I work often with children and adolescents that have been labelled depressed, addicted, oppositional or delinquent and I often remind myself how important it is to not forget the full picture. A person struggling emotionally does not deserve the label of his or her diagnosis the same way someone with cancer, a broken bone or diabetes does.
For one, if I go to the doctor for a blood test the medical professional is looking to see that my blood count is normal. We will know if something is wrong based on a concrete measurement. We know what normal blood sugar or iron levels are and also know when these levels become dangerous. Unfortunately for emotional concerns such as depression or anxiety, it does not work the same way.
There is no normal level of depression but a professional can tell that you are depressed. Also, there is no way to treat these troubles the same way antibiotics treat an infection or pain killers on a headache. Helping people with these concerns requires getting the full picture from the person's point of view so we can use their everyday success and bravery for good. The heroic things that the ‘depressed child’ does each day will tell us how we can help him or her out of their stuck place.
I have worked with a few young people this year that have struggled with being bullied at school. Some have gotten so low that they have self-harmed causing such alarm at home that their parents have reached out to me for help. One person in particular, an eleven year old, had decided that it was better eat lunch on his own rather than with any of his friends just to hide away from the kids that were picking on him. He had scratched himself while walking home from school and has started to feel that he would prefer to just stay home from school in bed instead of making the treacherous journey to school each day.
On the surface we see this boy as young person struggling socially with all the adversity happening around him. In trying to problem solve, we could focus on the bullying or the self-harm. However, there may be more to the story we don't want to miss.
During our second session together he talked to me about cricket. His coach had told his father that he was not a very skilled player and did not put in enough effort during practice and should probably look into different extracurricular activities.
Being born in America I know very little about cricket so I curiously asked him what he liked about the sport. He lit up. He sat on the edge of the couch and began explaining all the different ways the sport is played from test cricket to 20-20. He talked to me about how the players line up and strategies for bowling. Having cricket stumps along with our expedition gear I got them out. He started as the bowler and easier ended my turn at bat laughing as I joked about being a not-so-good cricketer.
We went back into the office to talk about his plan for the final two weeks before the school holidays. He told me about what the coach had told his dad and said he did not know what would happen if he was unable to play cricket at school. “It’s the main reason I wake up in the morning,” he said.
I spoke to the boy’s father the next day and told him about how passionate and enthusiastic this child was about cricket. He was not the depressed, low energy, effortless boy I had been referred. I said that it would be an enormous oversight to not let this boy play. The father rang the coach and advocated for his son. The coach decided to meet with the child and they spoke for a full lesson about strategies for improving the team and what the boy could offer in helping the other boys to improve their game.
During our session the next week he said that one practice the coach had allowed the boy to help teach a certain bowling technique he could do better than most the other kids. He said he was nervous but everyone was interested in learning this technique. He said some of the kids asked him to have lunch the next day.
Although this boy has serious concerns, self-harming behaviours and a challenging circumstance at school, we were able to find his heroic passion and use his strengths to our advantage. We were lucky to have such an engaged father and coach who had the best intention of helping through connection. Instead of hoping the child would fit-in or change his thinking about the bullying, they put him in charge using one thing he knew best.
How can we do this in our own life? Think about the things that put you at the edge of your seat. What are you most passionate about? What excites you?
For me it is music. I know that if I’m overwhelmed, stressed or anxious I can play my drums, pick up my guitar or learn something new on piano. I can even put a record on and sit for a second. It doesn’t take long to feel better when I’m using the part of me that is focused, passionate and skilled.
Think about what this is for you and use it.
Have a safe new year and a happy 2016!
Will Dobud MSW
Conflicts at home are all too common with the families I work with. This morning, just a few days before our holiday break, I had a session with a young boy after he had recently stolen from a family member. I was unaware of this event prior to the session but he told me during our check in while completing the Outcome Rating Scale. When asked how he is doing emotionally, he answered with the words guilt and shame.
Last week I wrote about using the right hemisphere of the brain during therapy sessions so when this important event presented itself, we pulled out the oil pastels and some paper. His task, to draw what this guilt feels like on the inside. Where no one can see it.
During sessions with children I try to teach them about the safety of the present moment. I try to make my office into a small sanctuary away from the real life, natural consequences of everyday life. This security allows us to explore difficult past experiences with feelings of peace and serenity.
