All Posts Tagged: child psychologist

child wearing face mask in empty classroom

Separation Anxiety: Going Back To School During The Pandemic

As the 2020 – 2021 school year begins, children who normally go through separation anxiety may be even more anxious about going back into the classroom during the pandemic. After all, the beginning of a new school year can be threatening during normal times, but returning into a situation where the coronavirus is likely to be present has raised anxiety levels in many kids and parents.

For parents who live in school districts that offer a choice between virtual or in-person learning, how do you make a decision about which is best for your child? Being safe at home means that kids who have special needs or who learn better in person will lose out on many learning opportunities. Children who are fearful of being in a classroom, however, will struggle more if they have to go back into the school.

All this stress can bring up school refusal in kids, not to mention heightened school anxiety in parents.

Separation Anxiety And Classroom Learning During Covid-19

Sometimes separation anxiety and school refusal begin for a child who has gone through an illness or an emotional trauma, such as moving from one neighborhood to another. In the case of the pandemic, however, illness and death is all we hear about on the news, so a child who may already be inclined to separation anxiety will only worry more.

Parents hardly fare better – in many cases they are having to choose whether to stay home with kids who will be learning virtually (thus, risking their jobs) or sending their child into a possibly contagious environment. Either way, the decision is highly distressing.

Separation Anxiety Definition

If an anxious child shows excessive concern about a separation from a parent or caregiver, or from their home, they might have developed a separation anxiety disorder. In addition, separation anxiety may be present if they show fear about the situation that is inappropriate to their age or stage of development.

Parents who are extreme worriers may show similar symptoms, which could indicate their own anxiety disorder. This is particularly true if they have been overly anxious about the safety of their child during the pandemic.

Emotional and Physical Symptoms Of Separation Anxiety

Children (and parents) who have separation anxiety may show the following symptoms including:

  • Constantly imagining worst-case scenarios
  • Difficulty going to sleep, fear of the dark, and/or nightmares
  • Avoiding activities that result in separation from the parent or child
  • Excessive worry about potential harm or illness happening to them
  • Children may be clingy, may fear being alone in a room, or may need to see a parent at all times
  • Adults may feel anxious about the child’s safety if they aren’t within sight
  • Trembling
  • Headaches
  • Stomach aches and/or nausea
  • Vomiting
  • Needing frequent trips to the toilet

If a child or a parent exhibits three or more of these symptoms for more than four weeks, they are likely suffering from a separation anxiety disorder.

Separation Anxiety Treatment

While you can’t control the things that happen around you, you can learn how to control your responses and actions. When treating someone for separation anxiety, therapists try to help them learn to identify and change their anxious thoughts. Then, they teach coping methods to help the person react less fearfully to the situations that trigger their anxiety.

Remember – it is natural to worry, but we can learn to keep our fears from spiraling out of control by “naming” and identifying our thoughts. For instance, if  your child starts to imagine getting sick in school, and then pictures getting so sick they end up in the hospital, have them practice labeling these thoughts as something less threatening (ie:”That’s just a Bugs Bunny thought hopping around!”). This can often help remind the child that they are just thoughts and we are in charge of how we react to them.

Sometimes, however, self talk still can’t calm the fear and an anxiety disorder can begin. If you suspect that your child is developing an anxiety disorder, it’s important to seek treatment as soon as possible. The longer the anxiety continues, the harder it can be to treat.

Connect with a Child Psychologist at our Children’s Center

For more information about our services to treat mental disorders in children,  contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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kids at summer camp

More Pandemic Grief: No Summer Camp, Plus School At Home

We’ve hit midsummer and kids across the country have had to deal with the disappointment of canceled summer camps this year. Now, many school districts are making parents choose between virtual learning this fall or sending their children to school during a pandemic. Some school districts are going entirely virtual. Having to face more upheaval in a year of unprecedented changes has brought up grief and anxiety for both kids and parents. Yet, despite this turmoil, there are some good things that have come from the pandemic.

