Here are some tips for parents to help shape desired behaviors:

Frame requests in a positive manner with emphasis on the negative outcomes rather than the negative behavior.

• Instead of…

“You cannot climb on the chairs, you know you are not supposed to!”

• Use …

“I would like you to walk around the chairs, climbing on them would not be safe, you can fall and hurt yourself”

• Instead of …

“You are not supposed to be standing. You are breaking the classroom rules.

• Use…

“If you stand up when your classmates are sitting down they may not be able to see.

Relate to and be aware of your child’s mental innocence and language capacity

Form a physical connection with your child by achieving eye contact and approaching the child in a non-threatening manner.

Optimize verbal connections with your child by using simple child-friendly language and maintain active listening.

• Instead of …

“It is unacceptable to hit your brother”

• Use…

“Please keep your hands to yourself and do not hit your brother”

Keep conversations brief!! One good rule is to speak to young children for no longer than 30 seconds and then ask him/her to comment on what was said.

Utilize open-ended questions

• What would happen if..?
• What do you think about..?
• How do you think we could..?
• What would you do..?
• Why do you think this happened..?

• Instead of…“Did you hurt your brother?”
• Use…

“Why is your brother crying?”

• Instead of…

“ Did you make this mess?”

• Use…

“What can you tell me about this spilled paint?”

Utilize “I” statements

“I” messages are less threatening and it helps the child understand how their behavior made you feel, instead of accusing/blaming.

• Instead of…

“You are not listening!”

• Use…

“I feel that when you are playing while I am talking, you don’t think what I have to say is important”

Provide choices to encourage a mutual compromise and discovery of solutions

• Example

“It is very hard for me to talk when you interrupt, but I know you have something important to say. You can say it when I am finished or you can write it down and say it when it is your time to talk. Which would you prefer?”

• Example

“You can take a bath before dinner or before you go to bed. What would you like to do?”

As you can see-just by making small changes to how you use language can really improve your relationship with your child, and can teach them how to communicate better with others!

Albert Ellis-Founder of RET

If you are suffering from depression, poor self-esteem, or anxiety, Rational Emotive Therapy (RET) can help you learn how to feel good.

Albert Ellis developed rational emotive therapy in the 1950’s. RET is one of the many cognitive behavioral treatment modalities currently used in the mental health field. This therapy focuses on helping the client change those events that can be changed, to gracefully tolerate those that cannot, and to develop the capacity to discriminate between the two. It was based on the idea that psychological problems are caused by self-defeating thoughts, such as “I must be loved or approved by everyone” and “If I don’t find the perfect solution to this problem, a catastrophe will result”. Once such thoughts are changed, emotional and behavioral changes will follow. My task is to help you recognize the illogical and self-destructive thinking processes and to help you replace them with healthier, positive ones.

The human mind can produce about 60,000 thoughts per day. Some of these thoughts may cause negative emotions that if untreated, can lead to depression, poor self-esteem, anxiety, and other insecurities that may be self-destructive. This is where RET can be useful. It is a therapy that empowers you to change your thinking and to have a more profound understanding of how your thinking affects the way you feel. If you are able to modify your patterns of thought by increasing awareness and training your mind, you will be able to minimize emotional distress and promote well-being.

How?

RET helps you identify the emotional and practical problems in your life, and helps delineate the difference between the two. You will be able to minimize emotional disturbances, obtain self-actualization, and experience an improvemnet in your quality of life.

For instance, Susan is a very sucessful lawyer, a great mother to two young children and an outstanding wife. The law firm where she was employed downsized, and as a result her case load decreased as did her salary. For the past month, Susan was waking up at 4 a.m., she was eating uncrontollably and cried almost on a daily basis. Some of Susan’s statements in treatment were as follows:

“I am very scared that I will lose my home; I feel like a bad wife and mother; I just feel like I am going to lose my mind!”

Emotional problem: Susan is upsetting herself about her current setbacks, why not continue doing your best at your firm without generalizing that EVERYTHING is a failure in your life. She fails to remember that she plays a crucial role in her family, and is has been able to carry a balanced life with a successful career and a stable home.

