Factors in Happiness
Happiness…it’s a broadly defined and sometimes vague and elusive term, yet we all know what it is and how it feels. Seeking and increasing one’s happiness is a huge area of literature and all over the self-help sections. Some books claim they have the secrets or the recipes for happiness, but just like most things in life, its really a combination of several things and balancing things out that is right for you. I recently read an article in Psychology Today titled “What Happy People Do Differently” going through this topic that I thought I would share.
Yes, it is true that our genetic predisposition and our innate temperament play a large role in our overall mood or our emotional thermostat’s “set point.” Some research suggests as much as 60% of our mood is based on these pre-determined factors. But that still leaves 40% that we can try to mold.
Variables that researchers have found to be largely at play when studying “happy people” are those including taking risks, not getting caught in details, friendships, feeling negative emotions, and purpose.
There is a time and place for us to take chances and try something out of our comfort zone. Often trying something new can be anxiety-provoking, but it also awakens our curiosity, an important component of our lives and feeling happy. Think of a time when someone convinced you to try something new that you were apprehensive about, and you ended up loving it. Those experiences can be more fulfilling than the usual go-to or tried-and-true activities or foods.
Studies have shown that people struggling with depression may actually have a more “realistic” view of the world, noticing more minute details in the environment around them than others. There is a balance here. One does not want to be completely naïve or unaware, but focusing too much on the small things and losing sight of the bigger picture can be negative too. Think about a time you’ve been in a bad mood and it feels like you’ve noticed every eye roll or annoying habit of those around you. Now think of a time you’ve felt happy and either don’t notice these things, or do but simply breeze past them.
Relationships and a sense of connectedness and belonging are important human needs that we all have from birth. In fact, infants cannot survive with only food, but need connection and a sense of attachment to others to survive and thrive. It is important to be there for one another in times of need, but research also shows that it is important for your happiness to be there for your significant others in times of celebration and success too. It increases both your and their levels of happiness.
It might seem counter-intuitive to say that happier people also are good at experiencing negative emotions, but all emotions are important in a well-rounded emotional life. There are times when we feel sadness, anger, anxiety, and jealousy. Being able to tolerate these emotions rather than rushing to brush them off, forget about them, or dismiss them is important to our emotional experience, and actually helps us to move through them more efficiently and appreciate the positive emotions on the other side. Research shows that our flexibility in feeling emotions is the important factor. We can feel sad about something and cry about it to our friend, but conceal it when at work and continue to get through the day productively.
Lastly, finding a sense of purpose in our lives. This one seems like a topic in itself, but think of it as finding ways to increase those activities that make you feel fulfilled and energized. What do others give you praise for? What are you proud of? These activities are different for everyone, and people who feel happiest find ways to keep these activities in their routines.
You can find the full article in the Psychology Today August 2013 edition or go to www.psychologytoday.com.
Learning about Anxiety
Anxiety is a feeling that affects all of us. It can be helpful, and even has an evolutionary component. If we did not fear anything, we could easily get ourselves into situations that are dangerous and we could not handle. But when anxiety starts to overcome us or pops up when there is no real threat to ourselves, it starts to become a hinderance.
For some people, anxiety is expereinced around a few specific issues or experiences like talking in front of a group, taking tests, or meeting new people. For some, it is experienced as a more intense, panic-like feeling, also called a phobia like to spiders, flying, or public speaking. Still others feel more of a generalized, constant anxiety to several different things. Children may expereince separation anxiety when caregivers leave, it is time to go to school, or at bedtime. Others may feel a constant feel of dread as if something bad is about to happen.
Anxiety can take many forms, but what it always includes is avoidance. Avoidance feels good in the moment, and solves the issue of anxiety momentarily. If we just do not have to fly, then we can avoid the panic feeling. Or if we an just avoid the park in the mornings when there are a lot of dogs, then we are fine and don’t need to worry about our fear or dogs. The problem with avoidance is that it only serves to reinforce our fear. If we never face our fear and realize that we can experience the unpleasant feeling of anxiety, yet survive and come out okay on the other side, then we only continue our fear. This might not be too difficult to understand, but it certainly is difficult to carry out.
