Monthly Archives: September 2017

The Counseling Connoisseur: Mental health cleanup following a natural disaster

By Cheryl Fisher September 14, 2017

“The sole meaning of life is to serve humanity.” ~ Leo Tolstoy

 

As I sit on my patio, warmed by the early autumn sun, I breathe in the alchemy of rosemary, thyme and oregano and a variety of mints — aromas from my herb garden. The squirrels chatter as they scamper across the trapezelike branches of the old maple and majestic oaks that provide me with shade and provide entertainment to a variety of creatures. Blue jays, robins and cardinals flit back and forth, foraging end-of-the-season strawberries. Finches hover overhead just long enough to steal a sunflower seed (or two) from the heads of the long stalks that have faded and now hang low. It is a beautiful September morning.

Yet, several hours away, nature has taken a different turn, spinning up water and winds of 185 mph, decimating lands and destroying lives. Hurricanes Harvey, Irma and Jose have created havoc on the Gulf and East Coasts, while fires have engulfed the West. An earthquake has devastated parts of Mexico. In each instance, homes have been lost and families separated. The same Mother Nature that offers me such solace during this early morning has wreaked havoc elsewhere.

As with any traumatic experience, I seek meaning, attempting to make some sense out of these tragedies. I try to identify who is to blame for such suffering and loss. Finding very little peace from my efforts, I turn to what I know best. I dive into my counseling toolbox for guidance and I DO something.

 

1) Volunteer

As mental health professionals, we offer skills that are much needed in cultivating calm and defusing crises. We can help by listening to the narratives of survivors, validating their experiences and providing tools for immediate coping. We can provide basic care and help them reconnect with loved ones. I have been a disaster mental health volunteer for the American Red Cross (redcross.org/take-a-class/disaster-training) for decades. (The American Counseling Association is an official American Red Cross disaster mental health partner organization.) It is a privilege to serve in local and national deployments. Additionally, we can assist local efforts through church or club affiliations. I am a member of the Maryland Responds Medical Corp, and I support the efforts of my faith affiliation.

 

2) Contribute to resource efforts

There have been many times when I have been unable to deploy. This is extremely frustrating because part of my healing is feeling that I have DONE something to help. I have found that numerous organizations accept both supplies and monetary contributions. Participating in these efforts allows me to feel that I have been actively involved in the effort toward recovery.

 

3) Gather with like-minded/like-hearted people

Being in the company of other compassionate advocates can lighten the load. Sharing the emotional burden may not only provide ease but may also promote collaboration and generation of innovative recovery strategies. For example, a group may want to craft a GoFundMe page, create a local fundraiser or organize an event in memory of those who were lost and in honor of the survivors.

 

4) Pray or hold intention

Regardless of one’s faith or belief system, lifting prayer and good intentions on behalf of another is an active service of compassion and kindness. It is (excuse the double negative) “not nothing.” In addition to a faith-based perspective, prayer and intention place the person or people in the forefront of our thoughts, reminding us of our connection with all humanity regardless of nation, culture, ethnicity, creed, age, gender, sexual identification or able-bodiedness.

 

5) Seek help

As advocates and first responders, we are not immune to the effects of tragedies. Viewing hours of social media in anticipation of the storm’s arrival, watching the desperate efforts of firefighters dousing the flaming forests of Washington and Oregon, or seeing the devastation in the Caribbean can take its toll on even the most resilient counselor. Seek professional help to aid in the development of strategies to provide nourishment and sustenance while buffering the abrasive nature of responding to traumatic events.

 

Conclusion

Nature provides us with endless sources of joy, wisdom and companionship. However, there are times — as with any living force — when disaster strikes. Counselors can contribute to the recovery plan in numerous ways that cultivate a sense of unity and community. It is a privilege to serve in times of need.

 

Satellite photo of Hurricane Katrina on August 28, 2005.

 

 

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Cheryl Fisher

Cheryl Fisher is a licensed clinical professional counselor in private practice in Annapolis, Maryland. She is affiliate faculty for Loyola and Fordham Universities. Her research interests include examining sexuality and spirituality in young women with advanced breast cancer, nature-informed therapy and geek therapy. Contact her at cyfisherphd@gmail.com.

 

 

 

 

 

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Developing trust in your effectiveness as a helper

By Peter Scheer September 12, 2017

As a newly minted counselor, I sometimes remember back to my early days in the program when my classmates and I shared some deep concerns about “doing it right.” Our heads were full of theories and dos and don’ts, and we really struggled to understand how we could possibly help anyone as we stumbled around during our practice sessions with other students during the prepracticum course.

While reviewing tapes of our sessions in class, we questioned ourselves: Were we doing anything to help this client? Were we just wasting their time? What the heck were we doing as counselors?

Many months later, after completing our required internship hours under the supervision of a licensed practitioner, we then had to supervise students in their early stages of counseling during prepracticum. I was actually very glad for this experience and quite surprised at how much it reminded me of where I had been at the beginning of the program. I observed my supervisee and recognized many characteristics that I had at that stage: self-doubt, setting high standards for myself, wanting to control the session.

It made me realize how far I had come. I was surprised at my ability to empathize with my supervisee and to find words to ease their concerns while providing some guidance and hope that they too could make it one day. I saw how much my internship hours had changed me and helped me develop some degree of confidence.

While reviewing tapes one week with my supervisee, I noticed that they were struggling significantly with self-doubt and wanting to see improvements quickly. The supervisee felt that because they had not managed the counseling session well enough, the client had not been well served. The supervisee took on a lot of pressure to get an outcome and ended up feeling very inadequate.

A few days after the session was over, I thought of a personal experience that had been significant in helping me to see how therapy works. It was a single session that was so helpful, although neither I nor my therapist knew it at the time. Over the course of about 20 years, I went to 12-step meetings to work on my codependency, went to therapy off and on, read many books and discussed mental health with others who were also in emotional recovery. I explored spiritualty and many forms of alternative healing modalities. Many times I encountered the concept and benefits of forgiveness and would remember my therapist’s story. Like water dripping on a rock, over time, my stubborn anger softened and yielded.

I want to share my journey to wholeness and how that first encounter with forgiveness was foundational in my eventual release of anger, even if that therapist is unaware of how she helped me. I share that with you now using an excerpt from an email to my supervisee.

 

Email to supervisee

I did have something else that I wanted to share with you to support you with this new skill that you are developing.