The Good – Some Pandemic Silver Linings

One of the most significant changes are the family ties that formed or remodeled after our hectic lives were halted. Parents and kids are spending more time together as a family because extracurricular activities aren’t taking precedence. Plus parents who are working from home have extra time to interact with their children since they don’t have to commute.

Just being able to play like children has been good for kids. Often their lives are structured from the time they awaken until they fall into bed at night, so being able to simply play has been good for developing their imagination, exploring their world, and just being a kid.

The Bad – Pandemic Grief And Anxiety

For many kids, having no summer camp has been very distressing. It’s something they look forward to –often, they have friends there that they don’t see for the rest of the year because they live in a different state. For teens who were anticipating becoming camp counselors or who were attending their final year of camp, not being able to go is beyond frustrating.

Furthermore, children haven’t seen most of their school friends in person for several months and are now being told they likely won’t see them this fall, either. In addition, when it comes to learning, many kids do better in a classroom environment where they can see examples and question the teacher directly, so it’s upsetting for them to know they will be stuck at home and struggling with virtual learning.

Parents faced similar emotions at the canceling of camp and the prospect of having their children home for at least some of the fall school semester. Along with having to figure out how to keep kids meaningfully entertained, they’re grieving the loss of their own couple’s trips and trying to navigate another semester of being involuntary teachers.

PTSD And Anxiety In Children During COVID-19

Just as with adults, the stress of life during coronavirus has dramatically altered children’s day-to-day world.

Natural disasters like a pandemic can have long term effects on kid’s emotional and mental health. In studies of children’s mental health after Hurricane Katrina, researcher Carolyn Kousky, reported that, “researchers found high rates of PTSD symptoms as well as other negative mental health impacts and behaviors, such as aggression in adolescent.” Furthermore, a 2013 study found that kids who had gone through a quarantine for disease control scored four times higher on a post-traumatic stress test than children who hadn’t been quarantined.

You can see why it is vital for parents and adult family members to help kids make sense of the pandemic, especially in an accurate way that minimizes their fears.

  • Be available to talk if they have questions (and be sure they know they can come to you).
  • Speak to your children in a calm voice. Try to be reassuring about their fears. Remember that kids can and do pick up on cues in your tone and body language.
  • Validate their feelings of loss and try to show empathy.
  • Try to reduce or limit news broadcasts and screen time so your child (or you!) doesn’t become overwhelmed by news coverage of the pandemic.
  • Try not to condemn or ridicule someone you know to your kids if they have been sick with the virus.
  • Remind kids that rumors run wild on social media. Many stories are inaccurate.

To avoid any long term consequences, it’s essential that parents take steps to address and reduce any COVID-19 anxiety their children may have. KidsHealth.org provides great resources for keeping kids busy during the pandemic and has some helpful ideas for addressing the topic with your child.

Helping Children With Anxiety

For more information about how our mental health professionals and child psychologists can help your child deal with anxiety about the pandemic, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Psychological evaluations

Psychological Evalutations

The Children’s Center for Psychiatry, Psychology and Related Services is pleased to again offer psychological evaluations to the community. To best serve the need of our clients we will be offering both in person appointments or remote video conferencing to get a better understanding of your child, their strengths and weaknesses, and what accommodations and interventions they would benefit from.

We are able provide our typical in person evaluations with procedures and materials to ensure safety during COVID-19 concerns. Additionally, while the evaluation process is typically a hands-on experience and the assessment tools require face-to-face interactions, we have also made adaptations to provide remote evaluations via video appointments.

As part of the evaluations we are conducting now, we will take the following steps:

  • Meet with parents via video conferencing and collect information so we can learn about your child’s emotional, behavioral, and social functioning.
  • Meet with the child via video conferencing to assess if they would be a good fit for a remote evaluation. If so, we will proceed with evaluating cognitive and academic abilities and social and emotional functioning via video conferencing. We will also be able to assess aspects of attention, impulsivity, language, and memory. We may decide that additional in person testing will be helpful.
  • Collect information from your child’s teacher through teacher rating forms and interviews.
  • Collect information from your child’s medical and school records if needed.

