Ask The Expert: Is It Necessary To Test Again?

  • June 7, 2013 7:23 am

My son was tested 3 years ago and was diagnosed with a math disorder and now his school is asking for an updated full evaluation because next year we will be applying for high schools.  Why does he need to be tested every 3 years?  What does the full evaluation entail and can’t he just be tested for the math disorder?

Your child needs to be retested every three years in order to determine how the current recommendations and accommodations are meeting your child’s needs. It is hoped that the changes that were put in place based on the initial assessment have helped your child. As your child gets older and advances in their academic career, he or she might need changes to their accommodations. This may include receiving additional time when taking in-class tests or additional academic help with certain subjects. Also, as your child gets older, s/he will have a better ability to not only discuss their difficulties, but also to understand how their difficulties influence them, why they get special accommodations, etc.

The full evaluation will include academic and intellectual testing, which will help compare your child’s potential with how they are performing in the classroom. It will also include academic reports, input from parents, teachers, and your child, and other measures which are designed to better understand and evaluate your child.

Retesting just for the math disorder would not take into account other aspects of your child that may have changed over the past three years. It is likely that he or she will have different strengths and weaknesses. Also, depending on your child’s age, he or she can be more involved in the process and start to become their own best advocate. In addition, as children age, there are more tests available to better determine the specific issue(s) that are affecting your child.This will result in more thorough, complete, and accurate recommendations and accommodations.

Jason Arkin, PsyD

Stealing From Our Children?

  • May 27, 2013 8:05 am

It was recently reported that six employees of the San Francisco Unified School District have been arrested for stealing and that they face no less than 205 felony charges stemming from the alleged misuse of an estimated $15 million in grant funding.  The allegations include redirecting money into slush funds, bonuses and non-approved pay increases.  The San Francisco DA reports that approximately $250,000 went towards the SFUSD employees’ personal use.

One of the defendant’s attorney, stated that his client “felt she had the right to do it”.  Currently there are many unanswered questions in this troubling case but one very important question is can it be possible that people are so unclear about what stealing is or are able to justify it to themselves?  Is it so complex and confusing to understand what is and isn’t mine, either professionally or personally?  It may seem clear to some of us, and we can only imagine people in this scenario acting out of pure greed or selfishness. And that may be the case. But people with stealing disorders – as with other addictions or compulsions – often use justifications and twisted logic to rationalize their out of control behavior.

In our years of working with people who have stealing disorders we have discovered that there are many people who steal who otherwise spend most of their time contributing to society and their families in a positive way. These people are therefore very confused about their stealing behavior.  While they are almost always clear that  when they go into a store and steal a watch they are stealing, they are often unclear if it is stealing to taste fruit at a grocery store before purchasing it, take something out of the communal fridge at work without asking, skim a little money from their wealthy employer, or take home office supplies from work.  These scenarios (and even stealing a watch from a store) get rationalized and thinking becomes distorted in the face of emotional reactivity.

In our work with people with stealing disorders, therefore, it becomes a priority to help them keep their thinking simple.  In other words, we encourage them to ask questions such as: Does this thing or money belong to you?  Have you already purchased it for it’s full price?   If the answer is “no” and you take it, then you are stealing.  If the answer is “I don’t’ know” then you have to ask if you can have it for free.

People with stealing disorders are often unable to distinguish what is stealing and what isn’t.  Their impulsivity overrides their thinking and their emotional empathy which would allow for them to formulate the question of whether or not a certain thing or money belongs to them.  The impulsivity is often driven by several factors which include: internal and/or external stressors, at times co-occurring mental or medical health issues, co- addictions and the neurobiological dopamine reward cycle taking place in their brain each time they steal.  The urge to get something for nothing feels like a “high” or a “win” but most importantly it is feels really good (and even alters their brain chemistry) and therein lies their problem: people get addicted to it.  When people are addicted they formulate all kinds of defenses, cognitive distortions, rationalizations, conscious and unconscious that allows them to repeat the cycle in order to get the payoff of good feelings again and again.

It is disheartening when we see cases like this and of course can’t imagine how could someone who has spent their life serving the public good get caught up in something like stealing from the very institutions and people they serve.  It is easy in a case like this to be cynical and political in our commentary, and it is possible these people are stealing out of pure greed, lack of empathy, and criminality. However, stealing occurs every day all day, all over this city, country and world, and some of it is by people who can’t help themselves.  There is treatment and help for individuals who compulsively steal and it is our hope that everyone with this problem can get the help they need so we can all live in a safer world.  

