55 Chapel Street, Suite 202, Newton, Ma 02458
www.nesca-newton.com
617-658-9800

75 Gilcreast Road, Suite 305, Londonderry, NH 03053
603-818-8526


Thank you for visiting. NESCA Notes has moved!

For articles after June 4, 2018 please visit nesca-newton.com/nesca-notes/.


Search This Blog

Showing posts with label stress. Show all posts
Showing posts with label stress. Show all posts

Monday, June 4, 2018

The Struggle is Not Only Real, It is Necessary


By: Angela Currie, Ph.D.
Pediatric Neuropsychologist

From an early age, we are subliminally taught that stress is a bad thing. Whether frustrated because your LEGO tower broke or confused about which two paint colors to mix to get green, you were more likely to hear “Calm down – no reason to get stressed,” than you were to hear “Let’s use your stress to help us make a plan for how to solve this problem.”

For most adults, the natural, well-meaning response to a child’s expression of stress, or most any unwanted feeling, is to try to fix it, make it go away, avoid it, or make it seem like it isn’t such a big deal. We do this by saying things like:

“Don’t be sad.”
“No need to worry about it.”
“It’s not as bad as you think it is.”
“Just try thinking about something else.”
“Let me do that for you.”

We all say and do these things, and the good intention is clear. Nobody likes to see a child struggle or experience discomfort. Unfortunately, manageable stress and discomfort is necessary for growth. When we minimize, distract, or dismiss a child’s emotional reaction, we are sending the message that feelings are unimportant, untrustworthy, and bad. This means that we are also missing the opportunity to teach the child about why we have feelings, and how even the unwanted ones are incredibly useful.

Stress and anxiety are at an all-time high nowadays. It is important to think about small things that we can do each day to help children feel more confident and competent in their ability to navigate this stressful world. One of the best ways we can help them to become more resilient is by creating an environment where emotions are acknowledged, accepted, and used in a functional manner. To start doing this, here are some basic things to keep in:

1) Feelings are information. They are telling us that something is important and may require our attention.
2) Feelings are never bad or “negative,” though they may be unwanted.
3) Stress is often a good thing – without it we would not prepare for tests, show up to work, or care about our relationships. Life without stress would be pretty unfulfilling.
4) The goal is not to control stress or other unwanted feelings – the goal is to recognize, use, and cope with them.
5) Acknowledging and accepting unwanted emotions is one of the best ways to reduce their impact.
6) Regular, casual discourse about wanted and unwanted feelings is healthy and normal. If we talk about the day to day feelings, it will make it easier to talk about the “big ones.”
7) Let children struggle sometimes. Don’t feel the need to fix things right away. Help them express how they're feeling, gently guide them toward problem solving, and praise their persistence in the face of challenge.

About the Author 

Dr. Currie specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

Monday, March 5, 2018

Mindfulness In Schools


By: Ann-Noelle McCowan, MS, RYT
Therapeutic Yoga Instructor, NESCA

Open Google and type in Mindfulness in Schools and you are presented with a buffet of resources. What was once seen as an alternative idea has become mainstreamed. But what is Mindfulness and why is it something that deserves a place in schools?

Mindfulness was originally developed as part of the 8 Fold Path of Buddhism. With mindfulness your attention would be turned inward and also impact your relationship with the world through mindful actions and behaviors.  Now it is scientifically studied and found in locations like professional locker rooms, jails and hospitals to fortune 500 companies like Nike, Google and Apple. Advancements in brain imaging show that a regular mindfulness practice creates increased activity in the areas of the brain associated with working memory, executive function, emotional regulation, perspective taking and empathy, with decreases in the areas of the brain associated with depression, PTSD and stress (correlated with a decrease in amygdala size).

Mindfulness’ increased popularity may be due to the fact that it is an adaptable, take with you anywhere antidote to a society that is increasingly fast paced and technology focused. In a global world it helps us feel both connected to ourselves and grounded where we are. More adults and kids are feeling stressed, anxious and depressed, and mindfulness can help soothe our worries without negative side affects.

Schools are responsible for teaching children skills and information across many content areas, yet how often are children taught the best way to pay attention, or how to use attention?  Attention is the lens through which all of our experiences are filtered through, yet it is rarely directly and specifically taught! Mindfulness is at its core simply focusing on a single thing at time, in a particular way, without evaluation. It is an invaluable life skill for helping children be successful students as well as happy well adjusted and connected children. An informal survey of my colleagues and friends found that yoga and mindfulness is being adapted to various school settings.  From class transitions that begin with listening bells, rounds of belly breathing before assessments, calming scented oils on cotton balls in the nurse's’ office,  books clubs with teachers, introductions to mindfulness apps in health class and  mindfulness or yoga activities and clubs.  mindfulness is staking its place in schools. 

