Tag Medical

Parenting Through COVID-19

Many parents are confused regarding how to parent through COVID-19. This entry addresses  three qualifications, three guidelines and two common questions.

Three qualifications:

1.    Most children who were free of psychiatric problems prior to being exposed to a trauma do not develop a psychiatric condition after the exposure. Children can be surprisingly resilient.

2.    Advice from mental health professionals is most effective when it supports and informs, but does not supplant, your intuition. You are one of the world’s leading experts on your child. Suggestions from experts should be filtered through that lens.

3.    Some of the suggestions below would not apply for children who have become symptomatic; for such children it would be best to consult with a mental health professional in order to develop a tailored plan.

Three guidelines:

1.    Intermittently let your children know that you are available to talk but do not try to force a conversation. Children are like adults; sometimes we cope by trying to put something out of our mind. Assuming the topic has upset her, your child might not be in the mood to talk about such at the same time as you. Following your child’s lead can communicate that you are sensitive and respectful.

2.    Try to create a venue and manner that makes it easier for your child to communicate with you. For instance, some teens might find it easier to discuss difficult feelings and thoughts while not making eye contact (e.g., while driving) while younger children may communicate through their play. Regardless of the age range, though, it is important to not jump in too quickly with reassurances. Once we parents start self- disclosing, even if for the purpose of being reassuring, it can have a dampening effect on our child’s self-disclosure.

Once your child has finished with his or her initial statements reflect back what you’ve heard and provide empathy (e.g., “I understand why you could be african woman's half facefeeling more scared these days”). This will feel very difficult to do as your entire being wants to be reassuring, but suppress that urge initially. This may cause your child to tell you even more. When it seems that your child is finished that would be the time to offer your thoughts and feelings.

3.    Let your awareness of your child’s developmental level and/or vulnerabilities guide your self-disclosure. No matter your child’s age, it is important to not say things that you do not really believe. Doing so is often ineffective and may damage your credibility. Selective truth telling would seem to be advisable; selective based upon your child’s developmental level and vulnerabilities.

For younger or vulnerable children you may want to only share those thoughts and feelings that are positive. For older children, who are also doing well, you may choose to share some thoughts and feelings that are unpleasant. Sometimes life is painful; honestly acknowledging that, with an older child who can handle it, can be educative and facilitate a closer relationship.

Two common questions:

1. What do I say to my children about our safety?

Much of this will be determined by how you rationally answer this question for yourself. What do you believe are the odds that your family will experience significant physical or financial consequences from COVID-19? Once you have answered these questions for yourself, selective truth telling–based on the principles listed above–may be advisable.

2. Is there anything I can do to protect my children from all the fallout?

Any of the following may help:

• Aggressively pursue your own adjustment. If I am afflicted I will have a more difficult time helping my child. If I believe we are significant medical or financial risk, then it ‘s important to develop an action plan for coping with and responding to this. Consultation with a good psychologist or mental health professional can be very helpful in this regard. Many psychologists now offer video conferencing services.

line of kids• Try to maintain as many functional rituals and routines as you can. Few things give a child a clearer message that life is safe than adaptive routines and rituals (e.g., maintaining the same routines at meal time, bed time, birthdays).

• Keep your child’s developmental level and wellness in mind when deciding how much he or she should have access to ongoing developments in the news. A good guideline for anyone stressed by COVID-19 new stories is to limit the exposure to once a day or less.

• Try to turn a sense of passivity into an active plan for healing and helping. Your family may decide to pray for the suffering, make donations, write letters, create art, and join online efforts to heal and to help.

• Think of any self-quarantines as a welcomed staycation instead of an apocalyptic retreat. How many of we parents have had the thought, “when we get some extra time together we’ll…” There are so many possible ideas: have a family campout in the family room, play balloon baseball, have a bracketed gaming tournament (including making up new and fun games like who can balance a grape on their face the longest), view old family videos, have a cupcake baking contest or any one of a hundred other ideas you can get by doing an internet search for “staycation ideas.” Doing this well will cause your child or teen, 10-15 years from now, to reminisce with a warming smile, and say, “remember in 2020 when we…”

• Once every day or so do an internet search for “good news COVID-19.” In doing this I’vehappy hispanic family learned that new cases in China have dropped dramatically, that some of the first identified cases in the U.S. are now well and the early science out of China indicates that warmer weather slows the transmission of COVID-19 For teens, reviewing a graph like this may be helpful.

