Could my child be developing an eating disorder?
In Spain, around 300,000 adolescents and young adults between the ages of 12 and 24 suffer from some type of eating disorder, according to data from the Spanish Association for the Study of Eating Disorders (AEETCA).
Eating Disorders or EDs are psychological disorders related to alterations in food intake, body image and weight that can affect the physical, psychological, social, and academic/professional spheres of the person who suffers from them.
EDs are complex disorders, so there is no single factor that causes their onset, but rather they are multifactorial in origin, where a variety of genetic, personal and social factors play a role.
The most common eating disorders in adolescents are anorexia, bulimia and binge eating disorder. Anorexia is characterized by a restriction of food intake resulting in considerable weight loss. Bulimia is characterized by a restriction of food intake, with episodes of consuming a large amount of food in a short time, followed by self-induced vomiting. Binge eating disorder is characterized by eating a very large amount of food in a short time with a feeling of loss of control, without subsequently employing methods to compensate for what has been eaten, and is therefore frequently associated with weight gain.
Although eating disorders can appear at any age, adolescence is a period of special vulnerability due to the large number of physical, mental and social changes, so EDs have a higher incidence at this stage of life, especially between 12 and 18 years of age.
Below are some warning signs that can help you identify if your child is suffering from an eating disorder.
Food-related warning signs
- Avoiding family meals.
- Skipping meals or eating small portions.
- Fasting (not eating for a period of time).
- Eating large amounts of food in a short period of time.
- Excessive interest in counting calories, diets, fat grams, and food composition.
- Creating "eating rituals" (e.g., chewing each bite a certain number of times, breaking food into very small pieces, eating very slowly).
- Eliminating entire food groups (e.g., carbohydrates, sweets or fats).
- Disappearance of food at home.
- Control and supervision of food preparation at home.
Warning signs related to weight and physical appearance
- Unjustified weight loss.
- Rapid weight gain.
- Worry or fear of gaining weight.
- Guilt about their weight or after eating.
- Feeling overweight, despite having a normal weight.
- Avoiding going to the beach or swimming pool.
- Hiding your body with oversized or baggy clothing.
Warning signs related to behaviors
- Exercising excessively.
- Feeling intense discomfort if he/she cannot exercise.
- Keeping an accurate record of body weight and calories consumed.
- Going to the bathroom immediately after meals.
- Depressed mood.
- Irritability.
- Social isolation.
- Difficulty concentrating.
- Perfectionism.
When to see a specialist
If your child presents any of these symptoms it is important to go to a mental health professional as soon as possible, since an early diagnosis and treatment increases the probabilities of success of the treatment. Your child may only present one of the indicators, but when in doubt it is best to see a specialist to rule out or confirm the presence of an eating disorder.
What the specialist's diagnostic process is like
The evaluation process for an eating disorder includes an initial interview with the patient, as well as with the patient’s parents in the case of children and adolescents. In this interview a detailed clinical history is done to learn about the patient’s developmental history, current symptoms related to eating behavior, the presence of other possible symptoms related to mood and personality as well as the family´s medical and psychiatric background.
Specific psychological tests for eating disorders that evaluate body image, eating behavior and eating habits are also usually performed. It is also important to conduct a physical examination to know the height, weight, body mass index and other medical parameters of the person.
How to talk to my child if I identify any of the warning signs of an eating disorder?
It is important to understand that children and adolescents with an eating disorder have little awareness of the problem and even if they do, they are usually ashamed of it and try to hide or deny it. Here are some tips for addressing the issue with them:
- Find a quiet time and place to have a conversation in a relaxed setting. It can be on a walk alone with your child or during a quiet time on the weekend. Avoid mealtimes or times when other family members are present.
- Express your concerns about changes you have observed in their eating behavior or mood, trying to be as objective and fact based as possible. Focus on expressing your concern for how they feel and their health, and avoid comments related to their weight or appearance.
- Provide accurate and understandable information about eating disorders, their treatment and the importance of getting professional help. You can explain that the psychologist's role is to help them understand what is going on and to help them feel better about themselves, and that what they tell the psychologist is confidential.
- Offer them a safe space to express their concerns, thoughts, emotions, and questions without interruption or judgment. As you listen, ask what you can do to support them and what they need.
- Practice patience and compassion: your child may have initial fear or resistance to seeing a specialist so it is important to be patient during this process as well as consistent. If he/she initially refuses help, do not insist at that time. Allow some time to go by talk to bring it up again and let him or her know that he or she can come to you with any questions or concerns that arise.
Eating disorders are one of the most common psychological disorders in children and adolescents. If your child develops an eating disorder it is important not to blame yourself or feel ashamed, as they are complex mental disorders that arise from a variety of factors.
If you identify one or more of the indicators of eating disorders in your child it is important to see a specialist as soon as possible because early intervention increases the chances of successful treatment. The family plays a key role in both the initial detection of warning signs as well as during the recovery process. Fortunately, eating disorders have a solution. With proper professional guidance and your love, support and patience, your child can overcome an eating disorder.
About the author
Verónica Sarria is a health psychologist at Sinews. She is specialized in eating disorders and obesity, working with adolescents and adults. She also treats other problems such as anxiety, depression, grief, self-esteem and interpersonal relationship problems, among others. Her orientation is cognitive behavioral but she integrates tools and techniques from other currents according to the needs of each patient, thanks to her training in mindfulness, mindful eating, attachment theory and systemic (family) therapy.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Is your child ready to speak?
Jarrisvette Villarreal, is from South, Texas in the United States. She worked as a Speech language Pathologist Assistant in Brownsville, Texas and then moved to Spain to pursue a Masters in Bilingual and Multicultural Education at la Universidad de Alcala in Alcala de Henares. She has been living in Span for 4 years and working as an English Language assistant with a variety of ages within the school system. She is currently working as a Speech therapist at Sinews and is excited to be a part of the team.
Do you notice that your little one is not yet speaking? Are you asking yourself why? Have you done a lot of research on how to promote talking, but can’t quite make it happen? Maybe we should take a step back, and ask ourselves if they are ready to talk? Have they acquired the pre-language skills that set the foundation for words?
As babies grow, their abilities change. Babies are like sponges; they absorb so much during their first years of life. They go from newborns who mostly sleep to walking, talking toddlers. This doesn’t happen overnight; there is a lot that happens in between these two phases, called “baby steps.” Little by little, they are going through minor changes every day and learning how to become these walking, talking toddlers. We always celebrate the big changes, like them producing their first word or taking their first steps. It’s incredible to witness the little ones learning and growing, but it’s easy to overlook the minor changes. These minor changes are what lead to their walking and talking, they are the skills that build the foundation for words and steps to happen.
We know that each baby is different and develops at their own pace, so maybe not every single one of them will hit that milestone mark at the, “said age.” However, there are still certain skills that a baby should acquire before they reach that milestone. Some children might need some extra help and guidance to gain these skills.
