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ANXIETY AND DEPRESSION THINKING SEEDS FEELING SEEDS DOING SEEDS Bob Schuppel, M.Ed., LPCC-S 17800 Chillicothe Road, Ste. 230 (440) 543-4771

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Presentation on theme: "ANXIETY AND DEPRESSION THINKING SEEDS FEELING SEEDS DOING SEEDS Bob Schuppel, M.Ed., LPCC-S 17800 Chillicothe Road, Ste. 230 (440) 543-4771"— Presentation transcript:

1 ANXIETY AND DEPRESSION THINKING SEEDS FEELING SEEDS DOING SEEDS Bob Schuppel, M.Ed., LPCC-S Chillicothe Road, Ste. 230 (440) bobschuppel.com

2 WHAT ARE SEEDS? 2

3 …OF LIFE? 3

4 WHAT ARE SEEDS? 4

5 WHAT ARE THE SEEDS? A Buddhist said the following… MIND IS A FIELD IN WHICH EVERY KIND OF SEED IS SOWN 5

6 WHAT ARE THE SEEDS? IN US ARE INFINITE VARIETIES OF SEEDS 6

7 WHAT ARE THE SEEDS? MANY SEEDS ARE INNATE HANDED DOWN BY ANCESTORS 7

8 WHAT ARE SEEDS? 8 …handed down by ancestors…

9 WHAT ARE THE SEEDS? SOME SEEDS SOWN WHILE IN THE WOMB 9

10 WHAT ARE THE SEEDS? OTHERS WERE SOWN WHEN WE WERE CHILDREN 10

11 WHAT ARE THE SEEDS? SEEDS FROM PARENTS AND FAMILY MEMBERS 11

12 WHAT ARE THE SEEDS? 12

13 WHAT ARE THE SEEDS? SEEDS FROM SOCIETY AND RELIGION 13 RIGHT and WRONG

14 WHAT ARE THE SEEDS? SEEDS THAT WERE THRUST UPON US 14

15 WHAT ARE THE SEEDS? 15

16 COGNITIVE DEVELOPMENT THOUGHTS, EMOTIONS AND ACTIONS 16

17 THE BRAIN 17 relay impulses and especially sensory impulses to and from the cerebral cortex

18 THE BRAIN 18  The cerebral cortex plays a key role in memory, attention, perceptual awareness, thought, language, and consciousness.memoryattention perceptualawarenessthought languageconsciousness

19 THE BRAIN Selective Attention 19

20 THE BRAIN 20 perform primary roles in the formation and storage of memories associated with emotional events

21 THE BRAIN 21  Brain has two memory systems, one for ordinary facts and one for emotionally charged one  The stronger the amygdala arousal, the stronger the imprint  Emotional memories can be faulty guides to the present – out of date

22 THE BRAIN 22  Amygdala is a repository for emotional memory – scans experiences comparing what is happening now and what happed in the past  One element appears similar to past? MATCH!  Commands us to react to the present in ways we were imprinted long ago – with thoughts, emotions, and reacts in response to situations ONLY DIMLY SIMILAR, but close enough

23 THE BRAIN 23

24 THE BRAIN 24

25 THE BRAIN 25

26 SCHOOL- AGED ANXIETY Generalized Anxiety Disorder Panic Attacks Agoraphobia OCD 26

27 GENERALIZED ANXIETY DISORDER G.A.D. Worries significantly disrupt school, social activities, family Worry is uncontrollable Worries are extremely upsetting and stressful Worry is about all sorts of things, tend to expect the worst Worry almost every day and at least for six months Typical Worries Worrying doesn’t get in the way of everyday activities & responsibilities Able to control worries Worries are unpleasant but don’t cause significant distress Worries limited to a specific, small number of realistic concerns Bouts of worry last a short period of time 27

28 PHYSICAL SYMPTOMS OF GAD Jumpiness or unsteadiness Edginess or restlessness Tiring easily Muscle tension, aches or soreness Trouble falling asleep or staying asleep Stomach problems, nausea, or diarrhea 28

29 PSYCHOLOGICAL SYMPTOMS OF GAD Inability to relax Difficulty concentrating Fear of losing control or being rejected Irritability Feelings of dread Inability to control anxious thoughts 29

30 CHILDREN AND GAD “What if” worries about situation in the future Perfectionism, excessive self-criticism, and fear of making mistakes Feeling source of blame for disaster (maturational crisis) and their anxious worries will keep tragedy from occurring Misfortune is contagious and will happen Need frequent reassurance and approval 30

31 PANIC ATTACK Must include a discrete period of intense fear or discomfort, in which four or more of the following symptoms develop abruptly and reach a peak within 10 minutes : ShiversPounding heartSweating TremblingSmotheringChoking Chest painDizzyLightheaded Fear dyingChillsHot flashes Abdominal distress Shortness of breath 31

