Monday, December 28, 2009

THE STRESS OF THE SWINE FLU

TIRING LESSON IN MISINFORMATION

Only as the last few days of 2009 draw to a close have I been able to not think about the H1N1 Novel Swine (or whatever other name you want to call it) Flu. It has occupied my every waking hour much of the past four months, as you can tell by the fact that I had to suspend one of my favorite passtimes, my blogging.

Much has been learned in these past four months, mostly about how hard it is to get to the truth and to know who can and can't be trusted to be telling the truth. I will summarize what I have learned about influenza in a subsequent blog and try to tell the truth as I can decipher it.





To me the most important revelation of the H1N1 Flu was for me to learn that probably more than 2/3 - 3/4 of Americans are deficient in Vitamin D. This came to me in the way of literature about the influenza preventative effects of really good levels of Vitamin D3 and I was amazed to
find that there is a wealth of information about the importance of Vitamin D in an increasing number of human illnesses, including cancer, heart disease, arthritis, pain, and mental illnesses.




I will also soon into the new year of 2010 add a blog about Vitamin D and it's many benefits.













Once I am done talking about the Swine Flu and Vitamin D we can continue with the long list of things I have learned in practice and outside the box.

Happy New Year

Happy New Year!

Sunday, September 6, 2009

MINDFUL PARENTING



In my mind this is the most important topic that I have added to this blog thus far. Mindfulness is the parenting buzz word of the future and if carefully practiced in parenting and our personal lives will lead to more functional families and children and young adults who don't already have "issues". This is a long read but worth the time.


"Mindful parenting is the hardest job on the planet, but it's also one that has the potential for the deepest kinds of satisfactions over the life span, and the greatest feelings of interconnectedness and community and belonging." Jon Kabat-Zinn


YES! Magazine Spring 1998:
Millennium Survival Guide


Mindful Parenting
by Jon and Myla Kabat-Zinn

Sarah van Gelder talks with Jon and Myla Kabat-Zinn about how the Buddhist concept of mindfulness can help us to see the wholeness and beauty of our children in each moment.





Jon and Myla Kabat-Zinn, the authors of Everyday Blessings: The Inner Work of Mindful Parenting, were married in a Zen ceremony in which their wedding vows were to help each other “attain ‘big mind' for the sake of all beings.” Jon Kabat-Zinn is founder and former director of the
Stress Reduction Clinic. He is also the author of Full Catastrophe Living and Wherever You Go, There You Are. Myla Kabat-Zinn has worked as a childbirth educator, birthing assistant, and environmental advocate. The Kabat-Zinns are the parents of three children aged 22, 18, and 14.
Sarah van Gelder recently met with them to learn more about the art of mindful parenting.

SARAH: What do you mean by “mindful parenting?”

JON: Mindfulness, which lies at the heart of Buddhist meditation, means moment-to-moment, non-judgmental awareness. It's cultivated by refining our capacity to pay attention, intentionally, in the present moment, and then sustaining that attention over time. It means
becoming more in touch with our life as it is unfolding. Parenting through mindfulness has the potential to penetrate past surface appearances and behaviors and allow us to see our children as they truly are, so we can act with some degree of wisdom and compassion. The more we are able to keep in mind the intrinsic wholeness and
beauty of our children – especially when it's difficult to see – the more our ability to be mindful deepens.

SARAH: You mentioned in your book that “unconscious parenting” – dealing only with your child's surface behaviors and not looking at the feelings beneath – can have long-term consequences.

JON: In my work in the Stress Reduction Clinic, I see people all the time whose feelings were not respected when they were children. For many people, childhood was a time of betrayal, when one or both parents were out of control to some degree, raining down terror out of their own addictions, deep unhappiness, or ignorance – even when they loved their children. One woman, whom I describe in the book, attended a five-day mindfulness retreat with me. After a meditation session, she said she felt there were pieces of her missing, as if she were
“Swiss cheese.” She realized she'd given parts of herself as a child to feed her parents – who had gone into a deep, lifelong depression after her sister died – and now she felt she couldn't get them back.
This is a chilling image, but it shows that the consequences of unconscious parenting can reverberate throughout the lives of the children.

