Compassion

The psychological definition of compassion is “a response that occurs only when the situation is perceived as serious, unjust and relatable. It requires a certain level of awareness, concern and empathy.”

With COVID-19 coming to a close and the trauma that we have ALL endured, compassion is necessary now. But, what does that mean???

It means taking a breath when someone complains about COVID (in either direction). It means listening and not judging. It means taking space for yourself when you are stressed. It means putting up boundaries in a kind manner. It means being responsive to others in a timely manner and respectful to them. It means being purposefully thoughtful and quiet sometimes.

I also want to take this post to personally apologize to the patients who have been on our waitlist during COVID. Please know that our staff have been working themselves on a daily basis to get you all in and have sacrificed their own self-care many times to help. However, this year has been very tough for us as a practice and honestly, overwhelming at times. We appreciate and care about you all as our patients, and words cannot express how we have appreciated your patience and understanding. We wanted to make sure to let you know we recognize that and are so very grateful to provide services in such a warm and loving community.

All our best,

WACCH staff and Dr. Kaplan

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The World has an Anxiety disorder!

 

Ok, folks. Here we go! Covid-19 is among us. Until now, as Director of the Washington Anxiety Center of Capitol Hill, I have decided that as a practice we needed to remain more in the shadows and treat each of our patients’ individual concerns about the virus. Recent events have now propelled me to speak further.

 

As a society (and I will bring social psychology into this), we have what is called diffusion of responsibility. Because we are not physically close to children starving in third-world countries, we do not think about it on a daily basis. We ‘diffuse’ responsibility to others. Now, Covid-19 is on our back doorstep and we are ruminating on it constantly.

 

The purpose of this blog post is to not discuss symptoms or Covid-19 recommendations. It is to discuss what is in our area of expertise: anxiety.

 

I have witnessed several events (majority occurring on social media) that have been concerning to me as a psychologist   These events range from parents teaching their kids how to create medical masks, checking out daily news blogs for the latest information every hour on the hour, telling your child to not talk to friends (even within an acceptable medically-recommended distance), to even telling your child the “world is ending.”

 

One of the robust etiologies (causes) of developing an anxiety disorder is through modeling (e.g., kids witness mom or dad be scared on a plane, so kids learn to fear flying). While there are reasons to be concerned about Covid-19 (I will not address those here), we must also be very aware of how our behaviors impact our children. We do not want our children developing schemas (i.e., ways of thinking about themselves and in relation to others) that the world is scary and dangerous. It is important to teach them that we can tolerate uncertainty, as hard as it may be to stomach. I implore our readers to recognize that each action we take, each sentence you speak, can have a very high potential to create a clinically diagnosable anxiety disorder in your child.

 

As for us as parents, well, it is important that while we recognize everyone is experiencing anxiety as a collective, that it does not mean it is not still clinical. If you are thinking about your response to Covid-19 constantly and it is making you feel very anxious and distressed and/or you are responding with behaviors out of your own normal (e.g., you used to read the newspaper 1x a day and you are now reading it every hour and getting more anxious every time), it may be time to seek out professional guidance. Psychologists who specialize in anxiety are trained to be able to recognize what is functional and what is not. I encourage any adult, if you are questioning your emotional response to Covid-19 or it is really bothering you, please seek out help. We are here for you.

 

Dr. Kaplan

Director of the Washington Anxiety Center of Capitol Hill

 

Talking with your child about difficult topics (i.e., race, disability, sexual minority status)

When talking with a child about hard subjects whether its race, disability, sexual minority status or something else entirely try out the 5 C’s.

  1. Show you C Children respond when they know that you are approaching them from a place of love and admiration for who they are and will become.
  2. Be C What made them say or think that? Why right now?
  3. Encourage C After asking open-ended questions, give them space to answer and let them know that they can always tell you what’s going on in their head.
  4. Provide gentle C If they said something inappropriate, teach them why it wasn’t a good thing to say and collaboratively come up with a better way for them to ask their question or communicate their thoughts in the future or a better context in which to do so.
  5. Celebrate differences. A child can always shock you with a novel thought or question but they are less likely to do so if you have already spent time pointing out differences that they may see in the world, explaining them, and celebrating them. Being different from others is not a bad thing. If the world were all one type of person, what a boring world it would be.

