How do you grasp at balance in an increasingly chaotic world?

I will be the first to admit: I am not very good at balance.  With so many aspects of life asking for my attention: work, chores, finances, family, friends, my partner, my dog….I sometimes feel exhausted before the day begins and worry that there is not enough of me to go around.  There are parts that I certainly would prefer to give my time and energy to (family, friends, home life), and others that are unfortunate necessities of my time (bills, cleaning, etc).  How do you achieve a balance of all aspects that demand your time, and feel energized by the daily ins-and-outs of life?  Is this possible?  I know it is; I have seen a balanced life in numerous friends and public figures whom I admire deeply.  They also will admit that it takes a concerted and dedicated effort to feel balanced and healthy in their life choices.  Achieving balance in your life can feel almost like a full-time job in itself (which, ironically, can only add things to the to-do list!).  As a psychotherapist, I feel I must be honest about my own human struggles and questions, as this can be helpful to clients and others who are on the same path.  I also feel that it is my ethical duty to try to “practice what I preach”, and implement into my own life the suggestions I give to clients about living a balanced life.  This is easier said than done for both myself, and I know, for many of my clients, and I think that having a discussion in the therapeutic process about how difficult it may be to make changes in one’s life can deepen the therapist-client relationship and frame the goal of balance as a collaboration and partnership in therapy.

What does balance mean to you? It is a chameleon, morphing into different forms and colors as we walk through life and meet new experiences.  I encourage you to sit down and think about this; how would you know when you feel balanced?  Would you have less stress and more energy?  Would you divide your time differently between work, home, and play?  Would you spend your money differently, or prioritize which types of events are worthy of your precious time? 

To me, a balanced life equals allowing time for numerous aspects of my daily routine that need to happen in order for me to be successful.  “Successful” is another word that requires careful attention and individual definition.  As I grow older and try new things, I have altered my own definition of what successful means.  Like anyone else, my quest for success is a work-in-progress, but an important recent addition to it is a balanced outlook as I set goals for my practice and my personal life.  Success does not just equal financial security; it does not just equal x amount of growth in my practice per year; it does not just equal having a happy home life and exotic vacations.  Success, to me, means working towards things that make me happy (many of which are those listed above), and appreciating them and the hard work that has gone into making them what they are today.  The last part – “today” – of that statement is crucial to remember.  As a psychotherapist, I work every day with clients towards achieving mindfulness, a state of dwelling in the present moment that helps facilitate relaxation and peacefulness.  Mindfulness is a central part of my definition of balance and success, as what does a success mean if you do not sit with it, really dissect it, remember how it came to be, and allow yourself to bask in the warm glow of its achievement?

Balance can feel even more allusive as we grapple with chaotic events in the world around us of which we have no control.  The recent assassination attempt on Rep. Gabrielle Giffords in Arizona is an example of a shocking and senseless act that can rip up any definition we thought we had of safety, sanity, and security.  The emotions that this event and numerous others like it bring up in us can feel out of control and helpless.  We ourselves can feel out of control and helpless.  And those two feelings are direct threats to our sense of balance.  We try to control feelings we don’t understand; we try to control our own reactions to senseless events because we fear what might happen if we don’t.  Desperately trying to control our feelings, our reactions, or even other people in an effort to cope with unforseen situations elicits a sense of panic that takes us away from our inner selves and away from a balanced life.

From one balance-seeker to another, I can only tell you that it is hard work to sit with feelings and decisions and to notice which parts of your life are sucking away your ability to feel balanced.  My personal goal is to consciously give more energy and attention towards the lovely parts of my life, as those are the aspects that tend to get thrown to the wayside in times of stress.  What goals do you have to create balance in your own life?

