The world has been a difficult place to explain these past few weeks, between terrorism in Paris and terrible shootings across the US. It is so hard for adults to wrap our own heads around -- how do we explain these events to kids?
I don't have a perfect answer. But, here is what I suggest and what I think is working okay for my own kids and my patients.
-For very young kids, protect, protect, protect. Until kids get to school age, and start hearing about world events from friends, let them be innocent for as long as you can!! This might mean no longer watching the evening news, not leaving gory newspaper cover stories out and about, and listening to kid music in the car instead of NPR. For the 3, 4, and 5 year old set, this stuff is just too upsetting to explain.
-Once kids are school age (elementary school), I still believe in some degree of shelter, particularly in the younger grades. I do not think young kids should be watching the news or reading newspapers. I think we can keep our kids somewhat aware of the world through family discussions -- for example, by discussing how our government works, how lucky we are to live in a democracy, how we can help people less fortunate than ourselves, etc. Yet, when we introduce these topics to our own kids (as opposed to them being introduced by the media), we can make adjustments for our kids' unique temperaments and sensitivities.
-At the time of the Boston marathon bombings, my daughter was in 3rd grade. I did not tell her about them, she found out at school, and she was furious at me. We now have a "policy" that I will tell her about events of national importance (as defined my me!). I would rather discuss such events at home than have her find out in a scary way at school and have no way to process the information until she gets home. So, I now provide information on big events, but I try to keep the information as simple and to the point as possible. I strongly believe that kids should not watch too many images of traumatic events. Memory for words is different from memory for traumatic images. So while I told my kids about the Paris bombings last month, they absolutely did not watch any news reports or look at any newspaper articles about it. Those scenes were hard enough for me to process.
-Anxiety is driven my discomfort with uncertainty. I talk at work all the time about how we can't guarantee certainty about much of anything. And, once we accept this, our anxiety actually decreases. We stop ruminating and we stop trying overly hard to prevent bad outcomes that we actually have very little control over. I see these big events in the same way. I do reassure my kids and my patients that we live in a very safe country - and how lucky we are for that! But, I do not say that these bad things will never happen "here". They could. It is highly unlikely. But, things DO happen and kids know this. Kids know about 9/11, and the Boston Marathon bombings and about people being out listening to music in Paris last month. By a certain age, they know we are not being genuine if we PROMISE that nothing bad will happen in Philadelphia or Cleveland or Seattle EVER.
-And, at the same time, we have to live our lives. Anxiety means avoiding things we used to enjoy or that should be fun. We don't want to give in to anxiety (or give bad guys the sense that they won). So, I tell my own kids and my patients that it is important to keep living. Although we would not go on a trip to a war-torn region right now, we WILL continue doing all of our usual activities which involve big cities, crowded places, running races, all modes of travel, etc. This is what life is all about -- living, even with a tiny bit of risk.
-What about bad guys? It is very personal how we explain these "Bad guys" to our kids. Sometimes religion can help. Sometimes psychology or neuroscience can help. I can't tell you how to explain these ghastly people to your children, and I won't share exactly how I speak to mine. The important thing is to keep the message simple. Choose an explanation, keep it short, and only provide more info if the kids ask.
I live with a 7-year old with a very busy brain. He is bright & inquisitive. He also has a lot of physical energy and loves to play soccer, go running with me (although I can't keep up!), or challenge our babysitter to a lively game of flag football.
More and more, I feel like the adults in his life are telling him to FOCUS and CONCENTRATE and PAY ATTENTION. And the more I nag him about this, the more I feel that we, the adults, are creating this problem for kids.
Let me outline my son's day yesterday - which I am sure will sound like a lot of your kids' days. He was up at 7:30 and in school from 9-3:30. As I noted in my last blog post, he has a working snack in school. Yesterday, one kid was misbehaving in his class so the whole class was kept in for 7 minutes of their 20 minute recess. The children can no long play kickball at recess because some kids were being too aggressive. The kids were apparently not behaving in their table pods, so their classroom was transformed to rows of desks. By his report, there is very little socializing during the day except at lunch.
When he got home, we spent half an hour studying for his spelling test today. It was a gorgeous fall day, but who has time to play outside when there is a list of 10 words to master?
At 5, he had his piano lesson. By this point, the poor guy was gone. He didn't misbehave, but his piano teacher told me that everything he was trying to teach went in one ear and out the other. The teacher asked me to please suggest some strategies to keep my son focused next week.
