Welcome to the Rest of Your Life

I have changed careers at a stage in life when people might ask why I did so.  I was successful as an Independent Educational Consultant.  I had many families who were happy to refer me to their friends in a crisis.  I knew many wonderful teachers and tutors, and had excellent connections with therapists, psychologists, doctors, lawyers, and coaches.  Not only did I change jobs, I left a life behind I had crafted over nearly four decades.  I moved from family, friends, and a geographical and political and economic area I knew as home to move to a completely different state.  Why change now?

I am the kind of thinker who sees the world in shapes and patterns.  I like symmetry, although to me symmetry is not always 1/2 and 1/2.  It might be a little lopsided here with something on the other side to offset the feature that “appears” lopsided to others.  That is my creative side.  I also think logically and intentionally.  My new job is related to what I know–it is not a “complete” change, not really.  It is just new.  But I am already figuring out many things.  I “knew” I could do this.

I look at human life and its stages as a puzzle of sorts, one that has different shapes perhaps, but I can recognize the general arrangement of pieces.  More than that, I look at the big picture and see human life as a series of three circles.  The first circle of life is a circle of growth that runs roughly from infancy to the late 20s.  I did a lot of maturing and changing during those years, beginning with my first tentative steps and attempts at speech to going to school to dating to marriage and to the start of a family.  During this phase is the initial development of self, the identity that one takes with one’s self throughout life’s journey.  The second circle of growth runs roughly from age 30 to the late 50s.  This is the acquisition phase, the consolidating phase if you will, when one develops a place in the world–a career, a community, a family.  There is overlapping of the portions of one’s life, but stability is the general framework in which one acquires these things and develops an identity in the bigger world.  It is also, at times, when the individual self sometimes drifts to the side.  This is, for some people, a challenging time, especially when their life does not make that perfect arc, that perfect circle.  Then again, nothing in life is perfect, and symmetry gets a bit lopsided.

I am in the third circle now that begins in the late 50s and continues to the inevitable conclusion.  In this circle, one comes around to one’s mortality and the inevitability of death is more present.  True, some people live a very long life, but there is no guarantee.  Yet this is not as morbid a thought as it might seem when one is young.  Instead, I have embraced this as a chance to return to that original identity–the one I fought so hard to attain when I was young!  Why did it take me so long to get here?  What happened during that second phase that took me away from “me”?

For me, at least, that second circle started at a younger age and enfolded me for so long that I was guilty of not reaching forward when I was young–in that first circle, when it would have been easier.  I let my identity be guided so much by circumstance rather than take things on for myself because I felt duty bound to do so.  But it is okay.  I am reaching forward now.  I am fortunate to be strong and healthy, and hopefully I have plenty of years left to embrace and enjoy this change in my life circumstances.  Even my husband is learning to let go of his trepidation, having gotten so “used to” things as they were.  But this is his chance, too, to reconnect with the things he dreamed of once when he as young.  No, you won’t find us skydiving anytime soon.  But you may see us running on a beach.  You may see us gazing in wonder at the stars on a clear night, and smelling roses in a garden.  And you will see me in a completely new job in a completely new state, thankful for this opportunity to say “Welcome, Eileen, to the rest of your life!”

 

 

Welcome to the Rest of Your Life

What is a Neuropsych Anyway, and Why is it Necessary?

Under the FAQs pages on many websites you’ll find information about different types of testing.  The original neuropsychological evaluation included medical testing to find areas of brain dysfunction in those who may have suffered a head injury or disease such as Parkinson’s.  It was also intended to address attention and/or working memory issues, particularly in cases where medication might be prescribed.  In addition to an MRI or other medical tests, an individual would take tests that might include a general intelligence test to measure working memory, logic and verbal acuity.  By contrast, a psychoeducational evaluation would be administered by a professional with an educational background.  This would include intelligence testing (as described previously) along with educational tests, and ability versus educational levels were compared.

Over time, testing has become increasingly sophisticated.  We now have measures for executive functions beyond the original Stroop Color Word Test and the Wisconsin Card Sort that were the gold standard of their day.  The Rey Complex Figure Drawing provides more than a glimpse of memory or visual-perceptual weaknesses.  The Trail Making tests measure more than just speed.  As for educational testing, the breadth of interpretation has changed dramatically.  The ability versus academic level discrepancy model has long since been discarded, and a skilled professional catches the subtleties of skill weaknesses through observation and an array of different approaches to the same content areas, such as silent versus oral reading and timed versus untimed performance.