Giggling into relaxation and health with laughter yoga

Have you ever heard of laughter yoga? I had not yet heard of this increasingly popular trend, but I love yoga and love to laugh, so I thought I would research it (and soon try it out) to see if it’s a positive addition to my own and my clients’ self care.  I was intrigued to discover that this type of yoga (wherein the participants ‘self-trigger’ laughter during practice) involves a physical type of laughter that is not necessarily related to humor or comedy.  What?  How could you make that happen, and what motivates you to continue laughing without an object to promote it?  I learned that the concept and exercise were developed by the Indian guru Jiten Kohi and physician Madan Kataria, respectively, and that Kataria has written a book about the subject entitled Laugh for No Reason.

The health benefits of yoga are no secret and the meditation and peace that it brings through community and practice are unique rewards of this ancient tradition.  Along the same vein, laughter has proven to be healthy in many ways.  In this sort of yoga, laughter is initiated in a group setting with engaged eye contact, a sort of childlike playfulness, and ‘laughter exercises’.  Sources say that fake laughter has no choice but to become real.  The reason behind it is that the body cannot differentiate between fake and real laughter, and so it causes your mind (which can tell the difference….up to a certain point) to become one with the body.  This brings to mind the mindfulness and body-centered exercises I am currently using in the therapy group I run, and solidifies the notion that body and mind are one. The deep breathing associated with yoga is increased and intensified with laughter yoga and facilitates a breathing rhythm that is unique to this practice.  In a chicken-or-egg conundrum, you tend to forget why you started laughing or which practice you started first, and the benefits of laughing impact us all both physically and psychologically.  Sometimes, if you are like me and can tend to focus on negative things sometimes, it may make a whole lot of sense to ‘force’ yourself to laugh and then reap the rewards that may have seemed so far-fetched and out of reach.  The laughter – and the positivity it brings – becomes contagious and more natural.  Practice makes perfect!

So who does this, and where?  I was amazed to find a ‘global movement for health, joy and peace’ at, where groups bring laughter to the workplace, act in shows that laugh all the way through, and go on spiritual retreats all in the name of laughter yoga –all around the world!  More locally, I found Denver Laughs, where I learned that there are more than 125 Certified Laughter Yoga Leaders in the Denver area!  This organization describes laughter yoga as ‘a body-mind combination of simple laughter exercises, deep breathing and relaxation techniques from Hatha yoga to enhance health and happiness.”  It states that it is a grassroots movement that has more than 600,000 members worldwide.  There are clubs in every part of Denver and the metro area that do plays, ‘happy hours’ and other laughingly fun events.  There is even a Denver laughter yoga meet-up group!

On my search I also found the American School of Laughter Yoga where you can become a Certified Laughter Yoga Leader or do professional development classes.  In light of all of the dreary and dismal news reports (and yes, I know many of my blogs are about these types of subjects), I am excited to find this happy-to-laugh movement that combines mental health and physical health in an effort to promote peace and wellness.  We all could laugh a bit more, don’t you think?

Peeking into the depths of hoarding: understanding this mysterious disorder

Happy New Year!  In light of the new year’s resolutions and “fresh starts” that abound this time of year, I thought I would try to clean up some of the misperceptions of the complex issue of hoarding.  What is hoarding?  Compulsive hoarding is defined as the excessive acquisition of possessions (and the failure to use or discard them), even if the items are useless, hazardous, or unsanitary.  Hoarding interferes with mobility in the person’s living space, and with basic life activities such as cooking, cleaning, sleeping, showering and eating.  Some symptoms of hoarding may include: saving items that most people do not see as valuable and find worthless, compulsively buying and saving large quantities of items, experiencing intense anxiety or distress when discarding (or thinking about discarding) any of these items that others deem useless, being unable to use furniture or appliances due to clutter and experiencing a severe deterioration in housekeeping because of the lack of space.  Hoarding has also been known to include animals, such as cats and dogs.  These animals are typically types that can be kept indoors in large quantities and often are not given the proper care.