This information will help us gain a better understanding of your child and their unique needs and will allow us to provide consultation and recommendations to support your child both at the home and at school environments.

Additionally, we can provide psychological evaluations to help with diagnosis of mental health concerns and to assist with treatment planning.

Schedule a psychological evaluation for your child.

For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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COVID paradox

The COVID Paradox

Never before in modern memory has the human race been faced with such a stressful and anxiety provoking foe. The novel coronavirus or COVI-19 has resulted in untold emotional unrest and fear among all nations and peoples of our world. There has been a lot of talk about the “invisible enemy,” an RNA based complex protein that looks like a World War 2 anti-ship mine with spikes sticking out of its surface. We are informed daily by the media that young and old victims of this virus are ending up on ventilators for weeks at a time if they survive. To “flatten the curve” and avoid overwhelming our hospitals we have had to become socially isolated, settle in place in our residences, wear masks when going out and remembering to wash our hands and not touch our faces. And after three months of dealing with this enemy of grown ups we are now being informed that children who we believed were not at risk of being made seriously ill have suffered as cases of a strange multi system inflammatory syndrome much like Kawasaki disease began to appear at hospitals.

The reality of this plague is bad enough to fathom by any rational person. The facts we are presented with certainly evoke fear and apprehension. Our frontline healthcare providers who are by their profession somewhat desensitized to run-of-the-mill suffering as they treat patients with terminal illness, heart attacks, metastatic cancer or debilitating strokes, find themselves traumatized by the COVID crisis.

So what is generating this degree of emotional suffering? Much of it comes from the unseen enemy, this virus that is only visible under special microscopes. Some of it comes from the fact that its genetic structure is novel. No human being had been exposed to it prior to its appearance in Wuhan so our immune systems had no defense against its onslaught. It is extraordinarily infectious so that an infected person will infect several people in close proximity over time.

What is the paradox that I am referring to? Actually, there is more than one paradox. The first one involves the media explosion that began last century and has exponentially continued this century. We appreciate all the benefits from being plugged in 24/7 to social media, internet messaging and an abundance of television news all day long. The digital revolution that amazed us has also proved to be harmful to our emotional well being. Multimedia exposure during the COVID pandemic has been like watching a horror movie that never ends! What we valued and embraced has turned out to be a traumatizing process. If you check the Centers for Disease Control website for data on the influenza outbreak for the 2018-2019 season you will find that 35.5 million Americans came down with the flu, 490,000 hospitalizations resulted, and there were 34,200 deaths. Imagine if the media tracked the annual flu season like they have tracked the COVID pandemic. Every flu season would be emotionally traumatizing. We certainly don’t go into lockdown every year for the flu nor do we social distance. We do have a flu shot available, but data on its effectiveness suggests a 45% effectiveness this past season. Our advantage with influenza is that over time, all of us have had some level of exposure to this family of viruses imparting a degree of “herd immunity.”

This brings us to the core paradox. If we stay locked down and isolated indefinitely there will be no herd immunity developing. The concept of herd immunity means that if enough of our population is exposed and develops immunity to this virus, ongoing spread becomes very difficult. For example, smallpox, chicken pox, measles and mumps had been the scourge of society until the administration of vaccines essentially created a herd immunity.

We will eventually have an effective vaccine for COVID-19 but it will be some time before we will be able to provide mass inoculation. If there had been no COVID-19 social isolation our healthcare system would be over run, resulting in a tsunami of fatalities.

So the course that is being taken is to gradually open up our lockdown while we carefully prepare for future waves of illness. Be reassured that there will come a day in the not too distant future that this horrible virus will be no greater a threat than the annual flu. That time will come.

Connect With A Child Psychologist At Our Children’s Center

If your child is experiencing anxiety related to the COVID-19 pandemic, our child psychologists are available for online services. For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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teen wearing fack mask

Is The COVID-19 Pandemic Affecting Your Child’s Mental Health?