Pre-language skills
Pre-language skills are prerequisites for speech and language. They are a set of skills that should develop alongside one another in both normal developing children and children with language disorders. These skills might not show up in the same order in every toddler, but they will show up before language emerges. These skills are what children use to communicate before they are able to form words. Pre-language skills must be consistently present, and stable in order for the child to be ready to talk.
How will I know if my child is ready to talk?
Lucky for us, Laura Mize, Speech Language Pathologist, has an awesome detailed podcast series that thoroughly describes pre-language skills. She talks about “11 skills a toddler must use before words emerge.” She helps us understand what they are, how to identify them and why they are important.
The pre-language skills mentioned in her podcast are:
- Responds to events in the environment: do they notice things around them? Children must be able to process things they hear and see. They must be aware of their surroundings, and react to it.
- Responds to people: are they interested in people? Children should interact with people. They’ll respond when you call them by name, or look for you, so you can play with them.
- Develops an attention span: attention spans in toddlers are typically 3-6 minutes long. They can notice something and are interested in it. They stay with it for a while and give themselves the chance to see how it works.
- Exhibits joint attention: they can share the moment. They can use a toy with you, and shift their attention from the toy to you.
- Plays with toys: toddlers learn through play and using toys. Toys are meaningful to them. Do they know how to appropriately play with the toys? For example: rolling a toy car on the ground.
- Understands and uses early gestures: Do they communicate with their bodies? Can they wave bye-bye, nod yes or no, follow a point?
- Understands early words and follows simple directions: Do they recognize names of familiar people or things they use every day? If you say “Where’s dad?” or “Do you want water?” they will understand.
- Vocalizes: Are they noisy? Toddlers should make intentional and purposeful sounds with their voice, before they can even speak.
- Imitate actions, gestures, and words: They copy what you are doing. They use a toy the same way you use it, they clap when you clap.
- Initiates interaction: They take the lead to try and get your attention. They want to play with you, they try to get you to look at them or grab something for them.
- Turn taking: They are able to play back and forth. They can roll a ball or a car back and forth.
These are the 11 skills a toddler must develop before they start talking. Each one of these skills are essential to language development. Toddlers must have these skills firmly established in order for words to flow.
You can listen to the first part of the podcast clicking here and to the second one clicking here.
How can I help prepare my child for words?
As a parent you know your child best. You know what they are able to do and what they are not. You must be able to identify if these skills are present, consistent and strong in order for language to emerge. If one of these skills is missing, or isn’t strong, those are the skills you need to target and strengthen to prepare your child for words.
Questions we should ask ourselves when trying to determine how to help our children talk:
- Which of these skills are present in my child? Which aren’t?
- Which of these skills show up consistently? Which of them only every once in a while?
- Which of these skills are strong? Which need some extra work?
We must determine which of these skills need reinforcement and which ones need to be introduced. Once we know what to target, we can work with our little ones to prepare them for words.
Should we go to a speech therapist?
Some people will tell you “don’t worry words will come on their own, he/she is still young”. While that might be true sometimes, that is definitely not always the case. It’s great that you’re getting informed and learning more about how to help your child. You are the expert on your child and know them best, so if you have a gut feeling to seek help, there is no harm in that. The earlier children get the support they need, the better their outcomes.
Pre-language skills play a key role in language development. Children must go through all these skills before they start talking. If our little ones are late talkers, we must look at this list and determine what is missing, and work on those skills with them, or seek help from a speech therapist . It is important for us to not skip any steps that will lead to communication. We don’t want to push for words when our little ones aren’t ready yet. We need to set them up for success, by giving them the tools they need for language. Once we attain these eleven skills, we can focus on speaking words.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Possible challenges about being a parent of a child on the Spectrum
Nerea Arranz is a psychologist focused on children and young people, with extensive experience in neurodiversity, especially autism and its comorbidities. Her aim is to understand holistically what families are experiencing and work with parents and education to promote their role as agents of change. Her approach to implement interventions is evidence-based, therefore she adapts the intervention to the individual needs and strengths of each person.
Most people say that being a parent does not come with an instruction manual, this becomes even truer when one or more of your children live in a world that has not been designed for them, this is the case for autism. This blog aims to introduce and name a number of challenges that may arise when autism is part of your family. It is not intended to be an elaborate and complete list where we all have to fulfil criteria; these are challenges that might be experienced or not by parents. If you are a parent of an autistic child and have not related with what is raised in this blog or feel that other challenges have not been mentioned along the way, we would be delighted to hear from you, because every comment, opinion and shared story opens up new queries and helps us to understand more about the diversity that exists in autism.
What do we mean by autism?
Autism is a condition with its strengths and needs that affects the way the brain processes information from the environment, and therefore, how autistic people relate to it. Autism is considered a disability and is listed in the DSM-5 diagnostic and statistical manual as a neurodevelopmental disorder. There are many myths about autism, but a key one is to understand that autism is not linear. You don’t have more or less autism, you are either autistic or you are not.
This image proposed by @autism_sketches aims to help us understand in a visual way how to recognize this condition that implies a challenge to live with, but also inspires, awakens curiosity, compassion and opens our minds to understand different ways of communicating and experiencing the world around us:
Autism in itself is a challenge and when it is the first time it happens in a family, it is accompanied by intense and deep feelings, to the point that it could be described as overwhelming. It is likely to generate doubts and big questions that will accompany you throughout the development of your son or daughter.
We are all different. There is no such thing as the «right» way of thinking, being, learning or behaving. Autism falls within the concept of Neurodiversity, which describes differences in neurodevelopment, alongside strengths and challenges. Neurodiversity is also a social movement that seeks to reduce the stigma around conditions such as autism. Autistic people like to use terms such as neurodivergent or neurodiverse to refer to this differentiation in brain development. A development that changes and affects different areas of a person, and that will vary over time.
So, what are the challenges that parents may face? Here are a series of questions that you may have asked yourselves or, if you are beginning to notice differences in the development of your children, you may be asking right now:
1. Why is this happening to me?
The first and one of the biggest challenges is to understand what autism means for your child and to accept that it is happening. A common saying is that sometimes we cannot see things we do not understand and, therefore, recognizing that your child is showing signs of a developmental differentiation is in itself a challenge. Especially because of the uncertainty it creates. But also because it is very likely that you have already imagined a life with your child that you are now being told you will not be able to live. This is often experienced as grief. In this process of acceptance, there are some bumps in the road, one of them is that the cause of autism is unknown. Not being able to understand the origin of things, generates lack of control, and this lack of control can end up freezing our ability to face what comes after, how we live the present and therefore how we behave with our children who we did not know were going to be as they are.
What could I do?
- Hearing from those with neurodiversity, they know first hand what autism can mean. Autism is a lifelong condition, this means that there are not only children with autism, there are adults with autism. Among these adults, we find a number of people whose aim is to raise awareness of neurodiversity and therefore we have at our fingertips first-hand information of how it could be to live with this condition. Here you have some resources: 45 Autism Youtube Channels For Autistics And Autism Parents, A list of autistic bloggers and YouTubers, A Story Of Undiagnosed Autism and different Stories from the Spectrum.
