The Child Mind BlogBrainstorm

  • The Oregon Shooting: What's Wrong With Blaming Mental Illness
    Oct. 6, 2015 Beth Arky

    Another horrific mass shooting, another chance to place the blame. For many who are adamant opponents of gun control, that means focusing on the mentally ill. Last week's rampage at Oregon's Umpqua Community College had a number of presidential candidates and other public figures pointing to the role mental illness may have played in the devastation wrought by the 26-year-old shooter, who took nine lives before killing himself.

    As satirist John Oliver pointed out, the sudden political interest in mental health after a mass shooting is not always sincere. During a particularly apt analysis on Sunday's  Last Week Tonight With John Oliver on HBO, Oliver said, "Perhaps the clearest sign of just how little we want to talk about mental health is that one of the only times it's actively brought up, as we've seen yet again this week, is in the aftermath of a mass shooting as a means of steering the conversation away from gun control."

    Besides being disingenuous, pointing fingers at mental illness right now is dangerous, too. As Oliver explained, the aftermath of a mass shooting might be the "worst time" to talk about mental health because "the vast majority of mentally ill people are nonviolent, and the vast majority of gun violence is committed by non-mentally ill people." The reality, Oliver added, is that "mentally ill people are far more likely to be the victims of violence rather than the perpetrators, so the fact that we tend to only discuss mental health in a mass shooting context is deeply misleading."

    Not only is it misleading, it effectively endorses the stigma that keeps many people from getting the kind of care that could transform their lives. What could be a constructive conversation becomes scapegoating.

    Already this shooting has elicited an outpouring of virulent anti-autism chatter on social media, stimulated in part by the fact that the shooter's mother, Laurel Harper, has written in online postings that both she and her son struggled with Asperger's syndrome.

    During his show, Oliver cited the shocking ways the mentally ill are dealt with in this country: We've gone from asylums to no treatment; nursing homes, even for the young and middle-aged; one-way bus tickets out of town; and jails and prisons. Some 2 million people with mental illness go to jail every year, and they are estimated to be 10 times more likely to be behind bars than receiving care in a state psychiatric hospital.  

    Oliver noted, as countless families have found, that making the criminal justice system a de facto provider of services to the mentally ill isn't just ineffective, it's dangerous. "Because often, when someone is having a mental health emergency, the police will be called, and that can end tragically," he said. "By some estimates, an incredible half of all incidents involving the police use of deadly force involve a mentally ill person."

    After playing tapes of Donald Trump, Mike Huckabee, and Ben Carson calling for the need to fix a broken mental health system, Oliver summed up this way: "Fine—do it then. Because if we're going to constantly use mentally ill people to dodge conversations about gun control, then the very least we owe them is a f------ plan."

    We can only hope the time will come when it doesn't take shootings to spur this important conversation.

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  • SuperBetter, the Game Designed to Improve Your Mental Health
    Sept. 22, 2015 Rachel Ehmke

    Six years ago Jane McGonigal, the game designer and creator of several extremely popular TED talks, had what she calls a "stupid household accident" that changed her life. McGonigal knocked her head against an open cabinet door and sustained a traumatic brain injury, with effects that lasted for a full year. She was in a mental fog—unable to concentrate or remember things—and experienced headaches, nausea, and vertigo. Her doctor put her on cognitive rest to help her brain heal quicker, which meant for months she couldn't read, write, work, run, drink coffee, or play video games. "Obviously there was no reason to live," she joked to the crowd she was telling her story to at the New York Public Library last week.

    But it began to actually feel that way for her. Like many people who experience serious brain injuries, McGonigal was also feeling depressed and anxious, which only increased as she avoided doing the things that made her happy. In a vicious cycle, her doctors warned her that it would be harder for her brain to recover if she stayed feeling depressed. And so McGonigal, who has big blonde curls and was wearing sparkly tennis shoes to her speaking event, disclosed that she starting having suicidal thoughts. "My brain began telling me that I would like to die."

    Jane the Concussion Slayer

    During this time she was supposed to be writing her first book, Reality Is Broken, not that she was able to work on it. The book would argue that games make us happier, more creative, and more resilient. She was surrounded by research claiming this, so she started to think maybe a game could be the answer for her. Working in short bursts, and with the help of family and friends, McGonigal began making a game to help herself get better. She called it Jane the Concussion Slayer, in honor of her hero Buffy the Vampire Slayer. Over time her symptoms began to leave, and while she says she can't totally credit the game, she does know that her mood improved as soon as she started playing.