• Maintain a healthy lifestyle for the entire family. This would include things like maintaining good diets and schedules for physical activity and sleep. Social distancing does not require becoming shut-ins. Activities like walking in nature, biking and stargazing may be safe, practical and energizing.

• Manifest for your family the psychological truth: crisis = pain + opportunity. COVID-19, like all pain, is often akin to a dragon guarding treasure when it does not kill us. Yes, we need to experience the pain and give each other empathy for it. After all, denial can take a heavy toll when it’s the driver. But, then we can wonder where the treasure is. If your children can reach age 18 knowing this deep truth about suffering they will have a Captain America Shield against life’s slings and arrows.

• If you child seems to be having a hard time adjusting, or otherwise has changed for the worse, seek out a professional consultation. Doing so may improve your child’s adjustment. To find a psychologist click here.

 

 

What Can I Do If My Kid Freaks Out About Routine Dental or Pediatric Appointments?

Trips to the pediatrician and dentist are commonly feared by kids. This fear ranges from mild discomfort to debilitating anxiety. Let me offer six strategies to help:

#1: Avoid unhelpful reassurances. As I’ve written in other entries, a reassurance is a cue that danger is approaching. While parents don’t intend for their reassurance to be heard this way, kids often hear “okay, time to start freaking out.” Think about this for a second. If you were meeting with me in my office and I told you not to be worried about the ceiling collapsing on our heads, you, of course, would start to wonder about the security of my ceiling. Wait until your child shows distress before reassuring, and then keep them brief and proportionate. If they don’t work, as they often don’t, try the other strategies listed below.

#2: Prepare. Confronting fears is like swimming in a cold lake. At the end of the day, it is sustained exposure to the feared object that calms a person down (i.e., one gets used to it).  Some people know this intuitively and are inclined to cannon ball in. But, many prefer to go in slowly, getting used to the water as they go. This is what preparing your child for the appointment is akin to. If you go to Amazon and type in search terms like “kid, dentist” under books, you’ll get a myriad of choices that will allow you to discuss what the medical appointment might be like. You can also get books that generally help with anxiety. My favorite along those lines is the Scaredy Squirrel series by Melanie Watt. (I have the entire series in my office, including a Scaredy Squirrel puppet.) A related technique is to visit the office on a day when your child doesn’t have an appointment, spending time in the waiting area while doing the next strategy.

#3: Relax your child. A relaxed body and anxiety are like oil and water: they can’t mix. So, you can try to train your child to flush anxiety out of his or her body. The three elements to this are breath, muscles and mind. I tend to focus on the first two with kids. I ask kids to pretend that their lungs are in their lower belly, instead of their chest, and to breath deeply, but comfortably, in and out from there. I also ask them to try to make all of their muscles like a cooked, rather than an uncooked, piece of pasta as I walk them through their muscle groups in a soothing voice. There are also resources you can acquire to facilitate your child’s training along these lines. One of my favorites is the relaxation CD that my friend Dr. Mary Alvord and her colleagues have created. Also, and if the cost benefit ration seems worth it, you can acquire a small, portable biofeedback device that can help your child get into a relaxed state; I like the emWave2 for this purpose.

#4: Distract. Once in the office, try to distract your child with something interesting. I was on the sidelines of a baseball game recently when a young girl, who was barefoot, stepped on a wasp. She started crying in terror and pain. I broke out a couple of magic tricks (I keep them with me) and distracted her, reducing both her pain and her anxiety (and delighting her mother). There are an endless number of ways to do this: read a story, play an electronic game, discuss the details of a fun activity coming up that weekend, and so forth. If the medical procedure your child is going to receive allows for this, distract your child during it as well; if it doesn’t, ask if he or she can listen to a portable music player that you provide.

#5: Reward. I wouldn’t do this unless you know that your child is going to struggle. But, if you’re confident that’s the case, tell your child that if he or she is brave, and doesn’t put up a fight, that you will reward him or her afterwards, specifying what the reward will be. Try to keep the reward proportionate to the level of challenge your child is experiencing. So, the reward can be as small as going to ride swings at a local park or as big as a trip to a water park. Then reward, or don’t, based upon how cooperative your child was.

#6: Get help. If these techniques fail please consider consulting with a qualified child mental health professional. Often these kinds of problems can be remedied quickly with treatments that beat having a couple of adults restrain a terrified child. To get a referral near you click here.

What Should I Say To My Child About My Chronic Medical Illness?

This week’s entry is a guest blog located on Dr. Lamar Freed’s website. Click here to go there.

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