The Mental Emotional Health Blog

Conduct Disorder is an interesting diagnosis for those of us that work with children and adolescents. Within the field of mental health, I have heard Conduct Disorder referred to as “the toughest diagnosis to work with for kids”, and “it’s just a catch-all diagnosis for misbehaving teens”. That’s quite a range. I am glad to be able to say the majority of colleagues I work with and worked with in the past emphasize the person over the diagnosis.

Destruction, aggressive speech and actions, frequent dishonesty, indifference to discipline, and breaking rules or laws are typical characteristics. As a clinician, I think the defining characteristic is lack of empathy and remorse. Most kids and teens get into a little trouble, or are defiant at some point. Those with Conduct Disorder go beyond isolated incidents and do these things often, and often ignore or minimize the emotional (or physical) pain caused to others.

When I work with kids and teens who have been diagnosed with Conduct Disorder, I try to speak in a matter-of-fact manner. I do that in order to remove my emotions from the conversation, since those that meet criteria of Conduct Disorder often tend to feed off of others’ feelings despite seeming to not care about them.

WebMD has a good summary of this difficult condition. Here is a link to info on Conduct Disorder at WebMD .

I would estimate in my practice that at least 50% of my overall time working with adults as therapist has been offering advice on how to deal with, or helping “clean up” the emotional messes inflicted on my clients by, toxic personalities. Some people are just chronically not nice.

So in my almost-daily skimming of a few sites for good articles, I ran across this one from Shine (Yahoo): 8 Toxic Personalities to Avoid by Brett Blumenthal (I also recommend her blog at Brett’s Blog ). She does a nice job of being specific and explaining why each personality is toxic.

Knowing what to avoid successfully in life is as important as finding your direction and purpose.

Have a great day everyone!

Devin

I thought of this idea for a blog entry a while ago. I’m not sure if it would even be interesting to any of you, but here it is.

It may be obvious, but a therapist experiences several emotions during each client session. Some therapists might deny that or not be aware of it, but it is definitely true for me. So I made some mental notes during a session with one of my regular clients, focusing on the different emotions I was experiencing during the conversation. After the session, I completed the list and it surprised me. These are all from one 50-minute session:

• pleased
• thankful
• curious
• confused
• confident
• tentative
• apprehensive
• anxious
• concerned
• content

With some of these feelings, I was mirroring the emotions I sensed from the client. Other times, they were just my emotional reactions to what was being discussed. In any case, it shows that therapists go through a range of emotions just like clients do.

An important perspective I learned in graduate school that I still hold to today is this: if showing your emotions will help the client then let them out; if not, keep them to yourself. (At least until later, when you do need to deal with your emotions wherever they came from.)  As a therapist, it is crucial to realize that the point of therapy is to experience and use emotions productively. The point is not to get to a “level of maturity” that is emotion-less.

By the way, the client felt better at the end of the session that day than when we started. I felt better later after I processed my own feelings. 

When things happen, it is almost automatic that you react. But if you overreact often or find yourself worrying about an event for long periods of time, there are a few ways to think in order to keep perspective and keep anxiety manageable.

When an unpleasant event happens:

1. Take two seconds before you react, and decide if it is a reaction you feel okay having. (This allows your rational mind to keep functioning, and avoids an emotional or impulsive reaction).
2. Take two more seconds and consider a likely consequence to your reaction. 
3. Take one minute (either right away or later that day) ask yourself what you can do now to move on from the event. The longer you mentally stay stuck in the moment and dwell, the tougher it is to let it go.
4. If you feel worried about it and expect to keep feeling that way for days, allow yourself a specific amount of time to worry about it. (Example: I’m worried about something next week. I will worry all I want for 30 minutes a day, and no more.) It may sound silly to put a time limit on it, but people sometimes allow worry to continue on and off most of the day and night and end up feeling more worried or depressed as a result.
5. Let it go through exercise. Good for your health + Good body chemicals released during exercise = Feeling better
6. Let it go physically and mentally. Take a pen, hold it in front of you, imagine all of your worry flowing into the pen from your mind, and then let the pen drop to the floor.
7. Get good, quality rest.

Today, I want to draw attention to a recent weekly column by family psychologist John Rosemond. He has a great website about traditional parenting, is a sought-after speaker, and is a syndicated columnist appearing in about 250 newspapers in the United States.

His parenting positions are based on common sense and tradition, and he isn’t afraid to be provocative. Actually, I could correct that to say that he can be very direct and many in the U.S. find that provocative when it comes to parenting concerns and beliefs. I personally like being challenged to consider different intellectual topics so I have spent some time considering his parenting column from last week.

The link is here, and is worth reading if you are a parent or guardian:  Living With Children. I initially bristled at his challenging of the idea that high self-esteem in children is good. As I read the rest of the article, I came around to agreeing with his point. Teaching a child to respect others is more important than teaching them to have high self-esteem. That doesn’t mean children should have no or low self-esteem, it’s just that minimizing respect for others in favor of self-esteem is a poor parenting choice and could be socially dangerous. Remember that children are forming beliefs that will stay with them for a long time, possibly for the rest of their life. Respecting other people should be emphasized. This makes sense to me as a therapist and as a parent, and I endorse Mr. Rosemond’s perspective on it.

Have a great week everyone!