Positive Self Talk

Positive Self-Talk

By Patience Domowski, LCSW

Did you know that talking positively to yourself can change how you feel and behave? It’s amazing how much our minds and thoughts can affect our feelings and behaviors. This is the basis theory for Cognitive Behavioral Therapy, known commonly as ‘CBT’. CBT teaches that changing your thoughts (often through a strategy or coping skill called ‘Self Talk’) changes your feelings, which then changes your behavior.

For example: You see someone you know at the store or a restaurant and they don’t talk to you at all. If you think “That girl didn't talk to me because she doesn't like me”, you might feel sad, annoyed, jealous, etc. Your behavior may be to snub her, not talk to her, or be rude. However if you change your thoughts to “That girl didn't talk to me today; maybe she’s having a rough day, or she didn't see me. Or she was busy/some other reason,” then your feelings change to more neutral/content feeling, not caring about it, or even feeling bad for the girl. Then maybe your behavior might be to go talk to her yourself or just let it go. The situation didn't change- the girl still didn't talk to you, however by changing thoughts from negative (‘she doesn't like me’) to positive (‘maybe she is having a bad day or didn't see me’, or some reason not related to feeling badly about me) then your feelings become more positive and your behavior improves as well.

‘Positive self-talk’ is also used to help you feel better about yourself when you have negative thoughts about yourself. So if your thoughts are ‘I’m a terrible person’, ‘No one likes me’, ‘I’m so stupid’, which makes you feel sad, disappointed, like a failure and leads to behaviors of withdrawal, avoidance, etc you can work on changing those thoughts to ‘Well, I did the best I could’, ‘Not everyone likes me, but my friends do’, ‘I’m still learning and everyone makes mistakes’, then your feelings become more positive such as feeling hopeful, happier, etc and your behavior likely would be to try harder, not continue to think harshly on yourself, maybe be more active or social.

Just going into a situation thinking positively about the possible outcomes will help you notice more positive aspects of situations and likely you will have a better experience than going in with a negative viewpoint. For example maybe you’re dreading a family party because you don’t know a lot of extended relatives that are attending, or there are often family arguments. You head into the party dreading these awkward moments that may arise. Instead you can change the thought to ‘I’m going to enjoy myself, regardless of others’, and instead maybe focus on the food, plan to talk to the one or two people you like/get along with, or anything else that may not be too bad about the event. Then after the party you may realize that it wasn’t so bad because you were focused on the good parts, and even if you didn't know some people, or someone started a fight, at least you were focused on the people you did know, and you stayed out of the drama.

Although thoughts won’t affect what happens- you can’t magically think away something bad happening, but if you focus on the positives/good things, you will feel better than if you are focusing on or looking for the bad things.

The situation may remain the same, but the outlook is different. For example let’s say you and your friend have a day off school or work due to the weather. One person is happy because they don’t have to go to school/work, and can hang out at home doing something they’d rather do for fun. The other person is upset because they either don’t get paid for not working, or they have to make up a school day later, and they are thinking they will be bored while home and really wanted to see their friends that day. The situation is still the same- school/work is closed due to weather, however the positive person will enjoy their day, despite the consequences of lost wages or having to make up the day later, while the negative person will be miserable thinking of what they would’ve rather had happen that day.

Common positive self-talk phrases include self-esteem affirmations such as ‘I’m a good person’, ‘Others like me’, ‘I am smart’, ‘I am loveable’, as well as motivating statements such as:  ‘I can do it’, ‘I can think positively about this’, ‘It will get better’, ‘I just have to try’, etc.

If positive statements do not automatically come to your mind spend a few minutes trying to think of something positive about a situation or thought that you have, and if you get stuck, think what would you tell your friend if they were struggling with the same thought. It might be hard to think positively for yourself, but it may be easier to think of something helpful to tell a friend. If you are still stuck, ask a friend or family member for some help coming up with some positive thoughts and phrases. Write them down so you don’t forget them. If you usually think negatively, it will be very hard to remember the positives, and even harder to believe them! So have them written down so you can go to them and use them when needed.

As you work on thinking more positively, just like physical exercise, it will become easier over time. At first it will be super hard, but then your brain will help you think of them faster. The more you try it the easier it eventually becomes. The more you focus on the positives, the better you will feel. So when you catch yourself thinking negatively about something, try to change that thought right away or focus on another positive aspect of the situation, in order to think and behave better.

People with anxiety and depression mostly need to work on postive self-talk, but all of us have times of feeling down or negative and can use this coping strategy so start stretching the positive 'muscles' of your brain now so you can be ready for when you are having a negative day. 

An old quote from Henry Ford (inventor of the Ford automobile) says “If you think you can, or you think you can’t: you’re right!”

Don’t Lose your Temper when You Lose a Game!

Don’t Lose your Temper when You Lose a Game!

By Patience Domowski, LCSW

No one likes to lose, but why do some people have such a hard time with it? We’ve all seen (adult) sports fans freaking out when their team loses, but often adults handle it fine. Children, however, are a different story. While most adults can process that while it's disappointing to lose, they know it's a part of life and maybe they will win the next time. Children, though often don’t think about the broader picture or the future impact and cannot accept defeat.

