HMNS 2150 – Week #12 – Family Stress

 

                                                                                                                                                           

Group Collaboration Exercise Week# 12:  Family Stress

 

1.         Identify the various stressful conditions and events that impact the Herring family, and prescribe stress reduction measures.

2.         Describe the events and conditions that commonly produce stress in contemporary families, and describe how to minimize their impact.

                                                                                                                                                           

 

Lecture Notes

CHILDREN’S STRESS

 

I.       WHAT IS STRESS?

 

          Response to a positive or negative physical and/or emotional                            change:  Can be learned or innate

                   Mild-> Moderate->Severe

                   Increases flow of adrenaline in preparation for “fight or                                     flight”, increases production of cortisol

                   May make memory permanent, leading to PTSD

 

II.      WHAT CAUSES STRESS IN CHILDREN?

 

·       New, Unfamiliar, or unpredictable situations

·       Unclear expectations

·       Anticipation of something unpleasant (pain)

·       Fear of failure (social or academic)

·       Major developmental “hurdles”

                   (Moving from elementary to middle school, leaving home)

 

III.    WHAT ARE THE SYMPTOMS?

 

  • Physical symptoms

o                                headache

o                                upset stomach or vague stomach pain

o                                sleep disturbances

o                                nightmares

o                                new or recurrent bedwetting

o                                decreased appetite, other changes in eating habits

o                                stuttering

o                                other physical symptoms with no physical illness

 

  • Emotional or behavioral symptoms

o                                anxiety

o                                worries

o                                inability to relax

o                                new or recurring fears (fear of the dark, fear of being alone, fear of strangers)

o                                clinging, unwilling to let you out of sight

o                                questioning (may or may not ask questions)

o                                anger

o                                crying

o                                whining

o                                inability to control emotions

o                                aggressive behavior

o                                stubborn behavior

o                                regression to behaviors that are typical of an earlier developmental stage

o                                unwillingness to participate in family or school activities

 

IV.    HOW CAN PARENTS HELP?


Parents can help children respond to stress in healthy ways. Some things parents can do include the following:

  • Provide a safe, secure, familiar, consistent, and dependable home.
  • Be selective in the television programs that young children watch (including news broadcasts), which can produce fears and anxiety.
  • Spend calm, relaxed time with your children.
  • Encourage questions.
  • Encourage expression of concerns, worries, or fears.
  • Listen to your child without being critical.
  • Build your child's feelings of self-worth. Use encouragement and affection. Try to involve your child in situations where he or she can succeed.
  • Try to use positive encouragement and reward instead of punishment
  • Allow the child opportunities to make choices and have some control in his or her life. This is particularly important, because research shows that the more people feel they have control over a situation, the better their response to stress will be.
  • Encourage physical activity.
  • Develop awareness of situations and events that are stressful for children. These include new experiences, fear or unpredictable outcomes, unpleasant sensations, unmet needs or desires, and loss.
  • Recognize signs of unresolved stress in your child.
  • Keep your child informed of necessary and anticipated changes such as changes in jobs or moving
  • Seek professional help or advice when signs of stress do not decrease or disappear.

V.      WHAT CAN CHILDREN DO TO RELIEVE STRESS?


Children can do some things for themselves to help reduce stress. Tips include the following:

  • Talk about your problems. If you cannot communicate with your parents, try someone else that you can trust.
  • Try to relax. Listen to calm music. Take a warm bath. Close your eyes and take slow deep breaths. Take some time for yourself. If you have a hobby or favorite activity, give yourself time to enjoy it.
  • Exercise. Physical activity reduces stress.
  • Set realistic expectations. Do your best, and remember that nobody is perfect.
  • Learn to love yourself and respect yourself. Respect others. Be with people who accept and respect you.
  • Remember that drugs and alcohol NEVER solve problems.
  • Ask for help if you are having problems with stress management.

 

                                                                                                                            

 

RESILIENCE

 

Psychological Competence:  a set of skills and attitudes that lead to positive mental health and a strong sense of well being.  (National Association of School Psychologists)

 

Resilience:  a set of qualities that foster a process of successful adaptation and transformation despite risk and adversity.  (ERIC Digest)

 

 

Focuses on strengths, not weaknesses or illnesses.

 

Humans have a “Self-righting capacity”.

 

 

Summary/adaptation of Resilience – Status of the Research and Research-Based Programs,  Nancy J Davis, Ed.D.,SAMHSA, Center for Mental Health Services.

 

“Given an adequately facilitating environment, people have the capacity for positive changes and for the development of at least some characteristics of resilience throughout their lives.”

 

No one has absolute resistance; rather, it is more appropriate to consider susceptibility to stress as a graded phenomenon.  (Rutter, 1991)

 

Resilience is a dynamic process, highly influenced by protective factors, whereby people bounce back from adversity and go on with their lives.  (Rutter, 1987)

 

General definition of psychological health and adjustment:  (Klohnen, 1996)

 

1.                                        Ability to be happy and contented with a sense of direction and purpose.

2.                                        Capacity for productive work and a sense of competence and environmental mastery

3.                                        Emotional security, self-acceptance, self-knowledge, and a realistic and undistorted perception of oneself, others, and one’s surroundings

4.                                        Interpersonal adequacy and the capacity for warm and caring relating to others and for intimacy and respect.

 

 

 

Determinants/Risk Factors:

 

1.                                        Chronic poverty

2.                                        Mother with little education

3.                                        Moderate to severe perinatal complications

4.                                        Developmental delays or irregularities

5.                                        Genetic abnormalities

6.                                        Parental psychopathology

7.                                        Prolonged separation from primary care giver during first year

8.                                        Birth of younger siblings within two years after child’s birth

9.                                        Serious or repeated childhood illnesses

10.                                   Chronic parental illness

11.                                   Parental mental illness

12.                                   Sibling with handicap, learning, or behavior problem

13.                                   Chronic family discord

14.                                   Father absent

15.                                   Loss of job or sporadic unemployment of parents

16.                                   Change of residence

17.                                   Change of school

18.                                   Divorce of parents

19.                                   Remarriage and entry of step-parent into household

20.                                   Departure or death of older sibling or close friend

21.                                   Foster home placement

22.                                   Family violence

23.                                   War

24.                                   Death of a parent

25.                                   Nuclear disasters

26.                                   Forest fires

27.                                   Institutionalizations

28.                                   Sensory-motor deficits, unusual sensitivities

29.                                   Deviant body morphology

30.                                   Temperamental characteristics

31.                                   Inherent disposition to passivity

32.                                   Incapacity to read caretaker’s cues

33.                                   Insufficient impulse control.

 

 

 

 

Risk factors differ by gender at different times in one’s life.  In general, boys are more vulnerable in the first decade of life, whereas girls become more vulnerable in the second decade.

 

Risk factors are cumulative.

 

Protective Factors (for the individual)

 

1.                                        Good intellectual functioning

2.                                        Appealing, sociable, easygoing disposition

3.                                        Self-efficacy, self-confidence, high self-esteem

4.                                        Talents

5.                                        Faith

 

For the Family:

 

1.                                        Close relationship to caring parent figure

2.                                        Authoritative parenting: warmth, structure, high expectations

3.                                        Socioeconomic advantages

4.                                        Connections to extended supportive family networks

 

Extra-Familial Context:

 

1.                                        Bonds to pro-social adults outside the family

2.                                        Connections to pro-social organizations

3.                                        Attending effective schools

4.                                         

Protective Factors are known to correlate with resilience, not necessarily cause it.  (They could be consequences of success!)

 

 

 

Supplentary Readings

 

                                                                                                                            

15 Elements of Resilience

 

I HAVE:   1.      People around me I trust and who love me, no matter what

2.                                                                People who set limits for me so I know when to stop before there is danger or trouble.

3.                                                                People who show me how to do things right by the way they do things.

4.                                                                People who want me to learn to do things on my own.

5.                                                                People who help me when I am sick, in danger, or need to learn.

