If you are reading this, more than likely you are unhappy or surprised by the election. As the election approached, I had more conversations with families about some of the statements and actions by the candidate Donald Trump. There was comfort in suggesting that people have a choice and that his behavior will not be championed by the people.  

Fast forward to earlier this week and that line went right out the window. It's now President-elect Donald Trump. The phone calls and comments were rapid. Parents and kids were processing the unimaginable for them.

“How do I tell my kids that he got elected?”

“I've always been taught to be nice and not be a bully, but he was, and now he is president.”

“Kids at school are saying I have to leave.”

That's what is in the pit of your stomach, the idea that everything you have been trying to teach your child has been destroyed in a day. The idea that love and kindness can overcome anything. It feels like these truths, that you hold to be self-evident, no longer apply. It's a scary time for many.

So let's take a moment and get familiar with some simple ways to protect and strengthen your children (and you) during the transition to a new president.

Take care of you.

It's difficult to be a good and effective parent if you are in an unhealthy state of mind. Recognize that your child may be reacting to what's happening in the world, but they are also reacting to how you are handling your anxiety and feelings. Do your best to speak with your child in a calm, warm, and collected voice. Engage in self-care activities if you find yourself feeling anxious or overwhelmed. What helps you manage your stress? Deep breaths, exercise, a good book, family, friends, writing, praying, music?

Take care of them.

Everyone wants to feel safe, especially children. Reassure your child that everything will be okay (even if you believe it won't be okay). Let them know that they can express their feelings and you are there to listen. Help them name all the great people in their lives, all the people (and God?) that love them and will keep them safe. Let them know that even though he won the election, more people voted against him and that means there are so many people out there that feel how you feel. You are not alone. 

Let the feelings flow, yours and theirs.

Feelings are real. You don't have to pretend to be a robot. Empathize with your child and even share that you have some or all of the same feelings of fear, uncertainty, anger, sadness, etc. Find the balance. With all of the negative feelings, let the positive feelings flow as well. Reassurance, love, togetherness, strength. The goal of processing any experience is not to avoid your feelings, but to feel them fully in a balanced and healthy manner.

Model a healthy attitude and coping strategies for your child. Show them how you are dealing with your emotions in a healthy manner, and they are more likely to follow. 

Perceived failure is a teaching opportunity.

You feel like you failed. You worked hard to teach your child prosocial behaviors, and how Trump's behavior in the last many months was mean and hateful. Then he wins. Take a step back and recognize this is a moment and not forever. This perceived failure is a chance to have an important teachable moment. Build resilience in your child by emphasizing the importance to keep doing good, to treat others with respect and kindness, even when it seems things are not going your way. To do or say what's right, even in the face of what's wrong. Parents have to think long-term in that you are providing a lesson for your child for the present and the future.

Empathize with Trump supporters.

You read that correctly. In your mind it's unfathomable that someone would vote for him. It just makes no sense to you. Step out of your shoes  and try to understand why tens of millions did. Do you really think it was because they are all racists? Maybe. But you have to recognize there are other reasons. Remember, you are explaining this to your child. Keep it simple and talk about how some people didn't agree with what Hillary Clinton believed or some people voted from Donald Trump for other reasons even though he said hurtful and mean things. Remember, empathy doesn't mean agreement, it's purpose is to increase understanding and awareness.

Character building.

This is the perfect time to build character and self-esteem in your child. This is the time for you and your child to be the authentic you. To have your child celebrate their uniqueness and their strengths. To say it's okay to be scared, unsure, and anxious, yet continue to enjoy the things that you do, go where you always go, and if something happens (which it probably won't), you will handle it because you are strong and can get through anything together. Build character and your child will grow in confidence and strength.

Stay aware and safe.

The reality is you can only control what you say or do. If you are concerned about your safety or others, be aware of your surroundings. Travel in groups, especially in the evening. Ask a trusted classmate to walk with you to a safe destination. Individuals, especially males, need to rise to the occasion and be available to escort anyone who feels unsafe. Know that social media has given anyone a platform to be hateful and most limit their actions to a comments section. With that said, take precautions.

There are apps, like Companion, Family Locator, and bSafe, that can allow for trusted people you select to know the location of you or your child during a walk. If you have to walk alone, stay on the phone until you reach your destination. Speak with schools, universities, and the local community about safe escorts as this service is beginning to be offered widely.

