Girls are different: Expanding our understanding of Autism.

In the United States, one out of every 54 children, is suspected of being autistic (1). This rate has increased each time that the CDC performs studies to explore the rate. One of the reasons is our increased understanding of autism and how we define autism. Our ability to detect and label early signs of autism is improving and this allows for early intervention strategies to be employed during key developmental growth time-windows.

Rates of autism vary around the world, and this may be a factor of access to resources, parental feelings about diagnostic labels, and growth in the prevalence of autism in general. Males outnumber females at a ratio of 4.5:1. (6)  In the past 10 years there has been a renewed exploration of girls and autism – to see why autism is less prevalence among females. We are discovering that our diagnostic criteria and approach to girls may mean that many girls have been missed. This has significant impact. Girls do not get access to early intervention which would benefit them. Additionally, they may be labelled as having other disorders that are an element of their autistic traits, rather than a diagnosis on their own. (6)  

How is autism in girls missed?

When researchers explore clinicians and school records of autistic girls, it seems that they were missed because they ‘fly under the radar” (8). One reason is that girls need to be bimodal- diagnosed – early and late (9) because of preferential diagnosis towards boys. Practitioners have been using indications of social isolation as a method to identify ASD (Autism Spectrum Disorder) and girls simply do not play alone as much as boys (9).

This inability to see autism, and label it as such, seems to happen at all the stages that typically identify a child as being autistic.  These stages include when a)  their parent thinks something is different and of concern with their own child, b) if teachers or another significant adult in the child’s life has concerns or has suspicions that this child is different from other kids, c) if the family doctor believes that this child’s agrees with the suspicions of those adults, and that then, d) a  psychologist observes and conducts appraisals that might be decisive that this girl child is different from other children and that autism may be the cause of those differences (8) .

In describing how it is that girls look different and get missed (7) , Carpenter and his colleagues write, “Many autistic girls have a desire to fit in with their peers. It appears that, to a greater extent than most autistic boys, many girls use protective and compensatory factors to give the appearance of social conformity and integration with their peer group. They may use observational learning to interpret and imitate facial expressions, create scripts for social interaction and apply rules by rote to social-emotional situations and friendships”. (7)

Girls with autism can use compensatory behaviours such as staying in close proximity to pears, weaving in and out of activities, which appear to mask their social challenges (9). Girls can even learn to “linguistically camouflage” using “Um” and “Uh” appropriately to create pauses in conversations (10). We call these compensatory behaviours camouflaging. It includes the skills of Blending and Masking (11).

It appears that girls are flying under the diagnostic radar in terms of being labelled autistic. It’s important to understand that when autistic girls act in a manner that looks normal, it doesn’t mean that they are typical. It is exhausting to mask. But girls do it because they seem to want friendships (11, 12). And there are consequences to this.

Firstly, girls are being diagnosed in a manner that Professor Francesca Happé , from Kings College in London, describes as diagnostic over-shadowing. In this process by which these girls are brought to the attention of psychologists struggling with other problems, or an educational or mental health nature. Happé comments, “Autistic girls seem more likely to conceal and internalise difficulties. Over time this imposes a detrimental psychological burden, making autistic girls vulnerable to emotional difficulties and mental health disorders such as anxiety, self-harm, depressive, personality and eating diseases. There are a growing indications that autism may be an underlying case of a significant number of undiagnosed girls experiencing those difficulties”(7).

From my personal perspective I meet teen girls that come for help, presenting with learning profiles such as dyspraxia, and anxiety together with communication challenges, or with ADHD, depression and signs of OCD, that are quite possibly autistic. Autism is the core component of their experience and these other challenges, are manifestations of living with autism and masking. Identifying that autism is part of the profile is a mental health, and learning therapy, game-changer.

We need to support autistic girls. Whilst they may look like they can manage friendships, and their cleverness to blend may distract from an autism diagnosis, research indicates that they also have trouble within those friendships. When compared to typical girls, autistic girls encounter more social and communication challenges and can find friendships much more difficult and stressful to manage than their neurotypical peers (12,13).

These problems include troubles with bullying, difficulties with conflict in friendships, understanding flexibility in friendships, understanding who they are versus playing personas, and understanding social rules (12,13). Indeed, it seems that whilst these girls are doing really well, we need to help them do better.

For too long girls’ abilities to fit in may have dismissed their need for support for their autism. Just because you can hide it, doesn’t mean it doesn’t exist. These autistic girls are the potential poster children of accomplishment, and we need to support them as such, not wait until they are overwhelmed and need help because they present to psychologists with another mental problem.

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About the author: Angela Watkins is a counsellor and psychologist working our of the RED DOOR Counselling practice in Hong Kong. In addition to her work with teens dealing with issues such as depression, learning styles, anxiety and perception of self, Angela is SEN educator working with teens with a variety of Special Educational Needs. Angela is the proud mum of Alex – an autistic teen girl.

References and Resources

  1. Australian Bureau of Statistics survey of Disability, Aging and Careers (2015)
  2. US CDC figures
  3. US census data 2019
  4. National Autistic Society UK
  5. Epidemiology and Research Committee, Child Assessment Service, Department of Health, Hong Kong. https://www.dhcas.gov.hk/file/caser/CASER3.pdf
  6. Naguy, A; and Alamiri, B (2018). Girls and Autism – Any sex-based peculiarities? The Journal of Nervous and Mental Disease. Vol 206(7) page 579.
  7. Carpenter, B; Happé, F, and Egerton, J. (2019) Girls and Autism: Educational, Family and Personal Perspectives. Routledge. Quotation from Chapter 1: Where are all the autistic girls?
  8. Happé, F. (2019). What does research tell us about girls on the autism spectrum. Chapter 2 of Carpenter, B; Happé, F, and  Egerton, J. (2019) Girls and Autism: Educational, Family and Personal Perspectives. Routledge.
  9. Dean, M; Harwood, R; and Karsari, C. (2016). The art of camouflage: Gender differences in the social behaviours of girls and boys with autism spectrum disorder. Autism. Vol 21(6), 678-689.
  10. Parish-Morris, J; Liberman, MY; Cieri, C; Herrington, JD; Yerys, BE; Bateman, L; Donaher, J; Ferguson, E; Pandey, J; Schultz, RT. (2017) Linguistic camouflage in girls with autism spectrum disorder. Molecular Autism. Vol 8(48).
  11. Ryan, C; Coughlan, M; Maher, J; Vicario, P; and Garvey (2020). Perceptions of friendships among girls with autism spectrum disorders. The European Journal of Special Needs Education. April.
  12. Cook, A; Ogden, J; and Winstone, N. (2018). Friendship motivations, challenges and the role of masking for girls with autism in contrasting school settings. European Journal of Special Needs Education. Volume 33(3), page 302-315.
  13. Sedgewick, F; Hill, V; and Pellicano, E (2018). It’s different for girls: Gender differences in the friendships and conflicts of autistic and neurotypical adolescents. Autism. Vol 23(5).