I recall your desire to steer and to control the session and hope to see some results, or at least some change in the client fairly quickly. Also, your desire to rate and assess your personal helping skills during a session. This mental health therapy is quite different than other professions, as we have discussed. I too came from a problem-solving profession where we assess, diagnose, make a plan, implement it and reassess … and try something new if that does not work. It is quite action-oriented and “managed” by us. We rely on feedback of some sort to assess progress.

However, mental health therapy is quite different. It has some similarities in that we may try different approaches until we see progress. However, the feedback we get from the client can range from direct and clear to none at all. Many times it is vague and sometimes even evasive. It is really hard to work with this kind of self-reporting as feedback.

Also, a reminder that counseling is a collaborative activity. We may forget that desired change in the client requires action and effort by both counselor and client. It is not realistic to think that we as counselors are solely responsible for client outcomes.

Finally, you may recall I mentioned that a client may actually be helped even if they do not show it in session. We may say something that triggers an awareness that proves helpful, but we, as the therapist, do not know of it. I want to share a personal experience I had to illustrate this point.

Many years ago, I saw a therapist. This was my first experience with counseling. It was possibly our third or fourth session, and I was struggling with unresolved anger at my father. She sensed that I needed help to forgive him and release the emotional burden I was carrying. She told me her personal story of forgiveness. How she managed to forgive the DUI driver who killed her only child, and how she found emotional peace after that. I was both stunned and impressed by her ability to forgive and her calm and peaceful demeanor while recounting it. Clearly, she walked the talk of emotional wellness.

While I found it impossible to forgive, I was deeply affected by her story and thought of it many, many times over the years. I returned to that story many times as I worked through my anger with my father and as I learned how to forgive.

Her story did not “fix” my problem with my father, but it certainly did give me a new awareness about forgiveness, what it means and the benefits of forgiveness for me. It has taken 20 or more years to forgive my father. However, I worked on it and am now at peace with that relationship.

To illustrate how a therapist may help a client but not know at the time, and how the collaborative nature of counseling should work, I offer the following questions and answers for you to consider:

Did that therapist “cure” me in that session? No.

Was that session helpful to me? Yes.

Did I tell the therapist at that time this was helpful? No (because I was just processing this information).

Did that therapist lay a foundation for a positive change in me? Yes.

Does she know today how that one session helped me? No.

Who had the choice to work on changing me? I did.

Who did the actual work to change me? I did.

I think what I carry with me because of this experience is the awareness that I may be helping this client in front of me, but I may never know it. I may be adding one brick to this client’s efforts to rebuild his/her house of emotional health. I may never see the finished house. It may never be finished. But I know I tried to help the client in the moment. I am not sure I can do more than give it my best effort and keep learning and stay focused on the client.

This all feeds into the notion of “letting go” of the outcome of a session. To accept that we just do not know in many cases what effect, if any, we may have on a client. Sometimes, it may be enough to just sit there and be present and caring as they tell us painful and personal stories.

This can be quite difficult to accept; to allow ourselves to believe that if we make an honest effort to help each client, that this may actually be enough. Improvements in mental health require a collaboration and involve a client being both willing and trying to change, along with a supportive therapist to help them change. It is complex and time consuming. It is vague and uncertain most times. This is what we are getting into.

I offer all this and ask you to reconsider your definition of what a “successful” session looks like. I offer this to allow you to reconsider how you judge your performance in this profession. Your heart is in the right place. I believe that you will help people by just having patience and persistence (with the client and with yourself), along with caring and empathy, ongoing practice and continual learning.

My best wishes to you!

Peter

 

 

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Peter Scheer conducts a private practice, Heartbeats to Wellness, offering private counseling with a focus on adolescents, major life transitions, and grief and loss in Harrisburg, Pennsylvania. He is a national certified counselor (NCC) and Health Rhythms facilitator offering drum-based group therapy. Contact him at peter.heartbeats@gmail.com.

 

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Related reading on practitioner self-doubt, from the Counseling Today archives: “Facing the fear of incompetence”

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Achieving a better understanding of adult autism

By Kenneth J. Smith September 11, 2017

Autism, Asperger’s and “nerd” personality features (to use a concept from Temple Grandin, a prominent author and speaker on both autism and animal behavior) seem to have something of an air of mystery and intimidation for many mental health professionals. Let’s face it, clients with autism/Asperger’s have very different ways of perceiving and thinking than most counselors do. For instance, talking about feelings in an unstructured way à la Carl Rogers is unlikely to be nearly as productive with these types of clients as with other clients. Barring extreme examples, I prefer to think of individuals with autism, Asperger’s or nerd characteristics as having a set of co-occurring personality features rather than a mental disorder. To that end, I refer to these kinds of clients as PFAANs (personality features of autism, Asperger’s and nerds). I refer to non-PFAANs (sometimes called neurotypical) as NONs.

When I became a licensed professional counselor, I had a decade of experience running pigs through mazes (animal behavior/animal welfare research) for my Master of Science and working as a humane handling consultant/reviewer in more than 350 slaughterhouses (basically, I did work similar to what Grandin does in slaughterhouses). During that time, I read all kinds of books by Grandin and others to see how autism might help me understand animal and human behavior and cognition to further my work and career. Coming from this background, I was rather surprised to learn that I was expert in counseling adults with PFAAN, and now a large part of my practice rotates around this. I provide a therapy group for developing social skills in adults with PFAAN, and I help NONs better understand and engage with spouses or loved ones with PFAAN. At least in my region, there are very few mental health colleagues I can refer to who have much expertise in adult PFAAN approaches and needs.

The lack of services for adults with PFAAN (and their loved ones) is striking. Many resources are available for childhood/adolescent autism, but these approaches do not seem well-suited for adults, and there is almost nothing for people over age 21. Although I have no hard statistics to back this up, I suspect that individuals with PFAAN make up at least 20 percent of the U.S. population. To quote Hans Asperger, “Once one has learned to pay attention to the characteristic manifestations of autism, one realizes that they are not at all rare.”

To illustrate how many clients you might be seeing without realizing that they have PFAAN, consider whether you could apply the ways of thinking presented in this article to many of your clients who work in science, technology, engineering and math careers. You will see clients with PFAAN in your practice, so it is important to have a way of understanding their thinking patterns.

A central issue for clients with PFAAN is their lack of ability to naturally recognize emotions and empathize with others. If you’re confused by how to help, it may be useful to conceptualize the different ways that emotions seem to work in these clients compared with most other clients. A common tool used in mental health therapy is the Feeling Wheel developed by Gloria Willcox. It is the one tool I have found that both PFAANs and NONs seem to comprehend, so it has served as a valuable tool in bridging the understanding gap between these two groups.