    She has since renamed the game SuperBetter and turned it into an app that other people can play to help them with things they are struggling with—anything from weight loss and lowering stress to mental health issues like depression or anxiety. The game isn't therapy, and shouldn't be used in place of therapy for people who have real mental health concerns. But McGonigal says it could be considered a good supplement to treatment, and anyone who has participated in cognitive-behavior therapy will see that it has some similarities.

    How the game works

    To play the game you have to identify and then battle "bad guys," or the obstacles or triggers in the way of your goal. There are "power-ups," which are specific positive things that you do to break negative cycles that you are in. For a confidence boost, players get to create a powerful secret persona—a version of yourself that is strong and capable of undertaking heroic quests. And as McGonigal wrote in her blog, "If you can't be yourself (due to your symptoms), why not be someone secret and awesome?"

    You also need to enlist "allies," which are family and friends who will help you on your quest to get better. Supportive family and friends are a big part of getting better for anyone struggling with a mental health disorder, but asking for their support as part of a game is a novel way of helping them understand what you are going through and also helps bust through some of the stigma.

    Gamers are often accused of being lazy couch potatoes more invested in an alternate reality than their own. McGonigal would contest this, and it's clear that SuperBetter requires the opposite of that mentality—to play the game you have to become an active, motivated player in your own life.  

    It seems clear that the game could have a lot of appeal for kids struggling with mental health disorders. If you are interested in checking out the game, you can download it in the app store or check out McGonigal's new book, SuperBetter, which is about the game and some of the research backing it up.  

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  • Advantage Mardy Fish: A Story of Tennis, Anxiety, and Getting Help
    Sept. 3, 2015 Harry Kimball

    American tennis player Mardy Fish ended his professional career yesterday with a loss in the second round at the US Open, sure, but he ended it on his terms. And considering that the last time he played in Flushing, in 2012, he was so consumed by his panic disorder that he has no memory of half a set against Gilles Simon and had to bow out of a career-defining match against Roger Federer, Fish has come a long way.

    What strikes me most are the particular contours of his journey—how universal they are—and what they can teach us about facing up to crippling anxiety. "This isn't a sports story," Fish writes at The Players' Tribune. "I didn't 'choke' in Act Two, and I'm not going to 'win' in Act Three. This is a life story."

    He's right—he didn't "win," or win. But that wasn't the point. "This is a story about how a mental health problem took my job away from me. And about how, three years later, I am doing that job again."

    And that process started, for Fish, with someone helping him stand outside his anxiety instead of tumbling down the path he was on. "My thoughts were filling with dread," he writes. "Would it happen on the court again? Was I going to get an anxiety attack, again, in front of thousands of people?" His wife presented an option that thoroughly escaped him at the time: don't walk into a setup. "You don't have to play," she told him. And he didn't—but he did begin working towards playing again one day.

    The first step towards taking back "the things that mental illness takes away from us," as Fish puts it, is recognizing what's going on, and then working to address it. When a kid has severe performance anxiety, the first step in treatment is not to...throw him under the lights at Arthur Ashe against Roger Federer, to pick a random example. One step at a time, Fish writes. "Addressing your mental health is strength. Talking about your mental health is strength. Seeking information, and help, and treatment, is strength."

    That's a great message, no matter the size of the stage, and we're happy that Mardy Fish isn't dropping the ball, as it were, and is "keeping the conversation going, and going, and going."

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  • Cook County Jail's New Warden Is a Psychologist
    July 30, 2015 Caroline Miller

    There's an excellent story in the New York Times today about Dr. Nneka Jones Tapia, the clinical psychologist who is now the warden of the Cook County Jail in Chicago. Her hiring underscores vividly the fact that American prisons have become de facto mental hospitals—but largely without appropriate care and treatment. 

    Dr. Jones Tapia is trying to do something about that, with comprehensive mental health screening for inmates and a pioneering transition program that is reducing recidivism. In the program, inmates receive cognitive behavioral therapy and job readiness skills to help them avoid getting into trouble again after release.

    Sheriff Thomas Dart, who appointed her to the post, tells the Times reporter that as many as one-third of the jail's 8,600 inmates are mentally ill. And he explains why many of them should not be locked up, in terms we couldn't agree with more:

    The person isn't choosing to be schizophrenic. The vast majority of mentally ill people are here for nonviolent crimes, like stealing food to survive or breaking into places, usually looking for somewhere to sleep, or getting caught with drugs because they are self-medicating. How is it different than us locking up diabetics?

    Indeed, until we treat mental illness the way we treat diabetes, and get care to kids and young adults before they run afoul of the law, there will be a steady stream of the mentally ill behind bars, and it will continue to be, as Sheriff Dart says in the article, a national disgrace. 