From what I can tell, this energetic 7 year old had about 10 minutes to blow off steam yesterday but even then, there were rules about how this could be done. The expectation that he should basically focus for 10 straight hours just seems off.
I looked back on my time in 2nd grade. I actually can't remember it, but I do remember third grade. I have a sister and went to a girls' school so some of my perceptions might not apply for a boy my son's age. But, here is what I can recall. Our recess time lasted at least half an hour, regardless of weather (in Canada). Indoor recess (so common here in our suburban Philadelphia public school) did not exist. I remember no restrictions on what we could do at recess. Extra-curricular activities like Brownies and ballet happened during lunch/recess time. We had after school electives one day per week, when for an hour we did cooking, knitting, a sport or whatever interested us. I recall no other after school commitments until grade 7. In second grade, I did walk to and from school (this stopped when I switched to private school because I lived too far) and this was the norm. Kids walked without parents. This allowed for more time in fresh air, getting exercise, and just being silly kids. At our school, we did get a lot of homework. But, I remember coming home and playing outside, getting homework done before dinner, and then watching all the classic shows of the 80s like Family Ties and Growing Pains!
And, I don't recall a single kid at my school who had attentional problems.
Before we start diagnosing every child with ADD, and putting kids on medication needlessly, let's look at our expectations. Let's ask ourselves if WE could maintain the level of focus they are being asked to maintain. Maybe it is these expectations that need to change, rather than our children.
Sometimes, your kids come home telling you something that seems too weird to be true. This Fall, my second grader came home saying that in his classroom, they have "working snack." Odd, I thought. Till Open House night when his teacher asked us to pack a snack the children can eat with ONE HAND so that they can eat and work at the same time.
As a mom, and a child psychologist, this broke my heart. This is not developmentally appropriate at all! The attention span of second graders ranges from around 5 minutes to maximum 25 minutes (and boys, by nature, will fall at the lower end of this range). In other words, kids of this age need frequent breaks and frequent shifts from one activity to another. Not honoring this truth simply increases the likelihood of bad behavior in the classroom!
My bigger concern, however, is the limit placed on time to socialize. Friendship skills are a huge part of the education of children this age. Shouldn't children be encouraged to eat their snack while chatting with their friends? Isn't this what we, as adults, do when we gather around the water cooler or grab a coffee with a co-worker?
As parents, can we instill change in our schools? Let's try. Let's speak up for rules and standards that just don't seem right. And, when our kids aren't in school, let's be sure we give them a lot of time to just be kids. Playdates that don't involve screen time, adult-directed rules, and time limits on having fun.
There are just some times in life when a lot of really sad things happen all at once.
In the past few weeks, three of my friends have lost elderly parents (and their children have lost beloved grandparents). One of my friend's mothers had an organ transplant. A third-grader in our community almost died in a drowning accident due to an undiagnosed heart defect (and thankfully, walked out of the hospital yesterday after amazing treatment and the implantation of a defibrillator).
And, the saddest of all is that a dear friend of mine (same age, with same age kids) was diagnosed this week with cancer. I am still struggling in a major way with this news (mostly in the middle of the night). It got me thinking of how to share terrible news like this with our children. These are the hardest conversations we will ever have to have as parents.
Rather than re-invent the wheel, I decided to turn to the wonderful Hollye Jacobs, founder of The Silver Pen, mom of a precious little girl, and breast cancer survivor. If you need to share really difficult news with your kids, take a look at Hollye's advice. She is thoughtful, wise, and she's been through it......
I have posted numerous times on mental health among teens facing the college admissions process. This article on campus mental health captures so many of the issues I consider important:
-The portrayal of a perfect self in the media.
-The pressure to be perfect, often driven from within an individual, rather than from their parents or from their teachers/schools.
-Constant contact between parents and kids, leaving kids with little ability to cope with even minor challenges on their own.
PLEASE read this article if you have a high school or college child -- consider all of these issues, and discuss them with your kids!!!
During the summer, many parents ask if their children should continue ongoing treatment (or begin a new course of treatment) or take a break until Fall. This is a really interesting question and varies from one anxious child to another. Let me try to provide some guidelines for parents trying to make this decision as the summer months are upon us.
-Some kids really only experience anxiety during the school year. Their stress is all about grades, getting their work done, and achievement. Once school is out, a sense of calm descends over the child and indeed, over the whole family! For many children, especially young ones, "out of sight is out of mind." Kids have a hard time re-capturing this anxiety when it is not actually happening in their "real lives". For these kids, taking some time off treatment is just fine. I like meeting up with these patients a week or two before school begins to review what was learned in treatment the prior school year and to set goals for the upcoming year.