If you find yourself avoiding situations or experiences due to anxiety, it might be time to confront your fear. If you feel like you can’t do it all at once, try it in small steps. If you want some direction or feel like you can’t do it alone, therapists experienced in treating anxiety can help you to determine the steps, and teach you skills to help keep yourself calm when you are confronting, and eventually, conquering your fears.
Everyday CBT Skills
“You are as happy as you make up your mind to be.” Supposedly this was said by Abraham Lincoln. Whoever said it first, I often talk about this with my patients.
While we can not control most of the situations and experiences that we encounter, we can try to control how we think about them and how we react to them. Our thoughts and our behaviors have strong effects on our emotions. Think about dealing with masses of people during your morning commute. That is something we’ve all had to deal with and can be frustrating. The trains are running late or the cars on the road are in gridlock. You can curse in your head or honk your horn, but it won’t make the trains or cars go any faster. In fact, usually these behaviors only serve to make us feel more frustrated, impatient, and angry. You can think, “I’m going to be late” or “Why won’t these people hurry up?” but that also doesn’t solve anything and adds to your frustration. Instead, try changing your thoughts or your behaviors, or both. Try taking a deep breath and reminding yourself that even though you might be late, if you can’t do anything to change the train schedule or traffic, what is the point in becoming angry and raising your blood pressure? These are every day techniques from Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT).
These skills can be helpful when you find yourself angry, sad, or even anxious. Give it a try or encourage your teen to give it a try when they are feeling frustrated or worried about something.
Defining ADHD
The terms Attention Deficit/Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) are often used interchangeably. ADHD is the more modern term of the two and can be either with hyperactivity and impulsivity or without. Some clinicians and clients still use the term ADD to refer to the condition without hyperactivity or impulsivity present, but just know that you can have ADHD and not have any signs or symptoms of hyperactivity and impulsivity.
Now that we’ve cleared up the terminology, we can talk about what ADHD is, and what it is not. ADHD can be a misleading name as having ADHD does not mean one has a slow brain or a brain that can not focus. In fact, it means instead that one’s brain is moving so much more quickly than other’s that it is constantly taking in a lot of different information. Because of this, people with ADHD can notice things many of their peers miss and can be more creative in their thinking and also have more charisma, energy, liveliness, and unique humor. Having ADHD can be difficult, yes, but in learning to manage the negative aspects, it can be a unique set of characteristics and traits that are a strength.
The negative aspects (the parts that get all the attention) are the symptoms that we use to make a diagnosis and are the focus of treatment. These include difficulty focusing, excessive distractibility, reacting too quickly without thinking through consequences, and restlessness. These symptoms can lead one to underachieve at school or work and also have difficulty in relationships. People with ADHD often have creative ideas, but have difficulty putting these ideas into action or carrying them through to completion. They may be inconsistent in their ability to perform, have difficulty with time management, and trouble organizing their things. The good news is, all of these difficulties are skills that can be taught. Clinicians can work with children and adults with ADHD to break down goals into small, distinct, manageable steps as part of an overall action plan to take advantage of the creativity that lies beneath.
Over-Diagnosing ADHD?
A common topic between psychologists, a concern for parents, and a question I get a lot from other professionals, particularly pediatricians, is “Are we over-diagnosing ADHD?” This is certainly not a new concern as it has been on the minds of many parents and professionals since the prevalence of ADHD diagnoses has been on the rise. Many theories exist for why this may be the case including having unreasonable expectations for children at school and other settings, jumping to a diagnosis since carrying the label “ADHD” can come with potentially advantageous accommodations in the academic setting, and using medication to more easily control difficult behavior in children. Since ADHD has been included as a diagnosis protected under the Individuals with Disabilities Education Act (IDEA), students with ADHD may qualify for certain accommodations in school including testing in a separate room or extended time on assignments or exams. This is motivation for those who may have ADHD to seek out proper diagnosis. But the negative side often gets more attention- those who may not have ADHD who are getting mislabeled due to unrealistic expectations, or those who are seeking out the diagnosis to obtain accommodations they do not need in hopes to gain a competitive edge. There are a several ways to think of this situation. Two of which are: Are we medicalizing normality or are we normalizing a disorder?
