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Darbi Miller, MS, LMFT – Consult The Expert About Increasing Relational Self-Awareness

In this month’s Consult The Expert interview, we spoke with Darbi Miller, MS, LMFT. She is one of the marriage and family therapists here at The Center For Treatment Of Mood And Anxiety Disorders. Although she likes working with all ages, she enjoys the dynamic surrounding family and relationships.

“One of my favorite things to work with is increasing clients’ relational self-awareness,” she said. “I also enjoy exploring peoples’ Families of Origin, which is connected to self-awareness from my perspective.”

What Is Relational Self-Awareness?

What does she mean by “relational self-awareness”? “Family of Origin and self-awareness are related,” she answered. “In any experience with another person, relational self-awareness can look like asking ourselves, “What is mine? What is yours? What is ours?”

“We each have our own stories, beliefs, and experiences,” she said. “Relational self-awareness looks at what each person brings to the table and how this affects the interaction between us. If we are self-aware, we have a compass for ourselves which translates into tolerance. We are able to share our personal values and beliefs and hear the other person’s.”

“If we are not self-aware, our interactions are based in fear. We begin looking for approval or we get defensive because we may feel we will “lose” in some way if we are vulnerable with the other person. When you have self-awareness, however, you can be vulnerable and can create more intimacy in all of your relationships.”

Ms. Miller talked about a Harvard study that has been following certain individuals over an 80-year period. One of the surprising things it has found is that the quality of our relationships has a higher impact on our health than even our cholesterol levels. “It turns out that surrounding ourselves with positive, close relationships creates a better sense of community within ourselves, which in turn, has a better health impact,” she reported.

So, how does relational self-awareness help with anxiety treatment? “With anxiety, behind that is usually fear on a basic level. Our thoughts are powerful. If you can get to the core and understand the fear (how can I feel more connection with myself?), connecting to your body and grounding yourself, allows this to be part of the healing process.”

How Does Family Of Origin Fit Into Mood Disorder Therapy?

Ms. Miller explained how Family of Origin can impact the treatment of anxiety and other mood disorders. “We come from our own system that was learned in childhood. This is the Family of Origin,” she explained. “This system has patterns, beliefs, and values that we can sometimes see, but sometimes aren’t aware of. We all have a family role – maybe we’re the funny one, the responsible one, or the nurturing one. This role can carry into our adult lives and play out between couples.”

“Sometimes people go into a relationship expecting it to heal their Family of Origin wounds,” she said. “Although it can happen that a new relationship can be good and healing, if we enter it expecting our partner to instinctively know what we need to heal, that may not be the case and we’re disappointed. If you are expecting your partner to heal you, where is this coming from? The answer leads back to relational self-awareness.”

How Can We Use These Concepts To Improve Mood Disorders?

We discussed how knowing what we bring with us from our Family of Origin can be used to help when dealing with mood disorders.

“Knowing what you have “inherited” and what you can change can be very empowering,” Ms. Miller told me. “You don’t have to operate out of same system you inherited. You have control. The realization that you don’t have to follow the same patterns – and you get to decide – can help with anxiety and trauma.”

“I mainly use this work for people who feel stuck in their life, work, and relationships,” she continued. “During therapy, my approach is always to start at the top. We begin with something action-focused, like behavior organization, and getting back into routines that can have a positive effect on the person’s mood and decrease anxiety.”

“I also use cognitive behavioral therapy to challenge negative thoughts. Taken together, these give people some relief. But if they are still looking for more, this is when we explore other things like Family of Origin and relational self-awareness.”

“When we look into Family of Origin, we can choose to do the work for ourselves and also within the family roles, with siblings and parents,” she said. “I typically go three levels up within the family to look at the generational dynamic. Doing this work can uncover patterns that influence a person’s mood, narratives, and the core beliefs that influence mood, which can be healing.”

“People want to explore these concepts, but in a safe space,” Ms. Miller said. “So, we balance a safe space with these tools, allowing them to go deeper to uncover the aspects that may be underlying their anxiety, depression, or trauma.”

We Are Here For You

If you are concerned that your child is struggling emotionally or showing signs of anxiety or depression, contact The Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.

About Darbi Miller, MS, LMFT

Darbi Miller is a Licensed registered Marriage and Family Therapist. She has extensive training in Integrative Systemic Therapy however, does not believe one model fits all. Her approach is strength-based, collaborative, holistic, and geared to meet her client’s specific needs and goals. She works to truly understand each client and the systems that surround them. She believes therapy is a courageous step and feels privileged to bear witness to their journey. Through her authenticity, empathy, and compassion, she provides a safe space for exploration. Darbi works to integrate her knowledge into meaningful and collaborative sessions with individuals, couples, and families. Her areas of interest include walk/talk therapy, the mind/body connection, increasing relational self-awareness, high-conflict couples, and full family work. 

She holds a Bachelor of Arts in Psychology from Michigan State University and a Master of Science in Marriage and Family Therapy from Northwestern University, where she received academic distinction. She is also certified as an Eating Psychology Coach and a Prepare/Enrich Facilitator. Darbi has worked in a variety of settings including schools, hospitals, university clinics, and in-home. She also published an article in the Encyclopedia of Couple and Family Therapy on conjoint sex therapy.