We need to talk about Mental Health

We need to destigmatize talking and being ashamed about mental health. Especially in times of heightened anxiety such as the global pandemic is creating.

September 10th is observed as the day to raise awareness of Suicide and Suicide Prevention around the world. Whilst people attempt suicide for a variety of reasons including loneliness, depression, physical illness, loss of self-worth, shame, bullying, and hopelessness, compromised mental health is a common factor. In Hong Kong we lose 800-1000 persons a year from suicide. Suicide is preventable death.

We need to help ourselves, our families and our friends better cope in moments of compromised mental health.

In order to help ourselves and others de stigmatize mental health we need to (1) evolve our understanding of mental health and (2) learn to talk to others about their mental health in a helpful, rather than unhelpful, way.

Understanding mental health.

A helpful way to understand mental health is to consider it, as you would physical health, as a continuum.

On one end of the continuum is good mental health and at the other end, very poor mental health. On any given day we may find ourselves moving along this continuum, just as our physical health is sometimes better, and sometimes worse on any given day.

Sometimes we have a chronic illness which lasts weeks, months, years such as a bad flu, diabetes, asthma, and this can make it harder for us to experience good health. We may need medications, undertake a change in lifestyle and seek out expert help to assist movement along the continuum towards better health. At no time do we expect that we will be completely recovered the next day, or do we expect this of others.

Similarly, mental health conditions can affect us for a day, a week, or for chronically long periods. Again, we may require additional help, medications, and a change in lifestyle to move towards the healthier end of the spectrum. Unlike physical health, people sometimes misunderstand that recovery takes time, and is certainly not just a matter of “getting over it”.

Mental health is a continuum.

Talking to someone about their mental health.

So how can we talk to people who might be experiencing mental health issues, or an episode of poor mental health?

Remember you are dealing with a GLACIER of an issue. What you see is not all of the issue. You are just seeing the part of an issue that is above the water. In order to reinforce this message, I have highlighted my “thoughts to remember when you talk to someone about their mental health” within the framework of the word Glacier.

Thoughts to remember.

G – Do no grandstand. Whilst everyone experiences anxiety and depression, we need to avoid depleting someone’s experience by comparing it our own challenges. It is sometimes enticing to share your experience, especially if you think you feel worse than they do. For example, teens often compare each other’s experience of anxiety, each teen detailing, in turn, how their experience of anxiety was worse than the person who spoke before them. This grandstanding is unhelpful for two reasons. Firstly, rather than helping to connect with your friend, you may be dismissing their experience as inconsequential. Secondly, it isn’t a competition where only the person who has the worst experience is entitled to have their feelings acknowledged or be deemed worthy access to help. We all need help and to be heard.

L – Listen. Real listening is an important skill to learn. When we listen properly, rather than focusing on continuing a dialogue we need to take the time to demonstrate that what has been said, has been heard. Reflecting back to the person some of the words that they said, or a summary of it, and asking for clarification, is helpful.  For example, what follows is a conversation between Laura and Sam. Sam is demonstrating reflective listening skills.

Laura: I have been feeling really anxious about the pandemic

Sam: so you feel anxious?

Laura: Yeah, the numbers keep going up, I’m worried if we should be in the office

Sam: So you feel anxious about keeping safe from the virus?

Laura: Yes, every day my stomach is a bundle of knots

Sam: Sounds like you feel pretty worried.

Try listening like this instead of jumping in with our opinion or even a solution. See how it changes your conversations and connections with people.

A – within the listening skill set is the simple act of ACKNOWLEDGEMENT. Help normalize people’s feelings but at least accepting that they are occurring, and that they are valid. In the example above Sam doesn’t give his opinion of Laura’s feelings. He simply allows them to exist and be acknowledged. The process of acknowledgement can be challenging if we believe that our college shouldn’t feel the way that they do. If you feel like this, I would ask you to consider if you can allow your colleague the respect and space to have their experience, even if you disagree with it. It may be more important for them to be heard, rather than “corrected”.

C- use the word CONSIDER rather than give advice. When we see people in distress we can rush to “solve” the issue, including providing solutions to the problem. Its is a real skill to sit with someone in their anguish and just simply experience their condition, rather than move to fix it. This is true empathy. Once you have listened and sat with someone, acknowledged their feelings, if you want to give advice you might like to frame it as a consideration rather than a recommendation. Rather than, “You really should give up drinking”, or “You really need to go to a counsellor”, or “You need to get medicated”, suggest it as something to consider. “Do you think you could consider changing your relationship to alcohol? Do you think you might consider counselling? Do you think you could consider if medication might help you”? Think of any advice as sowing seeds of trees that might start to grown on another day, not necessarily today.

I – Don’t IGNORE. Denial or ignoring a problem will NOT make it go away. Telling someone they “shouldn’t” feel the way that they do, is not a form of treatment. Telling them how you would like them to see the issue, also not helpful. Let people have their experience. Respect their experience of the world, and encourage change rather than deny or demand it.

E- ENCOURAGE people to seek help. As you would if you saw if a friend or colleague had a physical injury, ask them to consider if change could be possible and they could find a resource to help them feel better. Even top performers encourage coaches and counsellors to move from good to great.