Schools have been closed for the last couple of months since the coronavirus pandemic began to spread across the country. Stories about the virus’ effects and death rates abound on the news and on social media. Usually, we wouldn’t expect children to be too affected by broadcasts about a new disease unless someone close to them gets sick. In this case, however, their lives have been upended by school closings, parents working from home (or losing their jobs), the requirement to shelter in place and wear masks, and the inability to gather with friends or go to familiar venues.

Children are also likely tapping into their parent’s own fears and concerns. In turn, they may worry that they, their friends, or their family will catch COVID-19. We can estimate how this affects American kids by reading through the studies that were done on children in China, where the outbreak began.

In an article on Psychology Today, Jamie D. Aten, Ph.D., founder and Executive Director of the Humanitarian Disaster Institute at Wheaton College, reports that, “due to uncertainties surrounding the outbreak and ongoing scientific research, it’s estimated that 220 million Chinese children are at a risk of facing mental health issues due to potential prolonged school closure and home containment.”

If this is true for the children in China, why would it be any different here for kids in the United States?

Why Kids Need Mental And Emotional Support During COVID-19

The stress and apprehension surrounding the coronavirus pandemic has altered children’s day-to-day world in a huge way. We know that natural disasters such as this can have a long term effect on kids, just as they can for adults.

As an example, one researcher, Carolyn Kousky, noted that in studies of children’s mental health after Hurricane Katrina, “researchers found high rates of PTSD symptoms as well as other negative mental health impacts and behaviors, such as aggression in adolescent.”

For older children, the added disappointments that have come along with the safer-at-home orders – such as the cancellation of graduations and proms, no school athletic games or activities, and isolation from friends – is sure to have emotional consequences, too.

In fact, it was reported in a 2013 study that researchers found that kids who had gone through a quarantine for disease control scored four times higher on a post-traumatic stress test than children who had not had that same experience.

How To Help Your Child Through Pandemic Anxiety

It’s important for parents and adult family members to help kids make sense of the pandemic, especially in an accurate way that minimizes their fears.

  • Let your child know that you are available to talk if they have questions.
  • When talking to your children, do so in a calm voice. Try to be reassuring and also remember that kids will pick up on cues in your body language and tone.
  • Consider reducing or limiting news broadcasts and screen time so your child doesn’t become overwhelmed by news coverage of the pandemic.
  • Remember that this pandemic can affect anyone, so try not to condemn or ridicule someone you know who may have contracted the virus.
  • Remind kids that rumors run rampant on social media and that many stories are inaccurate.

Teach your children how to stay safe during the pandemic (and afterward):

  • They should wash their hands with soap and water for at least 20 seconds (have them sing the birthday song twice as an easy way to count the time). They especially need to do this after sneezing, blowing their nose, or using the bathroom, and before eating or handling food. Hand sanitizer is a great option if soap and water are not available (supervise young children if they are using hand sanitizer).
  • If your child needs to sneeze or cough, they should do it into their elbow or a tissue (then throw the tissue in the trash).
  • Stay away from those who are sick or are sneezing or coughing.
  • Keep things that they touch clean. Wipe down frequently used objects such as doorknobs, light switches, the television remote, their phone or tablet frequently with a disinfectant to avoid spreading germs.

It’s important for parents to take steps to address and reduce any COVID-19 anxiety their children may have, so they can avoid any long term consequences. KidsHealth.org provides some great resources for keeping kids busy during the pandemic and offers some helpful hints for addressing the topic with your child.

Connect With A Child Psychologist At Our Children’s Center

If your child is experiencing anxiety related to the COVID-19 pandemic, our child psychologists are available for online services. For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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child crying

Hurricane Anxiety

This summer’s hurricane season was fairly quiet until Hurricane Dorian blew through offshore earlier this month. Then, Humberto threatened the South Florida area last week, putting everyone on high alert for the second time in less than a month. For some children, hearing about the devastation in the Bahamas, watching parents make storm preparations and evacuation plans, or knowing that there are other menacing storms out there can bring up hurricane anxiety.

