For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490

2/10/04 -- ADULTS WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER

• People used to think that children would outgrow ADHD, but as many as 2 out of 3 children retain their symptoms as adults.
• About 3% of adults have ADHD.
• There are no definite answers about what causes ADHD, but heredity plays a big role.

Core symptoms are inattention, impulsivity, and hyperactivity. Some examples:
• Fail to pay close attention to details.
• Does not listen well.
• Many careless mistakes.
• Does not follow through on completing work projects.
• Difficulty with organization.
• Impatience.
• Constantly loses things.
• Feels "driven by a motor"
• Restless, squirms in seat
• Talks excessively and interrupts others

• ADHD symptoms are common to other disorders so people should not diagnose themselves.
• ADHD leads to problems in work and relationships. For instance, chronic lateness, very variable work performance, boredom.
• Many of the problems result from lack of understanding of the disorder. People think they are lazy or stupid.

Treatment:
• Research suggests that the greatest improvement results from a combination of stimulant medication and counseling.
• Counseling helps understand the problem, how it affects one's life, and how best to manage it.
• Learn organization skills such as using a PDA, making lists, and relying on routines.
• Find suitable work. For instance, hyperactive adults may not do best behind a desk all day. Counseling can help people identify work that is particularly suited to their strengths.

For a referral to a psychologist, click here to email Dr. Warshak or call Dr. Richard Warshak at 972-248-7700.
For an evaluation by a learning disability specialist, contact The Smith Clinic at 972-241-8155.

For counseling services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
An excellent Web site with much information on ADHD: CHADD.

12/26/03 -- KEEPING NEW YEAR'S RESOLUTIONS

• People tend to make the same resolutions year after year: they resolve to end a particular vice on average 10 times. Every renewed vow represents last year's failure.
• 1 out of 4 people give up by the end of the first week. Of those who fail this year, 60% will make the same resolution next year. People usually make the same resolution for 5 years before they manage a 6-month success.
• Failure rates are highest for addictive behaviors and unhealthy habits such as smoking and drinking.
• "The False Hope Syndrome" Despite repeated failures, with memories of limited successes people convince themselves that full success is in their grasp with a just few tweaks of the program.

10/6/03 -- TEEN DATING TIPS FOR PARENTS

1. Exercise your authority
Know who your children are with, where they are going, and when they will be home. Give them a curfew and make sure they stick to it despite their protests.

2. Give them a cell phone This gives you a chance to check up on them and them a chance to call for help.

3. Teach kids not to expect others to give them a sense of self-worth.
Many kids do stupid things because they feel inadequate. Teach them how to avoid manipulation and pressure to have sex.

4. Tell them to listen to their inner voice when they sense they are about to do something stupid.
Help them respect the voice inside that says, "I'm uncomfortable in this situation and don't want to do this." Teach them how to avoid unwanted sexual advances. Tell your sons that having sex does not make them a man and tell your daughters that having sex does not make them more desirable.

5. Be a good role model
Your behavior with your partner has much greater impact than the things you say. Bring to your child's attention how you compromise, stick up for yourself, give and expect respect and argue but love your spouse.

8/26/03 -- EMPTY NEST SYNDROME
Empty nest syndrome refers to the grief that many parents feel when their children move out of the home.

Risk Factors

• unhappy marriage
• poor self-esteem
• being a parent is your sole source of satisfaction and meaning in life
• difficulty adjusting to past changes
• uncertain about children's ability to cope on their own
• other major life changes occurring at same time (e.g., retirement, menopause)

• adjusting to being a couple without children present
• filling the void in the daily routine
• establishing a new kind of relationship with adult children

• Remain in contact with children through phone, email, and instant messaging. College dorms have low-cost phone service.
• Allow yourself time to adjust.
• Discuss your feelings with your spouse and friends.
• Pursue old or new hobbies, careers, educational, and recreational activities.
• Make plans for a family vacation.
• Avoid major life decisions until you have adapted to the change.
• Focus on the advantages of the "less-crowded" nest. The average parent is actually happier and less stressed when the children are out of the home.
• If sadness is overwhelming, or interferes with general activities, seek professional help.

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555

8/13/03 -- SCHOOL ANXIETY

Please check back in a few weeks for these tips.

8/5/03 -- BACK TO SCHOOL

Ease into the School Schedule
Many parents make the mistake of waiting until the night before school to send their child to bed early. If he has been used to waking up in the late morning, or even early afternoon for teens, he won't be tired early enough to fall asleep and get a full nine hours, which is the least that most children need. Instead, begin now waking your child up a half an hour earlier each day. In general, start early to ease your child back into "normal" routines and out of the summer slack. If reading has been neglected, coax your child to spend time each day reading.

Common Fears About the First Day of School

• Getting Lost: If children are attending a new school, a common fear is about getting lost in the halls. If your child is young, see if you can get permission to show your child the route to the classroom a day or two before school begins. Seeing the new classroom beforehand helps to relive some of the anxieties of young children.
• Getting Along with Peers: Arrange play dates with some of your child's classmates before the first day.
• Being Apart from Familiar Surroundings and People: Some children are so anxious that they don't want to attend school. Don't let your child's anxieties and worries keep you from sending her to school. Drop her off with reassurance and a kiss good-bye, but don't linger too long. Tell them you'll be back at the end of the day, and make sure you arrive on time.

7/8/03 -- ADULTS WITH ATTENTION-DEFICIT DISORDER

The advice for this topic is being prepared and should be posted by Friday, July 11. We apologize for the inconvenience.
In the meantime, the best Web site we know of with tons of information on ADHD and on where to get help is: CHADD.

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555

6/9/03 -- SUMMER CONTACTS WITH THE OTHER PARENT

Prepare Your Child
If you are the parent sending your children on the trip, don't burden them with your own anxiety. Help your children anticipate the trip with enthusiasm and the expectation of a pleasurable time with your ex. Be Ready for Your Child If you are the receiving parent, make sure that your home is child-friendly. This means baby- proofing the home for infants and toddlers, close supervision around the pool, and toys and games that can maintain children's interests. Arrange play dates with other children. Some parents want to occupy the child's time exclusively in order to make up for absence during the school year. This is short-sighted. You want your child to be comfortable in your home. This means spending some time playing with other children.

Be Sensitive to Your Child's Feelings
If the child objects to the trip, try to figure out why. Is it normal pre-trip jitters, is the time period too long, or has the child has prior bad experiences with the summer contact? Both parents should facilitate phone contact; sometimes it helps to prearrange times for these to take place.

Allow Children to Take Possessions that Comfort Them
Young children will want to take their security blanket, older children will want to take a favorite toy. Some parents do not want objects from their home to go to the ex's home; if they keep their focus on their child's needs, they will be less rigid about this.

Be Flexible
If both parents can agree on a different schedule, it isn't necessary to follow the same schedule every summer. What works for children when they are five is not necessarily the best plan when they are fifteen. Sometimes it can help to restructure the contact into smaller blocks of time so that a young child is not away from her familiar environment for too long a period of time. Keep your focus on your child's needs, not your "rights."

Avoid the Term "Visit"
Visit means that a person is set apart, in some fundamental way, from others at the same location. A visitor is a guest in the home. Without thinking about it, every time we use this term to designate the time children spend with their father we are endorsing a destructive idea. We are telling children that after divorce their relationship with their father must be transformed into something less than a normal parent-child relationship. Rather than reassure children that they have not lost a parent as a result of the divorce, we give them the message that their father is no longer central in their lives. He is no longer a parent in the same sense as he was before the divorce.

5/5/03 -- COPING WITH JOB LOSS

The Average 40-year-old-white-collar worker will change employers two or three times in the remainder of his or her career, at least once involuntarily.

Unemployment ranks with death and divorce as one of life's most stressful events.

Multiple Losses

Recognize that unemployment imposes many significant losses including:

• steady income
• self-esteem
• sense of purpose
• sense of security
• daily routines
• social circle

• Children can sense when their parents are unhappy. Rather than pretend that everything is o.k., let children know that you have lost your job while reassuring them that things will be fine. Encourage them to express their feelings. Now is a good time to teach the lesson that hard times build strong character. Your children will learn from you a lesson that will help them for years to come.