The Feeling Wheel is an excellent way of visually conceptualizing how emotions work differently for clients with PFAAN and NONs. Grandin has suggested that a good method for teaching cognitive flexibility to individuals with PFAAN is to describe people and their actions as a mixture of colors.

The Feeling Wheel (see above) is also in line with another of Grandin’s concepts in which she describes a difference between PFAANs and NONs. She says that many individuals with PFAAN tend to think in specific pictures, whereas NONs seem to think in words/emotions. How this pictures versus word concept works can be quite complicated, but the visual concepts in the Feeling Wheel simplify how to explain this difference. I have developed a list of concepts using the Feeling Wheel and its colors to help counselors and clients empathize with one another and to get to the clients’ goals and skill development.

Concepts

Concept A: People with PFAAN will intuitively get/understand only the innermost (core) feelings. If most people in the world had PFAAN, the Feeling Wheel would probably contain just an inner core (see image below).

The recognition of the detailed emotions (represented in the outer rings of the Feeling Wheel above) seem to develop naturally in NONs but not in individuals with PFAAN. The outer rings of the Feeling Wheel can be taught to clients with PFAAN, but this must be done in an inductive way, similar to the way that most NONs learn math. NONs start with 1+1=2; people with PFAAN need to draw a picture of what the more subjective feeling looks like in NONs so that they can relate the outer rings back to the inner core that they more readily understand. I’ll share more about this later.

Concept B: Emotional processing changes how the world is seen and experienced. NONs can have all kinds of emotions at the same time. For example, if a NON sees a cow, he or she might have several different emotions at different intensity levels about that cow at the same time:

a) Peaceful: “That cow chewing cud is so Zen.”

b) Anxious: “That cow might come and attack me.”

c) Sad: “That cow will be killed to be eaten.”

d) Angry: “I get angry about the ways cow are treated in bullfights.”

The NON’s emotions will also tend to make the picture of the cow less distinct when the person turns the cow into words and emotions. (I think this is somewhat similar in idea to Carl Jung’s archetypes. For example, you don’t remember one cow; you shove the individual cow you see into the archetype cow in your mind.) So, often, this will happen in NONs:

Individuals with PFAAN tend to have only one or a few emotions at a time. They seem prone to black-and-white thinking, rigidity to change and litigiousness (for example, they may ask what the hard rules are for social interaction). So, when a person with PFAAN sees a cow, and if he or she finds cows peaceful, conceptually, the emotional experience he or she will likely have is the picture of that cow overlaid with the emotion (see below).

The way that emotions work in people with PFAAN seems to more closely model the way that emotions work in social animals. For example, a dog either likes a person or is scared of a person, but the dog rarely seems to have both emotions at the same time.

Concept C1: Individuals with PFAAN tend to have one emotion at a time (AND versus OR emotions). NONs can often experience several emotions together. I refer to this as AND emotions (see below).

 

Clients with PFAAN may also have different emotions about something, but they can process only one at a time. I refer to this as OR emotions (see below).

Concept C2: NONs mix emotional colors to get completely novel feeling colors, whereas PFAANs flip between colors. Related to Concept C1, NONs use AND emotions to make new emotional colors (think of mixing paint). A NON might feel strongly peaceful yet a little afraid when seeing a cow (mix dark blue and light orange to get a teal emotional archetype cow).

Individuals with PFAAN won’t readily mix colors, although they might flip between emotions rapidly. The flipping is where they are analyzing what to do (“Should I cry or run away?”) if more than one emotion is present (for example, strong peaceful feelings and a little fear of a specific cow). Usually, the emotion expressed in the client with PFAAN is the most “vivid” color emotion.

Concept D: Individuals with PFAAN take more time to process and switch between emotions. OR emotions and emotional flipping appear to lengthen the time it takes to process the emotions. This lack of speed in emotional processing is often interpreted by NONs as not caring, being cold or being anti-social. The speed of emotional processing seems very important to most people, and many of my clients with PFAAN develop deep shame for their inability to rapidly process emotions. (See No. 5 under the “Counseling approach ideas” section below for more illustrations of this concept.)

Concept E: Individuals with PFAAN are prone to emotional and sensory overload, which may lead to a new emotional color that equals shutdown. What do you often get if you mix all the colors of the feelings together in individuals with PFAAN? Black. This is a good conceptualization of what happens in many people with PFAAN when they are confused or overloaded: shutdown.

Shutdown also happens in NONs (think about the shutdown of emotional controls in the animated movie Inside Out, where everything became gray and the emotions no longer worked). However, it usually takes much more time and intensity (think posttraumatic stress disorder) for NONs to get to black.

To extrapolate from the work of John Gottman in couples therapy, men are generally more prone to sensory/emotional shutdown than are women (see Gottman’s concepts of stonewalling and flooding for more information and illustrations). Based on my work with clients with PFAAN, I strongly suspect that men naturally have more features of PFAAN than women do. The Centers for Disease Control and Prevention reported that autism is 4.5 times more likely to be diagnosed in males. This means that many more men than women would have mild features of PFAAN. Grandin suggests that among girls, PFAAN is often labeled as being a “tomboy,” which doesn’t seem to receive the same level of focus or concern as the presence of autism in males. New research also suggests that females with PFAAN may generally be better than males are at social masking of these features. Or to quote Asperger, “The autistic personality is an extreme variant of male intelligence.”

An example from my experience is that giving too many food choices to a client with PFAAN can lead to shutdown. A large menu may be too hard for these individuals to process in a given amount of time because what they “feel” like having can often take much more time to figure out than it would for other individuals.

Concept F: The default emotion of most individuals with PFAAN is anxiety (if not shutdown). Anxiety appears to increase in those with PFAAN from adolescence on. I believe that increased anxiety proneness is a strong feature of being a person with PFAAN, although such a view is controversial. Novelty — good, bad or indifferent — almost always causes more fear in those with PFAAN than it does in NONs. Hence, rigidity in behavior, speech, routine or time management may often be an attempt to control fear.

Individuals with PFAAN and animals share the experience of novelty and sensory overstimulation producing anxiety and fear. An example from livestock science is the observation of flight zones in animals. The flight zone is how far an animal stays away from a person or experience. The less anxiety the animal feels, the smaller the flight zone. Novelty and sensory overload in animals produce fear or anxiety and lead to avoidance behavior. Thus, if this is the animal’s experience, the flight zone increases. Flight zones are reduced through exposure and positive (or at least neutral) experience. Being around strangers often produces great anxiety in animals and in clients with PFAAN. Thus, both will often avoid strangers whenever possible.