 

I AM:                  6.      A person people can like and love.

                   7.      Glad to do nice things for others and show my concern

8.                                             Respectful of myself and others.

9.                                             Willing to be responsible for what I do.

10.                                   Sure things will be all right.

 

I CAN:      11.    Talk to others about things that frighten me or bother me.

12.                                                           Find ways to solve problems that I face.

13.                                                           Control myself when I feel like doing something not right or dangerous

14.                                                           Figure out when it is a good time to talk to someone or take action.

15.                                                           Find someone to help me when I need it.

 

Source:  Grotberg, E.H. (1995) A guide to promoting resilience in children:  Strengthening the human spirit.

 

                                                                                                                            

Characteristics of Resilient Individuals

 

1.                            Physical Competence

 

Good Health and prenatal care, secure attachment              

Easy Temperament:

pleasant mood

          malleability

predictability of behavior

mild to moderate intensity of emotional reactions

approaching style to new situations

 

(Bi-directional responses)

 

2.                            Social & Relational Competence

 

Secure attachment: 

 

          Long-term benefits:      social behavior

                                                Affect regulation

                                                Endurance in challenging task situations

                                                Orientation to social resources

                                                Cognitive resourcefulness.

 

Basic trust   (Erikson)

 

During adolescence:         “Knowing” evolves into “Understanding”, which evolves into “Insight”:

 

                                                Examining evidence

                                                Sorting out the truth

                                                Protesting illusions

                                                Look for meaning (sub-rosa)

                                                Confront themselves honestly

                                                Asking searching questions

 

 

 

A. The Ability and Opportunity to Recruit Actively People Who Can Help.

 

     From teachers, ministers, neighbors, grandparents for social support.

 

     Resilient children also have a strong ability to make and keep a few good friends; positive peer relationships

 

     And learn to share, to help, to comfort, to empathize with others.  (Mutuality and reciprocity)

 

     Social competence is a predictor of life success.

 

     They like school, attend more often, and produce higher academic performance.

 

     Gain support of teachers.

 

3.                            Cognitive Competence

 

A.                                                               Research correlates high IQ with fewer behavior problems, social competence and generally successful adjustment.

B.                                                               Language Acquisition and Reading – parentally influenced

C.                                                               The capacity to plan - exercise foresight, problem-solve, understand consequences, carving out a piece of the environment they can control

 

Positive future expectations

Internal locus of control (I can influence the direction of my life)

D.                                                              Self-Efficacy:  The belief that one can have a desired effect on his world.

E.                                                               Self-Understanding:  “An internal psychological process through with an individual makes causal connections between experiences in the world at large and inner feelings”  (Beardslee,1993)

 

An honest appraisal of one’s real self, capacities, temperament, psychological roots, and behavioral tendencies such that behavioral prediction and appreciation of probable consequences is not only possible, but is sought.  (Hatfield, 2001)

 

 

 

 

4.                            Emotional Competence

 

A.                                                              Emotional Regulation/Control/Management

B.                                                               Ability to Delay Gratification

C.                                                               Realistically high self-esteem (Competence)

Sense of autonomy, effectiveness

D.                                                              Creativity and Sense of Humor

a.                                                                                                     Unlike “ridicule”, harming people by laughing “at” them

b.                                                                                                     Humor allows us to laugh at ourselves, not take ourselves too seriously

 

 

5.                            Moral Competence

 

A.                                                               The Ability and Opportunity to Contribute

 

1.                                                                            Parents, schools, communities must provide the opportunity to contribute

 

6.                            Spiritual Competence

 

A.                                                               Having Faith That One’s Life Matters (Meaningfulness)

 

1.                                                                            Children seeing beyond themselves

 

B.      Church gives children a sense of community and mission

 

 

                  

 

 

 

 

 

 

CHARACTERISTICS OF RESILIENT FAMILIES

 

All families have “self-righting tendencies” that can flourish given an adequately facilitating environment.

 

          In the U.S. there is a growing disparity between the rich and the poor, exacerbating the ability of the family’s self-righting capacity.  Poverty disturbs this capacity.

 

Family Characteristics:

 

          1.      Caring relationships

          2.      High expectations and support

          3.      Children contribute to the family

 

 

Characteristics of strong, resilient African-American families:

 

          1.      Strong economic base

          2.      Achievement orientation

          3.      Role adaptability

5.                                        Spirituality

6.                                        Racial pride

7.                                        Respect and love

8.                                        Resourcefulness

9.                                        Community involvement

10.                                   Family unity

 

Characteristics of protective factors in families in general:

 

          1.      Supportive parent-child relationships

          2.      Positive discipline methods

          3.      Monitoring and supervision

5.                                        Family advocacy for their children

6.                                        Seeking information and support for the benefit of their children

7.                                        Family communication

8.                                        Family cohesion

9.                                        Intelligence of the child

10.                                   Competence of the child

11.                                   Good relationship with at least one parent figure

12.                                   Setting and enforcing rules

13.                                   Parents’ respect for children’s individuality

14.                                   Child’s easy temperament and positive coping skills enhance good parenting skills, and conversely

 

 

Protective Processes Within Schools

 

“A school can create a coherent environment so potent that for at least six hours a day it can override almost everything else in the lives of children.”

 

                                                          Ron Edmonds, 1986

 

School Characteristics to Enhance Competence:

 

          1.      High structure, preparation, and planning

          2.      Homework and exams

          3.      Pupils accept responsibility for their actions

          4.      Maintenance of a prosocial atmosphere

 

Characteristics to foster resilience:

 

          1.      Increase pro-social bonding

          2.      Set clear, consistent boundaries

          3.      Teach life skills

5.                                        Provide caring and support

6.                                        Set and communicate high expectations

 

 

 

 

 

 

Supplementary Readings

                                                                                                                                                           

 

Understanding And Dealing With Children During Divorce


A great deal of study and thought has been given to knowing more about the impact of divorce on children.  While there is growing agreement among researchers and practitioners about the effects of divorce, there is still a lot we don't know.  We have not reached a point that we can be specific about the impact of divorce on a specific child.  What we do know is that the impact will vary with each child depending the child's age, gender, maturity, psychological health and whether or not other supportive adults are able to be a regular part of their lives.  However, there are some generalizations that apply in nearly every situation.

Generalizations

  • Ongoing abuse (e.g. child abuse, domestic violence) that cannot be stopped is more damaging to children than divorce itself.
  • Divorce can be the right decision and can be handled responsibly.
  • Divorce itself does not have a positive impact on a child's life and development.
  • Girls tend to handle divorce better and have fewer serious problems than boys.
  • Divorce is a failure of a couple's commitment to their marital and family roles.  This includes parental responsibilities to their children's psychological and emotional development.  Divorce has it's most negative impact when one or both parents abandon responsibility for their child's social and emotional development.
  • The negative impact of a divorce is not canceled out by new conditions or changes that may be positive.  Put simply, divorce is bad for children.  Children don't need perfect parents, they need "good enough" parents.
  • At best, a divorce or separation may help prevent abuse between parents that is a result of living together.  The resulting changes in location, environment and family structure may have a positive influence (but not necessarily).  This does not mean neglectful, abusive or retaliatory behavior won't occur.
  • Children don't grasp or appreciate how parents can stop loving each other, separate or divorce.  Children lose some degree of trust in others or themselves.  They often fear that one or both parents may abandon them.  They can feel guilty even when they have nothing to do with the turmoil between parents. They feel especially guilty when they created conflict or were the source of conflict between parents.
  • Divorce often makes parenting and raising children more difficult.   If there were conflicts or disagreements over parenting before a divorce, those problems will usually be worse and not better after the divorce.
  • Children raised in conflicted and marginally functional homes have fewer problems and develop in a manner that is often superior in many ways to those children whose parents divorce. 
  • It is important for children to have good enough parents within a functional home environment that is free of ongoing abuse.  It is not necessary for a mother and father to be "in love" or romantically involved to be good parents and to raise healthy children. 
  • The responsibilities of parents include providing an environment that is understanding, reassuring, open, kind, respectful and firm.  Emotions of love and romantic love between a husband and wife play an important role in a marriage.  That relationship in a marriage is the responsibility of a husband and a wife to create and maintain.  The roles of a mother and father are different responsibilities than those of husband and wife. 