• Your former job could not have offered all the things in life that are important to you. Make a conscious effort to think about other parts of your life that have more value than you have appreciated. Not only will this help you cope with the crisis. Maintaining a positive outlook on life will fuel your job search and allow you to present yourself in a more positive way during interviews.
• If your spouse works outside the home, take up some of the domestic chores.
• Get more involved with your children and recognize this as a positive aspect of the crisis.

• Work out a schedule for your job search activities just as you would for normal business activities. Force yourself to get out of the house. It is not unusual to be depressed after losing a job. You can minimize depression by treating your job hunt as your full-time job.

• Exercise helps to discharge the inevitable frustration and anger of being unemployed and gives a needed sense of accomplishment.

• Other than work our most intimate relationships give meaning to our lives. Don't allow your job loss to rob you of the rewards and pleasures of your marriage. Maintain romantic rituals such as candlelight dinners.

• If possible, postpone decisions to sell the house or move. Don't decide to end your marriage. Recognize that in a crisis things appear different. Changing other familiar aspects of your life compounds the crisis.

If you are depressed or severely anxious and don't seem to be getting better, or the tension in the family becomes unmanageable, get counseling. In the long run this will be a lot less expensive than ignoring depression.

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490


4/21/03 -- OBESE CHILDREN

Statistics

• Dallas is #9 on the list of top ten fattest cities in the U.S. Houston is #1. And our children are overeating along with their parents.
• 15% of kids and adolescents, about 9 million children, are overweight, and up to another 15% are at risk for being overweight. The statistics are even higher in certain ethnic groups, such as Mexican-American and African-American.
• Since the 1970s, the statistics have doubled for overweight children and tripled for overweight adolescents.

• become heavy adults
• suffer from low-esteem
• get teased by other kids
• avoid physical activity, which leaves them feeling isolated from other kids and keeps them inside eating more food, staying in front of a TV screen or computer monitor and not getting the exercise they need
• develop health problems such as diabetes

• Genetic factors: they way they are wired
• The reasons for overeating change as kids get older. Preschoolers stop eating when they are no longer hungry. By the age of 5, kids start paying attention to factors other than hunger. They eat more if the size of the portion is bigger.
• Older children overeat for the same reasons adults do. Sometimes eating is used as a substitute for coping with difficult feelings such as loneliness, anxiety, depression, or anger.
• If parents use food as a way to pacify an upset child, this can establish a pattern of relying on food to cope with negative feelings.

• It is always a good idea to check with your child's pediatrician to make sure there are no medical causes for your child's overeating.
• Don't assume your overeating child will grow out of it. Without help the odds are that your child will be saddled with a life-long problem.
• Overweight kids need help, but they don't need criticism, nagging, and shaming.
• Prevention: we don't have any consistently effective treatments for overweight people. We can help people stop gaining weight, or lose just a little, so we have to stop these kids from gaining more weight.
• Parents have a lot of control over what their children eat; they need to start exercising this control in a reasonable way.
• Think about the types of food you keep in the house. We can't expect children to exercise self-control when the pantry is filled with cookies, chips, and candy.
• It helps if the entire family changes its eating habits. Instead of grazing, have family meals.
• Keep fresh fruits on the counter out in the open sight.
• Reduce the amount of fattening snacks in the home.
• Reduce the size of portions. Serve chips and cookies in smaller quantities on a plate, rather than eating out of the bag.
• Reduce TV time and encourage physical activity. (30 minutes of active play after school, short breaks periodically while doing homework)

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490



3/31/03 -- MANAGING WAR-RELATED ANXIETY

Talk About Your Thoughts and Feelings and Encourage Your Children to Do the Same

Anxiety does the most damage when we ignore it or try to bottle it up. Be patient with your child's repeated questions.

When Relatives Are On Opposite Sides of the Issue

Feelings for and against our action in Iraq can tear families apart. Learn to establish the family rule that you can agree to disagree. Differences in beliefs about the war should not overshadow all the other experiences and history that bind a family together.

Recognize that Hard Times Can Bring People Closer To Each Other

Despite everyday family conflicts, everyone in the family can be on the same page when it comes to concern about our soldiers and other innocent people losing their lives.

Focus on the Positive Lessons of Current Events

Despite the tragedy, war also teaches us about the importance of courage, valor, and loyalty to values, traits that we should all aspire to and help our children develop.

Share Your Feelings with Your Children, But Maintain Your Composure

If your child senses that you are upset, don't deny it. It is best to strike a balance between two extremes. Parents who take a "business as usual" approach and act as though nothing is out of the ordinary encourage children to distrust their own perceptions. Parents who fall to pieces while discussing the war compound their children's insecurity at a time when they need reassurance. The goal is to show your children how to express strong feelings openly. If you frighten them by appearing out of control, the lesson they retain will not be that it is healthy to express emotions, but that it is frightening.

What We Say to Children Depends on How Personally They are Affected by the War

Young children who don't know anyone in the war can be shielded from the entire event. Those who have loved ones in service need reassurance and help to cope.

Tolerate Different Ways of Handling Stress

If your spouse is tired of hearing about the war, respect this. Many conflicts in marriages occur because spouses don't recognize and respect each other's differences. If your children seem content to play and be happy, even if they have a loved one serving in the armed forces, accept that this is normal. It is not a sign that your children are insensitive.

Give Children Plenty of Reassurance

There worries are normal and won't last forever.

T.V. Is Not the Enemy

Although younger children shouldn't be watching too much war coverage, most of them are more interested in Sponge Bob Pants anyway. But older children may find war coverage just as fascinating as do their parents. Unless the images become unduly gory, before automatically banning your children from watching the news, find out how the coverage is affecting them.

The Best Medicine: Take Positive Action

Write to soldiers, write to families who lost relatives in the war, volunteer for relief charities, study history and geography related to the war. Action helps offset a sense of helplessness. Working alongside others who are doing good things reminds us that there is far more good than evil in the world.

Humor is Important

Some people think it is disrespectful to laugh while our nation is facing such hard times. But humor is a potent weapon against stress and depression. It is also a great outlet for the additional hostility that we all feel when we hear about the cruelties of war. Now is the time to balance the war coverage with Seinfeld reruns. A joke a day keeps anxiety at bay.

Recognize Signs of Anxiety

Headaches, stomachaches, sleeplessness, rapid heartbeat are a few of the more common signs. If your anxiety is dominating your life, seek professional help.

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490

2/20/03 -- COPING WITH ANXIETY

1. Recognize the Signs of Anxiety

Headaches, stomachaches, sleeplessness, rapid heartbeat are a few of the more common signs.

2. Accept Your Fears

People often try to deny that they are afraid. This makes them less able to conquer their fears. You don't master a fear by pretending it's not there. When you acknowledge your fears you begin to take charge of them. You bring your fears within your control, rather than let your fears control you.

3. Learn Relaxation Techniques

Certain behaviors help to clear the mind of worries. Deep breathing, meditation, yoga, massage, and exercise all can help to reduce anxiety and induce relaxation.

4. Talk to People About Your Worries

Talking about distress helps to relieve it.

5. Focus on Life's Pleasures

Learn to draw strength from adversity. 9/11 should liberate us from a denial of mortality. We should emerge with a stronger passion for life and resolve to operate at peak capacity. Cherish close relationships and pursue dreams with enthusiasm. Take inspiration from the 9/11 heroes who reached for the best within themselves.

6. Laugh a Lot

Humor rapidly defuses anxiety, and provides a socially acceptable outlet for hostility.

7. If you can't manage on your own, seek professional help.

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490

2/3/03 -- TALKING TO CHILDREN ABOUT THE COLUMBIA SPACE SHUTTLE TRAGEDY

Don't Be Afraid to Talk About The Event

Whether or not your children say anything about a traumatic event, if they witnessed it or overheard conversations about it, you can safely assume that it is on their minds.

Encourage Children to Express Their Reactions and Feelings and to Ask Questions

Don't assume that you know what they are thinking and feeling about it. When they do ask questions ask them what they think. You want to learn what sense your children have made of the events. What do they know, think, and feel?