R- REFER them to experts. There are people who are great with people in a crisis. Natural talent is not the same as training. Mental health issues are best addressed by mental health experts. These experts are trained in listening, testing, helping to build allegiance, methods of behavioural change, and usually have a network of other experts that they access when required. Like any expert a personal recommendation from another user is always helpful. In the days of Facebook, a recommendation is only one post away.

I hope this helps you to help yourself and others. If you have any questions about your own mental health, or the mental health of a friend, feel free to contact the RED DOOR team at our email. Let’s talk about mental health – our own and that of others. reception@reddoor.hk

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Angela Watkins is a qualified counsellor and psychologist working with teens and adults within the RED DOOR Counseling practice in Hong Kong.

Talk to your Anxiety

You may feel that you are powerless over your anxiety. Using the following anxiety dialogue exercise may well help you learn to manage your anxiety during this time and in the future.

Talk back to your anxiety, as if it is a small child that lives inside you. Help this young child understand the risks that exist, in a realistic rather than catastrophic manner. Hold their hand whilst you explain the actions that you are going to undertake to help mitigate the risks ahead. Don’t tell dismiss their worries, by saying that worry is silly. Do not try to simply silence your anxiety. Rather, listen, and talk back. Acknowledge the fear, but explain that you do not need to let worries disable you. Reassure your internal anxious child that you will take care. Thank your anxiety for reminding you that there are threats in the world, and that there is danger, but that you have the resources and strength to face challenges.

Dialogues with your anxiety may run as waves lapping at the shore of a beach. Let the anxiety roll in and regress, as if your anxious child, and your adult self, are engaged in a dance – make it a waltz.

The Essential skills of Executive Functioning

executivefuntioning

Executive functioning skills include planning, organizing, prioritizing, self-checking, shifting are critical to children’s school performance.

The era of online learning or a mix of online and offline learning requires a student to know how they learn, and what their strengths and weaknesses are. There are critical skills that fit under the umbrella of “executive functioning” skills.

Executive functioning broadly refers to the skills which help you learn. To have strong executive functioning means that you can better learn to learn new information – you can organize your materials, your time, you use strategies to help you remember content and help you focus when you need to.

Children with executive functioning weaknesses are inefficient in their work, have difficulty showing what they can do, perform less well than expected in exams, forget key equipment at school, and/or have difficulty remembering key vs. erroneous information. Their problems tend to get worse as children progress beyond primary school, into middle and high school. Without remedial support, their issues can continue into adulthood. In fact, all teens can benefit from executive functioning assessment and training.

We can train children, especially they are entering adolescence, how to enhance their executive functioning skills. In fact almost all teens, and many adults, would benefit from learning about, and training in, executive functioning skills.

It pays to, firstly, access individuals executive functioning skills. Usually, a Likert scale or simple yes/no questions can help assess which areas are most in need of advice or improvement. I usually recommend that children under 12 complete the assessment in collaboration with their parents as one of their key areas of difficult is really understanding their strengths and weaknesses. Teens are usually mature and more self-aware so may be able to complete the assessment on their own. At RED DOOR, we use a special Likert type scale to assess executive functioning skills. Improving these skills should help our students become better learners.

Skill areas included in the area of Executive Functioning.

Understanding yourself. Some individuals overrate their ability to perform certain tasks, and do not see themselves in the same way that others see them. For example, they may overrate their ability to cooperate or listen. If you ask their parents about their performance of such skills, they may have very different views. It is important that we know what our strengths and weaknesses are, and that we maintain hopeful and realistic approaches to dealing with the challenges that we may have. You may not be good at something yet, but if you avoid the remedial education offered in order to overcome your challenges, your weaknesses will not fade away on their own. Sometimes kids define themselves only by their weaknesses and we need to defeat that kind of thinking as well. Understanding yourself also means being aware of the level of effort you put into projects – do you want to do your best, or just get by? It is important that we are aware of these decisions, strengths and challenges. Perhaps you can’t tell them for yourself. Normally we will help teens or children start to ask for objective and constructive feedback in order to help them understand themselves better.

Organisational skills. This is partly about having a place for everything, and putting everything in its place, but also having a system of some sort that helps your teen or child stay on top of the things that they need to have with them on a daily basis, or for specific classes. Sometimes kids have too many things with them, and need to learn to cull these items so that they ensure that they carry only what they need. Does your child turn up at class regularly with the wrong equipment – then they may need support to improve their organisational skills. We often help them develop customised checklists and planning schedules to help them know what to do, as well as train them to look at the schedule and edit their schoolbags accordingly.

Flexibility. This is an essential skill during both the COVID pandemic and the teen years. Changes happen to schedules, task parameters, and even your ability to go to school or participate in after school activities. Suddenly those subjects where you could easily achieve a top grade, or a pass, no longer is so easy. I find some neurodiverse children can read easily as young children because they have extensive memory skills. Suddenly at 8 or 9 years of age we realise that they can’t read, and have to go back to reading phonetic readers again. This is short lived, but can frustrate individuals who were use to finding reading easy, then suddenly don’t because the material is much more complicated. Learning to cope with your shortcomings or mistakes you make is even challenging for adults.

Emotional regulation. Being able to understand your emotions is an important skill for children and teens. These skills need to be learnt by all kids over time.  Sometimes children have difficulty dealing with anxiety, frustration, boredom or anger and these overwhelming feelings can derail their academic performance. We notice this, in particular, with children who’s anxiety effects their performances on tests. Sometimes we can construct accommodations for this in the school setting, but over the long term, we need to enable our children to better cope.

Behaviour management. Learning to behave in a constructive manner in a particular situation is a requirement of successful study, school attendance, and future work success. Knowing how to behave in an expected fashion helps kids understand that they may have some. Behaviour management is aligned to emotional regulation. Kids can get angry, but if they start hitting or destroying property as a result of their anger issues, we need to find a way to help.

Proactive initiative. The ability to start a project without prompting is an important skill to achieving academic success. This is aligned to remembering that one has a project to start as well as looking at the big picture and breaking it down into its smaller steps. Some kids find starting a project, or figuring out how to start a project overwhelming. Therefore, they procrastinate and, seemingly, avoid the activity. We try to help kids overcome fears, thoughts and avoidance tactics that stop them starting.