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How Pandemic Stress Is Affecting Society: A Psychologist’s Observations

As a psychologist who treats anxiety daily, I’ve been in a distinctive position during the pandemic. I can very clearly see the difference the last two years have had on individuals, families, and society, as a whole. Right now, our Children’s Center is overflowing with kids. They’ve been struggling through losing personal time with friends and peers. They have had to adapt to online learning and the disruption of their routines – and it shows. We are also seeing many more adults in our Anxiety Center. The family/children aspect is a big concern for parents right now. They are very worried about their kids (the schools are, too). Adults are not only trying to help their children, they are also juggling lost incomes, supporting kids who are learning virtually, and coming to terms with relationship challenges, not to mention the illness or loss of loved ones. When the pandemic started, I told colleagues that this virus would have two parts to it. The first and most apparent part would be the medical aspect, since we knew some people would get sick from it. The second part, however, was the mental aspect. There was no doubt that every one of us would be affected by the pandemic in some way. Maybe we would personally contract the virus. Maybe we’d lose a job or a loved one. We had the stress of shut downs and the upending of our normal lives. Even if we have somehow managed to escape the virus’ direct impact, we have become aware of this bigger force looming over and all around us, over which we have no control.

Pandemic Trauma Effects

The pandemic is malignant. It is malicious, evil, and malevolent. The virus infects without regard. It sickens or kills the old, the young, the rich, and the poor. Knowing this does not sit well with us. Humans have an inherent coping mechanism that helps us distance ourselves from a traumatic event. We may feel sad or upset about a tragedy, but we can still go on with our day-to-day lives. But, this pandemic is so big and so menacing, we find it impossible to ignore. In my opinion, one of the best stories ever written about life and how we ultimately deal with tragedy’s fallout is the Wizard of Oz. In the story, the malignant force is the wicked witch. Dorothy can’t defeat her on her own. She needs the wizard to protect her from the witch and send her back to her normal world. After many challenges, she learns there is no all-powerful wizard. He’s simply a man hiding behind a curtain. All seems lost. She has to manage on her own. Like Dorothy, we are on our own as we try to cope with the mayhem brought by the pandemic, both as individuals and as a society. When we entered this crisis, we were relying on authority figures (our governmental leaders, the CDC, the World Health Organization, etc.) to help get us through a new unknown, but this hasn’t turned out as well as we’d hoped. The problem is that humans have dependency needs. As children, we relied on our parents to keep us safe. Today, our needs are not being met by those in authority.

No Escape From Covid Stress

We don’t feel safe. We are fearful, so some have begun to lash out at other targets. Often, they find them in fellow sufferers. Here’s why. If you were lost in the forest, you wouldn’t want to be alone. You’d want to be with others. But if you were in a group that couldn’t find their way out of the woods within a reasonable time, the members would start turning on one another. “It’s your fault we didn’t turn left, instead of right,” someone might accuse. It wouldn’t take long for the group to begin fighting amongst themselves. People would start doing their own thing in an effort to gain a measure of control of the situation. This analogy is being reflected in the infighting we’re seeing amongst ourselves lately. Sadly, this will likely continue to be a long term situation as we emerge from the pandemic. We won’t suffer as much from the medical aspect of the virus anymore, but we will continue to feel the effects of the societal and psychological factors that have resulted from it. I can’t stress enough how essential it is to stop watching and reading the news. These reports are almost always shocking, negative, and upsetting. This is not good for your emotional health. Dealing with so much trauma in the news and in our personal lives creates chronic stress and disillusionment. This is very much like the battle fatigue that military personnel encounter during a war. It wears you down. In this case, however, we have no battlefield to come off of. We literally have no escape. Knowing this only adds to the anxiety, mental fatigue, apathy, and depression the world is dealing with. As in my forest analogy, since it seems that no authority figure can make things better, some people become defiant. As a result, we hear about fights on airplanes, trucker blockades, protests against vaccine mandates, and mask and vaccine refusals.

Resiliency And Moving Forward

There is no easy answer for managing the emotional stress of the past two years. As the pandemic recedes and we move forward, however, our built-in resiliency will help us bounce back. People can basically recover from anything. I have seen them do so over and over during my past three decades as a practicing psychologist. That doesn’t mean there won’t be long term negatives from the pandemic or that we’ll develop amnesia about what happened. Without a doubt, some people will come out of this feeling kinder towards each other, while some will feel more selfish, entitled, and rebellious. Nature has a way of correcting itself, however. Just as a pendulum swings back and forth, the anger will swing back to the gentler side. I believe that our innate nature to help each other will help all of us cope as we move forward. We must take care of ourselves as the pandemic drags on. Already, many people have begun to reevaulate their priorities. This has led to The Great Reset we’ve been hearing about. We’re deciding what is important to us. We yearn for something meaningful in our lives, something better – whether it is a new career, a new relationship, or a new hobby. So, I encourage you to take the time to do the things that make you happy. Spend time with family. Take a deep look inside yourself to figure out what you want going forward. Take what has happened and learn from it. Become more spiritual in a way that is meaningful to you. Be more aware of time and how quickly it passes: use your time well. Go out and live, but don’t be irresponsible. Instead, use this experience to make your life meaningful. Remember that the Japanese symbol for “crisis” is the same as the symbol for “opportunity.” So, find your opportunity and turn this crisis into something positive!

If You Are Struggling…

We can help. Whatever the difficulties you are facing, we are here to listen and offer effective solutions. For more information, contact us or call the Children’s Center today at 561-223-6568.