Be Patient with Repeated Questions

Children sometimes ask the same questions repeatedly. Naturally this gets tedious for parents, but you should understand that the questions are not intended to "bug" you. Rather, such questions show that the children have still not fully understood or accepted the answers. Try to be patient. Children's questions are precious gifts. They bestow upon you the awesome responsibility of shaping, or at least framing, your children's attitudes for years to come. Repeated questions deserve repeated answers. When your children no longer need to ask questions, they will stop on their own. If you tell them to stop asking questions, they will not stop thinking about the issues; they will merely exclude you from their inner thoughts.

Reassure Them That Their Reactions are Normal

School-age children who are anxious in the aftermath of a trauma often feel ashamed of what they perceive as babyish behavior. They also worry that their newfound fears will never go away. Reduce your children's shame and worry by reassuring them that it is okay to be afraid. Explain that it is not a sign of weakness to feel fear but a natural and protective response to danger.

Reassure Them That Their Fears Will Not Last Forever

One of the most effective ways to get this point across is to talk about a temporary fear that you suffered and surmounted when you were a child.

Take Positive Action

Help your children take some positive action in connection with the event. This helps offset feelings of helplessness and hopelessness. For instance, let them participate in memorial services, or write condolence messages.

Knowledge Is Power

Some children will cope best by learning more about space shuttles.

Try to Resume Normal Routines

The sooner life returns to familiar patterns, the sooner children will feel safe.

Share Your Feelings, But Maintain Your Composure

Parents wonder how much of their own uncertainty and anxiety to reveal to children. Children can certainly sense when we are upset. Not only would it be difficult to conceal our own reactions to traumatic events, it would give children the wrong message. We want them to know that when horrible things happen it is normal and healthy to react with strong negative feelings and to freely express these feelings. The best way to teach a healthy approach to difficult feelings is to demonstrate it through our own behavior. This principle is not a license to magnify the crisis for your children and burden them with your own sense of hopelessness and despair.

It is best to strike a balance between two extremes. Parents who take a "business as usual" approach and act as though nothing is out of the ordinary encourage children to distrust their own perceptions. Parents who fall to pieces while discussing traumatic events with their children compound their children's insecurity at a time when they need reassurance. The goal is to show your children how to express strong feelings openly. If you frighten them by appearing out of control, the lesson they retain will not be that it is healthy to express emotions, but that it is frightening.

By maintaining composure while acknowledging the reality of the trauma, you reassure your children that the horrible events have not shattered the security of their home and family. You show them that they do not have to deny horrible realities, but that even when life is not business as usual, they can rely on their parents to retain their roles as sources of comfort and security. This approach simultaneously demonstrates a very important virtue, particularly during hard times: the importance of exhibiting courage in the face of adversity.

Recognize the Positive Legacy of Trauma

Help your children draw strength from adversity and use the trauma to inspire a better life. Trauma's impact is not all negative, at least it does not have to be. When psychologists set out to study something like the impact of trauma, the type of questions they ask defines the range of answers they will find. Early students of trauma were concerned about trauma's negative effects and not surprisingly that is what they learned about. As a result, when psychologists discuss the impact of trauma many convey a one-sided negative view. More recent studies have searched for positive outcomes of trauma and have learned what novelists and historians have known for generations: many people draw strength from adversity. They take inspiration from their suffering. They transcend their traumas and become better people.

Watch for Warning Signs
Reenactments such as nightmares, excessive risk-taking.
Avoidance - becoming withdrawn, afraid to leave the house.
Becoming easily startled or having trouble sleeping.

Seek Professional Help If You Are Unsure About Your Child's Reactions

Click here for suggestions of where to get help.

1/7/03 -- CHILDREN AND OVEREATING

Statistics

• Dallas is #9 on the list of top ten fattest cities in the U.S. Houston is #1. And our children are overeating along with their parents.
• 15% of kids and adolescents, about 9 million children, are overweight, and up to another 15% are at risk for being overweight. The statistics are even higher in certain ethnic groups, such as Mexican-American and African-American.
• Since the 1970s, the statistics have doubled for overweight children and tripled for overweight adolescents.

• become heavy adults
• suffer from low-esteem
• get teased by other kids
• avoid physical activity, which leaves them feeling isolated from other kids and keeps them inside eating more food, staying in front of a TV screen or computer monitor and not getting the exercise they need
• develop health problems such as diabetes

• Genetic factors: they way they are wired
• The reasons for overeating change as kids get older. Preschoolers stop eating when they are no longer hungry. By the age of 5, kids start paying attention to factors other than hunger. They eat more if the size of the portion is bigger.
• Older children overeat for the same reasons adults do. Sometimes eating is used as a substitute for coping with difficult feelings such as loneliness, anxiety, depression, or anger.
• If parents use food as a way to pacify an upset child, this can establish a pattern of relying on food to cope with negative feelings.

• It is always a good idea to check with your child's pediatrician to make sure there are no medical causes for your child's overeating.
• Don't assume your overeating child will grow out of it. Without help the odds are that your child will be saddled with a life-long problem.
• Overweight kids need help, but they don't need criticism, nagging, and shaming.
• Prevention: we don't have any consistently effective treatments for overweight people. We can help people stop gaining weight, or lose just a little, so we have to stop these kids from gaining more weight.
• Parents have a lot of control over what their children eat; they need to start exercising this control in a reasonable way.
• Think about the types of food you keep in the house. We can't expect children to exercise self-control when the pantry is filled with cookies, chips, and candy.
• It helps if the entire family changes its eating habits. Instead of grazing, have family meals.
• Keep fresh fruits on the counter out in the open sight.
• Reduce the amount of fattening snacks in the home.
• Reduce the size of portions. Serve chips and cookies in smaller quantities on a plate, rather than eating out of the bag.
• Reduce TV time and encourage physical activity. (30 minutes of active play after school, short breaks periodically while doing homework)

For a referral to a psychologist, click here to email Dr. Warshak or phone Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490

12/26/02 -- KEEPING NEW YEAR'S RESOLUTIONS

• People tend to make the same resolutions year after year: they resolve to end a particular vice on average 10 times. Every renewed vow represents last year's failure.
• 1 out of 4 people give up by the end of the first week. Of those who fail this year, 60% will make the same resolution next year. People usually make the same resolution for 5 years before they manage a 6-month success.
• Failure rates are highest for addictive behaviors and unhealthy habits such as smoking and drinking.
• "The False Hope Syndrome" ? Despite repeated failures, with memories of limited successes people convince themselves that full success is in their grasp with a just few tweaks of the program.

Intense feeling of sadness or loneliness during the holiday period that is more unsettling because it contrasts with the spirit of benevolence and joy that we associate with the holidays. The holiday blues last for a few days to a few weeks around the holidays, but usually diminish after the season is over and we resume normal routines.

Causes of Holiday Blues

• increased stress
• unrealistic expectations
• inability to be with family
• memories of past holiday celebrations
• changes in routine, including diet and sleep

• sleep problems (too much, too little, or nighttime awakenings)
• significant changes in appetite
• irritability
• anxiety and agitation
• headaches
• excessive or inappropriate feelings of guilt
• difficulty concentrating or thinking clearly
• decreased interest in activities that usually bring pleasure, such as food, sex, work, friends, hobbies, entertainment

• Remind yourself that the holiday blues are temporary
• Practice good health habits: eat right, get plenty of rest, exercise regularly
• Set realistic goals:
• cut down on your expectations
• organize your time
• make lists
• prioritize
• make a budget and follow it
• If the past has you down, create new holiday traditions
• Help others find joy in the holidays (this helps to take away the focus on your sadness)
• Ask for help from people who care about you
• Spend time with people
• Accept the blues without berating yourself for feeling this way
• If money worries have your down, find and enjoy free activities
• Do allow yourself to feel sad, lonely or melancholy -- these are normal feelings, particularly at holiday times.
• Do something for someone else.
• Reach out to someone with whom you have lost touch
• Do something for yourself out of the ordinary, e.g., prepare a special meal

• Avoid overdoing it: drinking too much, eating foods high in sugar and fat, spending money you don't have
• Don't dwell on the past
• Don't compare your situation to romanticized movie images of the holidays
• Don't focus on what is missing in your life
• Don't make major decisions until the blues are gone
• Don't give in to despair; you won't always be feeling this way

For a referral to a psychologist, click here to email Dr. Warshak or call Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490

11/26/02 -- HOLIDAY STRESS

How to Reduce Holiday Stress

• Adjust your schedule to accommodate the additional activities of the holiday season.
  
