Behavioral Psych Studio

Author: BPS Staff

What Emotion Dysregulation Looks Like in Children
By Brooke Schwartz, LMSW

In a previous blo g, we discussed emotion dysregulation, which is the inability to regularly use healthy strategies to diffuse or moderate negative emotions. It’s common for parents to wonder whether their child is engaging in typical, normative, or age-appropriate behaviors, or whether they are experiencing more persistent emotion dysregulation. This may bring about even more questions about what kind of treatment might be effective for their child.

For those who suspect their child struggles with emotion regulation, it’s worth keeping in mind that emotion dysregulation is not a disorder. Rather, it is an umbrella term for a variety of behaviors that may occur in isolation or in combination with each other. These behaviors — such as frequent irritability or regular and severe temper tantrums or outbursts — are often listed as the criteria for various disorders. Which ones? Research shows that emotion dysregulation may be associated with the following:
- Neurodevelopmental disorders. Children with attention-deficit/hyperactivity disorder (ADHD) may exhibit behaviors related to the dysregulation of both negative and positive emotions. That is, children with ADHD may not only experience difficulty managing anger and frustration, but also emotions such as excitement or exuberance. Both, ultimately, may impede their ability to respond to their environment with flexibility or in a socially adaptive manner. Relatedly, because emotion regulation is a strong predictor of academic performance, it’s possible that emotionally dysregulated children experience other academic difficulties or even receive specific learning disorder diagnoses.
- Anxiety disorders. Research shows that children with anxiety struggle more than their non-anxious counterparts both to decrease negative emotions and to employ effective emotion regulation strategies. One study found that while anxious children may be able to regulate and achieve substantial emotional relief in specific conditions, these methods may not be applied often enough in every day life.
- Disruptive, impulse-control, and conduct disorders. Children who are emotionally dysregulated may engage in aggressive or impulsive behaviors, which may be in line with diagnoses such as oppositional defiant disorder, intermittent explosive disorder, or conduct disorder. In fact, one study concluded that oppositional defiant disorder is better conceptualized as a disorder of emotion regulation, rather than as a behavior disorder.
- Mood disorders. Emotion dysregulation may be considered an etiological factor behind the frequent, severe temper outbursts and irritability of a newer diagnosis called disruptive mood dysregulation disorder.
Because behaviors captured under the emotion dysregulation umbrella are associated with a variety of disorders, it’s possible and not uncommon for parents to mis-conceptualize their child’s behavior. For example, a parent may hear from their child’s teacher that the child is having difficulty tolerating anger and frustration in the classroom. A parent may suspect that their child is experiencing a mood disorder — and even seek out related treatment — when their child is perhaps experiencing symptoms of ADHD.

What’s a parent to do if they suspect their child is emotionally dysregulated? There are a variety of ways you may choose to respond effectively to your child’s emotion dysregulation, such as by:
- Modeling emotion regulation. Talk about the emotions you experience and what coping strategies you’ll use so that your child sees emotions being regulated. This may mean using positive self-talk or creating a pro and con list in front of your child when your own emotions escalate.
- Validating. Validating means communicating to someone that what they are feeling, thinking, or doing makes sense (it does not mean you agree with it). With emotionally dysregulated children, validate the thought or emotion rather than the behavior. For example, if your child is kicking, crying, and screaming, you may validate by saying, “I can hear how angry you are,” or “It makes sense that you’re upset that I turned the TV off.”
- Praising efforts to regulate emotions. Not only does praise feel good, it also lets your child know what you want to see them doing more of.
- Role-playing. Practice emotion regulation when your child is already emotionally regulated. If you know that your child becomes emotionally dysregulated at bedtime, practice going through the bedtime routine earlier in the day, having your child practice following specific instructions (for example, “speak in a soft voice,” and “walk from the bathroom to your bedroom”). Praise them as you go.
- Considering treatment. A variety of modalities are shown to be effective in treating emotion dysregulation among children, such as Dialectical Behavior Therapy, Mindfulness Meditation, and Parent Management Training. Parents often play a role in their child’s treatment, however the emphasis on parent involvement varies depending on the modality.
Whether or not you’re engaging in treatment — and even if your child isn’t emotionally dysregulated — the tips described above can help increase your child’s potential to effectively regulate their emotions.

Disclaimer

This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise, provide any clinical opinions. If you think you need immediate assistance, call your local emergency number.