Counseling approach ideas

It is important to realize that counselors will likely need to be much more directive and teacherlike with clients who have PFAAN than with their other clients. Unconditional positive regard, reflection and talk therapy probably won’t be particularly useful because these clients are unlikely to get what these Rogerian-based interventions are working on or doing. What is most likely to be helpful to these clients is to remain focused on the skills that they need and then teaching them those skills. What follows are some approaches I have discovered that seem to help clients with PFAAN in the context of therapy.

1) Teach/discuss the Feeling Wheel concepts. I have found that simply teaching the Feeling Wheel concepts discussed in this article provides many clients who have PFAAN with the tools to move toward their goals and something constructive to do in the counseling context. These clients tend to be analytical and often like testing ideas. Interestingly, many clients with PFAAN are shocked when they find out that most people experience more than one emotion at a time. PFAANs and NONs speak a very different emotional language, so it is important to have a “Rosetta stone” to help facilitate emotional communication.

2) Teach the general behaviors that the emotions cause or are related to. For me, these are the main behaviors that go with the Feeling Wheel, and teaching these behaviors gives clients with PFAAN clues of what to look for in others. Behaviors are often easier to measure than are other ways of interpreting emotion. I relate the core emotions to the following broad behaviors (although there are many others):

Emotion Behavior

Powerful Having a choice/creating

Joyful Attraction/pursuit

Scared Avoidance/flight/urgency

Mad Aggression/flight

Sad Slowing down/reflecting

Peaceful Calm/unhurried/content

In my experience, the best emotional states in which to be empathic/thoughtful are sad, peaceful and powerful. Mad, scared and joyful appear to be more action oriented. Make sure that the client with PFAAN is in or near one of the thoughtful emotional states when practicing empathy training.

3a) Teach these clients to label the emotion they see in others so they can relate it back to the core emotions and choose an emotionally appropriate response. Practice what the emotions on the Feeling Wheel’s outer ring look like. For example, ask what the visual and auditory signs are of a person who is discouraged. The person may look down, exhibit less body movement, speak about being discouraged and so on. Once that emotion is labeled, trace it back to the core emotion (discouraged is a kind of “scared”) to help the client understand it better and have empathy.

3b) Teach clients with PFAAN phrases and actions that can be used once they empathize with the person’s emotion. Just because clients with PFAAN learn to empathize does not mean that they know how to respond appropriately. For example, a client with PFAAN might feel great anxiety at a funeral. To break the silence and sense of mourning that is causing his anxiety, he may start talking loudly to those around him about a new model airplane he is working on. This incorrect social response can have serious repercussions.

It can be helpful for these clients if counselors assign them a set response (at least in the beginning) for each core emotion. For example, you might instruct the client, “If you determine that a person is sad, a good response is to tell that person, ‘I am sorry that X happened’ in a calm voice.”

4) Teach one concept from the Feeling Wheel at a time. Remember, the emotional parts of the Feeling Wheel should be taught to clients with PFAAN in much the same way that you would teach children math: Start with the basics and work up. Clients may have no idea what scared looks like in themselves or others, so provide clear, visual, colored examples to illustrate the emotion. For instance, if the emotion is isolation, you might provide the visual of a person trapped in a purple box (because purple is the color for sad on the Feeling Wheel). A mirror might also be useful to show these clients what their facial expressions seem to be communicating to the counselor at any given time.

5) Teach clients to say “whoa.” Emotional processing takes longer in people with PFAAN, so it becomes very important for these clients to be able to communicate this to others. This is especially important in intimate relationships. I have noticed that many individuals with PFAAN are married to or have intimate relationships with NONs who are very emotional. To adapt a Catholic marriage concept, I think there might be great complementary benefit to such matches. He (usually) balances out her (usually) emotionality, whereas she provides him with an emotional vocabulary and a feeling of being needed. Sometimes this arrangement works well for many years, but then the more emotional partner begins to believe that the emotional avoidance and lack of emotionality/spontaneity on the other partner’s part indicate that he no longer loves her. Very often, this is not the case.

To offer a case example, if a wife asks a husband how he feels about her, she usually wants an answer that is specific and immediate. If the husband has PFAAN, it may take him some time to work out exactly what feelings he needs to communicate, no matter how much he loves her. This delay is often interpreted as the husband not caring, which can cause serious relationship issues. Either the client with PFAAN or the counselor needs to explain to the wife that it is hard for the husband to rapidly communicate his feelings but that, given time, he will tell her exactly how he feels.

You might also help clients with PFAAN “schedule” spontaneity into their relationships to improve them. I had a friend who decided that his wife liked being surprised with flowers, but he was not at all given to being spontaneous. So, he sat down, budgeted how many times he could afford to give his wife flowers (yes, he had a flower budget), and then randomly assigned different dates on his schedule for presenting the flowers. As a result, she got spontaneous (thus emotional) demonstrations of affection, and he still got to operate via a schedule and a budget. It worked great for them.

In a work example, a colleague wants to know everyone’s gut feelings about a new project. It may be important to teach the client with PFAAN how to tell this colleague that it will take time to understand what he or she feels about the project. If forced to communicate too quickly, deep anxiety or shutdown may occur. Clients with PFAAN typically have difficulty with “gut” feelings.

6) Use superhero/comic/sci-fi character modeling. Most of my clients with PFAAN like superheroes, fantasy and science fiction. Anime, a kind of film animation that originated in Japan, also seems very popular with these clients. I have noticed that almost every time an anime character has an emotion, the emotion is accompanied by an exaggerated facial expression or sound cue. You almost always know how an anime character feels, which may explain why anime is so popular among individuals with PFAAN. Many researchers seem to suggest that Asian cultures include more PFAAN by nature (e.g., saving face, defaulting to authority) than many other cultures do, which may explain why anime has these features.

I always ask my clients with PFAAN about their favorite superheroes or other favorite characters. This gives me insight into the clients and often provides a good picture that I can use to help them develop the emotional attributes exhibited by the characters they admire. I use this superhero therapy in a variety of ways, but one good technique that uses the Feeling Wheel is to make a color feelings diagram based on the client’s favorite superhero so that the client has some visual concept to reference.