MYLA: These days we're pushing our children to be independent so early that they're really ending up being incredibly dependent. The whole cycle of addictive behaviors – of children reaching for alcohol, drugs, sex, or whatever – is a symptom of this dependency. Many young
people use addictive behaviors to try to take the place of their deep need for love, nurturance, and for feeling as if they're a part of something.

SARAH: Kids, as you point out in the book, know how to push our buttons. So we may be reacting as parents in ways that are much more based on the way we were raised than on our truest values.

MYLA: Right. And half of the work of mindful parenting is being aware of those old patterns that so often rule our behavior as parents. Those patterns come from deep wounds in our past, and they don't have anything to do with what's really happening in the moment. The wonderful gift of mindfulness is that we can stop ourselves and ask: What am I feeling? What is it like from my child's point of view? When you can do that, you often see things that you didn't let yourself see before because you were so caught up in the reactive mode, which
is very limiting.

SARAH: I think the “Aha!” for me in your book was the notion that a spiritual practice isn't just something you do in isolation, or in retreat centers; it's part of parenting, which is one of the grittiest parts of life. Could you talk a little about how that works?

JON: Well, I believe that spiritual practice is about life, not about retreat from life. The real work of spiritual practice in any tradition is to come to a deep understanding about what it means to be human. Sometimes it's wonderful to just be very, very still for long periods of time, but for most of us, that can only happen occasionally. The real meditative practice is to open up to the full range of what happens in life. And parenting is a fantastic arena for doing that kind of spiritual training. It's as much a potential door into enlightenment as anything else. It's interesting to look at your children as live-in Zen masters who can put their finger on
places where you're resistant, or thinking narrowly, in ways no one else can. You can either lose your mind and your authenticity in the process of reacting to all of that stuff, or you can use it as the perfect opportunity to grow and nourish your children by attending to what is deepest and best in them and in yourself. We're not trying to erase conflict and send messages like, “Only harmony allowed in this family. Let's all behave like little Buddhas.” That kind of requirement imprisons the family.

SARAH: There is this image of people who have a spiritual practice as being extremely eventempered. Particularly that a good parent is one whose emotional life – except for a vague affection – may not be expressed a lot around the children.

MYLA: Having everybody be nice all the time may mean that people don't get to be who they are. Certainly in our family, we really value authenticity. It's important to give children some latitude for trying out different behaviors. If they always have to be in a very constricted framework of what's acceptable, they don't get to explore different aspects of themselves. And they also don't feel the amazing transformational power of our acceptance. This doesn't mean we have no restrictions – we'll say, “You can't run into the street. No, you can't hit Johnny.” We might also say, “We're having a hard time with the way you're acting, but we love you.” We're able to look beneath the surface at what's going on. Often our children have lots going on, and we don't get to see it because we're so quick to label them, judge them, and see them within just the framework of our own expectations, which can be kind of a straitjacket.

SARAH: Can you share a story that helps to capture the kind of complexity and the vulnerability that you're asking of parents?

JON: One time, a friend of ours had taken her son to visit her mother, who hadn't seen him more than two or three times in his life. The grandmother had invited one of her friends over at the same time and proceeded to ignore her nine-year-old grandson as she chatted with her friend. Meanwhile, the child became bored and restless, and he proceeded to run around the room and knock into furniture.
Embarrassed by her inability to control her son's unruly behavior, the mother angrily dragged him out and took him home. She was furious and admonished him for behaving rudely and not listening when she told him to stop. He looked at her pleadingly and said, “But Mom, Grandma didn't even talk to me!”
Suddenly, a veil fell from her eyes. Here her mother had not made any effort to reach out to her grandson, to engage him, to think about what would be fun for him; yet when he reacted in a totally normal way for an active, energetic child, he was blamed. Her son could see that his grandmother was ignoring him, but his mother had been unable to see it until he pointed it out. Another example of how our children can teach us, if we are open to listening and learning. In thinking about this later, the woman said she felt that it would be unrealistic to expect her
mother to change, but that the next time they visited, she would bring some things for her son to do, or meet her in a park, or insist that her mother come to her house. She also did something that was very important in rebuilding trust. She acknowledged that she was wrong and apologized to her son for getting angry at him for having a difficult time in a difficult situation. No matter how hard we try to be mindful and present, there are inevitably many times when automatic behavior simply takes over. When that happens, we can apologize, or we can stop
and say to our child, “Let's begin again,” and do it over differently. In this way, we nurture –or begin to heal and rebuild – a trusting, caring relationship.