What causes hoarding? Is it linked to any other mental health disorders?  Hoarding is another of the “new” types of disorders that is in consideration for inclusion in the DSM-V.  Similar to other disorders I have written about in my blog, hoarding is controversial and there is still debate about its relevance as a mental disorder.  Clinicians are finding correlations between hoarding and Obsessive-Compulsive Disorder.  Some of the same factors in OCD, such as obsessive thoughts and compulsions that try to help cope with underlying feelings of inadequacy, emotional pain, and depression, can also be present in people who present with hoarding.  Hoarding not only affects the physical, emotional, and mental state of that person, it also affect the quality of life of the person’s family and anyone else who lives in the home.  Another effect of hoarding that might not be always recognized is the financial strain that this disorder causes on a person and/or a family.  A compulsion to aquire numerous possessions can initiate additional struggles of trying to figure out how to finance this need, and can force family members to learn how to be honest with each other about the consequences of this disorder and how it affects each member’s quality of life.

Feeling connected to large amounts of seemingly value-less possessions can be defense mechanisms against the more vulnerable feelings under the surface.  These possessions might be a physical representation of the emotions that have not yet been freely released.  When the hoarder is able to clean up their home and their life, unexpected emotions such as guilt and shame come to the surface and are given the opportunity to be explored and healed.  The ‘popularity’ of hoarding has been documented on television in such shows as TLC’s Hoarders: Buried Alive, and A&E’s Hoarders — making it a spectacle and a source of entertainment for the nation.  While these tv shows help give exposure to the issues behind the disorder and show that it is possible to recover from it, it also glamorizes this issue and can trivialize the true pain that comes with this and any other type of mental disorder.

Another outlet that I found for those affected by hoarding is through the internet — blogs, to be exact.  I found several blogs written by hoarders and written by children of hoarders.  Each blog depicts what it is like to live a daily life as a hoarder, or as the child of a hoarder, and how this has impacted them as they have grown and formed relationships of their own.   These are very real, honest accounts and can give hope and support to others in their situation — especially since this disorder can be judged inaccurately and misunderstood as to why it is becoming so prevalent.  Only since the early 1990s have we been doing research and looking deeper at the causes, consequences, and symptoms of hoarding, and we still have a long way to go.  Talk therapy and exposure therapy (wherein the client practices new ways of responding to triggers and uncomfortable thoughts that have previously caused hoarding behaviors) have been effective mechanisms for treating hoarding.

As new research and interventions are performed on people who suffer from hoarding disorder, we are finding new ways to treat this condition and bring peace to families who might now have realized what was going on.  Relationships are formed and renewed, and self-identity is explored in the healing process.  As we all have ways we can de-clutter our lives emotionally, physically, and spiritually, maybe hoarding is not quite so mysterious after all.  Now is the beginning of a fresh year! How are you going to begin?

Happy New Year!

Happy New Year from Kate Daigle Counseling!  It has been a wonderful year and we wish you all a healthy, safe, and bright 2011!  Stay warm and hug the ones you love ~


A new year of hopes and goals: reflections as we step forward into 2011

As I watch the fat white snowflakes gracefully dance in the Denver air, I am reflective of the year 2010 and am eager to set forth into a new year — which will bring new hopes, changes, challenges, and growth.  What are your goals for the new year?  Is there anything that you would like to change?  Or that you would like to build upon and nurture, as you grow deeper roots?  It’s the time of year when we sit down and make those resolutions — some of which we will keep and some of which will slip right out of our consciousness.  What makes a resolution one that we keep and set our minds to in attempts to realize it?  I think that a resolution that poses challenges and changes in our life is one that is both exciting and terrifying to make.  Why? Because it causes us to consider ourselves where we are at this moment in our lives — if we are happy in our career, if we feel healthy and able, if we feel fulfilled in the relationships we have with ourselves and others.  Often, there is room to grow in many of the areas in our lives, giving us a great opportunity to choose our next path.  However, this possibility for growth and renewal may cause feelings of dissatisfaction or disappointment with ourselves as we are right now, in this present moment, and can initiate doubts about our ability to actually achieve that goal we have set.