For referral information about our services, please click here or see our contact page on our website.
October 15, 2019
Choosing a College with Mental Health in Mind
By Brooke Schwartz, LMSW

Mental health concerns are widespread among college campuses. In fact, between 2007 and 2017, the percentage of college students with lifetime psychiatric diagnoses increased from 22% to 36%. If you or your child are in the process of choosing a college with mental health in mind, you may consider the following factors:
- Size. The size of the student body has several implications, including (but not limited to) how you make friends and what institutional resources are available to you. If you’re just beginning to think about what size school might best meet your needs, consider making a pros and cons list. This exercise may not lead you to a clear answer, however it can help organize your thoughts
Sample pros and cons list
- Social life and campus culture. Factors such as how people typically make friends, where people live, and where they spend their time may influence your social life at college and, thereby, your mental health. Consider the following questions: Is Greek life prominent on campus? Are there a variety of clubs and organizations to join? Do you feel that your identities are represented by the student body? Do most students live in on-campus housing or commute from home? How many people live in each dorm room? There’s no “good,” “bad,” “right,” or “wrong” answer to any of these questions. What matters is that you know yourself and your social needs. If you have any doubts about the importance of social support at college, consider this: 67% of college students tell a friend they’re feeling suicidal before telling anyone else.
- Geographic location and accessibility. There are many reasons to consider these factors as they relate to mental health. For example, if it’s important to you to be close to home, you may look for a school nearby, close to a train station, or that allows you to park your car on campus. Conversely, perhaps you know that being within reach of home is not ideal for your mental health — for example, because it may mean falling into a pattern of going home more than is effective or beneficial, or because it means more unwanted visits from family or friends. Further, location and accessibility may influence whether you need to find new mental health providers. Your current mental health providers may have varying limitations on whether they will continue to work with you once you go to college. Consider asking your current providers how they recommend you proceed with treatment once you leave for college. If they can’t continue working with you, they may have referrals near your school.
- Counseling options in the surrounding area. If you’re planning to find new providers near your school, it’s worth researching who practices in that area, if they have availability, if you can afford their services, and whether they offer the modality of treatment you’re seeking (such as Cognitive Behavioral Therapy or Dialectical Behavior Therapy).
- Counseling options on campus. It may also be worthwhile to look into what mental health resources your university offers. Is there a professional counseling center on campus? What are its hours? What do they offer (e.g., groups, one-on-one counseling, peer counseling)? How easy or difficult is it to make an appointment? Knowing about the school’s emergency response procedure is another way to assess how the university can support you if you do experience a mental health emergency.
- Accommodations. One study of college students living with mental health conditions found that 45 % of those who stopped attending college because of mental health related reasons did not receive accommodations (such as excused absences for treatment, adjustment in test times, increased availability of academic advisors, and assistive technology) through their school’s disability center for a variety of reasons. For example, some weren’t aware that they qualified for and had the right to receive accommodations, some feared the stigma attached to seeking accommodations, and some found that the process for obtaining accommodations was too burdensome or required too much documentation. If you think you may benefit from accommodations, it’s worth taking the time to research what the schools you’re interested in offer.
- Cost. Higher education is undoubtedly expensive, and there are many ways college students make ends meet including financial aid, work-study programs, loans, and scholarships. In thinking about your mental health, you may consider whether these methods of funding your education are contingent on full-time status or a minimum GPA. If you decide it’s too difficult to juggle both a full-time courseload and a work-study job, do you lose your funding? Once you graduate, how might being in debt have an impact on your mental health? How might taking out loans to attend the right (but expensive) college be worthwhile for your mental health long-term?
- Food. Some people with mental health conditions find it difficult to maintain a healthful and consistent diet — however, not eating, overeating, and eating certain foods (depending on your needs) may contribute to and maintain negative emotions. You may find it helpful to consider how accessible food is at the colleges you’re interested in. Is a meal plan offered? What is typically served? Are there local restaurants and do they deliver?
Deciding which college is right for you requires taking several factors into consideration, particularly if your mental health and wellbeing are priorities. Here’s to making an informed decision on your mental health and your college education!

Disclaimer

This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise, provide any clinical opinions. If you think you need immediate assistance, call your local emergency number.

For referral information about our services, please click here or see our contact page on our website.
September 3, 2019
What is Emotion Dysregulation?
By Brooke Schwartz, LMSW

Have you ever felt so overwhelmed that you’ve found yourself crafting an intricate to-do list? Or perhaps so angry that you joined a boxing class at the gym? Both of these activities are examples of ways in which we regulate our emotions — that is, they’re things we may do to effectively manage and respond to an emotional experience. We use coping strategies like these multiple times per day, often without realizing we’re doing so, in order to adapt to our environments. And while some coping strategies are healthy, harmless, and may even help to diffuse strong emotions, others (such as self-harming, abusing substances, avoiding difficult situations, and physical or verbal aggression, for example) often exacerbate negative emotions, make situations worse, and prevent us from finding solutions to our problems.

Thus, emotion dysregulation is considered the inability to regularly use healthy strategies to diffuse or moderate negative emotions. Why might someone experience emotion dysregulation? One explanation that was developed in the study of Borderline Personality Disorder (and that is undoubtedly relevant to other disorders, diagnoses, and behaviors) is called the biosocial theory. The biosocial theory posits that difficulties regulating emotions are rooted in biological predispositions which are exacerbated by specific environmental experiences. More on these concepts below:

Biological predispositions. Although research to identify the biological underpinnings of emotion dysregulation is ongoing, it’s believed that the following may contribute: genetic influences, disadvantageous intrauterine events, and early childhood environmental effects on the development of the brain and nervous system.