Symptoms Of Hurricane Anxiety

While you are listening to updates and getting ready for an impending tropical storm or hurricane, don’t forget to talk with your child about their fears. If a storm is coming, they will likely be worried about their friends, their home and school, their pets, and all the disruption that a major storm can bring.

In addition, if they have ever been through a hurricane, they will remember the fear they felt while sitting in the dark, listening to the wind howl and feeling the house shake. After a terrifying experience like that, even hearing the pounding rain of a normal storm could bring up some post-traumatic stress for the child. This can be magnified by the act of going through preparations for another hurricane.

Children who have hurricane anxiety might show their fears in the form of physical or emotional symptoms, or both.

Physical symptoms include thing like:

  • Trembling
  • Having headaches
  • Saying that they feel dizzy or lightheaded
  • Stomach aches, vomiting, nausea
  • Experiencing nightmares, having trouble sleeping, or being afraid of the dark

Emotional symptoms can show up in the form of:

  • Being clingy or wanting to keep you or another caregiver in sight at all times
  • Crying or being overly whiny
  • Talking incessantly about what they experienced in a past storm
  • Being jumpy and on edge
  • Getting physically ill or acting distressed if they are being separated from their loved ones for any reason
  • Expressing fears about them or someone they love possible being harmed because of the storm
  • Being afraid to be in a room by themselves
  • Refusing to participate or avoiding taking part in activities that will keep them away from their parents or caregivers, even briefly

How To Help A Child Who Has Hurricane Anxiety

If your child shows a heightened level of concern or fear about storms, our child psychologist recommends that you:

  • Talk to your child about their fears and let them know that it is okay to be worried.
  • Talk positively about the preparations you will be making to keep them safe and where you all will go if you have to evacuate. If the child knows they will be in a safe place, it can help to reduce their anxiety.
  • Assist them in soothing their fears by letting them sleep with a favored stuffed animal or allowing them to keep a nightlight or hallway light on at night during a storm.
  • Help your child choose something to take with them just in case you do have to go to an evacuation shelter. For example, they can pack a backpack with toys, books and games, then keep it nearby so they feel more prepared for the storm.
  • Remind your child that hurricanes can and do routinely change course. Many times, the storm won’t impact your area, despite the warnings. We saw this when Hurricane Dorian skirted the shore of Florida instead of hitting the state directly as forecasters first thought would happen.
  • This should go without saying, but do not tell your child about any bad experiences you might have had during a hurricane or bad storm! There is no need to add to their fears.

Even though you talk to your child about the steps you are taking to keep them protected, their hurricane anxiety may still continue. If their stress level seems too high for the current situation, it is best to seek the help of a child psychologist.

These experts can help your child identify and change their anxious thoughts. Through role-play and modeling of positive behaviors, your child will learn coping strategies to lessen their fearful response to an approaching hurricane or other storm.

Talk With A Child Psychologist At Our Children’s Center

If your child seems unduly worried about storms or overly fearful when there is talk of a possible hurricane, it may be time to speak with a child psychologist. For more information, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

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Destigmatizing Mental Health Services For Youth

Studies have shown that children in the United States have many mental health needs that remain unidentified. In 2015, the Centers for Disease Control and Prevention (CDC) reported that about 20% of the nation’s youth have or will have an emotional, mental, or behavioral disorder. Only about 7.4% of these children report having received any type of mental health services, however.

A 2014 National Center for Biotechnology Information (NCBI) study by Jane Burns and Emma Birrell noted that many mental health problems escalate in adolescence and young adulthood. The effects of these under treated childhood mental health issues can be higher rates of substance abuse, anxiety, and depression, as well as suicidal ideation and self harm.

There is a stigma surrounding mental illness and its treatment. This disapproval is a barrier that keeps young people from seeking assistance. The consequence is that they are not receiving appropriate care, which translates to an increased chance of dropping out of school, employment or relationship problems, future incarceration, or even suicide.