The Perspective of Children

The perspective and feelings of children are not usually considered when parents make their decision to divorce.  Parents may think about their children's well-geing, but it very rare that parents will ask directly or "consult' with their children during their discussions or decisions to divorce.  The following are comments from insightful teenagers who wanted their parents and other children to understand the importance and impact of a divorce.

Why don't parents ask the kids?
"Because they don't care about their opinion, or it doesn't effect their progress on working on their problems. Parents can get away with divorce.  Kids can't get away with anything."

Why do parents divorce?
"Because when you give them the ability to divorce they just abuse it."

Don't parents care?
If the parents say "We want to get a divorce." And the kids say "We shall be sad."  The parents don't say "O.K., we'll stay together."  That never happens.  That's what comedians are. 

How did your parents divorce make you feel? 
"Like I have no effect.  Like I'm a bystander.  Like they know how I feel, but they don't care."

How do you feel about your parents?
"My opinion is lower because I thought they would be more mature and solve their problems.  They didn't even ask what it would do to me."

What do you think parents need to know?
"I just think they deserve to suffer a lot just to know what it's like."

Symptoms And The Impact Of Divorce On Children

During and following a divorce there are a number of issues that parents will usually face. Sooner or latter, parents, family or friends should begin to notice the impact of divorce on children.  There is no avoiding it.   Children will feel bad.  The emotional pain is distressing. The impact and the child's response will vary according to their age, gender, maturity, psychological health and whether or not other supportive adults are able to be a regular part of their lives.  A lot will also depend on how skillfully and compassionately parents handle or mishandle their interactions with each other and their children.

When parents make a decision to divorce and children are expected to cope with the decision.  Except in cases involving abuse, it is rare that children will thrive during a divorce.  The impact of divorce is that children will have problems and experience symptoms.  This may include one or more of the following:

  • Impulsive and impatient behavior
  • Anger at others
  • Oppositional, rebellious, defiant, or conduct problems
  • Breaking rules and testing limits
  • Destructive behavior
  • Anger at self
  • Self-blame or guilt
  • Self-destructive or self-harming behavior
  • Drug or alcohol use
  • Apathy or failure to accept responsibility
  • Early or increased sexual activity
  • Isolation and Withdrawal
  • Suicidal thoughts or behavior
  • Violent thoughts or behavior
  • Superficially positive behavior

Information And Steps You Can Take

  • Spend regular time with your children. Maintain a familiar routine as much as possible. Keep your commitments and the promises you make to your children.
  • Seek immediate advice and consultation from a qualified mental health professional or crisis intervention specialist if you suspect any critical symptoms involving alcohol and other drug abuse, a risk of suicide or a risk of violence.
  • Seek advice and consultation from a qualified health care professional if your children have pre-existing mental, emotional or psychological problems. 
  • Seek advice and consultation from a qualified health care professional if you feel overwhelmed and unable to respond effectively to the emotional needs of your children.  This can be a tremendous support and can help you deal effectively with your children and spouse.
  • If you can't or don't know how to make things better for your child, don't make matters worse.
  • Do not rely on your children for emotional support.   (Take care of yourself. Spare your children that additional emotional burden and responsibility.)
  • Do not manipulate, pressure or lie in order to make your children take sides or to support you. 
  • Do not expose children to your arguments, abusive behavior or conflicts.
  • Do not tell children how they should feel.
  • Do not argue or become angry with children if they disagree with how you believe they should be feeling.

 

                                                                                                                                                           

 

FAMILY STRESS, BELIEFS ABOUT PARENTING AND COGNITIVE AND EMOTIONAL REACTIONS TO CHILDREN'S MISBEHAVIOR CAN LEAD TO HARSH DISCIPLINE, SAYS NEW STUDY

WASHINGTON - Low-income parents tend to endorse much harsher discipline, according to a new study, in part because they hold stronger beliefs about the value of spanking and experience higher levels of stress. And even though a parent's ethnicity didn't have a direct affect on discipline responses, African American parents did report higher levels of stress and used harsher discipline when their children misbehaved. These findings are reported on in the September issue of the American Psychological Association's (APA) Journal of Family Psychology.

Contemporary society can make being a member of a minority group stressful, said psychologist Ellen E. Pinderhughes, Ph.D., of Vanderbilt University and colleagues, and African American parents may experience more family stress and respond more harshly to their children because of this stress. "Our findings show that parents who are from a lower SES and/or from an ethnic group experience more stress. Because they are more stressed, they have more intense cognitive and emotional reactions to their child's misbehavior, and thus use harsher discipline. So, the harsh discipline is linked to low SES and/or minority ethnic status through high levels of stress and parents' intense reactions to child misbehavior," said the authors.

In a study of 978 parents (59% were mothers, 82% were European Americans and 16% were African Americans) with 585 kindergarten-aged children, the authors examined how a parents' SES and ethnicity influenced their discipline approaches. They also examined whether parenting beliefs, family stress, parents' perception of the child's behavior and the parents' cognitive and emotional state also played a role in parents' disciplining responses.

Parents were first asked about their beliefs in the effectiveness of spanking and whether their child should be aggressive in resolving conflict with another child. Second, the amount and level of stress the parent was experiencing was determined by a parent's marital status, number of children living with the parents, having an unplanned pregnancy, living in an unsafe neighborhood or having conflict in a romantic relationship. Third, the parents were asked if they felt positively or negatively towards their child and also asked how well they could describe their child as an individual.

Finally, the parents were asked to respond to multiple hypothetical vignettes involving children misbehaving to see how they would discipline their children. In deciding how the parents disciplined their children, their cognitive and emotional states were assessed. This included whether they blamed the child or the misbehavior, how angry the parents became when the child misbehaved, how concerned they were about the future implications of their child's misbehavior and whether they could think of alternative ways to discipline the child. Parents' use of harsh discipline was determined by asking parents how severely they would discipline the child and how frequently they used harsh discipline.

It seems that when highly stressed parents get into a pattern when their children misbehave, say the authors, "they assume their children intentionally misbehaved. They also get very upset and start worrying about their children's future. These parents don't see alternative ways to discipline their children and choose physical and severe punishment as the only option."

Any parent experiencing these intense cognitive-emotional processes may benefit from interventions targeted to reduce their intensity, say the authors, and learning about alternative discipline strategies may help make discipline decisions less reactive and harsh. "In addition, programs that reduce external stress on parents can help low income parents to reduce their intense cognitive and emotional reactions to misbehavior, and thus be more open to different discipline strategies."

http://www.apa.org/releases/familystress.html

                                                                                                                                                           

 

Ambiguity: A Factor in Family Stress Management

Pauline Boss


Perhaps the first thing to realize about stress is that it's not always a bad thing to have in families.In fact it can make family life exciting--being busy, working, playing hard, competing in contests, being involved in community activities, and even arguing when you don't agree with other family members. Stress means change. It is the force exerted on a family by demands.

If we think of a bridge, stress results from putting weight on the bridge. This usually can be managed since the supports under the bridge are designed to withstand pressure (or stress) from traffic on the bridge. This assumes that the supports are in place, and are numerous and strong enough to withstand stress on the structure, even over time.

Sometimes in a family, this is not true. The structure can't hold up under the pressure and there is a crisis. Since the supports are not strong enough to withstand the pressure, the structure collapses. This can happen to families just as it happens to bridges.

Stress, therefore, is simply pressure put on the family. It results from change and can be good or bad. Crisis, however, is a point of acute imbalance between pressure and supports. This imbalance is so severe that the family structure collapses and is immobilized for a time. The family can no longer function. For a time no one goes to work; no one cooks or even wants to eat; and no one performs the usual family tasks.

