Tag

emotions

The Holiday Blues Coupled with Covid

By | NESCA Notes 2020

By: Angela Currie, Ph.D.
Pediatric Neuropsychologist, NESCA
Director of Training and New Hampshire Operations

The holidays can be a time of great joy, but they can also be a time of great stress. Celebrations and merriment can be contrasted with pressure to amaze, long to-do lists, financial constraints or reminders of those we have lost. For many, it is a time of mixed emotions or strong internal conflict about why they cannot feel happy during a season that practically dictates it.

Holiday blues have been felt my many people for a long time, but now during a global pandemic, those feelings may be amplified and more prevalent than previous years. Families are trying to provide children with a positive holiday experience during a time of high stress and significant restriction. Family gatherings and holiday traditions are being cancelled, and many families are mourning the loss of loved ones. Adults are not the only ones feeling increased stress as we enter the holiday season. Children likely feel excited about the holiday but sad about not seeing family, not having holiday parties in school, and not being able to attend their traditional holiday events. This holiday season is simply different in ways that can bring great strain.

So, what can we do as adults to emotionally support children this holiday season? Do we allow them to observe our stress or do we keep it to ourselves in an effort to provide them with the happy holiday season that they deserve?

In June 2018, I wrote a blog post titled: “The Struggle is Not only Real, It is Necessary,” which discusses the importance of embracing uncomfortable, unwanted emotions as being necessary for personal growth and resiliency. By acknowledging, accepting and using unwanted feelings in a functional manner, we teach children to be competent and confident in their ability to navigate a stressful world. Of course, when I wrote the article, I could not have imagined the extent or duration of stress or discomfort that we would be facing in 2020. But does that change anything?

To put it simply, no, not really. Entering into the holidays with the expectation that we can protect our children from life’s stress is unrealistic. Attempting to do so will only add pressure while ignoring the mixed emotions that children are likely feeling as well. During this emotionally high-stakes time, acceptance of the struggles we face is even more critical. Adults and children both need “permission” to feel sad, frustrated, lonely or scared while also still allowing themselves to feel excited, thankful, and, yes, even joyful.

Here are some suggestions for how to help your family navigate the holiday blues this unique holiday season:

  • Talk about your feelings – wanted and unwanted ones – throughout the day, modeling and encouraging regular emotional discourse (e.g. “I love giving gifts, but getting all the shopping done is kind of stressful.”).
  • Help children label and interpret the emotions they may be having, as they may not have the right words or language for expressing them (e.g. “It sounds like you’re really disappointed we can’t go to Grandma’s house.”).
  • Be careful to not accidentally dismiss children’s feelings (e.g. “No need to be sad; we will find another fun way to celebrate.”), instead reflecting their emotion (e.g. “I know you’re sad that we can’t have a holiday party; I am, too.”).
  • Normalize the experience of mixed emotions (e.g. It’s okay to be excited for children while also feeling sad that we won’t see our family.).
  • Find new, safe holiday activities or events (e.g. holiday light drive, virtual gift exchange, etc.) and adapt previous traditions when able (e.g. virtual family gatherings).
  • Don’t romanticize the traditions that were lost this year (e.g. avoid such things as, “Our parties were always the most magical part of the holiday.”).
  • Help children understand new holiday plans as an opportunity to “celebrate” or “experience” the holiday, but be careful to not impose emotional expectations (e.g. “Enjoy the holidays!”) that can add pressure.
  • Reassure children that these changes are temporary, and traditions and visits will continue when it is safe to do so.

 

About the Author

Dr. Angela Currie is a pediatric neuropsychologist at NESCA. She conducts neuropsychological and psychological evaluations out of our Londonderry, NH office. She specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

 

To book an evaluation with Dr. Currie or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician in the referral line.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Londonderry, NH, Plainville, MA, and Newton, MA serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call (603) 818-8526.

10 Facts about the Rorschach Inkblot Test

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

As an evaluator, I receive a number of questions about the usefulness of the Rorschach Inkblot Test. The following “10 facts” are designed to answer some common questions and also incorporate some new and fresh scientific research findings related to the Rorschach.

The Rorschach Inkblot Test is a diagnostic tool that should always be incorporated within a comprehensive evaluation which includes projective or “performance-based” testing. If you are considering if your child or teen would benefit from projective testing, please refer to one of my earlier NESCA blog posts: More Than An Inkblot: Measuring Problem-Solving and Critical Thinking Skills with Projective Tests.”

  1. The Rorschach Inkblot Test is a test that provides data and information about how a child or teen problem-solves situations “in the moment.”
  2. Research indicates that the Rorschach is a valid assessment tool (with validity akin to other personality measures, as well as measures of IQ).
  3. Recent fMRI studies show high levels of brain activation in brain regions associated with emotion, emotion memories, perception, attention and visual processing.
  4. After the Rorschach Inkblot Test is administered, an experienced evaluator uses an evidence-based scoring system to compare a child’s responses to a normative sample to evaluate their performance. RPAS (Rorschach Performance Assessment System) is the most evidence-based scoring system to date and has strong empirical evidence.
  5. The Rorschach evaluates and detects psychotic symptoms.
  6. The Rorschach is helpful for evaluating trauma, including dissociation and intrusive symptoms.
  7. The Rorschach assesses both trait (stable characteristics or patterns) and state (a temporary way of being) variables. For example, the Rorschach tells us about how a person is coping with everyday stressors (e.g. from bullying to family loss to lack of sleep). The Rorschach also tells us if a person has a more pervasive habit of “bottling up” emotions or behaving rashly or impulsively when overwhelmed.
  8. The Rorschach quantifies a child or teen’s strengths, such as capacity for insight and adaptability, or resiliency to stress.
  9. The Rorschach Inkblot Test is not for everyone. More research is needed about the utility of the Rorschach for individuals with expressive language communication impairments or visual-spatial processing deficits.
  10. Not every evaluator is equipped to administer and interpret the Rorschach Inkblot Test. The Rorschach is a powerful diagnostic tool when interpreted in conjunction with observation and other test results by a skilled, experienced practitioner with extensive training in Rorschach administration and interpretation.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

When Parents and Kids Have BIG Emotions

By | NESCA Notes 2020

By Miriam Dreyer, Ph.D.