I want to encourage you to set goals, and to make plans to realize them in steps that are comfortable and realistic.  You may want to try running so that you can compete in a half marathon next year; plan work-outs that start simple and short, and slowly build up.  And let yourself take a break if you need it!  I have a colleague who makes lists of goals and wishes for her life and business every year.  As I was talking to her and asking “did you achieve all of your goals for 2010?”, she said “I’m not sure yet; it’s probably a mixture of achievements and goals-in-progress.  The number of “wins” is not what matters — it is the fact that you believe that your life will be that way in the new year and that positive mentality motivates you to try to improve your life”.    This statement really sticks with me — that you believe your life and yourself have the possibility of making changes, and setting that intention is the most crucial factor of resolutions.  Believing that you can do it — and if you don’t, you may feel that it is a challenge that takes more time and focus, or that it was a goal that might not be as important as you first thought.  But if you believe that you can, then the feelings of guilt and shame that typically accompany a “failure” will not pull any weight with you.  There will be no room for them.

New year’s resolutions can be challenging in ways other than setting the intention to achieve them.  Goals such as going to the gym or buying a piece of exercise equipment require financial investment.  Changing eating patterns or taking up a new hobby also require enough financial comfort to try — and try again.  For many of us, these types of intentions are out of reach for multiple reasons.  This does not need to be a recipe for giving up and feeling defeated.  You can make positive changes in your life with little or no financial cost, though you may need to be a little more creative about it.  Creativity and effort towards reaching your goal will open other doors for you as you may discover a new hobby, book, or activity that you had never tried before. 

Here are a few low or no-cost resolutions for a healthy mind and body that you can make for yourself in the new year:  go to the park and appreciate the season, write a letter to your grandmother or mother (a real letter, not an email!), keep a gratitude journal and record every evening three things for which you are thankful, write a letter to yourself listing the things you hope to change and achieve in the new year, go on a walking or running tour of the city in which you live, think about new hobbies or interests you would like to cultivate and borrow books, cds, audio books, or DVDs from the library.  What other ideas do you have?

Being healthy requires care and attention to your mind and to your body.  They are interconnected, and if there is discomfort or pain in one of them, you will certainly feel it in the other.  Often, one or the other is neglected and we can focus our anxiety or stress intently on the part of ourselves that is not being taken care of.  I encourage you to treat yourself with kindness and respect and hope that you can make that a goal for the new year.  It takes work to do so, as it is not a concrete task…but it will heap many rewards of inner peace and contentment.  We are all capable of turning our awareness to encouraging and enriching tasks and thoughts, and taking the power away from the negative and draining feelings that may plague us by the end of the year (or by the end of January!)  Challenge yourself to do this!  There is always an opportunity to have a fresh start and cultivate a life with mind, body, and spirit in harmony.  You deserve to be the healthiest, happiest, and most balanced version of yourself that you can imagine! 

Peace and health in the new year!  Have a wonderful holiday!

Holiday break

I will be taking a week off from my blog for the holidays.  I will resume writing on Thursday, December 30th.

Happy holidays!!  I wish you and yours a restful, joyous, and peaceful holiday!

Get to sleep! What disrupts your quality and quantity of zzz’s?

Got sleep?  My guess is that you probably don’t have as much as you should.  Or, you sleep great lengths of time but wake up feeling just as exhausted (or moreso) as you did when you went to sleep.  What gives?  There are factors that affect our sleep patterns all year long, but I feel that especially now, in the holiday season, we struggle to overcome the mental hyperactivity caused by: financial stress, excitement of parties and celebrations, travels, grief at losing a family member over the past year, joy at welcoming a new family member, and so many other things that can keep us up late at night.