  
• Set priorities and pare down your expectations of what you should do.
  
  
• Avoid comparing your situation to idealized images of what the holidays should be. Your childhood memories, or holiday songs and movies, are not the best measure of reality.
  
  
• Set reasonable limits: on what you can spend, on what you will buy your children, on how many parties you will attend. Learn to say "no" to people who are asking you to take on additional responsibilities. Remember that your children's wishes are not your commands. If your kids think they need a certain toy to be happy, then you can bet that the toy will not bring the wished for happiness.
  
  
• Ask for help. Tell your children that the more they help, the less stressed you are, and the happier holiday they will have.
  
  
• Don't expect to make everyone happy.
  
  
• If you have a blended family that requires several holiday celebrations, try to combine as many of these as possible, and limit the scope of the others.
  
  
• Accept reality. Be true to yourself. If you are not feeling cheery, don't fake it. If you don't like someone, don't pretend that all is well. The pretense takes enormous emotional energy and induces more stress.
  
  
• If you don't want to be alone on the holidays, don't wait for someone to invite you. Take the initiative. But if your are being asked to join in festivities when you don't feel like it, ask for understanding while declining the activity.
  
  
• Pay attention to your health. Get enough sleep. Avoid excessive amounts of coffee and alcohol. Plan time for exercise and relaxation.

• The blues come from missing people who are important to you. Stress comes from being around these people and trying to accommodate them. For some people, the contrast between their own sadness or loneliness and the happiness of the season makes them feel even worse. If you are unable to shake what you think are holiday blues, your feelings may not be about the holidays, but about other things in your life. Give yourself a gift and seek professional help.

For a referral to a psychologist, click here to email Dr. Warshak or call Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490


10/23/02 -- TALKING TO YOUR KIDS ABOUT SEX

• Myth #1: Young people know it all. Reality: They don't.
  
  
• Myth #2: Children who know about sex will practice it. Reality: Research shows that youngsters who do not understand "the facts of life" are more likely to make mistakes.
  
  
• Parents can't help teaching their children about sex. Even silence on the subject teaches volumes. So the question is not, "Should I teach my child about sex?" but "How should I?"
  
  
• When should parents begin sex education? It is never too early. In the bath, when the child is asked to show how he has learned to recognize the names for body parts, if the penis is mentioned along with the toes and the nose, from the start you are conveying that sex is natural.
  
  
• When should parents talk to kids about sex? As soon as they ask. If you are the sort of parent who welcomes questions and answers them patiently, your child may begin to ask questions about sex at around 2-3 years. If this hasn't happened by age 5, start the conversation, perhaps by reading a book together about where babies come from.
• How explicit should parents be? Many experts advise parents to use correct terminology rather than childish words such as "pee-pee." I'm not convinced this is so important. But it is important to give accurate information (e.g., the baby grows in the uterus, not the stomach) in as matter of fact manner as you can. Also, tailor your answers to the questions, perhaps giving just a bit more than you think you child can understand.
  
  
• If you find your child playing doctor with another child keep your cool. Let them know you can understand that they are curious about bodies and you will answer their questions. But genitals are private so they should get dressed and play something else. If you make a big scene you teach your child that it is wrong to be interested in sex.
  
  
• Preteens need information about menstruation and nocturnal emissions in advance so the events do not come as distressing surprises. If your goal is for your child to accept his or her sexual feelings without feeling guilty, you will want to convey that these feelings are normal.
  
  
• Talking about birth control does not necessarily send a message to your teen that it's okay to have sexual intercourse. Your teenagers should know what your values are, and you can certainly let them know that you think they are too young to have sexual intercourse. Girls need to know that boys use lines on them. A survey of 1,000 boys found that 7 out of 10 thought it was okay to lie to girls and to say they were in love with her in order to have sex.

• Prepare ahead of time. Let your child know that you won't be buying a toy or candy.
  
  
• If your child is having a tantrum, remove her from the situation and have as little interaction as possible until she calms down.
  
  
• After the tantrum is over, let it go. Say something like, "That was hard for both of us. Now let's see if we can have a good time."
  
  
• Use a firm but calm voice when setting limits.
  
  
• Give a time-out in the car and say we'll talk about this when we get home. Once home have some negative consequence for the behavior. For instance, because you yelled at mommy in the store, you won't be able to watch TV tonight.
  
  
• Acknowledge your child's feelings while enforcing limits on behavior. "I see that you are not happy, but you still can't have the toy."
  
  
• Grant in fantasy what you won't in reality. "I wish I could buy you that, but I don't have the money to spend on it now. Maybe we can put it on your Christmas wish list."
  
  
• Try humor and distraction. If you can help your child focus on something else, like helping you find a product on the shelves, or counting all the different colors of skirts, this can help defuse the situation.
  
  
• If you are losing your cool, take a time out yourself. Call a friend on a cell phone and talk about your anger. Just talking about it will help you get in better control and while doing this you won't be escalating the conflict with your child.
  
  
• If you think you are in danger of losing your temper and hurting your child, call the National Child Abuse Hot Line at 1-800-4-A-CHILD (1-800-422-4453). TDD/Hearing Impaired: 1-800-2-A-CHILD (1-800-222-4453). This line is answered 24 hours a day. To report child abuse in Texas, call the Child Abuse Hotline at: 1-800-252-5400.

For a referral to a psychologist, click here to email Dr. Warshak or call Dr. Richard Warshak at 972-248-7700.

For services at reduced fees, contact one of the following:
Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
Child and Family Guidance Center - Phone: 214-351-3490

9/26/02 -- HOW TO TELL YOUR KIDS ABOUT YOUR DIVORCE

• It is surprising how often parents fail to tell their children why they are divorcing or to explain the family's new living arrangements.
  
  
• When parents do not talk openly about the divorce, the children are less likely to voice their own concerns. Instead, the children will develop a variety of fantasies to explain the divorce and custody situation, none of which may correspond in the least with reality.
  
  
• Parents should be together when they tell children about their impending separation. This offers the children a reassuring demonstration that their parents can continue to function cooperatively in meeting the needs of their children.
  
  
• The new living arrangements should be carefully explained. Parents should tell children why they decided on these particular living arrangements.
  
  
• If, for any reason, the children are going to see little of one parent after the separation, it is imperative that they understand that this is no reflection of their own worth. For example, if a mother, seeking autonomy and escape from the demands of family life, moves far away from the children, she needs to explain that her decision reflects her own needs and is not a reaction to anything the children did. Unfortunately, this is a very difficult concept for children to grasp. Children who see little of their noncustodial parent invariably suffer a loss of self-esteem. Nevertheless, parents should try their best to explain that their absence is no reflection on the children. The children should then be encouraged to seek substitute relationships (by spending more time with friends, grandparents, aunts and uncles, etc.)
  
  
• Children should be encouraged to talk about their reactions and feelings and to ask any questions on their mind. Children sometimes need to ask the same question repeatedly. Although this gets tedious for parents, they should understand that the questions are not intended to "bug" them. Rather, such questions are a sign that the children have still not fully understood or accepted the answers. Try to be patient with these questions and repeat your answers. When your children no longer need to ask questions they will stop on their own. If you order them to stop asking questions, they will not stop thinking about the issues; they will merely exclude you from their inner thoughts.
  
  
• Although it doesn't help for parents to "fall to pieces" when announcing the divorce, it is certainly expected that they will experience and communicate strong feelings. It does not hurt the children to see their parents cry. Breaking up is hard to do, and when parents are open about expressing their own sadness at the failure of the marriage, this gives children permission to acknowledge and communicate their own sadness. The more children communicate their feelings, the easier it is for parents to provide needed reassurance and guidance.
  