For example, a client with PFAAN may really like and want to emulate Spider-Man. Spider-Man is a mix of powerful (he fights evil and has superpowers), joyful (optimism and hope) and scared (social anxiety caused by nerdiness) emotions. Aiming the client toward getting the emotions he or she needs to be more like the superhero provides structure for change. “I have plenty of scared. To be more like Spider-Man, I need to practice being more powerful.”

One warning: Make sure that clients choose characters who will move them toward healthy and effective goals. If a hero (or anti-hero) whom a client has chosen would be unhealthy to emulate emotionally or morally, don’t be afraid to speak up. I say this from personal experience. I had one client who really liked the character Deadpool, but under no account should this character be an emotional or moral model.

Conclusion

The concepts I have illustrated connected to the Feeling Wheel have been a revelation in helping my clients understand the difference between PFAANs and NONs and how to approach skill building and therapeutic effectiveness. It is the only tool I know of that explains and demystifies emotional responses in PFAANs and NONs (the group that most counselors fall into). These concepts and approaches have made a huge impact on my ability to help clients with PFAAN and their loved ones.

Adults with PFAAN will find their way into your practice. It is important to know how their emotions work and what may be effective and rewarding in therapy, both for them and for you.

 

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Kenneth J. Smith practices at Spirit of Peace Clinical Counseling in Ohio. He enjoys working with clients with PFAAN and clients with existential challenges, teaching and speaking. He holds a bachelor’s degree in animal science, a bachelor’s in history, a master’s degree focused on animal welfare/behavioral psychology and a master’s in clinical mental health counseling focused on the treatment of shame and guilt. Contact him at info@kentherapy.com or through his personal professional website at kentherapy.com.

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Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Coming to grips with childhood adversity

By Oliver J. Morgan September 7, 2017

Counselors and mental health professionals of all stripes are coming to understand the prevalence of childhood adversity, toxic stress and trauma in our caseloads. Barely a day goes by that we do not see someone with a trauma history, whether we are aware of it or not. Some have even called for universal trauma screening of all clients and patients as an ethical responsibility, especially for those individuals who are more at risk, including first responders, military personnel, refugees, those with serious medical and chronic illness, and people struggling with addiction. It would help to know what we are dealing with upfront.

I became aware of a duty to inquire about trauma in 2007 when I began the Supportive Oncology Service (SOS), a psychosocial counseling practice colocated in a medical oncology setting. I had been teaching, practicing and publishing mostly in addiction studies at the time, but I was hungering for change in my own clinical work. When the opportunity to work alongside physicians and learn about serious medical illness came along, I jumped at it. Quickly, I discovered that what I was learning about the interface between addiction and trauma could just as easily be applied to the occurrence of trauma in a cancer-involved population. This cross-fertilization of ideas and their practical outcomes has been a rich source of learning for me.

The Adverse Childhood Experiences (ACE) studies, a collaborative project between Kaiser Permanente and the Centers for Disease Control and Prevention (CDC), instigated my interest. The ACE project was designed to study long-term relationships between adverse experiences in childhood and adult health and behavioral outcomes. I had begun looking into this as an offshoot of my addiction work but promptly came to realize its applications in the general population. The initial studies were conducted from 1995 to 1997 with 17,000 ordinary Americans in a large outpatient medical clinic and now have been replicated across a number of states and even internationally.

Since its inception in 1995, numerous papers have been published by the ACE project that present the evidence for consistently strong and graded relationships between adverse experiences in childhood, household dysfunction and a host of negative health outcomes later in life. Many of the most serious illnesses facing our country — heart disease, cancers, chronic lung and liver disease, a host of autoimmune disorders, obesity, substance-related and addictive disorders — as well as a variety of health-risk behaviors, including smoking, use of illicit drugs, high numbers of sexual partners and suicide attempts, are strongly related in a dose-response or graded fashion to childhood adverse experiences.

This suggests that the impact of adverse childhood experiences on adult health status and adult suffering more generally is powerful. Dose-response relationships indicate a change in outcome (e.g., harmful substance use or ischemic heart disease) that is associated with different levels of exposure to a stressor. Experiencing multiple categories of trauma in childhood increases the prospects for later illness. ACE studies measure the number of categories of exposure and not the number of instances; for example, one instance or multiple instances of sexual assault would count as one category. If anything, this underestimates a person’s exposure to adverse experiences.

Researchers are finding that the occurrence of adverse experiences is quite common in all populations. Relationships found in the original population are being replicated elsewhere. Fifty-two percent of those participating in the original study acknowledged at least one category of adversity in childhood. Eighty-seven percent of those who acknowledged one adverse childhood experience also experienced additional adversities. The study revealed that adverse experiences occur in clusters, with 40 percent of the original sample reporting two or more categories of adversity and 12.5 percent experiencing four or more categories of adversity.

The ACE categories are as follows:

  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Physical neglect
  • Emotional neglect
  • Mother is treated violently
  • Loss of a parent for any reason
  • Mental illness in the home, including suicidal behavior or institutionalization
  • Substance abuse in the household
  • Criminal behavior in the household, including incarceration of a household member

‘Mild’ adversities?

What first strikes people when they review the categories above is how different the list seems from what we expect. It challenges our assumptions. Many of us are familiar with the standard understandings of trauma connected to natural or human-made disasters, battlefield experiences, violence or sexual assault. Clearly, these are life-altering events. Although these categories are on any list of traumatic events, so are forms of household dysfunction, neglect, and emotional abuse and humiliation. We are coming to understand that, when dealing specifically with children, a wider range of traumatic experiences can be equally devastating and produce debilitating outcomes years later. Further studies are also uncovering negative outcomes related to more “ordinary” adversities such as accidents, childhood hospitalizations or the loss of a sibling.

The ACE results had suggested that the different categories were essentially equal in their damage. This was startling. However, ongoing trauma science supports this conclusion. Although some categories of adversity stand out because of the social significance and stigma attached to them, we now know that more hidden or subtle adversities, such as neglect and experiences of recurrent humiliation by a parent, can both be detrimental in the present and carry long-term consequences for adult health and psychiatric illness. Scientists such as Martin Teicher and his colleagues at Harvard University have documented the potent negative effects of parental verbal aggression and emotional maltreatment.

More common adversities can have large impacts on children. The clinical and research focus on posttraumatic stress disorder may have slanted our expectations, giving us the impression that adversity comes only with high-profile suffering. If it doesn’t leave a mark, it can’t be all that damaging, right? In reality, nothing could be further from the truth.