Does your child ‘lose it’ when they lose? Throwing their gaming controller/sports equipment, screaming, stomping their feet, having a full tantrum when they lose a game? Are they unable to accept defeat or disappointment and overreact in anger? Do the blame the opponent and declare they must have cheated because they cannot take responsibility themselves for the loss? Do you worry taking your child to their sports events that they will lose their temper if they don’t win and it will embarrass you in front of the other team members and parents? If yes to any of these, keep reading!

Here are some reasons children struggle to accept loss in games (“games” refers to video games, board games, and sports games):

• Child puts a lot of pressure on themselves to do well, often due to anxiety, and sees losing as “failure”.

• Parents, coaches, others put a lot of pressure on child to win all the time, instead of just ‘do your best and have fun’.

• Child has low self-esteem and losing confirms their negative view of themselves which is already low.

• They are teased because of their performance by siblings, peers, friends, bullies, etc

• Parents, coaches get upset and overreact when their child’s team doesn’t win

• Child doesn't have the coping skills or emotional maturity to handle disappointment

• Child/team hasn't been taught good sportsmanship skills.

• There certainly can be other reasons too.

Some strategies to teach your child to handle losing a game better:

• Remind child that just because they lost doesn't mean they did anything wrong or are a bad person/team because of it

• Build child’s self-esteem in other ways, if games/sports are not helping or child is just not good at these activities, such as finding other things the child is good at like building, or art for example.

• Encourage child to do their best, regardless of outcome, and don’t make them feel bad for missing a shot or making a mistake

• Remind child that everyone wins some and loses some, and they need to just try their best, and it’s okay (if they can’t handle constructive feedback, say nothing, or just point out the positives, until they are more able to handle suggestions for improvement)

• Model good sportsmanship by handling it well when adult’s preferred professional sports teams lose or do poorly. “We’ll get them next year”.

• Praise the good as much as possible and focus on that: “You made a good pass” or “You got one goal!”

• Teach child that if they handle losing well, the opponent/friend is likely to want to play with them again, however if they throw a fit the other person is likely to not want to play with them anymore.

• Role-play/practice with child on how to react if they win or lose. Have child act out saying “Good Game” at end of game regardless of the results.

• Try not to focus or mention the score in a game, or even saying who won or lost, but just on how individual did in some moves/plays

• Also make sure to teach children to be good winners- not bragging, or teasing the other team, but just graciously accepting the result without over-doing their reaction (no show-boating). Make sure they say ‘good game’ regardless, and shake the other team’s hands (if appropriate).

• Point out how professionals handle loss (look up some good examples online of professional sports players) and point out how professional coaches look for good sportsmanship and want to see that behavior in pros.

• Teach child emotional regulation skills of recognizing their own emotions and how to handle anger and disappointment (like taking a deep breath, walking away for a minute to collect themselves, thinking about the problem differently) and have child practice and act out these behaviors

• Purposefully play a game with child where the point is for child to handle losing graciously- tell the child this is the plan. (Adult should try hard to win). Praise the child for handling it well, if they do, or have them try again if they get upset. (May need to remind child how to respond towards end of the game.) If needed, add in an incentive like a small reward if they handle losing without getting upset.

Excellent book resources to read  and discuss with your child:

• “If Winning isn’t Everything, Why do I hate to Lose?” by Bryan Smith (available on Amazon)

• “Bubble Gum Brain” by Julia Cook (addresses thinking flexibly, not giving up even if something is hard, handling mistakes, and growing)

• Search on Amazon for other books on this subject.

Quotes:

“If you’ve had a good time playing the game, you’re a winner even if you lose”

— Malcolm Forbes

“It is not up to me whether I win or lose. Ultimately, this might not be my day. And it is that philosophy towards sports, something that I really truly live by. I am emotional. I want to win. I am hungry. I am a competitor. I have that fire. But deep down, I truly enjoy the art of competing so much more than the result. ”

— Apolo Ohno

“First, accept sadness. Realize that without losing, winning isn’t so great. ”

— Alyssa Milano

“There are more important things in life than winning or losing a game. ”

— Lionel Messi

“You learn more from losing than winning. You learn how to keep going. ”

— Morgan Wooten

“Losing a basketball game hurts but when you see what you’ve been through, you look on it and say well if this is the worst thing that can happen to me, then I’m okay.”

— LeBron James

“I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed.”

— Michael Jordan

“You can’t win unless you learn how to lose. ”

— Kareen Abdul-Jabbar

“We didn’t lose the game, we just ran out of time”

— Vince Lombardi

“Success comes from knowing that you did your best to become the best that you are capable of becoming”

— John Wooden

Books flyer

Books for Sale, downloadable flyer to share

Link to Amazon. 

Aggression in Children and How to Handle it

Aggression- how to decrease behaviors

By Patience Domowski, LCSW

Aggression in children is really difficult. From yelling to hitting, its very disruptive and sometimes even dangerous. Especially as the child gets older it becomes more of a safety concern. A 3 yr old hitting a parent is not that big of a problem, but a 13 yr old could really hurt someone.