About Andrew Rosen PH.D., ABPP, FAACP

Dr. Andrew Rosen received his doctoral degree in clinical psychology from Hofstra University in New York in 1975 and completed an additional six years of psychotherapeutic and psychoanalytic training at the Gordon Derner Institute in New York, where he earned his certification as a psychoanalyst in 1983. In 1984, Dr. Rosen founded the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, where he continues to serve as Director and to work as a board-certified, licensed psychologist providing in-person and telehealth treatment options. Dr. Rosen is Board Certified by the American Board of Professional Psychology (ABPP). He is also a Clinical Fellow of the Anxiety and Depression Association of America (ADAA) and a Diplomate and Fellow in the American Academy of Clinical Psychology (FAACP). He is an active member of the American Psychological Association (APA), the National Register of Health Service Providers in Psychology, the Florida Psychological Association (FPA), and the Adelphi Society for Psychoanalysis and Psychotherapy. Dr. Rosen was appointed a Clinical Affiliate Assistant Professor at the FAU College of Medicine in November, 2021. He is a Board Member of the National Social Anxiety Center. He has previously served as president of both the Palm Beach County Psychological Society and the Anxiety Disorders Association of Florida.
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Marsha Glines, Ph.D – Consult The Expert On Overcoming Learning Challenges

Marsha Glines, Ph.D is the only person on the Center for Treatment of Anxiety and Mood Disorder’s team who is not a therapist or behaviorist – she is an educator who brings a diagnostic standpoint to the Center. Her role is best defined as that of an academic coach. “I believe very strongly that learning should be empowering and meaningful,” she says. “Everyone learns differently and not everyone can learn through traditional classroom methods.”

The frontal lobe of our brain synthesizes and organizes information. “We have more than 100,000 neurons in our brains, so we each receive information differently than anyone else,” Dr. Glines says. “This means we also process the information we receive differently from each other.”

These information reception and processing systems are called metacognitive skills. Figuring out someone’s metacognitive skills tells how the person thinks, which then can help determine their learning strengths.

When an individual has challenges with learning through traditional classroom methods, “My role is how to find the appropriate path to learning for this person. Part of that is really getting to understand the student. This involves analyzing how they look at a problem and adjusting my strategies to help them learn and understand.”

To better recognize how each client learns, she begins by observing the individual and asking questions to help figure out their learning process. In addition, Dr. Glines takes an informal “inventory” of the skills and methods the person has successfully used in the past. Putting this information together gives her a good indication of where the student is in terms of learning.

The process then turns to modifying and experimenting with this information to see what works for the student. “If they are struggling in algebra, for example, we need to figure out how to change up the way they study algebra to make it useful for everyday skills.”

“The goal of my work is to find meaningfulness and purposefulness in how we learn. I help individuals find what their strongest cognitive pathways to their brain are, how to understand these pathways, and how to learn with them,” she explains. Does the client do better by hearing a lecture? Are they a visual learner? Do symbols or colors combine with what they are hearing to help them learn? Uncovering these unique methods makes a huge difference in the person’s understanding and retention of information.

Once Dr. Glines knows these strengths, she creates personalized education plans for what would be helpful for this person’s learning method. To do this, she uses repetition, challenge, novelty, and movement. “Our brains are wired to respond to new things, so changing up our learning method helps us learn and retain information,” she says. “I might teach them how to use symbols to remember something. Tools like mind maps and graphic organizers work well for a visual learner, for example.”

Similar to mnemonics, using tools, such as color coding the papers that students take notes on, can help with processing and retention.

At one point, Dr. Glines worked with students in a Psychology class to help them remember the differences between the pioneers in the mental health field. “These historical figures can all blur together,” she says, “so we discussed what color they thought of when they learned about Freud. Let’s say it was red. They assigned the color red to everything about Freud, even down to taking lecture notes on red paper.”

“Maybe Jung was the color brown”, she continues. “So his information was keyed to everything brown. At test time, when they saw a question about Freud, they recalled that he was red, not brown.” This allowed the students to “see” their lecture notes section in their notebook, which jogged their memory and often allowed them to correctly come up with the answer to the test questions.

Along the same lines, spatial models, symbols, and even acting out the information can function like a mnemonic. “Instead of just thinking in language and words, this is a different way of processing information and memory. It taps into different pathways of the brain’s retrieval system.”

Dr. Glines might also incorporate technology into the student’s learning process. “There are devices like smart pens that can record a lecture as the student takes notes, then lets the student replay that lecture,” she says.

This can be especially helpful for individuals who have learning disabilities. The person may not be able to visualize a spoken word in a text form, for example, which makes taking notes extremely challenging.  A smart pen can record oral notes, however. Later, the student can replay the lecture and even transform it from oral form to written text with the touch of a button. “A student can even tap a word in those notes, which then comes up to show them the meaning of words they find challenging,” she says.

Before any of these non-traditional learning plans can help an individual, though, they need to take ownership of what they value and what is important to them.

“What have you achieved and what do you hope to achieve? These are things you value and every decision we make is based on what we value,” she says. “These answers are empowering. Many people don’t take their school knowledge and think of how to apply it in real life, yet this is what gives ownership to the information we learn. If you can give the topic or subject meaning, you can learn and recall it much better.”