Environmental experiences. While traumatic events and chronically invalidating environments often contribute to emotion dysregulation, it’s possible that simply experiencing a “poorness of fit” within one’s environment may contribute as well.

While emotion dysregulation may seem quite obvious to observe, the way in which it manifests is more complicated and is made up of the following oftentimes unobservable components:

High sensitivity. People who struggle with emotion regulation often react quickly to events — it doesn’t take much to provoke an emotional response from them.

High reactivity and emotional intensity. Emotional reactions are extreme — often for both positive and negative emotions. Compared to emotionally regulated individuals, people who are emotionally dysregulated may experience joy more easily and more deeply, however they may also turn anger more quickly and easily into rage. Having difficulty regulating emotions may lead to a sense of being out of control and a certain unpredictability about the self. Emotionally dysregulated people may be so overwhelmed emotionally that they attempt to stop the intensity in maladaptive and even destructive ways (for example, through self-injury).

Slow return to emotional baseline. Reactions are long-lasting, even if the experience of the emotion takes only seconds or minutes. This is the case because emotional arousal (or mood) affects cognitive processes, which are related to the activation and reactivation of emotional states. People who are emotionally dysregulated often don’t have the skills needed to get them back to an emotional baseline, which sets them up to be more sensitive and vulnerable (see #1) to a future event.

Emotion dysregulation takes time and effort to treat, however treatment can be incredibly effective and gains are often long-lasting. Dialectical Behavior Therapy (DBT) is an evidence-based treatment designed for emotion dysregulation that stresses

Experiencing and labeling emotions

Increasing mindfulness (and decreasing judgments) of current emotions

Identifying obstacles to changing emotions

Reducing emotional vulnerability

Increasing positive emotional events

Changing emotions by changing physiological arousal

Whether or not you’re engaging in treatment, there are many ways to improve emotion regulation, such as taking care of your physical needs; engaging in activities that build a sense of mastery and achievement; or exploring the connection between thoughts, emotions, and behaviors.
August 20, 2019
Understanding Borderline Personality Disorder in Men
By Brooke Schwartz, LMSW

**Disclaimer: This blog post discusses Borderline Personality Disorder in the context of the gender binary due to the limited research that currently exists outside of it. Borderline Personality Disorder transcends gender, affecting cisgender, transgender, and gender nonconforming individuals — anyone can be diagnosed with Borderline Personality Disorder.**

Mental illnesses have long been represented in media — we’re accustomed to seeing our favorite characters cope with anxiety, depression, and bipolar disorders, among others. But Borderline Personality Disorder (BPD) is largely untouched in media, despite between 1.6 and 6 percent of the United States population (that’s as 14 million people) carrying a diagnosis. When BPD is portrayed in media, it’s predominantly depicted by women (e.g., in Girl, Interrupted, Silver Linings Playbook, and Crazy Ex-Girlfriend). On the surface, this makes sense; as many as 75% of those diagnosed with BPD are in fact women. However, recent research has begun to focus on the fact that while women are more often diagnosed with BPD, rates of the disorder may be more or less equal among men and women.

In exploring gender differences and patterns in BPD, it’s important to have an understanding of what BPD is and how it develops. BPD is a mental disorder characterized by a pattern of instability in mood, behavior, self-image, interpersonal relationships, and impulse control. BPD has both biological and social etiologies. Genetically, those with BPD have been found to have a predisposition to stress vulnerability; socially, those with BPD tend to have lived in invalidating or ineffective environments, or ones that they experience as such. Transactions between one’s temperament (influenced by their genetic predispositions) and their social experience (such as chronic invalidation, adverse family environment, or physical or emotional abuse) can cause individuals to perceive, think about, and relate to themselves and others in inflexible and maladaptive ways. When this results in functional impairment or subjective distress, clinicians may consider the individual to meet criteria for BPD.

As mentioned, even though rates of BPD are thought to be more or less equal among men and women, women more often receive BPD diagnoses. This may be due to:

Presentation. Women and men with BPD differ in how their symptoms present, which may contribute to the services they seek out and the diagnoses they receive. Women with BPD are more likely than men with BPD to meet criteria for eating disorders, as well as mood, anxiety, panic, and posttraumatic stress disorders. On the other hand, men with BPD are more likely than women with BPD to meet criteria for substance use disorders, intermittent explosive disorder, narcissistic personality disorder, and antisocial personality disorder. Further, men with BPD often have more explosive temperaments and exhibit more novelty seeking behaviors than do women with BPD. It is worth noting that although men and women with BPD tend to vary in symptom presentation, research has found that both genders experience equal levels of emotional distress and that equal proportions of men and women with BPD engage in at least one type of self-harm behavior and attempt suicide.

Setting. One’s symptoms and presentation often influence the setting in which they’re treated (and if they’re treated at all). While having an eating or mood disorder will likely lead you to a mental health setting, having an antisocial or explosive presentation may lead you to a correctional setting, where it is less likely that a diagnosis will be given, thus leading to a potential sampling bias.