Sustained focus. Having a sustained focus is important across a task. Some kids are great at starting a project but their efforts trail off as they get into the thick of the work. Maintaining focus and effort when tasks become lengthy or not interesting is challenging. For some children, with attention problems, the middle of a project may require extra support to keep them going.

Persistence. This is an attitude towards “sticking at something” without losing motivation, becoming overwhelmed, or quitting when you find it hard. Children and teens can give up a bit easily so we work with them on strategies to help them keep going when the going gets tough.

Memory skills. Working memory in particular helps children achieve well as school. Working memory is the interactive system between understanding the needs of a task being presented, and the pertinent information stored in long term memory that would help you solve that task. You may not remember facts, processes, formulas, and may need training to help you better retrieve information. Sometimes more complicated memory issues exist that create filing errors when we are trying to build ways to store information. Many memory problems can be overcome with training.

Goal setting. Understanding the goal of a task, and your goals at school and in life help students focus their attention to those tasks that will be of most benefit to them. Learning isn’t just about normalising, and bringing everyone up to the pass bar. Sometimes its about understanding those areas in which you excel and how those strengths need to be stretched beyond imagination. Goal setting helps teens in particular to review their work, audit their time, select appropriate mentors, and learn about what their lives could be like. These need to be set around the strengths and interests of the teen, not their parents, not their friends. You may even like to consider your own personal board of directors to help you start to achieve your dreams.

How would you rate your executive functioning skills? What areas could you improve in? If you have any questions, or would like an assessment or discussion of your skills please email us at RED DOOR. AngelaW@reddoor.hk

Intervention 101 – knowing who will be a good fit as an intervention partner.

intervention areasWhen you are deciding on how to approach early, or continuing, intervention strategies to help your child with special educational needs, it maybe overwhelming.

Here are some thoughts that might help parents views the situation in a systematic and manageable way. I am writing this not only from the perspective of a psychologist who leads a team of intervention focused practitioners, but also as the parent of a child with autism. Even as a psychologist I found navigating this territory difficult, understanding who really could help and was intentioned appropriately.

Intervention provides might include speech language therapy, occupational therapy, and behavioural skill therapy.

Finding a good partner to help you with intervention practices.

The right kind of partner. It is important to work with key providers who really HELP.

They should have a (H) helpful and holistic perspective of your child. Being the parent of a child who required special educational adjustments is worrying. Your provider can help you see the strengths is your child as well as their challenges. They need to look at the activities needed today and in the future.

They should have a clear (E) evaluation roadmap for your child. They should able to tell you what key skills need to be developed, and why, show you a roadmap and help update you where your child is in their development. Your intervention provider should contribute to, even lead the IEP (Individual Education Plan) or IDP (Individual Development Plan). That whole plan should be updated 3-4 times a year, if your chid is under 8. For children 9-12 year old, the plans should be updated 2-3 times a year. From the age of 12, their plans need to be completely reworked in line with the second wave of development. See this article for more information https://reddoor.hk/2020/01/08/activating-the-second-wave-intervention-for-teens-with-sen/)

Listening (L) and cooperating with you is really important. You are the current expert on your child and your team should feel like real team members with a shared goal. It’s important that your fears, your worries, aspirations are heard.

Planning (P) is also important. Any intervention strategy should be clear to you and you should be able to turn up, or down,  the volume as needed. You should be able to place scenario within an overall agenda.

Respectful. You may have heard that there is a lot of negative feedback from neurodiverse adults who were subjected to ABA therapy. Their main complaint is that the actions that they use to regulate their emotions, often seen as “stimming”, has been treated in a negative way. Our knowledge of “how to best help” kids who have delays expand with information every year. We now understand that making kids “look normal” shouldn’t take precedence over their need to feel reassured and safe. Ask your provider how they approach and treat “stimming” behaviours such as hand flapping, jumping, hair twisting. It is important that you are truly comfortable with their approach and that their approach is respectful to the needs of your child.

Goal-oriented. The purpose of an overall plan, and each element and activity within the plan should be completely clear to you. When kids are under the age of ten, our intervention efforts are often focused in a more concentrated manner towards helping the child start to achieve age expected behavioural, academic or communicative goals. This model is often referred to as a deficit model. I prefer to think of it of these behaviours as creating equalizing opportunities for these children. As your child becomes older, you will want the focus to alter – so that expansion of their key skills becomes a greater focus. This strengths focus helps prepare your child for potential vocation opportunities.

Fair -It is important that you believe that intervention therapies are fairly priced. It takes a lot of energy and education to provide appropriate intervention strategies and activities. As a provider I can tell you that it isn’t cheap to provide these services well. However, as a parent I have seen many programmes that are ‘eye=-wateringly” expensive. I encourage you to select a partner where you feel that you are getting a fair service for a fair price.

Lastly, please watch if your caregivers and intervention providers really care about the kids that they are helping. Warm relationships work wonders. Be sure that your child is being stretched by a person who really cares about them, and is interested in their development.

 

These are both my personal and professional opinions. When you start this journey, it is hard to know those who really care from those who are trying to just go through the motions, or overcharge and under deliver. Life is hard enough. Use the above guidelines and I hope you, and your child, can get the support you definitely deserve.

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If you would like to know more about the UPSTART set of interventions provided by RED DOOR in Hong Kong please send a message, telling me about your child, to angelaw@reddoor.hk

Be the best parent you can be after divorce

collaboriave coparenting image...The question is never if divorce will have an impact on your children, but rather if this impact will be minimal or significant Children can adjust to divorce with help.  An important element that determines if there will be long term negative consequences on your child will be your ability to collaboratively co-parent with your ex-partner.

Collaborative co-parenting is a practice where parents agree to parent in a discussed, organised and agreed manner, even if they have to parent differing views on how to raise a child. For families of divorce, children often become innocent victims of the tension and resentment between the parents. Collaborative co-parenting can change that situation by providing parents with constructive tools to use in building positive child custody and visitation plans.