  
• Be aware that your own attitude about the divorce may color the way you respond to your children's feelings. Generally the parent who wants the divorce is inclined to emphasize the positive aspects for the children (eg., less parental fighting, two birthday parties, more Christmas or Hanukkah presents). To assuage guilt, this parent may overlook or minimize the children's distress. The parent less in favor of the divorce does the opposite. This parent is ever on the lookout for children's stress reactions and uses this as evidence to defend their opposition to the divorce.

  Parents should try to separate their own feelings from their children's. Children need their feelings recognized and validated as normal and understandable. If children feel that a parent does not want to hear anything negative about the divorce, the bad feelings will not go away. They merely go underground, where they do more damage and are less accessible to parents' reassurances. On the other hand, it does not help children to magnify the crisis and burden them with a rejected parent's own sense of hopelessness.
  
  

• How to explain the reasons for the divorce? This is the most difficult part. Parents who feel wronged, or do not want the divorce, often want to tell the children that the divorce is all the other parent's fault. They want to avoid accepting responsibility for the failure of the marriage, they want their children to feel sorry for them, and they want the children to be angry with the other parent. Most helpful accounts of the divorce avoid laying exclusive blame on one parent.
  
  
• Bottom line: Tell kids about the divorce. Give them a reasonable explanation pitched to their age. Reassure them that it is not their fault. Let them know you won't ask them to take sides in the conflict.
  For more help in protecting your children from the harmful effects of divorce, see my book available in bookstores, libraries, or online by clicking on the cover or title below.
  
  Divorce Poison: Protecting the Parent-Child Bond from a Vindictive Ex

  For a referral to a psychologist, click here to email Dr. Warshak or call Dr. Richard Warshak at 972-248-7700.

  For services at reduced fees, contact one of the following:
  Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555
  Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198
  Child and Family Guidance Center - Phone: 214-351-3490
  
  9/10/02 -- KIDS AND 9-11
  
  Don't Be Afraid to Talk About 9-11

  • Let them know that they will be hearing a lot about 9-11 and that this is something you can talk about.
  
  You Don't Have To Turn Off the T.V.
  • Much of the coverage tomorrow will help us heal. In the aftermath of 9/11, some experts cautioned parents against allowing their children to watch the media coverage of the burning and collapse of the World Trade Center. The concern was that young children might mistake the repeated images of the attack as separate attacks on hundreds of buildings. Because of the potential for such misunderstandings, it is always a good idea for parents to monitor what their children watch and talk with them about it. Children do not need exposure to the more graphically horrific aspects of a trauma. Here is a good rule of thumb: information or images that might give you nightmares is the stuff to keep away from your children. The younger the child, the more details you should withhold. Older children can benefit from watching news coverage of traumas.
  
  Encourage the Expression of Thoughts, Feelings, and Questions
  • Don't assume that you know what they are thinking and feeling about it. When they do ask questions ask them what they think. You want to learn what sense your children have made of the events. What do they know, think, and feel?
  
  The Best Medicine: Taking Positive Action
  • When we are overwhelmed by events that are beyond our control, our natural inclination is to do something, anything, that will move us beyond the initial shocked paralysis induced by the trauma. We flew the flag, we read books on the Taliban, we gave blood.
  • One of the best things we can do to offset children's sense of powerlessness about 9-11 and restore a sense of being in control is to involve them in assisting with relief efforts, writing letters to Afghanistani children and to our President, working to collect money for victims of 9-11.
  • When parents promote benevolent behavior toward victims, they foster a reverence for life that defies the terrorists' contempt for life.
  • Working alongside others who feel the same reassures children that despite the existence of evil people in the world, there are far more people around them who reject he use of violence to achieve their goals.
  
  Reassure Them That Their Reactions are Normal and Will Not Last Forever
  • School-age children who were anxious in the aftermath of 9-11 worried that they were acting like a baby. They also worried that their newfound fears would never go away. Reduce your children's shame and worry by reassuring them that it is okay to be afraid. Explain that it is not a sign of weakness to feel fear but a natural and protective response to danger.
  
  9-11 Has Important Lessons
  • We should seize this opportunity to reaffirm our cherished values and virtues. Never have our children seen such a graphic and compelling demonstration of the importance of creating and living in a society that respects individual rights. We should explain how acts of terrorism illustrate what is wrong with using terror, force, and intimidation to achieve one's goals. Emphasize that the proper way to get what you want from others, and to resolve disputes, is to use good communication skills, reason, persuasion, and voluntary trade.
  • The actions of the terrorists provide a sober lesson on the importance of making wise choices and the importance of ideas. The ideas children learn in school about the history of our country and the government are what rule history. Terrorists do what they do because of certain ideas that they have accepted. Also, there is a lesson about the importance of critical thinking. The terrorists were raised in a society that influenced them to hate Western civilization. It would have been far better if they questioned what they were being taught, rather than blindly accept the ideas that led them to do evil things.
  • Also, 9-11 reminded us of the importance of showing courage in the face of fear. We should exploit children's admiration for heroes by helping them implement in their own lives the virtues shown by their heroes.
  
  

  Click here for suggestions of where to get help in the Dallas metroplex.

  
  9/3/02 -- SHY CHILDREN
  
  About 10% of 2-year-olds show an extreme degree of shyness; for instance, they will stop playing and assume a wary expression when an unfamiliar woman talks to them.
  
  The shy response is temporary. The inhibited child may warm up within 10-15 minutes, but the trait is consistent during the 2nd and 3rd years.
  
  Although about 1/4 of shy 2-year-olds lose their shyness by age 4, no children who are extremely sociable and bold become shy by age 4.
  
  Signs of Shyness in a Preschooler
  
  Shy preschoolers:

  • Rarely approach the other kids and are usually passive when attacked by another child. By contrast, uninhibited kids make frequent overtures, occasionally take toys, and in general are active and gleeful.
  • Are more likely to have frequent nightmares and unusual fears.
  • Are usually obedient because they are very sensitive to being reprimanded by their parents. This is sometimes seen as an advantage. For instance, they are easier to potty train.
  • Rarely interrupt adults.
  • Speak in soft, hesitant voices.
  • Are restrained in their actions.
  • Are easily aroused by stresses of daily life, even to the point where their heart beat is elevated.
  
  How Parents Can Help
  • Gently encourage a less fearful approach to unfamiliar people and situations.
  • Arrange a play date at your house with a child who will help break the ice. If you don't know which child to invite, ask the teacher for some guidance. She can point out a few children who are particularly nice and sensitive. It is easier to make friends in the comfort of your own home. Have only one child over at a time.
  • Teach kids how to make friends. Explain the importance of smiling. It is easier to walk up to one child than a group of children. Teach your child to ask new kids questions about themselves. Help your child be prepared with answers to common questions, such as what hobbies they like.
  • Enroll child in extracurricular activities. These not only give a place to meet new children, they help children develop talents that they can use in social situations to cope with their anxiety.
  • At about the ages of 6-8, it is easier to help the shy child come out of his shell. Explain that his behavior hurts other's feelings, or that not saying please and thank you is rude. Make rules that enforce good manners and socially appropriate behavior, such as: "you must say good morning to your teacher, you must say thank you to the sales clerk, etc.
  • Labeling is disabling. Try to avoid labeling your child as "shy" and instead focus on helping your child become more outgoing.
  
  For more information, I recommend the following books (they can be ordered through amazon.com by clicking on the cover or the title):
  
  Normal Children Have Problems, Too: How Parents Can Understand and Help by Stanley Turecki, M.D. and Sarah Wernick
  
  The Highly Sensitive Person: How to Thrive When the World Overwhelms You by Elaine N. Aron, Ph.D.
  

  Click here for suggestions of where to get help in the Dallas metroplex.

  
  8/22/02 -- TEACHER-STUDENT CONFLICTS
  
  Possible Signs of Conflict

  • Child is chronically unhappy
  • Child is reluctant to talk about the school day
  • Child is constantly in trouble at school
  • Teacher seems very intolerant of your child -- e.g., she seems to have it in for him
  
  Different Sources of Conflict
  • Child's behavior: he would be a problem for any teacher
  • Child's learning style clashes with the teacher's classroom style
  • Teacher has the problem -- e.g. has less patience because of personal worries
  • Personality clash between teacher and student
  
  Remedies
  • Talk with your child to learn all you can about his or her views of the teacher and the classroom.
  • Talk with the teacher in a non accusatory way to discuss ideas about making things better.
  • Educate the teacher about your child's unique personality and learning style.
  • If the teacher seems unwilling to work with you on the problem, speak to the school counselor or principal.
  