Socialization. Whether or not we like it, individuals tend to be socialized to view others’ behaviors as more or less acceptable based on that person’s gender. In one study, researchers found that intense anger was believed to be more abnormal for a woman than for a man, suggesting that society may have different thresholds for what is considered normal and abnormal, depending on one’s gender. This can have an impact on treatment utilization (for example, if ‘inappropriate or intense anger’ is chalked up to masculinity rather than as a symptom of a disorder), and may also be responsible for gender bias in diagnosing BPD among clinicians.

Treatment utilization. Research has found distinct gender differences with regard to treatment utilization. While lifetime levels of mental healthcare utilization are high for men and women with BPD, men with BPD are more likely to utilize drug and alcohol rehabilitation services, and less likely to utilize psychotherapy and pharmacotherapy services. This may contribute to different rates of BPD diagnoses given among men and women.

Evidently, men and women with BPD often present and are perceived differently from each other. Differences, too, exist between men with BPD and men with other personality disorders — when compared to men with other personality disorders, men with BPD show more dissociative symptomatology, more frequent use of maladaptive defenses, as well as higher frequencies of childhood sexual abuse, more severe childhood sexual abuse, and increased rates of early separation or loss.

While it’s true that women are more often diagnosed with BPD, and that symptom presentation and patterns differ between genders, research indisputably shows that more men than commonly believed experience BPD, and that rates may actually be equal among men and women. With interest in this topic generating and research evolving, it may not be just Girl, Interrupted for much longer.
July 16, 2019
The Summer Slump: Increasing Structure Over the Summer
By Brooke Schwartz, LMSW

Every year we spring forward and fall back, but have you ever wondered what we do in the summer months? Some enter into a “summer slump,” a period characterized by isolation, boredom, or unproductivity, all of which may heighten symptoms of depression and anxiety. Children and adolescents who don’t engage in summer activities are particularly susceptible to summer slumps given the stark contrast between daily life during and outside of the school year. Being without structure may initially feel freeing, but may ultimately lead to behavioral issues and difficulty adjusting back to school in the fall. For college students, unstructured summers may induce feelings of disappointment and inadequacy that linger into future seasons.

Many of the suggestions you’ll read below, both for children and college students, are rooted in a treatment called “behavioral activation.” Behavioral activation involves scheduling activities to encourage people to reconnect with environmental positive reinforcement and to decrease avoidant behaviors that maintain negative emotions. And although behavioral activation is an evidence-based treatment for depression, one of its core principles — that they key to changing how people feel is changing what they do — is helpful in targeting the summer slump.

Parents and caregivers of younger children may consider the following tips to help their kids avoid a summer slump:

Stick to a schedule. It’s nearly impossible for summer days to look just like those in the school year. However, it can be helpful to maintain certain part of your school year’s daily schedule, for example by keeping mealtimes and bedtimes as consistent as possible. Doing so can help with summer behavior and make the inevitable transition back into the school year feel easier. Wondering how to keep bedtime consistent? You may consider adjusting your child’s sleep environment by using blackout curtains to block light, or a fan or air conditioner to block sound.

Fill the schedule. Schedule activities throughout the day to keep your child engaged and entertained. Activities don’t have to be elaborate or costly — you may schedule a time to check the mail, go to the park or library, color, or have a playdate with a friend.

Schedule unscheduled time. While it may seem counterintuitive, there are actually several benefits to including unscheduled time in a child’s daily schedule. Children learn the important skill of being able to amuse themselves in the absence of plans, for example by coming up with a game to play or exploring. When children have unscheduled time with others, they learn skills such as negotiating and collaborating. The following may be helpful things to keep in mind when it comes to unscheduled time: limit time on devices; stock up on tools your child can use for creativity (e.g., art supplies, building blocks, or baking equipment); and resist the urge to suggest activities for your child if they say they’re bored — instead, remind them of the materials they have access to. If you’re a working parent, consider putting your child in programs that have free or choice time built time, or if this isn’t possible, scheduling unscheduled time when your child is home.

Make the schedule visual and understandable. Children often respond better to transitions when they’re predictable ones, so communicating the schedule to your child is essential. Depending on your child’s age and developmental level, consider using images or clipart to help them understand the schedule.

Use a reward system. Providing rewards for certain behaviors you want to see more of is an effective way of encouraging children throughout the summer. Choose two or three desired behaviors. Behaviors should be stated positively — that is, if you want your child to put their sneakers in the closet when they get home, state the behavior as, “Put your sneakers in the closet when you get home,” and not as “Don’t leave your sneakers in the hallway.” Give your child consistent and positive praise when they do the desired behavior, and actively ignore undesired behaviors (when it’s safe and appropriate to do so). Decide on how the reward system will work and what the rewards are collaboratively with your child. Many people find sticker charts to be effective reward systems for younger children. Keep in mind that rewards don’t have to be expensive — some ideas of affordable rewards include reading an extra book at night, a trip to the park, or eating a meal outdoors.