MYLA: Those moments when our children are disruptive or difficult can be tricky, because I think children want so many different things.
Oftentimes, what they say they want takes on material form, and because parents are so harried and overworked, it's often a lot easier to just give children what they want. The objects start to take the place of really soul-satisfying, connective moments. I think it's very useful to ask ourselves, “Does my child need this? Is this in my child's best interests?” When we ask ourselves that, it can lead us to see that something else is needed, and not necessarily something material or tangible. That's when this work of parenting calls upon our own genius to be really creative in those moments. Every parent has that ability.

JON: When our son was in nursery school, his teacher was struck by something that happened one morning. As the children sat on the floor in a circle, she asked each of them what they liked to hold when they went to sleep at night. Some children mentioned stuffed animals, others, their baby blankets. When our son's turn came, he looked at her and said simply, without embarrassment, “My mommy.” We might ask ourselves, is it healthier for our children to be reaching for blankets or toys when they are distressed, or reaching out to human beings?

SARAH: Finding time has become one of the real big issues for many people with both parents working, and with so many more single-parent families. Is the kind of attentive parenting you're describing doable in this society?

MYLA: I think attentive parenting requires the desire to really examine the fabric of your life. If we look at our family life, and we ask ourselves, “Is this really working for all of us?” that may mean making choices. And that's very difficult.
It's not just the economic pressure to work – it's also the desire that we have to fulfill ourselves in our work. It would be wonderful if the culture supported both parents working part time, because children need both parents. But I think that sometimes if we're willing to give up things and find some creative solutions, we do find them.

JON: There are very few people who, on their deathbeds, smack their heads and say, “My God, I wish I'd spent more time at the office.” I think a lot of people reflect back on how they were as parents, and they realize that they did not bring enough perspective to it. They were too economically focused, or too stressed. All understandable, but not necessary. It just takes attention – attention in the present moment.

SARAH: Could you talk a bit about the effects of media and especially television on the family?

MYLA: In some ways, the media is raising our children instead of us. Whatever we can do to create a haven in our home from that broader culture, which has a lot of very toxic elements to it, is a worthwhile endeavor. And I think that people don't realize that it's not just the TV that's turned on that affects your family. Just the mere presence of a TV in the home controls what happens in those moments when there's nothing to do. It's hard to compete with something that's such a quick fix. I think that one thing that we can do with our children is to start asking them when they turn off the TV, “How do you feel?” Very often you see that they're grumpy, that they're fighting, that in some way, the watching has not really given them anything.

JON: It hasn't sustained them. But it has erased time, and it can erase very large amounts of time from your life.

SARAH: One of the things that helps us raise our eight year-old and our 12 year-old is that we live in a cohousing community where there are always other children of all ages for our kids to play with. I'm very aware from having spent time in Third World countries that the isolated single family is rare in other parts of the world, and it was here, too, until recently.

JON: As they say, “It takes a village to raise a child.”

MYLA: That's wonderful that you have your village, because so few people do. We all need support in this. In some ways due to the pressures on us, we are becoming managers of our children's lives rather than really loving, connected human beings in relationship to our children.

JON: Society conspires to disrespect the work of parenting in many ways. It's totally socially acceptable to give 150 percent of your energy to work. It's so misunderstood what the potential would be for a kind of wise attention given to the children. It's not smothering attention. It's not neurotic attention. It's not an overprotective attention. It's the recognition of the relationship and the sacred quality of the parent/child relationship.

SARAH: How can you start to bring this sacred quality to your parenting?