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  • Chirlane McCray's Initiative to Connect New Yorkers to Care
    July 30, 2015 Caroline Miller

    New York First Lady Chirlane McCray has announced her new program, called Connections to Care, aimed at making mental health care more accessible to more low-income New Yorkers.

    The $30-million program includes two initiatives we applaud: to add mental health services to existing community agencies that currently don't offer them, and to train more people, from pre-school teachers to job-placement counselors, to recognize signs of things like depression, anxiety, and substance abuse.

    In the New York Times story about the plan, Gabrielle Fialkoff, senior adviser to Mayor Bill DeBlasio, says something revealing about the work that needs to be done to make mental health an ordinary topic of conversation. People with mental illness, she notes, are most likely already encountering people who could potentially help them. But unless we combat the stigma and misunderstanding about mental health, we would add, people who are struggling aren't likely to be open about it.

    The bottom line: Expanding access to care also has to include making people feel more comfortable asking for help. 

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  • Problem Solving, Not Suspension, Sets Kids Up for Success
    July 7, 2015 Caroline Miller

    An excellent piece in Mother Jones this month drives home the point that using suspensions to punish kids who have behavior problems in school doesn't help them learn how to control their behavior. What it does is channel them into the "school-to-prison pipeline." 

    A 2011 study of the records of nearly a million kids found that those suspended or expelled—even for minor infractions like small scuffles, using phones or making out—were three times as likely as other students to end up in the juvenile justice system within a year. And kids with diagnosed behavior problems like ADHD are the most likely to be disciplined.

    As the writer, Katherine Reynolds Lewis, asks: "Are we treating chronically misbehaving children as though they don't want to behave, when in many cases they simply can't?"

    The article chronicles successes in schools that have reoriented their disciplinary approach to helping kids solve their behavior problems instead of punishing them. By recognizing that many kids are struggling with anxiety, learning disabilities, ADHD, or trauma, school staff can help kids identify why they are acting out and teach them techniques to manage their emotions more effectively.

    Problem solving strategies are being tried by several hundred schools around the country, from public and private elementary schools to juvenile detention centers. One youth correctional center in Maine found that not only did disciplinary write-ups and injuries of both students and staff decline dramatically; the recidivism rate also dropped from 75 percent to 33 percent. 

    That's what Ross Greene, who pioneered this skills-based approach, sees as the big win: not just to reduce behavior problems in school, but to set kids up for success on their own. 

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  • What Kids (and Parents) Will Learn From 'Inside Out'
    June 23, 2015 Harold Koplewicz

    What's going on inside the brain is a mystery to many of us. The brain doesn't come with an owner's manual, and it's up to each of us to figure out how to work with what we've got. Learning how to navigate our emotions is one of the major lessons of childhood, in fact, and something that nearly all children struggle with at some point. So I was overjoyed to see Disney's latest Pixar movie, Inside Out, which takes place almost entirely inside an 11-year-old girl's brain. For all of the criticism directed at the movie industry for its questionable moral standards, Hollywood is at its best when it creates compelling, engaging content about complex topics. Inside Out does exactly that.

    The movie is about a girl named Riley who moves from Minnesota to San Francisco because of her dad's job. Moving is hard for everyone, but for a child a change like that can feel catastrophic—Riley is leaving behind her house, her friends, her hockey team, even the pond where she skates every winter. We see Riley and her parents struggling to adapt to their new surroundings, but in a novel twist the characters getting most of the screen time in Inside Out are Riley's personified emotions—Joy, Fear, Disgust, Anger, and Sadness. We watch as her emotions try to run the control center in her brain—they call it Headquarters—and see the chaos that ensues when different emotions take over. Part of the charm of the movie is that it takes some of the mystery and fear out of our emotions and imagines what a stressful moment might look like inside our brains.

    Kids will enjoy the movie, which is partly an unlikely buddy comedy and road trip starring Joy and Sadness. But if you're a parent you'll appreciate the wonderful lessons that are built into the plot. We tend to think of childhood as a mostly happy time, but of course children experience an intense range of emotions. Inside Out lets kids—and adults—know that all of our feelings are okay, even the ones that don't feel very good at the time. In fact, the unexpected hero of Inside Out is Sadness. When Riley is struggling to cope with the move everyone at Headquarters assumes that Joy will come to the rescue, but it isn't until Riley is allowed to face her sadness that things begin to improve. And perhaps most importantly, the secret to feeling better for Riley is speaking up and telling someone how she feels. For most of the movie Riley tries to be brave and hide that she's struggling from her parents, but she eventually learns that keeping her emotions hidden doesn't help.