Elizabeth Corsale, MA, MFT

Not Getting Clean: It’s A Killer

  • May 3, 2013 12:15 pm

In his recent book Clean, author David Sheff writes about addiction treatment and why it fails to help so many addicts. The idea for the book came out of his struggles helping his son with his addiction, which led to further research on the state of addiction treatment in the U.S. In a recent article on Time.com, he started his article by stating that:

“Every year in the U.S., 120,000 people die of addiction. That’s 350 a day.”

He goes on to write that “A growing body of evidence has proved that addiction isn’t a choice subject to willpower but a brain disease that’s chronic, progressive and often fatal.” He then writes that in spite of this, there are a shocking number of treatment programs which do not use techniques that are based on research on effectiveness. He writes that it is crucial that people need to find and utilize these programs which “use therapies that have proved effective in clinical trials, including cognitive-behavioral therapy designed to train addicts to recognize and interrupt the cues that trigger the relapse mechanism; motivational interviewing, a therapy approach widely used to treat many psychological disorders that helps addicts engage in treatment; contingency management, which essentially rewards addicts for clean time; and psychopharmacology.” These treatment programs can also include “alternative” therapies that have been proven effective, such as meditation, acupuncture, and animal-assisted therapy.

Importantly, he goes on to say that “most researchers agree that no single therapy is appropriate for every addict. Often they’re used in concert. An effective treatment regimen may include AA, but only for those patients who are open to it.”

One of the most important points that he makes is about how unregulated rehabilitation is, and how widely the programs vary.  He writes:

Currently there’s a chasm between these and other evidence-based treatments (EBTs) and rehab programs. Every day addicts fall into it, and many never make it out. Most people in need find themselves in the same frustrating position I was in when I was desperate and overwhelmed, shopping for programs and doing the best I could to navigate an unnavigable system that’s also largely unregulated. In many states, anyone can open a rehab program — no licenses or accreditation are required.

This is slowly changing. More people are being educated about the fact that addiction is a disease and therefore requires treatments based on the medical model. The more consumers are educated and demand EBT, the more the billion-dollar rehab industry will adapt and offer it. That is, the industry will adapt or it will die and be replaced. In the meantime, those who need treatment must do the best they can to find programs that offer EBT. The place to start is by receiving an assessment from a psychologist or psychiatrist who is trained in addiction medicine. … A competent doctor can determine the severity of addiction and the presence or lack of co-occurring psychological disorders and prescribe the next step. It may include a brief intervention, therapy, psychopharmacology, an inpatient or outpatient program that offers quality care or a combination of these things.

Sheff’s points are crucial and a matter of life or death for many. For some addiction programs, even “certifications” are simply designed by people who had theories rather than based on research and/or outcome studies. His plea for standard of care for addiction is critical – for the health and well-being, and even life or death, of so many.

Samantha Smithstein, PsyD

(Re)Defining Justice

  • April 13, 2013 10:48 am

Restorative Justice is a process to involve, to the extent possible, those who have a stake in a specific offense and to collectively identify and address harms, needs, and obligations, in order to heal and put things as right as possible.”

– Howard Zehr, 1990

Restorative (or Reparative) Justice is based on the Native American principle that criminal behaviors are offenses against human relationships and that after these behaviors are committed, there are both dangers and opportunities:

  • The danger is that everyone emerges further alienated, more damaged, disrespected, disempowered, feeling less safe and less cooperative.
  • The opportunity is that injustice is recognized, equality is restored and the future is clarified. So that participants are safer, more respectful, and more empowered and cooperative with each other and society.

Restorative justice is a process designed to try to “make things as right as possible” for everyone involved.  That includes: repairing what has been broken, making society safer, attending to needs related to the behavior, and making amends.

Traditional criminal justice seeks answers to three questions: What laws have been broken? Who did it? and What do the offender(s) deserve? Restorative justice instead asks: Who has been harmed? What are their needs? Whose obligations are these?

Restorative Justice can take place in a diversity of settings, including neighborhood courts, schools, therapy groups, and nations. The 12-step community has also attempted to address the need for restoration through steps 8 and 9: making a list of the persons harmed and making direct amends to such people whenever possible. Making amends is different from an apology – one is simply an acknowledgement and expression of regret, whereas the other attempts to create restoration. Sometimes people also talk about “living” amends, which has to do with choosing to live differently so as to not create more harm.