Practical problem: This would involve the success of her business. How can she increase her salary, what are other work related options?
Many people may believe that the practical problem causes the emotional problem, yet it is our thoughts and the perceptions about that event that cause the emotional response.

ABC model

Activating event (activating experience)

Our perception of an unfortunate environmental occurrence.

ie. Susan’s decrease in her case load and decrease in salary due to changes in her company.

Belief system

Our irrational and rational beliefs about the event. These are our automatic thoughts. Irrational beliefs are the ones that we want to address with RET. These thoughts typically consist of “must’s/should’s.” They are also referred to as “thinking errors.”

Three main irrational beliefs are:

“I must be an outstanding component or I am worthless.”

“Others must treat me considerably, or they are absolutely rotten.”

“The world will give me happiness, or I will die.”

In Susan’s case her irrational beliefs will consist of “I must make $70,000 a year, or I am a failure”

Emotional and behavioral consequences

These are the negative emotions such as depression, panic, rage that stems from our beliefs.
Ellis adds the D and the E, D stands for disputation in which you learn how to challenge and debate your irrational thinking. When you are successful at accomplishing this task, then you can move on to E. At this point, you should ultimately enjoy the positive psychological effects of rational beliefs.

I belive empowerement is the key to therapy. Empowerment is the ability to be adaptive and flexible with a positive attitude and good problem-solving skills that enables us to meet our needs over the course of our lives. We all face life challenge. The key is to modify our thinking patterns and find a way to maintain positive self-esteem over the course of our lives, regardless of what kinds of challenges face us.

“Being happy doesn’t mean everything is perfect.  It means you’ve decided to look beyond imperfections”

- Unknown

Today in the U.S. it seems the predominant narrative available to make sense of much internal suffering is a scientific narrative, the belief that, much like diabetes or cancer, mental illness can be “found,” accurately identified through formal diagnostic procedures, and addressed through scientifically vetted treatments.  Much as we colloquially understand diabetes to be an imbalance in, or a compromised capacity of the body to interact with, insulin, one recent narrative of depression is that there is a similarly challenged relationship between the brain and serotonin.  More generally the common colloquial explanation for much of what we categorize as mental illness has become that it is, or is often caused by, “a chemical imbalance,” a graciously vague statement which most of us could accurately use to describe as a major influence of our mood before having our morning coffee.

In his article Watters explores the efforts, several decades in the making, by well meaning scientists, doctors, mental health advocates, patients, and other interested parties who have advocated for the integration of this narrative with the noble goal of lessening the stigma of mental illness by identifying it with something as impersonal as cancer or an infection by bacteria, to counter an earlier time’s belief in mental suffering as purely stemming from a personal or moral failing or weakness.  He also describes how there is a growing body of evidence that this approach has ironically not only failed to lessen social stigma of mental illness, but has in fact increased it (due to the assumption that those identified with mental illness may not morally “less-than,” but are simply less capable due to their mental “disabilities”).  But there presumably is also an underlying belief that such a framework will not only decrease stigma, but that it will also also assist people in their suffering and increase their odds for recovery. One reason why we might be so drawn to this view of internal suffering is that it makes such experiences appear handleable, something which we can tackle with the right approach, optimism, and a lot of elbow grease.

For those of us serving in partnership with those seeking relief from suffering, does this framework help us in our work or does it constrain us?  Possibly this narrative is so compelling because it speaks to dearly held cultural assumptions and values of personal responsibility and self-reliance; if our mental and emotional suffering is the same as a medical disease then it resides somehow both inside and outside the self (inside the self as a “physical” entity which we can therefore take control of, and outside the self as something impersonal, not of our making, and therefore not our fault), then theoretically it would not result in self-blame and would also allow us to view it as a concrete issue which can be solved through task-oriented problem-solving.  This potent narrative not only makes a great deal of sense, but it is also quite soothing, not only to the sufferer, but equally (or maybe sometimes more so) to the treator.  And maybe sometimes that is the more important point of why we are so drawn to it.  Too often though, the journey through mental, emotional, or spiritual suffering is not quite so direct.

