Posts Tagged ‘therapy’

Self-Esteem

Wednesday, September 28th, 2016

Everyone has potential. To discover it is a road to success. To apply it is a road to happiness.

by Dr. Veronica Brodsky, PsyD

The above statement has been my philosophy and core belief ever since I have established Interactive Discovery in 2007. However, one of the main challenges for me as a clinician is not only to recognize someone’s potential, but to help adults and children learn to recognize this within themselves. How can one apply their potential and their talent when they face struggles with low self-esteem on daily basis? While many educators, mental health providers and even politicians recognize the importance of self-esteem as a way to improve performance and feel more satisfied in life, we are still faced with many people feeling that they are simply not good enough. Most clinicians will attest that a common treatment plan goal, regardless of the presenting problem, is to improve self-worth and confidence and yet few feel that this is an easy goal to accomplish.

We all have a history and past that can influence how we experience ourselves. What is striking in my practice is that regardless of how bad or good one’s past experience has been, the struggle with self-esteem is very similar across the board. It just varies in its intensity. One of the things I have observed over the span of 20 years of working and studying psychology, is that one common element the majority of my patients have is high self-criticism and low self-compassion. Teaching children and adults to be kind, loving, and gentle with themselves has been one of the most important, and yes, the most difficult aspects of my practice. Unwiring the habit of self-criticism is a lot more challenging than receiving a promotion at work, high grades in school, and being selected for an Ivy League college.

Recently I came across an article in The Atlantic by Olga Khazan about why self-compassion works better than self-esteem. This article resonated with what I have observed over the span of my work as therapist. In her interview with Dr. Christine Neff, a psychology professor at the University of Texas, she speaks about how we as a society promote high self-esteem. However, what it actually means is to “feel special and above average.”

As a society, we are competitive. The term “keeping up with the Joneses” is an understatement. We are constantly comparing ourselves to others. We want a lot more than we need and feel that by obtaining things, status, senior positions, and real estate, we will be happier. In his book Happier, Tal Ben’ Shahar, a Harvard professor of psychology, states that “While levels of material prosperity are on the rise so are levels of depression.”

We want our kids to go to the best schools, get the best grades and be the best in everything –athletics, music, arts, social leadership; the list goes on and on. Kids know this & they feel it. Just the Middle School selection process in New York City is enough to make a healthy child develop anxiety, panic attacks and depression. If you didn’t get “that” job, didn’t get into “that” school, didn’t pass “that” test, what does it say about you? So when we equate our accomplishments with self-esteem, it is not surprising that we often don’t feel good about ourselves, no matter how much we accomplish, because there will always be something that we didn’t get. According to Neff, “When we fail, self-esteem deserts us, which is precisely when we need it most…The best way to think about the problem of self-esteem is not whether or not you have it, but what you do to get it… usually self-esteem is highly contingent on success.”

I think it is very important to have goals, ambitions and purpose, but it is no less important to have self-compassion. Being gentle with yourself, setting realistic expectations, forgiving yourself for mistakes, allowing yourself to be taken care of, asking for help, making space and time to do something you truly enjoy and nurturing yourself helps to develop self-compassion. Neff suggests that self-compassion is “treating yourself with the same kind of kindness, care, compassion as you would treat those you care about — your good friends, and your loved ones.” Without self-compassion, the road towards achieving our dreams can be self-destructive. Applying one’s potential cannot lead to the road of happiness if self-compassion is missing.

References:

Ben-Shahar, T. (2007). Happier. New York: McGraw Hill Publication.

Khazan, O. (2016). Why self-compassion works better than self-esteem. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2016/05/why-self-compassion-works-better-than-self-esteem/481473/.

Dr. Brodsky received her doctorate from New York University. Her research interests are in the areas of examining child and parent relationships and their effects on child development.
BLOG: EMDR, Separation And Divorce And Its Impact On Children Part I, Separation And Divorce And Its Impact On Children Part IIWays to decrease anxiety through rewiring our brain: Mind-Body Connection

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EMDR

Wednesday, September 28th, 2016

by Dr. Veronica Brodsky, PsyD

“Wow, I have just processed in this two-hour session what I have tried to process in therapy for years.” This was a statement made by a client after I had incorporated EMDR into his session. While not everyone has this experience, many patients do report that past traumatic or highly disturbing experiences have been processed, through bilateral stimulation, in an accelerated manner. Many studies indicate that by using EMDR therapy, people can experience the benefits of psychotherapy that once took years to make a difference. In addition, what is remarkable is that EMDR therapy shows that the mind can heal from psychological trauma much as the body can recover from physical trauma.