  For more information, I recommend the following books (they can be ordered through amazon.com by clicking on the cover or the title) and Websites:
  No Easy Answers: The Learning Disabled Child at Home and at School by Sally L. Smith
  
  The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities by Larry B. Silver

  
  8/15/02 -- BIPOLAR DISORDER IN CHILDREN
  
  Bipolar disorder is what we used to call manic-depression. Most psychologists believe that even very young children show features of this disorder and that it is much more common that we thought. Bipolar disorder appears different in children than it does in adults. Children have rapid shifts of mood many times within a day, as opposed to adults who have abnormally intense moods for weeks or months at a time. One expert has observed a pattern of children with bipolar illness having major difficulty getting up in the morning, but showing increased energy in the afternoon and evening.
  
  Early Warning Signs

  • As infants and toddlers, children with bipolar disorder are extremely difficult to soothe, sleep less than normal, are easily startled, and are overly stimulated. Also many show very clingy behavior. One mother said, "If he could crawl back into the womb he would."
  • Preschool children with this problem may be hyperactive, inattentive, very easily frustrated, and overreact to stress and frustration. They have terrible explosions and meltdowns that can last a long time. Sometimes they are over-aggressive or even violent with parents and siblings.
  • Many of these children are bossy and negative. They have a lot of trouble shifting from one activity to another. For instance, when parents ask them to stop watching tv and come have dinner, instead of just the mild frustration that most children show, they blow up and cuss at their parents.
  
  How early do the symptoms appear?
  • Some parents report that their children seemed different from birth or that by 18 months they noticed there was something wrong.
  
  How does bipolar disorder differ from Attention Deficit Disorder?
  • Children with bipolar disorder are more irritable, more moody, have a more exaggerated sense of their own abilities and their own status, and more disturbed sleep patterns often with night terrors. Also, some children with bipolar disorder have hallucinations or delusions. For instance, they, may tell you that they see bugs or snakes that aren't there.
  • It is important to make the correct diagnosis because stimulant medication that helps children with ADHD can make a bipolar condition worse.
  
  How is bipolar disorder diagnosed in young children?
  • When symptoms are present, a family history is taken because there is a strong genetic component. Red flags are mood disorders or alcoholism in one of both sides of the family tree.
  
  How is it treated?
  • Various medications or combinations of medications are used to stabilize the child's mood. Psychotherapy helps everyone in the family understand the illness and its impact on behavior and teaches children and parents better ways to cope.
  
  What can parents do?
  • Reduce the frequency of meltdowns. Reduce demands for flexibility and frustration tolerance. Identify in advance the situations that usually lead to an explosion. Cajoling and empathy can help avoid meltdowns.
  • Choose battles wisely. Some things, such as safety issues, you will always have to respond to. Others are not worth fighting about, such as having the child sit through the entire dinner with the rest of the family.
  • During the child's rage, reasoning is useless. Force merely inflames the situation. Humor and distraction can defuse volatile situations.
  • Learn to interpret the child's gross disrespect (e.g. cussing at you) as a sign that your child's capacity for rational thought is temporarily out to lunch and that he needs help to cope with the frustration, not immediate punishment.
  • Don't rely on punishment as the first choice for managing behavior. Rather than search for better ways to reward and punish, learn better ways to communicate and compromise.
  • When you practice these skills others may criticize you for being too lenient. They do understand what it is like to live with an inflexible-explosive child. Normal parenting skills don't work. A simple assertion of authority can trigger a huge explosion.
  • Dr. Warshak's maxim: Become the parent your child needs, not the parent that society decrees.
  
  For more information, I recommend the following books (they can be ordered through amazon.com by clicking on the cover or the title) and Websites:
  
  The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated "Chronically Inflexible" Children by Ross W. Greene, Ph.D.
  
  The Bipolar Child by Demitri and Janice Papolos
  
  Child and Adolescent Bipolar Foundation
  A new and national, parent-led organization providing education, support and advocacy for children, adolescents and families. Visit CABF's virtual community center for families with children diagnosed with or at risk for bipolar disorder.
  
  Time Magazine on Bipolar Children
  

  Click here for suggestions of where to get help in the Dallas metroplex.

  
  8/1/02 -- SHOULD CHILDREN DECIDE CUSTODY?
  
  The Law
  In Texas, children as young as 12 years can express a preference to the court about where they want to live. It used to be 10 years old! There are payoffs and perils when children are involved in making custody decisions.
  
  Payoffs
  When we pay attention to children's thoughts and feelings, we are able to see the divorce through their eyes. Children can enlighten us: what they tell us may help us make better decisions on their behalf. In the past courts and parents did not see divorce through the kid's eyes and made decisions that resulted in unnecessary suffering for children. For instance, we thought it was okay for kids to see their fathers only 2-4 days per month. Kids let us know that we had this wrong.
  
  Perils
  1. Children's attitudes during the breakup may be temporary. They may be reacting to an isolated event, such as a fight between parents or the discovery of an affair, rather than the full history of their relationship with each parent.
  2. They may complain about a parenting plan because of minor frustrations and not really consider the drawbacks of alternative plans.
  3. Children may tell each parent what they think that parent wants to hear at the time.
  4. May reflect trivial reasons or immature thinking. Examples: A five year old girl wants to live with her daddy because he lets her eat as much candy as she wants. A ten year old boy wants to live with his mom because she lets him stay up as late as he wants. A fifteen year old girl wants to live with her father and stepmother because they impose no curfew, allow her to drink alcohol, commiserate with her about the uselessness of education, and promise her a luxury car if she moves in with them.
  5. Preference to live with a parent may be unhealthy. For instance, a boy may have a close identification with a father who treats the mother with violence and disrespect. The boy's closer tie to his father may be long-standing and may lead the boy to express a preference for a parenting plan that maximizes time with his dad while minimizing time with his mom. Such a plan, though, is likely to further entrench the boy's unhealthy identification. Another example: a boy may be too closely tied to his mom and afraid of leaving her side, so he says he doesn't want to spend the night at his dad's house.
  6. Children may say they want to live with a parent because they think they need to take care of that parent.
  7. Children may show loyalty to one parent because they are afraid of him and don't want him to be angry with them.
  8. The biggest problem with giving children a say in custody decisions is that it puts them in the middle of their parents' disputes. If the kid's attitude is going to influence the court, then there is a greater risk that one or both parents will put pressure on the child to takes sides with one parent against the other. So when a child expresses an opinion about custody, it may be the child's voice dubbed with the words of whichever parent has the most influence over the child at that moment in time.
  
  How Kids Are Involved in Custody Litigation
  1. Court-appointed attorney for kids
  2. Testify in open court
  3. Talk to the judge in chambers
  4. Talk to a custody evaluator
  5. Signing an affidavit of preference - Texas is one of the few states to allow this. Often dad takes the kid to his lawyer to sign an affidavit saying she wants to live with dad, and then the mom takes the kid to her lawyer and the child signs an affidavit saying she wants to live with mom.
  
  How to Do It Right
  It is best to protect children from involvement in the court battles but still learn their thoughts and feelings.
  
  Consider how major decisions that affect children are made prior to divorce. For instance, when parents contemplate buying a new house, or moving to another city, the children are not usually charged with making the final decision. Yet, sensitive parents faced with such decisions will consider their children's needs, may elicit the children's concerns, will try to anticipate their children's reactions to the proposed changes, and will keep their children's perspective in mind when dealing with the children regardless of what decision is ultimately reached.

  
  7/25/02 -- CHILDREN WHO LIE
  
  Set a Good Example
  Children learn most by what we do not what we say. Practice the virtue of honesty and direct your children's attention to times when you are honest even when tempted to lie.
  