Co-create a plan.

Help your child process feelings, but then make a plan. Co-create a plan for your child that includes how to manage feelings but also how to better oneself and society. Actively engaging in a plan can extinguish feelings of hopelessness and powerlessness, replacing them with feelings of agency and a sense of control, direction, and empowerment. Praise your child for attempting to turn a negative into a positive and how life has ups and downs, but they are doing a great job navigating this challenge. A plan is a blueprint and recognize that it may work great, but sometimes the plan may have to be revisited and adjusted.

Take your power back.

Why are you giving your power to this election? The idea that everything is over and nothing can be done. In the last election, did you give your power to President Obama and stop working, stop growing, stop striving for success? I hope not. Again, feel your feelings, but don't give away your power. Listening is power. Finding support in one another is power. Organizing is power. America is still America. It's progressing, and with progress are setbacks. Debate the size of this setback if that's a part of your process of moving forward. Take the steps above and recognize that you control your daily experience, and that can mean the world to your child.



As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

A preteen said something I felt needed to be shared. Before doing so, this individual and guardian gave permission to share the thoughts publicly. For clarity, I ask permission to share conversations from both families I work and ones I interact with outside of work. This post was approved by both the preteen and guardian.

For perspective, the conversation was in the context of healthy relationships and how to make “real” friends.

Preteen: Sometimes I feel that it's not even a kid problem, it's a parent problem.

Me: What do you mean?

Preteen: Well, most kids are nice, they just want to have fun and do fun things. Sometimes it's the parents who put kids into categories...cool, smart, jocks, nerds, weirdos.

I just wish parents would understand that some kids are unique and weird because that's how they are, but then some kids are weird because stuff happened to them in their lives. Bad stuff. Stuff that shouldn't have happened to anyone, especially a kid. And sometimes a kid doesn't realize that they are being weird, it's just who they are.

These kids are working on not letting the bad stuff be in their head every day, all the time. Maybe not paying attention to a conversation is a way to be less scared and anxious, or maybe being too excited to see someone isn't awkward, maybe it's happiness of having a friend.

I'm not usually bothered when a kid is mean to me because they're a kid, they don't understand. What hurts is when a parent treats me like there's something wrong with me, like I'm broken. Parents are adults, and adults are supposed to be smarter than kids. Shouldn't they know that if a kid is a little different, that maybe there is a reason for that? So maybe instead of looking at me like I'm from a different planet, they could maybe think about why I am the way that I am. There is a reason.

When bad things have happened in your life, you just want to be cared about. You want the bad to stop and just be okay. I don't wake up with the goal of making people uncomfortable. But when you can't remember feeling normal, how do you know how to be normal?

If you could do something for me, that would be great. When you talk to parents or adults, could you ask them to care about all kids, not just their kid? Tell them that they may think other kids don't notice or can't hear them, but kids notice way more than adults think they do.

I just want to know that it's okay to be me.

I wanted to share this because I felt it really portrayed how impressionable kids are, especially to adults. Unfortunately this isn't the first time I've heard kids share sentiments similar to what was expressed above. Even if in passing, kids pick up on body language, cues, facial expressions. So be an adult. Even if a kid is different, unique, or even odd, be polite and care. A simple smile or hi-5 can make someone who feels weird, feel “normal”.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

I've written about relationships over the last few years, ranging from parenting, friendships, marriage, and even your relationship with food. Let's shift to how to overcome a break in trust. The break in trust might be infidelity, habitual lying, or omissions of the truth. The key here is you actually have to rebuild that trust, it's a process. It will take time. Here is a step-by-step process of how to regain the trust in your relationship.

1) Define trust. Let's start with the basics. What does trust mean to you personally? What does it mean in a relationship? Trust is one of those words, like love, that is easier to identify than conceptualize. If you don't know what something is, how can you fix it?

2) Own your role. When trust is broken, both individuals bear some responsibility. What was yours? Each person is responsible for their own behavior, but behavior does not exist in a vacuum. Try to understand each other's behavior from both your perspective and theirs.

3) Radical honesty. Lies, dishonesty, and deception have jeopardized your relationship. Your relationship is surrounded with pain, hurt, anger, confusion, and loss. To rebuild your relationship, this is the time to be completely honest and open. Allow each other access to phones, accounts, or whichever platform was used in the trust-breaking behaviors. If you're going to be late, let your partner know ahead of time.