Impact of Childhood Mental Disorders

The most prevalent mental disorder in children is attention deficit hyperactive disorder (ADHD). Other common conditions are:

  • Depression
  • Anxiety
  • Autism spectrum disorders
  • Substance abuse
  • Learning disorders
  • Eating disorders

A 2013 study by Khong, et. al. stated that “The highest-ranking top 25 causes of disability include anxiety disorders, drug and alcohol problems, schizophrenia, and bipolar effect disorders. By age 5, mental health and behavioral problems become an important and soon dominant cause of years lost to disability, peaking between ages 20–29.”

There is often a gap of up to 15 years between the onset of symptoms and the person getting the appropriate care. Because behavioral and mental health concerns are not being addressed early enough, they become issues down the road – major depression is one of the top four causes of disability in adulthood.

As the study noted, mental health conditions can begin to emerge as early as 5 or 6 years old. Symptoms of anxiety disorders often include:

  • trouble sleeping
  • trouble concentrating
  • fatigue,
  • irritability
  • restlessness
  • numerous, lingering, or intense periods of stress, anxiety, or fear that seem out of proportion to the triggering event and which affects the child’s daily life

Ways to Destigmatize Mental Health Services

Children with mental health challenges are often marginalized or bullied by their peers. This social exclusion keeps them suffering in silence, discouraging the majority of adolescents and teens from seeking help.

To destigmatize mental health in general, we need to:

  • Equate mental illness with physical illness. Mental illness is a disease, just the same as physical illnesses like diabetes or cancer, but mental health conditions are often thought of as something the person could overcome if they just “tried harder.” They are disorders of brain function, however, which means they are based in the physical body in much the same way as something like a heart condition or high blood pressure. We certainly wouldn’t expect a heart patient to just “try harder” to get their blood pressure or irregular heartbeat under control.
  • Show compassion to those with mental illness and don’t treat them differently. People with mental health conditions live meaningful lives, but they often have to fight to keep from being judged.
  • Watch what you say. Don’t use words like “freak” or “crazy” because this type of language continues the negativity against mental illness.
  • Change the culture by taking a good look at children who are acting out. Try to figure out why they are behaving in certain ways, instead of writing them off as bad kids.
  • Don’t judge yourself if you are struggling with mental health issues. Your condition is out of your control. Being ashamed only adds to the burden and can keep you from seeking help.
  • Encourage family members or friends to seek help if they are facing mental health challenges.
  • Familiarize your child with mental health concerns like anxiety and depression from a young age. For example, help them understand that everyone has days when they are sad or angry or feel stressed, but if they can’t shake those feelings, it is okay to ask for help.

People who are challenged with mental health issues often feel alone. The reality is that the majority of us have some type of mental health condition. Great examples include the new mother with postpartum depression, the college student with ADHD, and the coworker who has post-traumatic stress disorder from their military service.

By destigmatizing mental health problems and services from a young age, we can teach children to challenge negative attitudes so they are more comfortable asking for help.

Connect with a Child Psychologist at our Children’s Center

For more information about our services to treat mental disorders in children, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

References

Monshat K, Khong B, Hassed C, et al. “A conscious control over life and my emotions:” mindfulness practice and healthy young people. A qualitative study. J Adolesc Health. 2013;52(5):572–577.

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Self Harm – Is Your Child Engaging in it?

Self harm or self-injury is the intentional wounding of one’s own body. Most often, people who self harm will cut themselves with a sharp object.

Self harming may also include:

  • severely scratching areas of their body with a fingernail or sharpened object
  • carving words or patterns into their skin
  • burning or branding themselves using lighters, cigarettes, lit matches, or other hot objects
  • biting themselves
  • excessively picking at their skin (dermatillomania) or wounds
  • hair pulling (trichotillomania)
  • head banging
  • punching or hitting themselves
  • excessive skin-piercing or tattooing may also be indicators of self harm

Generally, people who self-harm do so in private. Often, they follow a ritual. For example, they might have a favorite object that they use to cut themselves or they may listen to certain music while they self injure.