  Teach the Value of Honesty
  Help your child learn why it is a bad idea to lie.
  Lying does not change reality. It makes it harder to deal with reality. It is like a band-aid with flesh-eating bacteria on it. It covers the wound but keeps it from healing.
  If you keep lying it can become a bad habit and you end up deceiving yourself.
  It damages people's trust in us and hurts our reputations.
  Remind your child about "The Boy Who Cried Wolf."
  
  Learn the Reasons for the Lies
  Children lie for different reasons, and our response should be tailored to the underlying reasons.
  Lies to get attention, praise, prestige. Solution: Pay attention to and praise the child when he is honest even when tempted to lie. For instance, if child lies to win at a game, catch the child being honest and tell him that he is fun to play with when he is playing fair. Work on ways to build your child's genuine sense of competence and self-respect.
  Lies to escape punishment. Solution: Examine whether your punishments are too severe or frightening. Let child know that lying will bring more punishment. But don't tell child, "If you tell the truth I won't punish you."
  Lies to avoid disapproval. Solution: Make your expectations more in line with child's abilities and talents.
  Lies to get something for self. Solution: Help child find other ways to get the desired object.
  
  Don't Ignore Children's Lies
  If you do, the lies will get bigger and more frequent.
  
  Don't Call Your Child a Liar
  Children tend to live down to our expectations.
  Dr. Warshak's maxim: You don't help children become good people by telling them how bad they are.
  Instead, express your belief that lying is out of character for your child and out of place in your family.

  
  6/27/02 -- SIBLING RIVALRY
  
  Understand the Basis for Sibling Rivalry
  Imagine if your husband tells you, "I love you so much I have decided to have another wife. When she arrives visitors say how adorable she is, and then turn to you and ask how you like her. She needs some clothing so your husband goes in your closet and takes some of your clothes for her. When you protest he says that they don't fit you anymore. You are enjoying the new computer your husband bought you and one day she asks to use it. When you say no, she runs crying to your husband who comes back with her and chastises you for not sharing. You get the idea.
  
  Don't Dismiss Negative Feelings, Acknowledge Them
  To get rid of unwanted feelings, you have to first let them come out in the open. If you tell your child that he shouldn't angry at his sister, the feelings won't go away. They'll just go underground where they can do more damage. It is comforting for kids for you to listen to their negative feelings without making them feel guilty for having them.
  
  Teach Children Appropriate Expressions of Anger
  Show them how to use words to express their anger and assert their rights.
  
  Stop Hurtful Behavior
  Expressing angry feelings is okay. Acting on them is not.
  
  Give your attention to the injured party, not the aggressor.
  
  Know When to Step In and When To Let Kids Handle It Themselves
  
  If normal bickering, ignore it.
  
  If the situation is heating up, acknowledge the feelings, describe the problem, and express confidence that they will find their own solution. E.g., You two sound mad at each other. You both want Gatorade but there is only one left. I'm sure you can work out a fair solution.
  
  If the situation is possibly dangerous, ask if it is a play fight or a real fight. Set the limit that if it's not fun for both it has to stop.
  
  If the situation is dangerous, act immediately. Describe the situation and separate the kids. E.g., it looks like you are about to hurt each other. Since it's not safe for you to be together, we have to have a calming down period. Each of you go to your rooms.
  
  Avoid Comparisons
  If you really want to stir up animosity between siblings, constantly compare them, especially when reprimanding them. E.g., your sister was able to finish her homework on time. Why can't you? Even favorable comparisons cause problems. E.g., I wish your brother cleaned up after himself as good as you do.
  
  Comparisons encourage children to compete.
  
  Instead of comparing, describe what you see and feel or what needs to be done. E.g., I see you have not finished your homework. You'll have to work on that problem. Or, you did a nice job of cleaning your room.
  
  Treat Children Uniquely, Not Equally
  
  Children don't need equal time from us. Give according to what they each need.
  
  You don't have to show equal love. Show each child that she is special to you.
  
  Labeling Is Disabling
  The danger in labeling a child is that he might believe you. Instead of calling the older son a bully, help him see that he is capable of better behavior. Instead of sympathizing with the younger child as a victim, "my poor baby," teach her how to assert herself: e.g, "Tell your brother that it's your birthday present and you can decide when to share it."
  
  Emphasize Children's Abilities Instead of Their Disabilities
  Accept their frustration and show appreciation for what they have accomplished. Focus on solutions instead of special needs. E.g., This isn't easy. You're doing better. What would help you get it done?"
  
  Help Children Understand the Life-Long Value of Siblings
  Your siblings are the only people in the world who will know exactly what it was like to grow up in your home and can share your childhood memories. They also know you in a unique way that even a spouse doesn't. In most cases siblings outlive your parents, so you should treasure the bonds despite the rivalry and frustration.
  
  

  6/26/02 -- HELPING CHILDREN COPE WITH TRAUMA
  
  Understand the Impact of Trauma
  It leaves children feeling vulnerable and helpless.
  Trauma victims feel weak, scared, and ashamed.
  The traumatic memories haunt the victim.
  
  Don't Be Afraid to Talk About The Event

  Whether or not your children say anything about a traumatic event, if they witnessed it or overheard conversations about it, you can safely assume that it is on their minds.
  
  Encourage Children to Express Their Reactions and Feelings and to Ask Questions

  Don't assume that you know what they are thinking and feeling about it. When they do ask questions ask them what they think. You want to learn what sense your children have made of the events. What do they know, think, and feel?
  
  Be Patient with Repeated Questions

  Children sometimes ask the same questions repeatedly. Naturally this gets tedious for parents, but you should understand that the questions are not intended to "bug" you. Rather, such questions show that the children have still not fully understood or accepted the answers. Try to be patient. Children's questions are precious gifts. They bestow upon you the awesome responsibility of shaping, or at least framing, your children's attitudes for years to come. Repeated questions deserve repeated answers. When your children no longer need to ask questions, they will stop on their own. If you tell them to stop asking questions, they will not stop thinking about the issues; they will merely exclude you from their inner thoughts.
  
  Reassure Them That Their Reactions are Normal

  School-age children who are anxious in the aftermath of a trauma often feel ashamed of what they perceive as babyish behavior. They also worry that their newfound fears will never go away. Reduce your children's shame and worry by reassuring them that it is okay to be afraid. Explain that it is not a sign of weakness to feel fear but a natural and protective response to danger.
  
  Reassure Them That Their Fears Will Not Last Forever

  One of the most effective ways to get this point across is to talk about a temporary fear that you suffered and surmounted when you were a child.
  
  Take Positive Action

  Help your children take some positive action in connection with the event. This helps offset feelings of helplessness and hopelessness. For instance, let them participate in memorial services, write condolence messages, pray, give blood, advocate for better screening of bus drivers.
  
  Knowledge Is Power

  Some children will cope best by learning more about car accidents and how and why they occur.
  
  Try to Resume Normal Routines

  The sooner life returns to familiar patterns, the sooner children will feel safe.
  
  Share Your Feelings, But Maintain Your Composure

  Parents wonder how much of their own uncertainty and anxiety to reveal to children. Children can certainly sense when we are upset. Not only would it be difficult to conceal our own reactions to traumatic events, it would give children the wrong message. We want them to know that when horrible things happen it is normal and healthy to react with strong negative feelings and to freely express these feelings. The best way to teach a healthy approach to difficult feelings is to demonstrate it through our own behavior. This principle is not a license to magnify the crisis for your children and burden them with your own sense of hopelessness and despair.

  It is best to strike a balance between two extremes. Parents who take a "business as usual" approach and act as though nothing is out of the ordinary encourage children to distrust their own perceptions. Parents who fall to pieces while discussing traumatic events with their children compound their children's insecurity at a time when they need reassurance. The goal is to show your children how to express strong feelings openly. If you frighten them by appearing out of control, the lesson they retain will not be that it is healthy to express emotions, but that it is frightening.

  By maintaining composure while acknowledging the reality of the trauma, you reassure your children that the horrible events have not shattered the security of their home and family. You show them that they do not have to deny horrible realities, but that even when life is not business as usual, they can rely on their parents to retain their roles as sources of comfort and security. This approach simultaneously demonstrates a very important virtue, particularly during hard times: the importance of exhibiting courage in the face of adversity.
  