Utilize your community. As important as it is for children to have structure, it’s also crucial for their parents and caregivers to feel up to giving it to them. Consider reaching out to someone — a family member, friend, or babysitter — to help you entertain your child or give you some time off.

Whereas younger children are often provided with a sense of structure in the summertime, college students tend to be responsible for creating it themselves. And many obstacles can get in the way of achieving this task (e.g., not getting offered an internship or job, wanting a break from work or responsibility, or lacking motivation/understanding of how to make a summer plan). If you’re a college student looking to bring some structure to your summer, consider the following tips:

Create a schedule that excites you. Scheduling positive activities throughout the summer will give you something to look forward to and help prevent you from feeling stuck. Just remember to also schedule “you time.” It’s compelling — and often fun — to schedule social activities throughout the summer, but building in time for yourself can help you maintain the energy you want or need in order to enjoy other summer activities. Scheduling any amount of time (ten minutes, a few hours, or a full day) to do something you enjoy or that has a positive effect on your well-being or health can be rejuvenating and lead you to better enjoy the time you do spend with others. Looking for examples? Consider engaging in simple acts of self-care (such as drinking water, cooking a healthy meal, taking a nap, or showering), kicking a soccer ball around in the park, or journaling.

Build downtime into your schedule. Downtime (with or without others) replenishes your attention and motivation, encourages productivity and creativity, and is essential to achieve your highest levels of performance for those activities you do build into your schedule.

Maintain a social or support system. It’s tough to spend the summer away from friends you’ve spent the rest of the year with, which is something that happens for many college students. Scheduling phone calls or video chats with friends from college, especially those in different time zones, is one way of continuing to feel connected to others even from a distance. Being around people (even ones you don’t know) may also make you feel more socially supported. If there’s no one you’re close to around or available, consider doing an activity that doesn’t directly involve others, but puts you in proximity to them (such as reading in a coffee shop or taking a walk in a dog park).

Try something new. One of the major perks of being a college student? The power of a student ID — it can grant you discounted access to museums, libraries, shows, sports games, and more. Not interested in going anywhere? Forget the ID and spend time trying new things that inspire, interest, or intrigue you, such as reading a new genre, drawing, gathering clothes to donate, or gardening.

Challenge expectations. It’s particularly common for college students to think of summer as a time that they “should be” doing something — they “should be” building their resume, they “should be” socializing, or they “should be” spending time outdoors. One problem with the “should be” mentality is that it can set you up for disappointment and feeling as though time spent doing anything else is time wasted. Challenging expectations about what summer “should be” like — even by simply rephrasing a thought from “I should be hanging out with my friends more” to “I may want to spend time with friends next week” — can help buffer feelings of disappointment and allow you to be more engaged in the present moment.

While summer may seem appealing in the winter months, it’s quite common to experience a much different reality. Hopefully these tips help you avoid a summer slump!

Disclaimer

This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise, provide any clinical opinions. If you think you need immediate assistance, call your local emergency number.

For referral information about our services, please click here or see our contact page on our website.
July 5, 2019
Homesickness: When The Going (Away) Gets Tough
By Brooke Schwartz, LMSW

Summer means warmer weather, outdoor activities, time off from school, and for many…homesickness. The American Academy of Pediatrics defines homesickness as the distress and functional impairment caused by actual or anticipated separation from home and attachment objects (such as parents). As you may know from experience, it’s actually quite common for children, adolescents, and even adults to experience homesickness. And fortunately, there are several tools and tricks that can be effective when working to prevent and address the symptoms.

If you were to imagine a homesick child, what would they look like? While you may be picturing a child who appears sad, nervous, or anxious, there are actually a number of other ways that homesickness may manifest, including the following:
- In physical symptoms such as gastric and intestinal complaints, sleep disturbances, appetite loss, headache, and fatigue.
- In behavioral characteristics such as apathy, listlessness, withdrawal, and lack of initiative.
- In emotional manifestations such as depressive mood, anger, irritability, and feelings of insecurity or loss of control.
Parents and caregivers may consider the following to help prepare themselves and their child for time apart:
- If possible, involve your child in the decision to spend time away from home. Taking part in even the smallest decisions can increase feelings and perceptions of control, whereas feeling forced to leave home often increases the severity of homesickness. Preparing and packing as a family is often an effective way of involving your child.
- Discuss the upcoming separation. Contrary to popular belief, talking about homesickness doesn’t cause homesickness. Instead, it can be a way of educating and encouraging the homesick person. By sharing with your child that homesickness is normal and that many people miss something about home when they’re away, you’ll provide them with normalization and validation.
- Ask questions. You may assume that your child is homesick for their parents or caregivers; however, some children most miss other things about home, such as home cooking, their favorite toys, or the family pet. You may consider asking, “What will you miss most about home?” in order to better understand your child’s concerns and help them start thinking about parts of the separation that might be most difficult for them.
- Practice communication and correspondence. Ensuring that children know how to communicate with you — whether through snail mail, phone calls, or emails — increases the likelihood that they will maintain some contact with home. You may consider giving your child pre-stamped, preaddressed envelopes and notebook paper so that communicating while apart doesn’t feel as difficult for them.
- Express enthusiasm and optimism about the fun your child is going to have in the new environment, and try to limit expressing anxiety or ambivalence about the time away from home.
- Commit to the separation. Promising a child that they can leave if they’re unhappy (e.g., “If you don’t like it, I’ll come pick you up”) reduces their likelihood of success for several reasons. These kinds of agreements indicate that you don’t have confidence in your child’s ability to cope with a normal response to separation, and also prevent their development of effective coping skills by giving them the option to escape.
Because homesickness can manifest in a variety of ways, it can be challenging to identify. And when it does show up, it often won’t remit spontaneously but rather will get better with the use of positive coping skills. Practicing “doing” strategies (observable, behavioral ways of coping) and “thinking” strategies (unobservable, cognitive ways of coping) is often an effective way to combat homesickness. The following “doing” and “thinking” strategies may be helpful for your child:

Doing strategies:
- Do something fun, like play with friends. Not only might this distract from the homesickness, but it will encourage social connection.
- Do something to feel closer to home. Writing a letter, looking at a family picture, or reading a letter from a family member can increase feelings of connectedness with home.
- Talk to someone who can help you feel better. At camp, this may be a trusted staff member or mental health professional who can serve as social support during the separation.
Thinking strategies:
- Think about the parts of the separation that you’re enjoying most. Thinking thoughts along the lines of, “I like that I get to be near a lake over the summer” or “The summers are when I get to make the most new friends” can increase optimism and distract from homesickness.
- Put time into perspective. Thinking about the days, weeks, or months away as fractions of larger amounts of time (e.g., “I’m spending 8 weeks at camp out of 52 weeks in the year”) can make the time spent apart seem less daunting.
- Think about what loved ones would say. Imagining how a missed family member or friend would respond to feelings of homesickness is a way of getting vicarious social support.
- Or in contrast, practice purposeful avoidance. Turning the mind (e.g., reading a book, immersing oneself in an activity, thinking about something positive) when thoughts about home and loved ones pop up is an effective way for some children to distract themselves from homesickness.
Homesickness can be challenging both to experience and tend to. Hopefully, these strategies will be helpful whether you’re anticipating a separation for the summer or down the line!

Disclaimer

This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise, provide any clinical opinions. If you think you need immediate assistance, call your local emergency number.

For referral information about our services, please click here or see our contact page on our website.
June 17, 2019
High School Hurdles: When School Throws Shade
By Dr. Carmen Lalonde

It was exciting at first, the anticipation of seeing your friends, hearing about everyone’s summer adventures, and everything seemed to be going ok… and then it all comes crashing down. Loads of assignments, navigating the demands in each class, and ugh…the social drama, and all of sudden it just feels VERY overwhelming. High school can be a great and a tough place, and if you struggle with anxiety, depression, or social issues, whether you are a freshman, sophomore, junior, or senior, it can feel scary.

We mentioned in a previous post on back to school worries, that anxiety is one of the most common issues that affect teens at school. According to the National Institute of Mental Health, depression is also common in teens and young adults and is also one of the leading causes of difficulties at school, as low mood and lack of energy (two common symptoms of depression) can affect your ability to manage daily routines such as sleeping, eating, and completing your school work. So, if you are a high school student and you struggle with the demands of school or you have anxiety or depression, here are some tips you can use to help you wade through the academic and social maze that high school can feel like.

1. Maintain multiple social circles.
- Shifty friends, new peers with conflicting interests, and new “in-groups” are challenging situations to manage, and when you become the target of gossip or drama, you can begin to feel hopeless and very alone. If your social world has started to feel very small, the idea of going to school can feel impossible.
- Having friendships outside of school can help you feel less alone and provides a social spot that is not connected to the drama that often occurs at school. Having friends or activities unconnected to your school life can help you have a safe place to talk about issues without the worry of it becoming the headline gossip of the week.
- Another way to combat feeling isolated at school is to join different social groups, clubs, and make friends with people who don’t typically run with your crowd. This way, if something goes awry with your current group, you won’t be left without any friends.
2. Create a calendar or daytimer.
- Managing the demands of each class is an enormous task. Some teachers assign homework each day, some each week, and others are just plain unpredictable it seems. Trying to hold all of this information in your head can create massive anxiety, and lead to feelings of defeat and the thought that, “it’s just not worth it.”
- Learning how to organize your daily tasks can not only help reduce anxiety, it can also help you feel more confident. If you have never used a daytimer, try finding one that you like (there are a million on Amazon to choose from), or if you are a tech person, try out a few calendar apps. Or if you are old school, try a classic wall calendar to begin to organize your daily and weekly tasks.
- You can start by listing out your daily classes, and then add in long-term due dates for assignments. One helpful hack with planning is to think about how long an assignment might take to complete, and then add on a few extra hours. This way, if the homework takes longer than expected, you have set up a safety net to give you more time.
- Also, giving yourself reminders before an assignment is due can also help orient you to starting your work sooner, which will help reduce anxiety and that awful feeling of cramming the night before an assignment or test. And while, asking your parents for help may be a strategy lower on your list, sometimes seeking their advice is a great way to learn how to manage increasing life demands.
3. Get good sleep (not too much, not too little)

We have all heard it, “get more sleep, go to bed, it will help.” Easier said than done. Mindlessly scrolling through social media, watching just one more show on Netflix, or attempting to cram for that test you forgot to study for, make it nearly impossible to get good sleep.