The collaborative co-parenting approach means finding a way to work with your co-parent with dignity and respect. What was once a personal relationship changes and becomes more like a business relationship wherein both parties set aside personal feelings for the benefit of the children. Collaborative co-parents learn to develop strategies for conflict management and to establish a stable routine for the children via a collaborative child custody and visitation parenting plan.

The backbone of collaborative co-parenting arrangements can be discussed with specialist counsellor and divorce mediators. When I work with divorced couples, I remind them that the Collaborative Co-parenting process focuses and assesses each parent around the best parent that they can be, rather than on hurting or scoring points against your ex-partner.

A collaborative co-parenting agreement is not legally enforceable it should be signed with honest intent. Copies of the agreement can be held by each parent, and shared with relevant family members, including older children if this is done in a supportive manner.

collaborative coparenting agreeentA Collaborative Co-parenting process has three areas of discussion. The first, and most importantly, is to agree on certain principles that parents are willing to adhere to. These principles provide a framework of you promising to be the parent your child needs you to be. The second discussion is logistics – such as how living arrangements are split, holidays agreed, ECAs discussed and decided. The third section is often the most contentious, is about how finances will be allocated in order to support the child. The arrangements are summarised into a collaborative co-parenting agreement to be signed by both parents.

The logistics and the finances need to be discussed within a framework that protects each parents, whilst stretching them to turn up as the best parents they can be. If you are struggling getting to an agreement, get help.

What I can easily share are some of the principles that I ask parents to consider when setting the framework of decisions. Ask yourself where you stand on the following topics – would you agree? If not, why not?

I agree to:

  • Hold my children’s needs above my own territorial needs or desire for independence.
  • I will take the adjustment required by divorce to rise to the occasion and be the best parent I can be to my children.
  • My child’s emotional well-being and self-esteem are paramount and I will act in a manner that best supports my children.
  • I will not over promise support to my child, and under deliver
  • I will not use my child as confident, messenger, bill collector or a spy with my co-parent
  • I will abide by the rules of fair and practical time sharing and will make a serious effort to honour this agreement.
  • I will communicate necessary changes in the schedule of child care with my co parent in advance. Any changes in the schedule will always be discussed with the other parent prior to informing the children
  • We agree to respect the other’s parenting style and discuss any concerns at agreed upon communication meetings
  • I promise not to only do fun things with our child, leaving hygiene, homework and day to day care explicitly to the other parent
  • We agree to make arrangements which can be understood by our child and are sustainable.
  • We agree to clearly communicate to our children our respect for their other parent
  • We will keep our child safe
  • We agree to reinforce to our children that time with their other parent is important
  • I will be mindful of my child’s need for a stable diet and sleep and not return them to their other parent over tired and poorly nourished
  • We agree to work on our problems as individuals privately and not in front of the children. We agree to allocate an agreed designated communication time
  • We will agree to communicate to our children that no new romantic partners will be introduced to them in meetings that have not been agreed by the other co parent
  • We agree to speak or write derogatory remarks about the other parent to the child
  • When we are with our child, we will be focused on spending quality time with that child, and not primarily engaged in another activity (drinking with friends, attending meetings) as agreed
  • We agree that the child can display photos of both parents in their bedroom.
  • We agree to collaboratively set behavioural guidelines of expectations of our children in front of step parents, relatives, etc.
  • We agree that we will not consume alcohol at all/ become intoxicated in front of the children. Drug consumption at any time, prior to or during child care time is not tolerated within this agreement.
  • We agree to only leave our children with agreed third party caregivers and with the other parent’s agreement
  • We agree to both collaborate in school meetings
  • I agree to honour our arrangements about financial support of children and will not withhold this support from the co-parent

These principles are designed around best parenting practices. Are you ready to be the best parent you can be, as you divorce?

 

#parenting

#divorceandparenting

#collaborativecoparenting

#childrenanddivorce

 

I’ll never fall in love again….

never fall in love again

 

..or will you?

Can you fall in love again after the pain of divorce? If your partner left you, you may be currently focused if the ache of being discarded will ever go away. A new romance is the not the cure to that ache, but it can make for a useful distraction. Even deciding to date again can be a challenge.

 

Could you start dating again?

When: There is a time that you might contemplate dating again. I divide the stages of divorce into phases, and certainly the earlier phases are not the time to start dating.

Contemplating: this is when you are wondering about your relationship, if you should split, if you should stay. This phase can last several years. It is not easy to decide if you should end your marriage. The attached article might help. https://reddoor.hk/2019/10/28/considering-divorce-key-prep/

The next phase – Declared involves the early stages of your divorce process. You might have verbalised the desire to divorce but have not actioned the divorce paperwork yet. In this stage you might even resolve your relationship issues, potentially with counselling. Dating during this stage might actually end your marriage, so perhaps wait until you have started the next step.

divorce stages

Filed. This means that you have started the divorce process and your partner has been formally informed. You may find dating at this time makes the process rather muddy, but at least you have said that, for you, the marriage is going to be over.

Who: Do yourself one favour whilst you are divorcing and conduct a self-audit on your strengths and weaknesses before you jump into dating? Know yourself as well as you can. If you have explored what role you played in the ending of your marriage. This is not about accepting or attributing blame for the end of the marriage, this is a mature reflection on your role in the end of this marriage. If you accepted too much criticism, if you gave and gave of yourself – only to be unappreciated, take a cold hard look in the self-accountability mirror. Have you started to change those elements in yourself that will prevent you falling into the same trap for a second time?  Can you honestly say that you love yourself yet? If not perhaps explore self-love first. https://reddoor.hk/2020/02/14/self-love-first

It is natural to look to date someone very different from your previous partner, it’s a natural response. Just take your time to explore if that is a good fit for you.

How: There are a number of apps on offer to meet up. If you use apps, remember to take to the process with an open mind, and a sense of humour. Rather than looking for love specifically explore if a person might be a potential friend or contact. It doesn’t hurt you to meet a bunch of new people. Meet for coffee rather than a drink or dinner. Coffee can be a short introduction and can lead to a potential second meeting.  If your meet up is painful, you can orchestrate an urgent text from the office so has to escape easily and leave. From the women in our divorce groups, they commit to meeting many new people, and sometimes romance blossoms. Many times, they, at least, make great new friends.

