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Helping a First Born with Social Anxiety

Being the oldest sibling and having a shy disposition isn’t an easy combination. Why? Oldest children are expected to be highest functioning and independent of all, to be more self-sufficient and mature than their younger sibs. They are continually frustrated with younger sibs soaking up their parents’ attention. Life rarely seems fair in their eyes, and they’re correct: it isn’t no matter how hard parents try.  As a result, oldest kids have little choice but to get their emotional needs met outside their family with friends, peers, and organized groups. Anecdotally, there’s a reason why many of the CEOs and other high-achievers I’ve met tend to have been the oldest of the children in their families. They embraced independence early in their childhood (but almost all had higher social skills and that worked great) and they adopted an early world-view that they had to make it on their own. That built confidence. That build mastery.

But when the oldest also struggles with social anxiety or shyness, that can interfere with this progression to the outside world beyond the familiar comfort and safety of the immediate family. So while social anxiety stresses all kids, I think it’s hardest when first-born kids have it, because they get pushed quicker into the outside world without a role model in front of them to show them the ropes. Parents also are less experienced with their first born, so there’s more urgency and worrying communicated by parents. Anxiety is contagious. Many of the anxious kids I’ve worked with got a lot of that anxiety early on from their parents unintentionally.

Know that the shy, oldest child wants to be strong and independent, and get close to others outside their family – but it causes them fear. That fear often wins out, holds them back. The more they escape from social contact, it reinforces to them that maybe there was something dangerous or bad “out there.” Hence, they pull back further, stay indoors, don’t separate, go less on play dates, rarely do a sleep-over, they don’t reach out to other kids when bored but turn to screens to kill the time, a place where they “artificially” can feel competent/empowered (but it isn’t real, it’s virtual). Over time, avoiding contact with others solidifies beliefs like “I don’t really like the other kids,” “There’s something wrong with them.”… or worse “There’s something wrong with me.” None of these beliefs are necessarily grounded in reality, but once they build and get reinforced, they seem like reality, and they are powerful.

If you are seeing a lot of frustration, melt downs, and regressions in your oldest, it’s likely due to being stressed. So, start by giving it a name. Say “You’re the oldest. That’s the hardest position/job. There’s no one in front of you to show you the way. That takes courage. We expect more and that’s stressful. We will get you there but it will be tough. We’re not perfect and learning as we go along too… You need to be treated uniquely in this family, so help us to help you. Tell us what you need.” 

Regarding social anxiety, do not push too hard or too aggressively to fix or treat it, but slowly move things in the right direction. Keep your child more and more engaged outside the home with positive and safe peer relationships and organized groups. For example, if he’s on the intellectual/artistic side think science activities, robotics, i-labs, maker spaces, and consider fun low pressure classes in art, music, and theatre groups. There are cool museum programs for kids, and think more “individual sports” like martial arts, tennis, cross-country, track, swimming, gymnastics, wrestling… and keep an eye out for more cooperative sports that tend to draw more academic type kids like ultimate Frisbee.

In short, everyone can shine. Everyone has potential and it has to be explored. Read up on Carol Dweck’s work on Mindset. Be flexible in your beliefs that we all have potential and making errors is just part of exploring our potential. Teach this to your kids as well. Therapeutically, if social anxiety is high, I would try to find someone locally that he likes, a therapist that he can meet with every few weeks or so, to touch base and develop his confidence. Why confidence? Confidence is the enemy of anxiety. The two can’t co-exist. Confidence always wins out. Find ways to boost his confidence, not just “teach social skills.”

Please contact Dr. Rao about reproducing any material found on these pages.


The End of Year Slide – and What to Do (and Think) About It

A parent asked: Help! My son went from an A to a C+ in science… what is going on??

Parents are terribly scared. So many of you have put your finger on one of the most frustrating and scary moments in raising bright, young boys: Most boys are checked out of school. They won’t take pride in (or ownership of) their academic/school work until late, typically freshman to sophomore year, sometimes later. Meanwhile, parents know what’s coming. There are realities to consider. The stress builds at home. Everyone is overwhelmed!