- Meeting other parents who are also going through a similar moment or who have already gone through it. In other words, participating in a community where you will find understanding and knowledge. One way to find these families, is to connect with specific autism spectrum associations where you live. If you are not yet at that point where you are able to talk about the reality in which you live, you can always start by reading or watching how other people describe the experience of being a parent of a child with special needs. This video is about a story and here you have a playlist with plenty of videos of the autism spectrum.
2. This is called the autistic spectrum, so what now?
While trying to process this grief there is at the same time a clear demand, the need to seek support and services that are going to help your child. The idea of being able to make a decision about what is best for your child, without yet understanding what is happening to them, is challenging in itself.
Therefore, seeking services and support can be a complicated and daunting process, as there are many options and it is not always easy to know which option is best for your family. Among those paths in which a parent finds himself/herself, there is the path of trying to make your child look like the others, which is the aim of certain type of therapies, those that understood autism as something to be corrected. But there is also the way to accept that one can be different and work from those strengths. To teach him/her skills that are going to help him/her to live in the society we live in, but without changing fundamental aspects of his/her being. In order to be able to distinguish what the different treatments offer, and what can be better for your child, it is necessary to understand more about autism and what it means to your family.
In addition, to help autistic people, parents must be involved actively and directly in using strategies in every aspect of the routine, sometimes almost every minute of the day. This is very difficult to juggle with other demands of adult life. Many of the services and possible treatments are also not available for free, so cost and availability will also play a role in the level of help each child can receive.
That is why the phrase «less is more» is important. Start small with what you can get involved with (routine and stability, play, communication, sensory, etc.) and take some time to get to know and trust those people who want to guide you in how to support your child. Consistency will be key, but if you do not trust what they recommend, it will be hard to find the strength to keep trying strategies that will never work right away. It takes time and perseverance to start seeing results, so it is best to take it one step at a time, because there will be many aspects to cover.
For exploring different number of treatments or where to start:
3. How far will it change the life I imagined?
On the journey that starts after recognizing that there is a difference and after hearing the word autism, we find another challenge. How to balance family life and the life of the autistic child: Autism is often accompanied by inflexibility, it is in fact one of the diagnostic criteria. This inflexibility, especially during childhood, will lead parents to have to tolerate or introduce changes in their daily life that they did not expect. In addition, it often falls on brothers or sisters who are more tolerant or have a greater capacity for waiting and understanding.
The difficulty of achieving this balance can generate feelings of helplessness, pain and anger. As well as an opportunity for parents to develop unimaginable skills to meet the needs of different family members. The change in the way parents face day-to-day life will help to find that balance, to be able to observe and differentiate how to promote the autonomy of the child and to identify what things need to be done for him/her instead of to him/her, will bring us closer to that balance.
All this entails a cognitive burden for adults, which may be accompanied by a feeling of exhaustion, which generates rejection or the need to move away from the family nucleus to seek respite or perhaps, on the contrary, an activation and reactivity where others are not allowed to take care of your children. Many professionals place great emphasis on self-care, but the reality is that in the beginning it is very difficult to find that space to take care of yourself and to accept that you will have to sacrifice hopes and wishes in order to ensure that your child achieves his or her full potential, while making sure that no one else in the rest of the family goes unnoticed, including yourself.
It is important to consider the idea that giving your best will be enough to build a world you did not expect, step by step.
4. Why don't others understand me?
Among all these feelings, there is a major challenge and that is the emotion of loneliness. Autism is becoming a more common condition as its incidence is increasing, but that does not mean that your family and friends know or understand what you are going through.
The unpredictable behaviours that often occur when an autistic child has to face a new place are like a constant reminder that your family is different. Therefore, activities such as going to the park, dining out or visiting a museum, places where there are other children with apparently expected development, will remind you of what you are not experiencing.
The neurodiverse community has a long way to go in terms of advocacy and sharing the existance of more than one way of experiencing the world. Therefore, those behaviours that are atypical for us are also valid. In this website you can check more information on neurodiversity.
Everyone, maybe including you, will have experienced rejecting the unknown at some point. This means that on many occasions, as a parent of a child on the spectrum, you will experience rejection and discrimination first hand. You will have to try to be able to separate that those feelings that others share with you, those looks or comments have more to do with how they are feeling and not so much with you. Being able to separate what might be arising from ignorance or fear will help you to cultivate courage on your journey.
Being brave enough to speak up in a society that is not designed or familiar with neurodiversity is not easy, and may take years. Remember that, although you could raise awareness about autism, it is a responsibility that you do not have to impose on yourself. There are always different ways that may work best for you, although they often include seeking help from others, whether professional or informal support, which might change that feeling of discomfort, which many refer to as loneliness.
5. But what is considered atypical behaviour?
Neurodiversity entails behaving in a way that is not usually accepted or expected in the social and cultural context in which the child finds him/herself. It is common, in the course of their development, for autistic children to exhibit what is known as challenging behaviour. The first thing to understand is that this word does not refer to the child as being defiant, but to the fact that his or her behaviour is a challenge to the adult. The responsibility for managing these behaviours lies with the adult and therefore the challenge lies in being able to understand and manage these behaviours. The emotions they generate in adults and how to respond to them is one of the greatest challenges of neurodiversity.
As you become more familiar with what autism will mean for your family, I would like to propose a series of questions you can ask yourself when these behaviours occur. When you do not understand something, your child has done, you can ask yourself:
- Is this autism?
- What is happening in the environment? is it predictable enough for him/her? Could this be related his/her sensory experience?
- How many demands has my child perceived today?
- What happens when he/she acts like this? Does this behaviour help him/her to get something out of it or does it help him/her to avoid something?
- What is my role in mantaining this behaviour?
- What skill could my child learn to reach the same outcome, but in a way that is less challenging for me?
- What can I do next time to prevent it?
Explore more about challenging behaviour in this website or this other website.
To conclude, I would like to name what Dr. Stephen Shore, autistic American professor and advocate for autism once said:
If you know one autistic person, you only know one autistic person.
Just as autism is experienced so differently from person to person, this is also reflected in the challenges that each parent will face. It is important to remember that this is not something you have to do alone, that you could seek support to explore those questions that autism raises for you as a parent, and to look for practical ways to implement on a daily basis that will enhance you family quality of life.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Why has the arrival of our baby been a challenge to our relationship as a couple?
Reasons and possible solutions to the difficulties experienced by a couple since the arrival of a baby.
Marta Gray is a licenced Psychologist working at Sinews. She has a flexible approach combining different scientifically proven methods (Acceptance and commitment Therapy, CBT, EMDR) depending on the patient’s needs. Her main field of expertise is working with adults and she is specially interested in complex trauma, anxiety disorders, emotional deregulation and couple’s therapy.
Having a new member in our family usually means a crisis in a relationship and that is when many couples decide to start attending couples therapy for the first time. Many studies show a significant decrease in relationship satisfaction with the arrival of a new member in their family (Otero Rejón and Flores Galaz, 2016).