-With teenage patients who experience a great deal of school-related stress/perfectionism, I often encourage them to sign up for some sort of class over the summer so that we can continue to work on their anxiety. We can even re-create some school stress in our sessions. For kids who worry about finding just the right topic for an essay (and thus, never actually write the essay!), I give them assignments right in the session and we do an exposure to starting to write before they feel perfectly ready. For kids who worry about class presentations, I have them prepare a presentation and deliver it to me in the session. It is also worth noting that older teens are better at thinking back on the year that they have had and discussing how they would like the upcoming year to be different so therapy with this age group can be very productive even when school is not in session.
-If kids and families don't expect to have much anxiety over the summer, I like to get creative and see if we can create some so that we can continue working over the summer when there is less stress and busy-ness overall. For example, let's take a child with separation anxiety who is going to be home with mom all summer. We can most certainly continue to work together by planning playdates, sleepovers, some half-day camps, time with babysitters, etc. This takes effort and planning, but pays off in the Fall when children are more at ease with saying goodbye to mom in the morning to go to school!
-Of course, some anxiety is not limited to the school environment or pressures of the school year (e.g., OCD about dirt and germs; worries that extend beyond school; etc.) and treatment can continue very successfully over the summer.
-And, there are other anxiety problems best treated in the summer like fears of specific insects (bees, spiders), fear of storms, and fear of swimming in pools/lakes/oceans.
Please contact me if you have questions about summer treatment for your child/family!
Parents in our area were devastated yesterday to learn of the death of an 8th grader from a wonderful local private school. Although we don't know the cause of death yet, articles about the event have noted that the boy was under a lot of pressure to get schoolwork done. From my reading, this has so far been noted as the ONLY contributing factor to this boy's death.
Many, many children and teens are under pressure to get their schoolwork done, to get good grades, to get into the best colleges. Are they are risk? How can we talk to them about what happened to this boy and what they should do if they feel overwhelmed with the pressures they are facing?
The first thing we must emphasize is that suicide (if this boy in fact took his own life) is caused by multiple factors. School pressure can be one factor in teen suicide, but, there are typically many others. A major one is the presence of psychiatric illness -- 90% of people who commit suicide suffer from a psychiatric disorder including depression and substance use. Hopelessness is also associated with suicide -- people who feel that their lot in life will never improve are at heightened risk. Furthermore, in the six months prior to committing suicide, individuals have typically experienced a number of stressors ranging from interpersonal conflict to interpersonal loss and/or rejection. Again, it is generally not one, isolated event that leads to suicide.
When I speak to my patients about this sad case this week, I would like to emphasize that simply being stressed out about school does not make people commit suicide. There is almost always more to the story.
What else do I want kids to know?
I want kids to know that they can always talk to their parents about "bad things" -- even if they think it is the worst thing in the world. Parents WILL get over intense anger at a bad choice, but they will never get over losing their child.
I want kids to know that things always improve, even when it seems life is unfixable. Middle schoolers and high schoolers feel things very intensely and can act impulsively. I want to teach kids that feelings come and then they go. We can surf bad feelings, wait them out, and generally life improves.
I want kids to know that no one is perfect....even the kids at school who seem to "have it all". Most kids have a struggle -- maybe a learning problem, or anxiety, or a family issue. I wish that kids were more open with each other about these struggles. We all have something we are working on and that is part of life. The less we hide, the more open we are, the better off we all will be.
What else has come up in your discussions with your kids about this tragic loss?
We live in a pretty competitive environment for kids. I have noticed lately that whenever I meet new people, or even when I am with my friends, the following question arises, "What's your kid into?"
The answer to this question is not meant to be Mine Craft or Lego or American Girl dolls.
People are talking about travel soccer, elite swim teams, competitive gymnastics, and many times per week ballet lessons.
My kids don't do any of these things. They do a lot of stuff -- they play instruments, they play sports, they go to religious school, they do some theatre. But, they do all of these activities once per week. They aren't tremendously talented at any of them. They certainly aren't destined for Broadway or the Olympics (so far as I can tell). As one of my dear friends said a few years ago as all of our girls were galloping around ballet class, "I guess if any of our kids were prodigies, we would know already!" In our home, we place a lot of focus on school and also on education outside of school (through travel, exposure to culture like museums, concerts, etc.). We view the rest of these activities as "icing on the cake".