What we want to discuss here is what makes some families able to manage stress so that it never reaches this point of crisis.

The Meaning a Stressful Event Has for the Family

The meaning a stressful event has for the family (or the family's definition of the event) is important in explaining why some families can manage stress while others go into crisis, even when faced with the same event. What the family thinks of what is happening to them is critical. What seems stressful to our family may not be to others; what may not seem stressful to us may be highly stressful to other families.

For example having a baby can be a positive stressor for a couple who has tried to have a child for years and suddenly finds out that the wife is pregnant. For a couple who already has four children and wants no more, finding out that the wife is pregnant would be a stressor event with a negative meaning.

How we see an event or a demand will determine how we feel, how we cope or don't cope, and what alternatives we see for resolving the problem. Our perception is very important in determining how and if we can manage a particular stressful event that happens to us.

All of us will deal with normal family-life stressor events more often than with events resulting from disasters such as storms, fires, or wars. For all of us, there will be births, deaths, marriages, divorces, and the comings and goings of family members across the family life cycle. These are stressor events that happen in all families. We cannot avoid such events, but we can become aware of and minimize barriers to the family's resolution of stress.

Boundary Ambiguity: A Barrier to the Management of Family Stress

Sometimes, the family's perception of a situation is such that the family is prevented from managing the stress. One such barrier to the resolution of stress in families is what I call "boundary ambiguity." In simple terms, that means not knowing who is in and who is out of the family. Sometimes a family experiences an event or situation that makes it difficult--or even impossible--for them to determine precisely who is in their family system. Or something may happen to them that seems clear to an outsider, but the family denies the facts about "who is there," psychologically or physically.

In both of these cases, the family's perception of their membership, their roles, and rules is what matters in determining how they'll manage the stress (see Figure 1 for examples).

Uncertainty and lack of agreement about family roles--who does what, who decides what--is quite common between parents and offspring and between husbands and wives, especially under stress. All families have some system of rules regarding appropriate behavior and relationships when problems need to be solved under pressure. To be effective, such rules need to be understood and agreed upon by all members of a family. Often this is not the case.

Figure 1

High Boundary Ambiguity

 

Physical
Absence

 

 

Psychological
Presence

  Examples: physically missing
  family members. There is a
  preoccupation with thinking of
  the absent member. The
  process of grieving and
  restructuring cannot begin since
  the facts surrounding the loss of
  the person are not clear.

 

 

Physical
Presence

 

 

Psychological
Absence

  Examples: alcoholic/
  chemically ill family members.
  Families where a member
  is physically there but not
  emotionally available to the
  system. The family is intact but
  a member is psychologically
  preoccupied with something
  outside the system.

Confusion or ambiguity about family membership, family roles, and rules then become a barrier to stress management for that family. This is what we call family boundary ambiguity: not knowing who is in or out of the family, not knowing who does what task, and not knowing what rules the family will use to solve their problems when stress occurs.

The Family Gamble

Sometimes when families cannot get the facts about the whereabouts of a family member who is missing or the status of someone who is chronically ill, they take it upon themselves to decide whether or not that person is in or out of the family system. Also, if a family member is consistently "missing" due to chemical dependency, the rest of the family may decide to "close them out" and proceed with family life as if they weren't there. Whenever you have a "missing person," the family's boundaries will be ambiguous. Then its membership, roles, and rules are also unclear.

If someone has run away, is missing, or is constantly drunk, the family is in limbo. The family is unable to grieve the loss because they don't know if the person is "in or out of the family." After being in limbo this way and not having been successful at attempts to find or cure the missing person, families may decide to conclude that the missing person is indeed dead or unavailable to them. They make a "family gamble" to give up on that person and begin to grieve their loss. This is an agreed upon perception arrived at in the absence of definite facts.

Sometimes there can be errors in the gamble. The missing person may show up after years of being gone and the family may have to reopen its boundaries to let that individual in again. The alcoholic person may suddenly go into treatment and change behavior. These changes, although positive, will also cause stress for that family system. Getting family members back as well as losing them can produce stress for the family system.

Why Family Boundary Ambiguity Matters in How Families Manage Stress

Families are systems. Systems must maintain their boundaries if they are to survive and not collapse under pressure. In order for a family system to maintain its boundaries, the family members must know who is in and who is outside the family. We find this out by asking families whom they perceive to be in their family and by asking them who performs the necessary roles in the family in day-to-day living and what their family rules are for dealing with stress. It is surprising sometimes to find that physically absent persons are seen as psychologically present. The actual absence or presence of a family member is less related to high stress than is the incongruity between reality and perception of family boundaries.

Points to Remember so that Boundary Ambiguity Does Not Become a Barrier to Family Stress Management

  1. If a family member is physically absent but seen as psychologically present, that family's boundaries are ambiguous and the family will remain at a high stress level.
  2. If a family member is physically present but seen as psychologically absent, that family's boundaries also are ambiguous and the family will remain at a high stress level.
  3. If a family member is both physically and psychologically absent or present, then the family's boundaries are clear and the family will be able to manage the stress.
  4. The significant barrier to family stress management then is not so much the events of loss or acquisition that take place over the family life cycle, but the ambiguity caused when we don't know if the person is or is not part of the family system. Most families can manage stress, even the worst of events, like having a tornado blow away their home. But families cannot cope well with an event about which they cannot get the facts. Having a loved one ill with alcoholism or having a family member kidnapped or missing puts the family boundary in limbo. The family cannot grieve because they don't know if the loss is real or not. They are stuck. They cannot reorganize. They cannot manage their stress.

What Can Be Done to Work Through the Situation?

  1. Actively seek whatever facts can be discovered about the stressor event or situation (as when a family member is missing, an alcoholic, or ill). Even the smallest bits of information will help as knowledge enables you to manage stress.
  2. Once that is done, realize that for a short time ambiguity will not be dysfunctional. Not even when there is a clear-cut loss, such as a death, will the family accept the fact immediately. It takes time to clearly accept a loss.
  3. Realize that families have boundaries: that it is important to know who is in and who is out. Talk about the loss and the ambiguity surrounding it even if it is a forbidden topic. Break the family rules and talk about it. Discuss with your family how they see their membership and boundary.

This may help to stimulate needed discussion about the missing or chronically ill family member so that the stress can be managed rather than ignored. Permit the airing of all views, even those which are uncomfortable, unpleasant, or with which you do not agree.

Families are often the source of their own healing. Sometimes, all that is needed is to gather and talk as a total unit about the stress, to talk and listen and struggle with the problem. If this is not sufficient, you may need to seek help from a church, mental health center, or other counseling agency.

Summary

Family boundaries cannot be maintained by outsiders: they must be maintained from the inside, by you and your family. When you have clear and healthy family boundaries, a major barrier to the management of stressful family life events is overcome. You and your family will be capable of managing the stress (change) that will inevitably happen to you. You should establish clear family boundaries in order to meet the task of stress management in your family as it grows and develops.

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Change, Crisis, and Loss in Our Lives

Ronald L. Pitzer


Everyone has troubles at times. For example, you lose your job, your child becomes very ill, or a family member dies. It is a time of crisis. Sometimes the event is not severe, but it puts a strain on you or your family. For example, your nine-year-old child starts school in a new town, you start a new job, or you have your first baby. Such events cause anxiety. Personal crisis can be brought on by the fundamental events of the human life cycle such as birth, marriage and death. It can be caused by divorce, the loss of a job or by a natural disaster such as a flood, drought, or tornado. These events make us question the way we view the world and what we believe.

A crisis may be a personal loss, as when someone dies or gets divorced, a physical loss due to a flood or other natural disaster, or a psychological loss when our routine has changed and we do not have a clear direction. There is a process of grief and mourning associated with each of these losses. The change of a routine or even the loss of money or physical possessions, is not nearly as painful as the loss of a loved one, but the process of adjusting is basically the same.