To solve this problem we need to figure out why it is happening. Here are some possible causes:

-Child cannot manage their emotions (needs coping strategies), gets easily angry, anxious, frustrated, etc

-Child cannot effectively communicate (hasn't developed full speech due to age or speech delay, or autism)

-Child has a mental health diagnosis (autism, bipolar, ODD, …)

-Child has observed and copied aggression from older siblings, parents, violent TV

-Child is very impulsive (can’t stop and control themselves)

-Child has discovered that this gets them what they want from others  (example: if they hit then people leave them alone, if they yell then dad gives in, etc)

-Child gets attention from their behavior (even though it is negative, some children still want this attention).

-Other reasons…

For some children there may be a combination of reasons. Sometimes the reason is easy to discover but other times it may be more complicated. Collecting data (writing down the behaviors and what happened before and after) and doing an FBA (Functional Behavior Analysis) can be helpful. Ask your child’s teacher or behavioral therapist about how to do one if it is difficult to figure out the ‘why’ for the behaviors.

To correct the behavior we want to teach the child a combination of better coping strategies and a more effective way to get what they want.

For example: if they get angry easily when their sibling takes their toy we want to teach them to calm down, and also the skill of asking for the toy nicely, or asking a parent for help. If the child wants attention then teaching the child a more appropriate way such as saying “Mom, play with me!” instead of hitting would be helpful. Also the parent should ignore the inappropriate behavior until the child does the expected response.

If the child is copying others aggressive behavior- whether in person or on TV shows/games/ etc it is important to limit this exposure. If the parents are showing aggression such as yelling and hitting children, then it's likely the child will copy this as well. If the parents can try to be more patient and handle their frustrations in a more appropriate coping way, this can greatly help the child. Parents may want to seek therapy on their own, or try anger management groups, or even medication to help, if they are really struggling with depression for example. If older siblings are exhibiting aggression it is helpful to try to get them some more help and teaching the younger child to not copy those behaviors. If the child is watching violent TV shows, movies, video games, eliminate or at least reduce the frequency the child is exposed to that. If the child resists, explain that if they reduce their aggression they can slowly return to those games/shows etc. Pay attention to the ratings on games and shows however and the child’s age.

For cursing- if it’s in conjunction with anger and aggression, use same strategies already listed to teaching better coping behaviors, but besides that mostly ignore it, or teach a silly replacement word “peanut butter jelly sticks!” The more attention you give the curse word, the more powerful they become. You can tell them not to say that word and maybe even why, and if necessary punish for it, but if you make a huge deal about it (such as yelling and lecturing) it will likely make it worse. Also make sure parents and older siblings are refraining from using those words completely. Even if parents tell child not to say a word, if they are saying it themselves, the child will still learn it and repeat it. With any behavior, parents need to model good behavior and not to do anything they would not want their child to do (for the most part). Sometimes an old fashioned ‘swear jar’ is helpful. The person that says the bad word is ‘fined’ and has to pay real money into the jar.When the jar is full some families will use it for a fun activity, sometimes the money would go to the non-swearing person, or maybe the family would donate it to a charity.

Make sure the child’s aggressive behavior is not getting them what they want. If they are hitting their sibling to get them to leave them alone, and its effective, that is going to maintain the behavior. Try to teach the sibling to respond better and quicker and teach the aggressive child to request space in a better way. If the aggressive behavior is getting them the attention or item they want from parents, parents need to try hard to not give in. Even though it makes the screaming stop now, it will just make the behavior worse the next time if you give in.

If the child has not developed appropriate speech, due to age or delays, it maybe be helpful to teach a simple hand gesture/sign language to use to communicate. Maybe a clap means ‘Can I have it?’ or a hand tap means ‘I need help’. Ask your child’s speech therapist for some ideas to figure out what will work best for your child’s speech needs.

For kids who don’t have good coping strategies have them write up a list (or draw) several things they can do when they are angry and then hang the list in a well-trafficked area in the home (living room or kitchen is usually good). The list should be visible because when someone is angry they are not going to go searching for a paper in a drawer to figure out what to do. The strategies can include deep breathing, walking away/ignoring, asking parents for help, doing something fun to distract yourself, and remembering to ask nicely for things. There are many coping strategy lists that can be found online. The key is to find which ones work best for your child and to have your child identify these as well. The more the child is involved in identifying the strategies the more likely the child will use them.  Also have the child act out the appropriate coping strategy when they are in a good mood, as a role play, or after they made a poor choice to reenact making a better choice.

Try giving a reward to the child for using a strategy. For example if the child takes a deep breath instead of hitting mom, or stops screaming by deciding to go chill out in their room, give them a piece of candy, access to a special toy, or extra ipad time for making a good choice. Praise your child for calming down, whether it took 10 seconds or 1 hour, immediately praise them when they are calm so they associate positive attention with calming down.