The 11-year-old boy’s finished project, pictured above, showed a fiercely drawn red circle in the centre of the body with four small blue dots at each limb. The red represented a feeling of fire in his chest that made him feel a whole range of emotions like anger, sadness, anxiety about what will happen and regret. He told me that when confronting what he had done, he felt immobilised. It was as if he could not move his arms or legs. I assured him that this guilt was normal. He had done something he knew was wrong and regretted.
Worry about this scenario would come if his guilt turned inward and he began to feel shame, or feeling bad about himself. Guilt is a fairly natural response to doing something that we feel is wrong or that in which we could avoid. An appropriate level of guilt should protect us from repeating the undesired behaviour and motivates us to repair any pain we may have caused to those around us.
Shame, on the other hand, can motivate us towards denying, hiding or blaming others. The general rule of thumb for avoiding this shame is to remember that there is only one good kind of guilt. That is guilt about something you did. A specific behaviour. It can be hard to do in the moment but if we can tune in to the specific thing we did then a lot of the background noise should diminish.
Guilt about things you think you should have done, something you are unable to do or guilt about feeling as though you are better off than someone else are easy roads towards shame. The goal to this balance is to be really specific about why the feeling is arising and how justified it is.
If you can label the explicit behaviour that you feel is wrong then its time to make a change. If you need to address it with your loved one or coworker then do it. If you need to talk to someone to get some tips or tricks on how to avoid repeating the behaviour than go out and find the right person for you.
You can’t go back and change what you’ve done but you can make a better moment in the present and feel hopeful for the future.
Have a safe and happy new year.
Will Dobud, MSW
Recently I came across an incredible book “Being A Brain-Wise Therapist” and have been posting a lot of resources from psychiatrists Bruce Perry and Daniel Siegel. Many of our followers have told me they appreciate these resources as this inside look of the brain can be really helpful for finding out what is going on beneath the surface when someone experiences trauma, addiction, anxiety or depression.
What I find the most incredible, however, is the importance of this understanding for healing and bringing positive change into people’s lives. It also gives an incredible justification for experience-based therapies like our use of adventure therapy.
Two Hemispheres - The Right & Left
If we cut the brain in half long ways we have broken it down into the right and left hemispheres. Although there are billions of different functions across all areas of the brain, understanding the specialties of the right and left is really important; especially when it comes to therapy.
Let’s start with the left hemisphere. The easy way to consider the left is to remember the L’s: Logic, Linear thinking, language and literalness. The left-brain likes it when things make sense. If we go through a certain event, the left-brain attaches words to that experience and likes to find patterns like cause and effect, right and wrong, and yes or no.
The right brain, on the other hand, is much more receptive and nonlinear. It is responsible for understanding nonverbal communication, how we interact in relationships and helps with using words creatively such as in poetry or music. It's our meaning maker.
Bringing this understanding to our emotions, as is so pivotal in psychotherapy, the left and right hemispheres work in different ways. Our right brain, which is centred on relationship and emotional understanding, is where our reactionary emotions are produced. When there is a threat, our right brain decides if we should avoid or withdrawal. The left brain, with its logical thinking, creates emotions based on our approach to the experience (i.e. Expectations).
To make some of this jargon more comprehendible, think of left-brain and the L’s and the right brain and Relational. Overtime, research has suggested that more than any other factor contributing to outcomes in therapy, the relationship between you and the therapist is one of the most important. And doesn’t that make sense!
Our relational mind begins creating relational meaning from the moment we are born. Babies that miss this connection may develop abnormally or have physical and mental health issues later in life. The brain will literally not grow. This goes the same for those that have experienced trauma (more about this from a previous blog on addiction). The relational right brain is active well before the logical left. This is where the therapist can help.
A psychologist, counsellor or social worker knowledgeable in this style of work is very focused on the conditions required for healing. And it’s all about relationship. When you see your therapist you should feel safe, secure and supported. While difficult emotions may emerge, this sense of security helps you to stay present for re-wiring areas of the right brain required for healthy self-regulation.
This type of work goes deeper than words and talking. It is not about the acquisition of skills or techniques but truly healing in a relational context, both with your self, family, loved ones and the world. During a session you may decide to talk about a difficult scenario or something challenging that happened earlier in your life. If you can stay present with these feelings you will be working to re-write this memory ensuring growth and change.
The big takeaway from the right brain’s role in therapy is remembering the motto “Connection before Correction”. Feeling safe and attuned with your therapist is the real first step before a big change.
If you would like to learn more about this approach, with children or adults, feel free to contact me directly at firstname.lastname@example.org