Yes, he has stopped trying and he’s avoiding his work. Before you see your son as the problem, step back and see the big picture first

This has been one of the worst years in my memory seeing kids and families. They are completely stressed and beyond their ability to adapt to the demands placed on them. There aren’t enough tutors, pills, executive coaches, Russian Math classes, or psychologists to “fix it.” And, don’t forget the late long winter we had here in New England that just battered everyone down, compounding the situation.

The biggest problem, though, isn’t these boys. It’s us. We keep following the herd blindly and piling on more and more expectations, whether its grades, sports, social expectations. And we are doing it to them earlier and earlier. This is not the world we recall of our childhood.

Back to your unmotivated, school-hating son. What to do? Here’s what I recommend:

  1. Acknowledge he’s stressed. Tell him he gave up because he’s stressed. Name the problem for him, and tell him it’s not him. He’s overwhelmed. Admit that it’s too much to sit in school everyday and feel like nothing valuable is happening. Tell him he’s not alone in feeling this way. Validate and join in, because until you do that, he won’t hear a word you say after.

THEN…

  1. Promise him it will get better. Tell him that at some point the learning becomes power. He realizes it gets him status among his friends. They start competing about grades, scores, schools… Boys are very competitive and he’s going to feel an inner drive (for the first time) to do better at school.
  2. Tell him it will get better because (at some point) he will also start liking what he’s learning – the material and the way he learns will be more interesting, next year and certainly beyond… the teaching style changes and teachers often become more passionate and open to broader, more real-world topics in the higher grades.
  3. Tell him what college really is. These kids are told they have to go to “college” but they think it’s a continuation of grade school. They think it’s going to be more of the same. They think it’s just 13th, 14th, 15th, and 16th grade! I tell kids what college really is. I say, “you take only 4 courses that last only 14 weeks. These courses meet only twice a week for about an hour and a half, and then, done. You spend about 12 hours a week literally in classrooms. The rest of the time? You live with your friends.”  I don’t scare kids about college. I make it seem like heaven, which compared to middle and high school, it is!
  4. Finally, share with him your experiences, any examples of where you were checked out, bored, and didn’t care, but slowly pulled it together. Tell him (not as a lecture) what it’s like to grow up and move from being a kid to man. That’s where he’s at right now. He doesn’t want to give up being a kid. He’s scared way deep down that he doesn’t have the stuff to make it in this ridiculously competitive world, so he tunes out or drops the ball here and there.

See the deeper, richer aspects of what’s going on beneath the shrugging that frustrates us as parents. Behind the shrugs and “bad attitude” there’s a real human being trying to grow up and feel good about himself.

Please contact Dr. Rao about reproducing any material found on these pages.


Believe in your child – and yourself – before you believe in medications

Many parents that I work with ask the same question: “Should we medicate our boys?” Here are the basics you’ll want to consider:

  • There’s no way to predict what being on medications will be like for any particular child. There’s also no way to know ahead of time the side-effects beyond those that most of us already worry about: sleep problems, attenuated height, decreased appetite, weight loss, possibly mood swings. Some parents (and older kids) have reported to me a dampening of personality, and rarely, I’ve encountered cases where there was a cardiac concern. I don’t say this to frighten or discourage parents, but to make certain we all appreciate that these are significant medications. Always check with a pediatrician, and if possible a psycho pharmacologist. Most kids do tolerate side-effects well – or the side-effects are minimal. Go into this with your eyes wide open!
  • Keep in mind that psycho-stimulants are performance enhancing drugs. That means, they work on everyone. Kids will likely focus better and be less impulsive on these meds. We would, too, so don’t think the diagnosed of ADHD is confirmed because you see a change. Also keep aware of unanticipated problem that might come up down the road. I’ve seen many young men who started to use medication as a psychological “crutch.” That’s their word, not mine. They said they came to believe they “needed” meds to do homework, sit in class, to get themselves into college, get through college. Many have had a hard time dealing with the demands of their first job and rely on medications so much that they panic at the idea they won’t be are to face work without them. Dependence can happen on any mind altering substance.
  • This is why I recommend parents never use meds alone. People should always be working to improve themselves, identifying strengths and weaknesses, and nourishing their development – at any age! Believe in your child and believe in yourself first before you believe in medications. In fact, the treatments of choice (what is now recommended at the start of an ADHD diagnosis) are non-medical. These are behavioral training/tutoring/organizational types of interventions. All of those work better than meds for the long haul, according to research. Maybe that’s because, unlike meds, these interventions develop new skills. They change the brain for the better via learning and new ways of adapting. Pills tend to suppress the unwanted symptoms, in my experience, mainly impulsivity and motor movement. Focus improves too, but once off meds, kids fall back to where they started from.
  • If your child takes psycho-stimulants, you might very well see a sudden boost in their grades. Sounds great – but beware. Evidence shows that a boost in grades may not be about better learning – but rather – kids are performing better on tests that don’t translate to long-term gains. Also, the way in which teacher’s grade can be biased, based on behavior rather than true achievement.
  • Finally, if you try meds for ADHD, always have an exit strategy in place. Try to see this as a time-limited intervention. Try to have time off meds as well (e.g., not on weekends, not on holidays, or not during summers).

Those are my general (behavioral psychologist’s) take on the role of meds. I’ve seen some kids do better and some worse on meds, and it wasn’t entirely predictable ahead of time. I do have many other caveats I ask parents to consider. Ask if there’s anxiety at play, or some other underlying emotional issue that masks as ADHD. Is there an educational problem – bad school fit? Learning disability? Is there family conflict, parenting stress, marital stress, or is there a dietary/sleep issue which we now know have been correlated to ADHD symptoms? And always, make certain your kids are getting enough vigorous daily exercise and movement of all sorts – outdoors preferably – which have been shown to substantially lower ADHD symptoms.

Please contact Dr. Rao about reproducing any material found on these pages.


Helping Your Children Understand the Loss of Someone They Love

Losing someone – a friend or family member – is such a difficult time. It’s also an important time to think about how to talk to your kids. Foremost, be honest and direct (avoid euphemisms) with your children, but–and this is key–pitch whatever you say to the developmental level of your child. The great psychologist Piaget offers us developmental markers to guide us.

Before 7 children think more magically, more imaginatively, and often think they can cause events outside of their control. This age group gets confused or misled most by euphemisms. They can’t think abstractly. Some very young children wonder if they did something to cause a death, simply because they’d wished it during an angry moment or had a fight just before someone died, so make sure they don’t think they caused it. And, offer only as much information as a youngster can handle. Young kids often circle back and ask for more information when they need it or can tolerate it. Otherwise, don’t overload them.

Between 8 and 11 or 12, kids are more sophisticated, but concrete in their thinking. They like to connect things, appreciate how things go together, and start to think about how the bigger world works. They can handle greater complexity, so don’t sell them short. Tell older kids the truth, but it’s a good practice to ask permission – have them tell you when they feel ready to talk. They too can get easily overwhelmed by the strong emotions associated with these tragic events.

Teens possess abstract thinking skills. They can handle more information than younger sibs. They can think more critically, have opinions, and strong beliefs of their own. It’s important to respect their way of understanding things. Tell them you are available to talk when they want. Tell them you’re sad and confused as well. But reassure them that, together, you will all get through this. Know that social relationships are important in the teen years, so they may want to be with friends more than usual. Encourage this and tell them its great to have good people to help them through tough times.