Try behavioral charts. Children are often not motivated to make a better choice internally - it’s easier for them, or not big deal for them to yell and hit versus breathe and ask nicely. But if you sweeten the deal by offering candy, toys, extra time, other privileges then they are more likely to make the better choice. Some kids will need the reinforcement reward immediately and some can wait until the end of the day or week. Think about your child’s needs and personality to figure out the immediacy of rewards. If you aren't sure how to do this seek out a behavioral therapist who is experienced in this and can help you. Once your child learns the strategies to handle their feelings more appropriately they are likely to reduce aggression and you can fade out the behavior chart, or use the rewards to target another behavior.

Sometimes if the child is so out of control and aggressive they have to be restrained. Parents can learn appropriate ways to restrain their children (ask the school, doctor, or a therapist). If the child is in danger to themselves or others it is okay to restrain them until they are calm and in control again. The police and mental health crisis workers can also be helpful in these situations. If aggression is a regular occurrence, behavioral interventions are not effective, and the behaviors are fairly severe, medication may be necessary. Talk to your child’s doctor or seek a child psychiatrist for help.

Helpful Links:

Swear Jar: https://en.wikipedia.org/wiki/Swear_jar

Child Restraining: https://www.k-state.edu/wwparent/courses/rd/toolbox/rdtool-37.html

Causes of Aggression:

https://childmind.org/article/aggression-in-children-causes/

Handling aggressive behavior:

https://www.empoweringparents.com/article/how-to-manage-aggressive-child-behavior/

Taming Aggression and Coping for parents:

http://www.parentingscience.com/aggression-in-children.html

Anger Strategies (Other helpful blog articles)

My Child Can Talk, But Won't, Why?

My Child CAN Talk, But Won’t, Why?
Selective Mutism/Social Anxiety

By Patience Domowski, LCSW

Assuming your child is able to talk, and not dealing with a speech delay or autism, but the child sometimes, or often, refuses to talk, usually in certain situations,you may be quite confused why this happens, and what to do about it.

Usually the reason is excessive anxiety. The child could have social anxiety, social phobias, or be diagnosed with ‘Selective Mutism’ (an anxiety disorder where the child will not speak at all in certain settings).

Children can get anxiety from genetics (anxiety ‘runs in the family’, so to speak), from a traumatic event (the child considers it traumatic, even if others might disagree), or sometimes anxiety seems to come out of nowhere (likely to be biological). Social Anxiety or Social Phobia is a fear of others judging or looking at them. Often children, and adults, know that know one is technically watching them but they feel like they are being watched. It's like paranoia, but may not be quite that severe. The affected person may feel like if they speak others will think bad thoughts about them. Maybe they are worried they will be bullied, or taunted. Maybe they get so anxious they can’t say what they want to say so they clam up. Maybe in the past they were actually bullied, or ridiculed or yelled at by peers or adults, or maybe nothing ever bad happened, they just worry it will happen.

If the child has become mute from a traumatic event, it is likely they will not speak across many settings, not just some. They may show signs of fear and other issues like bed wetting. Usually the mutism occurs right after the trauma.

Sometimes children refuse to talk because they don’t know what to say, they want control, they want to  frustrate their parents, or for behavior issues. However if the child is showing other signs of anxiety like acting nervous, only refusing to talk in certain situations of high anxiety (like at school, in the community, around strangers), trying to avoid social situations, and even other symptoms like panic attacks, headaches, stomachaches, throwing up, etc it is likely to be for anxiety reasons.

So what do we do about it? One major way is to not pressure the child to speak. Instead of saying ‘You HAVE to say Hi to Grandma!’ you can prompt gently ‘Would you like to say HI? Or you can just wave, if that’s easier’. And then don’t expect any response and be okay with that.  Don’t punish the child or yell at them for not speaking. This will make the anxiety much worse and not help at all. If the child is already afraid to speak, then by being yelled at or punished, they will become even more fearful of speaking. They should be encouraged to speak, but then let it go, not pushing it, just telling them they can speak when they are ready. Maybe the child can learn a simple sign/gesture that is acceptable such as a wave, high five, or fist bump for greetings. If that is too much for them, it’s okay.

To help the child become more comfortable, praise them (if they like praise) when they do speak in more relaxed settings. Remind them of the good job they did when in another situation “Remember when you were so brave and said Hi to Uncle John? You did a great job! It went great, didn’t it?  You can try to say hello to Uncle George today!”  Have them warm up to others by watching before approaching, and visiting places in advance before an event (if possible). For example starting at a new school- have them visit the school a few times when no one is there, or meet the teacher one on one, before the first day, or orientation day.

Try to make meeting new people or new situations relaxed and friendly and not expect or make a big deal about the child talking,  just let the child warm up slowly on their own time and at their own pace.  Example: “Sweetie, you can join the other kids on the playground if you want, or it’s okay to just stand by me if you prefer.” or “Let’s just watch the other kids play this game and when you’re ready, if you want, you can join in. Wow, that looks like fun!”