Now you may ask–so what does all this have to do with anything?  The short answer is that what was known as neuropsych testing and what was known as psych-ed testing has morphed into a discombobulated and confusing universe of five dollar words that mean little or nothing to the average person.  Some professionals will tell you one is superior to the other, while others will say that’s not true.  Some professionals perform some parts of each, while some perform none of these tests.  Neuropsychologists, Clinical Psychologists, School Psychologists, and Educational Psychologists among other professionals often perform overlapping tests.  And why does it matter who does the testing?  Or what type of testing is done?  The short answer is–it depends on what you want/need to know.

So why does one get tested (or refer their child for testing)?  Perhaps the individual is acting out or struggling with strong emotions.  Or they are struggling with attention.  Or with math.  Or with school in general.  Maybe they had a head injury that seems to have affected the speed with which they complete tasks.  Or their memory.  In any event, the goal of any evaluation should be to determine what the individual’s strengths and/or weaknesses are, and what can be done to help them achieve whatever is hoped for them to achieve (such as learning to read, learning to work independently, learning to manage their emotions, etc.).  And how do you decide what testing you need?  Instead of answering that question, I would like you to consider some questions you might ask a provider:

  • Our daughter has poor attention.  Do you test for that?
  • Our son is struggling in school.  Do you test for learning disabilities?
  • I am very depressed and anxious.  Are there tests for that?
  • Can you diagnose learning disabilities/attention deficit disorders/mental health disorders?
  • We had his eyes checked and he wears glasses, but he’s struggling with reading.  Do you test for dyslexia?
  • She doesn’t make eye contact and doesn’t have friends.  She doesn’t communicate much.  Does that mean she’s autistic?  Are there tests for that?
  • My son was always a strong student.  Now he just sits in his room all day and plays video games.  His grades have fallen and he doesn’t eat right or talk to anybody.  I’m concerned.  Should he be tested?

You may have more than one of these questions to ask–and that is okay, too.  Think about what you are looking for, even if you’re really not sure what it is, and see if you can frame it into a question.  An ethical professional will answer you and will ask you questions in an effort to figure out exactly what is needed for you or for your loved one.  Sometimes, a couple of different professionals will be needed as part of a team effort (such as a Clinical Psychologist to find underlying emotional dysregulation, and a physical exam to see if there are medical symptoms that may be amplifying those emotions).  Sometimes, one professional will be sufficient.  Sometimes, you may begin the work with one professional who will then suggest that perhaps something different is needed.

Another important consideration in selecting an evaluation is learning something about the experience and knowledge of the evaluator.  I have had families call and ask about other clinicians in the area.  I will not “rate” my competition–it would be highly unethical!  Besides, I know many good folks out there who do a fine job, so I am not going to insult them in order to get your business.  I can, if asked, provide copies of sample reports.  That can be helpful for parents who might realize they are seeking something different.  For other parents, that has been excessively helpful in pointing them in my direction.  There are also your referral sources to consider.  I, like many of my colleagues, refer routinely to other professionals when I think that a family’s needs are outside the parameter of the services I offer.  At the same time, there are many pediatricians and family health providers who regularly refer parents to me, as they already know what I do and what I can offer.

In summary, don’t feel like you have to do something, especially if it’s not warranted; however, don’t be afraid to move forward if it is.  Ask questions.  And if you don’t get satisfactory answers, ask someone else.

What is a Neuropsych Anyway, and Why is it Necessary?

The Cranky Masseuse and Other Stories

A friend wanted to do me a kindness, and offered to pay for a massage.  I travel a lot for work, and I get stiff and sore from sitting in airports, on planes, on buses, in taxis, and in rental cars.  So my response to the offer was an enthusiastic “Thank you!”

The masseuse greeted me nicely with the usual questions about any injuries she needed to know about.  When she asked about problem areas, I told her that my stress centers in my shoulders–always has.  Hard to say if it’s from a serious injury I suffered as a child, or if it’s “just me”, but it is what it is, as they say.  I also told her that I had been traveling a lot for work lately, so the lower back and hips were feeling a bit stiff.  I should add that I go to the gym and work with weights and swim, so I’m fairly limber for a woman “of a certain age”.  But she decided I should be “more” limber I guess, and clearly she was not satisfied by my lack of cooperation (I didn’t know body parts could be twisted that way!).  And then there were my shoulders. . .