32 SYMPTOMS OF AGORAPHOBIA 32 I don’t care if it IS Tweety, I ain’t going out there!

33 SYMPTOMS OF AGORAPHOBIA Anxiety about being in places or situations from which escape might be difficult (or embarrassing) or in which help may not be available 33

34 CDO!! 34

35 OBSESSIVE-COMPULSIVE DISORDER Obsessions are recurrent and persistent thoughts, impulses, or images They are unwanted and cause marked anxiety or distress Frequently, they are unrealistic or irrational They are not simply excessive worries about real-life problems or preoccupations 35

36 OBSESSIVE-COMPULSIVE DISORDER Compulsions are repetitive behaviors or rituals Appears in behaviors like hand washing, hoarding, keeping things in order, checking something over and over “Appears” in mental acts like counting, repeating words silently, avoiding, tally marks 36

37 OBSESSIONS Fear of contamination or dirt Having things orderly and symmetrical Aggressive or horrific impulses Making a Mistake 37

38 COMPULSIONS Washing and cleaning Counting Checking Demanding reassurances Performing the same action repeatedly Orderliness 38

39 WHAT DO WE DO? 39

40 Neurotransmitter 40

41 NEW ENGLAND JOURNAL OF MEDICINE COGNITIVE BEHAVIORAL THERAPY, SERTRALINE, OR A COMBINATION IN CHILDHOOD ANXIETY OCTOBER, % rated ‘very much’ or ‘much improved’ for combination therapy: c.t. & sertraline (Zoloft) 59.7% for cognitive therapy 54.9% for sertraline (Zoloft) 23.7% placebo Anxiety disorders are common in children and adolescents and cause significant impairment in school, in family relationships, and in social functioning High prevalence (10-20%) and substantial morbidity, anxiety disorders in children and adolescents remain underrecognized and undertreated 41

42 WHAT IS NEUROPLASTICITY? The human brain is incredibly adaptive. The brain’s ability to act and react in ever-changing ways is known, in the scientific community, as “neuroplasticity” billion nerve cells, constantly laying down new pathways for neural communication and to rearrange existing ones throughout life Aids the processes of learning, memory, and adaptation through experience Because of the brain’s neuroplasticity, old dogs, so to speak, regularly learn new tricks of every conceivable kind 42

43 COGNITIVE THERAPY Creatures of Habits Thinking Feeling Behaving 43

44 MINI FORMULATIONS OF ANXIETY-INDUCED PROBLEMS 1. What happen? 2. What did I think? 3. How did I feel? 4. What did I do? or How did it change my body? 44

45 PREPARATION FOR DEALING WITH ANXIETY CAUSING PROBLEMS 1. Where might it happen? 2. What is the best thought I can think? 3. What might I feel? 4. What can I do? 45

46 MEASURING THE ANXIETY Out of Control Feeling Worried Doing Alright Calm & Cool 46

47 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE There are many ways that schools can help a child with anxiety disorders Meetings between parents, school staff, such as teachers, guidance counselors, or nurses, AND community-based counselors / therapists will allow for collaborative process to develop helpful school structure for the child The child may need particular changes (accommodations and modifications) within a classroom and home 47

48 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Schedule check-ins on arrival and throughout the day to reduce the child's anxiety and facilitate transition during school, even at home Accommodate late arrival due to difficulty separating, getting to school 48

49 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Identify a safe place where the child may go to reduce anxiety during stressful periods. Developing guidelines for appropriate use of the safe place will help both the child and staff or parents Develop relaxation techniques to help reduce anxiety at school. The same techniques that are useful at home can often be implemented at school as well. Gym time, run time, etc. 49

50 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Provide times for the child to convey messages to family. Brief (a minute or so) contact with family may substantially reduce anxiety and may help younger children recognize that their connection to their parents is intact. (In some children, this strategy may instead heighten awareness of the separation.) In preparation for possible times when the parent is not available, identify additional people for the child to contact 50

51 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Ask the parent to send short notes for the child to read as a reward for staying in school. These can be placed in the child's lunchbox or locker, so that they can be obtained after the child has succeeded in class for a period of time. Could also be a problem! 51

52 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE If the child is avoiding school, address the cause(s) and initiate an immediate plan for him or her to return. The child may require gradual reintroduction to school and may readjust more quickly if allowed to attend for partial days at first 52

53 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Encourage the child to help develop interventions. Enlisting the child's ideas in the task will lead to more successful strategies and will foster the child's ability to problem-solve. However, sometimes children will try to negotiate a "date" to attempt to return to school or go to some other activity. In most cases this strategy is not successful, and it can increase conflict ("You promised you'd go today") 53

54 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Provide assistance to the child during interactions with peers. An adult's help may be very beneficial for both the child and his or her peers. Small, initially supervised, group activities. Pair-up 54