Restorative Justice, or making amends, doesn’t require forgiveness. Forgiveness is a step that the victim(s) may or may not be able or willing to choose. Instead, Restorative Justice seeks to restore and heal, so that everyone may move forward less broken, and more whole.

Samantha Smithstein, Psy.D.

Is Sexual Addiction a Real Addiction?

  • March 16, 2013 8:31 am

By M. Deborah Corley, PhD, LMFT, LCDC, LSOTP, CSAT, CMAT
Co-owner/founder of Santé Center for Healing (www.santecenter.com)

The acceptability of a vast range of sexual behaviors in the United States reflects our changing society in which every form of expression of sexual behavior is available to anyone with access to the Internet. But even those who do not use the Internet for viewing sexual materials, engaging in sexual conversations, or arranging meetings for sexual purposes, anyone who has access to mainstream media has been exposed to explicit coverage of sexual behaviors in the news or in prime time television and movies. Strip clubs have moved from the backroom into multimillion dollar establishments and are available in every state in the union. However, engaging in one or several of these types of behaviors does not make someone a sex addict. Sexual addiction like any addiction – it is not so much about the type or amount of behavior, but about the impact the behavior has on someone’s life. For people who are finding it hard to control their sexual impulses, many fear they are sex addicts but are not sure if it is a real addiction or what to do about it.

Although it was in 1980 that a very famous researcher and clinician from Johns Hopkin University, Dr. John Money, proposed that sex addiction existed, it was later in the early 1980’s that Dr. Patrick Carnes really began the conversation about whether sex addiction was a disorder or not. Sex addiction has been used synonymously with sexual compulsivity, sexual dependency, and excessive sexual desire and hypersexual disorder and the discussions about the definition have been ongoing for the past thirty years. In the past year, the American Society of Addiction Medicine (ASAM) took the lead in the debate about whether sexual addiction is really an addiction. ASAM set about to define addiction with a focus on what happens in the brain for an addict and they included what mental health professionals refer to as process or behavioral addictions like sex, gambling, and Internet use.

ASAM defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by an inability to consistently abstain, impairment in behavioral control, and craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. (ASAM, 2012)

The criteria most recently proposed for the DSM-V (Diagnostic and Statistical Manual, sort of the psychiatrist’s encyclopedia of mental health disorders) contains aspects of the criteria mental health professionals have been using for some time now in addiction treatment center sand private practices all over the United States. Basically, criteria requires the behavior must be occurring over a period of at least six months – so it is not about just an affair or two, or two weeks of looking at pornography on the Internet. There is a persistent and pervasive pattern of behavior in which a person is not able to control their sexual fantasies, urges, and/or behaviors despite negative consequences to self or others. The person spends excessive amounts of time seeking or engaging or recovering from the sexual activity and generally uses the behavior as away to cope with anxiety, depression, or emotionally distressing situations. And the behavior can’t be the result of drug use or another medical condition like a brain injury. (APA, 2010)

Most people report that the behavior started in adolescence. Women sex and love addicts report more sexual abuse as children than do men but more men have the disorder than women.In a recent study of women sex and love addicts, exposure to pornography as a child was the greatest predictor of sexual addiction, even more than sexual abuse. The most common behaviors reported in studies of sexual addicts includes masturbation with the use of pornography, followed by sex with a consenting adult, and then cybersex activities on the Internet.

Studies done in the recent past have identified how both women and men put themselves and others in harm’s way. Women sex addicts also tend to stay in relationships after they become abusive as compared to other women. Women sex and love addicts report higher numbers of unplanned pregnancies, terminated pregnancies, depression, suicide attempts, and infertility problems than do non-addicted women. Both women and men report an average of 15 different sex partners in a year, unprotected sexual encounters, and higher rates of sexually transmitted infections than non-addict groups so in many ways sex addiction is also a public health problem. Other behaviors often reported by sex addicts that have caused a variety of negative consequences includes use of prostitutes, multiple affairs, viewing pornography on Internet at work, having sex with employees, and heterosexual men having sex with other men.