Throughout the massage, she poked, jabbed, rubbed hard, and repeatedly told me to relax, to breathe, to “let it go”–all to no avail, of course.  She told me to do exercises I already do.  I could hear her becoming tense, and her breathing more labored.  I knew she didn’t believe me.  I couldn’t help it.  I laughed.  “I told you that’s where my stress goes.”  She became terse, her lowered voice betraying her tension.  “Just breathe!”  “Let it go!”  Her jaw tensed, and finally she muttered testily, “Be that way!”  That, of course, made me laugh more.  I couldn’t help myself.  “My chiropractor has been telling me this for nearly 40 years. . .” I began, but she was having none of it.  Personally, I don’t think I was so awful a customer.  I tried my best to cooperate!

It made me think of folks I know who go into the mental health field thinking they have or should have all the answers or that they can or should make everything “right”.  I know I try to make things right, but sometimes things don’t work the way I’d like them to.  One family is struggling with their young adult son, while another is finally finding amazing levels of success.  I am working hard with both families.  Is it my “fault” that one family has had a terrible experience while the other could not be happier?  Could I have done something differently?  Or is it the “fault” of the program?  Or the parents?  Or the young man?  Is he trying to cooperate?

There are never any easy answers when a family is in crisis, when one is dealing with the emotions, experiences, abilities, strengths, weaknesses, health, fears, wounds, and destructive or malevolent tendencies (or not) of an individual and their family system–whatever that looks like.  What works for one person may not work for another–or might work for different reasons.  A great deal of interest is piqued by genome testing to see if one can metabolize certain drugs, as even pharmacology is called into question as to its efficacy in treating any number of mental illnesses.  And is it a mental illness or a developmental delay?  Or is it temporary, say in the case of a situational trauma?  There are many “ifs” and many stories that must be examined along the way.

Part of my job is to begin the intake and analysis so I can guide a family forward.  The deep tissue stimulation begins with capable Marriage and Family Therapists, Psychiatrists, Neuropsychologists, Occupational Therapists, Mental Health Counselors, Speech and Language Pathologists, Addictions Counselors, Special Educators, Residential or Field Staff, and/or Tutors who work with a student.  Those professionals then give me ongoing feedback about what they find.  The next part of my job is to analyze all of this new information in conjunction with the student’s history, and provide ongoing feedback to those professionals working directly with the student.  I am part of the process and part of a team that includes the family as well.  Many voices, many stories, are part of one hopeful expectation–to see that student succeed.

So, when things don’t work well–well, it is awful.  It is rare that there is a clear reason “why” things did not work, just as it is rare that there is a clear reason “why” things do work.  We are dealing with human beings, with all their foibles and joys.  I am very disappointed when a student and/or their family doesn’t succeed, no matter the reason.  And there are many stories out there, both joyous and tragic.  It is difficult to realize that just as one cannot reasonably take all the credit for another person’s success, neither can one take all of the blame for another person’s failure.  We like to receive credit, but we don’t want blame.  But in our hurt, we place blame with others.  This is our bitter reality.

I do my best not to be the cranky masseuse.  It hurts when families look to me for help then blame me when things go awry–or take all the credit when things go well!  Still, it is not my job to be all things to all people.  I do my job, and I do it well.  As long as I continue honing my craft, as long as I keep listening, as long as I keep learning, then I know I have done my best.  And if a family has stiff shoulders, so be it.  I do, too.  And I have learned to laugh about it.  Hopefully, someday, they will, too.

The Cranky Masseuse and Other Stories

On The Road Again

I just got back from Utah.  I am often asked why those of us who work with families seeking therapeutic options place so many clients in Utah, and why there are so many programs there.  It is not a black and white answer.  We have many good federal guidelines in place to protect those with mental illness as well as many that protect our children.  Utah just takes things a little further in terms of standards, and they have some pretty outstanding laws and guidelines.  There’s lots of land, and the cost of living is lower than some areas of the country.  And many programs have good relationships with the Bureau of Land Management, so schools and programs can take  advantage of the space afforded in public parks (and the scenery is stunning!).

At any rate, I wind up in Utah at least once a year.  I check out new programs and revisit programs to keep updated on new initiatives, new programming–even new buildings and renovations.  So I was there again last week.  While there, I happened upon something that is going to work perfectly for one of my clients, and he is very excited.  That makes me satisfied as well!  I also met a young client I had to send to wilderness whom I had not yet met.  We had a nice chat as we sat in the rain under a tarp, and he said he has figured out some things.  I hope so.  I always do.

Traveling a lot is part of my job.  It is necessary to visit the schools, programs, and colleges I would recommend to someone sending their child or young adult for an education and/or for treatment.  There is a lot of education that goes on as well, as I hear about the latest innovations and research going on.  I have made many friends and connections.  It is great to visit and reconnect with esteemed colleagues.  Sometimes, like this past week, I am able to travel with a peer, and we share insights and observations.  We can also provide advice when a fellow consultant is unsure about something, like which school has the best arts program for a particular client, or which wilderness therapist(s) works most effectively with trauma.