The dark side of this positivistic view of internal suffering is the potential of our clinging to the belief that control is possible, and that if we are unable to initiate such control through scientific understanding and prescribed evidence-based treatments that we are somehow lacking in the necessary gumption to live a good life; we’re just not working hard enough or just haven’t found the right prescription.  This fits in perfectly with an American view of self-reliance and of being captains of our own individual destinies, but what about those times when internal torments and external circumstances swamp such dearly held beliefs?  It is far more threatening to consider and embrace the reality that sometimes the sufferings of the mind and heart can be far more mysterious than even the most complicated mysteries of the physical brain, even in its extraordinarily complex and indecipherable functioning.  Considering this possibility, much as considering the reality of our own impending deaths (a problem, which regardless of whatever mental and acrobatics we attempt, our minds know is a problem which cannot be solved), can be the cause of intolerable anxiety.  The broadening of our scientific and medical framework of mental illness allows us to cling to the belief that the absence or presence of internal sufferings are within our control, a belief which can be shored up especially during the times when such strategies prove effective and identified symptoms diminish or vanish.

Tragically this narrative, in the end, always breaks down.  There are things within our influence, but there is very little in our minds, our hearts, or in our brains that are within our control.  The successful use of our capacity to influence our minds and the functioning of our brains can be used wisely, with the appropriate gratitude, humility, and humor, lightly holding the relationship between a wise effort and the accomplishment of a desired outcome, or it can be used in the desperate service to temporarily strengthen the soothing delusion that we are in control, an effort which, in the end, is bound to fail, and if that failure happens sooner rather than later, leaving us unmoored and uncertain how to approach a life which continues on its own path, regardless of our wishes and commands.  Things change; life is guaranteed to present further experiences full of surprise, joy, and pain, regularly demanding that we either desperately continue to construct edifices to show we can command internal and external tides, or that we find ways to sail those tides, knowing that we cannot see every wind, every reef, every wave of beautiful, terrifying, chaotic or soothing experience which will greet, toss, and cradle our little boat until, like all boats and all lives, it finally springs a leak which cannot be patched.

Chequers

You don’t need a mental health professional to tell you that a serious illness or loss of a pet can be as psychologically devastating as that of a person. Many people go through the same range of emotions and grief process as that experienced after the death of a person.

WE LOSE OUR SOURCE OF NON-JUDGMENTAL LOVE AND CHANNEL FOR NURTURING

It has been suggested that the death of a pet is a loss of a source of non-judgmental love. Pets don’t judge us and give us affection unconditionally. Pets allow us to satisfy our need to nurture and care for others.

WE NEED OUR QUESTIONS ANSWERED

Totally out of the blue, my 9-year old poodle Chequers, started having some serious health problems recently. He underwent a series of tests and then was diagnosed with Lymphoma after ruling out just about everything else. He was near death with little bodily functions when he was prescribed Prednisone, and within a few days he stabilized. Our local vet did not sugarcoat the news and to guard against our enthusiasm and sense of hope- he and the hospital Vet both labeled his prognosis “guarded at best” and we were told that he had only a few months to live, at most.  We wanted answers to all  our questions, but were left feeling there was no hope or options, and the tests were often inconclusive. After depleting us of our hope (and our bank balance), they still didn’t know what was going on with Chequers- leaving us frustrated and angry.

FINANCIAL AND EMOTIONAL STRESS, RE-EXPERIENCING OF PREVIOUS LOSSES

Needless to say, this has been an extremely stressful time for me and my family emotionally and financially and brought up memories of past losses of pets and relatives alike. I re-experienced the feeling associated with the loss of my first pet and recalled the grieving process that I went through. When sharing our story with friends and relative many described similar experiences with their pets and the “rollercoaster ride” of emotions that they experienced. After conducting some research into what I was going through- I discovered that over half of American households have pets. Because these pets are companions and share our lives on a daily basis-most of us consider them part of the family.

SHARING YOUR STORY WITH OTHERS HELPS

Knowing that others had similar experiences and sharing them was helpful to me but I learned that unfortunately, society as a whole does not give as much support for pet loss as that of a person. There are no days off work allowed in any company I have ever worked for-to cope with the loss of a pet, and many people ask you “when you are going to get another pet?” There is somehow the belief that pets, like objects, can be replaced easily and the implication is that grieving is not necessary.