In short, poor health and risk for illness — medical as well as psychiatric — can be rooted in childhood psychosocial experiences. They can also be hidden due to time, denial and social taboo. The ongoing ACE studies and allied research have given us a new lens for viewing health, wellness and disease. This is nothing short of revolutionary. It is instructive that this new vision has been picked up by the Center on the Developing Child at Harvard University and the American Academy of Pediatrics. Programs for medical education, intervention and prevention are being developed by these groups and others.

Looking at cancer

In 2010, one of the ACE papers made the dose-response link to risk for lung cancer. This got my attention. Adverse childhood experiences are obviously not the only causes of cancers — disease is often multicausal. However, the associations this paper made between having a history of adverse childhood experiences and those who were first hospitalized at younger ages with lung cancer and died prematurely at younger ages from lung cancer were striking. Smokers were much more likely to have a history of adverse childhood experiences than were nonsmokers. In addition, those with adverse childhood experiences were more likely to begin smoking at younger ages than were other smokers.

I was amazed until I went back and did a chart review for my small oncology service. At that time, we had seen about 100 patients. Admittedly, this was a potentially skewed population, but even so, 60-70 percent of our patients with a variety of cancers met the ACE criteria for adverse experiences, and a large proportion of them had multiple ACE categories in their past. Research had suggested that those with four or more categories of childhood adversity were likely to be diagnosed with cancer or some other serious illness. Those with six or more categories had a life expectancy shortened by up to 20 years. My patient population buttressed those numbers. In addition, several of my patients who were not smokers but nevertheless were diagnosed with lung cancer did have a history of trauma. That day I became a believer in universal screening for trauma in my population of cancer patients. My colleagues and interns have also become believers.

When I discussed these outcomes with several of my physician colleagues, they quickly came to the conclusion that because childhood adversity was strongly associated with the risk of early smoking — nicotine is a powerful anti-anxiety agent — that would likely explain the prevalence among patients with lung cancer. Case closed. If a cancer patient also had a traumatic childhood history, smoking was the likely pathway from trauma to lung cancer. Risky behavior led to later disease.

This did not sit well with me, however. First, it did not explain the high trauma numbers in my cancer patients more generally (a number of whom were nonsmokers) and, second, identifying only this pathway seemed too facile. I believed that more was involved.

Changes that make us vulnerable

At first blush, ascribing disease to risky behaviors and poor lifestyle choices seems reasonable. There is obviously some truth to it. Lots of scientific evidence points to smoking as a risk for cancer. Still, I wondered, could there be other pathways from childhood adversities to cancer? The connections seemed clear, but what were the explanations? As an addiction specialist, I was suspicious of the “poor choices” explanation. Were there other, hidden dynamics that were not so obvious?

This is where the intersection of childhood adversity and neurobiology becomes so important. As a counselor, I had focused my thinking on the social and psychological explanations. Childhood adversity short-circuited psychosocial development. Trauma created toxic stress in a person’s life. Negative experiences became part of a person’s sense of self and view of the world, which made living difficult. These negative experiences also placed emotional burdens on the person’s psyche and spirit, creating negative internal images, expectations and attachments at the core of the personality. People learned to be wary of others and became more guarded, isolated and distrustful. Fair enough. But how do we get to physical disease?

This move requires an alchemical kind of insight — namely that the footprints of our psychosocial experiences of attachment and caregiving are inscribed into our brains and bodies in what Allan N. Schore, Daniel J. Siegel and others call “psychobiological” experiences. Donna Jackson Nakazawa, in her 2015 book Childhood Disrupted, described it this way: Biography becomes biology.

We are continuing to learn about the depths of this process. From our earliest beginnings, experience shapes the development of our brains, bodies and critical survival systems. The formation of our neural architecture, emotional and cognitive networks, regulatory systems, coping and stress response, and immune systems depends on the kinds of caretaking we receive. Social networking is part of our DNA it seems; it is essential for our survival but can also create vulnerabilities.

In childhood, all the essential systems are forming and developing. When children are caught in cycles of abuse, neglect or humiliation, their stress response and coping mechanisms can be degraded and become stuck in the “on” position. Their bodies are continually bathed in inflammatory stress chemicals. This can lead to physiological changes, long-lasting inflammation, eventual breakdown and disease. The immune system can be weakened, even at the level of genes. Neuroscience is helping to document these enduring kinds of changes, large and small, that are the pathways to later illness.

Another form of negative development that can follow from childhood adversity affects the child’s regulatory coping mechanisms for stress. This can lead to difficulties such as substance use and addictive disorders. Emotional and behavioral regulation are essential skills, built upon the foundation of neurological development. Toxic stress, however, can alter and “miswire” the development of critical coping systems, resetting their baseline levels of activity and making them supersensitized, not only to stress but also to triggers that signal the approach of rewarding or stressful situations. In these instances, individuals may substitute chemical or behavioral forms of coping, reward, relieving stress or alleviating anxiety and pain. Regularly resorting to such substitutes can ingrain these choices into neural channels that are resistant to change once firmly set.

These ways of thinking have opened my eyes. Childhood maltreatment and adversity alter children’s brain development and create the underlying conditions for short-term coping and long-term medical and psychiatric problems, including cancers and addiction. The intersection of knowledge from developmental psychology, attachment theory, trauma and neuroscience is presenting us with many new ways to conceptualize the challenges that confront us. As counselors, it is imperative that we remain open to these new developments.

Recommendations

Based on my experience, I want to make some practical recommendations:

1) Counselors need to learn all we can about adverse childhood experiences and their impact on adult living.

2) We can all benefit from universal screening for adversity and trauma as a first step in clinical work. A few simple questions can be added to our standard history taking. Asking these questions on an abstract or computerized form, followed up with face-to-face conversation, has been found to be the best practice for obtaining accurate information. There may be direct health benefits to these conversations. As reported in Nakazawa’s book Childhood Disrupted, physicians who discussed adverse childhood experience questions with patients following completion of intake forms found a 35 percent reduction in office visits and an 11 percent reduction in emergency room visits for patients with chronic ailments over the ensuing year.

3) When we discover a history of adversity, we should remain curious, be empathic and be predisposed to believe. The primary consideration initially is creating a safe space.

4) Be prepared for pendulum swings in the conversations. It is normal to move forward in the story and then back off when the client shows anxiety.

5) Teach grounding techniques so that the client can retreat to safety when overwhelmed.

6) As is the case in much of our counseling work, self-knowledge is critical. Each of us can benefit from conducting our own self-assessment of adversity and trauma. Understanding our own issues and working with them may be the most important first step in recognizing the problem and then working with others.