In a first couple’s therapy session, one of the members told me, quite angry and saddened, «I don’t know what happened. My boyfriend was my best friend, my rock. We have always been there for each other and, although we have had difficulties, we were always able to solve them without much difficulty. Our son has been a very wanted baby and he makes us very happy. But since he was born there has been nothing but reproaches, anger and defensiveness between us and I can’t quite understand what has happened. Out of a sudden we have become enemies». As her therapist I said to her this was completely normal and common; even when the relationship was healthy and stable and the new arrival was a very wanted baby. She was very surprised. How was it possible?
Anger is one of the most common emotions we encounter in couples’ therapy. Anger appears to inform us that we feel as if our rights were being disrespected in a specific situation. When we feel our rights are not being respected, it is very difficult to understand and empathise with the other person’s rights and emotions. There are several reasons why we feel discomfort in our relationship when a baby arrives and also different strategies to work through them.
In this article I will talk about the main 8 challenges a couple faces with the arrival of a baby and some possible solutions to them:
1. Fatigue and extreme tiredness:
I recently saw a meme on a social network that I found very funny. It said «You don’t really know what tiredness really means until you become a parent». Tiredness and fatigue play a very important role in the challenges a couple faces when a baby is born. You are never as tired as when you have a child.
Have you ever tried to come to an agreement, to empathise, to communicate assertively or to have an objective point of view at work with only 3 or 4 hours of sleep a day?
The same thing applies to your partner. Caring for a baby is a 24/7 job. It requires a lot of effort and becomes a stressful situation, no matter how nice your baby and your parenting skills are. Imagine you are in a beautiful beach. Do you think you would be happy or calm drinking pina colada on only 3 hours of sleep and not being able to do anything else? Not even talking to anyone or taking a walk? Just lying on a deserted beach drinking pina colada over and over again around the clock?
When we are tired, we cannot have an objective point of view and we need help. Now imagine the only adult person around is also feeling the same way. Tiredness and fatigue then become a real challenge and a source of stress.
Possible solutions:
Talk to your partner and take turns to rest. Rest is not just sleeping, but it also includes disconnection. Find time for both of you to rest and disconnect. Getting external help can also be a solution. Covering your basic needs such as eating, sleeping and hygiene is crucial for an emotionally stable mindset. Everything becomes way easier when your basic needs are met.
2. Sharing household chores and baby care. Asymmetrical dynamics:
Another challenge couples may face with the arrival of a baby is when the relationship doesn’t feel balanced or equal and there is an asymmetry in the sharing of tasks, responsibilities, power, free time, individuality, or anything important to the individuals and this is felt as unfairness.
Task sharing means distributing both the physical and emotional workload and also mental tasks.
In a different couples’ session someone told me the only thing their partner would participate in is doing the laundry while looking at their phone. After analysing the situation we were able to discover they were not just on their phone but also managing the mental workload: anticipating there would be not enough food for the baby and doing the grocery shopping, texting the nursery staff to let them know the baby would go to the doctor next week, finding photo printing shops in the area to have some pictures ready for the baby’s birthday that was soon coming up, or looking at the weather and buying a rain cover for the stroller to go out for a walk on Saturday.
It is the responsibility of both partners to keep up with taking care of the baby and the household chores. I have also encountered people who say things like «but just tell me what needs to be done and I’ll do it» to their partner. This kind of dynamic result in only one person carrying the emotional workload even if the physical workload is fairly distributed.
The same couple said to me: «Sure, we can share the household and baby tasks but in my case I work in the office 8 hours a day, 5 days a week and my partner only goes to her workplace 3 days a week, so I am therefore not as involved in the household tasks and the baby care». Yes… and no. Household work is hard work too, sometimes I have even had patients telling me that they feel they rest more when they go to the office than when they take care of the baby! If, for example, one member takes care of the baby and household chores 8 hours a day while the other person is in the office during that time, that leaves us with 8 hours of household tasks to be shared equally and that would be the fair thing to do. It would also make sense that the person who has been working in the office all week wants to spend more time with the baby during the weekend and for the person who spends more time with the baby during the week to want to spend more time doing something else in the weekend.
Some studies indicate the most satisfied members of a relationship are those who feel that their partners care for, educate and attend their children (Otero Rejón and Flores Galaz, 2016).
Possible solutions:
The truth is some people are better at certain tasks than others and therefore it is important to talk about what each of us is good at, and to write down all the different chores including the physical, emotional and mental ones. Make sure that both you and your partner are covering areas that are important to your sense of self. For example, imagine one member likes to play tennis and the other prefers to spend time with friends, make sure that both partners’ needs are met (when you have time) in a balanced way. With regard to the household, it is a good idea to have a schedule and assign tasks to both of you. Organise them from most urgent to least urgent and from most important to least important. Assign different tasks to specific days. A helpful tip would be to also focus on dividing free time. The relationship satisfaction increases when the spare time is assigned equally to both members just because it feels fairer and more balanced.
3. Communication, decision-making and conflict resolution:
Good communication is a great indicator of a healthy relationship and it increases the relationships´ satisfaction. A good communication implies using a flexible, optimistic and accurate style when communicating, doing our best to respect our rights as well as the other persons’ and with the aim of reaching an agreement. (Pérez Aranda & Estrada Carmona, 2006).
When we are trying to reduce our discomfort and to find middle grounds or agreements, some of the challenges we face include becoming defensive or avoiding conflicts. You can read more about it here.
Before the arrival of the baby each member used to dedicate more time to rest, to their friends and hobbies, to their individuality, and to their partner. There was also enough time available to find middle grounds and to plan a good communication with the other person. The challenge starts when the available time is limited and that leads us to cover the urgent and practical matters first. Limited time also means not regulating our emotions in a healthy way which leads to not using an ideal communication style when talking to our partner.
Possible solutions:
To use an assertive communication style (respecting both our needs and the other person´s), to empathise and to listen actively. Find a middle ground, be flexible. Be aware of your needs and communicate them to your partner, and then compromise on what the other person needs and is not so important to you. A very helpful strategy is to take time out from discussions when emotions become very intense. Less intense emotions lead to a better communication. You can read more about time-outs here.
4. Affection, closeness and intimacy:
One of the challenges couples may face with the arrival of a baby is the disconnection with their partner in terms of intimacy, sexuality, activities, finances and, in general, time spent with their partner. Healthy sexual relationships, physical health, emotional support received from your partner and intimacy in particular are important predictors of psychological well-being in a relationship (Pérez Aranda and Estrada Carmona, 2006).
Possible solutions:
We can focus on demonstrating small daily gestures of affection (even when time is limited), and on doing activities inside the house with our partner (such as playing a board game together, doing crossword puzzles, preparing a romantic dinner when the baby is asleep). These tips can help us reconnect with our partner.
5. Different emotional languages or different love languages:
Our learning history, family background and individual experiences shape and influence the way we express love to others. (I suggest you to read the following book: “Attached: The New Science of Adult Attachment and How It Can Help You Find and Keep Love”. You can find a summary here.