    In the end Inside Out is a movie about growing up, too. We see the control panel in Riley's brain expand after she learns how to embrace her emotions and talk about how she's feeling. We can see that she is maturing, and ready for the new demands that she will be facing. Parents will find it reassuring and poignant. Kids will laugh at the joke about her newfound interest in boy bands and the looming prospect of puberty. With Inside Out everyone will walk away happy—but know that feeling sad is okay, too.

    Harold Koplewicz, MD, is the founding president of the Child Mind Institute. This piece was originally published on

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  • 'Infinitely Polar Bear': The Ups and Downs of a Dad With Bipolar Disorder
    June 23, 2015 Allison Baker

    The title of the film Infinitely Polar Bear comes from something funny a small child says about her father: "Dad has polar bear." What dad actually has is bipolar disorder, and while that isn't funny, it isn't tragic either in this movie that is warm and sweet as well as realistic about some of the darker aspect of life with the disorder. 

    Dad, played rather irresistibly by the cuddly Mark Ruffalo, is Cam Stuart, a blueblood Bostonian who is the principal caregiver for two adorable little girls, while their mother is in New York working on her MBA so she can get a higher-paying job. We see him in both manic and depressed periods as well as periods when he's in between, and really has his stuff together.

    In manic mode he's this fun-loving, high-energy, fast-talking, creative dad who invites the neighborhood kids to the house to jump on an indoor trampoline and listen to jazz and learn to make a chocolate soufflé. The girls are embarrassed to invite their friends over because their home is so chaotic but their friends think it's super cool; they get to do zany things and have more fun than they do in their own homes.

    When he's depressed and irritable, he sometimes uses explosive language in front of these tender-aged girls. And he sometimes goes out drinking at night leaving the girls alone—something that's nervous-making to watch and in real life could certainly get the attention of child protective services.

    You see the mixed relationship Cam has with his medication. He takes lithium—on and off, that is. This, too, is fairly typical. On medication, people with bipolar disorder can achieve mood stability—that middle ground we psychiatrists call euythmia—and stay there for years, for decades. But this is less the norm. People go through their own processes of accepting their illness and the fact that it requires maintenance, having to take medication, and having to tolerate some side effects of the medication or the euthymia you may not care for.

    It surprised me that, unlike Silver Linings Playbook,  there was no relationship with a psychiatrist in the movie—his only treatment seemed to be the lithium in the huge brown bottle in the bathroom cabinet.

    What felt most honest about the movie is that living with these chronic illnesses can be messy, and families that are loving and supportive tolerate the mess, hang in there through seasons of good and bad and in between.

    There's a sweet moment when mom is in town for the weekend and she and the older girl are talking about daddy and his illness.

    Mom says: "When we got together I didn't know about all this stuff. I fell in love with his charisma."

    Daughter asks: "Are you sorry you married and had kids with him?"

    Mom says: "Absolutely not!"

    That was a neat moment of acceptance, of someone accepting this person and loving him for all that he has to offer, his illness notwithstanding.

    Allison Baker, MD, is a child and adolescent psychiatrist at the Child Mind Institute.

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  • What SPD Is to Me
    June 16, 2015 Putting Socks on Chickens

    This is a guest post from Putting Socks on Chickens, a blog about sensory processing issues.

    By Erin

    At 18 months of age, my son starting showing signs of "odd" behavior and aggression. I heard from others "the terrible twos actually start at about 18 months." So I thought...ok, other parents go through this too! The twos came. Then we heard..."you think the twos are bad, wait till he turns three." Then, I'm thinking to myself, "oh's going to get worse." The threes came and this time others said "wait till he starts school, it'll get better then." Finally, the day for him to start school had arrived. Guess what, it didn't get better.

    It all started with my son biting his hand. He was a pacifier baby and still had the pacifier at the time this started, so I wondered what it was about. At first, I paid little attention to it, but then he started biting his hand all the time and so hard that his hand was callused. Concerned, I asked his pediatrician and she reassured me to not worry about it.  As time went on, we tried various tactics to help him break this habit. We started with ignoring it, then bringing it to his attention. We also tried wrapping it, putting a yucky tasting rub on it, and basically anything else that we could think of. To this day, my son still bites his hand.

    He also became extremely aggressive around 18 months of age. I can remember him pulling my hair with such force that I actually had to have medication because of an infected hair follicle. When he'd pull my hair, it would take both my husband and myself to get my hair out of his tiny little grasp. We would tell him no, slap his hand, time-out, all of the "parenting" recommendations. Whatever we did, he just seemed to smile, laugh and pull harder. Hair pulling soon turned to hitting and throwing things.