Sleep disruption can impact not only our own functioning, but it can disrupt the sleep of other family members.  You may toss and turn (or have a partner who does) as the events of your day cycle through your mind or you ponder the “what ifs” of the next day.  You may get up to watch tv or stare at the computer in a desperate attempt to calm down your mind and get exhausted enough that you cannot stay awake any longer.  Lack of or unrestful sleep can make us lethargic the next day (or days — if you have a sleeplessness hangover), causing us to consume large quantities of caffeine in an effort to remain alert throughout the day.  Where we are physically impaired, we are also emotionally impaired by lack of sleep.  Without adquate rest and processing time for your brain, you may tend to be more emotional the next day and experience mood swings that really do not need to be so extreme.  Sleep problems interrupt our work day, insert themselves in our connections with loved ones, and cause us to fall asleep in the middle of presentations.  Like eating, sleep is a universal need of every living being and thus it is essential to tend to concerns you might have and find ways to get better and longer sleep.

As I was doing some research on sleep issues and ways to intervene, I came across a few types of sleep disorders that I had not heard about before.  How exciting to find NEW sleep disorders, right?? It did make me pause for a moment and wonder about the correlation between the pressure of our society — the amounts that we push ourselves to be better, bigger, and faster — and the ever-growing types of sleep issues.  We all need a – literal – break!  The first sleep disorder I came across is called delayed sleep phase disorder.  This might describe someone who thinks they are a “night owl”.  This disorder affects the circadian rhythm that humans naturally follow (when, apparently, not stressed) and might disrupt a person from feeling tired at a “normal” bedtime such at 10pm, and from waking up at a “normal” time, such as 7am.  The circadian rhythm is a 24 hour sleep/wake cycle that naturally puts us as awake when the sun is out, and puts us asleep when it is down — we follow the cycle of the sun.  Of course, with daylight savings, some of us nearer the equator get darkness earlier in certain seasons, and those of us up north in say, Sweden, have almost half-day shifts of all sun or all darkness.  That has certainly got to disturb your natural rhythm! 

Another strain of this type of sleep disorder is shift work disorder.  Nearly 20% of Americans do some type of shift work — meaning they are awake in the middle of the night, or have to get up in the wee hours.  Not only will this type of disruption affect your sleep cycle but it will also affect your eating cycle and how your body’s need for food shifts throughout the day.  An interesting sidenote about shift work disorder points to research that has shown a link between shift work disorder and heart disease.  Doctors have noticed that people who work during long night shifts often have higher blood pressure while they sleep.  Shift work disorder also can cause auto accidents, work accidents, and can be linked to other mental health conditions such as anxiety and depression.

The exact cause of delayed sleep phase disorder is not known but sleep lab researchers are careful to caution that it is not the same thing as insomnia.  In treating sleep phase disorder, researchers and doctors use doses of melatonin to try to re-set the circadian rhythm make to more of a natural state.  Melatonin can be useful with insomnia as well, but it is important to note that while people suffering from insomnia experience difficulty falling or staying asleep, people who have sleep phase disorder or shift work disorder may be able to sleep just fine — but their cues to be tired or awake may fall at times that are not natural for the body’s normal state.

Here are a few tips for getting to sleep — and trying to stay there.  If anxiety or “to-do lists” keep you up at night, wake yourself up and write down everything that is on your mind.  Whether it is a worry about how to manage a situation with a difficult colleague, or if it is a note about remembering to pick up something at the store, it can help your mind “forget” about it if it is assured the worries are written down.  If you are a worrier or a person who stresses easily, allow yourself a half hour before bed to be your “worry time”.  In that time (and set a timer so that you have boundaries), you are allowed to worry or stress about anything and everything.  Let it all out.  Then, when your alloted time is over, you are not allowed to worry about that again until the following evening (if you need to).  This can also soothe your mind and soften that voice that may focus on anxiety.  Writing in a journal, listening to calming music, and drinking hot tea or milk also help to naturally calm down your body and mind.

Wishing you a restful evening — get yourself some sleep!