Finally – here are general points that parents should keep in mind:

  • Children are thinkers and they generate lots of questions, and that’s healthy. Encourage it.
  • When parents (and other adults) don’t know the answers to difficult or complex questions, just admit it. We’re all human. It’s ok to be confused. It may take a long time to understand what happened and adjust. Sometimes there are no answers, and that’s ok too.
  • If you’re sad, be sad. Show your sadness, don’t hide it. You need to model the full range of human emotions as normal and healthy. Tell younger kids that you’re upset and sad, and that by crying or being angry, you are going to start feeling better soon.
  • Let everyone work through loss in their own way. In my experience, boys may be less emotional than girls, but not always. Teens may get more angry and irritable. In general, those of us who are more social may reach out to other people for support, but those of us who are more introverted may need time for personal reflection.
  • This isn’t a time to pressure yourself. Don’t worry about being perfect or getting everything right. It’s very human to feel your way through these hard unfamiliar events. Expect mistakes. Learn from them.
  • Finally, take care of yourself. If you’re staying healthy and emotionally supported, you can better help your kids through tough times.

 

 

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The Halloween Hangover

Tooth decay? Pediatric obesity? Sleep deprived the next morning from all night trick-or-treating?  How are you going to handle the day after Halloween? How will you deal with the sudden abundance of sweets your children will drag home?

After you inspect the candy, to insure it’s safe, and maybe claim the best treats for yourself, you need a plan. On average, kids bring home two plus pounds of sugar, cocoa butter, corn syrup, hydrogenated palm oil, and many other things few of us can pronounce or identify. Don’t get me wrong. I’m no prohibitionist. I love Halloween. I’ve been known to shake down clients for Kit Kat bars and Peanut M&M’s well into mid-November. But there have to be some guidelines to handle the confectionery loot.

Here are a few great ideas:.

Out of Sight… Out of Stomach

It’s simple, but it helps: By keeping most of the candy out of visual range, many children won’t be as tempted to dive in and overeat. I know parents who set up rules, before their kids don costumes. They establish the firm expectation that parents will be in charge of the candy once it arrives home. If kids don’t accept this, there isn’t any trick-or-treating. Tough love meets Halloween!

Treats for Track!

Walk or ride or run around the playground could earn a treat later on. Beyond the healthy, regular exercise all kids need, extra physical activity justifies being able to have an additional treat. This is a version of smart calorie counting. Children who learn to think about what they are eating each day, and how much they are burning off, will likely grow into young adults more aware of their bodies, nutrition, and more willing to engage in physical exercise.

Space It Out.

Candy has a very long shelf life. Break it up for long-term enjoyment. Spill out the contents of all those plastic pumpkins and pillowcases to visually plan what you want to do with so much candy. Maybe a few pieces at the end of the week, perhaps for getting to school on time or getting teeth brushed, for eating healthy dinner, for homework done. Maybe limit one or two a day after eating a health dinner.

Enlist your child’s help.

That may sound like asking the fox to guard the hen house, but children often come up with great solutions if you tell them they need to be in charge of their bodies and tell them they are smart enough to brainstorm solutions with you. “I need your help,” one parent I know recently said to her seven year old. “We have too much candy. I know its fun to eat, but we have to figure out a way to handle so much of it. I want you to enjoy it, but how can we keep from eating it all at once?”

Give Away and Share.

Finding people with whom to share your candy is a loving, caring act. Maybe it’s an elderly person on your block with whom your children don’t interact with very much. Maybe it’s your regular postal carrier, teachers, or a new potential friend. This is a great way to turn something often seen as frivolous, and sometimes greedy, as fueling positive social interactions.

Throw Away?

When all else fails and there’s just too much candy, it might be time to throw some of it away. Better inside the garbage pail than too much inside your child’s tummy. Yet, is this the right message to be giving to your kids? Isn’t it wasteful to throw food away? Yes. Fortunately, there’s nothing of much nutritional value inside the colorful, shiny wrappers. Sometimes, throwing things away that we don’t need teaches kids not to be wasteful in the first place. Given how much we spend on Halloween candy, upwards of two billion dollars a year, it seems better we buy and consume less to start with. If the idea of throwing it away still bothers you, some communities have candy

Buy Back Programs help reduce the amount of candy consumption. Start one in your school or town.

 

Please contact Dr. Rao about reproducing any material found on these pages.