BLAME ANGER AND GUILT

As many people do-we tended to blame ourselves and each other for our pet’s illness. Did we give him the wrong (tainted) brand of dog food? Did we allow him to play on too many lawns with chemicals?  Did we not take him to the vet often enough? We could not help but wonder if we made “the right” decisions at key points in the crisis.  We were also distressed and angry by the varying levels of competency and caring of the professionals involved that we experienced-especially after we spent so much money and still did not have a definitive answer as to the cause of Chequer’s illness.  At the animal hospital we ran into a number of people who shared our concerns, sense of guilt, anger and disappointment with the staff involved. Many we met or observed were in shock, angry, or grieving.

NORMAL GRIEF RESPONSE

Grief is the normal response to any important loss in our life. It occurs regardless of the circumstances surrounding the death-whether it followed a prolonged illness, or suddenly. People that grieve experience both emotional and physical trauma as they attempt to adapt to the upheaval in their lives caused by their loss.

THE STAGES OR PHASES OF GRIEF

The normal process of grieving that most people experience is not a process that can be gone through phase by phase. Rather, the grief process is on a continuum, with each person experiencing it in a different way. Many mental health professionals divide the grief process in to phases or stages to help the grief stricken person to understand that what they are going through in the way of experiences and emotions is normal. Some people will progress through all the phases fairly quickly, while others may appear to be “stuck” in a particular stage. The stages of grief, summarized below, are those that are the most accepted, and they are as follows:

1. SHOCK AND DENIAL:
 Denial may begin when you first learn the seriousness of your animal’s illness or injuries. Often, the more sudden the death, the more difficult the loss is to accept and the stronger the denial. In this stage-the reality of death has not yet been accepted by the bereaved. He or she is still in shock-not having fully comprehended the loss, feels stunned and bewildered.

2.ANGER: 
 Anger and guilt often follow denial. The grief stricken person often has angry outbursts at family, friends, health professionals. themselves, God, or the world in general. The bereaved will also experience feelings of guilt or fear in this stage.

3. BARGAINING:
In this stage, the bereaved tries to make a deal or offers a reward to either God, the Vet or  a Clergy member. They might say things like “I will go to Church every day if only my pet will come back to me.”

4. DEPRESSION- 
Depression occurs in reaction to the changed way of life created by the loss. Day-to-day tasks can seem impossible to perform and you may feel isolated and alone. Many depressed people will avoid the company of friends and family. The bereaved person will feel intense feeling of sadness, hopelessness, exhausted, and often helpless. The pet is deeply missed and thought about constantly.

5. ACCEPTANCE- 
Acceptance can be seen when the changes brought about by the loss are stabilized into a new lifestyle. 
The  level of intensity in the mourning process depends on a number of factor such as the circumstances surrounding the death, the age of the pet and pet owner, the relationship of the pet to the owner and to other family members. Recently experiencing the death of a significant person in the owner’s life can also affect how the pet’s death is handled. Usually, children recover more quickly, while the elderly take the longest. Sometimes, the death of a pet will finally enable the bereaved to mourn the loss of a person, whose death had not yet been accepted.

PET LOSS AND CHILDREN

Many people do not realize how traumatic and confusing the death of a pet or person can be on a child. Although children typically grieve for shorter periods of time, their grief is no less intense than that experienced by adults. Children also tend to want to talk about it more; so patience is required when dealing with a grieving child. Some helpful tips for helping children cope with grief include:

1. Encourage the child to talk freely about the pet giving them permission to work through their grief. Encourage them to express their grief by drawing pictures of their pet, and sharing what the pictures mean to them.

2. Inform other caregivers. This includes teachers and day care providers. They are in an excellent position to observe and understand any significant changes in your child.

3. Try to openly and honestly discuss death, and grief. Explain the permanency of death.

4. Spend more time with the child and give them plenty of hugs and reassurance.

5. Never say things like “God took your pet,” or the pet was “put to sleep,”  because the child will then learn to fear that God, or their parents will take them, and may become afraid of going to sleep.