Self harmers will target any area of the body, but the legs, arms, or front of the body are the most commonly selected. These areas are not only easy to reach, they are also easy to cover up, allowing the person to hide their wounds away from judgmental eyes.

Additionally, self harm can include actions that don’t seem so obvious to others. Activities like excessive substance abuse or binge drinking, driving recklessly or having unsafe sex can all be signs of self harm.

Causes of Self Harm

There are many reasons that people engage in the unhealthy coping mechanism of self-injury.

Oftentimes, a self-mutilator may have trouble understanding or expressing their emotions. Those who self harm report feelings of worthlessness and rejection, loneliness or isolation, guilt, self-hatred, and anger.

When a self harmer attacks their own body, they are really seeking:

  • distraction from painful emotions
  • to release intolerable mental anguish
  • a sense of control over their feelings, their body, or their lives
  • a physical distraction from emotional pain or emotional “numbness”
  • to punish themselves for supposed faults

People who self injure often feel an intense yearning to injure themselves. Even though they know it’s destructive, this feeling grows stronger until they complete the act of mutilation.  Feeling the resulting pain releases their distress and anxiety. This relief is only temporary, though, until their shame, guilt, and emotional pain triggers them to injure themselves again.

Who is At Risk for Self Harm?

Self injury happens in all walks of life. It is not restricted to a certain race or age group, nor to a particular educational or socioeconomic background.

It does happen more often in:

  • people with a background of childhood trauma, such as verbal, physical, or sexual abuse
  • those who have difficulty expressing their emotions
  • those without a strong social support network or, conversely, in those who have friends who also self harm
  • people who also have obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), eating disorders, borderline personality disorder, or those who engage in substance abuse

Although anyone may self harm, the behavior occurs most frequently in teens and young adults. Females tend to engage in cutting and other forms of self-mutilation at an earlier age than males, but adolescent boys have the highest incidence of non-suicidal self injury.

Self-Harming Symptoms

Physical signs of self harm may include:

  • unexplained scars, often on wrists, arms, chest, or thighs
  • covering up arms or legs with long pants or long-sleeved shirts, even in very hot weather
  • fresh bruises, scratches or cuts
  • telling others they are clumsy and have frequent “accidents” as a way to explain their injuries
  • keeping sharp objects (knives, razors, needles) either on their person or nearby
  • blood stains on tissues, towels, or bed sheets

Emotional signs of self harm may include:

  • making statements of feeling hopeless, worthless, or helpless
  • isolation and withdrawal
  • impulsivity
  • emotional unpredictability
  • problems with personal relationships

Help for Self Harm

The first step in getting help for self harm is to tell someone that you are injuring yourself. Make sure the person is someone you trust, like a parent, your significant other, or a close friend. If you feel uncomfortable telling someone close to you, tell a teacher, counselor, religious or spiritual advisor, or a mental health professional.

Professional treatment for self injury depends on the specific case and whether or not there are any related mental health concerns. For example, if the person is self harming but also has depression, treatment with address the underlying mood disorder as well.

Most commonly, self harm is treated with a psychotherapy modality, such as:

  • Cognitive behavioral therapy (CBT), which helps the person identify negative beliefs and inaccurate thoughts, so they can challenge them and learn to react more positively.
  • Psychodynamic psychotherapy, which helps identify the issues that trigger their self-harming impulses. This therapy will develop skills to better manage stress and regulate emotions.
  • Dialectical behavior therapy (DBT), which helps the person learn better ways to tolerate distress. They’ll also learn coping skills so they can control the urge to self harm.
  • Mindfulness-based therapies, which can teach them skills to effectively cope with the myriad of issues that cause distress on a regular basis.

Treatment for self injury may include group therapy or family therapy in addition to individual therapy.

Self care for self-harming includes:

  • Asking for help from someone whom you can call immediately if you feel the need to self injure.
  • Following your treatment plan by keeping your therapy appointments.
  • Taking any prescribed medicines as directed, for underlying mental health conditions.
  • Identifying the feelings or situations that trigger your need to self harm. When you feel an urge, document what happened before it started. What were you doing? Who was with you? What was said? How did you feel? After a while, you’ll see a pattern, which will help you avoid the trigger. This also allows you to make a plan for ways to soothe or distract yourself when it comes up.
  • Being kind to yourself – eat healthy foods, learn relaxation techniques, and become more physically active.
  • Avoiding websites that idealize self harm.

