Your Family Matters : Parenting

"Preventing Eating Disorders"

drkanner — Sat, 04 Nov 2006 04:15:00 GMT

Be sure to watch this segment live on FITM this Monday, 11-06-06 between 8:00 and 8:30a.m.

Background: 14 year-old Karen recently told her best friend Stephanie that she is "fat" and needs to lose at least 15 pounds. Stephanie's eye's grew quite large as she responded to Karen with "are you crazy, you are too skinny as it is". Despite Stephanie's accurate assessment of Karen, these two girls have completely different perceptions of what Karen's body actually looks like. Over the next two months, Karen decided to eliminate all carbohydrates and fats in her diet and when she would eat, only would ingest salads, fruits, and liquids, such as Crystal Light. Sure enough, she did lose about 15 pounds but also stopped menstruating. Her physique to all outside of her view was dangerously thin, yet Karen thought she still had at least 5 to 10 pounds to go before she felt she looked "okay". In addition to the loss of her monthly period, her grades in school began to slip due to Karen developing concentration problems during class and when attempting to do her homework. Her loss of energy made it difficult to complete her assignments and subsequently her straight A's were moving downward towards B's and C's. Despite these changes, Karen was convinced it was all worth her feeling thin and no longer fat. Obviously her parents were concerned and one afternoon, Karen's mother pulled Karen into the bathroom with her and looked in the mirror together. "How can you feel fat?", Karen's mother stated. "Look mom, see these folds of skin on my stomach"? "No Karen, I don't, those are your ribs not folds of skin". "No mom, it's fat and I hate my body for doing this to me!". At this moment, Karen's mom knew that Karen had a real problem hightlighting that even Karen's perception of herself was distorted.

Leading up to Karen’s present disorder were some important developmental experiences beginning early in her life. As a toddler, her parents were very concerned about her tantrums and subsequently set very stringent limits when she would express any sort of anger and opposition. Here it seems that Karen internalized that anger was a “bad” emotion that should be inhibited and repressed. During her childhood and early adolescent years, Karen never expressed her anger in spoken words. In fact, she continued to fear punishment if she were to express her feelings directly. This led to experiences of being manipulated by many of her peers for not speaking up for herself.

Eating had also been a point of contention. Concerned that she would not grow to her full capacity, a family rule was that she must “clean her plate” at each meal before being excused from the table. Over the years, this became a dreaded experience for she felt forced to eat even at times when she did not feel hungry. This led to a general dislike of almost all forms of food.

Finally, Karen’s mother has been a habitual dieter and exercise guru expressing frequent concerns about gaining weight and looking “fat”. Over the years her mother would encourage Karen to watch what she eats and mandated that she exercise at least three days a week since she was 8 years old.

Taking this history together illustrates how certain external experiences must become internalized and processed. But exactly how do these eating disorders develop? Despite some attempts to portray some sort of classic syndrome, the truth is that the eating disorders are no different than any other psychiatric symptom. In other words, there could be a number of different underlying conflicts which give rise to the development of this type of syndrome just like when an adolescent develops a depression. However, when an adolescent develops an eating disorder, the condition can become very serious and frequently can cause physical health as well as psychological problems. In other words, it is a very serious condition that always will warrant professional help once it has developed. The treatment protocol for the eating disorders frequently combines medication (usually antidepressants) and psychotherapy aimed at helping the individual both understand the causes of the condition as well as helping them develop an accurate view of themselves which has frequently become distorted.

Although there can be a variety of different conditions and conflicts that can cause the development of an eating disorder which could include: conflicts over aggression, control, sexuality, growing up and moving out of childhood, just to name a few, there are certain measures that parents can take in their roles as caregivers that could help to prevent eating disorders from manifesting in their child. These include the following:

1. do not battle over food consumption
2. never criticize your child's body
3. encourage your child to express feelings to you always
4. be accepting to your child's feelings towards you
5. be careful about dieting in front of your children
6. always encourage acceptance of the natural body
7. educate about mature bodily development over time

Following these guidelines help the child and adolescent both accept themselves in a healthy manner, allow for some uniqueness and differentiation, and promote the healthy expression of feelings which often offsets the development of many psychological disorders including the eating disorders.

Dr. Keith Kanner
Show Host
Your Family Matters
Fox6 News - San Diego

"Halloween Guidelines"

drkanner — Fri, 27 Oct 2006 02:29:00 GMT

Watch this segment live on FITM this Monday, October 30th between 8:00 and 8:30a.m.

Background: Most children are busy daydreaming this week about getting ready for Halloween parties and trick or treating next Tuesday. However, Halloween can be both a fun or scary experience depending upon certain precautions that parents need to put in place. To begin with, costumes can be both amusing and fun but also quite frightening when considering the age of the child.