I became particularly interested in EMDR after recognizing that many of my own patients felt “stuck.” Although we made many connections to their past and its impact on their current functioning, simply recognizing this connection was just not enough to help patients move forward in a way that freed them from their past. As a result, “talk therapy” alone became less productive, so I was in search of other modalities that could be of help.

What attracted me to EMDR was its fundamental link to our physiology and “mind-body” connection. I observed that many people with a history of trauma, especially complex trauma, held on to these experiences in their bodies. Somehow I wanted to aide in helping them to release these experiences from their body, similarly as we want a massage therapist to help us to release a tense knot in our body.

EMDR Institute describes Eye Movement Desensitization and Reprocessing (EMDR) as a “Psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories (Shapiro, 1989a, 1989b). Francine Shapiro developed this modality about 20 years ago. Shapiro’s (2001) Adaptive Information Processing model posits that EMDR therapy facilitates the accessing and processing of traumatic memories and other adverse life experience to bring these to an adaptive resolution. After successful treatment with EMDR therapy, affective distress is relieved, negative beliefs are reformulated, and physiological arousal is reduced.”

EMDR is used for a huge range of clinical application. The premise is that 1) we move towards health and wholeness; 2) we have a natural impulse to heal; 3) we have wisdom within us. EMDR incorporates the Adaptive Information Processing model and its main premise is that we move from a dysfunctional state to a functional one. Trauma impacts the integration of the information and stores traumatic experience in a fragmented way on the right side of the brain. By incorporating bilateral stimulation, we are reprocessing this experience and moving it in more organized way to the left side of the brain. The other important premise of EMDR is that you don’t lose anything you need.

Often in this work we refer to various traumatic events as “Large T” or “Small t.” Large T traumas are referred to the events that were life threatening (e.g. war, accident, rape, etc.). Small t – traumas are referred to the events that were experienced by individuals as traumatic, but were not life threatening (e.g. humiliations, sense of inadequacy, shame, difficult interpersonal relationships). Thus, these experiences limit how we view ourselves in the world. The impact of many “small t (s)” on one’s psyche can be just as devastating as experiencing one “large T” trauma.

In my training with Dr. Laurel Parnell, who had modified the original protocol and incorporated “Attachment Focused EMDR” I have learned that a lot of the techniques and the use of bilateral stimulation can also reduce anxiety, improve sleep, and overcome trauma. With successful EMDR process often “anger turns into power and fear turns into love.” While the techniques used in EMDR can be helpful to many, they are not for everyone and the success rate can vary depending on the individual and other factors. However, I feel fortunate in having this technique in my “tool-box” and have seen impressive results when they are incorporated into “talk therapy.”


References:
Parnell, L. (2007). A therapist’s guide to EMDR; Tools and techniques for successful treatment. New York: W.W. Norton & Company.

Parnell, L. (2013). Attachment focused EMDR; Healing relational trauma. New York: W.W. Norton & Company.

Shapiro, F. (1995). Eye movement desensitization and reprocessing; Basic principles, protocols, and procedures. New York: The Guilford Press.

Dr. Brodsky received her doctorate from New York University. Her research interests are in the areas of examining child and parent relationships and their effects on child development.
BLOG: Self-EsteemSeparation And Divorce And Its Impact On Children Part I, Separation And Divorce And Its Impact On Children Part IIWays to decrease anxiety through rewiring our brain: Mind-Body Connection

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Now Offering Telepractice Remote Online Internet Speech Language Therapy Services

Saturday, November 10th, 2012

Brooklyn Letters has just added Telepractice Speech Therapy to our catalog of services. This is an excellent option for those who require flexible scheduling and want access to high-quality speech language therapy services from the convenience of their computers.

We’ve outlined the entire process here. Please contact us should you require more details.