I've noticed lately, however, that when people discuss what their kids are "into," it brings up a lot of emotion for me. A little anxiety, a little frustration, a shade of sadness....
On the one hand, I worry that I haven't pushed my kids hard enough. Should their tennis lessons be less fun and more focused on the game? Should we amp up the sports to travel teams? Should my daughter who is good at theatre be doing theatre all year round instead of just over the summer? Should she have a vocal coach and a dance coach? Ah!!!!
But then, I take a step back. With school and the relatively limited activities we do, there is barely time for our kids to PLAY. Play is extremely important for young children -- building with Lego, playing make believe with dolls, doing crafts with materials available to them that aren't dictated by a specific assignment. In my clinical work, kids say all the time that they wish they just had more time to play -- and I think this is a statement we should listen to.
Furthermore, while I believe there are some kids who do come to a true passion on their own at a very young age, I am angry by the idea that all is lost if our kids haven't found that passion before they hit the double digits. Is it possible that they have not been exposed to the activity yet that they are meant to love and excel at? Perhaps they haven't yet met a certain teacher or other influential adult who they want to emulate. Developmentally, they might not be ready yet to be an amazing lacrosse player or to be committed enough to play piano for two hours per evening after a full day of school. Isn't it okay if this hits in 7th grade or 10th grade?
Here is my thought. As parents, I think all we can do is expose our kids to a wide variety of activities that we think they might enjoy. We should take their lead. If a child is very artistic, we should expose them to more art, rather than forcing them into sports because "everyone else does sports" or because it might get them into college. We should be responsive to our children saying they want to do more.....and be comfortable saying NO to coaches or teachers who are demanding more to the detriment or play time, social lives, or even sleep. And, we should be okay with our kids just liking lots of things, rather than having a specialty at a very young age. After all, variety is the spice of life.
In my practice, I see a lot of really smart kids - it seems to go along with anxiety, for better or for worse. I am struck by how often parents and schools expose smart kids to information beyond their emotional capacity. Kids who are really bright can inadvertently trick us into assuming that they can emotionally process very difficult information. But, a smart nine year old is still.....NINE.
An example of this has hit my house these last few weeks. My daughter is a 4th grader, and is in her school's gifted program. It is a wonderful program and we are grateful that it exposes her to like-minded kids who love to learn and to in-depth learning about focused topics - something that is not often done in the regular classroom. This semester's topic, however, has been very challenging. The children are studying the yellow fever epidemic that affected Philadelphia in 1793. Their learning began with a very vivid film that included those affected vomiting black fluid, and a small girl burying her dead mother. Apparently, most of the kids in the class were in tears during this film.
When we discussed it at home, it became very clear to me that my very smart daughter thought the people in the film were real. She completely identified with the little girl whose mother died and she felt absolutely devastated for her. She was horrified by the blood, black vomit, and yellowed eyes. I posed her the following question -- "Were there video recorders and TVs in 1793?" A moment of realization came across her face. She said, "Oh mommy, they were ACTORS!"
Yes, they were actors. But, did any of the children recognize this? Or, did we grown-ups assume that these super-smart kids "got it" and could process the content like we could?
Given how upsetting the film was, I decided to read along with my daughter as they read the book, "Fever 1793" by Laurie Halse Anderson. As a psychologist working with anxious kids, I have to say this book is horrifying. For my adult self, it is very well written, interesting from a historical perspective....but still horrifying. I can't imagine that 9 and 10 year old kids, even gifted ones, can process the idea of half a city dying from a contagious illness; children losing every family member and being orphaned; or a 14 year old having to ward off invaders in her previously safe and loving home.
Could the children learn about the yellow fever epidemic in a different way? Sure. They could learn about the immune system and vaccines and how such epidemics can't happen anymore (yes...I know what you're thinking....Ebola, measles, but we are talking to kids here, so let's keep it simple!). They could learn about the racial issues affecting Philadelphia at the time and how they played into this public health crisis. They could learn about what life was like in Philadelphia at this pivotal time and how different factors made the spread of disease so likely (ie., what were bathrooms like, what was the water supply like, where did people get their food from, how hard was it to get out of the city given that there were no cars or trains or taxis)? I am not saying that we shouldn't expose kids to emotion or to difficult topics -- but we need to be mindful of their developmental level and how it might not match up with their scores on tests or on how articulate they are.
I am a licensed psychologist working with kids, teens, and adults with anxiety disorders.