Hiding the truth or sharing partial truths is attractive, especially when you are trying to spare the other person's feelings or not make things worse. However, this choice makes the situation worse over time. Put everything on the table. In my couples work, both individuals are usually relieved when the complete truth is revealed. Yes, it is painful but it's more painful to think someone is being honest and finding out that they are not.

4) Empathize. This is a tough one, especially when you are feeling (and rightfully so) hurt and angry. Empathy (lack of) probably played a role in the breaking of trust, so it has to be a part of the healing process. Learn about what role empathy has played in your relationship and your daily life. Confide in each other what empathy looks and feels like to you.

5) Contextualize the origin. Breaks in trust don't just happen. When you find out about the distrust and deception it can feel like a surprise, but usually there is a trail that's much easier to see after the fact. Spend time reflecting on where things went wrong, how they went wrong, and what was your role in the process. What was happening in your relationship during this time? Were there historical signs that were ignored or downplayed?

6) Co-create a plan. Building trust is a two-way street. The relationship can't survive if it's based on one person's beliefs, rules, and demands. Sit down together and prepare for a long, honest conversation. When trust is broken, usually one person feels they have made most or all of the bad decisions. In therapy, I've seen that person surrender their rights and voice out of shame, guilt, and desperation. What I find is that seemingly selfless gesture can quickly turn into resentment and anger.

Sitting down and co-creating a plan accomplishes a few things. First, it provides balance to the plan. Each person has input and a voice. Second, it's a good step in regaining trust in that you're both working together on a plan for your relationship. Lastly, you are building confidence in yourself, the other, and the relationship as you work together.

It's not easy, and there will be bumps in the road. But a plan with both people participating will have a better chance of success than a plan where one person makes all the decisions.

7) Separate the past from the present. Focus on the present. That doesn't mean forget what has happened and all is forgiven. Certainly reflect on the past (as stated above) but don't relive the past in the present. This is very easy to say and much more difficult to live. After all, you are a human being with feelings and thoughts.

Part of your plan should include what to do when you are having a difficult time of letting go of the past. The plan might involve participating in your own therapy so you have a place to learn and process past events and feelings in a healthy way.

8) Hold each other accountable. Check in with each other regularly, and not only about the negative. If you've followed the earlier steps, then you should have a sense of what you need to hold each other accountable. Accountability doesn't mean being the relationship police and pointing out violations or the breaking of rules, it means reminding one another of promises and supporting and praising one another for progress.

9) Actions speak louder than words. Usually when trust is broken, actions carry much more weight than words. It's only natural to want to see change and progress, not just hear about it. That's the reality of the situation. The rebuilding of the relationship has to be visual.

It's important to know that even with actions, there will be mistakes and setbacks. It may feel hopeless when the relationship takes one (or two or three) steps back but look at the intent of the behavior. Even if the result was a negative, was the intent a positive?

10) It's okay to seek support. I hope these suggestions seem straightforward and maybe even simple. Usually what happens is the steps become more complex and challenging as you attempt each. If that's the case, then seek professional services if you feel it would be helpful. Whether a psychologist, trusted community member, or family member, sometimes the experience and perspective of another can help a relationship get back on its feet.



As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

I have been experiencing panic attacks lately and they are getting worse. How do I stop these attacks?

--Anonymous January 2015

Anxiety disorders are the most common mental health issue in the U.S. When anxiety becomes unmanageable and unpredictable, panic attacks can develop. If you're suffering from panic attacks, you may feel alone in your struggle. Panic attacks are not uncommon as approximately 6 million Americans are afflicted with Panic Disorder at any given time with women being almost 3 times more likely to develop this disorder compared to men.

I tell patients three things when they first process their panic experiences:

1) No one has ever died from a panic attack, ever. Yes, you may have difficulty breathing, a rapid heartbeat, and even thoughts of dying, but no one has ever died from a panic attack.

2) Anxiety and panic disorders are highly treatable with many effective strategies.

3) You are already getting better as you've begun the process of talking about and mastering your anxiety.