About Marsha Glines, Ph.D. (Academic Coach / Learning Specialist)

Dr. Marsha Glines has a national reputation in teaching and learning theory, special education, non-traditional program design and higher education curriculum development. Prior to joining the Lynn University community in 1991, Dr. Glines was the founding president of Beacon College and in October 2021 she was awarded an Honorary Degree Of Humane Letters from Beacon. While at Lynn University, Dr. Glines created and provided oversight of many academic alternative, innovative programs including: an undergraduate human service degree, the Advancement Program, the Lynn Educational Alternative Program and the “nationally recognized” Institute for Achievement and Learning.

Among her many achievements, Dr. Glines has published several pieces on post-secondary learning opportunities for students with learning disabilities and her work has been discussed in several books. In addition, she has conducted numerous training workshops both nationally and internationally and is a frequent presenter at various conferences on learning and higher education. She continues to teach remotely in Regis College’s undergrad and graduate education departments.

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It’s All About Trauma

“Now is the winter of our discontent,” a speech by Shakespeare in Richard III says it all as we muddle through the beginnings of a third year of this pandemic. This horrendous experience has taken a toll on all of us. David Brooks in his op-ed in the NY Times (America Is Falling Apart at the Seams, NYT, Jan 14, 2022) comments on the current misbehavior of Americans. He describes the angry outbursts noted on commercial airline flights, in retail establishments, as reflected in highway fatalities, suicides and homicide rates or even evident in members of Congress. He identifies the usual suspects including the pandemic, politics, media, Facebook/Twitter/Instagram et al.

I think that we would all agree with his observations and many, if no most of us identify with the frustrations, irritability and general crankiness that has resulted from the Covid 19 “gift that keeps on giving”. However, I believe that there is more to the story than what is stated above. It is my contention that the entire populace has been traumatized by the unfortunate saga that we have endured. The unremitting psychological stress has resulted in anger, frustration intolerance, depression, hopelessness, out-of- character risk taking, impulsivity, substance use and a general loss of trust.

Psychotrauma had historically been defined by mental health professionals as exposure to a near death experience. The individual has had to have the intense fear of believing that they would die. Classic examples include severe car crashes, plane crashes, muggings, heart attacks and combat. It also includes abusive life experiences whether they be sexual, physical or emotional. One end of the spectrum is represented by Post Traumatic Stress Disorder (PTSD) which for a long time was what we considered the primary trauma syndrome. The criteria for PTSD had been extraordinarily specific and if one did not meet the necessary components found in column A, column B or C there was no pathological trauma condition we labeled PTSD. We now know better and have thankfully expanded the concept to include direct or indirect exposure to traumatic events. For example, the 9/11 tragedy created PTSD not only in those who fled the twin towers but individuals in the area around the twin towers who witnessed the catastrophe. Other examples include family members who watch a loved one succumb in an ICU and subsequently develop PTSD themselves.

Recent research has extended our understanding of traumatic exposure and trauma syndromes. We now understand that trauma does not have to develop in response to an identified traumatic event but that persistent exposure to a lower level of abuse can traumatize the victim. It has been my clinical experience that day after day exposure to an abusive parent whether it be emotional, sexual or physical can be more pathologic than an isolated horrendously abusive event. In addition, we now recognize that there is an entity called complex trauma. Complex trauma signifies the presence of repeated traumatic experiences over time. For example, the individual who has had a number of abusive relationships can develop a complex trauma syndrome.

So let us now return to our pandemic journey. We have all been exposed to multi-media’s painfully graphic reporting of our experiences throughout this pandemic. We have witnessed people on ventilators, grieving loved ones, heard of entire families wiped out by this virus, learned of the need for lung transplantation and observed our loved ones suffering uncertainties as to whether or not they would end up on a respirator or in an ICU. To make matters worse, the presence of a virus that none of our professionals had experience with before it infected the world led to much uncertainty, misinformation, changing recommendations from these health experts. We have observed angry politicians blaming governmental health agencies with harming the public. We even heard that Dr.Anthony Fauci had to endure credible death threats to himself and his family. All of this uncertainty and confusion naturally leads to a sense of helplessness and fear. We are human beings and as such have became a captive audience to the two plus years of stress and traumatic life experiences. Not too different from the child who has to survive an abusive family system. This person spends each day not knowing what the outcome will be or having the means to protect oneself.

So I believe it is safe to say that based on the multitude and varied pandemic-related traumatic experiences all of us have had to deal with there comes a point where the fabric of our humanity begins to shred. We need to understand this level of suffering and recognize that as this pandemic winds down we will all need time to heal. And remember, you are not alone.

Let Us Help

Trauma can be difficult to understand and even more so, to handle on your own or for your child to handle. Whether your challenges are recent or from years ago, the professionals at The Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida can help. For more information, contact us or call us today at (561) 223-6568.

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Jerome Siegmeister MD

Jerome Siegmeister, MD, MaED – Consult The Expert On How Virtual Schooling Is Affecting Children

Dr. Jerome Siegmeister, the Center’s newest clinician, is an expert on the psychiatric concerns of children and adolescents. A former high school teacher, he is in a unique position to help children through mental health resources that are tailored specifically for kids or teens in need.

Since the pandemic, parents and children have had to adapt quickly as schools shut down for periods of time. Virtual classes have become routine. An online learning environment can be difficult enough for kids, without being isolated from their peers. “Covid has really devastated these kids,” Dr. Siegmeister says. “Though some children can do well in this environment, virtual learning causes an issue for most.”