It may be helpful to tell others, especially adults, that the child is anxious and not speaking, so the other adult doesn't try to force the interaction and make the child more anxious. Sometimes other children may not even notice, if they are very young, as a lot of play is nonverbal, or the other child will just do all the talking. Often adults may get upset and confused however so it may be helpful to calmly say ‘She might not respond, but don’t take it personally. We’re working on anxiety’ or ‘Don’t worry if she doesn't respond, she will warm up eventually.’

For the socially anxious child they may do great with one on one playdates but be a mess at parties and larger gatherings. Encourage the small group settings to start with, and don’t force larger parties too soon. If possible, just have them observe from a distance, and not expect them to join in the activities.  For older children giving them a script of something to say may help if they aren't sure how to start a conversation. “Ask them about their favorite TV show” may be more helpful than “Just try to talk to him!”

Seeking out professional help may be needed if the child isn't making progress after a few weeks. Often children may adjust to a new school after a month or so, or get used to a new group of friends, but if they are still quite mute even after a typical adjustment period, it may be time to ask for some more help. A Behavioral Therapist may be more effective than a speech therapist, find out what their approach would be when selecting someone. Make sure the therapist works with kids with anxiety, not just behavioral disorders, as the approach should be from an anxiety point of view, not a oppositional defiant type approach. The strategies are likely to include acceptance, not forcing, relaxing the environment if possible, preparing child for new and scary situations, telling people not to expect a response, allowing the child to slowly warm up, but not avoiding all scary anxiety situations, and slowly building child’s confidence and reducing fear in being able to speak to others.

Try to remember as a parent, it’s probably not your fault, and it’s not the child’s fault either! Being calm and accepting will help a lot even though it’s very frustrating and of course you want your little darling to speak up. If you as the parent also struggle with anxiety getting some help for that can be useful. Or if you are just so frustrated to the point that you are getting angry with your child about this, it might be helpful to seek out a therapist as well to help you cope. If you aren't feeling so upset about it it may help your child feel less anxious about the situation too. Try not to take the problem personally or that it reflects badly on you as a parent, and that can help you feel better about it as well.

Some kids may grow out of this problem, but likely it will worsen if not treated. Getting some help for anxiety such as coping strategies, learning how to change negative thinking, and sometimes even medicine can go a long way to making things get a lot better. If your child won’t talk to the therapist or doctor, see if the therapist will work with you as a parent to handle the child and teach them the strategies indirectly and that may be sufficient. Also don’t give up too easily. Often children warm up to therapists after a few visits, but not always the first or second meeting. Giving the child an incentive or special reward may be helpful like getting to go out to eat before the session, or can bring a favorite toy with them may help. Even telling the child they don't have to talk about their anxiety, but about anything they want can help a lot (even though of course you want them to talk about the problem!).  A good therapist will go along with what the child wants to discuss first and bring it around to the topic they need to work on at some point (may be after a few sessions so the child can warm up). Child therapists also should have some toys, books, coloring, something to do besides just talking which may help the child feel more comfortable. Even if the child isn't talking in therapy, if they are listening to a story, or coloring a picture, it can still be really helpful. Try not to get too frustrated if the therapy isn't working right away, it often takes a while for kids who are slow to warm up. Some kids may even surprise you and talk immediately to the therapist, when they normally wouldn't talk to a strange adult at all.

Remember your child can learn how to speak in social settings with some help. It gets better. Hang in there.

• Some helpful articles and information:
• https://selectivemutismcenter.org/whatisselectivemutism/
• https://childmind.org/guide/selective-mutism/selective-mutism-what-is-it/
• One family’s story: https://childmind.org/story/joint-effort-help-sofia-speak/

I hate you!

When your kid says “I hate you!”
by, Patience Domowski, LCSW

When your kid says “I hate you!” and how to handle it…

1)      Remember you’re not alone. Many kids say this at some point to their parents.

2)      Recognize they usually don’t mean it. Knowing they don’t mean it and it’s not personal can help parents feel better about themselves and also not overreact. Instead of getting hurt or angry, recognize that your child is really trying to communicate something.

3)      Realize it’s a lack of skill. They don’t know how to express their frustration properly. Teach them by modeling the correct feelings words, giving them space to calm down and later discussing with them how they could’ve handled that situation differently.

Usually when kids say “I hate you” or similar mean things like “I want a different family!”, “You’re the worst parent”, etc… they are really trying to say “I don’t like the answer you gave me”, “I’m upset I'm not getting what I want”, or “I’m mad/frustrated/etc”.

Instead of saying “We don’t say Hate” or “You don’t mean that” or “You’re hurting my feelings” etc try saying this instead: “Sounds like you’re frustrated. Can you say “I’m really mad!” or “I don’t like that!” Model it for your child and hopefully they will copy you in the moment and then remember next time how to handle it.

4)      Teach empathy. Talk to them later about how they would feel if someone said “I hate you” to them when they really didn’t mean it. Even if they apologized later. Explain how it makes parents feel. Talk to the child about their feelings and teach them to identify some better coping strategies.

5)      Train kids to change their thoughts from Negative to Positive. Instead of seeing the bad sides to situations, help the child identify the positive sides of the situation. Over time they will better be able to handle disappointments.