Not understanding your partner’s love language or the way your partner relates to the baby is another challenge couples experience with the arrival of a baby. There are also times when one person has more emotional experience than the other, and, for example, is faster at understanding the baby’s needs, or sometimes one person tries to «educate» their partner, or feels overwhelmed when the other person finds it harder to grasp the baby’s emotions and even their partners, etc. Having different emotional languages is not necessarily a challenge on itself, but it may become one when each partner uses different styles when covering the baby’s needs and when each of them believes their strategies are crucial for their survival.
Our family background and our own ways of viewing life, our upbringing and our personal learning experience may influence our way to nourish and nurture our child and there may be disagreements about this within a couple. For example, there may be one partner who thinks it is best to focus on covering the basic needs and saving money, while the other person believes in always finding the best alternative for their child and therefore spending more.
Possible solutions:
To be able to communicate with empathy and to understand that different people have diverse ways of loving, educating, and seeing the world. I suggest people to find and read scientific information in regards to the education of their child, and to find middle grounds and compromises with your partner as long as the basic steps for a non-violent and positive discipline education are met.
6. Families of origin influencing the couple:
It is a good thing to ask for advice from people who have raised us and helped us become the people we are today. The challenge begins when families of origin give unsolicited advice, or meddle in matters that are solely the couple’s business, or cross the boundaries that the new family has set. A different challenge people experience is when they feel their partner does not set appropriate boundaries with another family member.
In my practice I have observed the above-mentioned situation can create feelings of loneliness, lack of affection and empathy, helplessness and anger, and a feeling that their partners do not prioritise their new family as much as their birth family and therefore feeling not important enough, which can lead to disagreements. For example, another patient explained to me: «My partner and I agreed that no one would visit us after 7 p.m. so that our baby could be calm and ready for bedtime, but my partner’s parents visit us after 7 on a weekly basis. My partner does not communicate our needs to my in-laws and the baby gets nervous”. In this case, she is finding it hard to set boundaries to her birth family and it creates tension within herself and also with her partner and baby.
Possible solutions:
Talk about what respect means to each of you. Discuss the different parenting styles, and create rules that work for you both in your new family. Learn to set assertive boundaries to the families of origin in the event that these agreements are not being respected. An example of assertive boundaries for this couple’s family of origin would be: «I really appreciate you coming to see the baby and we are very grateful you want to be part of their life, but when you visit us at this time of the day, the baby usually gets nervous. I understand that you can’t visit us earlier in the day, what do you think about seeing each other this other day in the morning instead?” Respectful limits and boundaries are a good strategy we can use and will not make the people who love us feel upset.
7. Our self-concept and individuality. Postponement of individual plans. Grief:
When an individual loses something important to them (even if it is temporary), they experience grief, sadness and loss. With the arrival of a baby, one of the challenges is the loss of individuality, hobbies, the idea of what we thought we were, spare time, social connection, exercise, rest, body image, individuality, etc. The baby is a great source of happiness, and at the same time this happiness can coexist with a sense of loss and grief.
Possible solutions:
It is important to understand that your partner is also going through a grieving process, and to try to find time to meet those needs that are not being met and to also give that opportunity to your partner.
8. Trying to control what is not under our control, perfectionism, fears, and individual problems that affect the couple:
Other things such as individual fears and issues can become a challenge in the couple’s relationship with the arrival of a baby. Some of them include to try to control what is not under our control: for example, to need things done in a specific way even when we are not around, or to want our partner to be a certain way or to adopt a particular attitude, etc. Other times it can be perfectionism, to try to do everything perfectly and expecting the same from our partner. Similarly, people sometimes anticipate the future (thinking that something horrible will happen if certain requirements are not met) or have individual fears and these can influence the relationship dynamic. Please note we can only apply these tips to balanced and equal relationships.
Possible solutions:
Ideally, we should take responsibility for our own emotions and discomfort and only focus on the specific things we can do ourselves to improve the couple dynamic, rather than on what the other person can do, and reduce our demands as much as possible.
Conclusions
As we have seen before, the arrival of a baby can lead to challenges in some couples, even when the relationship was healthy and fulfilling beforehand. Extreme fatigue and tiredness, difficulties in communication, asymmetrical dynamics, the influence of families of origin, difficulties when it comes to balancing work and private life., losses to our individuality and personal goals, time limitations that affects the intimacy, conflicts or challenges when finding middle grounds and compromises, that lead to a reduction in affection. In addition, different ideas about education, respect, and our own individual variables can become a great challenge with the arrival of a new member to the family.
The keys to increase satisfaction in a relationship would then be respect, understanding, good communication, an increase in affection and intimacy, good skills for conflict resolution, being flexible, the capacity to set boundaries, empathy, and finding time to meet both our own and our partner’s needs (Armenta Hurtarte and Díaz-Loving, 2008).
If after putting these tips into practice you continue to find your relationship challenging you can contact a specialised psychologist. At Sinews we are happy to help you get through this period in the best way possible, giving you practical tools to make your relationship more satisfying.
Your partner is the person you have chosen to spend the rest of your life with, and the person you spend the most time with. It is therefore a priority to give your relationship space and time to nurture and cultivate it.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Self-criticism and being demanding with one's self
It has been scientifically proven that self-criticism, perfectionism and self-demandingness (or imposing extremely high standards to ourselves) play an important role in the occurrence and maintenance of mental disorders such as anxiety, mood, and eating disorders.
The psychological treatment of these factors produces a decrease in the number of symptoms in different areas and also reduces some symptoms that have not yet appeared. Many studies exist which have proven the significant reduction of anxiety and depression with the treatment of self-demandingness and perfectionism as the only treatment.
Being demanding with one´s self
The majority of patients have learnt this mechanism from their parents or during their upbringing. There are healthier ways to accomplish our goals, but the self-demandingness begins as a response to the environment that “helps” people achieve their goals. It appears that in fact, it gives people a leg to succeed, grow and evolve. But distress or intense negative emotions is the best indicator to know that it is time to change these patterns.
When self-criticism and self-demandingness cause distress
Our pattern of thoughts and coping mechanisms are based on our experiences and what worked well in the past. But when the self-criticism and self-demandingness cause distress or intense negative emotions it´s time for change.
Imposing extremely high standards to ourselves means to constantly notice our failures and the need to be perfect, strong, good enough, efficient enough and a wide range of endless non-flexible and self-imposed requirements. It becomes a judging and blaming inner voice that finds errors even when the mistakes are minimal or non-existent. The self-demandingness usually comes together with the self-criticism.
When the desired result is not within our reach but we still impose its achievement to ourselves, that is when we start to feel intense negative emotions such as guilt, anger or sadness. We are then not considering other circumstances or variables that may be influencing on the achievement of that outcome. We can also feel distress when we think we made unpardonable mistakes and there is going to be catastrophic consequences.