Pediatric Neuropsychologist Fellow

Brianna Sharpe’s recent essay for the New York Times – Parenting section titled, “I’d Like to Melt Down When My Kids Do,” captures an essential challenge of parenting – managing one’s own emotions when your child is having big and difficult feelings. Ms. Sharpe writes about her own extensive training as a mental health professional and how even with lots of experience working with children, she was not prepared for the emotional demands of parenting. She writes, “. . . like all preschoolers, my son needs an anchor when the waters get rough. But just when he needed me most, I found myself being pulled under by my own emotions. Although I never called him names or outright accused him of being at fault, I would yell in anger when hurt. My irrational response was often, ‘Why would you do that?!’ Once the red haze faded, I knew he was doing just what preschoolers are designed to do – but I had a hard time reconnecting with him.”

Ms. Sharpe beautifully depicts the intricate link between a child and a parent’s emotions. As parents, one of our essential roles throughout our children’s lives is to help them regulate. From birth, our job is to love, soothe, feed, attend and help our kids make sense of their feelings. This is a hard job, made even more complicated by the nuances and complexities of our own emotional lives.

Emotion regulation is a multifaceted process. As defined by Gross (1998), emotion regulation involves conscious and unconscious processes that operate both before an emotional response is generated and after it occurs. He writes that emotion regulation consists of “processes by which individuals influence which emotions they have, when they have them, and how they experience and express these emotions.” Challenges with emotion regulation are a component of many of the presenting problems we see at our center. Children with ADHD can struggle with emotional impulsivity, shifting and modulating emotional responses. Individuals with depression and anxiety face challenges balancing positive and negative feelings, as well as controlling irrational thoughts and worries. Difficulties with emotion regulation for individuals on the Autism spectrum are also common and intersect with social/emotional and behavioral problems that can arise with symptoms related to rigidity, self-direction and repetitive, self-soothing behaviors.  Symptoms associated with traumatic stress, such as dissociation, mood lability and alexithymia, all interfere with one’s ability to regulate emotionally. Even challenges like communication disorders and other learning disabilities are related to emotion regulation since they generate anxiety and can impede expressing oneself using language, which is a key regulatory process. In fact, theorists are now conceptualizing emotion regulation as a possible unifying, underlying component across psychological disorders (Aldao, Nolen-Hoeksema, & Schweizer, 2010).

What are we, as parents, to do then in the face of our children’s and our own stormy emotions?  How do those of us caring for children who are struggling help them while attending to our own complicated emotional processes? A helpful framework for considering these questions comes from researchers who focus on attachment relationships in parenting, mentalization, as well as the mindfulness and self-compassion literature. 

  • Cultivate self-compassion. Parenting is hard, as is childhood. A stance of self-compassion which acknowledges challenges and encourages kindness to oneself helps move out of cycles of self-blame and anger.
  • Encourage curiosity about your own and your child’s emotions. Developing awareness of our own and our children’s emotional lives helps create a buffer in moments of heightened emotional arousal and can shed light on challenging patterns and interactive cycles.
  • Take a pause. Try breathing and mindfulness exercises to regain calm in difficult moments.
  • Consult with a therapist for parent guidance. There are many different types of parenting programs and support that can help tailor strategies and target complicated dynamics within family systems.

 

References

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review30(2), 217-237.

Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of general psychology2(3), 271-299.

Sharpe, B. (2019, June 21). I’d like to melt down when my kids do.  The New York Times.

 

About the Author

Dr. Dreyer enjoys working with children, adolescents and families who come to her office with a wide range of questions about learning, social and emotional functioning. She is passionate about helping children and parents understand the different, often complex, factors that may be contributing to a presenting problem and providing recommendations that will help break impasses – whether they be academic, therapeutic, social or familial.

Dr. Dreyer joins NESCA after completing her Doctorate in Clinical Psychology at the City University of New York.  She most recently provided psychological assessments and comprehensive evaluations at the Cambridge Health Alliance/Harvard Medical School for children and families with a wide range of presenting problems including trauma, anxiety, psychosis, and depression.  During her training in New York, she conducted neuropsychological and psychological testing for children and adolescents presenting with a variety of learning disabilities, as well as attentional and executive functioning challenges.  Her research focused on developmental/complex trauma, as well as the etiology of ADHD.

Dr. Dreyer’s experience providing therapy to children, adolescents and adults in a variety of modalities (individual, group, psychodynamic, CBT) and for a wide range of presenting problems including complex trauma/PTSD, anxiety, depression, ADHD, and eating disorders informs her ability to provide a safe space for individuals to share their concerns, as well as to provide tailored recommendations regarding therapeutic needs.

Before becoming a psychologist, Dr. Dreyer taught elementary and middle school students for nine years in Brooklyn, NY.  She also had an individual tutoring practice and specialized in working with children with executive functioning challenges, as well as providing support in writing, reading and math.  Her experience in education informs both her understanding of learning challenges, as well as her capacity to make specific and well-informed recommendations.

She received her Masters in Early Childhood Education from Bank Street College, and her B.A. in International Studies from the University of Chicago.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

To book an appointment with one of our expert neuropsychologists, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.