At the root of a panic attack is anxiety. Instead of a consistent and expected level of anxiety, panic attacks are marked by extreme and quick waves of anxiety that manifest as fear or discomfort. Other symptoms include (from the DSM-V):

palpitations, pounding heart, or accelerated heart rate
sweating
trembling or shaking
sensations of shortness of breath or something
feeling of choking
chest pain or discomfort
nausea or abdominal distress/pain
dizziness, lightheaded, or faint
fear of losing control
fear of dying
paresthesias (numbness or tingling sensations)
chills or hot flashes

Panic attacks are like an emotional tsunami. A wave of discomfort or force that you want to stop but you can't. The more intense it feels, the more severe the panic. This emotional wave happens quickly, usually within 5 or 10 minutes. Sometimes it ends just as quickly or the panic feeling can last for a few hours. The good news is you can intervene with some fairly straightforward strategies to decrease the duration and frequency of panic attacks.

Strategies To Decrease And Extinguish Panic Attacks

1) Study your anxiety. Why are the attacks happening now? What's changed in your life? Are the attacks worse during certain days or times? Which of the previously mentioned symptoms are present before, during, and after your attack(s)? 

When suffering from a panic attack, the instinctual response is to end the anxiety, to run from the anxiety. Unfortunately, trying to avoid the anxiety usually makes the anxiety worse. You start to become anxious about being anxious. Get to know your anxiety. Study it.

2) Pay attention to your body. Your body is always talking to you, always. Whether you are hurt, hungry, tired, happy, or anxious, your body is sending you signals. The question is are you paying attention? 

Check in with your body throughout the day, anxious or not. Where is your stress level at the time? Your anxiety level? You will quickly learn that your body responds in certain ways to stress and emotions. This will help you become more aware of when you are feeling anxious or when a panic attack may be emerging.

3) Reflect on how you manage stress. What's helpful? What isn't? What's happening right before the panic attack? Reflecting on the efficacy of your coping skills accomplishes a couple of things: 1) increases your awareness of what is stressful in your life, and 2) increases your understanding of how stress affects you physically and emotionally. The greater your awareness, the greater your belief and confidence that you can manage stress and anxiety.

4) Be proactive. Usually the first panic attack is dismissed. Often it is followed by a second attack at some point and hope that it doesn't happen again. After the third one, the panic and fear of more attacks sets in with frequent thoughts of when, where, and what time the next attack may reoccur.

When someone seeks services for a panic attack, it's usually to make the attacks stop, but also how to stop them when they start. The key is to manage your anxiety before signs of a panic attack. Even the best psychologist can't say or do something in the middle of a panic attack that will make it stop immediately. If you intervene before the anxiety becomes overwhelming, you'll have a better chance of managing your anxiety.

Think of stress management techniques not only for moments of tension and crisis, but also for when you're feeling relaxed or happy. It's a great way to train your mind and body to easily return to a relaxed state. Utilizing stress management techniques on a regular basis keeps your anxiety at a minimal level. Usually a person's anxiety is already elevated before a panic attack. Even though it feels like it, panic attacks don't appear from nowhere. There are signs that are going unnoticed.

5) Mindfulness. I've really incorporated mindfulness into my life and therapy practice in the last couple of years. Mindfulness is simply being in the present. It's been shown to be very effective in treating anxiety, especially anxiety marked by worrisome and fearful thoughts. 

People suffering from panic attacks usually report extreme thoughts during and after the attack (thoughts of helplessness, death, hopelessness, etc.). Mindfulness helps with accepting your experience but stopping your mind from going to extremes.

Mindfulness techniques can be performed in any setting and for any amount of time. Whether in a therapy office, at your home, in a plane, or in the checkout line at the grocery store. The exercise can be 45 minutes or 45 seconds. Mindfulness is an incredibly powerful tool that can be change your mindset in an instant.

6) Laugh. Are you laughing enough? I'm being serious. Laughter has a positive impact on your mood and can instantly relieve stress and anxiety. I'm not saying tell jokes in an attempt to avoid a panic attack, but make sure you laugh on a regular basis. In essence, stay connected with friends and loved ones, even if your anxiety says to withdraw and isolate.

If you follow these steps, you will have success. This doesn't mean the panic attacks will go away immediately. You may have success and then have a panic attack days or weeks later. That's not failure, it's a moment to reflect on what was going right and wrong. Don't give up. Stay consistent. You'll see progress.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

Over half of American kids have tried a drug by the end of their teenage years. That percentage drops to less than 20% when describing those who use drugs on a regular basis. In 2002, a survey conducted by CASA found that 46% of students at public schools and 24% of students at private schools reported drug use at their school. In 2012, those numbers rose to 61% for public school and 54% for private school.