For example: It is actually impossible to be 100% focused on your studies and get perfectly good grades during a pandemic, or to be super productive at work when you are looking after your two kids at the same time. In these examples, the self-demandingness is not taking into consideration all the circumstances that have changed and it´s talking from a black and white perspective. How can we run a marathon with a broken leg? How can we be 100% productive at work when we are not feeling well? How can we focus while studying if, social contact is the most important thing for us and we cannot have it?
Self-criticism is the root of a low self-esteem. Self-criticism is our inner voice making subjective judgements and interpretations of ourselves, without taking into consideration objective and reliable data.
Tips for reducing self-demandingness and self-criticism
These are some steps you can follow:
- The first step is to detect our critical voice, paying attention to the specific situations where it occurs; for example, when we make a mistake, in social interactions, …
- Second of all it is important to see if there are unhelpful thinking styles within our thoughts (“shoulds”, labels, name-calling, etc.) and try to eliminate them from our internal language. For example: “I shouldn’t have told my colleagues about my problems, I am sure they all must hate me right now, I am very immature”. In this case, we are using the “shoulds and musts” (“I shouldn’t have said that” and “they must hate me”), also “mind reading” (I believe people will not like what I said, even when I don’t have evidences for that thought), “labelling” and “name-calling” (thinking I am immature) and the black and white thinking (now they ALL HATE me). When we eliminate this unhelpful thinking styles from our internal language, the result would be something like: “I would rather not tell my problems to other people, but I cannot tell if they have negative thoughts of what I did, I have no evidences. I am assuming that the vast majority of a group is going to hate me, but it is more possible that only some of them are not going to like my comment. According to my own standards about the world and social interactions, people my age don´t usually communicate their problems to their colleagues, but being immature cannot only be based on a specific behaviour or situation.”
- It is not about giving ourselves a positive message but to give ourselves a message adjusted to the facts and reducing the risk of biasing our vision.
- Last but not least, understanding the self-criticism purpose can help us overcome it. Once we are aware of its role, addressing it becomes an easier task. We may ask ourselves: “what does this self-criticism statement invite me to” and then understand where does it come from, or what is its purpose.
- We can also change the self-criticism for a more compassionate and realistic point of view, challenging the behaviours the criticism invites us to do.
In conclusion, when we start to change the self-criticism, we feel anxious or guilty at first. We need then to remember that the self-criticism has been helping us to survive for a very long time. However, when we persist on challenging it, it ends up being less intense and we can then achieve an even more fulfilling life.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Film review: God's Crooked Lines (2022)
The successful novel written by Torcuato Luca de Tena in 1979 has reached the big screen taking the same name of the book that has managed to hook readers since it was first published. Luca de Tena, with Los renglones torcidos de Dios or God’s crooked lines, takes us into a psychological thriller in which the reader will not be able to stop reading as questions will swirl around in his mind and he would hardly be able to leave those questions unsolved for the next reading. The film, on the other hand, engages the audience with the main character’s discourse -logical and very organised, which will generate new inquiries. Flashes from the past will make us reflect on the veracity of the facts.
Synopsis of the movie
The novel, and its eponymous film, tells the story of Alice Gould, a private investigator, who is admitted to a mental asylum on behalf of a client in order to clarify the circumstances of a murder. To do so, Alice documents herself about a mental illness, paranoia, and she pretends she is suffering from that illness. Recall that in the era in which the novel is set, wives had to ask their husbands for permission on certain things, getting Alice to trick her husband into signing the application for her admission to the sanatorium.
Throughout the pages and minutes of the film, readers and audiences will be making decisions about the reliability of what at one point seemed very obvious, the sanity of the main character of this story. But for the author of the book and the director of the film, sanity and insanity are separated by a very thin line.
Comparison with reality
According to the author of the novel himself, in order to write the book he had to voluntarily commit himself for 18 days in a psychiatric institution to be able to adjust to the reality of what was really living within those walls. Finally, in the dedication included in the book, he wants to thank the entire medical community for their work and tenacity to «straighten out» those crooked lines of God, the patients. Those patients who met himself and on whom he got inspiration from.
The main interest that this novel can generate in society lies not only in a simple leisure activity, but also in the progress that psychiatry and psychology have experienced since the time in which this thrilling story is framed. The different illnesses or conditions of the patients shown in the film and the book, bring mental health closer to anyone outside the field of health, although in some cases not in the most accurate way. The reader or the audience will be able to experience the close relationship between mind and physiology, the different techniques that were used for different disorders and even how patients were treated in these institutions. Nowadays, all of it may seem abusive or unacceptable for the audience but we shouldn’t put the spotlight on that. On the contrary, we should focus on the advances that have been experienced in those fields to preserve dignity and security of patients without depriving them of the inherent freedom to the human condition.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Why should you go to a nutritionist?
According to the regulation of healthcare professionals, a Dietitian-nutritionist is the healthcare professional legally qualified to perform diet and food-related activities for patients (always individualising the recommendations according to the physiological and/or pathological conditions), and to provide nutritional advise and treatment.
Currently, we live in the era of information, and it is becoming increasingly easier to find food-related advice and recommendations in magazines, newspapers and, of course, on the internet. However, it is very important to take into account that not all the information available out there is reliable and up to date. What it’s more, all of this flood of information is very ambivalent and what according to a source is beneficial, it appears as the opposite in a different one. This is why you can find arguments to support a position as easy as to disprove it. Hence the importance to attend a dietitian-nutritionist who will provide with individualised recommendations and always with scientific evidence.
What exactly is a dietitian-nutritionist?
It is very often that when people hear the word “Nutritionist” the first thing that comes to their mind is “lose weight” and “dieting”. However, a dietitian- nutritionist is a healthcare professional whose functions go far beyond this, as they are experts in nutrition and dietetics who not only manage the nutritional treatment in a wide variety of conditions and the nutritional approach in all the stages of life, but also the quality management, food security and, lastly, the prevention of lifestyle and nutrition-related conditions.
A Dietitian-Nutritionist will provide individualised recommendations not only considering the general situation of the patient, namely age, stage of life, associated conditions and so on, but also other personal situations, such as their culture.
When should I go to a Nutritionist and how can it be helpful?
These are some of the reasons why you should attend a consultation:
- Change of dietary habits to help prevent lifestyle-related conditions such as type 2 diabetes mellitus, hypercholesterolemia or hypertension, as well as contribute to the nutritional management once diagnosed. In these cases, nutrition is the first line of action, and even when pharmacological treatment is necessary, nutrition is still a key part of the treatment.
- Specific moments in a woman’s life such as pregnancy or breastfeeding. In these stages, the nutritional requirements are increased, and it is essential to ensure an optimal nutrition intake from all macro and micronutrients.
- Nutritional approach in all different stages of life from childhood to advanced ages in both health and disease, and always considering the singularities of every different stage.
- Infant nutrition. Dietary advice in transitioning from exclusive breastfeeding to solid foods, that is, how and when to introduce the different solids gradually. Also, with the baby-led weaning (BLW), which has been on the rise in recent years: precautions, benefits and inconvenients, which foods and how to cook them, textures and much more.