Sleep, according to the American Academy of Pediatrics plays an essential role in managing anxiety, depression, social stress, and school performance. Yes, we just heard it, hot off the press from the experts, not only your parents say this, sleep will help you feel better. So if you’re like most teens who have a hard time getting good sleep, here are some ideas to try to get those ever-valuable Zzzs:
1. Set a time limit for when you will shut all social media off and try to stick to this each night.
2. Don’t take your phone to bed with you. The more you are looking at a screen, the more alert your brain is and therefore, the longer it will take you to fall asleep.
3. Set an actual bedtime and wake-up time for yourself that allows you to get as much of the recommended 8-9 hours of sleep a night as possible.
4. Enlist one of your friends to create a sleep routine with you, and at night you can support each other in sticking to your goals.
As hard as it is for everyone to get enough sleep, getting enough rest at night will improve mood, reduce anxieties and increase your self-confidence.

5. Be active.

According to American Psychological Association exercise reduces anxiety, improves mood (makes you feel better) and helps with concentration and memory. And while this might feel like an added job to the list of work you have to do, exercise can really help distract from the grind of school work.
- One way to add activity to your schedule can be to explore the different clubs and sports teams at your high school to see what sparks your interest. You can also explore the recreational facilities in your neighborhood to see if there are some special deals for teens.
- Another way to increase your activity level is to walk a portion of the way to or from school. Getting in a brisk walk before your head into class or after school can help create balance, clear your mind, and improve your mood.
4. Make a list of what motivates you.
- Sometimes the demands of school can become so great that we lose track of what makes us happy. The daily grind of school can feel so far away from your life goals that you lose sight of what motivates you to keep going to school. Sometimes reminding yourself of why you want or have to complete school can help you see the light at the end of the tunnel.
- I have often recommended to the teens I work with that they create a motivation board or a “life goals list” with their short-term and long-term aspirations listed out. I have them place it in a spot where they can see it each day, like a mirror or by their bed. Many told me that reading this on a daily basis helped them feel more energy for the day.
5. Reward yourself.
- Setting up an award system can also help you stick to your goals or things you want to accomplish. Basic behavioral principles state that if you want to increase the chances of doing something, reward yourself after doing the behavior, and you are more likely to do that behavior again.
- So, if you feel great after completing an assignment and you reward yourself with your favorite show or hanging with friends, you are more likely to complete future tasks on time. So, if you enjoy going for special drinks at Starbucks with your friends, or to the movies, or taking long hot baths, use these as rewards for yourself for being successful with your goals and routines.
- If you are able to stick to your sleep routine, reward yourself the next morning. If you complete an assignment on time, allow yourself to watch your favorite show for 30 minutes afterwards.
6. Develop a relationship with school counselors and know when to ask for help.

It can be intimidating and scary, but speaking to your school counselor and creating a relationship with them can help you feel less anxious at school. Knowing that there is someone at school who understands your worries, and who is devoted to your successful completion of high school can be a source of relief and refuge at school.
- Guidance counselors are there to help, and if you can create a good relationship with one of them, they can be that go-to person, that safe haven, when things feel like they are falling apart.
- They can also help support you in seeking outside help if your anxiety, depression, or school struggles remain constant.
- Knowing how and when to ask for help is an important skill to develop that requires knowing yourself, your moods, your worries, and the right people to ask for help. Even though relationships with adults and parents can be complicated during high school, know that your parents, teachers, and guidance counselors are there to help.
Hopefully, these strategies and developing the skill of asking for help will add a little relief as you make your way through the hurdles of high school. Good luck!

Disclaimer

This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise, provide any clinical opinions. If you think you need immediate assistance, call your local emergency number.

For referral information about our services, please click here or see our contact page on our website.
September 14, 2018
Summer Blues: Tips for Transitioning Back to School

By Dr. Carmen Lalonde and Dr. Stefanie Sugar

The school year is fast upon us… families are returning from vacations and summer camps have come to end. For many youths, the month of August is a time of excitement as they start to turn their mindset from summer break towards the fall. For others, however, it isn’t excitement they feel; It is the anticipatory anxiety of returning to, or starting school, for the first time that fills their final weeks of summer. With children and teenagers, anxiety often presents as worry, agitation, irritability, moodiness, and anger, as well as outright school refusal. For many young people, the idea of resuming school can create a great deal of strain and stress as September approaches and many parents feel helpless and frustrated by the escalating tension in the house. What can parents do to help their children manage their anxiety and prepare for school?