“The virtual learning modality is basically a lecture modality,” he continues. “What do you and I do when listening to a lecture? If we are honest, most of us listen to it in the background while doing other things, so we miss a lot of the information.”

“Children are no different,” he says. “From a developmental standpoint, it is clearly better for kids to attend in-person schooling, but the unfortunate reality is that we need to be worried about public health, as well. In many cases, virtual learning is all we have right now, but this isn’t workable for many kids.”

Aside from the loss of knowledge, the pandemic has affected our children’s social interactions. “Virtual classes have their place because kids need to be learning, one way or another, but it comes at a price,” he explains. “It is very obvious that our children’s socialization has been affected and will be for a long time to come.”

“At this point, we have lost at least eighteen months of socialization,” he says. “Society pushes the idea that we need others to validate us, so kids rely on social acceptance for much of their self-worth. Covid took away much of that.”

Even older teenagers are being tested by this new normal. “The pandemic has been very hard for kids who are transitioning to college,” he notes. “Life is drastically different for them, especially if they are having to do their first year of college virtually. They are missing out on the social aspects that help them adjust to college life.”

Nevertheless, Dr. Siegmeister is optimistic. For most kids who are struggling, “it isn’t too hard to stabilize them and they can do really well,” he says. “Counseling and working one on one with kids will make things better in the majority of cases.”

When it comes to mental health concerns, Dr. Siegmeister believes in treating the whole person. He often uses a team approach and commonly involves the child’s parents, teachers, or college faculty. He also may combine two or more treatment methods for children whose needs that are not being met by one single approach. For example, he may use cognitive behavior therapy along with medical treatments if the child has an underlying psychiatric concern.

And, although a pandemic silver lining would seem unlikely, Dr. Siegmester says there is one. “Mental health is often swept under the rug,” he says, “but depression is now pretty pervasive in both children and adults and people recognize this. In fact, many so called “sick days” happen because the person is depressed and really needs to take a mental health day. The positive outcome from covid is that people are now much more aware of anxiety and depression because they’ve experienced it themselves. This means it has become much more acceptable to seek help.”

About Jerome Siegmesiter, MD, MaED. (Child And Adolescent Psychiatry / General Psychiatry)

Jerome Siegmeister, MD, MaED, is a South Florida Native. He has worked with clients of all ages, and believes that the whole person needs to be treated. Consequently, he evaluates all aspects of the situation, from medical to situational, to determine the best initial course. He has a background in both individual and group therapies, employing supportive, behavioral, and insight oriented approaches, as appropriate to best fit his client’s needs, as well as comfort with medical treatment of any underlying conditions that might manifest psychiatrically. He has significant experience in all forms of psychiatric issues, including mood symptoms, thought disorders, anxiety, phobias, attention deficits, behavioral issues, insomnia, compulsive disorders, emotional lability, substance abuse, and trauma.

Dr. Siegmeister graduated with his Bachelor’s from Florida International University, after which he spent a number of years teaching, and obtained a Masters from the University of South Florida in Career and Technical Education/Adult Education. Upon deciding to pursue medicine, he initially completed a Post Baccalaureate Pre-Medical Certificate program at the University of Miami, and then obtained his MD from the University of Miami Miller School of Medicine, staying there afterwards for his specialty training in Psychiatry, followed by a fellowship in Child and Adolescent Psychiatry, where he served as Chief Fellow, and was awarded with a Research Distinction. After training, he has worked providing Emergency care, with additional work in inpatient settings, both in mental health and as a consultant to medical units at multiple hospitals. He is currently Board Certified by the American Board of Psychiatry and Neurology in both general Psychiatry, and Child and Adolescent Psychiatry, and by the National Board of Physicians and Surgeons in Psychiatry.

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Children Can Now Get The Covid Vaccine, But Some Parents Are Anxious

As we have watched the Covid-19 pandemic unfold, the focus has been on vaccines being the key to getting us safely through the crisis and back to our normal lives. When they first came out early this year, adults were clamoring to get the jab. Since then, many parents have eagerly awaited FDA approval for their kids to be eligible as well, especially since mask-wearing is optional in some school districts.

Despite recent approval for children as young as 5, however, some parents are wary of the lack of long-term data on the vaccine, as well as some of the potential side effects. This has resulted in anxiety over whether it is better for their kids to risk getting the virus or the jab.

Why Are Parents Vaccine Hesitant?

Getting a child vaccinated against Covid-19 can be a very difficult decision for parents. Clearly, they want to protect their kids, but on the other hand, many are deeply concerned about the potential for long-term vaccine side effects. According to the Orlando Sentinel, “In a survey of 1,000 parents, 57% said they were willing to vaccinate their young kids against COVID-19, meaning more than 40% were not…”

The same referenced survey, done by the Centers for Disease Control (CDC) and their partners, “found many of those who are hesitant were worried about long- and short-term side effects, said they want to wait to see if the vaccine is safe or said they did not trust it.”

Parents are also concerned about the reports of myocarditis and pericarditis (inflammation involving parts of the heart) in teens and young adults (mostly males) who have gotten the vaccine. Johns Hopkins Medicine says, however, that “myocarditis is a much more common complication of having COVID-19 than from getting vaccinated.”