Woops: There are some woops behaviours you might like to pay attention to.

  • If you see warning signs – listen to your antennae. Step back, take a breath.
  • Do not introduce the person you are dating to your kids, until you have been dating for a few months at the very least.

 

If you feel tempted to dive back into the pool of possibility, go ahead. Remain open minded, have a sense of humour, and just have fun.

 

 

 

Minimizing the impact of Divorce on your Children

DIVORCE PIX

Every year there are a significant number of divorces between couples. For example, there are over 20,000 petitions for divorce a year in Hong Kong, over 90,000 in the UK, and over 780,000 in the USA. For those cases involving children produced within the marriage, parents are usually concerned about the impact a divorce may have on their child. As a counsellor helping individuals responding to divorce, I would like to highlight the following guidelines regarding how to best inform children and how to minimize the impact of your divorce on the mental wellbeing of your child.

How to tell your children about your decision to divorce.

  • Tell the child together as a couple rather than separately, if possible. Children often fear that divorce may mean that they will lose a parent. Telling the child together reinforces your intention that both parents remain dedicated to the child.
  • Consider telling your child at home rather than outside of the home. Inside their own home children can respond in an authentic and real manner.
  • If possible, tell the child in a neutral area of your home such as the lounge or kitchen. Do not tell the child in their bedroom. That room needs to remain an impartial safe zone where they are entitled to retreat.
  • Tell your child at a time when the household is quite calm, not just before bed, or after a long day out or when they must yet complete their homework.
  • Try to be as calm as you can – explain that the marriage is over, but the family is not. You both remain parents to your child.
  • Remind you child that you love them.
  • Make sure you reinforce that the divorce is not their fault. Do not assume they will know this automatically.
  • Children will undoubtedly have many questions. Answer these as fully as you can. It may be better for you and your partner to discuss, and agree, interim living arrangements, before telling your children.
  • If you cannot answer every question when it is asked, communicate that you will intend to answer that question a s soon as you can. Some ambiguity is to be expected. At the time that you are informing children of a potential split, your obligation is to help them see that the future will still be positive.
  • Do not allow emotionally hurtful descriptions to be presented by one partner. For example “Daddy is leaving us”, can heighten the pain of abandonment. If your partner paints the scenario in this way, simply correct without judgement. For example, “Mummy is a bit confused. We are splitting up and I am going to live somewhere else, but I’m still your Dad and I am not leaving you”
  • Offer access to counsellors or support networks to allow your child to express their feelings to other people. Whilst they may have many questions for you, they may not initially feel comfortable asking YOU those questions at the beginning.

 

Building positive practices whilst the divorce is in progress.

It is not a matter of if your divorce will impact your child, the question is how much it will impact your child. Here are my recommendations as to what you can DO, and DO NOT DO, to best support your child.

  • Do understand divorce from the perspective of your child. From their perspective this is a big change so that there may be feelings of grief and fear, and anger, involved. These feelings come in waves rather than all at once. You may have offered counselling at the time when you announced a split. Offer counselling or support options repeatedly over the next year or two.
  • Don’t fight in front of your kids. The divorce should be the END of their experience of parents fighting in front of them.
  • Collaboratively co-parent – working and agreeing together how to respect, negotiate, organise and stay well boundaried when you split, it a superior model of parenting during a divorce. You may need to utilise a mediator or counsellor to help exercise your arrangements.
  • ow to build an honesty-based, collaborative relationship that resolves conflict, including managing emotions, showing mutual respect, and entering healthy negotiations
  • Be the best version of a parent that you can be for your child. Your divorce need to both rise to meet the needs of your child. You might consider reading a few books about parenting during divorce or attend a parenting effectiveness course.
  • Remember that a clear structure is important to children. They need to know when they are going to see each parent, and what their weekly schedule might look like. If one of the parents refuses to be transparent about the time that they will turn up for your child, allocate them sometimes and move on. Tell the child of the times that have been offered. If one parent does not turn up, it will hurt. Be mindful of this.
  • Believe in your child. You may fear losing your child’s love. Perhaps your ex-spouse has gone into “super-parenting” practice. You kids might love this. After all who wouldn’t? Let them get all the love they can get. Kids know who looks after them in a crisis.
  • If one parent wants to play Santa-Dad or Santa-Mum let it happen. Most of this behaviour can not be sustained so utilise these moments. If one parent is being very generous, remind your child to ask for that new computer for school, or to ask them to volunteer to run the school bake stall this year. It will not last, so enjoy it.
  • Hold the line on positive healthy practices when the child is with you. Agree on a limit for the ipad, bedtime, and guidelines around junk food. That said,
  • Don’t sweat the small stuff. The occasional muffin is not going to kill the child. Have some perspective on when rules could be bent. If rules become habitually bent, then they are no longer rules.
  • Keep your ex in check. If your child is constantly late picking up or returning the child keep a record and take this up with them, either one to one, or with a mediator. This data may help you negotiate subsequent childcare arrangements.
  • Don’t be fooled by labels. Too many times I have encountered parents who are labelled ‘bad parents’ by their ex, when they are clearly not bad parents. Remember judges have seen these cases countless times, they will ask for proof. Your ex’s opinion of you as a parent is not a fact, or proof. Additionally if your ex tells you that experts say “x,y,z” look this up. I have read some painfully misinformed claims – often cited to frighten, or even bully one partner, Get the facts.
  • Do not use your child as a messenger between yourself and your ex. They are not part of your interpersonal conflicts.
  • Do not ask your child to spy on their parent for you. This is extremely destructive.
  • Avoid badmouthing the other parent to your child. Do now harm your child by trying to paint your hurt image of your spouse over their image of their parent. Children often feel that they have to choose sides. Do not encourage this. Over time, applying this pressure, often backfires on the person trying to force the child to choose. .
  • Do not guilt or blame your child for the divorce as a means to manage their behavior. If you could have just gone to bed on time, I would have bene less stressed and Dad probably wouldn’t have left us.”