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Late Talkers: A Variation of Normal Development? By Michelle MacRoy-Higgins, Ph.D., CCC-SLP

Friday, February 24th, 2012

In adjusting the eligibility criteria for speech only children in Early Intervention, the New York State Health Department frequently stated that “late talkers were a variation of normal development.” The more stringent eligibility was intended to decrease services to “late talkers” because it believed that these children would catch up to their peers over time. The following information reflects research and resources compiled by Michelle MacRoy-Higgins, Ph.D., CCC-SLP, Assistant Professor, Communication Sciences Program, Hunter College-CUNY, who has researched the topic of late talkers and presented at the 2010 ASHA convention on the topic.

Who are Late Talkers?
The late talkers reflect 15% of the toddler population and are identified around two years of age when children produce fewer than 50 words and do not combine words. The late talker also has normal hearing, cognitive, sensory and motor development. A typical child at two years of age would be using over 300 words and putting together 2-4 word sentences.

Why Late Talkers are Not a Variation of Normal Language Development
Language characteristics of the late talkers are not reflective of typical language development in the areas of:

1. Word learning
Receptive language (understanding): Late talkers do not learn (point to) new words as accurately as their peers. (Ellis Weismer & Evans, 2002; MacRoy-Higgins, Schwartz, Shafer & Marton, 2009)
Productive language (expressive vocabulary): Once late talkers say words, they are slow to add more words to their vocabularies; they do not systematically add words to their vocabularies as observed in typically developing toddlers (MacRoy-Higgins et al., 2009).

2. Phonology (sounds)
The sounds in the words that they do say show delays and disordered patterns. For instance, late talkers produce atypical sound errors, atypical sound patterns and show little change in development over time as compared to language-matched peers (Williams & Elbert, 2003)

3. Morphology/syntax (grammar and word combinations)
Once late talkers begin to combine words they show delayed and disordered patterns. For instance, late talkers produce more errors than their language-matched peers (Thal et al., 2004)

4. Social skills
At risk for social/behavioral disorders. Late talkers are less social than their peers; quality of parent-child relationships in late talkers is judged to be more stressful than parent-child relationships in typically developing toddlers (Irwin, Carter & Briggs-Gowan, 2002)

Are there Long-Term Implications for Late Talkers?
The research has indicated that late bloomers show improvement in language skills but that they perform significantly poorer than their peers in reading/literacy, syntax and morphology (word combinations/sentences and grammar) and vocabulary deficits are observed through 17 years of age.
Toddlers with Specific Language Impairment (SLI) demonstrate significant difficulties with all aspect of language (understanding, expression and literacy/reading).

Why is it Important to Provide Speech and Language Services to Late Talkers?
Approximately one-half of toddlers who are late talkers will be labeled as having Specific Language Impairment in preschool/elementary school. Those that show improvement (late bloomers) continue to perform poorer than their peers in language and literacy skills throughout elementary and secondary school.

Late talkers are not a variation of normal development because at age two they show disordered patterns of
• Vocabulary acquisition (understanding and naming)
• Phonology (sound system)
• Grammar
• Social skills

Why is Early Intervention so Important for Late Talkers?
An early foundation in oral language skills is paramount for the development of literacy and reading skills. Late talking toddlers are at significant risk for academic difficulties and therefore would benefit from language intervention as early as their language disorder is identified.

Is Language Intervention for Late Talkers Effective?
Language intervention for late talkers is effective. Late talkers receiving intervention by a Speech-Language Pathologist over a short period of time showed improved language skills (vocabulary, production of sentences, speech sound production) as compared with late talkers who did not receive intervention (Robertson & Weismer, 1999), and these results suggest that if untreated, late talkers will not improve their language at the same rate as their typically developing peers, with the significant risk of lifelong language difficulties impacting academic achievement, reading and literacy.

References
Ellis Weismer S., & Evans, J.L. (2002). The Role of Processing Limitations in Early Identification of Specific Language Impairment. Topics in Language Disorders, 22(3), 15-29.

Irwin, J.R., Carter, A.S., & Briggs-Gowan, M.J. (2002). The Social-Emotional Development of ‘Late-Talking’ Toddlers.Journal of the American Academy of Child & Adolescent Psychiatry. 41(11), 1324-1233.

Leonard, L.B. (2000). Children with Specific Language Impairment. Cambridge, MA: MIT Press.