It can be hard, though, on a personal level.  I miss my husband and my dog.  I miss my home.  I miss my own cooking, believe it or not!  Yet the only way to remain current and to be the best I can be for my clients is to travel.  So, I travel a lot.  There’s lots of planning and scheduling that has to go on.  I need to get a travel itinerary.  I need everyone’s cell phone numbers, the names of hotels, and times to get some rest and catch up on calls.  I have to change the message on my work phone.  I have to pack my bags, including at least one book and some trail mix, and try to only bring carry on if at all possible.  I have to remember my vitamins and prepare for possible headaches, backaches, or heartburn!  I give my dog extra belly scratches and treats for the few days prior to my leaving.  And I hug my husband one more time before entering the airport.

I had actually hoped to travel again in August, but it looks like day trips will have to do.  I am scheduling a trip to Arizona in September, and hope to get to Colorado as well.  Then there is regional NATSAP in Maine in October.  So, here I go, on the road again.

 

On The Road Again

Help! What do I do now?!

So many parents feel overwhelmed by the demands of being a parent.  After all, once this child has been brought into the world, you as a parent know you must provide food and shelter, you must clothe this child, you must bring this child for medical and dental checkups, you must tend to bruises, cuts, and boo-boos, you must dry tears and read nursery rhymes and change sheets, you must smile and laugh, you must discipline. . .in other words, you must parent your child(ren).  There is no rule book, no play book, no straight guidelines for parenting, as we all know that each child is different.

Most parents are excited at the birth of the child while maybe also being a little scared because of the sheer responsibility that they know will be theirs for the next 18 years or so, but with few exceptions parents are excited by possibilities.

And then there are the curve balls tossed your way.

Maybe your son was born with all his fingers and toes, but he cannot see them.  Maybe your daughter is absolutely perfect but she comes down with meningitis and it robs her of the potential talents with which she had entered into the world.  Maybe your child is reckless and gets hurt badly because of their curiosity and impulsivity.  Maybe your child is bullied, or has learning disabilities, or gets caught up in a gang.  Life happens, and we cannot control life.  We can only control how we respond to life’s challenges.  Yet for many parents, even when they recognize this seemingly simple fact, the fact is there may be things they can do but they don’t know where to turn.  How can one make lemonade from lemons if one does not know how to squeeze a lemon?

I always encourage parents to ask for help.  But there’s a catch.  If you want good advice, seek it from those whose successes are those to which you aspire, or that somehow seem related to your challenges while offering hope for positive outcomes.  For example, if a friend had a tough time raising children through a divorce but came through it better on the other side, then ask how they approached the problem of blended families and dual homes.  If a family member had a child who faced a challenge in school and they found help for the child, ask whose help they accessed.  If a coworker struggled balancing their family’s needs through a crisis with the challenges of holding down a full-time job and wound up keeping their position while giving their family the time it needed, ask what they did to find some balance.

We all struggle from time to time.  You don’t need to be perfect, because no one is.  And you cannot control life.  It is easy to say that struggle can lead to positive changes or outcomes, but it is hard to struggle–emotionally, physically, psychologically, intellectually, financially, morally–and can drain a person particularly when the struggle is prolonged.  But asking for help and good advice is usually a good first step.  The rest is up to you.

Help! What do I do now?!

Where Are You?

At this time of year, I’d like to believe that my prospective college applicants have completed their college applications, and that private school applicants are nearly done as well.  Yet every year there is one student out there testing my limits.

I sometimes feel like the proverbial voice in the wilderness, shouting out loud and no one to hear me when it comes to that “one student”.   Where are you? I ask, more for myself to hear than for anyone else, since the student does not generally respond as quickly as expected.  It can be very frustrating, to say the least.  But I try to keep a sense of humor about it.

Many parents think of educational consultants as something like miracle workers when it comes to getting things done, particularly with students who believe that putting things off is perfectly appropriate in all situations and at all times.  And sometimes we have to think like miracle workers–how am I going to get this student’s work in on time when they still haven’t done (whatever it is)?  But we slog forward, trying to keep their eyes focused on their goals, even if sometimes it seems we do so when they are completely uninvested.  For the most part, I believe that these students do care–they just don’t understand deadlines.