55 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Be aware that transitions may be difficult for the child. When a child with separation anxiety refuses to follow directions, for example, the reason may be anxiety rather than intentional oppositionality 55

56 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Reward a child's efforts. Every good effort, or step in the desired direction, deserves to be praised! 56

57 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE “A child reaps the benefits of affirming words for a lifetime!” The 5 Love Languages of Children by Gary Chapman & Ross Campbell 57

58 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Discuss anxiety symptoms privately with the child. Never single out a child or call attention to their anxiety in front of the class or siblings at home. This can cause humiliation or embarrassment and increase anxiety symptoms. 58

59 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Teach positive self-talk to the entire class or family. Helping children to be aware of the negative way they talk to themselves, such as the use of “I can’t” and help them to develop a more positive way of talking to themselves. 59

60 INTERVENTIONS FOR SCHOOL & HOME PROACTIVE Post the daily routine in the classroom and at home and let children know in advance any changes in the schedule. 60

61 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS 61

62 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Respond calmly to the child’s crisis (maturational or actual), anger and outbursts. At the same time make it clear, both verbally and nonverbally, that you are taking their crisis seriously. 62

63 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Be sure that you do not inadvertently reinforce the intense expressions of affect. Avoid defensive or confrontational words. Be mindful of body posture. 63

64 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Notice what behavior on your part may have triggered intense reactions. Monitor your own behaviors (behavior include thoughts, words spoken, emotions expressed and physical movements). 64

65 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Work collaboratively with the child to maintain a moderate level of intensity. Solicit feedback/expression of emotion (moderately) from the child and take it seriously. 65

66 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Once the child is calm, highlight the disadvantages of intense reactions, the ways in which they interfere with achieving the child’s goals. Then collaboratively work to identify more adaptive alternatives (such as dealing with situations and emotions before the reactions become too intense) 66

67 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Encourage recognition and acceptance of moderate levels of affect. Encourage and reinforce moderate expressions of affect. When affect is expressed in more adaptive ways, make a point to recognize it, validating the child’s reactions, trying to understand and respect the responses 67

68 DECREASING THE EMOTIONAL INTENSITY OF CHILDREN’S REACTIONS REACTING Identify and address the child’s fears regarding expression of affect. Address dichotomous (polar, extreme) thinking (i.e. use of always; never; should; must; need, etc.). 68

69 BREAKIN’ HABITS 69

70 NONVIOLENT COMMUNICATION MARSHALL B. ROSENBERG, PH.D. NVC Process: Compassion Based The concrete actions we observe that affect our well-being How we feel in relation to what we observe The needs, values, desires that create our feelings The concrete actions we request in order to enrich our lives… WANTS not NEEDS or HAVE TOs! 70

71 NONVIOLENT COMMUNICATION MARSHALL B. ROSENBERG, PH.D. Positive Feeling Words AstonishedCalmEagerExcited GratefulHappyHopefulLoving PeacefulPowerfulRelaxedRelieved SatisfiedSensitiveSurprisedThankful TrustingUnderstoodWarm 71

72 NONVIOLENT COMMUNICATION MARSHALL B. ROSENBERG, PH.D. Negative Feeling Words AfraidAggravatedAgitatedAnnoyed AnxiousBoredConfusedDepressed DisappointedDiscouragedEmbarrassedFearful FuriousGuiltyHelplessHopeless JealousMiserableNumbSad ScaredSorry 72

73 73

74 SUPER-PARENTS! 74

75 STRATEGIES THAT WORK! Relaxation Letting go of random and focusing on automatic (i.e. breathing) Acceptance of Anxiety Do not fight or try to control anxiety, then control Agreeing to other’s requests Letting others be in control puts you in control Accepting others Trying to control others leads to feeling out of control 75

76 INTERVENTIONS FOR SCHOOL A.W.A.R.E. A: Accept the anxiety. Welcome it. Don’t fight it W: Watch your anxiety. Look at it without judgment A: Act with the anxiety. Act as if you aren’t anxious R: Repeat the steps. Accept, watch, and act with it E: Expect the best. What you fear the most rarely happens 76

77 THE 10 RULES OF PARENTING MICHAEL BRADLEY, ED. D. Be dispassionate! Be Cool! Listen, even as you are being shouted at 77

78 THE 10 RULES OF PARENTING MICHAEL BRADLEY, ED. D. Never, ever shout! Speak wisely Add 15 minutes to every interaction involving a teen 78

79 THE 10 RULES OF PARENTING MICHAEL BRADLEY, ED. D. Check your ego and pride, it’s not about YOU! Never, ever harm or injure 79

80 THE 10 RULES OF PARENTING MICHAEL BRADLEY, ED. D. Apologize at every opportunity Acknowledge and respect the child’s identity 80

81 THE 10 RULES OF PARENTING MICHAEL BRADLEY, ED. D. Be your true self Know that “This Too Shall Pass” 81

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