Is it really all about me? The growing irrelevance of the clinical term narcissism

I’ve written several times about the debates in the therapeutic community concerning the relevence of adding certain types of mental disorders in the upcoming addition of the DSM: Parental Alienation Syndrome, new variations of eating disorders, and Seasonal Affective Disorder.  It seems that every other day there is an article in the newspaper or on popular blogs that questions how we define mental disorders.  If once named a mental disorder, is is always going to be classified that way?  The most recent sighting of therapuetic chatter was found in the New York Times Sunday edition, the author of said blog despaired over the “Malady of Me”.  His question: is Narcissistic Personality Disorder relevant for the DSM anymore, given how commonplace narcissistic behaviors are?  Where is the line between symptoms of narcissim and a truly pathologic mental condition?  Narcissism is clinically most commonly represented in Narcissistic Personality Disorder.  Someone diagnosed with this condition would be described as being “excessively preoccupied with issues of personal adequacy, power, prestige, and vanity.  It is closely linked with self-centeredness”.

The term “narcissism” has been used for decades – centuries, even.  It was coined originally by Freud who named the condition after Narcissus, a character in a Greek myth who fell in love with his own reflection in a pool.  While in this myth, Narcissus was forever content staring at himself, real-life narcissists need someone else to validate their self-centeredness.  This need for approval, grandiosity and ego stroking begs us to wonder about deeper levels of vulnerability and perhaps a defense against shame.  The editors of the upcoming edition of the DSM are considering removing personality disorders completely — Narcissistic Personality Disorder plus four others — and instead picking certain personality traits traits that describe a particular client.  This makes diagnoses like this less stigmatizing, but what will happen to the personality disorders — and are they even relevant anymore?

I found this topic fascinating because of the numorous ties that the focus on narcissism draws between medicine, psychology, and pop culture.  How do psychiatrists treat narcissism? Is there a medication that can help allieviate symptoms (having a sense of entitlement, preoccupation with having unlimited success, power, beauty, and other complicated criteria)?  Can we even treat it?  How would we know when it was getting better?  We are a culture that is becoming more and more narcissistic every day.  Everywhere we turn, there are celebrities, tv stars, and politicians in the public eye trying to get you to learn more about “me! me! me! and how wonderful I am!”.  A recent segment on NPR focuses on several examples and types of narcissism in our culture and ties them to psychological constructs.  The most blatent figure outlined in this segment is Nicole “Snooki” Polizzi, who told Barbara Walters recently that “I think I’m fascinating”.  The degree that Snooki and her Jersey Shore castmates could be diagnosed as narcissistic is questionable, as the lines between psychological symptoms worthy of a clinical diagnosis and plain old self centeredness in our culture today are getting quite blurry.

Clinicians would agree that a diagnosis of Narcissistic Personality Disorder would have to “come after the symptoms are totally pervasive in one’s life, affecting all areas of functioning”, states psychologist Keith Campbell.  Whereas vanity and being full of oneself could be off-putting to others and create an aura of disdain around the nacissistic individual, the commonality of these symptoms amongst certain types of individuals make these traits quite expected — almost accepted.  So maybe there is no use of Narcissistic Personality Disorder in the DSM anymore?  Having that type of diagnosis would almost justify the crazy antics of reality tv shows, wealthy celebrities, and cocky sports stars: “see? there is an explanation for me.  It is you all that are crazy, not me!”

I am drawn back again to the counseling professionals’ assertion that underneath the layers of fabulousness (which in reality may not be so fabulous and which may be quite thin) often lies terrifying fears of worthlessness, shame, and vulnerability.  What if the tan skin, the million dollar jewels, the bleached hair were taken away?  That security blanket often shields one’s true nature which, when exposed, is truly beautiful and worthy.  I fear that at the rate this society is going, we may find it more and more difficult to let the inner nature show and we may feel we “must” cover it up with obviously beautiful qualities such as botox and Porsches.  Every day with clients I encourage openness and acceptance for who they truly are, and I hold a non-judgmental space for them to explore that person.  It is amazing to me to watch as clients realize that the qualities about themselves that they might think are the most “undesirable” are actually the qualities that bring them the most authentic joy and inner peace.