Anxiety is one of the most common issues when it comes to school-related problems, and according to the Anxiety and Depression Association of America, anxiety disorders are found in 25.1% of youth between 13 and 18 years. Understanding the connection between anxiety and both school refusal and challenging behaviors at home is the first step to helping parents reduce their children’s worries about school. Here are a few more concrete tips parents can do to help their children get ready:

1. Validate: Validation is the act of making sense of someone else’s feelings, thoughts or behaviors. Be curious about how your child feels about school. Try not to interrupt, problem-solve or anticipate their answers. Just being heard can often feel soothing to children and teens because it lets them know you are there and are not judging them. Basic validation of your child’s or teens worries, thoughts, or concerns is soothing and can often increase the effectiveness of problem solving, later on. Some simple ways to validate your child/teen are; active listening, reflecting back what has been heard, normalizing their experience, and sharing personal stories about similar thoughts/feelings you’ve experienced. Once you have spent some time learning about your youths worries and used validation, problem solving becomes possible and more effective.

2. Prep: For children and teens who struggle with anxiety, change can be difficult. Therefore, doing a lot of prep and discussion about school can not only help reduce worries, it also helps your child learn that their fears are manageable. Learning where their classroom will be, who their teachers are, and going to their school to look at the layout can help decrease what is known as “uncertainty fears,” which are fears of the unknown, and often the root of anxiety. For younger children, another way to engage in effective prep, is to try and obtain a picture of their new teacher, which can reduce uncertainty worries and create a cognitive anchor so that everything does not feel so unfamiliar.

3. Help teens organize and plan an agenda: If your adolescent is transitioning from middle school to high school the idea of having multiple classrooms and class periods can be overwhelming and paralyzing for those who have social anxiety. Current research also shows that individuals who have anxiety often struggle with executive functions such as, organization, planning, and initiation of tasks, which can make transitioning back to school more challenging. If this is the case, take time to sit down with your adolescent to help teach them how to read their schedule, create an agenda, and practice opening a locker. These basic life skills can help your adolescent reduce the amount of planning and cognitive energy they will need during the day, which allows them to have more internal regulation resources available to them, which ultimately helps them to have more energy to manage their anxiety.

4. Ease back into the routine: For children who struggle with early mornings and tend to stay up late during the summer when it doesn’t get dark until later, the shift back to early mornings can be a tough transition for the whole family. Discuss with your child and adolescent that you want to help them get back into the routine of getting up early and provide lots of encouragement. Then, two weeks before school starts, begin waking your teen or child 5-15 minutes earlier each morning. This slow transition into early rising can feel less harsh and will hopefully reduce the battles that can occur when adjusting sleep schedules.

5. Create a coping plan of strategies: For children and youth who require coping skills to reduce their worries and nervousness, explore with your child what helps them feel calm by creating a “coping bag” to keep in their backpack or desk. Music, deep breathing, funny memes, stress balls, fidget toys, gum (if permitted in school), essential oils that are soothing, and motivational quotes are all simple strategies that can be kept in their desk or backpack to help cope with their anxiety.

Other simple strategies to support your child and teen include:

6. Prepare a healthy breakfast for the first day of school.

7. Connect your child or teen with peers that they go to the same school with.

8. Ensure a good night’s sleep before the start of school.

9. Begin to adjust screen time two weeks before the start of school to help your child or teen ease back into managing their time differently.

When in doubt, validate and listen to your child’s concerns. Sometimes just having someone that understands our internal thoughts and worries, can be enough to reduce the anxiety. For more helpful tips and strategies check back throughout the month or join our mailing list to be notified when we post a new blog!

Disclaimer

This site is for information only. It is not therapy. This blog is only for informational and educational purposes and should not be considered therapy or any form of treatment. We are not able to respond to specific questions or comments about personal situations, appropriate diagnosis or treatment, or otherwise provide any clinical opinions. If you think you need immediate assistance, call your local emergency number.

For referral information about our services please click here or see our contact page on our website.

August 24, 2018
About BPS

Welcome to “Let’s Talk Psych at Behavioral Psych Studio”, a science and evidenced-based mental health blog created by Behavioral Psych Studio. Behavioral Psych Studio is a private, group psychology practice, dedicated to providing effective, science-driven treatment to people struggling with psychological or social issues in New York City. At Behavioral Psych Studio, we are passionate about providing effective, comprehensive and compassionate treatment and we believe that treatment should be driven by science. To ensure that our clients receive the best treatment at BPS, our practice is committed to using interventions and treatments that have been empirically supported by scientific research. Very often, mental health issues are fraught with stigma and people feel shame or judgment about seeking out treatment. Behavioral Psych Studio is launching “Let’s Talk Psych at Behavioral Psych Studio” to both help combat the social stigma people face, and also provide up-to-date, accurate information on the types of treatments that exist for various mental illnesses and issues, across the lifespan. Stay tuned for our first post!

Check in frequently to see new posts.

July 30, 2018