Here's a link to a list of great responses!

Panic Attack Advice

Panic Attacks Advice
Patience Domowski, LCSW

Panic attacks usually include difficulty breathing, hyperventilating (short, shallow breaths), trouble controlling your breathing, feeling overwhelmed, severely anxious, sometimes racing thoughts, pounding heartbeat, and other symptoms.

Panic attacks usually occur when in an anxiety-producing situation like a large crowd, feeling confused and overwhelmed over school or work assignments, or other environments or thoughts that cause anxiety. Sometimes panic attacks come out of nowhere too for no specific reason.

Here are some ways to calm down during a panic attack:

If possible, Go to quiet space away from crowds and people (At school go to the hallway, bathroom, nurse’s office, guidance office. Don’t stay in a crowded hallway or classroom, if possible). If you feel the panic attack is going to start soon, try to preemptively leave the area.

Focus on breathing. Try to take Deep Slow Breaths from your stomach, not from your chest. You can try breathing into a paper lunch bag too, if available.

Don't think about why you are panicking, or what is causing the attack. Try not to think about anything anxiety related, or trying to figure out why you are panicking. Focus on calming. Think about a happy place or memory. Say in your head a calming word over and over like “Peace”, “Calm”, “Chocolate”, or the name of your pet, for example. Pick a calming word in advance to use for when you’re having a hard time.

If your panic attacks are happening several days a week and  also affecting  your life – such as interrupting school day, causing you to not be able to go to school or work, etc, consider medication and therapy. Therapy can help you discuss what makes you anxious and come up with some coping strategies. Medication can help calm your anxiety in general, and a rescue medication you can take when you’re panicking that can calm your body down immediately.

Coping strategies

Coping skills List
by, Patience’s Behavior Therapy

It’s good for kids to have their own list of coping strategies hung up in the home or within easy access, for anxiety and anger. Here are some examplesand ideas for your list.

Here’s a list of things that can help calm you down when angry:

•      take a deep breath

•      count to ten

•      go to a quiet space (like your room) to calm down

•      walk away from what is making you mad

•      listen to music

•      take a walk/exercise/dance

•      pet your dog/cat

•      ask for a hug

•      draw/writewhat you’re mad about and then rip it up and throw it away

Here’s a list of ways to fix anger problems:

•      think about it differently

•      try to find the positive

•      try to understand the other person’s perspective

•      problem solve

•      talk calmly with the person who is upsetting me

•      remember “if I’m nice, than people are more likely to give me what I want”

•      If I do what I’m told quickly I have more fun free time and won’t be as grumpy

•      try to get enough sleep and enough to eat

Calming strategies for Anxiety

·         deep breaths

·         try to think of the positive/realistic situation

·         use logic

·         progressive muscle relaxation

·         listen to music

·         think of a happy place/time/memory

·         draw a picture

·         talk to someone

Click here for a downloadable printable list

Breathing exercises to help calm kids down

Taking DEEP SLOW breaths are important to help teach your brain and body to relax. These breathing exercises are great for kids with anxiety as well as anger or any strong emotion. 

Download this list of breathing exercises! Print out and hang up in your child's calm down spot to help them remember how to relax! 

Breathing exercises for Anxiety or Anger to help kids calm down. 

Autism/Aspergers and teaching social skills at home

Autism/Aspergers

If you have a child on the autism spectrum you are probably realizing that parenting this child is extremely different that parenting neurotypical children.

[If you aren't sure if your child is on the autism spectrum have them evaluated by any of the following: their pediatrician, a developmental doctor, a licensed therapist, psychiatrist, Early Intervention evaluation team, child psychologist- either independent or at the child's school.

Signs of autism include at least some of the following symptoms -extreme difficulty with social interaction (including poor eye contact, difficulty understanding other person's tone or intent/meaning, struggles to make friends/initiate conversations, "tuned out", doesn't seek out others for interaction, doesn't understand emotions/how others feel), difficulty with communication (either not talking by age 2, barely talking, difficult to understand, difficulty with conversation skills/pragmatics/turn taking), repetitive behaviors/sensory problems (head banging, flapping, spinning in circles etc), restricted interests (will only play with dinosaurs, lines up cars, etc), other difficult behaviors (defiance, lack of focus, extreme inflexibility, difficulty transitioning between activities, needs a lot of help with basic life skills activities).] 

Children on the Spectrum need visual directions often, and help learning every behavior that most other kids will naturally pick up on without having to be specifically taught. I recommend find a good therapist and get them in a school/classroom that will meet their needs. Because autism is such a spectrum: from the severe nonverbal kids that might also have intellectual disability to the high functioning brilliant Asperger’s kids that your child’s treatment needs to be individualized and work best for their needs.