Remember, be kind to yourself, and your kids when you are going through divorce. The process of divorce will undoubtedly reshape you, so make this as positive as posisble.

#divorce

#divorceandchildren

#collaborativecoparenting

#reddoor

 

A guide to the emotional journey of REDUNDANCY

redunancy_overallBeing made redundant is one of the most stressful events you can experience in your career. Many of us count on our professional image not only for financial security, but as a source of identity. When you loose a job, you loose so much more than the salary that went with that post.

It is an emotional journey. As counsellors, we help professionals navigate the journey, helping them adjust and, eventually, re imagine their futures. Here are some outtakes from what we have learnt helping individuals through this process.

redundancy_notadirtywordRedundancy is not a dirty word

There has been a shroud of shame associated with the word redundancy. You may be feeling embarrassed, as if you are not good enough, or that you are not needed. That feeling is not necessary. Most recruiters are familiar with the concept and wide use of redundancy as a common HR  tool during hard times. Redundancy decisions are often financial rather than personal. Being embarrassed or shameful, might prevent you from seeking legal advice when it might be of benefit to you. It is your right to fight for the best exit deal you can get. You may feel shame, but don’t let that let you  stop negotiating the best deal you can

 

redundancy_understandemotionsAcknowledge what you are feeling

Aligned to the experience of shame are many other feelings associated with job loss including shock, grief, depression, fear,  and even anger.  It is healthy to accept those feelings rather than reject them as they are experienced. It is a natural cycle of adjustment to move through these feelings. You might consider writing a journal to work your way through these emotions. This will help you capture if you get particularly stuck feeling a particular way.

 

redundancy_familyprotection

Family focus

Redundancy can put your personal relationships under pressure. If you are the major breadwinner, you may find that your partner becomes fearful about the future and money. Children, as well, may not understand.

Embrace this situation as an opportunity for your partnership and family to learn to confront a problem together. This stress will pass, but in the meantime you may need to tighten your belt, suspend spending on luxury items. Everyone can help, rather than wait. By modelling partnership and leadership within your family during times facing redundancy, you are modeling how your children see the world of work, and learn about emotional resilience through observation.

 

redundancy_rememberTwo important things to remember

Firstly, try to remember that this is a temporary situation. As long as you continue to move forward, any event, including being made redundant, will become simply a page in a chapter of a book.

Secondly, remember that there are two key stages in the progression through redundancy – the first stage is the initial reactive stage. This stage ends when you are able to start accepting what has happened. The second stage is the resolution stage – this is finding a solution to the issue of joblessness and how you are going to approach ending that condition, and when. You don’t have to go backwards, and do the same as you have done before. The future stretches out before you filled with possibility.

 

redundancy_ExploreresponsibilityExplore responsibility

Whilst it is not constructive to blame yourself for what has happened if you have been made redundant, it will benefit you to explore what you are responsible for, and what you are NOT responsible for.

For example could you have done more to make yourself essential to an organisation? Would you have been willing to do that in order to keep your job? Did you make enemies that could maneuver against you during downsizing? Could that be avoided in the future? Can you learn from this experience? Now you have done that, consider the role of your previous organisation in your departure.

How much of the responsibility for your redundancy sits with your (previous) employer? Had they ignored the need to find efficiencies in the past? Did they not believe your function was business essential? What could be learnt from this experience?

 

redundancy_opportunitytoexploreYou can use this opportunity to re-imagine your future

Given the length of your life span, you might consider changing career completely. It would make sense that you have two to three careers over a 50 year work span.

Maybe consider a complete change of career? If not you can use some pen and paper tools to help brainstorm potential futures for you to consider. In coaching sessions we use eight pronged spider diagrams to discuss at least 8 career change options with clients. We use a large number to help people break out of the restrictions they may have put on themselves. For one of the positions I usually ask the client, “What would you do for nothing?” Once the 8 slots are filled we start further information on what clients would like about each of the opportunities, and how they could make money from those activities. Usually two to three of the options start to look more probable or attractive, or something new can be created from combining 2-3 of the items.

Many of the skills you have already are transferable to another industry. Creativity, ability to write, budgeting skills, and project management skills, can be helpful in a number of different careers. Working with a counsellor or a coach will be extremely helpful with these brainstorming activities.

 

redundancy_looatthefutureConsider the future of work

It may have been a few years since you have had to apply for a job. The shape of the world of work is changing, because of mobility, illness and global interactions. You may need to upgrade your tech skills and your attitude towards the physical workplace. Update your view of your occupation so that you are ready for the future of your job.  You might find this blog helpful. https://reddoor.hk/2017/08/09/defeating-fo-fow/

Additionally the job search mechanism has changed. You will be encouraged to network so that your world of contacts becomes bigger. For middle and senior executives I want you to consider your view on recruitment experts – headhunters. There was a time professionals waited to see what jobs headhunters could put in front of them. This model of job search is not the only way. Pitching yourself to an organisation can be framed under the umbrella of ‘market research’. Rather than selecting from offers that a recruiter can, or cannot, put in front of you, make the future happen for you. Employers generally respond to evidence of  responsibility and pro activity in a positive manner.

 

redundancy_networkNetwork

Many people find their next job through their network rather than in response to a job advertisement. Utilizing your network is the way to find the jobs that nobody knows about. If you can apply for the job before it becomes available you have a special advantage. Any meeting of new people may be treated as the first stage of a job interview, so have your ‘elevator pitch’, that is your 2-3 sentence summary of who you are and your differentiation, well practiced. It can be difficult to be positive if your ego has been hurt by your current job frustrations or job loss. It can be tough to be positive. However remember job stress and job loss are not rare or exceptional, just state the facts in a non-emotive manner. You have nothing to be ashamed of – just focus on the positive rather than list your litany of complaints about your previous job.

 

redundancy_AngerWork your way through your anger

It is very common to be resentful and angry if you have been moved out of an organisation. It is really quite possible that you were not treated with respect, or given  a chance. It is not fair. That may keep you angry for a while. I get it. I’ve been there. It is in your long term interest to work your way through your anger. The only person it hurts is you.