Good luck. This work, I believe, is one of the greatest secrets and potential resources in clinical practice today. Trauma continues to be a hidden occurrence among our clients and patients for too many counselors, physicians and human service providers. We need to do better.

 

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Oliver J. Morgan is a professor of counseling and human services at the University of Scranton in Pennsylvania. He is beginning his 27th year at the university and is completing a book titled Hungry Hearts: Unlocking the Secrets of Addiction and Recovery. Contact him at oliver.morgan@scranton.edu.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

Viewing fathers as attachment figures

By Ashley Cosentino September 5, 2017

The role of fatherhood has changed over the years. Hundreds of years ago, the father was the most important parent for raising the children, then he became the breadwinner, and today an expansive volume of research details a general lack of involvement by fathers in their children’s lives. Plenty of fathers want to be a part of their children’s lives and do whatever they can to stay involved. However, many fathers encounter barriers created by myths that limit, or in some cases prevent, their ability to engage with their children.

Many people may believe some common myths about fathers. These myths include:

  • Fathers are not interested in being involved.
  • Fathers do not have the capability to be involved.
  • Fathers are harmful if they are involved.
  • There is little to no effect if a father is not involved (or, relatedly, the hassle of dealing with the father is worse than any negative effects that his lack of involvement might have on children).

In reality, both fathers and mothers are important, and not just as a means of feeding, bathing and sheltering their children. Their importance extends beyond meeting the family’s physical and safety needs.

All of us likely know someone who has either grown up with a single parent or been a single parent, or perhaps we fall into one of those categories ourselves. A faulty assumption that people often make is that married fathers are always present, whereas divorced fathers (or unmarried fathers) are always absent. This assumption is based on the faulty idea that a father is only involved if he is present in the home and that when a man doesn’t live with his child, the father then becomes disinterested.

Research has shown that children who grow up without consistent father involvement commit more crimes, become teenage parents more frequently and are unemployed more often than are children who grow up living with both of their biological parents full time. This is regardless of the parents’ race, educational backgrounds, whether they were married at the time of their children’s births or if a parent remarries. According to the research, children growing up without father involvement were also found to perform more poorly in school, use drugs more frequently and have other social problems even when controlling for generally lower income.

The prevalence of single fatherhood has doubled in the United States throughout the past decade, and the number of nonresident households is growing. A residential household is the parental home where the child spends the majority of his or her time, whereas a nonresident household is the home where the child stays when spending time with the other parent. Escalations in divorce and nonmarital reproduction during the past 30 years have preceded escalations in the percentage of children living separately from their biological fathers. Between the 1970s and 2000, the percentage of children living with a single parent grew from 12 percent to 20 percent. In 2002, 69 percent of children younger than 18 lived with both biological parents, whereas 23 percent lived with their mother and 5 percent lived with their father. Fifty to 60 percent of children born in the 1980s and 1990s lived with only one parent for at least a year before reaching age 18.

These statistics help to illustrate the lack of attachment that many children have with their fathers. An attachment is characterized by intense feelings of intimacy, emotional security and physical safety in association with an attachment figure. Attachments are significant throughout one’s life, and they can vary over time. When established in early childhood, attachments can continue, but new ones can also be formed during later childhood or in adulthood, and current attachments can be reinterpreted with new perspective and conditions. The goal of attachment is to have a secure relationship with several caregivers to improve normal social and emotional development.

John Bowlby established attachment theory in the 1950s and 1960s as an addition to psychoanalytic theory. Attachment theory is a secure base from which to explore close relationships that can accommodate an extensive variability of methods and findings. Attachment theory proposes that affectional bonds are essential to the survival of humans. It has a protective function (e.g., a mother keeping her child safe in times of danger) and an instructive function (e.g., a mother providing a secure base so her child can explore the surroundings). Attachment occurs if there is closeness and active shared interaction between the child and the attachment figure. Attachment theory is the prevailing theory for understanding early social development in children.

Attachment styles

Mary Ainsworth and her associates experimentally defined three subgroupings of attachment associations: secure, anxious-avoidant and anxious-resistant (or ambivalent).

Secure attachments: A secure attachment is categorized by passionate feelings of intimacy, emotional security and physical safety in the company of an attachment figure. Features that accompany a secure attachment include remarkably good communication abilities, the use of productive coping tactics and the capability to assimilate inconsistent emotions, normalize negative emotions and resolve conflicts cooperatively and constructively. Secure children show little anxiety when separated from a caregiver and develop a sense of self-worth and belongingness. Secure attachment relationships provide a safe base from which to explore the world and an affirmative model of self in relation to others.

Insecure attachments: Insecure attachment relationships occur as the result of trauma or neglect. They create noteworthy shortfalls in the child’s development of self and his or her capacity to relate to others. These effects can have enduring negative psychological concerns such as not being able to compromise or form meaningful relationships. Forty to 45 percent of children in the United States and Great Britain are classified as insecurely attached based on research done in both countries.

Children with anxious-avoidant attachments are characterized by their insignificant need to receive physical contact from their parent(s) when united after a separation. Anxious-avoidant children use defense mechanisms such as having a low need to accept physical contact from caretakers. As adults, people who are anxious-avoidant withdraw in relationships and are emotionally distant.

Children with anxious-resistant (ambivalent) attachments demonstrate a lack of inclination to explore, a lack of precociousness and a lack of self-protection, while also showing intensification in irresponsibility and accident proneness. These children are characterized by intense misery at their caretaker’s parting and an inability to be pacified upon return of the caretaker. Children with an anxious-resistant attachment style appear to show infrequent amounts of inner conflict concerning the apparent physical and emotional accessibility of their parent. Research on the concerns of this attachment style signifies that anxious-ambivalent children experience developmental interruptions that are not typically experienced by securely attached children.

A fourth type of attachment, disorganized, could also be added. Disorganized attachment is a combination of anxious-avoidant and anxious-resistant. Regardless of the attachment style, children create an attachment blueprint for future interactions that will guide them throughout their lives.

Fathers as attachment figures

Bowlby’s original construction of attachment theory proposed the role of the father as ambiguous, but he later recognized that fathers are imperative as attachment figures. Bowlby’s philosophy about the role of fathers as attachment figures developed over time with the publication of applicable research findings.

The infant-father attachment turned out to be prevalent while Bowlby was working on his second, more clearly defined version of attachment theory, published in 1969. He found that the father’s reactions to the child form the pattern of the child-father attachment relationship. Bowlby’s son, Richard Bowlby, who has also lectured and written on attachment theory, has said that he suspects his father’s initial concentrated focus on mothers and their attachment role may have ended up prejudicing subsequent research and distorting cultural values.