The good news is that sexual addiction can be treated. There are several screening tests that can be used to help identify people that meet the criteria for sexual addiction (see list at end of article.) People in the early stages of the disorder have had success by attending 12-step meetings for sex addicts or group therapy specifically for sexual addiction. (Individual therapy can be very helpful however, group therapy lets an addict be with peers who are dealing with the same issues and thereby has access to others who can be supportive as well as hold the addict accountable for his or her actions.) When people have combined other addictive behavior like alcohol or other drug use with sexual addiction or have had the disorder for a long time and have a long history of secret keeping or trying without success to stop, more intense therapy is often needed like that offered in intensive outpatient programs or in a residential setting where a safe environment helps the addict have enough time in therapy, support, and accountability to learn other ways to manage emotional distress and life’s challenges.

Some behaviors that have severe negative consequences include illegal behaviors. Sexual offenses are beyond the scope of this article, but the addiction model has also been found useful for those who have engaged in sexual offending behaviors. Family therapy is an important component to any addiction treatment. Family members, especially spouses/partners have been betrayed by the addict through his/her behavior. Support of a family member can be significant in an addict’s path to recovery. Yet being supportive when a person has been betrayed is difficult, so everyone in the addict’s immediate support system needs a chance to heal and learn to respond in a healthy way to the addict’s behaviors. Therapy and mutual help groups are also beneficial for family members.

Sexual addiction is a complicated disorder that deserves additional research to clarify
who is most at risk and the most effective treatments. This will take time. As we learn more, it is
important to see that people who suffer from this disorder get the help that is needed. If you have questions about sexual addiction, the Pathways Institute would be happy to answer them for you. Additionally, SASH (Society for the Advancement of Sexual Health) is a national organization devoted to helping sexual addicts and their families find help (www.sash.net). For other assessment, treatment information, referrals, or copies of recent research articles, you can contact www.santecenter.com.

Screening tests:
Sexual Compulsivity Scale (Kalichman & Rompe, 1995. Available at www.santecenter.com)
W-Sexual Addict Screening Test (www.sexhelp.com) (for women)
Hypersexual Behavior Inventory (RReid@mednet.ucla.edu)
Internet Sex Screening Test (Delmonico@duq.edu)

M. Deborah Corley, PhD, LMFT, LCDC, LSOTP, CSAT, CMAT is co-founder and co-owner of Santé Center for Healing, a residential treatment center for addictions near Denton, Texas. She serves as clinical consultant to the Santé treatment team. She won the 2008 Merit Award from Society of the Advancement for Sexual Health (SASH), the 1999 Carnes Award for outstanding achievement in the field of sex addiction and was the co-recipient with Dr. Schneider of the Clinician’s Most Valuable Article Award by the American Foundation for Addiction Research in 2003 for their work on disclosure. She is the past president of the Board for SASH and a clinical member of the American Association of Marriage and Family Therapists. Licensed both as an addiction treatment specialist and marriage and family therapist, Deb has over 30 years of experience working with and conducting research on addictive disorders and high risk families. As an international speaker in the US and Canada, her focus on treatment of addictions, trauma resolution, disclosure, interpersonal neurobiology and meeting attachment needs is well received. In addition to Disclosing Secrets and Surviving Disclosure, she is co-author of Making Advances: A Comprehensive Guide to Treatment of Female Sex and Love Addicts.

References:
Corley, M. D., & Delmonico, D. (2011). Closing the gap: Results from the women’s sexuality
survey on female sex and love addicts. Presentation at Society for the Advancement of
Sexual Health Conference, LaJolla, CA.
Corley, M. D. & Hook, J. N. (2012). Women, female sex and love addicts, and use of the
Internet. Sexual Addiction and Compulsivity, 19, 53-76.
Corley, M.D. & Schneider, J.P. (2012). Disclosing secrets: An addicts guide to when, to whom,
and how to much to reveal. Tucson, AZ: Recovery Resources Press. Available at
www.amazon.com.
Langstrom, N. & Hanson, R. (2006). High rates of sexual behavior in the general population:
Correlates and predictors. Archives of Sexual Behavior, 35, 37-52.
Reid, R., Carpenter, B. & Lloyd, T. (2009). Assessing psychological symptom patterns of
patients seeking help for hypersexual behavior. Sexual and Relationship Therapy, 24, 47-
63.
Reid, R. et al. (2012). Report of findings in a DSM-5 trial for hypersexual disorder. Journal of
Sexual Medicine,
Reid, R., Garos, S., & Carpenter, B. N. (2011). Reliability, validity, and psychometric
development of the hypersexual behavior inventory in an outpatient sample of men.
Journal of Sexual Addiction and Compulsivity, 18(1), 30-51.
Schneider, J. P. & Corley, M. D. (2012). Surviving disclosure: A part

This is your brain on dope(amine)

  • January 25, 2013 11:32 am

Dopamine is a neurotransmitter responsible for movement, pleasure, motivation, and cognitive processes, such as learning. For the purposes of understanding its role in addiction, let’s concentrate on pleasure and motivation.