    As he got older and the violent outbursts continued, it prompted me and my husband to seek outside help. Starting with his pediatrician, she recommended that we see a child psychologist. After only a couple sessions with a psychologist, he suggested we have him evaluated for Sensory Processing Disorder (SPD). I looked it up after his recommendation and was in shock. This was my son. We went on to have him evaluated to find that he does in fact have SPD. While we are still learning about his condition, I most definitely am not an expert. I cannot tell you all the facts about SPD, but I can tell you what it means to me.

    SPD is never having a full nights sleep because your kid wakes up all the time. I finally gave up and let him sleep in my bed because honestly, I am too tired to get up with him every 30 minutes and put him back to sleep.

    It's not knowing what set your kid off, but being so distraught that you can't do anything because he is jumping, screaming, biting and having a meltdown. It's constantly telling him "No, don't do that. Get off of your sister!" It's a constant battle until he has overcome his "fit."

    It is having everyone tell you how wonderful your child is and how he is the best-behaved kid in class while you look at them in disbelief. And then for them to look at you in disbelief when you tell them about problems at home. It is the constant assurance from others that just don't get it, that you just need to reinforce your parenting skills. "Give him a swat on the butt. You should try watching Super Nanny. Read this parenting book. Have you tried this?"

    SPD is watching your child jump up and down and bite his hand in frustration because that wall hit him. It is not getting him to understand that objects don't hit people, that we run into them. And hitting the wall because it "hit" you is not going to make anything better.

    SPD is smelling everything. It doesn't matter what it is, if it's in the same room as him, he wants to smell it. It's dealing with those burnt chins because his need to smell the cookies fresh out of the oven is so intense. It's getting those looks from people, as if though they are saying with their eyes "what is this weird thing that your child is doing?"

    It is knowing that as soon as he is home and in his comfort zone, those underwear are coming off and making sure to ask if he has underwear on when you leave the house. It is constantly having to "fix" his glasses because they aren't fitting right and then having his 3rd pair for the year break again because he is putting them on with such force so that they will feel right. It's asking people to not buy your son clothes because he probably won't wear them.

    SPD is the constant worry that I won't be able to teach my child how to control himself and his fits will start happening in school and he will then be considered a "problem" child. SPD is the constant worry that at some point kids will start to bully him. SPD is the constant worry that I am not a good parent. It is the love of my child and his quirks. It is the joy of a great day when he can express what is bothering him with words rather than actions. SPD is a constant learning game and me taking on the role of an OT. But above all else, SPD is unconditional love and making sure my son knows that I love him NO MATTER WHAT.

    Erin is a mother of two children and part-time fundraiser for a nonprofit. Erin blogs about having a child with sensory processing issues at Putting Socks on Chickens. You can also follow her on Facebook and Twitter

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  • Celebrating Diversity at the Tony Awards
    June 9, 2015 Jessica Kashiwabara

    The biggest winner at the Tony Awards on Sunday night was diversity, as the Broadway theater's top honors went to two shows that evoke the challenges of coming of age (and in one case coming out) of people who are different. Both shows (which collected seven other Tonys between them) are brilliantly staged and acted, and neither of them is conventionally commercial fare.

    The Tony for best musical went to Fun Home, the stage adaptation of Alison Bechdel's graphic memoir about the search to understand her closeted gay father, in the wake of his suicide, as well as her own sexual identity as a lesbian.

    The Curious Incident of the Dog in the Night-Time, which won for best play, is the adaptation of the novel of the same name by Mark Haddon, which follows Christopher, a 15-year-old boy with Asperger's, as he tries to solve the mystery of the suspicious death of a neighbor's dog. Curious Incident is an exploration of what autistic activists call neurodiversity, as it moves from the neighbors' comic misunderstanding of Christopher's eccentricities to plumbing the intelligence and the courage he discovers as his family unravels. 

    Alex Sharp, an actor just one year out of Julliard who won a Tony for his portrayal of Christopher, used the spotlight to speak out to other kids: "This play is about a young person who is different and who is misunderstood and I just want to dedicate this to any young person out there who feels misunderstood or who feels different."

    Sharp ended the speech with a teaser about the play: "And to answer that question at the end of the play for you, does that mean I can do anything? Yes it does."

    Michael Cerveris, accepting the best actor Tony for playing the father in Fun Home, noted: "Our show is about home, it's about finding who you are." Cerveris added a plug for same-sex marriage, saying he hoped the Supreme Court justices were watching. But champions of diversity also have to be hoping that other theatrical producers were watching, and gaining encouragement for what Variety called "opening up Broadway to greater diversity in both form and subject matter." 

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