Bowlby added fathers as significant attachment figures because two distinct attachment roles seemed to exist for two separate but equally important functions for a child’s development. One attachment role is to deliver love and security, and the other role is to participate in exciting and challenging practices. In other words, the bond of attachment is more than keeping children safe from danger, which is often seen as the mother’s role. Attachment is also a bond that promotes exploration and gives confidence to venture forth, which is often the father’s role.

For children to grow into proficient adults, it is recommended that they first need to develop psychological security, which consists of both secure attachment and secure exploration. Researchers have defined this as confident, attentive, eager and resourceful exploration of materials or tasks, especially in the face of disappointment. Secure exploration implies a social orientation, particularly when help is needed.

Understanding the difference between secure attachment and secure exploration helps us see how fathers have a distinct impact on the raising of children. A father’s behavior should create a feeling of safety for the child as the child explores new understandings. These instances will allow the father and child to become familiar.

Humans have an instinctive need for enjoyment, discovery and a sense of achievement. Bowlby considered play to be an important aspect of the father-child relationship. The role of father-child play is alleged to be critical for child development and adds to the expansion of attachment relationships. A father’s role becomes noticeable in child development later; consequently, the impact of father involvement may be progressively more important and observable as the child grows older. A father’s awareness of his child’s exploratory behaviors will contribute to the child’s sense of safety during difficult tasks and increases the chances for the child to focus, follow his or her curiosity and master new talents in an emotionally unhindered way.

Parents’ roles: Separate but important

Both parents are considered attachment figures in attachment theory, and the child-father attachment is autonomous from the child-mother attachment. Whereas mothers are commonly involved in caregiving and providing emotional refuge, fathers are particularly involved in play and exploratory undertakings. Healthy development depends on a child’s positive attachment to both parents because the parents provide separate but equally important secure bases for the child’s attachment needs.

In families in which two parents are raising children, one parent serves as the main attachment figure for providing a lasting secure base and refuge for safety in periods of distress, whereas the other parent serves as the primary attachment figure for providing opportunities for exploration and excitement. There are fluctuating amounts of commonality between the two attachment roles; however, each parent will offer one type or the other. Scholars have established that individuals who excel in social situations as young adults typically had mothers who delivered a stable secure base and a positive model for intimate relationships within the family and fathers who shared in exhilarating play and interactive encounters.

To optimize the chances of a child being successful, two distinctive systems need to be in place: a secure base for the child to come back to when the action ends or goes wrong, and a trustworthy confidant to show the child the way. Children can use their parents as a secure base in diverse ways, and each parent can attend to a child’s needs differently. For instance, fathers generally take part in more physical play, inspire more risk-taking and induce a greater assortment of excitement and stimulation in play than mothers do. Fathers typically encourage competition, challenge, initiative and independence. Parents who compete for their child’s love and devotion are more likely to have offspring who are insecurely attached to both parents.

Little is known with certainty about the behavioral correlates of secure child-father attachment. Measures of this attachment should include the assessment of warm, supportive and sensitive challenges during joint play. These are indicators of an activation relationship. If we begin to view men as primary attachment figures, a change might take place in the importance we ascribe to fathers.

Need for father involvement

The issue of fatherlessness is discussed in many books and articles, but it is primarily prioritized as a financial problem. These children are considered worse off because they may not have the same level of monetary resources that can give them a better life. Most of the initial early research concentrated on the regularity of contact with the father and payment of child support. The financial assistance of fathers is unquestionably a vital resource for children in all forms of families. However, if children truly are to “profit,” fathers also need to be obtainable and involved in their children’s lives.

There is a need to reevaluate the significance of fathers and to recognize that their worth in their children’s lives is equal to that of mothers. Regardless of the eminence of the mother-child bond, children who are close to their fathers are happier, more fulfilled and less anxious. According to the research, it is important to position the father within the larger context of family relationships. When nonresident fathers maintain parentlike contact, partake in an assortment of activities with their children and spend holidays together with their children, the children’s welfare is sustained. Positively involved fathers reduce their children’s probability of externalizing and internalizing difficulties, limit children’s school failures and avert children’s self-image problems during puberty. The social interactions between fathers and their children who are raised by a single parent are important predictors of healthy functioning in children in both cognitive and behavioral realms.

The transference of social capital between nonresident fathers and their children is calculated by the quality and quantity of involvement. High-quality father involvement is essential for children’s security because fathers who cultivate close relationships with their children are more effective in observing, teaching and communicating. When children sense love and care from their fathers, their sense of emotional security is reinforced. Emotional security helps children cope with stress and makes them less susceptible to anxiety and depression. When both parents are involved, children are more likely to respect and obey parental rules and imitate parental behavior.

Studies of nonresident fathers often indicate positive correlations between father involvement, regular payment of child support and children’s behavioral adjustment, psychological welfare and academic achievement. Frequency of noncustodial father visits has been found to be linked to greater academic achievement, self-esteem, social competition and overall well-being of children. Father involvement is also positively related with children’s social capability, internal locus of control and capability to empathize. A father’s involvement in making key decisions that impacted his children also led to grown children looking to him for support. A longitudinal study of 12th-graders in divorced families found that children with recurrent contact with their fathers received more guidance and provision and were less depressed.

According to the literature, the lack of a father in a child’s life can have damaging effects on both boys and girls. Male and female adolescents from divorced and remarried families exhibit higher rates of conduct disorders and depression, and they are more likely to become teenage parents.

Boys whose biological fathers do not live with them have increased chances of conduct problems and acting out more frequently at home or school, whereas girls are more likely to become depressed. Many researchers believe that boys respond longer and further to the separation from their father attachment figure. Boys, more so than girls, can suffer from lack of contact with a father attachment figure, causing them to struggle in school.

Bowlby’s attachment theory presents that both parents are needed as attachment figures in a child’s early development. We have a long way to go before our society considers fathers to be just as important as mothers, but each step is a step closer. A successful future depends on children having secure relationships with their fathers. This means fathers being able to see their children often and being regarded as more than just financial support. Fathers are attachment figures who challenge their children and are right there with their children to explore the scary world ahead of them.

 

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Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

Ashley Cosentino is an assistant professor in the Counseling Department at the Chicago School of Professional Psychology. She is a licensed clinical professional counselor and a national certified counselor. Contact her at acosentino@thechicagoschool.edu.

Letters to the editor: ct@counseling.org

 

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

 

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