Crisis occurs when you or your family face an important problem or task that you cannot easily solve. A crisis consists of the problem and your reaction to it. It's a turning point for better or worse. Things will never be quite the same again. They may not necessarily be worse; perhaps they will be better, but they will definitely be different. The Chinese written character for crisis is composed of two equal symbols. One means danger, the other means opportunity. While you must remain aware of the danger of the crisis, you should try to also recognize the opportunities.

 

Responses to Change, Crisis, and Loss

When you are suffering loss, facing a crisis or experiencing change, you may feel disoriented and confused. Your thinking, work habits and relations with others all seem less logical and rational than usual. Your thinking may be less grounded in reality and you may become totally preoccupied with your problem. You may also be thinking about past losses and past crises. In such situations, you may, at times, be tense and irritable and at others, depressed and moody. You may feel restless and unable to eat or sleep. These symptoms are the normal and expected reactions of a person in crisis or loss.

Eventually, with the support and help of others, you can develop new ways to deal with the unfamiliar and threatening situation. You can make an internal adjustment, solve the problem and recover from the loss. You will learn to function in a new way. How the crisis was handled, however, will determine whether or not you can come out of it stronger or weaker.

Typical Stages of Response to Loss

Dr. Elizabeth Kubler-Ross and others have found a typical set of stages that people go through when facing a terminal illness. Others have found similar response stages to any serious crisis or loss, including weather problems such as too much rain, insect infestations, and other variables of farm life. The stages are a useful guide to understanding our reactions to loss. However, they are not absolute; not everyone goes through every stage in the same sequence and certainly not at the same time. People go back and forth between stages.

Stage One - Denial

"No, not me, it can't be true." This is a typical reaction of a person facing a loss or impending loss. It is an important and necessary stage. It works as a buffer after sudden shock to allow people to collect themselves and, with time, find less radical responses. It is dangerous to become stuck in denial, pretending the loss hasn't happened or won't happen, and putting off plans to deal with the problem.

 

Stage Two - Anger and Blame

"Why me?" When denial can no longer be maintained, likely replacements are anger, rage, envy, and resentment. God is a typical target of anger, especially in cases of death or natural disasters such as floods, drought, or fire. Anyone who the person thinks could have prevented this situation, such as doctors or family members, are also targets of the distressed person's anger. The person may also resent those affected less severely than he or she.It's also a normal, and not necessarily bad stage as long as the person does not destructively act out his or her anger against him- or herself or others or remain stuck in this mode.

Anger coming out of deep loss is different from occasional day to day flare-ups. It may be helpful to get away from the situation for awhile to calm down or find some constructive way to work the anger out of your system. Then return and take some positive step towards the problem. Talk about your feelings but avoid blaming others. Blaming fuels anger and may result in violent actions. Anger is often a secondary emotion. Find out what's behind it. It may be worry, fear or embarrassment. Then work through that feeling, too. Think of new ways to act in which you are in control of your anger. Talk to others who have learned to control their anger and may suggest some tactic to use.

 

Stage Three - Bargaining

"Yes, but..." Once anger is somewhat under control, people suffering a deep loss (such as death or job termination) or threat of loss may enter a bargaining stage. Bargaining mostly with God, they promise to be good or to do something in exchange for more time (when facing terminal illness) or for the rain to stop or for a reprieve (from an impending event). Faith and prayer can comfort and help as long as people don't withdraw from planning and activity. Witnesses of those experiencing death, job termination or other loss, report cases of people sinking into a fatalism wherein they cease all planning.

 

Stage Four - Sadness and Depression

"Oh, woe is me." A crisis almost always means loss, and loss probably always is accompanied by sadness. This is normal, understandable, and not necessarily bad. A danger at this stage is giving in to or becoming absorbed by the sadness. This is called depression.

Some signs of depression are not eating or sleeping; constant moodiness and irritability; no longer caring or concentrating; intense, absorbing sadness; lack of energy; feelings of helplessness and hopelessness. Anyone, especially when in crisis, may experience one or more of these conditions. If several exist for two weeks or longer, it may indicate depression and the need for professional help.If the depression is severe, professional help is needed. Depressed people should be encouraged to contact their community mental health center, or another person may have to intervene to establish this important connection.

The most serious danger of this stage is suicide. A person in deep depression, who sees no hope, is a prime candidate for suicide. That's why arranging for professional help for a deeply depressed person, especially if he or she has talked suicide, is so important.

Stage Five - Acceptance

"It's all right." Once these steps have been worked through and at least the outlines of a new plan have been drawn, the final stage of acceptance is reached. The person probably will not be happy about either the process or outcome, but accepts the situation and is ready to go on with life. It's comforting to know that most people in a crisis do eventually reach acceptance, even though the pain of getting there may be intense. However unlikely it may seem to one in the midst of grieving, people often emerge stronger from the crisis and sometimes find their new situation more rewarding than their previous situation. Comprehension of these stages can help us adjust to any crisis, change, or loss.

Reacting to Crisis

What makes one person come out of a crisis weaker and another stronger? In a nutshell, the person who has a problem (a crisis, loss, or change) has to recognize and face it, and actively search for a solution. Harvard psychologist, Gerald Caplan, based on studies of a variety of crises, concluded that the more people faced the realities of the problem and persevered in actively grappling with them, the stronger they emerged after the crisis.

People who came out of a crisis weaker, less effective, or spinning toward breakdown had evaded the issues the crisis presented. They had belittled the importance of the problem or pretended that it was not there or that they were not upset by it. They had not sought the help of others and refused it when offered, as if to say "Why do I need help? There's really nothing wrong." They may have talked themselves into believing that somehow the problem would magically disappear. Thus, there was nothing they needed do.

By mental acrobatics, they had shifted their energies away from solving the problems the crisis posed and focused them instead on blaming someone for their plight. They may have frittered away the energies needed for problem solving, by sleeping excessively or developing headaches or stomach trouble that would replace the crisis itself as the main concern.

If we know these ways of evasion and illusion are unhealthy, can we avoid them and turn to ways to make us mentally healthy? To some extent, we can anticipate certain life crisis and rehearse our future roles. We can have at least an intellectual awareness of the healthy road, even though in the midst of crisis, we may not be wholly in command of our feelings and actions. Our knowledge can censor us whenever we slip into irrational solutions and encourage us to come back to reality.

The key to healthy adaptation during a crisis is the ability to face up to the situation , despite its stress and unpleasantness and despite the inevitable frustration and tension that afflict us when dealing with problems without ready solutions. People who weather a crisis well actively search for a solution, both abstractly and by trial and error. They thirst for any information that may help them. They want to know ahead of time exactly how it feels to be away at camp for the first time, or what surgery is like, or how to care for a premature baby. They focus their energy on problem solving instead of wasting it. They avoid blaming themselves and others, realizing that blame is another way to avoid the real problem. They are not ashamed to express their fears, anxieties and sorrow to those they love and they explore possible solutions with them. They learn to pace themselves, to rest when their efficiency drops because of fatigue and to discipline themselves to return to the painful struggle as soon as their health permits. They are able to accept and even enlist the help of others, considering asking for help, not a sign of weakness and overdependence, but of strength and maturity.

This ability to accept help is particularly important, because people in crisis are more susceptible to influence by others than they are normally. Since a crisis is a time of rapid change, the help, advice, comfort, and particularly the encouragement from family, friends, or counselors to continue to grapple with the problem and wrest a solution has an enormous impact. The fact that people in crisis are in a state of disequilibrium or off-balance, means that a relatively minor force can push them to one side or the other.

In every life crisis there is danger and opportunity. The resources that any of us bring to the hazardous times of life are not completely predetermined. Though not entirely masters of our fate, neither are we prisoners of an unalterable personality. We can make meaningful choices, with the help and support of family, friends, and trusted counselors, and when we make these choices during the critical turning points in our lives, they may change the whole quality and direction of our existence.

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Family Communication in Times of Stress

Ronald L. Pitzer


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Copyright  ©  2005  Regents of the University of Minnesota. All rights reserved.