Whenever we do something that propagates the advancement of our species, dopamine is released in order to motivate repetition of the action. When we sleep, eat, and have sex dopamine is released in our brain and the message is, “That was great, do it again!” We also release dopamine whenever we find something pleasurable. Be it 18th century poetry, heroin, or Radiohead, our brain will release dopamine to encode the stimulus as something that brings us pleasure.

Dopamine not only serves to categorize the good things we encounter in life, it also programs our pre-frontal cortex (the part of the brain involved in judgement and decision making) to alert us when the pleasurable stimulus is available. If your brain cells could talk, it might sound something like, “OMG! There’s a flyer on that lamppost for a Radiohead concert. Go look at it!” In other words, we become hyperaware of opportunities for engaging in behaviors that bring us pleasure. In fact, a study on people with alcoholism found they were more likely to spot alcoholic beverages in a busy photograph than people who don’t have problems with alcohol.

When we consume substances, it makes us feel good because our brains release dopamine, but drugs elicit a higher amount of dopamine release than is necessary. This is part of what causes experiences of euphoria and feeling high. Sometimes the amount of dopamine released is so great, the chemicals in our brain become unbalanced and we may experience hangover or withdrawal. In time, our brain regains chemical equilibrium. However, if one abuses substances, the brain may develop a tolerance (meaning the person needs to use greater amounts to get high) or dependence on the substance as a source of dopamine. If one becomes dependent on a drug, it may take some time for the brain to regain equilibrium and the person may experience extreme physical discomfort and emotional distress when they aren’t using. The period of re-calibration depends on the amount, type, and frequency of the drug used. For this reason, it’s always a good idea to be under medical supervision and receive support from friends, family, and a mental health professional if you’re dependent on a drug and want to stop or decrease your use.

The mechanism of tolerance is also evident in impulse control disorders, such as sex addiction, kleptomania, and compulsive gambling. Although it doesn’t appear that persons with an impulse control disorder undergo the same intensity of withdrawal that persons addicted to substances experience, there can certainly be a period of re-calibration of dopamine receptors during which a person feels irritable and agitated after stopping a behavior.

Based on the information presented here, we can conclude that we are all hard-wired to potentially become addicts and you may be asking yourself, “If this is true, why do some people become addicted and others don’t?” This is a really good question and the answer is “We don’t really know.” We can predict the likelihood of someone becoming an addict based on factors such as first age of substance use and family history of addiction, and we know that a lack of social support and coping strategies (especially when coupled with mental illness) can also lead to addiction, but there is no conclusive answer to date.

The best ways to prevent addiction are to educate yourself about the substances you use (or to abstain from substance use altogether) and to be mindful about the choices you make. If you have a mental illness, ensuring that you are getting appropriate treatment and maintaining social support are good preventative measures.

Jennifer Fernandez, PhD

We Admitted We Were Powerless

  • December 3, 2012 4:13 pm

The very first step of every 12-Step program begins with these words – an admission of powerlessness. For many people, that very first step makes participation in a 12-Step program very difficult and with good reason: powerlessness is an uncomfortable feeling and not one that most people seek out or admit to.

In fact, most of us spend a great deal of energy, time, and effort attempting to try to control things and other people in our lives. We work hard to try to create a life of happiness, as we should. However, these efforts often involve trying to gain control over something we don’t have control of, like an addiction. Other times, the efforts involve trying to change or control other people who are in our lives. And understandably, because the people in our lives – their choices and behaviors – affect us; sometimes profoundly.

But when we stop and look at how effective our efforts are to bend others’ actions to our will – when we really examine how well our efforts to control things go – we find that, in fact, we cannot figure out a way to make others be or do what we want. We discover that using all of our efforts to control someone so they don’t cause us pain doesn’t, in fact, protect us. As the program of Alanon says: we don’t cause the behavior of others, we can’t control it, and we can’t “fix” it. Trying to do so simply makes our life feel unmanageable and increases our unhappiness.