For the under 6- year olds, too much exposure to costumes or decorations involving blood, guts, or mangled body parts, as well as too scary a costume, can evoke both extreme anxiety and bad dreams. In some cases, such over-stimulation can cause fears which can last up to a month or longer. Parents of this group of children need to both be careful what they allow their child to wear as well as what they are exposed to during the Halloween ritual. It is recommended that this group begin trick or treating as early as possible and end before the older children get onto the streets wearing graphic costumes and engaging in possible pranks. Obviously, parents need to stay very close to the children in this age group. In addition, when approaching homes with creepy decorations, be sensitive as to whether your child will be too affected by the decor and if so, you may wish to miss that particular house. Haunted houses are also NOT recommended for the under 6 year-olds for the same reasons as mentioned regarding costumes and decorations for children in this age group are still between fantasy and reality thinking and graphic exposure may feel "too real" to them causing undue anxiety.

For the 6 to 11 year-olds, it is suggested that parents also stay close by as they venture onto the streets due to possible dangers that could occur due to group behaviors and the effects of anonminity that wearing costumes can cause - for example, children are more likely to act out if their identity is masked. In addition, impulsivity increases in numbers. Therefore, parents are needed to safeguard the grade school aged child.

Regarding the early to middle adolescents, they will most likely try to ditch any parent who attempts to tag along, but it is still suggested that the parents of this age group are still somewhere present in the neighborhood - perhaps in a parked car at the end of the street - here, the adolescent has some independence but also some supervision to help keep them from getting into any trouble. Hopefully, the post 16 year olds have given up trick or treating, so this should not be an issue for most parents.

As always, parents need to check through the candy and toss away anything that is unwrapped or seems questionable. Furthermore, limits need to be placed on the amount of candy eaten in order to avoid potential negative health effects. Following these guidelines should assist in a fun and happy Halloween.

Safe Halloween Planning Key Points:

1. For the under 6-year olds, be careful about exposure to scary costumes/houses.
2. Start the evening early for the small children to avoid older children antics.
3. Up to preadolescence, parents need to be chaperones for safety.
4. For the early to middle adolescent, position yourself at a checkpoint.
5. Always check through candy and limit consumption.

Dr. Keith Kanner
Show Host
Your Family Matters
Fox6 News - San Diego

"Profiling School Shooters"

drkanner — Fri, 29 Sep 2006 14:24:00 GMT

Be sure to watch this segment live on FITM this Monday, October 2nd between 8:00 and 8:30a.m.

Background: Once again our Nation was faced with another school shooting this past week while still recovering from the last one three months ago. One difference with this latest tragedy was that the shooter was not a student, but a 53 year old man who made his way onto a high school campus in disguise before committing this horrific crime. Human suffering is once again on the minds of all along with feelings of anger and sadness that these type of crimes continue on our school grounds despite extensive efforts of all states and school districts insisting and implementing greater security measures to protect the lives of their students.

Whenever something like this happens, many questions come to mind. "Why?" ; "What kind of person commits something like this?; and "Is there anything that could have been done to better prevent this from happening?". All of these are very important questions but difficult to answer.

Meanwhile many children are once again afraid to go to school while also reawakening past experiences of previous school shootings. Despite the actual rarity of such shootings taking place, as compared to other acts of crimes, there is a continued need to educate the public on what signs to look for in everyday encounters to better protect one another. Such efforts are being encouraged by Homeland Security in reference to terrorists and the same type of interventions need to be applied to identifying disturbed individuals in general.

One active area of investigation and inquiry has been an attempt to "profile" the type of individual or individuals who could commit these types of awful crimes in hopes of identifying them before a potential crisis could occur. These joint efforts of law enforcement, along with mental health professionals, continue and offer checklists to both school personnel and students in hopes of getting everyone involved with protecting one another.

Below is a list of some of the common profiling characteristics found in individuals who have committed school shootings as well as other serious acts of crimes. These characteristics are felt to be long standing in nature and in many cases not identified in advance:

1. A history of psychological and/or behavioral problems.
2. A lack of close friends
3. Historically poor judgment
4. Significant use of magical thinking
5. A serious lack of moral integration
6. Strange habits
7. Antisocial thoughts and behaviors
8. Isolative
9. Tend to be socially rejected due to their qualities
10. Self-centered

Most professionals agree that if more adults and students alike were better educated about such identifying characteristics and were made to feel more comfortable bringing these individuals to the attention of adults, the incidence of school shootings and other serious acts of pathology would decrease and these targeted individuals could perhaps receive help that they have obviously needed and have not received.