 

The healthy way to deal with stress or to work through feelings of loss or sadness is to talk about it with someone--a family member, a close friend, a pastor, or a professional counselor. Many persons who experience stress or loss deny or ignore the normal feelings of anger, guilt, fear, and sorrow which accompany these experiences. Such denial can lead to emotional or physical difficulties. At a minimum, it is likely to lead to a breakdown in communication with others, thus blocking the natural means of recovering from the stress, grief, or change.

 

Talk It Out

A first principle of communication for a person undergoing stress, then, is talk it out. Don't bottle it up. Confide your feelings and worry to some level-headed person who is likely to understand and care and who you can trust. Just knowing that someone is aware of our stress, hurt feelings, worries, or difficult decisions and cares about us can mean a great deal. Burdens shared with a caring person are often lighter to carry. As someone once said: "A joy shared is doubled; a sorrow shared is halved." You may have at least one such person among your informal support network--your husband or wife, father or mother, brother or sister, or a friend. If not, you may need to reach out to a more formal helper--clergy, family doctor, social worker, counselor, or psychologist.

Reaching out to some receptive listener is urgent. Talking things out helps you relieve the tension, see your situation in a clearer light, and often, see what you can do about it. Harvard psychologist Gerald Caplan says that persons who weather crisis well are not ashamed to express their fears, anxieties, and sorrow; are eager to explore possible solutions with others, and are able to accept--even enlist the help of others. The "good copers" consider talking it out and asking for help a sign of strength and maturity rather than of weakness and overdependence.

 

Just Listen

The other side of the coin in communication and stress is listening. To talk it out requires a listener. Unfortunately, family members and friends are often notoriously poor listeners--not because they are unskilled or indifferent or uncaring, but because they care so much that they want to ease the stress or unpleasant feelings, take on the burden, solve the problem, or offer advice. That is noble. However, even if sound and eventually followed, such advice may not feel helpful at the moment of intense feeling or great stress. At such times, "just listening" can be a powerfully important contribution.

It's important that a person under stress be allowed to vent his or her feelings. If you are the listener, this means that you allow the person to talk, to yell, or to cry. How you respond to someone feeling stressed is important. Advising, analyzing, or judging by saying things like "Don't get so emotional," or "Try to get organized," or "It's silly to worry about it," is not very helpful.

What stressed people need is someone to listen, to support, and to allow feelings to be expressed. It's helpful to ask short, neutral questions or express concern and willingness to listen--for example, "Would you like to talk about it," or "You sound upset," or "I can see that would bother you."

Sometimes a person can find the cause of stress and see the most likely solution simply by talking it out. At other times, a person may need help seeing the source of the problem or in seeing alternatives for solving it. In those cases, your experience, wisdom, and objectivity may be valuable. Either way, facing up to the problem and getting feelings out in the open are the first steps in managing stress.

So don't underestimate the value of "just listening." Listening is perhaps the most important communication skill. Yet many of us don't listen as well as we might--because we are busy; because we allow ourselves to be distracted; because we don't take our children, parents, or spouse seriously; because we allow our prejudgments to distort our receiving; or because we want to help so much.

 

Watch Your Interpretations

It's important to realize that as listeners we always interpret what is said. That is, when we observe some behavior or action on the part of another, when we hear words being spoken, or get information by any of our senses, we always draw some conclusion about what was meant or intended, and make some interpretation of what we perceived. If our interpretation or conclusion is reasonably correct, our response probably will be reasonably appropriate. If, however, our conclusion is incorrect, or the meaning we make of the person's actions or words is different from what was intended, our response may not be appropriate. Since our interpretation is based on our values, beliefs, and experiences, it could be incorrect. The solution to this potential error is relatively simple. Get feedback; that is, check out your interpretation with the other person before responding or acting. It takes only a few seconds to ask "Do you mean...?" or to say, "Now I understood you to say..., is that correct?"

The following poem by an unknown author nicely summarizes some major points about stress communication:

 

LISTEN

When I ask you to listen to me and you start giving me advice, you have not done what I asked.

When I ask you to listen to me and you begin to tell me why I shouldn't feel that way, you are trampling on my feelings.

When I ask you to listen to me and you feel you have to do something to solve my problem, you have failed me, strange as that may seem.

Listen! All I asked was that you listen, not talk or nag--just hear me.

Advice is cheap: 50 cents will get you both Dear Abby and Billy Graham in the same newspaper.

And I can do for myself; I'm not helpless. Maybe discouraged and faltering, but not helpless.

 

 

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Helping Persons Cope With Change, Crisis, and Loss

Ronald L. Pitzer

It's natural to feel more or less inadequate when someone, perhaps a friend or relative, tells you their troubles. Actually, you often can be of real assistance perhaps far more than you think. Nonprofessionals (neighbors, friends, or relatives) who show warmth and common sense can be a wonderful help in many instances.

Following are some suggestions for helping persons close to you when they are temporarily upset or disoriented following a change, crisis, or loss in their lives.

Show By Words and Actions That You Care

Small, kind deeds and the expression of sincere feelings of affection, admiration, or concern for a troubled person mean a lot. Our society has been accused of a "taboo on tenderness." Simple, open affection and honest compliments embarrass some of us. It is well to remember, however, that a friendly arm around troubled shoulders, a few words of support and encouragement, or an opportunity for a long talk can help a lot. Let the person experience your warmth, concern, and availability.

Help the Person to Accept Help

One way people avoid facing a crisis is to deny they need help. Studies show that people who have difficulty working through a crisis or loss are inclined to brush off offers of assistance and persist in the fantasy that everything is all right. The person who acknowledges that he or she is in trouble, actively looks for help, and gratefully accepts it is on the way to a healthy solution of the crisis.

Help With Everyday Tasks

The notion that a person in trouble needs to be soothed and reassured is a misleading one. But the intuitive feeling that a person in trouble needs assistance with the small everyday tasks is right and sound. Examples are the neighbor who cooks dinner for a friend with an ill child, the husband or friend who puts the children to bed and does the dishes when a woman is mourning her father's death, the person who quietly assumes an extra amount of work when a co-worker is having trouble at home and the friend who takes care of a baby for an afternoon or evening. All are recognizing that a crisis disorganizes and disorients the energies that persons in trouble have for ordinary things because so much energy, if they are to survive the crisis, must go into recognition of the pain, grief or trouble. Especially if we can give this help without the suggestion that the person we are helping is so weak or incompetent as to require it, such simple kindness and thoughtfulness can be a real support.

Help the Person Confront the Crisis or Loss and "Talk It Out"

Discussing troubles has two chief values. It is a method of expressing emotions, and so often helps to get rid of their effects. Then, too, putting feelings into words can help a person to see the situation more objectively. Just knowing that someone is aware of our hurt feelings, worries, or difficult decisions and cares about us can mean a great deal. Burdens shared with a friend are often lighter to carry. As someone once said: "A joy shared is doubled, a sorrow shared is halved."

So help the troubled person talk about and realize the danger, the pain, the trouble, the feeling of loss, the real elements of the crisis. Help the person to speak of unspoken fears, to grieve, and even to cry.

Be a Good Listener

If the other person is to talk it out, you must be a good listener. Good listening encourages people to talk about their problems. Here are a few ways of listening to others:

  • Stop talking. You cannot listen while you are talking.
  • Try to put yourself in the other person's place. Trying to recall how you felt in similar circumstances or what you know of how others have been affected by similar circumstances may help. Don't, however, assume that the person's responses are or should be the same.
  • Show that you are paying attention.

    Relax physically; feel the presence of the chair as you are sitting on it. Let your posture be comfortable and your movements natural. For example, if you usually move and gesture a good deal, feel free to do so at this time.

    Initiate and maintain eye contact with the person. If you are going to listen to someone, look at him or her. A varied use of eye contact is most effective; staring fixedly or with undue intensity usually makes the person uneasy.