Helping aging family members: the best care for them while caring for yourself

Often there is talk of life cycle phases and the emotional, physical and mental challenges that can come when coping with change.  I read articles and blogs about managing parental stress and learning communication skills in a new romantic partnership — but there is significantly less talk about helping an aging parent or loved one accept the physical and emotional changes of growing older while maintaining their integrity.  Often there are shifts in cognitive ability and functioning as the years go by and this can elicit feelings of fear, despair and misunderstanding — experienced by both the caretaker and the aging parent.  I am also interested in looking deeper at ways that children and younger caretakers can tend to their own emotional needs and hopes as they support the folks who have been their caretakers all their lives.

There are many factors that  should be considered as parents age: financial situations, physical capacity to take care of oneself, the responsibilities and expectations of each child in the caretaking roles, and emotional reactions as both parent and child realize that there is no way to stop the effects of aging.

A blog that I came across lays out in simple terms the things to look for when tending to the needs of aging parents: go visit them and see for yourself how effectively they are functioning, ask your parents’ permission to go through their checkbooks and statements to see if there are any finaicial red flags, remember that they can sell their house and move into a more cost-effective one (and one that may require less household maintenance), and help them get all of their important legal documents in order such as their wills and power of attorney.  These steps are very rarely as simple as they might appear — often times the house holds memories and feelings that parents do not want to give up (rightly so).  Sometimes the fact of a son or daughter trying to make decisions for the parent can bring up some insecurities about the parent’s mental functioning and ability to make sound decisions and can create discord in a family.  I can certainly understand the difficulty when considering that a parent might be better off moving out of the large family home that he or she has tended to and nourished for decades…and for many aging parents, this is not necessary.  But when it is, how do you have that conversation with your parent in a way that shows compassion and understanding, but also a bit of no-nonsense decision making?

Members of the “sandwich generation” might be raising children of their own — making decisions about curfew and piercings while also needing to make decisions about the best care for an aging parent or loved one.  This might mean needing to take a more active role in your parents’ lives …and nothing can prepare you for that sudden illness or accident that may put finances, caretaking, and functioning ability in a tailspin.  Going back to what I brought up before about self-care while managing this situation, it is important to note that there is no harm in letting parents go about their business and remove yourself from meddling if there appears to be no just cause to sound the alarm.  Why stress yourself out more when you don’t need to? Just keep a vigilant eye and note if there are more forgetful episodes or disorientation as time goes by.

What if one of your parents was verbally, sexually, or physically abusive? How will that type of past influence you today as you hold more power in the family?  Blogs differ on this topic, but I agree with several writers I have come across who argue that you do not need to get involved in something that you do not feel comfortable doing.  This is not to say that you should neglect your parent in ways that they might have neglected your needs…but you might hire an unbiased nurse or find a good assisted-living home for your parent(s) to move to so that you are not retraumatized by needing to get too emotionally close to the abusive parent again.

I ran across a very interesting concept in the New York Times – a blog talks about the “Caregiver Relief Fund”, which is a charity founded about a year ago that awards family caregivers one-time vouchers for professional at-home care, allowing them to re-energize and tend to their own physical and emotional needs.  This goes back to that self-care thing I keep bringing up.  This fund partners with organizations across the country to offer services to families in need.  It is headquartered in Chicago and over the next few months will spread to five more states – including Colorado!  The fund’s founder aims to give vouchers to over one million caregivers in the next decade.

While there are positive opportunities such as the caregiver fund, there are also millions of families who do not have such fortune to receive monetary assistance when caring for an aging parent.  Tending to the household needs, a potential move to an assisted-living facility, paying for medications and doctors visits, and other expenses pile up enormously and it is all too often that families have not been prepared for such demands.  Caring for an aging parent can also cause strong emotional swings and reactions as family members might feel that the parent they knew is changing and drifting, and the parent might feel that they do not know what to do with their lives anymore.

Trying to make decisions about longterm care for a parent can bring about conflict between children in a family and can trigger anxieties and wounds borne decades earlier.  How should the money and possessions be divided when the parent cannot manage their household by themselves anymore? Who will be the best person to talk to mom or dad about difficult topics? If your family is going through this phase or if it has already, did you notice certain members taking on certain roles? Is one person more of a caretaker? One more of an avoider? One more of a planner and navigator?