JON: The first thing is to intend to bring mindfulness into one's parenting on a daily basis. You also need to focus. It's through sustained attending that we develop insight. We're not saying that this is easy to do. There's no formula for a perfect way to raise children, or that results in “perfect” children, whatever that would mean. What we are saying is that our children are perfect just the way they are – including their imperfections. It's important that we are authentic, and that we honor our children and ourselves as best we can, and that our intention be to, at the very least, do no harm. Mindful parenting is the hardest job on the planet, but it's also one that has the potential for the deepest kinds of satisfactions over the life span, and the greatest feelings of interconnectedness and community and belonging.

Twelve Excercises for Mindful Parenting

1. Try to imagine the world from your child's point of view, purposefully letting go of your own. Do this every day for at least a few moments to remind you of who this child is and what he or she faces in the world.

2. Imagine how you appear and sound from your child's point of view; imagine having you as a parent today, in this moment. How might this modify how you carry yourself in your body and in space, how you speak, what you say? How do you want to relate to your child in this moment?

3. Practice seeing your children as perfect just the way they are. Work at accepting them as they are when it is hardest for you to do so.

4. Be mindful of your expectations of your children, and consider whether they are truly in your children's best interests. Also, be aware of how you communicate those expectations and how they affect your children.

5. Practice altruism, putting the needs of your children above your own whenever possible. Then see if there isn't some common ground where your needs can also be met. You may be surprised at how much overlap is possible, especially if you are patient and strive for balance.

6. When you feel lost, or at a loss, remember to stand still. Meditate on the whole by bringing your full attention to the situation, to your child, to yourself, to the family. In doing so, you may go beyond thinking and perceive intuitively, with the whole of your being, what really needs to be done.

7. Try embodying silent presence. Listen carefully.

8. Learn to live with tension without losing your own balance. Practice moving into any moment, however difficult, without trying to change anything and without having to have a particular outcome occur. See what is “workable” if you are willing to trust your intuition and best instincts.

9. Apologize to your child when you have betrayed a trust in even a little way. Apologies are healing, and they demonstrate that you see a situation more clearly, or more from your child's point of view. But “I'm sorry” loses its meaning if we are always saying it, or if we make regret a habit.

10. Every child is special, and every child has special needs. Each sees in an entirely unique way. Hold an image of each child in your heart. Drink in their being, wishing them well.

11. There are very important times when we need to practice being clear and strong and unequivocal with our children. Let this come as much as possible out of awareness and generosity and discernment, rather than out of fear, self-righteousness, or the desire to control. Mindful parenting does not mean being overindulgent, neglectful, or weak; nor does it mean being rigid and controlling.

12. The greatest gift you can give your child is your self. This means that part of your work as a parent is to keep growing in self-knowledge and in awareness. We have to be grounded in the present moment to share what is deepest and best in ourselves.

http://www.yesmagazine.org/article.asp?ID=856






Saturday, August 1, 2009

OFFICE VISIT = AN ANXIETY ATTACK = MENTAL MODEL


When infants and toddlers come to the office for "well" infant/toddler visits, there is a sequence of events which transpire. The baby/toddler is taken into or enters the exam room, their clothes are removed, they are taken to the scale to be weighed, they are placed on "the table", the doctor comes and "gets into their space" (without asking) and the nurse comes in and "stabs" them.



Parents are often surprised and embarrassed by the behavior of their child in this situation. And it seems to only escalate with each visit even though the child is getting older and "should be getting used to it". I have created a new Spanish colloquialism which might apply to this situation: Dola? (which is a contraction of duh + ola and means duh, hello!)





Actually, the neurobiology/neuropsychiatry researchers have in fact figured out exactly why the infant/toddler brain does what we see. A lot of this information is in a book listed on the Sea View web site entitled "Parenting From The Inside Out" written by Daniel Siegel (UCLA, sorry USC people) and Mary Hartzell. The following is a quotation from an article by Dr. Siegel and helps us to understand what is going on in our infant/toddler's mind and the behavior which follows:

"Memory is the way in which past experience is encoded in the brain and shapes present and future functioning (McClelland, 1998; Milner, Squire, & Kandel, 1998). The processes of memory and those of development in fact are closely aligned. For the first year of life, the infant has available an “implicit” form of memory that includes emotional, behavioral, perceptual, and perhaps bodily (somatosensory) forms of memory. Implicit memory also includes the generalizations of repeated experiences, called “mental models” or schema (Johnson-Laird, 1983). The way that the brain readies itself for retrieval of certain memories in response to specific cues is also a part of implicit memory and is called “priming” (Schacter&Buckner,1998). When implicit memories are activated, they do not have an internal sensation that something is being recalled. They merely influence our emotions, behaviors, or perceptions directly, in the here and now, without our awareness of their connection to some experience from the past."