When introducing mindfulness in classrooms and schools the following steps help outline ways to weave mindfulness into classrooms and schools.

1. Learn More. 

Starting with this blog post the internet is full of articles and videos to explore.
     How Meditation Can Reshape Our Brains: Sara Lazar at TEDxCambridge 2011
     https://www.nytimes.com/guides/well/mindfulness-for-children
     Kids getting lessons in mindfulness in school - Today's Parent

2. Model Mindfulness and Practice Yourself. 

You can’t teach what you don’t know. Practicing mindfulness will help you be aware of your own reactions if at first your students are squirmy or resistant. Keep in mind that students may not use the words you expect to describe their experience, listen for what is behind their words.

3. In an age appropriate way, explain how mindfulness is beneficial for them. 

My teens love learning about how their brain works and that mindfulness is a form of training for their brain. 

Some videos for younger  kids:

4. Teach about the monkey or animal mind. 

Children of all ages enjoy the practice of noticing how many places their thoughts go and how quickly thoughts connect to others. There are fantastic books for younger kids such as Moody Cow Meditates and  Mindful Monkey, Happy Panda.  Teens understand how if walk into class and see their friend laugh with a peer after a glance towards them their thoughts immediately race.... “ “what did I do” ...“ they are mad”...“I’m not going to have a partner for this project”... “ there goes my secrets, begin the rumors”... “I’ll be left out of the weekend plans” … “I’ll be alone forever”.  Teach them to acknowledge the chatter but not get caught in it.

5. Start small. 

Begin with 1-3 minutes at the start of class directing kids to feel their seat in their seat, their feet on the floor, their hands on their lap and intentionally take 5-10 long inhales and exhales. Other ideas:

  • Practice silent snack one day a week, take a mindful walk as a class and have them focus on their senses and record it in their own journal ( words or visuals) when back in the classroom. Create a mindful space in a corner of your room with coloring books, pencils, cushions as a safe break place.
  • For kids it may be hard to focus on a single item at a time, so use manipulatives. A Hoberman Sphere, Pinwheels or feathers to demonstrate breath.  Build Worry Jars, adapt Chutes and Ladders or other familiar games with mindful exercises. Use one of the many Yoga Card Decks. 

6. There’s an App for this!

Ironic perhaps to use technology but most kids love technology and it offers choice and control. Try  “Calm.com”, “Stop, Breathe and Think”, “Smiling Mind” or the “Insight Meditation Timer” (after medications my kids love to check out the world map and see all the locations where people are meditating!).  Try a classroom program such as http://www.innerexplorer.org/

7. Be consistent.

Greater benefits and habits are created when mindfulness is done repeatedly. Colleagues who practice mindfulness daily, even for a few minutes notice the impact is greater than if  done sporadically. 


Mindfulness is good for us and our children and has a natural place in our schools. Benefits abound like enhanced attention, self-regulation, social competence, as well as greater kindness and compassion. After I have practiced mindfulness with my students or clients they look different, calmer and relaxed and ask for it again. I too notice the rest of my day feels more manageable and my smile is broader. Enjoy adding mindfulness to your classroom or express your hope to your child’s teacher or school leaders that mindfulness be a part of your child’s school experience. 

Monday, January 22, 2018

Mindful or Mind Full? Can You and Your Child Be More Present?


Mindfulness Activities For Caretakers and Youth

Pediatric Neuropsychologist
NESCA

Mindfulness is an area of psychology that continues to gain popularity in our culture and in therapeutic practice. By definition, mindfulness is the practice of being conscious or aware of our current state without judgement. That is, focusing our awareness on what is happening in this very moment related to our feelings, thoughts, and bodily sensations. We ignore what was happening in the past and what could happen in the future by being present in this moment. While this seems like a simple concept, in our distracted world of technology and instant gratification this can be difficult to put into practice. Too often we lose sight of the present and our current experiences, as our mind races and analyzes what just happened or what could happen, giving rise to anxiety. 

Research suggests that the benefits of mindfulness include improved emotional regulation by decreasing rumination and improving attentional capabilities. There is also emerging evidence that mindfulness can decrease emotional reactivity which can have a positive impact on interpersonal relationships. Other positive benefits include improvements in sensory processing as well as sensitivity to internal stimuli. 