Even parents who want to vaccinate their children may be waiting until the vaccine comes to their kid’s pediatrician. They feel that putting their child through a mass vaccination setting with hundreds of people and an unfamiliar provider might be too traumatic.

 What Do The Experts Say About Covid And Children?

The American Academy of Pediatrics reports that children are at a lower risk of getting severely ill or dying of Covid, however it does also note that more than 5 million U. S. children had tested positive for the virus as of mid-September, 2021. Even though the vast majority have recovered, some of those children have become Covid long-haulers.

In addition, getting the virus naturally has been known to cause severe disease in some cases. The CDC has published information about the link between Covid and Multisystem inflammatory syndrome in children (MIS-C). They state that MIS-C “is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs.”

How To Talk To Children About Getting The Covid Vaccine

If you are getting your child vaccinated against Covid, remember that kids take their cues from adults. If you are very worried about this vaccine, you will likely convey that fear to your child, unconsciously or otherwise. If you or your child are reluctant or afraid of the vaccine, talk to your child’s pediatrician for reassurance. They can provide you with statistics about the virus in kids and about the vaccine side effects, as well as give you their professional opinion about the jab.

Then, if your child is old enough, we recommend first asking them how they feel about getting the Covid vaccine. Are they scared? Eager? What are their concerns? Explain why you feel it is (or isn’t) a good idea for them to get the vaccine. You can also compare getting the Covid jab with the other vaccines they have gotten in the past, and how they have protected them from childhood diseases.

Lastly, talk to your child about the potential side effects that can be expected from getting the jab. They might run a slight fever, have a sore arm for a couple of days, or feel yucky for a day or two. But those possible side effects are small in comparison to being able to do more things, such as being able to get together with family over the holidays and enjoying a more pre-pandemic lifestyle.

Your child will also be reassured to know that you will stay with them while the get the vaccine and that you will be there for them if they don’t feel well afterwards.

Let Us Help

If you or your child are very fearful about the pandemic or are showing signs of anxiety or depression, 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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Why It Is Important To Set Limits For Children

Parents often avoid setting limits for their kids because they think doing so will upset the child. Not setting boundaries, however, can lead to an unhappy child who doesn’t know how cope with difficult feelings, which is an essential life skill.

By setting limits on what they can and cannot do, you are giving your child a chance to practice managing their emotions. When they are sad or feel overwhelmed, allowing them to figure out how to handle the situation on their own (with limited parental intervention) helps them grow into strong people who can face the challenges of adulthood.

Why Rules Are Important For A Child

Discipline is the process of shaping a child’s behavior in order to raise emotionally mature adults. It teaches self-control, core family values, and consideration for others’ needs. It also instills assertiveness without being aggressive or hostile. Learning what is expected of them in terms of behavior gives a child an understanding that their actions have an effect on those around them. Through discipline, children become emotionally mature, considerate people who can tolerate discomfort when necessary.

Contrary to the negative connotations of discipline, such as “punishment” or “controlling” the child, boundaries and limits actually help children feel more secure. Adherence to rules, expectations, and routines make things predictable. They reduce confusion and uncertainty, which in turn decreases anxiety. If a child is able to get the parent to change their mind or relax the rules on a regular basis, it threatens their security because they learn they have more power than the adult.

How To Set Limits With Your Child

Through the years, there has been much controversy about appropriate ways to discipline children. Oftentimes, parents want to set boundaries but they have no idea how to go about it. How to do they balance the freedom to be a child with restrictions so their kids learn self-discipline?

The first step is that you, the adult, need to know what behaviors you personally value and what you believe in. Is it important to you to be respected? To be loyal? To be honest? If, for example, you value honesty and you don’t discipline your child for lying to you, then you’ve taught them it is okay to lie to get what they want.

Next, you need to decide what values you want to uphold as a family. Is it important to eat dinner together as a family? To get homework done before watching television or playing games on the computer? To have a scheduled quiet time to wind down in the evening? These values may change as your children grow and mature, but setting down family values will help your child function respectfully within the family unit.

Along the way you have to also do the things you are asking your child to do. Children learn from example and if you ask them to do one thing, but you do another, it’s confusing to them. In addition, both parents should agree as much as possible on the limits and boundaries they are setting for their children. Without this agreement, kids will quickly learn to play one parent against the other to get what they want.

Consistency is the key to discipline. Sometimes the hardest thing to do is to be consistent and keep to those limits, though. This is especially true when you are worn out from work, not feeling well, or are under pressure. If you occasionally let your child off the hook, don’t be too hard on yourself. The trick is to keep it from becoming a habit.

Setting Age Appropriate Limits For Your Child

Obviously, your child’s limits and boundaries will change as they age, but the following are our age appropriate recommendations:

  • Infants (birth to 12 months) – Limits for this age basically revolve around setting schedules. This includes setting a nap or bedtime schedule, a feeding schedule, and a playtime schedule.
  • Early toddlers (one year to two years) – Children need to explore at this age, so you need to be somewhat tolerant. Limits include keeping the child safe, limiting aggression (hitting, biting, etc), and keeping possessions safe from toddler destruction. During this age, toddlers do not understand verbal explanations, so simply say, “no” and remove or redirect the child away from what they are doing and towards a more suitable activity.
  • Late toddlers (two years to three years)This is the time for temper tantrums as the child leans there are limits to what they can do or play with. Kids this age don’t understand how to change their behavior based on your directions or anger, so it is better to remove or redirect them. If the child throws a tantrum, remove them from the activity until they calm down.
  • School-age (eight to eleven years) – Children at this age rely on rules and order to make sense out of their environment. They think in absolutes and enjoy predictability, which means security to them. Despite what they will tell you, they want rules and need structure in their lives. Without guidance, there is uncertainty, which is very scary to children in this age group.
  • Adolescents (13 years to 18 years) – Adolescents are typically caught between the demands of their peers and parents. They may abandon family and parental values as they become more involved with friends. They may challenge limits without apology. They may also distance themselves from family members. As tough as it can be sometimes, the best thing a parent can do is to avoid lecturing or belittling an adolescent. Stay available to talk when the child needs to and continue to require them to adhere to the rules you’ve set down. Making a “contract” for behavior between you and your teen can be helpful, as well.

When you know where to draw the line, it will be easier to maintain a healthy relationship with your child. By defining what they can and cannot do, parents are able keep from disciplining emotionally, which allows their child to develop the skills they will need to be self-aware, independent and happy as they mature.

We Can Help

If you are concerned about setting and enforcing limits for your children, we can help. 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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Handling Anxiety About Going Back To School During The Pandemic – 2021

School is starting up for the 2021 – 2022 education year and most districts are returning to in-person learning. While some kids and parents deal with anxieties during any given school year, COVID-19 and the Delta variant are still very much in the news, which has added more uncertainty for everyone.

Virtual learning took place this past school year and many kids may now find it difficult to adjust to being away from the safety of their homes. Those children who already suffered with pre-existing depression or anxiety might have an even more difficult time adjusting than normal. Even well-adjusted children may experience undue stress.

What Signs Of Stress Can Be Observed In Children During The COVID-19 Pandemic?

Generally speaking, kids are resilient. Most children will manage this transition just fine with help and support from their parents. Those who already struggled with anxiety or emotional problems before the pandemic might need additional assistance though; it’s important that you keep a watchful eye on them because they could be at risk for increased depression or anxiety.

Signs of stress to watch for include (by age group):

Preschool age – Children in this age group may be more whiny or clingy than usual. They may have problems sleeping, have nightmares, or become afraid of the dark when they weren’t before. You may also find that they withdraw or their behavior may regress. They may lose their appetite or become picky eaters.

Ages 5 – 9 – Children who are in elementary school also may be clingier. They may be angrier or more irritable and cry or otherwise resist to going to school. They might have nightmares and sleep problems, along with poor concentration. In addition, your child may stop showing interest in friends or activities they used to enjoy.

Ages 10 – 19 – Adolescent children may show everything from sleeping and eating disturbances to agitation or arguments with others. They may have physical complaints such as headaches or stomach aches. They may also exhibit poor concentration or engage in some type of delinquent behavior.

Back To School Anxiety For Parents During The Pandemic

The pandemic has made in-person schooling nerve-wracking for some parents. They are apprehensive about their child’s health and well being, but they also have to try to reassure their child that school will be safe for them. It can feel like a balancing act between supporting your kid while also telling him/her to be sure to wear their mask or stay socially distant from others. It’s all very stressful!

Dealing with stress and fear is a learned skill. Children need to learn how to react when faced with difficult situations. They benefit from having someone show them how to deal with worrisome situations without panicking and who can find positive ways of handling their fears.

To keep them safe in school, ensure your child knows how to wear a mask correctly (it should cover their nose and mouth). Teach them to carry and use hand sanitizer and how to wash their hands (wash for the time it takes to sing the birthday song). Make sure they understand how social distancing helps to reduce the spread of the virus. Teach them to cough into their elbow or a tissue and to throw a used Kleenex away immediately.

Lastly, protect your child’s health by encouraging them to eat well, get plenty of sleep and exercise daily. This will help build their immunity so they can fight off illness in the future.

Supporting Students Return To School During Covid

Going back to a physical classroom is a transition and, as with any big change, it will take time for your child to settle into a new routine. Expect there to be times of distress and upset for the first couple of weeks. This is particularly true during the pandemic when kids are having to adjust to so many new things.

Your child may be overly tired during the first few weeks of school. They might act out more often or be more emotional than usual. If there are major shifts from their normal behavior, however, such as refusing to take part in things they usually enjoy or withdrawing from friends, this could signal problems. You should consider seeking help if this behavior doesn’t go away after a couple of weeks.

Also, make the time to sit down and talk to your kids during the first few weeks of school. Encourage them to tell you what’s bothering them; acknowledge their concerns even if you don’t agree with them. When you know what is concerning your child, work with them to come up with a plan for addressing it. What can you, as the parent, do to help? Is there something the child can do? Does the school need to get involved?

Self care is vital for maintaining your own physical, emotional and mental well being. One way to do this is by engaging in calming activities such as yoga or crafting. What were some ways that made you feel better before the pandemic? Use what worked for you during previous times of stress, be it reading, exercising, listening to music, etc. Even just taking a small break can help you mentally regroup and make you feel less overwhelmed. Take a short walk around the block or indulge in some deep breathing exercises. You don’t have to take a long break – even just taking 15 minutes here and there will help.

We Are Here For You

If you are concerned that your child is struggling with anxiety or depression when they go back to school, 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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How Will The Delta Variant Affect Going Back To School?