We have a solid understanding of why teens try drugs. They try because of curiosity, peer pressure, rebellion, independence and boredom to name a few.

But why do teens use drugs? Why do drugs become an integral part of their life?

In working with teens, they have confirmed a couple of national statistics. The vast majority are introduced to drugs by peers, marijuana is usually the first drug used, and almost all know someone who abuses drugs regularly.

So why do teens use drugs?

Part of therapy is helping people gain insight and awareness into their behavior. Whether the behavior is healthy or unhealthy, positive or negative, I work with each person to critically think about what benefit they are receiving from the behavior. It may sound odd to consider negative behaviors as beneficial, but they are being repeated for a reason, even drug use.

I get the same answer, over and over, from teens. They use drugs because it numbs the emotional pain in their life. Drugs make problems and emotions go away. I've yet to work with a happy-go-lucky teen who uses drugs. I've yet to work with a drug-using teen who doesn't have deeper issues that have been years in the making.

My approach in therapy to helping teens understand their drug use revolves around three issues: attachment, life experiences, and coping capacity.

Attachment.

I'm embarrassed that I have written so little on such an important topic. Attachment is the foundation of human development. Attachment refers to the emotional bond or connection one human being has with another. This process starts at birth. When a healthy attachment is formed, the result is a person who feels safe, secure, curious, and confident.

So what does infant attachment have to do with teens and drug use? Glad you asked. Longitudinal studies have found that teens with healthy attachments are less likely to engage in risky sexual behavior, excessive drinking, and drug abuse. Teens with healthy attachments feel loved, manage stress more effectively, and are less likely to be influenced to partake in negative behaviors. Teens with unhealthy attachments tend to be more anxious and withdrawn, as well as experience more trauma in their lives.

Life experiences.

Every teen with a drug issue that I've worked with has trauma in their past. Not necessarily traditional trauma (assault, death of loved one, abuse, etc.), but attachment trauma. Amongst many, a common life theme teens report is parental conflict. “My parents don't like or have time for me,” or even “My parents hate me, they wish I was never born.” Some teens draw these conclusions on their own, but parents have said these things to their children.

I know people reading are probably mortified by these statements but it happens regularly. Be careful what you say and don't be afraid to apologize. Everyone has said something they regret. Mistakes happen but make sure you repair the damage. Teens may seem distant, insensitive and self-centered, but they are still profoundly impacted by words. So imagine having an unhealthy attachment (feeling insecure, unloved, neglected) and then add negative life experiences.

Coping capacity.

I mentioned earlier how an unhealthy attachment is marked by an inability to manage stress, feelings of worthlessness, and poor self-esteem. I am regularly surprised by how many teens have difficulty giving examples of how they positively handle life stress. Part of my work is starting with the basics of coping.

Drug use is a coping mechanism. Drug use may seem like deviant behavior, but it's more about filling a void and numbing emotions. Increasing a teens coping capacity to include positive coping skills will give the teen more confidence to lean on those positive strategies instead of holding on to drug abuse.

You may feel my approach in this post isn't harsh or critical enough toward teens and illegal behavior. I know for parents a drug-abusing teen can cause anxiety, extreme stress, and even marital discord. With that said, I believe it's time to start thinking of teen drug use as a symbol of personal struggle and inadequacy instead of rebellion and deviance.

I felt ambivalent about posting this during a holiday week when most are in a celebratory state of mind. However, if you find yourself thinking, “What went wrong with my child, friend, sibling?” or you're feeling confused on how to help, I hope this post was helpful.

Reflect on the themes of attachment, life experiences, and coping capacity of the person on your mind. Also, parents and families will have more time with their kids this time of year. It might be a great time to emotionally connect with your child to strengthen that attachment.



As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

Before discussing tantrums and children, adults throw temper tantrums. All the time. We just label it differently. If everyone is honest, you'll be able to think about a time (or many) when you threw a tantrum when not getting your way. 