MacRoy-Higgins, M. Schwartz R.G., Shafer, V.L., & Marton, K. (2009). Word learning and phonological representations in children who are late talkers. (Doctoral Dissertation), Graduate Center, CUNY, New York, NY.

Rescorla, L. (1989). The Language Development Survey: A screening tool for delayed language in toddlers. Journal of Speech and Hearing Disorders, 54, 587-599. 22.

Rescorla, L. (2009). Age 17 Language and Reading Outcomes in Late-Talking Toddlers: Support for a Dimensional Perspective on Language Delay. Journal of Speech, Language, and Hearing Research. 52, 16–30.

Robertson S.B. & Ellis Weismer, S. (1999). Effects of Treatment on Linguistic and Social Skills in Toddlers With Delayed Language Development. Journal of Speech, Language, Hearing Research. 42, 1234-1248.

Thal, D.J., Reilly, J., Seibert, L., Jeffries, R., & Fenson, J. (2004). Language Development in children at risk for language impairment: Cross-population comparisons. Brain and Language, 88, 167-179.

Williams, A.L., & Elbert, M. (2003). A Prospective Longitudinal Study of Phonological Development in Late Talkers. Language, Speech and Hearing Services in Schools, 34, 138-153.

Dr. Michelle MacRoy-Higgins has worked as a Speech-Language Pathologist for nearly 15 years. In addition to being a private practitioner, Michelle is an Assistant Professor in the Communication Sciences program at Hunter College (CUNY) and teaches graduate students in the areas of language development, language, phonological, articulation, motor speech and swallowing disorders in children. Michelle has worked clinically in a variety of settings including home-based, preschool, elementary school and private practice clinics; and has enjoyed working with a variety of children presenting with language, phonological, articulation, and feeding disorders ranging in age from birth through adolescents. Michelle’s clinical and research expertise is with children who are late talkers. She enjoys working with children and their families to develop individualized and evidenced-based treatment, while having fun and encouraging communication success.

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Getting Divorced? When it Comes to Helping Your Children Adjust Appropriately: Anticipate Problems and Minimize their Effects [Part 2], by Susannah Gersten, M.S.W., LCSW, Psychotherapist

Tuesday, January 17th, 2012

Minimize the problem:
• As much as possible, do not encourage your kids to side with you over their other parent. Empathize with them, help them problem solve if it feels appropriate. But remember, your child does not have the option of divorce from their parent. They need to find ways to deal with their other parent in a way that will work for them for the rest of their lives. Therefore, do not allow your children to polarize the two of you in this way. Neither you nor your ex are perfect and your child needs to learn how to have the best possible relationship with both of you that they can. Sometimes it helps to stop for a minute and remember that there was a reason you married this person in the first place, and no matter how far away that seems at this point, your children are still hanging onto those positive qualities. It is in their best interest to have as close of a bond with both of you as possible, despite whatever long list of imperfections have now presented themselves in your ex. If you don’t feel that you can be a somewhat neutral source of support for your child when it comes to issues with their other parent, find them someone else to talk to.
• Do not vent your own frustrations about your ex to your child. There are many other appropriate people to discuss your own ongoing feelings of anger and frustration about your ex with. Your child is not one of those people.
• Although you may be angry at your ex, DO find ways to be on the same team. You owe it to your children to maintain communication with your ex in some way, shape, or form, and maintain consistent rules and expectations for your kids at both houses. If you cannot communicate on the phone without fighting, try texting or emailing. If you still cannot communicate, seek help. Therapy is a great way to show children that even though you no longer live under one roof, you are all still a family and are willing to do what it takes to make the family work in a way that benefits the children without getting back together.

*Remember that you don’t have to be alone and out of social resources to seek professional help. Sometimes a therapist can be a great non-biased ear for you, your ex, and your children to vent to during this difficult time.

Susannah Gersten is a Brooklyn based psychotherapist with experience in mental health as well as community based counseling services in Park Slope, making her invaluable in building relationships with the schools and other services in the area. In her private practice, Susannah offers play therapy with young children as well as behavior management, behavior plans and other techniques that involve both children and their family. She also offers couples and family psychotherapy, in order to help the parents and family address any underlying concerns in the family system. She runs an equine assisted psychotherapy group for middle-school aged children out of Kensington stables to address anxiety, shyness and depression.

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