Medicalizing Normality
The view that we are potentially medicalizing normality is that we have too high or unrealistic expectations of behavior for children, thus, they are getting labeled as having a disorder. That label is often ADHD. Examples under this theory are that we are now expecting students to leave Kindergarten having learned to read, when this used to be a 1st grade requirement. Many curriculums have more sitting and instruction time and less recess and active play time. Further, the way the Diagnostic and Statistical Manual (DSM) outlines ADHD includes symptoms such as fidgeting or blurting out answers, both of which could be normal impulsivity or restlessness for a child. Also, about three times more boys than girls are diagnosed with ADHD. This leaves some to wonder, are active children being mislabeled as ADHD rather than us as professionals working to adapt their environment to help them and teach them the skills they need to succeed in certain settings?
Normalizing ADHD
The other side of the coin is that, with more children and adults being diagnosed in recent years, it has helped to normalize the disorder and remove stigma. Even adults seeking post graduate education are comfortable with teachers and administrators knowing about their diagnosis so that they can work together to be successful in school. I have often found that when giving feedback to clients or to their parents, people often feel relieved to know that they (or their child) meet criteria for ADHD. I have heard several times that they feel their behaviors finally make sense to them, they are happy to know there is a “reason” for their difficulties, and most do not have a negative reaction to the actual label of ADHD. In fact, many people have a relative or sometimes friend who also has the diagnosis, which helps it to feel more common and normal for them rather than having a stigma attached to it. These are positives in that those who need treatment are more motivated to get it. And those who truly need accommodations in school can gain them. So often issues such as low self-esteem, anxiety, and depression as well as substance abuse can co-occur with ADHD due to the struggles that individuals face from their untreated ADHD symptoms. Being able to get the correct diagnosis and treatment is hugely beneficial to these individuals.
These two ideas of medicalizing normal development and normalizing ADHD need not be separate from each other. Perhaps both are occurring simultaneously. Both are important to remember as a professional diagnosing and treating ADHD. We need to take care to make a thorough, well-informed assessment and diagnosis of the client’s symptoms looking at their medical history, developmental history, family and social factors, educational factors, and all psychological symptoms in order to best serve our clients.
Medication or Therapy for ADHD?
Often when parents wonder about their child’s inattentive or hyperactive behaviors, they bring these concerns to their pediatrician. Their pediatrician asks a series of questions, and may give the parents and teachers forms to fill out regarding their child’s behaviors and symptoms. Depending on the interview and responses on the forms, the pediatrician may make a diagnosis of ADHD. Alternatively, parents may seek out a psychiatrist or social worker who also follows similar steps as the pediatrician in interviewing and diagnosing. No matter which of these professionals you ask, the first treatment recommendation is usually medication. Who hasn’t heard of Adderall, Ritalin, or even Concerta? These are common stimulants used to treat the symptoms of ADHD. They are well-known and often effective.
The first line of treatment has been medication for some time; however, medication is no longer recommended as the first line of treatment. It can still be an important component of treatment and be very helpful to those with ADHD, but it is not the first recommendation anymore.
Research by William Pelham, PhD, of the State University of New York at Buffalo, and others shows that when children are treated with behavioral interventions and their parents are trained to better manage their children’s behavior, medication is used less often and smaller doses are effective when it is used.
Why is this? Behavioral interventions are effective at increasing attention and reducing hyperactive impulsive behaviors, which are the symptoms targeted by medication. Because once people experience some relief from medication, they often aren’t as motivated to make the difficult behavioral changes that they would still need. This then results in less overall improvement than if patients had first made the behavioral changes which, yes, are difficult and require time and perseverance, and then add in medication to get even more benefit from there if still needed.