The coronavirus pandemic has affected our world in so many ways and we aren’t in the clear yet, despite vaccine availability. The virus continues to evolve, which is especially concerning if you’ll have children attending in-person classes this fall; as children head back to school, they do so under the specter of the Delta variant of Covid-19.

The pandemic response is deeply impacting our children. Virtual learning has become common, so kids who will be attending traditional classrooms this year may not have done so during the last school year. As a result, they may need to cope with new rules and regulations designed specifically for the safety of all students. In addition, extra-curricular programs like sports or clubs may be closed due to fears of exposure. It is also likely our children will have less of a chance to gather with friends at school as teachers and administrators attempt to maintain social distancing.

What Is The New Delta Variant Of Covid

The Delta variant, originating in India and first making news around the middle of June, has caused concern among health experts as cases become more prevalent.

The new strain is spreading more rapidly than COVID-19 strains before it. In fact, the Centers for Disease Control and Prevention reports that the Delta variant is now responsible for more than 80% of new cases in the country.

Delta is different from prior variants because it is not only much more contagious, it also grows more rapidly in the respiratory tract and is making people sicker faster.

Are Children At Lower Risk Of COVID-19 Than Adults?

Originally, Covid-19 was affecting mostly older adults. Children were less vulnerable to the virus. That is no longer the case. Because the Delta variant is so transmissible and vaccines aren’t yet available for children younger than 12, kids are now at a higher risk of contracting Covid than they have been in the past.

Research, however, has proven that vaccination is an effective way to protect against COVID-19. For this reason, it’s safest for all children 12 years of age and older to be vaccinated from the disease. However, unvaccinated children are also safe in the classroom as long as they take precautions such like masking and limiting social contact during their time at school.

Delta Variant Symptoms In Children

The symptoms of the Delta variant are basically the same as those we all know by heart now: fever, coughing, shortness of breath, headache, and the possible loss of taste and / or smell. The problem with the Delta variant is the fact that it has a greater chance of becoming serious – especially among the unvaccinated.

Delta Variant Back To School Safety Tips

After vaccination (which may be available to kids younger than 12 by the end of 2021), wearing a mask is the most important thing your children can do in the classroom. This goes for school staff and teachers, as well – regardless of vaccine status.

Although schools will try to keep kids socially distant, this can be a challenge when they are indoors. It may be hard for them to physically distance themselves from friends after possibly spending the last year separated from them through virtual learning. In addition, the fact that they have to stay socially distant can create anxiety for some kids who may fear that others will get sick and pass the virus on to them.

We know that children naturally crowd together during more social times, such as at lunchtime. While recent studies have shown that we only need to be three feet apart (instead of six), you will still want to teach your child the importance of wearing their masks at all times, except when actively eating or drinking. Also, remind your kids to wash their hands often during the school day and teach them to cover their sneezes and coughs with their elbow.

At the same time, try to avoid making your children feel overly cautious to the point that they are afraid to do anything. While it’s good to make them aware of their part in helping to stop the virus’ spread, it can be upsetting and frustrating for them to be constantly on guard and worrying about everything little thing they do.

Lastly, it’s important to make sure your child’s school has good policies in place to limit infection. Since masking provides extra protection against the virus, there should be a universal masking requirement in the school. In addition, the school should take steps to immediately quarantine students or staff who show signs of being symptomatic.

To support your child’s mental health during this school year, remember to keep to a routine. Doing so gives kids a sense that things are under control. Also be sure to foster an environment in which your children know that you are willing to discuss any worries or fears they might be facing.

We Are Here For You

If you are concerned that your child is struggling emotionally or showing signs of pandemic anxiety or depression, 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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What We Have Learned From 2021

No one can deny that 2021 has been a momentous year. It has had a mixture of the good, the bad and the ugly for sure. It has at times been frightening, confusing, comforting and educational. We have witnessed a very unusual presidential election, a subsequent denial by some of the validity of the election and an unheard of polarization of our peers and lawmakers. Most critically, we have endured a gift that keeps on giving; the novel coronavirus that has killed countless people world-wide and more fellow Americans than we would have ever anticipated. We have had to learn the meaning of the word epidemiology as it relates to health and wellness. Unfortunately, we now know explicitly what a spike protein is and looks like. More than ever before we have been influenced (for good and bad) by the internet and social media. Although we have been witness to conspiracy theories in the past, but this year has certainly been a boon time for them.

So it is important for us to sit back and take stock of the emotional and psychological impact of these events.   A major fallout has been the confusion over what is fact and what is fiction. We have seen the major news networks disagreeing on many important issues. Who to believe? Proponents of networks that broadcast their unique take on the news may be diametrically opposite of the proponents of the “other” networks. To avoid getting into trouble I will leave the network names blank, but I am sure you know what I am talking about. There was a time in the 1950s and 1960s when veteran newscasters like Walter Cronkite, Huntley and Brinkley, Douglas Edwards educated us nightly on national and world events. Marshall McLuhan’s “the medium is the message” conveyed the power and influence of the media. Somewhere during the subsequent decades all this has changed. It became apparent to television and radio that communicating news is basically a form of entertainment. Like most popular entertainment venues it becomes essential to be able to sell the programs to the masses. Media outlets have always been for profit businesses (exceptions being Public Radio and Public Television) but it seems that profitability became linked to the entertainment value of their shows. Newscasters and news commentators became the entertainers that we see today. Walter Cronkite would not succeed as a newscaster in 2021.

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