There is not really a one size fits all treatment for every kid on the spectrum but some basic tips include:

- use visual cues and directions

(social stories, picture schedules, show pictures or gesture/sign language of what you are asking them to do, write down reminders, instead of telling them what to do use picture cards or list the directions)

-don’t give long explanations just short, concise directions

With typical children explaining WHY is really helpful. With kids n the spectrum they often don’t care or don’t understand. Its usually just extra words they are confusing. SO just state what you want them to do in as a short a way as a possible. Example: “Put toys in box”- for autism child. For typical child you might say- “Please clean this room, because we are having guests visit tomorrow and I don’t want them to trip”.

-Teach and encourage your child to interact with peers.

Instead of expecting them to invite friends over to visit, you might need to take the initiative and invite the peers over and even teach/tell your child what they will play with. They might need some adult directives to play together instead of alone.

-teach them how to recognize and manage their own feelings as well as recognize and react to others feelings

Point out how you feel and how they feel so they start to recognize it.

Examples: “Mom is happy because you just gave me a hug! You can tell I’m happy because I’m smiling!” or “Dad is sad because you just kicked your brother. You can tell I’m sad because I’m frowning and shaking my head”.

“You seem so excited about going on vacation! I know you are happy because you are jumping up and down and smiling!” “You seem angry because your brother took your toy. I think you are angry because you have a mad face and are stomping your feet.”

-if they have sensory needs get them the sensory tools they need to help and a good O.T./therapy to help. [See sensory article] 

Anxiety

Anxiety

For kids with severe anxiety I recommend therapy and possibly medication if they can’t get through the day or are having many panic attacks.

While the child might ask you multiple times about various anxious scenarios I would suggest not constantly talking about their sources of anxiety and constantly reassuring them, but instead refer them to a professional therapist. They often may only need a few sessions to start feeling better. They need some reassurances from parents that they are safe/okay, but constantly talking about it can lead to them thinking more about their worries instead of getting them to think about other relaxing thoughts. Don’t tell your child not to worry about things or make them feel bad for having anxiety- it’s not their fault and saying this will just make them feel worse. Help them examine evidence if their fears are irrational to challenge their anxious thoughts. Also ask them how to make them feel better and teach them how to solve their problems. Also help them develop some coping strategies.

Coping strategy suggestions:

·         Take deep breaths from stomach (instead of chest)

·         Picture a relaxing scene/favorite place (often kids pick a vacation, or thinking about their pet)

·         Progressive musical relaxation (tighten and then relax your muscles)

·         Try to change your thoughts by questioning your fears if they are really likely to happen. [For example- if you worry your parents will die, then think- is it really likely? Probably not if you examine the evidence- that they aren’t sick and have never died before. Then you can try to challenge your thought and remember they will likely be fine and you can try to relax].

·         Problem solve:  If your child is asking “What if” this or that happens, ask them to try to think of logical solutions.

Anxiety about going somewhere new

Some kids have a lot of anxiety about going somewhere new (or somewhere they haven't been in a while) or visiting/meeting new people. Some kids may not show their anxiety, but rather internalize it (may be worried but not express it) and other kids express it in different ways. Some kids show this anxiety in the typical way: clinging to mom/dad, crying, refusing to go.  Other kids show this anxiety by throwing a fit or a tantrum. Sometimes parents don't recognize the reason for the tantrum- the child doesn't or can't appropriately express his feelings so they throw a fit.

Tip: Review and prepare. Show the child the website of where you are going (all attractions like museums, zoos, etc have websites with pictures), or show your child pictures of who you are visiting (grandparents for example). Discuss what you will do, what you will see, etc. Explain to the child it’s okay and normal to be a little anxious about doing something new or going somewhere new. Tell the child what the OK reaction should be. Also remind them how they can cope (hug parents, hold their hand, bring their favorite toy). Finally make sure you emphasize the fun part! Remind kids it will be fine.

Some kids do great with "Social Stories" where a story is written with the child in the story and it explains what will happen, what the expected behavior is, and reminds the child they are doing a great job learning whatever the skill is you want them to learn. (Search online for some free available social stories, or you can make one up yourself!)

Here's an example of something you can say to your anxious child before you go, and maybe during the car ride too.  "I know sometimes you (or use "kids" in general if the child gets upset if you specifically focus on them) get a little worried or anxious when going somewhere new. It’s okay, and normal. Even mommies and daddies get anxious sometimes. (You can say if it’s true that you feel a little nervous too).  Remember you can tell me "I feel worried" or "I'm scared" (use whatever feeling word you think your child is most familiar with and would understand) and come give me a hug, or you can hold my hand until you feel comfortable. We're going to do and see lots of fun things (give specific examples, if you can).  I'm sure you will have lots of fun!”

  (If you are leaving the child with a new babysitter for example, explain you will be back very soon and will give lots of hugs and kisses when you return, and you will miss them too.)