Below is a list of mindfulness-based activities that can get you and your child started on the journey of being more present in the moment and begin reaping the benefits of a mindfulness practice. For more information or to explore therapeutic options at NESCA that utilize mindfulness strategies please read about our therapeutic services

  • Breathing: Have the child breathe in for three seconds, hold their breath for three seconds, and then breathe out for three seconds. For younger children, the very act of focusing on this activity will ground them to the moment. For older children and teens, there might be more instruction like having the child focus on how the breath feels coming in, holding it in their lungs, and finally blowing out through their nose or mouth. 
  • Seeing the world: Ask the child to spend a minute looking around the room while being silent with the goal of finding things in the room that have never been noticed before. After one minute, the child should be asked to share the most interesting thing that they see now but have not noticed before. 
  • Feeling objects: Provide the child with an object or series of objects and ask them to spend a minute just noticing what the object feels like in their hand. Guiding them to attend to the texture, temperature, size, shape, etc. Afterwards, ask the child to share what they noticed. 
  • Listening: Ring a bell or other chime-like noise that provides a long trailing sound. Ask the child to indicate when they can no longer hear the sound. After the ringing ends, ask the child to listen to any other sound they hear for the next minute. 
  • Emotional acceptance: Young children tend to be more "in the moment" than most when it comes to emotional experience. When a child is expressing an emotion, rather than tell them “You’re okay,” validate their emotional experience and let them know it is okay to be angry, sad, etc. Then follow with asking your child how their body feels when they are in this emotional state. This process can help children to be more in touch with their bodies and begin to recognize how their emotions feel in their body to create greater emotional awareness. 

To learn more about mindfulness and practice techniques, check out:
About the Author:

Dr. Amity Kulis joined NESCA in 2012 after earning her doctoral degree in clinical psychology from the Massachusetts School of Professional Psychology, with a concentration in Children, Adolescents and Families (CAF). She completed post-doctoral training in pediatric neuropsychology with an emphasis on treating children with developmental, intellectual, learning and executive functioning challenges. She also has extensive training psychological (projective) testing and has conducted individual and group therapies for children of all ages. Before joining NESCA, Dr. Kulis worked in private practices, clinics, and schools, conducting comprehensive assessments on children ranging from toddlers through young adults. In addition, Dr. Kulis has had the opportunity to consult with various school systems, conducting observations of programs, and providing in-service trainings for staff. Dr. Kulis currently conducts neuropsychological and psychological (projective) assessments for school aged children through young adulthood. She regularly participates in transition assessments (focusing on the needs of adolescents as they emerge into adulthood) and has a special interest in working with complex learners that may also struggle with emotional challenges and psychiatric conditions. In addition to administering comprehensive and data driven evaluations, Dr. Kulis regularly conducts school-based observations and participates in school meetings to help share her findings and consultation with a student’s TEAM. 

Friday, December 22, 2017

Special Holiday Edition: 'Tis the Season for Self-Care



By: Jacki Reinert, Psy.D., LMHC
Pediatric Neuropsychology Post-Doctoral Fellow

As a child, the idea of Christmas meant cookies, presents, time with family, and of course, giving up TGIF’s Full House in favor of holiday movies. Everything from Scrooged to A Miracle on 34th Street to Home Alone, and every clay animated favorite served as the framework for my formulation of what the holidays truly meant; “It's Christmas Eve. It's the one night of the year when we all act a little nicer, we smile a little easier, we cheer a little more. For a couple of hours out of the whole year we are the people that we always hoped we would be." Frank Cross’s commentary on Christmas set expectations high, and year after year, we hoped to top the magic and splendor of the previous year’s festivities. 

As a parent, the holiday season conjures up warm memories of childhood, ignites aspirations to establish new traditions, and creates opportunities to share experiences with our loved ones, particularly our children. The magic of the holidays can also cultivate high expectations; to act nicer, smile easier, and to cheer more. These expectations more often than not exceed our capacity to truly encapsulate the hopes and aspirations we drum up in our heads. High expectations can pave the way for increased levels of perceived stress. 

The American Psychological Association recently released its annual review, Stress in America (November, 2017), which indicates the United States has reached its highest stress level yet. Acute arousal stress in isolation can activate and enhance mobilization, sharpening our concentration and preparing our bodies to engage in challenging tasks, such as wrapping those last two presents and baking another round of cookies. This basic human reaction known as the “flight-or-fight” response has served us well, priming our bodies to flee or combat unsafe situations; however, our bodies can also overreact to simple, non-threatening situations, such as holiday pressure, financial difficulties, and increasing family demands. 

