to replenish their energy. This time away makes them better parents, better able to nurture their children and better able to deal with the difficult job of parenting. The families I work with have often adopted traumatized children who have just moved in. And, just like new parents bringing home a baby from the hospital, they often don't think about leaving their new children with anyone else for any length of time. Weeks and months go by and you can see the energy and enthusiasm draining away as exhaustion sets in. Dealing with the difficult behaviors of children who have lived with multiple families can test the most experienced parents. Parents who are focused on building the bonds of attachment with their new children feel guilty leaving their children and often have difficulty finding friends and family members who can handle their kids. That's why it's one of the first things I suggest to my families. "Go on a date. Leave the kids." This kind of grown up time out also teaches children how to take care of themselves and nurtures the relationship that is the model for the relationships we want our children to develop.