[see articles on breathing, preparing for a new school, separation anxiety and depression]

Emotionality/Handling Meltdowns in children

Emotionality and handling Meltdowns

When your child is very emotional/gets upset easily/meltdowns

Do’s and Don’ts for parents~  by Patience Domowski, LCSW

Do…

·         allow your child to express their feelings (as long as they are safe)

·         provide a safe spot for your child to go to calm down

·         give your child space (if they are really angry don’t keep talking to them, let them calm down first or they will just get more upset)

·         use a “code word”  (silly secret word) for your child to say if they need space and need to be left alone when upset and respect that word by not continuing to engage with them at that time (Alternatively parents can use the word when they need child to give them space too to calm down)

·         come up with a list of coping strategies/chill skills for child to use when child is in a good mood and post it where they can see it

·         try to remind child of coping strategies BEFORE they become extremely angry (include an incentive like extra time with something or a treat if they use a chill skill to calm down)

·         try to help our child recognize the middle part between annoyed and furious so they can work on calming at that time instead of when they are super angry

·         wait until child is calm before problem solving

Remember: FIRST Calm, THEN problem solve!

Don’t…

·         tell your child not to feel angry/anxious/sad/ etc (they can feel what they feel)

·         punish your child for feeling [discipline for “behavior” not “feelings”]

·          keep yelling/pushing your child to do what you asked/discuss the problem/etc when they are getting upset

·         allow child to be disrespectful or aggressive even if they are upset. [If they do so have them apologize afterwards ]

·         threaten things you don’t mean or won’t follow through with such as a punishment

·         give in to child’s wants when they aren’t making a good choice, or after saying no already (even if it means a meltdown is coming)

Breathing Exercises for strong emotions

Breathing Exercises for Children ~ Compiled by Patience Domowski, LCSW

Kids and other professionals have given me many ideas for breathing exercises!

Deep breathing is so important for kids to learn because they can use it to calm their body down when stressed, anxious, angry, or other strong emotions. Children should try to breathe all the way from their stomach and as slow and deep as possible. Deep breathing tells your body and brain to relax.

Blow out candles

(pretend to blow out candles, pretend fingers are candles. blow out all 10!)'

Smell the flowers

(pretend you have a flower in your hand and inhale deeply)

Snake breath

(slow hiss to let your breath out)

Blow fish breathing

(pretend you’re a blow fish and fill up with air)

Square breathing

(hold and release breath for 4 seconds each)

7-11 Breaths

(count to 7 breathing out, count to 11 breathing out) 

Belly breath

(put hand on your stomach and breathe from belly, not just from chest)

Butterfly hug

(cross arms across chest and tap your shoulders)

Starting at a new school

Anxiety about starting at a new school

Tips ~ by, Patience Domowski, LCSW

1)   Tour the school alone (or with friends/family) [call office and ask]

2)   Attend orientation/group tour events – meet teachers and classmates

3)   Ask school if can come visit when no one is around during summer

Teens:

-get class schedule early

-chart route for classes

-practice walking the route

Kids:
                   -find out who teacher is
                   -check out the classroom
                   -play on the playground during summer

4)   Try to meet the guidance counselor over the summer [or beginning of school year. The school counselor is a great resource to go to when anxious at school]

5)   Try to make a friend before school starts- meet people at orientation, find out who in your neighborhood attends your school, or ask counselor to pair you up with someone

6)   Remember it will be fine. It will be fun. Try to look on the positive side. 

Anger Management

Helping your child calm their anger ~  Strategies for parents

~ by, Patience Domowski, LCSW

·         Remind your child it’s okay to be angry but they need to make good choices when angry

·         Make a list with your child of anger coping strategies and post it somewhere easy to see in the home

·         Model using anger calming strategies for your child and let them know you are using the strategy. (For example: “I am really angry right now that you colored on the walls. I am going to take some deep breaths to calm down.” or “I am really angry that you lied to me about your homework. I am going to go to my room to calm down and then we can talk about it later.”)

·         Name your child’s anger so they can recognize how they feel and also empathize with them. Just acknowledging the feeling can be helpful. Then offer a solution, if possible. (For example: “You seem really angry. I know its upsetting when your brother doesn’t want to play with you. It’s okay to be upset. Let’s figure out what we can do instead!”)

·         Notice what sets your child off and try to avoid it if possible. For example: If telling your child “No” makes them angry try saying “Yes, after_______” if they can have what they want after they finish something you want them to do (behavior, homework, chores, et)

·         Notice when your child is starting to escalate and bring it to their attention that they should use a calming strategy or if you know a situation is about to occur during which your child is likely to be upset prepare them to use a proper coping skill beforehand (For example: “I have to tell you something that will probably make you mad, please try to make a good choice and take a deep breath and let’s figure it out. Okay here is the news…”)

·         If your child needs time away to calm down- give them space instead of yelling at them. If you think it’s rude for them to walk away and if they cannot ask for space politely, try a “code word” which lets you both know you need some space to calm down. The word should be silly and respected if used.

·         Try a simple reward to help give your child an incentive to use their calming strategies such as a piece of candy if they use a strategy, or they get out of the something if they calm down, for example

·         Tell your child when they are calm we will discuss how to problem solve the situation

·         Try not to give them attention for making poor choices but more attention when they make good choices. Praise your child for making a good choice by calming down and focus on that good choice versus the other angry behaviors

Frozen Coping Skills

If your little darling loves Frozen and needs some calm down skills this might be helpful!