    Take your cues for response or action from what the person is saying. Don't jump from subject to subject or interrupt. If you can't think of anything to say, go back to something the person said earlier in the conversation and ask a question about that. There is no need to talk about yourself or your opinions.
  • To help the person begin, use "door openers--open-ended questions that allow the person to go into the subject at length.

"Tell me about it."

"Would you like to talk about it?"

"Let's discuss it."

"I'm listening."

"This seems really important to you."

  • Keep encouraging the person to talk. Here little things can make a big difference. Any one of these tend to keep the person talking, if you are sincerely interested and genuinely listening. Their rote repetition have no magical power.

Saying "Umm hmmm." Nodding.

"Oh?" "So?" "Then?" "And?"

The repetition of one or two key words:

"Tell me more."

"How did you feel about that?"

"What does that mean to you?"

  • Ask questions and listen to the answers. Especially try to find out how the person feels.
  • Don't guess what the person is going to say and answer that without really listening.
  • Check out what you understand the person to be saying to be sure you're getting their meaning. Repeat what you think the person said, asking if you are right: "Is this how you feel?" or "Is that it?"
  • Try to avoid judging the person. This can stop communication.

Don't Give the Troubled Person False Assurance

Persons in trouble desperately want to be reassured, and all our feelings urge us to give that reassurance. But the "there, there, everything will be all right" approach is not a help. It relegates them to the role of a child and makes them weaker, rather than stronger. It may actually be a disservice; everything may not be all right. The kind of reassurance that persons in grave difficulty need is not the meaningless comfort that the crisis will take care of itself but rather our statement of faith that they will be strong enough to work it out even if it is not all right. Let them know that you are available and would like to work with them in finding something that can help--preferably to help them help themselves. Lend a shoulder as an equal, instead of reassuring like a parent. This provides a more important kind of reassurance--the reassurance that you have faith in their ability to handle the crisis.

Don't Encourage Blaming Others

A typical stage of mourning is anger and a blaming of others for the condition or loss. Research has shown that persons who did not cope very successfully with their crisis had an overwhelming tendency to dwell on the people or things they imagined were responsible for their trouble. Blaming is a way of avoiding the truth, of looking at an ephemeral might-have-been instead of looking at the problem at hand. Don't encourage persons in trouble to speculate on the villains in the case with the idea that they will feel better if they can place the blame on someone for the trouble. Blaming may make it harder and less likely that they will come out of the crisis strengthened.

Encourage a Presentation of All the Facts and All Constructive Possibilities

Emotional tension can easily lead to misunderstanding and misinterpretation, so it is important that the facts be clear. It's amazing how often people make important decisions without taking time to ascertain all the facts and to look into all the options. Ask the person to tell you about the change, crisis, or loss--when it started, how it occurred or developed, what consequences have resulted, how it has affected them, how they feel about it.

Following are some specific steps you may want to use to guide troubled persons:

  • Help them sort out the pieces of the problem they are facing.
  • Help them separate those parts about which they can do something from those about which they can do nothing; there's no use wasting energy on the latter.
  • Encourage them to describe what they have tried; there's no use repeating things that haven't worked.
  • Encourage them to describe or discover other posssible solutions: "How else might this problem be settled?"; "What other approaches are there?"; "What other information is needed before a wise decision can be made?"
  • Help them examine each of these in terms of their probable consequences--"What will probably happen if you...?"
  • Help them to decide which of the various alternatives they want to try now.

Encourage the Person to Focus on the Practical Future

This is much healthier than dwelling on past wrongs and mistakes. Granted, spouses, neighbors, children, and relatives do make minor as well as major mistakes. Outside events may also cause injustices, inconvenience, and discomfort. A woman miscarries. A loved one dies. A man loses his job. A child fails in school. A family has to move. Bemoaning misfortunes does not help to build a better future. Heaping blame on other people or on fate may lessen willingness to accept responsibility for current actions and may prevent persons from doing the best they can to cope.

Naturally, you do not want to criticize those you are trying to help--they may interpret criticism as blanket rejection. Instead, aim at guiding them gently by showing your interest, attention, and sympathy when they begin to talk about what they are going to do now to solve or at least lessen present problems. If the person does not voluntarily indicate such intentions, you may--again, gently--want to raise some question such as, "All right, what can you do about this matter?"

Some steps in this process probably include the following:

  • Encourage them to plan just how they will begin doing what they have decided to do; the plan should be realistic, with achievable goals.
  • Encourage them to commit themselves to doing this, beginning soon and at an agreed-upon time.
  • If they resist beginning to act on the problem, help them discuss and resolve these feelings.
  • Point out that as they begin to do something, however small, about the situation, they'll probably start to feel better--less depressed, more hopeful.
  • Have them phone you to let you know how the action plan worked or make a date to see them again soon.
  • Help them find the resources to cope--spiritual, interpersonal, inner.
  • In subsequent contacts, have them describe what happened, affirm them for successes in implementing the action plan (however small these successes), help them rethink their action goals (what's the next step?), and repeat those parts which are necessary to help them continue coping.

Encourage Sensible Health Habits

The body influences emotions and mental functions. People are particularly likely to be upset when they are hungry or overtired. You might remind a troubled friend that when problems seem insoluble, new perspectives sometimes are gained simply by a good night's sleep and well balanced wholesome meals. Encourage some form of exercise to the point of fatigue. Walking is a great tension reliever!

Respect Privacy

When persons are upset they may tell intimate secrets. Later they may be sorry they talked so freely. If you are listening to a friend's troubles, try not to lead her or him into revealing information they may later regret.

lf your friends and relatives do mention an act that is usually condemned, try especially hard to show that you are for them as precious human beings regardless of their past actions. The value of every human person, no matter how they have acted, is basic to the philosophy of giving help to others.

Resist any temptation to pass on confidences that have come from intimate conversations. Persons who confide in you can be comfortable with aid received only if they feel sure their privacy will be respected. If you violate this confidence, they are almost certain to eventually learn of it and any trust that has developed will be lost. Similarly, sharing with them conversations others have confided in you will suggest that you will do the same with their confidences.

Know Your Limitations

Serious problems need professional and experienced help. Individual counseling by a psychiatrist, family service agency, mental health or human development center, clinical psychologist, or accredited marriage counselor can often supply the help needed. Group help from psychotherapy groups or Alcoholics Anonymous also meets the needs of many. If you become involved with someone who you think may need more help than you can provide, you will probably want to scout around for possible referrals.

Most everyday human troubles, however, are not serious enough to need this kind of assistance. A wise, warm, kindhearted spouse, parent, or friend can do much to ease the emotional distress that comes from the worries, disappointments, and conflicts of life.

If enough of us are aware of these ways in which we can help each other in times of trouble, more and more people can be assisted in working through the inevitable life hazards that confront us all.

As Harvard psychologist Gerald Caplan says, "It is remarkable to see the power that ordinary people have to adapt to reality, however unpleasant. They have a great deal more strength than we often give them credit for. Unassisted, in a time of crisis, this strength may fail them. But if we recognize it and build it up, we can help each other through times of trouble."

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Helpful Hints for Reducing Family Stress

Anyone who's been to the mall recently knows there's a lot of stress on families these days. Parents are under strain from working long hours on top of their other responsibilities and kids are overloaded with school and extra curricular activities. There isn't enough time to get everything done, let alone occasions for relaxing and spending time together as a family.

Stress at home can affect job and school performance, which in turn causes more stress. For this reason and many others, maintaining a stress-free home environment is very important.

"The home should be a place for families to relax, recharge and rejuvenate," says Todd Imholte, president of Environmental Graphics, a Minneapolis company that offers interior wall murals designed to create a soothing home environment.

Is your family under too much stress? Here are some signs that you may be doing too much, compiled by ourfamilyplace.com:

  1. Cleaning up the dining area means getting the fast food bags out of the back seat of your car.
  2. You refer to your dining room table as the flat filing cabinet.
  3. Your grocery list has been on your refrigerator so long some of the products don't even exist any more.
  4. Your idea of being organized is multiple colored post-it notes.
  5. You get all excited when it's Saturday and you can wear sweats to work.
  6. You know the people at the airports better than you know your next door neighbors.
  7. You think a "half-day" means leaving at 5 o'clock.