- Optimisation of the sports performance in order to adapt recommendations according to the type of sport discipline and individual requirements as well as to assess potential needs for supplementation to enhance performance.
- Gut disorders: fructose and sorbitol intolerance, Small Intestine Bacterial Overgrowth (SIBO), non-celiac gluten intolerance, celiac disease, Chron disease or ulcerative colitis.
- Nutritional management in other conditions such as renal disease or cancer. Also, in hormonal problems such as hypothalamic amenorrhea.
- Learn how to eat healthily and nutritional education. You do not have to be sick or have a specific situation to attend a Nutritionist. Sometimes a person might just want to learn how to eat better and make a habit change.
- Vegetarian diets. Either due to animal welfare reasons, the environment or because of other personal arguments, sometimes a person decides to reduce or eliminate the animal-derived products from their diet to some extent. In any case (ovolactovegetarian, vegan…), a nutritionist can assist in making the transition progressively, and can also provide alternatives to substitute all these products for other plant-based options to make sure that all the important nutrients are covered.
In summary, our health is very important and for that reason we should always aim to find qualified healthcare professionals to always make sure that the dietetic recommendations will be coherent, evidence-based and individualised depending in the individual circumstances.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
A Superhero therapy tool kit to help your children cope with difficult situations
Superhero therapy, is that a thing?
Janina Scarlet PhD, adapted an evidence-based therapy called Acceptance and commitment therapy (ACT) and turned it into the superhero lover’s dream. To help children and adults manage their symptoms of depression, anxiety, post-traumatic stress disorders and other mental health conditions. ACT and Superhero Therapy’s objective is to help people learn to have a healthier, more flexible relationship with their thoughts, feelings and other significant private events. Which in turn will allow them understand who they want to be and to move towards what is truly valuable to them.
Working on values with children can be a very challenging task given its abstract background. Asking children or teens to do what is important above all pain or discomfort might seem impossible. Fortunately, That is where superheroes come in handy. Using an ACT framework, a therapist can help a patient relate to a fictional superhero, understand that superhero’s origin story and discuss how that superhero has overcome many of their own challenges (probably social, emotional or psychologically related) by taking actions toward their values (Washington, 2019). Prompting children to connect with a superhero’s story will allow them to play with different perspectives which can help them clarify what is important to them.
So how can we use superhero therapy in our everyday life?
Ideally, superhero therapy should be used as a guideline for evidence-based therapists to use with children or adults in session. However like Marvel Comics creator Stan Lee said, “The person who helps others simply because it should or must be done, and because it is the right thing to do, is indeed, without a doubt a real superhero.” So grab your cape and lets bring out our superhero within.
1 – Find a superhero your children can relate to. Can you think of a superhero or a character your child can relate to? It can also be their favorite character, it does not have to be a superhero in a strict sense of the word. It can be any character in their favorite book, movie or series. It can even be a family member or a person in their life they admire. A character that might have an origin story or a struggle they can relate to.
For example, for Dr. Scarlet it was Storm from X-Men. When she was very young, Dr. Scarlet was exposed to a nuclear explosion because she lived in a small town near Chernobyl. This had incredibly debilitating effects on her health. To make matters worse, her symptoms where heavily influenced by the weather, if it was hot outside she would get severe nose bleeds, if it was humid she would get migraines or seizures and so on. When she was twelve her family decided to move to the United States, thinking the situation would get better being away from radiation but there she faced other types of struggles. In school her new classmates could not understand what she had gone through. She had to endure intense bullying, she was called radioactive or contagious, her peers were afraid to touch her or be near her. This made her feel completely alone and depressed but it all changed when she watch X-Men. The “Super mutants” made her feel less lonely specially when she discovered Storm a superhero who could control the weather. A superpower she always wished to have since her own struggles depended on the weather.
Is there any superhero that could make your child feel a little less alone in the world. A character they love or admire? It can be Batman, Ironman, Hulk, Harry Potter, Katniss Everdeen, even a Disney princess, a character from Encanto, Frozen and anime series. Anything you can think of.
2 – What is their superpower? Try to find out what is it that your kid loves so much about this character. What superpowers do they have. What struggles have they faced and what have they needed to overcome them. What are they like, what characteristics have hook you child to this character. This is a conversation you can have with younger children too, they might not be as clear as older children but if they tell you they like batman because he is good at getting out of trouble there are a couple of characteristics you can take away from that, like smart, problem solving, quick, strong. There is always something behind the obvious answer, this superpowers might be the window to your children’s values.
3 – Superhero diary. Once you have found the superpowers your child looks up its important they are translated into actions. Find a way you and your child can be a little bit more like Superman, Batman, Elsa, Katniss or whoever you have chosen. To make it more fun think of them as special missions and write them down in a Superhero Diary where your child can draw or write all the things they have done like their superhero so they can come back in difficult times and remind themselves all they are capable of.
4 – Find a Superhero Mentor. Every Superhero has a sidekick or a mentor who supports them during their missions. Batman has Alfred, Harry Potter has Ron and Hermione, Ironman has Jarvis, Katniss has Haymitch. Encourage your child to find a sidekick or a mentor it can be a family member, a friend, a pet or even a therapist or a counselor. Sinews can be a great source for counseling, we great group of child therapists that will gladly jump at the chance to be a superhero mentor.
5 – Every superhero journey starts with a struggle. Last but not least remind your children that all superheroes have an origin story that usually involve some kind struggle. Batman lost his parents, Harry Potter not only lost his parents he had to endure the horrible family he had left, Hulk was exposed to radiation. This stories turned them into the superheroes they are, the struggles helped them develop the incredible superpowers that we all admire. So if your children feel like life is a little daunting remind them it will turn them into amazing superheroes.
References:
Scarlet, J. (2017). Superhero Therapy: Mindfulness skills to help teens & young adults deal with anxiety, depression and trauma. New Harbinger.
Washington, K. (2019, April 25). What is superhero therapy?. Denver Health Blog. https://www.denverhealth.org/blog/2019/04/what-is-superhero-therapy
Sinews MTI
Psychology, Psychiatry and Speech Therapy
The importance of setting limits and how to do it: children and adolescents
We encounter daily situations of «disobedience» on the part of children. It is normal and necessary that it happens when the child is in the moments of consolidation of his individuality. And even more so when dealing with people with whom the emotional involvement is intense, so we should not feel like victims.
There are always difficulties and contradictions when educating children but let us keep in mind that the lack of consistency and clarity in transmitting the rules makes children insecure and nervous (more crises, tantrums, and whims). Those who live with the child must agree on the rules and educational guidelines that will be asked.
If disobedience is continuous, we should think that the child is not happy and that he/she is asking for help.
Why do they sometimes provoke us?
The child loses limits easily, which distresses him, so he calls the adult to see if the same thing happens to us and to know with our example how to react. What reassures him/her is to see our security (it is not that he is asking for a spanking to calm down).