It is no surprise that we don't know why our infant/toddler is behaving this way because she doesn't know either. But she has created a "mental model" and that model ends with getting the shots (pain). And the obvious reaction to knowing the end of the sequence is to call on the "fight or flight" response and that is exactly what they do.





Now, instead of feeling anxious, embarrassed or irritated, we can all just say "Dola?"


More about Dr. Siegel:

http://www.latimes.com/features/la-mag-july122009-taste-siegel,0,1272981.story
From the Los Angeles Times

Tastemakers

Daniel Siegel, MD
by Nancie Clare

July 12, 2009

When Siegel was a med student, he was actively discouraged from finding out what patients were thinking. Now in his current practice as a clinical psychiatrist, executive director of Mindsight and codirector of the Mindful Awareness Research Center at UCLA, it’s the mind he is most interested in—specifically how it can be channeled to help the whole body. One of the core practices of “mindsight” is concentrating on the breath. “Mindsight can increase one’s ability to perceive the world,” he says. Siegel created practical applications from his research: He has lectured to school superintendents, and educators confirm mindsight’s effectiveness as a foundation for social and emotional intelligence. Even the world’s spiritual leaders are interested—he met with Pope John Paul II and the Dalai Lama. And what of Freud? Siegel thinks he would approve—heartily.

Sunday, July 19, 2009

SAFETY AND SET UP





One of my one liners I have often used over the years applies to children's behavioral development, their self-value development and their safety.

"If we don't set it up (meaning their world they live in), we set them up."








This applies to safety as much as any other part of parenting. Many parents have trouble seeing and understanding that providing the proper fences and gates around the house is nothing more complicated than helping a child learn about boundaries in life. It has always been my impression that as soon as a baby leaves the womb, they are looking for the walls of the uterus and those boundaries that they have known for nine months. Most babies love to be swaddled and they will move themselves into the corner of the crib and wedge in there as soon as they can. In the office, babies are always most calm in their mother's lap (as close to the place where they loved the boundaries as they can get).


So, when we confine an infant to a playpen or to a play yard and put inside with them all the things
that they can do and can play with, we are setting up a place that they can be happy entertaining themselves and where they don't need our opinion about how they are doing. It also creates a place where they cannot misperceive what we say in trying to "redirect" their behavior if such boundaries do not exist. If a parent is continuously saying to you, "Don't touch that", "Come over here", "Get out of there" or "Stop doing that", I consider that they are micromanaging the baby and my impression is that there is a high likelihood that they baby may easily perceive that he is not doing a "good enough" job of being himself.



When it comes to safety, it's not even a question of helping a child learn about boundaries, it is about keeping her alive. Infants and toddlers and 3-5 year olds cannot be trusted because they have an intense curiosity which will get them into trouble every time they have the opportunity.
There should be no way that your child can open the front door of the house alone and they should not be able to reach the garage door opener or the latch on gates out of the back yard. There is no reason for any young child to be in the kitchen or the bathroom - fence them out. They can figure out most safety devices and we forget to latch them and they create a false sense of security regarding needing to know where the child is at all times. A fenced-in child is just one more layer of safety which protects us as parents as well as helping the child learn about boundaries. Safety must be an absolute boundary. We can't set them up for accidents and injury.

Finally, I continue to say that "Second boys following girls are the most dangerous children ever made." Girls tend to be much less physical than boys, but second boys learn by watching their sister and figure out how to do things much younger than the sister did. And as parents, we are not ready and can easily be caught off guard. So remember boys following girls are DANGEROUS and set-up is everything with them.