 If your loved one self-injures:

  • Offer support and don’t criticize or judge. Yelling and arguments may increase the risk that they will self harm.
  • Praise their efforts as they work toward healthier emotional expression.
  • Learn more about self-injuring so you can understand the behavior and be compassionate towards your loved one.
  • Know the plan that the person and their therapist made for preventing relapse, then help them follow these coping strategies if they encounter a trigger.
  • Find support for yourself by joining a local or online support group for those affected by self-injuring behaviors.
  • Let the person know they’re not alone and that you care.

Need More Information?

Are you concerned that your child is engaging in self harm? Don’t wait to seek help – speak to a compassionate child psychologist at The Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us for more information or call us at (561) 223-6568.

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7 Tips for Overcoming Back to School Anxiety

Another school year has come around and with it, the possibility of extreme fear and separation anxiety for some children. Although it’s normal for any kid to have a certain degree of back to school anxiety, there is a huge difference between a child who is nervous about the new school year and one whose anxiety is severe enough to seek professional care.

Kids often worry about things like fitting in or whether the teacher will pick on them, which increases their stress. In the week leading up to the beginning of the school year or in the last few days before the end of a school break, younger kids may show some separation anxiety by crying frequently, throwing temper tantrums, or being more clingy than usual. Older children’s school anxiety symptoms can include being moody or irritable, complaining of headaches or stomach aches, or withdrawing into themselves.  So how can a parent tell if their child just has school jitters or if they truly have back to school anxiety?

Fears about new teachers, harder school work, and being away from their parents are common for kids and usually stop within a couple of weeks once the child settles into the routine of the new school year. For those children whose anxiety symptoms continue beyond the first four or five weeks of school or seem extreme or inappropriate for their developmental level, a consultation with a therapist may be in order.

Tips to Ease School Fears

If your child is worried about the new school year, these back to school anxiety tips can help

  • Help you child identify what it is they are worrying about. Assure them that it’s normal to have fears. Give them your full attention and be sure to set a regular time and place to talk to them about their concerns. For example, bath time might be a good time to talk to a younger child, while a teen might be more receptive later in the evening.
  • Focus on the positives: In order to redirect your child’s attention from their worries, ask them to tell you a couple of things that are positive about school. Generally, even the most nervous child can think of something they like about it. Maybe they have a new friend or enjoy a certain subject or look forward to working on an art project. Looking for the positives can make the negatives seem a little less overwhelming.
  • Don’t pacify the child, instead coach them to come up with ways to solve their problem. Telling your child that “things will be okay” doesn’t help them get past their fears. What does is giving them some control. Encourage the child to give you some ideas of ways they can deal with what’s concerning them. This type of problem-solving helps them learn coping skills and teaches them critical thinking so they can develop a plan instead of simply reacting negatively.
  • Try role-playing. Going through a particular scenario can often help your child feel confident. Let the child be the “bad guy” teacher or scary bully, while you play the part of the child. Your responses can help them learn how to deal with the situation appropriately and allow them to respond with less fear.
  • Reinforce positive behaviors and reward their successes and their bravery in facing what they fear.
  • Be supportive, but don’t allow them to stay home from school. Even though it is normal for your child to worry about going to school, it is crucial that they attend. Allowing them to avoid school only increases and reinforces their fears. The longer they stay out of school the harder it can be for them to go back.
  • Seek professional help for back to school anxiety that gets worse or lasts more than about four weeks. Additionally, medication is sometimes appropriate in severe cases of separation anxiety.

Help Your Child Overcome Back to School Anxiety

If your child is struggling with back to school anxiety, it may be time to seek help from a compassionate child psychologist at Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida. Contact us or call us for more information at (561) 223-6568.

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