Research teaches us that individuals who demonstrate antisocial behaviors do not just “snap”. They have histories of maladaptive styles that many people in their lives have known about, but not intervened.

Hopefully, the joint efforts of law enforcement, school districts, and parents will lead to better educating both children and school personnel about these profiling characteristics in hopes of further decreasing crises such as the one again experienced this past week.

Dr. Keith Kanner
Show Host
Your Family Matters
Fox6 News - San Diego

"Parenting An Adolescent"

drkanner — Fri, 22 Sep 2006 17:45:00 GMT
Watch this segment live on FITM Monday, September 25th between 8:00 and 8:30a.m.

Background: The onset of adolescence typically brings an uncomfortable change in the relationship between parent and child. Where characteristics of sharing, relating, and mutual admiration were evident during the late childhood years (roughly 9 to 12), the developmental shift into early adolescence promotes a shift into avoidance, secretiveness, and public embarrassment. Once 12 year old Courtney began Middle School, she requested that her mother drop her off a block away from school so she could walk in herself and not look too dependent on her mother. Courtney would leave the car with her head held high and confidently walked upright to school, while her mother wept in the car watching her "baby" leave her behind.

Parents of the early adolescent are left feeling bewildered, sad, and angry and the degree to which these attitudes are present varies. Often they alternate with the long-established closeness and mutuality which form the basis of the normal relationship between parent and child at all levels of development, including adolescence. We tend to see this most when the adolescent is physically ill or in trouble. At these times, they will slip back into a position of "need" and will rely on the parent to help them through the temporary condition, but will then balk once they are feeling well again.

The underlying dynamics driving the child and the change in relating to the parents are multiple and are due to both physical and psychological changes. Powerful hormones and neurotransmitter changes catapult the adolescent into stronger sensations of aggression and sexuality which often become difficult for the boy or girl to manage. On the psychological side, the recognition of the parent being both a parent and a member of the opposite sex creates further conflict and anxiety. Hugs and kisses, and any form of physical contact, may produce feelings of discomfort associating the parent unconsciously to a member of the opposite sex. Privacy, modesty, locked doors, and physical distance are all common manifestations during this phase of development. 13 year-old Dylan took his own allowance money and bought himself a lock to place on his bedroom door to ensure that neither his parents of siblings could "walk in on him".

Most adolescents create door signs reading "Parents Keep Out", or "Enter At Your Own Risk", which although humorous are unnerving and underlie this developmental process. Strange music, wild posters, suggestive attire and costumes, and the absence of neatness are all indicators of the intense need to create space and independence from parents both physically psychologically while remaining in their required and needed protective atmosphere. Parents who understand adolescent development will tolerate most of these efforts to "individuate" unless the efforts are outlandish for they understand that such creations are benign aspects of differentiation. When confined to the home, although not enjoyed by most parents, the adolescent is given the chance to "safely individualize", and often when parents are tolerant of such benign efforts, behavior and attitude outside of the home is well modulated.

Another major theme in the adolescent is the need to view parents in less powerful ways in efforts to feel more in control of themselves. Due to the strong developmental need to attain enough nurturance and guidance in the earlier years of life, the adolescent attempts to break these apron strings by "de-idealizing" the parents, especially the mother. Both boys and girls come to see their mother in a less potent, more imperfect light, gradually assuming more and more power for themselves. Adolescents of both sexes tend to have a more conflictual relationship with their mother than father as they try to ward off the early wishes for fusion, not unlike how they were as toddlers years ago. Then, as now, the father, is seen in a more rational, balanced light, and commonly serves as a go-between for both the mother and child.

From a parenting perspective, just as the toddler required the consistent presence of the parents to help them work through their conflicts and manage their behaviors, so does the adolescent need regular contact with parents to help them safely manage the developmental tasks of this stage of development. The optimal parental position is a combination of consistent caring and the exercise of mature judgment and limit setting, while gradually allowing the adolescent increased freedom and responsibility once they have demonstrated enough functional maturity.

What often further complicates the interaction between adolescents and their parents is the strong emotional conflicts that arise in both the child and parent alike. The more the parents can manage their emotions during this time and try to better self-understand what conflicts are being awakened, which may date back to one's own childhood and adolescence, the better the parent is prepared to help their child and themselves get through this exciting, yet challenging, phase of development.

Optimal Adolescent Parenting Key Points:

1. Parents need to have regular contact with their adolescent despite resistance.
2. Consistent caring is blended with mature judgment and limit setting.
3. Gradual freedom and responsibility is introduced based on demonstrated maturity and self-responsibility.

Dr. Keith Kanner
Show Host
Your Family Matters Fox6 News - San Diego