In addition, while medication can be effective at reducing the inattention and hyperactive symptoms, it is not as effective at improving other symptoms including low self-esteem, difficulty with social skills and interactions with peers, difficulties in reading and math, and difficult relationships with parents and other family members.
Therapy and mediation both have their place in the effective treatment of ADHD and both are important to consider given your child’s difficulties. If only medication is recommended for you or your child, please do not hesitate to ask questions about what other treatments are available. The CDC recommendations state that, in most cases, ADHD is best treated with combination of both medication and behavior therapy. School interventions are also highly beneficial. Be sure your treatment provider recommends all of these areas and closely monitors treatment. If you have questions about obtaining an evaluation for ADHD or treatment recommendations, please do not hesitate to contact Dr. Weissglass for a consultation.
What is testing and what is it used for?
Psychological testing can be helpful if your child is having difficulty in school- academically, behaviorally, or emotionally. It can be helpful if your child is having difficulty socially or at home and you aren’t sure what is going on.
Maybe you’ve heard a diagnosis from a provider but you aren’t sure about it or you want to get more information. Maybe you and your provider are sure about the diagnosis but want more specific recommendations for treatment. For example, anxiety can look different from one person to the next. ADHD can look different. Depression looks different in children versus adolescents versus adults and can look different for boys versus girls as well as each individual.
A label is merely that- a label of a broad category. It helps providers understand what we are working with and what kinds of treatments might be helpful, but we need more than the label to generate an effective plan. We need to understand each person’s areas of strength and weakness, how they think, how they view themselves, how they view others, how they view the world and relationships. No, a paper and pencil test cannot “unlock” the secrets within someone’s mind, but we can use a variety of methods to learn more about people. We then gather all of the information we’ve taken from each method and we’ve learned much more about someone than in a typical conversation.
There is no magic behind psychological testing. I cannot read minds; I cannot learn what people aren’t willing to share; just as in therapy we as therapists cannot help someone who does not want help. What testing can do is provide multiple ways of learning information with methods that have been researched and shown to be helpful in that area. Some methods are “standardized.” All that means is that, through research, we have a baseline for a sample of people; some of those people fit certain diagnoses while some of those people do not. This allows draw conclusions that a person we have tested showed patterns similar to those who have ADHD, or not. We then take all of the information gathered into account and make a diagnosis.
So what does psychological testing typically involve? An evaluation begins with a conversation with your provider. I’ll ask you about your concerns that brought you in today as well as your background including school, jobs, family, relationships, and your relevant medical history (i.e. have you had concussions that could contribute to the memory difficulties you are concerned about). I ask about children’s developmental history- did they learn to walk and talk early, on time, or delayed in a certain area.
Evaluations then vary regarding what measures are used depending on the question. An evaluation with the question of an ADHD diagnosis might use some of the same measures as an evaluation with the question of anxiety or depression, but will also include some different ones. For more detailed explanations of what might be included in your evaluation, please don’t hesitate to contact me and ask. I also have links to many of the common tests on my website to help explain what each test involves.
Talking to your children about tragedy
In the aftermath of tragedy, whether it occurs close to home or elsewhere, parents are often left wondering how they should talk to their children and how they should answer questions.
One of my former supervisors and child psychologist, Dr. April Harris-Britt, shared this advice regarding talking to your children:
“In traumatic situations such as this, parents are often faced with their own feelings of sadness, grief, helplessness, and even fear. There is often a sense of confusion about what, if anything, you should tell your children. For young children, under the age of 6, and in cases where you can be more certain that they will not be exposed to the case via news, other children, or school, you do not necessarily need to share the case with your children.
For children who are older, they are likely to learn about the events in the media or during discussions at school. Therefore, it is more important that you are able to discuss the events first and to answer any questions that the child may have. Each child may respond differently, and some may have more questions than others. It is important to be truthful and to use words and phrases that are age appropriate. A few points that may be helpful include the following:
1. Explain to your child that a very sad event happened at a school that is far away and that they may hear about it on TV or from others.
2. Let your child know that the person who hurt the children and others was mentally ill, and does not make good choices.