 

Here are some resources to help guide conversations.

Hyperlinks to insert:

https://www.washingtonpost.com/lifestyle/2019/11/22/childrens-books-can-help-start-conversation-about-race-parents-have-continue-it/

https://www.parenttoolkit.com/social-and-emotional-development/advice/social-awareness/how-to-talk-to-kids-about-race-and-racism

https://cecr.ed.psu.edu/sites/default/files/Ten%20Tips%20for%20Teaching%20and%20Talking%20to%20Kids%20About%20Race.pdf

What are some ways you have approached difficult topics with your kids?

 

Thank you to Celenia DeLapp, MA for this blog post!

School refusal, a podcast by our colleagues

School refusal is defined as when a child or adult refuses to attend school or their workplace as a result of anxiety, poor distress tolerance, or pathological avoidance.

Since the explanation of school refusal is long and complicated, our colleagues at Rogers Memorial Hospital recently released a podcast in 4 parts describing it and the treatment for it. We highly recommend you take a listen.

https://rogersbh.org/school-refusal?utm_source=Rogers+Memorial+Hospital&utm_campaign=706f18a9a1-EMAIL_CAMPAIGN_2019_05_14_02_40&utm_medium=email&utm_term=0_2b85836e2e-706f18a9a1-343194849

Great new book recommendation!

One of the best researchers and clinicians in our field of CBT just published an updated version of their book on Exposure Therapy (the MOST evidence-based treatment for anxiety). We highly recommend it for professors and consumers alike!

Our very own Dr. Kaplan was asked to review the book by the publishers! Take a look at her review on the link to the book below!

Summer is a break from school but not mental health!

With the exception of last summer (which I secretly hope is a result of the many talks and outreach activities our practice has given in the DC community), our child/teen appointments dwindle in the summer. Unfortunately this is not due to family vacations, but rather a strongly held “American belief” that kids needs a break from all things in the summer.

We HIGHLY recommend against the practice of only doing therapy during the school year. Our yearly, VERY predictable, schedule is that we become flooded with appointments in late September, early October. This is because the newness of school has worn off and clinical problems get their chance to emerge. In our kids who attend over the summer regularly, we see them frequently and effectively managing the stressors of transition back into the school year.

Remember it’s better to be proactive than retroactive!

 

 

Does my child need therapy?

Parents of young children often say that it can be difficult to decide if what their child is experiencing warrants treatment. They may be wondering if this is a “bump in the road” or something more.

Treatment may be appropriate if your child experiences:

  • Lack of self-confidence or self-esteem
  • Excessive worry about the future
  • Fears or phobias
  • Excessive reassurance-seeking
  • Reluctance or fearfulness when separating from you, sleeping independently, being in new situations, or socializing with new people
  • Repetitive behaviors
  • Difficulties with transitions
  • Frequent negative statements
  • Excessive tantrums or emotional outbursts
  • Challenges following directions
  • Difficulties hearing “no”
  • Toileting concerns

Psychologists use methods that not only treat emotional and behavioral challenges but prevent them. Whether your child needs help navigating typical, age-appropriate challenges or is managing more serious mental health difficulties, psychologists can provide helpful services that can make life healthier and more meaningful for your child and family.

Further, waiting to treat concerns typically results in longer, more intensive treatment. When concerns are left untreated, children may face the compounding challenges that come with rehearsing the same difficulties. Because the problem can seem unsolvable or out of the child and family’s control, it can also lead to decreased confidence and low self-esteem.

By Dr. Rachel LaFleur, Staff Psychologist, Washington Anxiety Center of Capitol Hill

http://www.washingtonanxietycenter.com