Acknowledging that we are powerless is not about acknowledging that we are weak. Instead it acknowledges what is true, and allows us to focus on the things that we can control and the person who we can help: ourselves. Acknowledging the ways we are powerless also allows us to be more accepting of others, and to find a more peaceful way of being in the world and in relationships.

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing. Helen Keller

Capacity to Love

  • October 19, 2012 2:41 pm

Recently, the Pathways Institute facilitated some parent discussion groups at the Parent Education Network (PEN) September parent meeting. Instead of focusing on their children, the parents were asked to share their experiences and talk about what it has been like for them to raise a child with learning and/or attention differences.

The sharing was heartfelt, moving, and emotional. The Pathways Institute had contemplated offering a support group for parents of kids with learning and/or attention differences – where they could support each other as well as exchange information and experiences – and the meeting at PEN confirmed that such a group would be helpful and is much needed.  It was a challenge for most parents to talk about themselves versus their children, but as they did many teared-up and a few cried. It was clear by the end that most parents need support to deal with the guilt, helplessness, acceptance, overwhelm, sadness and grief. It was also clear how deeply these parents love and cherish their children.

As the parents spoke to each other, some themes emerged:

  1. 1.    Frustration
  • Many parents felt as if their children were trapped in an educational system that does not meet the need of so many children – that the methods of educating children were too rigid and too narrow.
  • Parents spoke about the painful reality that they had to give up certain things like family vacations because the child can’t be out of their structure and comfort zone without big meltdowns. For some families, that included not even being able to have family dinners together.
  • Many parents felt judged by family and friends about their “parenting” and how others don’t understand that some issues are not parenting issues, but are instead issues related to learning and/or attention (and therefore can’t be “fixed”).
  • Some parents turned anger and/or frustration on themselves.
  • Many people – teachers, therapists and other professionals – don’t understand what “slow processing speed” is, and thus it is very challenging to get the necessary accommodations for a child.
  • Parents expressed frustration about knowing something was wrong with their child and being dismissed/not listened to by others.
  • Many parents expressed frustration and disbelief that teachers and educators don’t even read the ISP or IEP, and that many are unwilling to accommodate the educational needs of their child.
  1. 2.    Overwhelm
  • Many parents expressed deep feelings of guilt that the demands of parenting an LD/ADHD kid is can be overwhelming. They thought they somehow should be able to do it without complaint or with ease.
  • For some parents, the stress of parenting kids with learning and/or attention differences had led to divorce.
  • Children with learning differences can have a much longer dependence on the parents, which can be very draining over the long term.
  • Several parents asked how do we “build a community of understanding friends or friends with the same parenting challenges”? They reported feeling isolated and alone in their struggles and challenges.
  • Sometimes a child’s learning and/or attention differences can mirror that of a parent’s, which can make it doubly challenging.
  • Knowing the difference between respecting a child’s difficulty versus allowing the child to slack-off when they could be doing more is confusing.
  • Parenting a child with learning and/or attention differences can be exhausting. Many parents reported feeling some envy for other parents who they perceive as having it easier than themselves.
  • Parents reported that it is difficult to take care of themselves in the face of taking care of a child with a learning and/or attention difference.
  1. 3.    Acceptance
  • Many parents struggled with denial about their child’s learning and/or attention differences. In some families, one parent continued to be in denial while the other struggled alone to help the child. At times parents differed about what interventions should be taken. Sometimes the kids moved in and out of denial.
  • Sometimes a child’s challenge mirrors that of a parent’s, so they need to move into acceptance together.
  • Some parents felt it was important to accept “simple” interventions, such as the importance of exercise in order to help kids integrate especially before homework.
  • In the process of wanting to do everything they can for their child, parents at times feel they are doing too much. There is work in figuring out the balance between protecting/caretaking and leaving the child to his or her own devices in a healthy way.
  • Some parents discussed going to a group on codependency to help them learn about it and work on it with their children.

Some parents felt tremendous relief over receiving a diagnosis for their child. They felt deeply validated about their own experience and that they were given a language for their experience (and their child’s experience) and struggles. Some parents felt tremendous loss when their child was diagnosed. They felt a loss of the fantasy of who their child might be and what they hoped their parenting experience would be.  That said, many parents felt that there were immense gifts they received through parenting a child with learning and/or attention differences. They spoke of the ways their children were creative, bright, and even gifted. They spoke of how they had gained the ability to accept others for who they are, and grown in their capacity to love.