So how can families reduce the stress in their lives, and make sure that life at home is pleasant? Here are some suggestions with help from plainsense.com:

  • Don't think that you are alone in having to deal with family stress; millions of others are in the same situation. It's the ability to handle stress rather than suppress it that is important.
  • Create a peaceful home environment. One way to easily and economically achieve a calming effect in a room is with wall murals. Minnesota-based Environmental Graphics offers more than 20 full color wall murals that feature such soothing subjects as "Oriental Garden," "Lake in the Woods," "Daydreaming," and "Dolphins Paradise."
  • When problems begin to arise, take the time to discuss them as a family. Avoiding something usually serves to intensify it. Once an issue has been discussed everyone can move on.
  • Get the whole family involved in doing work around the house. Even younger children can help if they are given a task that is age appropriate. Mom and Dad shouldn't have to do everything themselves.
  • Leave work at work. Set aside some time when your only focus is on family activities.
  • Keep things in perspective. Put your energy toward those tasks or activities that bring the most benefits and eliminate the rest.

http://www.mental-health-matters.com/articles/print.php?artID=422

                                                                                                                                                                                                                                                                                               

Resilience, Parenting Techniques & Discipline

Why are children so different? Because each has his or her own temperament! This accounts for why infants and children need to be raised in different ways. Parenting methods and techniques must be compatible with their personalities.

Researchers have long wondered why some children with very supportive and nuturing homes still have done poorly, while some from cold and barren home environments have excelled. Part of the answer is that infants are born with differing levels of resilience in their personalities. Another part of the answer is the 'goodness of fit' between the child's individual behavior and the way they are reared. Generally the better the "fit," the better the results.

Temperament is important in parenting in 1) knowing the proper parenting techniques and how to discipline, and, 2) how it affects the parent's view of the child and themselves as parents. Both of these dimensions are critical in determining how the parent-child relationship evolves over time.

First, since parents can't change or determine the child's temperamental style, parenting needs to be molded around the child's temperament. Parents who try to make the child fit their concept of the 'perfect child' usually end up feeling very frustrated. A better approach is to observe and learn about the infant's behavioral style and then change the way the parent reacts to the situation.

Temperamental characteristics can be very positive in some situations and challenging in others. Only by sensitizing themselves to the infant's personality can parents learn how to respond to in a helpful way. Most parents learn this through a period of trial and error but when conflict continues to increase rather than resolve itself, or when it appears unexpectedly, assistance may be welcome.

Key points:

1) Do not punish the child for temperamental style. If a child is shy, she should not be reprimanded for being hesitant toward a stanger. If the child adapts gradually, she shouldn't be punished for not obeying completely if her response is better than last time (moving in the right direction). If the child is intense she shouldn't be criticized for being loud when she feels upset, just as she isn't punished for being loud when she is happy. If a child is irregular, she shouldn't be punished for not being hungry at every meal or not ready to sleep at every bed time.

2) Notice the times when things are going well. How are you reacting at the times when you and she are feeling good about each other? There are clues there about what the infant or child needs.

3) Recognize and accept the way the infant really is. If parenting is stressful and your infant doesn't act like the one next door, she may be 'spirited' and need specialized parenting techniques. You may need to learn more about how to parent a spirited child than the parent next door.

4) Recognize your feelings toward the child. It can be isolating to feel that you are frustrated rather than fulfilled as a parent, that you are stressed by parenting rather than energized by it and that you sometimes wish that your child were different. Lots of other parents have these feelings. Find a way to discuss these feelings honestly. It will probably benefit your child also, if you do.

Resources for dealing with a spirited child at this website include suggested readings, temperament counselors, temperament assessment and links to discussion groups, chats, and other parenting sites.

 

                                                                                                                                                           

 

What Is Traumatic Stress?

Traumatic stress

Traumatic events are shocking and emotionally overwhelming. People who experience or witness them may have reactions of intense fear, horror, or helplessness. These events might involve actual or threatened death, serious injury, or sexual or other physical assault. They can be one-time occurrences, such as a motor vehicle or airplane accident, natural disaster, house fire, or violent crime, or they can be repeated and ongoing, as is often the case in child abuse and neglect, other forms of domestic violence, and combat. Unfortunately, traumatic events are quite common. In the United States, over two-thirds of the population has experienced at least one traumatic event and most of those individuals will experience more than one.

Reactions to traumatic events vary considerably, ranging from relatively mild, creating minor disruptions in the person's life, to severe and debilitating. It is very common for people to experience anxiety, fear, shock, and upset, as well as emotional numbness and personal or social disconnection. People often cannot remember significant parts of what happened, yet may be plagued by fragments of memories that return in physical and psychological flashbacks. Nightmares of the trauma are common, as are depression, irritability, sleep disturbance, dissociation, and feeling jumpy.

Some of the problems people encounter after a traumatic incident are part of the diagnosis of acute stress disorder (ASD). ASD describes experiences of dissociation (e.g., feelings of unreality or disconnection), intrusive thoughts and images, efforts to avoid reminders of the traumatic experiences, and anxiety that may occur in the month following the event. When these experiences last more than a month, they are described by the diagnosis of post-traumatic stress disorder (PTSD).

Other equally uncomfortable problems or symptoms may exist with or instead of PTSD. For example, a traumatic event often challenges the person's sense of personal safety and control, leaving him or her feeling less secure, more vulnerable, and personally changed. Physical health may suffer as well, and individuals may notice increased feelings of fatigue, headaches, and other physical symptoms. Many people traumatized in childhood also experience revictimization (being harmed again) or aggression, identity disturbance (a feeling that you don't know who you are), bodily problems such as illnesses or aches and pains without detectable physical cause (somatization), difficulty staying on an even keel emotionally, and relationship problems.

How to decide whether you need help

People who have had traumatic life experiences cope the best way they can with the memories and painful effects. For many people, reactions gradually diminish over time. Some find it helpful to talk about what happened and their feelings, to get support from people who can be trusted, or to be involved in other activities that help them to reconnect with people and find meaning in their lives. But for some people, the symptoms and disturbing reactions persist or even worsen. This can lead people to find ways to cope that are not so helpful, such as withdrawing from friends and family, using drugs or alcohol, or avoiding activities that are empowering. It is important to consider seeking help if important areas of life, such as relationships, work, or school, are being affected by traumatic stress. Likewise, people who become more and more depressed or anxious or for whom the use of alcohol or other drugs increases significantly may need treatment.

Treatment options

There are many types of treatment for traumatic stress. Research supports the effectiveness of medication, anxiety management, cognitive therapy (focusing on thoughts and beliefs), and exposure therapy (helping the person confront painful memories and situations that are realistically safe although still frightening, through talking about or imagining them) for reducing PTSD and related symptoms. Interpersonal, relational, or psychodynamic psychotherapies, which focus on the meaning of the event and how the experience has affected relationships, may also help people understand the source of their current problems and how these relate to their traumatic experiences. A combination of psychotherapy and medication is often helpful for depression and anxiety following traumatic experiences.

No single treatment is effective for everyone, and it may take time, as well as trial and error, to find the right treatment. There are also likely to be difficult periods in any treatment. Therefore it is important to find a trained psychotherapist or physician, preferably one with experience treating people with traumatic stress, who can collaborate with the survivor to find a treatment approach that makes sense for the individual.

 

                                                                                                                                                           

 

Questions for Discussion

 

1.         Describe some of the ways in which stress is detrimental to children.

2.         How could parents help their children to relieve their stress and increase their resilience.

3.         How could the Herring family have increased their resilience?

4.         How can families help to reduce family stress?

5.         How can family members avoid misinterpretation in family communication?

6.         In what ways do children misinterpret or misunderstand divorce?

 

 

Key Concepts

 

Resilience

Stress

Family support

Family communication