6. Include the child in everything that is going on.

7. Involve the child in memorializing the pet by making a scrapbook or log with photos, as well as drawn pictures of the pet and family members. Write memories beneath or next to the picture.

HEALING OCCURS WITH TIME AND SUPPORT

Given time, healing will occur for the bereaved owner. 
However, there are several things that the grief-stricken owner can do to help with the healing process:

1. Give yourself permission to grieve. Only you know what your pet meant to you.

2. Memorialize your pet. 
It makes the loss real and helps with closure. 
It also allows the bereaved to express their feelings, pay tribute and reflect, and serves to bring in social support.

3. Seek professional help when your emotions become so severe or prolonged that they interfere with your ability to manage daily activities. Many people experience grief for weeks and months. Grief and depression are just as real over the loss of a pet as they are over the loss of a person. If needed, you can even find a pet loss support group in your area. At a group like this you will be with other people in the same situation as you who understand your grief and can share experiences.

4. Get lots of rest, eat well, and exercise regularly.

5. Surround yourself with people who understand your loss. Let others care for you.

6. Learn all you can about the grief process as it helps pet owners to realize that what they are experiencing is a normal response.

7. Accept the feelings that come with grief, and talk, write, draw or sing.

8. Be patient with yourself. Don’t let society dictate how long mourning should last. One study of grieving pet owners found that one third of them experienced grief and sadness for atleast  six months.

9. Give yourself permission to backslide. Grief is like waves in the ocean: at first the waves come in fast and hard, but as time goes on, the waves become less intense and further apart. 
Don’t be surprised if holidays, smells, sounds, or words trigger a relapse.

10. Ask for help in coping from a higher power if it helps.

THERE IS A LACK OF UNDERSTANDING

Oftentimes well-meaning family and friends may not realize how important your pet was to you, or be able to comprehend the intensity of your grief. They may try to be supportive but end up seeming cruel and uncaring. Be honest with yourself and others about how you feel. If despair mounts, talk to someone who will listen to your feelings about the loss of your animal. Talk about your sorrow, but also about the fun times you and the animal spent together, the activities you enjoyed, and the memories that are meaningful to you. Grief is probably the most confusing, frustrating and powerful emotion that a person can experience. It is even more so for pet owners. Society in general does not give bereaved pet owners “permission” to grieve openly. Consequently, pet owners often feel isolated and alone. Luckily, more and more resources are becoming available to help the bereaved pet owner realize that they are not alone and that what they are feeling is entirely normal.

I hope this information and resources are helpful to you in your quest for healing after an illness or loss of a pet. Chequer’s condition now is stable and even appears to be improving although we worry about the long-term effect of the Prednisone. We give thanks everyday for his time with us and give him much love and comfort each day as if it were his last -because we know it could well be.

REFERENCES:

1. Anderson, M.  Coping with Sorrow on the Loss of Your Pet

2. Guntzelman, J. and Riegger, M. : Supporting Clients Who are Grieving the Death of a Pet. Veterinary Medicine Jan 1993

3. Hetts,S et all: Do Animals Grieve? Loss and the Companion Animal. Perspectives Nov/Dec. 1994

4. Lagoni, L Grieving the death of a pet.
Anthrozoos.  2004. v. 17 (2) p. 182-186

5. Malay, M: Grieving the Loss of Your Beloved Pet . Pamphlet distributed by Community Service Systems, Fairview, Pennsylvania

6. Montgomery, H. and M. Goodbye My Friend: Grieving the Loss of a Pet

BOOKS FOR KIDS:

1. Buscaglia, L. PhD The Fall of Freddie the Leaf

2. Viorst, J. The Tenth Good Thing About Barney

3. Wilhelm, H. I’ll Always Love You

WEB RESOURCES

http://www.deltasociety.org articles, counselors, groups, websites, memorials
http://www.avma.org– Also, search “pet loss” in Search AVMA box                                                                         http://www.aplb.org Association for Pet Loss and Bereavement has a list of pet cemeteries, member/events, list of books, links, counselors, support groups

Rodin's The Thinker

We choose how we think.  How we think about ourselves, our life and our worth.  At first blush, this seems Pollyanna, or just plain wrong.   Our thought patterns, particularly when they relate to how we feel and think about ourselves and our circumstances certainly must be  “automatic”  “natural” and most importantly uncontrollable.  The  idea of choosing to think differently must therefore be contrived, fake and unnatural.