Chronic stress has far more lasting and serious complications, particularly when it exceeds our ability to cope and leads to emotional and physical dysregulation. Stress is negatively related to our coping potential and our perception of control, which decreases use of problem-solving coping strategies and increases negative coping strategies, such as alcohol consumption and avoidance tactics (Rui Gomes, Faria, & Gonçalves, 2013). Individuals who experience elevations in stress and engage in maladaptive coping strategies such as drinking more alcohol, complaining, sleeping less, and consuming unhealthy foods which increase chances of becoming physically and mentally run down.

For parents, the added stress of the holidays and high expectations can have a significant impact on not only themselves, but those around them. Research suggests that adults are more likely to find family responsibilities stressful than they have in the past (APA, November, 2017). High expectations can make capturing the perfect holiday, particularly when parenting a child with special needs, a stressful time, leading to feelings of resentment (“I’m doing all of this and no one is helping me”), frustration (“I have no time to fit this all in”), and disappointment (“It seems like they didn’t have a good time”).

This year, I encourage you to lower your holiday expectations, increase self-care and self-compassion. While practicing self-care may be the furthest thing from your mind, the following may offer some reprieve from the hustle and bustle of the holiday season. 

1. Expect that things will go wrong, and that’s okay. Someone will get sick, you might burn a dish, and yes, that’s okay. Avoid catastrophic thinking, a common cognitive distortion where we imagine and worry about the worst possible situation, either consciously or subconsciously. For example, your ability to prepare the perfect holiday dinner for twelve people is an act, not a representation of how good of a person you are. You are not the sum of how well-executed things are, how perfectly the house looks, how your children act. 

2. Practice self-regulation and utilize coping skills. The easiest way to understand the subtle difference between these two concepts is to imagine yourself in a car, driving down I-90 into Boston and someone cuts you off. To access a coping skill to manage your anger, you would first need to pull off the highway, put the car in park, and throw on your hazard lights. Conversely, if you were utilizing a self-regulation skill, you could continue driving and manage your thoughts and feelings in the moment. Self-regulation is the ability to modulate our emotions and impulses, to keep ourselves in check, whereas coping is a process or actions that help you manage difficult emotions. Examples of self-regulation skills include diaphragmatic breathing (learn more here: https://www.youtube.com/watch?v=hFcQpNr_KA4&t=140s) and box breathing (https://www.youtube.com/watch?v=dP4Jxxhhzl0). Coping skills can include meditation (https://www.youtube.com/watch?v=4Bs0qUB3BHQ), and progressive muscle relaxation (https://www.youtube.com/watch?v=1nZEdqcGVzo). 

3. Practice micro-moments of positivity. Research suggests that rather than pursue the perfect gift to demonstrate your love for a family member, seeking out opportunities to be present and make a meaningful connection have a more lasting effect (Heshmati, Oravecz, Pressman, Bathcelder, Muth, & Vandekerckhove, 2017). Crawling into bed and reading a holiday book with your children, or complete a small craft together can have a more lasting impact that securing a sloth Fingerling for them. You can read more about micro-moments here: https://www.npr.org/sections/health-shots/2017/12/09/568834440/what-s-better-than-expensive-presents-the-gift-of-presence

4. Opt outside! Research suggests that spending time in nature can have significant effect on mood (https://www.npr.org/sections/health-shots/2017/12/09/568834440/what-s-better-than-expensive-presents-the-gift-of-presence) and can increase sun exposure and the benefits of Vitamin D. Locate a winter wonderland hike here: http://www.bostonmagazine.com/health/2016/01/11/winter-hiking-massachusetts/

5. Finally, don’t forget about self-care. Self-care is a deliberate act to support and nurture your physical and mental health. Taking care of yourself not only helps you but those around you. There are several TED talks highlighting the benefit of self-care: https://www.ted.com/playlists/299/the_importance_of_self_care


From the clinical team at NESCA, we wish everyone a happy holiday season!

About the Author:

Dr. Jacki Reinert is a Pediatric Neuropsychology Postdoctoral Fellow who joined NESCA in September 2017. Dr. Reinert assists with neuropsychological and psychological (projective) assessments in the Newton office and will join the Londonderry office in March 2018. In addition to assisting with neuropsychological evaluations, Dr. Reinert co-facilitates parent child groups and provides clinical consultation. Before joining NESCA Dr. Reinert worked in a variety of clinical settings, including therapeutic schools, residential treatment programs and in community mental health. She has comprehensive training in psychological assessment, conducting testing with children, adolescents, and transitional-aged adults with complex trauma.