With that said, lets stick to kids for now. In working with families, the parent(s) usually states there is almost nothing that is effective in stopping a tantrum. That's actually true. Just like adults, when a child is in the middle of a tantrum, there isn't a magic word, machine, or potion that can stop a tantrum dead in its tracks. There are, however, a number of strategies you can use to stop tantrums before they start or minimize the duration and intensity of tantrums.

Developmental psychology. Know your child's developmental stage. Sometimes our children can be so impressive: sharing without asking, unannounced hugs, being a great helper. With that, kids are still kids. Tantrums usually happen because children don't yet have the capacity to manage their feelings in an appropriate way. This is especially true for kids under the age of 5. Even though it may feel that way, tantrums don't happen because kids just feel like being difficult.

Keep your composure. The automatic reaction is to stop the meltdown as quickly as possible. Sometimes that results in impulsive decisions, by the adult. Keep a level head and calm by understanding that tantrums are a normal part of child development. Presenting as a calm and steady force can actually deescalate your child and shorten the duration of the tantrum.

Let it happen. Once a tantrum has started, let it happen. Sometimes that might be 30 minutes or 3 hours of screaming. If you're in a public place, remove yourself and your child from that area. That doesn't mean you have to leave the mall, but be prepared to ask the waiter to pack your meal or to leave your grocery cart in the middle of an aisle.

The ABC's. Antecedents, behaviors, and consequences. Most parents initially say the tantrum came from such a small request or even out of nowhere. That's possible, but in my experience, when a parent reflects on an situation there are usually antecedents to the tantrum. 

As for the consequence, be thoughtful and not reactionary. Don't pile on consequences when a child is in the middle of a tantrum. That approach usually exacerbates the tantrum as your child is not in an emotional or psychological state to gain composure and instantly change behavior.

Play detective. Reflect on what happened before the tantrum, those antecedents. Was your child tired, hungry, sad, anxious? Was he already having a bad day? Is he sick? Does your child do well with a shift in plans or do they like routine and predictability? You may have a fun, surprise activity in mind, but if your child likes routine, don't be surprised if they say no or aren't excited.

Attention. A common theme in families is children will learn that they get mom and/or dad's attention by acting out in the form of a tantrum. It's the same concept as when a parent says, “the only way someone listens is if I yell.” Parents feel in order to get kids to behave or obey, they have to yell. Sometimes kids learn in order to get a parent's attention, they have to kick, scream, and act out. You see the same dynamic in teenagers and even in marriages and other relationships. 

Set your child up for success. What is going to increase the chance of success in a situation? If your child can't swim, are you going to get mad if they don't jump into the deep end of the pool? So if you are pushing your child through their nap or past their bedtime or comfort zone, recognize that you are increasing the possibility of a meltdown. 

If your child likes structure and predictability, tell them there may be a surprise after school on the morning ride to school. Give them the option of doing this fun, unplanned activity or keeping their schedule. If your child is breaking a rule, instead of instantly punishing them, let them know what will happen if they do it again. If they do it again, follow through on the action you said would happen.

Return to the scene of the crime. The purpose of this is not to show the child the damage or mess they caused to shame them. The idea is to reflect with your child on what happened for both parties to better understand the situation to minimize the chance it happens again.

When you revisit the tantrum, wait until your child is calm and mentally available to talk about what happened. If they are still upset, revisiting won't be very effective. If they are in a positive mental space, they'll be able to have a dialogue about what happened. They may even provide answers and ideas to what you can do differently when this situation arises again (and it will). 

Revisiting and having a healthy conversation shows your child that something bad can happen but you can still talk about and learn from it. This is an incredibly important part of the process. Many times, parents don't revisit the tantrum because they feel it is obvious that the child overreacted. However, it may not be obvious to the child. Your child might be thinking it should be obvious to you what you did wrong. Revisiting strengthens your relationship, especially if you allow your child to express their feelings on the situation. 


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!

Ask someone about what makes a relationship strong, and you'll get responses that include trust, honesty, communication or a mix of all three. Trust is a requirement for a healthy relationship. But what happens when that trust is broken? Here are some tips to consider to rebuild the trust in your relationship,

Acknowledge the process will be difficult. Rebuilding trust is a complex and difficult task. Accept that there will be progress and setbacks, it will be time-consuming, and that the relationship may not survive. 
 
Reflect on how trust was broken. In order to fix something, you have to know why and how it broke. Every relationship is different, but usually there are signs of trouble in the relationship. 