HOT OFF THE PRESS:

New advice: Rear-facing car seats safer for children until they are 2

Lori O’Keefe
Correspondent

Toddlers between the ages of 12 and 23 months who ride rear-facing in a car safety seat are more than five times safer than toddlers in that same age group who ride forward-facing in a car seat.

Overall, children under the age of 2 are 75% less likely to die or experience a serious injury when they ride in a rear-facing car seat, according to the first U.S. data to substantiate the benefits of toddlers riding rear-facing until they are almost 2 years old


COMMENTARY

Rear-Facing Car Safety Seats: Getting the Message Right

Marilyn J. Bull, MD andDennis R. Durbin, MD, MSCE

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

Information learned during medical training changes frequently with advances in nearly every field of medicine. Now we are asked to learn new advice to give parents and caregivers of infants and young children regarding the safest way for them to ride in a car.

Child fatalities and injuries in motor vehicles have been significantly reduced since initiation of occupant-protection measures in the 1970s.1 The combined efforts of the counseling of primary medical care providers, the education and research provided by the National Highway Traffic Safety Administration, the carsafety seat manufacturers, and many research facilities, and the support of child passenger safety advocates across the country have been largely responsible for these results. Many challenges remain as we strive to continue to reduce the rates of injury to children on our nation's highways. It is critical to realize that, despite marked improvement in rates of restraint in all age groups, over half of children killed are improperly restrained or unrestrained. Our first priority must be to ensure that every child is restrained appropriately for his or her age and size for every trip in a car.

Helping parents make the best decisions for selection and proper use of car safety seats and seat belts is very important. Continual evolution of knowledge, safety information, and changes in car safety seat designs make this task extremely challenging for health care providers.

One significant change in counseling is now emerging that may greatly improve the safety of infants and young children. A recent analysis of the protection provided in rear-facing compared with forward-facing car safety seats has revealed that children under the age of 2 years are 75% less likely to die or sustain serious injury when they are in a rear-facing seat.2 This finding was true regardless of direction of the crash, even those crashes with side impact, which typically are the most severe.

Although the study could not provide data dividing the ages by individual months, it is notable that rear-facing car safety seats were more effective than forward-facing car safety seats for both infants under 1 year and children aged 12 to 23 months. The odds of severe injury for forward-facing infants under 12 months of age were 1.79 times higher than for rear-facing infants; for children 12 to 23 months old, the odds were 5.32 times higher.

This information is additionally supported by data from Sweden, where children have ridden in rear-facing seats up to 4 years of age for many years, and very low death and injury rates have been documented3.

For many years the American Academy of Pediatrics has recommended that for best protection, children should ride in a rear-facing seat to the highest weight that is allowed for use by the manufacturer of the seat.4 Health care providers and many parents with older children, however, have learned the earlier message that children should ride in a rear-facing seat up to 1 year of age and 20lb,5 although that recommendation was later modified to "at least 1 year of age and... at least 20 lb."4

Now we are challenged by greater evidence to implement what we know to be best practice: Children should ride in a rear-facing seat to the highest weight or height allowed for use rear-facing by the manufacturer of the seat. As an infant approaches 20 lb, when his or her head is within an inch of the top of the seat, and at the 4-, 6-, or 9-month visit, it is appropriate to counsel families that they should transfer the infant to a convertible seat that is approved for rear-facing use to higher weight and height limits.6 Parents may be helped to understand the importance of using the convertible car safety seat in the rear-facing position longer than 1 year if they are counseled that children are 5 times safer than when riding in a forward-facing seat into the second year of life.

At this time, it is not possible to determine at what month of age, if any, that this is no longer true, but as more and more parents follow this advice, we hope it will be possible to elicit these data in the future.

Another barrier to implementation of this best-practice recommendation is the common myth that if a child's feet or legs reach the back of the vehicle seat, he or she is at increased risk for a lower-extremity injury. Current data do not substantiate that myth. Lower-extremity injuries are rare for children facing the rear, on the order of 1 per 1000 children (Partners for Child Passenger Safety Study, unpublished data, 2007). In addition, riding facing front does not eliminate a child's risk of lower-extremity injuries, because these injuries, as well as injuries to the head and spine, have been described among forward-facing children in child-restraint systems.7