All families go through transitions – and there is never a cookie-cutter way of planning out how to navigate these changes.  Shifts in roles and responsibilities can bring up insecurities but can also bring families closer together.  In every new chapter, there is the possibility of hope and healing!

What is Parental Alienation Syndrome (PAS) and should it be included in the next DSM?

Families go through numerous transitions and life cycles as the years progress.  Reality brings happiness and hardship.  Unfortunately, numerous families break up due to parental conflict and disconnection.  This type of distress often brings uncertainty and change for children involved in a family break-up, and children cope in any way they know how to try to make sense of their parents’ split.  In the early 1980s, Richard A. Gardner coined the term Parental Alienation Syndrome (PAS) to describe a disorder in which a child, on an ongoing basis, belittles and insults one parent without apparent justification.  This can be due to a combination of factors, including encouragement from one parent (almost always in the process of a child custody conflict), and the child’s own effort to criticize the targeted parent.  PAS is up for review to be included in the Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), due to come out in 2012.

The Denver Post ran an editorial yesterday describing the personal effects of PAS on a family system and wondering about its justification for being included in the DSM.  The editorial focuses on a 46-year-old father of two adolescent girls who “desperately wants a relationship with his two girls” but “feels that their mother has brainwashed them against him”.  In court, the girls told the judge that they had been sexually abused by their father and their fabricated testimony appeared “rehearsed and prepared”.  The evident devastation of the father (who states that his ex is “executing a campaign of denigration” against him) is almost as upsetting as the fact that the girls appeared to be “genuinely terrified” of their father and he did not know why.

This man is not alone.  There are men and women in broken families who experience the effects of PAS every day — and, as the article describes, there are also millions of children who experience the strain of two warring parents.  In the family spotlighted in this editorial, the writer states that the mother purposely did not take the children to their father even though he was awarded joint custody and turned them against him so that the girls refused to see him when they had the chance.

Think about the emotional effects on each member of the family in this situation.  You may know a family that has gone through or is going through similar issues.  As a child in a family that is splitting up, so much is already tragic, already horrific, that to have a parent feel that he or she needs to demonize the other parent and turn the children against them exemplifies the emotional harm tremendously.  This might put the children in the middle and force them to choose — who loves them more? who is the better parent? who would it be better to live with?  These are questions that may have no clear answer …and are definitely not questions that children should have to consider at this tumultuous time.  Putting the serious emotional consequences on the children aside, I have to look at the emotions that each parent might be feeling.  What the editorial did not spend much time on was the way this affected each parent individually.  PAS may be defined as a syndrome that a child experiences in a broken family, but I also believe that the syndrome throws the targeted parent into a role of defending him or herself against their own children while they are experiencing the destruction of the family system they have built.  The personal feelings this role might scramble include guilt, shame, anger, fear, sadness, loneliness, and despair.

And what of the parent who drives the targeting?  Behind the defenses, behind the army-building, there must be a terrified parent who fears losing his or her children as well.  For some reason, instead of stating this or exploring why he or she is creating a sense that there is a “bad parent” in the family, the automatic response is to turn the children against the other parent.  I wonder if there is evidence as to if certain types of family breakup scenarios encourages PAS more than others?  Is it more likely to occur when one partner has strayed?  If one partner has taken more of an involved role in the upbringing of the children?  If one type of parenting style is more likely to lead to PAS than another if the family breaks up?

There is much controversy about including PAS in the upcoming DSM V.  Some argue that it will help get more insurance coverage for families experiencing this issue and that it will bring more attention to the severity of it in court.  Others have difficulty even understanding what PAS is and why it is considered a “syndrome”.  I tend to agree with the author of the editorial:  “the key is education.”  Educate the courts, educate parents, educate professionals about the effects of Parental Alienation Syndrome and perhaps it will be eradicated before it even has a chance to be included in an official manual.  Tell me: what do you think?