What was each person's role? It takes two to tango. It's important to be accountable for your behavior, however, it's equally important to understand how the distrusting behavior came about. I've written more about this process in a post about infidelity. 

Express your pain and uncertainty. People aren't computers. You can't just reboot and wipe out a virus from your system. Share your feelings with the person. Acknowledge that there is pain, confusion, anger, and sadness. You have to purge your emotional world. 

Let go. Letting go is not about forgiving the other person, it's about forgiving yourself and moving forward. In order to move forward in a relationship, you have to come to peace with the past. Letting go can be difficult but it doesn't have to hold you back from happiness. 

Mutual recommitment. Both people have to recommit to the relationship. If there has been infidelity, all communication has to be severed with the person, all communication. You can't recommit when your mind and emotions are somewhere else. 

Communicate. Start from the basics. Seek counseling. If trust was violated, it almost always means the communication was lacking or artificial. Learn how to communicate respectfully and effectively. 

Express what you need from one another. Part of the recommitment process is being clear and direct about not only what was lacking, but also what each person needs moving forward. 

Set goals together. A therapist may be helpful here to provide balance and a realistic expectation. Setting goals together provides two things: 1) both people are on the same page about the direction of the relationship, 2) it's a healthy exercise of communication and connection, which was probably lacking in the relationship. 

Check in regularly. Again, weekly therapy sessions can be helpful here. Or set aside time each week to check in and reflect on progress, difficulties, or changes in the trust rebuilding process. Weekly discussions also keep you invested and mindful of your relationship. Another thing that was lacking that lead to the trust fissure. 

Praise and show gratitude. Praise one another for effort and positive growth, even if it's minuscule. Just like letting go, the process of praising can be beneficial not only for the other person, but also for you. 


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

I rarely go to movies, maybe once a year. Inception (2010) was an exception largely in part of the fantastic reviews and I'm a DiCaprio fan. However, I was also curious as a psychologist. The movie was about levels of consciousness and memories. Memory formation has been a controversial area of research for decades with implications from the law to abuse to your own memory (check out the TED Talk "The  fiction of memory").

As I reflected on the movie, my mind kept returning to the therapy process. There were many themes in the movie that I experience in the therapy room. Initially I thought my narcissism was kicking in. Is it a bit much to compare working with a patient to a blockbuster mind bender? Set aside the process of inception or extraction. Reflect more on the underlying process of entering someone's mind, circumnavigating their and your own defenses, and uncovering raw, genuine experiences. Read below and you be the judge.

A major theme of therapy is the patient protecting the unconscious. Dom Cobb (DiCaprio) offers a service to Saito (Ken Watanabe) of training his mind to protect its secrets from extractors when in a vulnerable mental state. In Saito's case, the vulnerable state of dreaming.  People protect their emotional world by gaining distance from real feelings by utilizing defense mechanisms such as repression, rationalization, and humor. These mechanisms offer protection from the power of our emotional world. 

Therapy is the process of extracting. Extracting that memory or experience that lies deep within the psyche. An emotional experience that's difficult to reach. In the real world, we present differently than we do in the privacy of our home or a therapy room. We work to maintain our composure in public, counting down the minutes until you can finally be yourself. Our public and private experiences are different levels of consciousness. Therapy is the plot of Inception, gaining the combination to a personal safe.

Enter the character of Robert Fischer (Cillian Murphy). Saito has asked Cobb and his associates to enter Fischer's subconscious. This is mantra the role of psychoanalytically informed therapy; bringing the unconscious to conscious. Freud posited that people have developed simple and complex mechanisms to keep unconscious thoughts, feelings, and experiences from entering consciousness. Freud utilized a number of strategies to bring the unconscious to the conscious including hypnosis, free association...and dreams. 

The process of entering deeper into the mind has a sinister feel in the movie. For therapy, the belief is the opposite: if emotions are brought from the unconscious to consciousness, experiences can finally be resolved, leading to psychological relief and growth. During the process of exploring the unconscious, the therapist will regularly encounter resistance in the form of the patient's defense mechanisms. 

The projections in the movie are the defense mechanisms that are present in therapy. The role of projections were to block Cobb's team from completing their extraction mission, much like a defense mechanism blocks a therapist or even you from accessing experiences and feelings in the unconscious. 