As adults, we must adapt our authority to the new individual who is growing up, with his own desires and rights that come up against the limitations corresponding to the desires and rights of others.
What are boundaries for?
Throughout their growth, children need limits and rules that help them know their possibilities, how far they can go, and what is expected of them. It is about providing a frame of reference and not so much about what to do when the child becomes «impossible».
Limits help them grow, while punishments create anxiety and low self-esteem. Through them, you can teach your son or daughter self-discipline; he or she will learn to deal with his or her own responsibilities without being reminded, developing strategies to impose limits on himself or herself.
The first limits have to do with the care provided to the baby in the attention to his basic needs, and allow him to differentiate little by little what he is from what others are, the internal and the external, with which he will be able to advance in the organization of his personality.
Limits will also help the child learn to deal with uncomfortable emotions such as frustration, anger, boredom, or sadness. Every boundary is an opportunity to learn to manage emotions.
Through boundaries, we teach our children that we care about them. Very often, children test limits to see how adults will react. Implementing negative consequences for breaking the rules shows that the adult is not letting the situation get out of control, creating security in the child.
Thanks to limits, he/she will learn to be able to postpone the immediate satisfaction of his desires, which favors coexistence and socialization. They will also be able to advance in their autonomy, from the external control provided by the adult to the development of their own criteria, being responsible for their actions and self-control.
How to set boundaries?
When setting boundaries, we must consider certain factors that will help us to do it correctly:
- Be clear that limits are necessary for the child.
- Be calm when we request or prohibit something from the child, so he/she will be more willing to comply with what is asked of him/her. That is to say, do not wait to set limits when they have already exceeded our patience.
- If the child reacts to a small frustration with a tantrum, we must wait until it passes, restrain him physically if there is a risk of injury, and then put into words what has happened («you got angry because of…»).
- When we forbid something, we can offer the allowed alternative. Knowing how to give him alternatives helps them learn to decide.
- It is better to select and establish the highest priority that we are going to ask for and wait until it is achieved, rather than trying to make him respect new rules. Neither wear out our authority in the face of unimportant details nor fall into the extreme of «let them do it» for everything.
- Offer explanations or reasons to justify the demands («it can break… «you can hurt yourself… «it is not yours…») without trying to justify ourselves.
- Do not try to discuss the reason for the limit. It is enough to give a reasoned explanation of the expectation we have, sometimes silence is a powerful tool.
- Few commands, but clear and expressed in a positive way (negative commands invite rejection, create more resistance and desire to transgress them). In other words, express what you want, not what you don’t want.
- Make sure that the rules are appropriate to the child’s maturity level (make sure that the child understands them) and that they are coherent, not contradictory or arbitrary. And also, they must be true.
- The limit must be set in time and the child must be made aware of it, and even know how much time he/she has to react to the proposed rule. We cannot always demand immediate obedience as soon as we try to set a limit since we are not looking for a submission but for learning.
- Involve your son or daughter in the creation of limits or house rules. In this way, not only are they motivated to follow the limits and routines by having participated in their creation, but they are also learning problem-solving skills.
- Let’s try not to mix up the different situations; it’s not the best time to «teach» rules when we spend time having fun through play and conversation.
Setting boundaries in adolescents
In adolescents, being able to set boundaries is one of the best ways to improve communication and build more trust, thus reducing conflict. At this age, knowing how to set and shape boundaries (perhaps from when they were younger) forces you to recognize the fact that your son or daughter is growing up and needs the control established when they were younger to be loosened and adapted to their new circumstances so they can mature.
It is especially important in adolescents that the limit be very clear; the following formula can be used:
Limit or rule (what is not allowed) + exceptions to the rule + consequences of not complying.
Important points to keep in mind when setting limits for adolescents:
- Be consistent with the rules, it is especially important to agree with everyone in the house on what the limits are and not to forget to apply the consequences. Adolescence is a period in which it is normal to try to find inconsistencies in the rules we are given in order to break them.
- Allow them to understand the natural consequences of their actions and decisions. Many times, it is not necessary to set a limit but to make your son or daughter understand that he or she will be responsible for the consequences of his or her actions. For example, if their actions result in a financial cost, they will be responsible for paying for it with their own money, or they will do a chore around the house that is monetarily equivalent.
- Respect in the same way you want to be respected. Adolescents are beginning to create their own identities and understand their place in the world, and to do so they need to feel respected as individuals by their parents. It is through mutual respect that we manage to set limits that they themselves choose to respect.
At the end of the day, we have to remember that rules and limits are essential, but from the support, affection, and above all the understanding that makes us understand the struggle between complying with certain rules and limits and the child’s need to assert their independence and autonomy.
We must find a balance between the socialization of our children and their need for affirmation, autonomy, and independence. It is from here that they will be able to face the negative emotions that appear throughout their lives without having to recur to alternative ways (alcohol, drugs, violence…) to manage them.
Sinews MTI
Psychology, Psychiatry and Speech Therapy
Is dyslexia affected by bilingualism?
Question:
My child is bilingual, and we have just detected that he presents dyslexia, should we remove one language?
Answer:
Dyslexia is a specific learning disorder of neurobiological origin. It is not related to low intellectual abilities, poor schooling, laziness, or the number of languages that your child speaks. Dyslexia is not related to oral language, so your child will be able to speak as many languages as he/she wishes.
Within dyslexia, we can differentiate between decoding difficulties and comprehension difficulties. The first ones stem from phonological deficits and it is related to being able to associate sounds and letters. In contrast, comprehension difficulties are associated with vocabulary, morphological and pragmatic skills.
We can find two types of orthographies when writing and reading a language: transparent orthography, the grapheme-phoneme correspondence is clear (like Spanish) or opaque orthographies, the correspondence between grapheme-phoneme is not as straightforward (like English). Some authors suggest that learning to read in both, opaque and transparent languages, would help people with dyslexia compensate for their deficits in phonological decoding by transferring phonological awareness and sublexical decoding abilities from consistent to inconsistent orthography.
I would like to stress the need to receive therapy in both languages because the needs will be specific to each language.
All in all, bilingualism doesn’t cause dyslexia nor does it increase the risk of presenting it, so there wouldn’t be a need to stop using one language. Some authors even say that bilingualism may have some benefits for dyslexia. The only thing is that your child will need to have therapy sessions in both languages because each language is different, and he/she will have different needs in each one.
Although it will take some effort, it will be possible for your child to achieve a good reading and writing level with the right approach. If they find it very difficult to keep up with one of the languages and you chose to remove one of them, I would remove the one they use the least in reading and writing form. But that doesn’t have to be a choice as they will be able to read and write in both of them.
If you need more help regarding this topic you can click here to get your online appointment with us.
References:
- Do Amaral J. & de Azevedo, B. (2021). What research can tell us about the interaction between dyslexia and bilingualism: an integrative review. Letronica, 14(2), 1-17. https://revistaseletronicas.pucrs.br/index.php/letronica/article/view/38695
Sinews MTI
Psychology, Psychiatry and Speech Therapy