The Pathways Institute provides psychoeducational testing, consultation, and reports with understandable explanations for parents and teachers, and second opinions on school-based testing. We help parents navigate the next steps of diagnosis, intervention, and remediation, and offer therapy to support parents through the complex experience of raising a child with learning and/or attention differences. We also offer groups for kids and teens, helping them to build resiliency, understand how they learn, and how to advocate for themselves. For more information contact the Pathways Institute assessment program (click link).

Enjoy Your Life

  • September 1, 2012 8:51 am
Sometimes change is simple, even if it’s not easy

Enjoy your life and be happy. Being happy is of the utmost importance. Success in anything is through happiness. More support of nature comes from being happy. Under all circumstances be happy, even if you have to force it a bit to change some long standing habits.

Just think of any negativity that comes at you as a raindrop falling into the ocean of your bliss. You may not always have an ocean of bliss, but think that way anyway and it will help it come. Doubting is not blissful and does not create happiness. Be happy, healthy and let all that love flow through your heart.

— Maharishi Mahesh Yogi

 

To many, this quote by Maharishi Mahesh Yogi may seem trite, or overly simplistic. And indeed, there are times when we need more than this to create happiness—we may to make changes in our lives or our behaviors, we may need insight and/or healing. We may need transformation through meditation, psychotherapy, or relationship before we can apply new ways of thinking effectively.

However, there is a basic truth to the above quote, as evidenced by Cognitive Behavioral Therapy (CBT); a psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systemic process. It is also evidenced through programs such as the 12-Step programs, which helps its members transform, in part, through addressing habits of thought. Programs such as this address a basic truth in the same way Maharishi does: habits of thought create an experience in life, and sometimes we have to consciously change those habits in order to create a different experience, one of happiness.

Addiction or Excuse?

  • September 1, 2012 8:47 am
Public shaming is counterproductive and simply wrong.

Whether it’s food, alcohol, or sex, there are a number of people who react strongly to hearing that someone has engaged in self-destructive behaviors because they are an addict by saying, “Don’t use addiction as an excuse for your behavior! Take responsibility!”

This concept of an “addiction excuse” is relatively new, and while it captures the imagination of those who are hurt, angry, or frustrated by the behavior of an addict, or by someone who lacks basic understanding of addiction, it simply doesn’t hold water for people who are addicts or those who work with people who struggle with addiction. People who speak about addiction as a “convenient excuse for bad behavior” or a “way to not take responsibility,” don’t comprehend what addiction is, and what the experience is like for the person who struggles with it.

Addiction is a psychological and physiological disorder. Even for “process addictions” such as those related to eating, sugar, sex, gambling, and stealing, there is strong scientific evidence that the neurological pathways related to dopamine are activated similarly to an addiction to cocaine. So addiction is not something made up by people to explain something away, it is a real condition, with both biological and psychological underpinnings.

For the vast majority of people who suffer from an addiction or impulse control disorder, acknowledging an addiction is one of the most difficult steps they will ever take. Most are in denial for years, believing in the “free will” that addiction naysayers speak about; addicts want to believe they are in control, and can stop any time they want. Many struggle for years to gain that control and feel deep shame when they fail, again and again.

Acknowledging an addiction, therefore, is an incredibly important first step. No problem can be solved if the problem is not acknowledged. Until someone admits, “I have lost control of this situation and can’t stop myself,” they cannot possibly be open to learning and working on the steps it takes to change their behavior. To the addict, acknowledging an addiction may be the most difficult, shameful, and scary step they take … but is also a crucial first step in saving his or her life. In fact, rather than being about shirking responsibility, acknowledging an addiction is the first step to taking responsibility.

As a society, we must stop shaming them further by telling them that acknowledging their addiction is an “excuse” and that they should “take responsibility for acting badly” and just feel ashamed. Instead, addicts must be supported in their first step and invited to take the many steps— psychological, physiological, spiritual, and emotional—that must take place for them to become well.

It may be that part of what people are reacting to is the overwhelming list of addictions that we hear about these days. People have begun to feel as if it is an overused term, and that there simply can’t be so many people in our society addicted to so many different things. Sadly, this is also not something that is made up. It doesn’t take much work to look around and see the sheer numbers of people who are addicted to food, shopping, electronics, alcohol, drugs, gambling, sex, and the myriad of ways available to us to avoid the profoundly beautiful but sometimes acutely painful process of being human.

Samantha Smithstein, Psy.D.

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