Much of this may well be true. But with critical distinctions.   Over time, we do in fact develop automatic patterns of thought. But, this is only because we have engaged in this pattern of thought consistently and without interruption or challenge.

Practice anything long enough and you will get good at it.  The first time you got on a bike (or if you are a Gen Xer, a skateboard or better yet a Snowboard) it felt insane.  Surely, you would never feel normal on this thing.  Fast forward a year o two and it is hard to make yourself feel anything but comfortable on it.

This is an example of how through practice and a belief that we can in fact have a different experience and mindset, the brain is literally rewired to think and experience differently. We do have choice in which patterns of thought we choose to make automatic.

How can this be?  If you are a person who often feels quite badly, despairing or who often has negative and harshly critical “self talk”,  it is likely that this “habitual thinking pattern” has been established over months or likely years of “practice”.  At a certain point in time, you likely made a decision to listen and trust the voice in you which undermined and attacked your worth as a human being.  (it may not have felt like a conscious decision but the effect is the same)

You will probably notice that unless you are suffering from longer term Major Depression (which can also respond very well to Cognitive Therapy though perhaps in combination with medication) that even though most of the time your thoughts about yourself are negative and your experience of your life generally bad, there are still moments of pleasure, joy and even a sense of well-being.

The problem is, these moments are few and fleeting.  And yet, they do occur.  Why? Why and how can we have these pleasant and healthy thoughts but only rarely.  The answer likely lies in how we choose to think about theses feelings and thoughts of joy at the very moment in which we  have them.

For example, if I am suffering with a negative and habitually self-critical mindset, when I have moments of pleasant, positive thoughts, I likely talk back to them with language like “I’m feeling good now, but this will never last, this isn’t real. “ What I am saying to myself here is “good feelings don’t count”  “Good feelings and thoughts are false, illogical and wrong.”

THESE are the thoughts to push against, to fight, to challenge.

These are the thoughts that are the most illogical.  Why do I say that these thoughts are illogical?  Now we get somewhat into the domain of Philosophy of the Mind, but in short, it is arbitrary to put faith in any one way of thinking. After all, none of us know what is absolutely true in the world.  And there is no objective and absolute fact about our own value and worth. Therefore we must choose how to think of ourselves.  Most of us can look at ourselves and our lives and see ample reasons to love and trust or mistrust and loathe ourselves.

The important distinction is that one way of thinking leads to a dramatically healthier and satisfying way of going through our lives than the other. If two choices are absolutely equal in validity but one feels good and one bad, we must, if we desire a better life, work to choose the positive.

it is far from my intention to say anything like “it’s just that simple” It ain’t simple. Not by a longshot.  Neither is this approach to therapy “purely cognitive” in spite of the name.  Without the development of trust and connection between client and therapist which is rarely a thinking process but rather an emotional and experiential one, can this change begin to take root.

If you are engaging in a goal similar to the one I have described, I salute your courage, and I wish you the very best of luck.  A little luck never hurts either.

Aaron Gilbert, LICSW

The search for the right therapist should not add to your discomfort and frustration.  So how to decide with so many options and different therapeutic techniques?

The good news is that although therapists you may encounter will have a wide range of clinical orientations, levels of education and training,  years of experience  in the field or high praise from other professionals, your interaction with a therapist is foremost a human relationship.  We are innately wired to relate to others and interactions, particularly intense ones which therapy typically engenders result in strong reactions either positive or negative.  A positive rapport usually leads to trust and trust is the key to success in therapy.  So in this difficult choice,  I suggest you take the George W. Bush approach and “trust your gut”.  This works great for interpersonal relationships, for domestic and world policy making…. not so much.

However you make your decision, I salute your courage.  It is difficult and often painful to face life’s problems directly, but the rewards can be great.

Best wishes to all!

Aaron Gilbert, LICSW Boston Evening Therapy Associates

Brookline, MA