  Recognize the Positive Legacy of Trauma

  Help your children draw strength from adversity and use the trauma to inspire a better life. Trauma's impact is not all negative, at least it does not have to be. When psychologists set out to study something like the impact of trauma, the type of questions they ask defines the range of answers they will find. Early students of trauma were concerned about trauma's negative effects and not surprisingly that is what they learned about. As a result, when psychologists discuss the impact of trauma many convey a one-sided negative view. More recent studies have searched for positive outcomes of trauma and have learned what novelists and historians have known for generations: many people draw strength from adversity. They take inspiration from their suffering. They transcend their traumas and become better people.
  
  Watch for Warning Signs
  Reenactments such as nightmares, excessive risk-taking.
  Avoidance - becoming withdrawn, afraid to leave the house.
  Becoming easily startled or having trouble sleeping.
  
  Seek Professional Help If You Are Unsure About Your Child's Recovery
  

  Click here for suggestions of where to get help.
  
  

  6/13/02 -- ANXIETY
  
  Everyone feels some anxiety from time to time. How do we know if we are too anxious?
  

  Anxiety becomes a problem when it goes on too long past the original threat and it interferes with your life. Some types of anxiety disorders are: Panic disorders, specific phobias, generalized anxiety, and the one we hear the most about in the wake of 9/11: Post-traumatic Stress Disorder or PTSD.
  
  What is PTSD?
  

  We used to call it shell shock or combat fatigue. The form that Hollywood made familiar to us is the soldier who experiences flashbacks where he relives the horrors of the battlefield miles and years removed from the original battle. When psychologists recognized that the condition is not restricted to wartime casualties, that other catastrophic, terrifying, or life-threatening events left victims in the same state, the condition was renamed post-traumatic stress disorder or PTSD.
  
  Symptoms of PTSD
  

  Traumatized victims are haunted by the event. They cannot think of the event without experiencing great anxiety and anguish. So there is a natural tendency to try to avoid thoughts and feelings about the event and to avoid people, places, activities, and situations that might remind us of the event. Avoidance is one of the cardinal symptoms of PTSD. We do our best to push memories out of mind. The attempt to anesthetize ourselves to the emotional pain unfortunately results in a general numbing of all emotions. Some victims report feeling detached or estranged from other people. Children may regress to less mature behavior, such as bedwetting or thumb-sucking.
  

  Efforts to avoid trauma-related thoughts and feelings invariably fail. Try as we might to avoid thinking about a terrifying ordeal, our minds just won't cooperate. This is a second cardinal feature of PTSD. The event returns to haunt its victims in the form of persistent, recurrent intrusions into consciousness. Traumatic replays occur during the day in the form of troubling memories and they occur during sleep in the form of nightmares.
  
  What types of anxiety disorders do children suffer?
  

  Children can suffer from all types of anxiety disorders, but one that is more likely to first appear in childhood is separation anxiety disorder. Children are anxious about being apart from their parents. They have trouble leaving home to go to school. They don't go to camp. They won't even spend the night at a friend's house. They worry about being kidnapped. They worry constantly that something bad will happen to their parents. They can't sleep in their own room without a parent present. If parents want to leave them with a babysitter they panic and throw tantrums. Not unusual in children under the age of 2 years, but if this condition persists in older children for more than two weeks, parents should seek professional guidance.
  
  Where Can I Go For Help?
  

  Click here for suggestions.
  
  

  5/30/02 -- WHEN TO CONSULT A CHILD PSYCHOLOGIST
  
  What types of problems do child psychologists treat?
  

  Behavior problems - e.g., not complying with the rules at home or at school, substance abuse, truancy

  Academic problems - e.g., not meeting teacher's expectations in learning or on tests, not doing homework

  Social problems - e.g., trouble making or keeping friends

  Behavior or feelings that are troubling to the child - excessive fears, worries, low self-esteem, symptoms of stress, compulsive behavior, tics, or other unwanted habits. Some examples are :severe separation anxiety that makes it hard for your child to attend school or be apart from parents, headbanging, troubling thoughts that your child cannot stop thinking about, chronic stomachaches for which no medical cause can be found, bedwetting, excessive nightmares
  
  How do I know whether or not my child's behavior is normal?

  The difference between normal and abnormal behavior is a matter of degree: how often does the behavior cause a problem for the child, the parents, the school, the community. The more misbehaviors, the less age appropriate, the longer the duration of the problem, the more likely that professional help is needed.
  
  Warning Signs

  Constant anxiety and worry that is not warranted by the situation.

  Signs of depression such as increasing withdrawal from people

  Abrupt changes in mood or behavior that last more than just one episode, e.g., a child who is usually reliable and responsible suddenly starts lying or acting hostile or not doing homework.

  Sleep disturbances - e.g., nightmares, trouble falling asleep
  
  Other Examples of Problem Behavior

  firesetting

  cruelty to animals

  bullying other kids

  difficulty paying attention in school frequent temper tantrums that are not age appropriate, or "meltdowns" at the slightest frustration

  overly perfectionistic

  compulsive habits such as a child who constantly wipes his nose so that the skin above his mouth becomes raw
  
  What to do before calling a psychologist.

  Talk to friends and read articles to learn whether or not your child's difficulties are normal and expectable behavior for this age. Talk to your child to learn how much distress the problem causes for him or her.
  
  How to talk to your child about going to the psychologist.

  In telling your child about the visit to the psychologist, it is best to be honest. For instance, "You know we have been trying to help you do better in school. But we haven't helped enough. So we are going to a doctor who will help us learn a better way to help you." For younger children you might refer to the psychologist as "a worry doctor who helps children with their worries." Stress that this is not a doctor who gives shots or looks in ears, but one who talks to people and tries to help them solve problems.
  
  Preventive Psychology

  Parents should not always wait for problems to develop in their children before talking to the psychologist. For instance, if parents are planning to divorce, a psychologist can coach them on how best to handle this with their children. If you are worried about a problem, trust your instincts. In matters of health, physical or mental, it is wise to follow this advice: When in doubt, check it out.
  
  Where Should I Go To Get Help?

  For a referral to a psychologist, click here to email Dr. Warshak or call Dr. Richard Warshak at 972-248-7700.

  For services at reduced fees, contact one of the following:

  Adult Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-5555

  Child Psychiatry Clinic at the University of Texas Southwestern Medical Center - Phone: 214-648-3198

  Child and Family Guidance Center - Phone: 214-351-3490
  
  How To Select a Psychotherapist

  Locating the right therapist can be frustrating. Therapists come with different educational backgrounds and different training experiences. They come with different degrees and different certificates and licenses.

  Psychotherapists can be clinical psychologists, psychiatrists, social workers, or counselors. Each discipline has its share of excellent, good, fair, and bad therapists. In the United States the use of the title psychologist is regulated by law. Most clinical psychologists have earned a doctoral degree (Ph.D. or Psy.D.) and completed an internship, although some may have a master's degree (M.A.) which takes fewer years in graduate school. Psychiatrists are medical doctors (M.D.), most of whom continued their training in a residency program following medical school. However, a physician may use the title psychiatrist without having completed a psychiatric residency. Most social workers and counselors have a master's degree, although some have a Ph.D. and others have only a bachelor's degree.

  Look for a therapist with credentials and experience beyond the minimum required to hang a shingle. For a psychologist this could be a listing in the National Register of Health Service Providers in Psychology. For a psychiatrist it could be the completion of a psychiatric residency. For a social worker it could be certification through the Academy of Certified Social Workers (ACSW) or status as an Advanced Clinical Practitioner (ACP). For counselors it could be a doctoral degree or status as a licensed professional counselor (LPC).

  You should not choose a therapist, though, based solely on degrees, certifications, and licenses. Paper credentials are no guarantee of competence or expertise. Select a therapist the way you would a surgeon. If you would not pick your surgeon from the telephone directory, don't choose a therapist this way. Get recommendations from people you trust, such as pediatricians, who are in a position to know which therapists work best with families such as yours.

  E-mail Dr. Warshak

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