3. Ensure your child that you, their teachers, the school, and others will work even harder to keep their school and other schools safer in the future.
4. Allow your child and your self to recognize that this was a scary, sad event.
5. Tell your child that you are able to talk to them about how they feel and to answer any questions that they might have.
6. If your or your child want to help, draw a picture together, make a card, or allow your child to know that the family is donating something to help the families.
7. If you are noticing that your child is becoming more clingy or anxious or even have nightmares, be there to provide more physical contact and support, as well as emotional reassurance.”
Remember that you know your child best. Try to keep as much of a sense of normalcy in their routines and their day as possible. Don’t hesitate to reach out for support in your neighborhood through your child’s school, doctor, or any other professionals during these difficult times.
Divorce and Children
I have seen this article floating around on the internet for some time now and I still find it relevant to talk about with many parents. Judge Michael Haas, who is now a retired Minnesota Judge, made these comments during a difficult divorce case. While his words are rather blunt, they are helpful. He talks about how children are half of each of their parents, and to give them messages that their parent (or your ex) is bad, is to give them a message that they are bad. Something that I often discuss with parents is that children are very sensitive and perceptive. They do not necessarily need to hear you call your ex a bad name to feel the negativity. They can sense it through our complaints, our roll of the eyes, or our tone of voice.
Another important note about Judge Haas’s comments is that I do not think he is saying that parents should never divorce. In fact, sometimes it is better for children if parents do. Research suggests that children growing up in a two-parent versus one-parent household does not have as large an effect on children’s wellbeing as the amount of arguing between parents does. This goes for parents who are together or separated. Children experiencing high conflict between their parents is confusing and upsetting. Just as children are perceptive at sensing negativity in the relationship, they are perceptive at notcing conflict and arguments. They hear a lot more than we think they do when they are supposed to be in their bedrooms, sleeping, playing outside, or waiting in the car.
While you may loathe your ex, and you may even have good reasons to, trying to remember that they are half of the reason that your child is in this world and your child sees themselves as half made up of them, may help you to refocus yourself and prioritize your child’s point of view over your own hurt feelings. This is not an easy task to accomplish, and we often have to work at it over and over again. Reading these words may be a helpful reminder.
Read here for the full article.
Skills Training for Kindergarten
In addition to learning their ABCs, colors, and numbers, children entering Kindergarten need social and emotional skills to succeed. Read more about the social and emotional skills needed for Kindergarten success. Children need similar skills to be successful on the Kindergarte entrance exams and private school entrance exams. Read more about these skills in relation to Kindergarten testing.
Social Skills Training
Social skills training can be one-on-one with your child and a professional, or can be a professional and a small group of children similar to your child’s age. You’ll want to talk with a professional experienced in child development so that you can best understand your child’s needs and the best format to meet their needs. Some children best learn the skills needed working individually while other children learn better when they can practice these skills in the moment with their peers and the professional. Social skills training can help your child to learn skills such as establishing and maintaining eye contact, learning how to approach and make new friends, learning how to handle disagreements with friends, learning how to handle frustrations, and learning how to take turns and share. Each of these skills are important for the overall adjustment of your child, but are also important for your child’s transition into and success within Kindergarten and the grade levels beyond.
Cognitive Training
Cognitive training has been found to be effective in building important skills needed for school success. Cognitive training can increase working memory skills, increase listening skills, decrease impulsivity, and increase one’s awareness into their own attention (learning how to pay attention to paying attention). Each of these skills is important for success in the classroom and in building effective study skills later in your child’s academic career. You’ll want to consult a professional experienced in working with children, knowledgeable about child development, and trained in teaching these skills. These skills can be taught through fun and interactive computer games such as Play Attention and Captain’s Log Mental Gym. With each of these games, a professional establishes your child’s baseline skills and then designs a program address the skills they need to build. These games use biofeedback to teach your child when they are maintaining sufficient attention while they build their skills of memory, listening, processing speed, or logic. These games teach children that persistence and paying attention can be fun.