It is challenging to have been overlooked, or moved against. write your way through these feelings. At some point in time, you will start to feel, “I’m done”.

 

Seek Helpredundancy_seekadvice

You do not need to work through the journey of redundancy on your own. Sometimes organisations offer counselling as part of their downsizing plans. If offered, consider it. Talking about your feelings and fears will be extremely helpful. Especially if you feel stuck in anger, or fear seek professional advice how to move forward.You may prefer to do this with an independent expert, not attached to your organisation.   A counsellor can help you explore patterns in your past that may have you stuck in your present, and help you move on.

If you want to re imagine your future work with a counsellor or coach who specialises in strategies to expand your career plans. That person needs to understand you, your values and emotional state, your goals and needs, as well as how your strengths can be channeled into new endeavors.

 

Redundancy is unpleasant to be sure. Whilst it is definitely a PAUSE, remember it is not the END.

————

#careerchange #resiliency  #futureofwork #stress #redundancy

 

About the author: Angela Watkins. Having worked in corporate life for 20+ Angela is familiar with the stresses and strains of work and family life in Hong Kong. Angela started her career as a psychologist and educator. She was attracted into work for corporates for many years, before return to her psychologist roots, and opening RED DOOR in Hong Kong. RED DOOR is a psychology counselling practice operating in Hong Kong.

 

Life, Interrupted

life interupted

Episode one.

Live under the pandemic of COVID19 is manageable in 2-week chunks. But, the reality may be much longer than a series of 2-week chunks, with an eventual return to normal. Things may be challenging for quite a while.

Breathe before reading this paragraph. …

What is probably going to be the case? According to Dr Marc Lipsitch (1), epidemiologist and leading commentator from the school of Public Health at Harvard University. We are just at the beginning of learning to live with COVID-19. The nature of infectious diseases is to replicate and spread as much as possible. The interim strategy of social distancing has been effective to slow down transmission, but does not work permanently. What we need is the security provided by a immunization, proven treatment regimes and a dearth of recovered cases. We will be living with COVID19 until there is a vaccine -one that is available to everyone. Estimates for a vaccine range from 1 year to 18 months away. In the meantime, we will manage with the range of public health activities that we have been using thus far (hand washing, social distancing, mouth covering) Things are not going ‘back to normal’ for a while (1,2.3)

 

The new ‘normal’.

Over the next year to eighteen months will possibly feature repeated periods of work-from-home scenarios, new models of education, suspension of gathering of large groups, and interruptions in activities – a new normal.

This interrupted life is unsettling. It is created by the progression and regression of a pandemic, that despite our best unattempts, is not completely predictable. Anxiety is a natural reaction to this uncertainty.

Anxiety can be experienced in an acute or chronic form. We experience acute anxiety in a strong concentrated form, possibly escalating into a panic episode. These acute instances are intense, usually one-off episodes attached to a trauma. Anxiety around exams and in response to an accident may be examples of acute anxiety.

Chronic anxiety is more constant. Perpetual. It presents as unregulated feelings of nervousness – often located in the stomach, head and neck. Frequent worries persist. Catastrophic thinking – expecting the worst to happen – becomes more regular. Sleep disturbances, stomach upset, migraines and aches and pains in the body are expressions of this anxiety.

What can you do? Anxiety considerations during the new normal. I will cover actions in a series of episodes.

Episode 1: Anxiety dialogues

Episode 2: Create calm

Episode 3: Body basics

Episode 4:  Untangled

Episode 5: New beginnings

 

Episode 1: Anxiety dialogues

Monitor your feelings of anxiety when you watch the news or spend time on social media. For some people those activities can increase their sense of anxiety, for others it may decrease their anxiety. If you are reacting with increased anxiety, consider to decrease your exposure to news and social media streams.

Given the severe outcomes from COVID-19 you may worry about other tragedies that might befall you, Because of our fight/flight/freeze stress response that we respond to threats, remains over stimulated. We can’t calm down without deliberate activity aimed to do so. Our already heightened anxiety starts to look for additional threats. In the case of our experience of COVID-19 this is not an imagined threat to the human species. We can sometimes overgeneralise the threat of these threats to us specifically.

anxious childYou may have felt that you are powerless over your anxiety. This anxiety dialogue exercise may well help you learn to manage your anxiety during this time.

Your anxiety child: Talk back to your anxiety, as if it is a small child that lives inside you. Help this young child understand the risk. Hold their hand whilst you explain the actions that you are going to undertake to help mitigate your risk of infection. Don’t tell dismiss their worries, by saying that worry is silly. Do not try to simply silence your anxiety. Listen, and talk back. Acknowledge the fear, but explain that you do not need to let worries disable you. Comfort your internal anxious child that you will take care. Thank your anxiety for reminding you that there are threats in the world, and that there is danger.

Dialogues with your anxiety may run as waves lapping at the shore of a beach. Let the anxiety roll in and regress, as if your anxious child, and your adult self are in a dance – make it a waltz.

*****

As always we are open to feedback and questions about the advice that we provide. If  you would like more information on want to provide feedback please contact us at reception@reddoor.hk

#COVID19 #anxiety #newnormal #anxietymanagement #reddoor #chronicanxiety

 

Readings

  1. Kissler, SM; Tedijanto, C; Goldstein, E; Grad, YH; and Lipsitch, M. April 2020. Projecting the transmission dynamics of SARS-CoV-2 through the postpandemic period. https://science.sciencemag.org/content/early/2020/04/14/science.abb5793
  2. Gates, B. Feb 2020. Responding to Covid-19 — A Once-in-a-Century Pandemic? Bill Gates. The New England Journal of Medicine https://www.nejm.org/doi/full/10.1056/nejmp2003762
  3. Ferguson, NM; Laydon,D; Nedjati-Gilan, G et al. March 2020. Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand. Imperial College COVID-19 Response Team https://spiral.imperial.ac.uk/bitstream/10044/1/77482/14/2020-03-16-COVID19-Report-9.pdf