To illustrate, let's use a therapy example. A patient conveys a story where a family member forgets the patient's birthday. The patient dismisses the forgetfulness as a non-issue because the family member has a busy life. The patient may then state birthdays are blown out or proportion, and actually express relief that their birthday was forgotten. 

However, at a deeper level the patient may actually feel hurt and disappointed. At an even deeper level, the patient may feel dismissed and unloved by family. The deep, core issue here is feeling dismissed and unloved. However, the rationalization (e.g., busy family member) and intellectualization (e.g., debate of birthday value) of the situation  serves as a defense against the realization of deeper, more profound emotions. 

Each "kick" represented a different level in the dream state, with its own world and sense of time. The same applies to the different levels of consciousness for each person. In the birthday example, each level of consciousness came equipped with it's own defense mechanism as well as a unique sense of time. Just as in the movie, as you move to deeper levels, the laws of time are compromised, and more signals or markings are needed to keep perspective. 

Yusuf kept a sense of time by playing music in the van. In therapy, a sense of time may occur by recognizing the context of the memory (e.g. the physical location of the experience, who you were with, etc.). Just like the kicks, moving from one conscious state to another with a patient can be smooth or violently jarring. Just like a kick, therapy is finite, each session is limited to 50 minutes. 

With each "kick" into a deeper dream state, stability and predictability were compromised. Cobb's team experienced a loss of control as they descended into deeper levels of the dream state. In therapy, as you venture deeper into a patient's psyche, there is the risk of destabilizing the patient. It's one thing to process a family member missing your birthday, it's an entirely different thing to process feeling unloved and forgotten by family. 

It's a very delicate process to venture deeper into someone's mind. Now add the time constraint of 50 minutes. It's not often talked about but there is a psychic pressure similar to the experience of deep sea diving or climbing a mountain. If you ascend from a sea depth or ascent a mountain too quickly, the body and mind sometimes have difficulty transitioning which can result in a sickness, shock, or even death. If you move quickly in and out of the unconscious, the patient can suffer a similar experience of sickness, shock, or even psychosis. It's imperative to bring a patient out of a deeper psychological state, and help them recover toward the end of the session. When the session is finished, that's the "kick" back to reality, the return to the world outside the therapy room. 

The underlying subplot of Inception is Cobb's unresolved trauma of his wife's, Mal, psychosis and subsequent suicide. Cobb feels responsible for her death, and his own psyche proves to be a complex web for the inception team. Ariadne, the dream architect, repeatedly questions whether Cobb can keep his own projections contained during the dream extraction and inception. 

This subplot is quintessential countertransference. Countertransference is the therapist's feelings that are stirred and brought to consciousness by the patient's experience. Entering Fischer's dream state stirs Cobb's own dream experience with his wife. A patient talking about abuse, loss, or fear can stir the same emotions in a therapist. Like Cobb, the therapist has to be vigilant and set aside their own experiences to work with the patient and their psyche. Countertransference is a powerful experience and should be addressed whether in a therapist's own therapy or in peer consultation. 

Inception concludes with Cobb returning home to his children. He spins his totem, his reality check mechanism, and the screen goes black leaving the viewer wondering if this last image is in fact reality, a dream state, limbo, or all of the above. 

Memory and the patient's reality (whether accurate or not) is the foundation of therapy. I often encourage patients to journal or talk to their parents, if possible, about early childhood experiences that we process in therapy (I encourage you as well). Sometimes we are sure of a memory, then are surprised by how we are our own inception team. Each person decides how they are going to encode an experience into a memory, without the guarantee of accuracy.

For example, I was sure of a decades old memory until a year ago. I remember riding my bike home as a kid and seeing my mom pull out of the driveway with a child in the passenger seat writhing in pain. I remember feeling confused and wondering what happened. According to my memory bank, I found out the injury details hours later when everyone returned from the hospital. 

I revisited this memory with my mom last year and her recollection floored me. She recalled sending me out to find this child as she feared something bad had happened. I found him injured in the woods, carried him from there into the house, and my mother took him to the hospital. 

Two incredibly different stories for the same experience. Only one of us can be right. So if my mom and I both spin are totems, which spinner will continue to spin?

Take a moment and ask someone about one of your memories. Ask them their experience and compare notes. You might learn something about yourself.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!