I think my favorite case (like this) was a nice and talented young man who was determined to apply to an Ivy because the coach told him he was a shoo-in.  I said no, he was not.  He had good grades, but nothing that would get him there.  And the coach does not have the final say.  He insisted that he was going to get in because the coach at the Ivy said so, and therefore this was the only college to which he would apply.  I warned him, and his parents, that I would not be available during the holiday break.  The applications for the other colleges were due December 31st.  I got the phone call on December 30th that he was not accepted to the Ivy.  We spent my vacation day finishing his other applications.

To all parents, I hear your pain.  I feel it, too.  And to all the would-be applicants out there, Where are you?  This is your future.  Make it count.

Where Are You?

Not My Child

I have felt my heart break a lot lately, reading obituaries and front page (and back page) headlines about individuals struggling and dying from opiate addictions.  In this day and age, while we acknowledge that there are addictions, and we even use celebrities as examples of successful or not pictures of addiction (think of the differences between Robert Downey, Jr. and Amy Winehouse), we still turn a blind eye within our own households.

Not my child!

But the fact is that anyone–anyone–can become addicted to opiates.  The gateway drug is not marijuana, as many folks would like to think, but cigarettes.  But even these bad habits cannot explain how individuals morph from an occasional toke or an occasional drink of beer to a full-on addict.  The reasons are complex, but a few pop to mind.  Our world does not provide the kind of security our parents knew.  A job can be lost in a heartbeat, so having that college degree does not guarantee employment anymore.  We are lost in a digital world, with little personal contact or communication, and even that in sound bites (are you not reading this on-line?).  We are polluting the Earth, and everyone is fighting over whose fault it is rather than remediating the issues.  Ethnic and racial and gender issues fire up because some folks fight hard to avoid recognizing the rights of The Other. Terrorism and wars are like a black plague, spreading everywhere so that nowhere is truly safe.  Public schools have become a breeding ground for confusion rather than for education as test taking is more imperative than knowledge or skills training.  The rich are becoming obscenely rich while many working families cannot afford decent healthcare.  Etc., etc., etc.

Addiction is sneaky.  It is insidious.  It ravages the brain’s ability to distinguish between what feels good and what doesn’t.  It arouses centers of the brain to the point where the individual cannot feel joy anymore–and they keep trying to reproduce that first high, but they cannot.  It is a mad carousel of chasing something you cannot catch, while knowing the whole time that nothing else will ever feel “right” again.  It does not just cost money, it costs lives–the lives of the addicts as well as those around them.  Their families, their co-workers, their fellow students, their neighbors, their friends.  It does so mercilessly and ceaselessly.

And it can happen to your child.

Even if we argue, conversely, that the world has never provided easy answers, that there have been and likely always will be wars, that economies crumble and rebuild, etc.–each individual experiences the world as an individual.  What is easy for you may be very difficult for someone else, and vice versa.  What is peaceful and stress-free to one is not to someone else.  Parents and caregivers see the world through their own lens, as do their children–we do not see things the same way as someone else!  Your child may be naturally resilient, or naturally anxious, whereas you may be the opposite.  Whether or not you have struggled with addictions does not mean that your child will or will not.  Not only that, for those who have struggled with addiction, the nature of your child’s potential addiction will be different from your own, so you cannot draw black and white assumptions about their drug of choice, the intensity or duration of their addiction, or even whether or not they will survive it.  That is why addictions are so scary–they can happen to anyone.  They do not always present in exactly the same way or for the same reasons for the same type of personality.

And it can happen to your child.

Have frank and open discussions with your child(ren) about substances.  If you do not know what to say, there are many resources.  Below are some resources.  Most importantly, do not make the assumption that so many parents/caregivers make: that if you love them enough, they will stop/change/improve.  Outside help is necessary when the “one time” becomes once a week or once a day or when the individual is stressed/depressed (as in, they are now self-medicating).  You may begin by placing their child in intensive outpatient therapy–but at least begin!  Just remember that the younger a child is when they begin using any substance (think underdeveloped brains!), the more likely they are to develop addictions and/or to experiment with more deadly substances like opiates and develop addictions that way.  There are wonderful therapeutic and rehabilitation options out there that can help when the use becomes routine.  Do not wait until things spiral out of control.  Ask for help!

And believe it: it can happen to your child.

https://www.na.org/

https://www.aa.org/

https://www.sevenchallenges.com/

http://www.drugfree.org/wp-content/uploads/2014/05/How-to-talk-to-your-kids-about-drugs-if-you-did-drugs.pdf

http://medicineabuseproject.org/assets/documents/parent_talk_kit.pdf

http://www.drugabuse.gov/publications/marijuana-facts-parents-need-to-know/talking-to-your-kids-communicating-risks

Not My Child