Invisible Girl (Book Review)

Mariel Hemingway grew up feeling invisible, and now she's written a book with Ben Greenman to share her story with teens called Invisible Girl, (Regan Arts, 2014). She was born in 1961, a few months after the death of her famous grand father, writer Ernest Hemingway. That's just the start of her complicated family.

In Hemingway's family, she grew up dealing with her parent's alcoholism, OCD, and depression. Her mother became frail with cancer and dependent on Mariel. Her parent's marriage was full of conflict. She has memories of hearing them argue and fight intensely. She'd wake up and clean up all the broken dishes after their late night drunken tussles. Mariel was the youngest of three daughters, and both older sisters had mental illness. (Later in life, older sister Margaux, an actress, also died by an intentional drug overdose, just one day before the anniversary of her grandfather's suicide.)

The book is written like a diary in the voice of young Mariel as she observes what is going on in her family, and attempts to make sense of it. She includes "things to think about" at the end of each section for teens who may be reading it. Growing up in the small town of Ketchum, Idaho, Mariel often found solace and comfort by going outside into nature. The book has suggestions for teens on how to cope in positive ways with family problems, including talking about your experiences with someone you trust.

All the concepts in the book are put into teen-friendly terms. It's a short read of just 176 pages, with sketches and self-care tip lists in each chapter.

When children grow up with alcoholic parents, they adapt in different ways. Mariel became the "parentified" child, often cleaning up after her parent's drinking bouts and caregiving for her ill mother. The concept of growing up feeling invisible is an apt one. It's tough to grow up in a home where your development is overshadowed by parent's problems like substance abuse, a high conflict relationship or mental illness. Young people can see themselves as supporting cast to the family drama.

Learning to tell your story and have it validated by someone you trust, and to learn to do self-care are steps to becoming visible. This is a simple little book about some important subjects that don't often get talked about with teens. Hemingway's tone is kind and caring, and she carries credibility for having lived through family issues and becoming a happy, well-balanced adult who still finds her comfort in nature.Young people can feel less alone if they know that others are dealing or have dealt with similar family issues. Hopefully, Hemingway's book can reach girls and help them process difficult family dynamics and begin to consider their own needs.

The Importance of Play

Over the last 50 years, children have lost a great deal of their free time for self-directed play and free time. Psychology researcher Peter Gray from Boston College has studied this cultural shift in the U.S., and is an advocate for the benefits of play. Gray has written, "Free to Learn: Why Unleashing the Instinct to Play Will Make Children Happier, More Self-Reliant, and Better Students for Life".

I can remember spending many summers swimming, playing with my neighborhood friends, and riding my bike until dark. Those are some of my fondest memories. In the 1960's, most American neighborhoods were full of children outside, engaged happily playing. Over the last 50 years, fewer children are outside, and more parents have children involved in structured after school activities, sports, and lessons.

The school day and school year is longer. Homework is more intense, even in the very early grades. There is pressure on children and teens to build their resumes, rather than "waste" time with friends.

Many parents are fearful about having children play in the neighborhood. Safety concerns have trumped the need for free play. Most American children have lost the chance to play at something creative that doesn't involve adults or uniforms.

Play, according to Gray's research, is a biological and evolutionary need. Most animals play as babies. They learn about the world this way, as well as develop muscle strength and agility, social skills, and risk taking ability.

Virtually all cultures have their young learn and develop through play.

Gray has identified higher levels of anxiety and depression in children who don't get enough free play. I have a number of children I've seen for child counseling who long for more unstructured free time. Children and teens can get stressed. They need to relax with play frequently for optimum mental health.

Parents need to not over plan and over schedule. While some structure is good for children, such as bedtime and meal times, too much structure is overkill. Remember that for most children, the amount of time they have during the school day to free play--- recesses and lunch--- have been cut way back from what we experienced growing up.

Adults also need to play. Having a hobby that you can lose yourself in is good for us. There is a natural, hypnotic state that our mind goes to when we are playing with gardening, art, hiking, baking, or any other activity we love.

I like to see couples cultivate joint play activities into their relationship also. It's important for couples and families to play together. With couples, playing together elevated the relationship from all business and task-sharing, and helps you associate your partner with play and joy.

When I am counseling families who are healing from loss or trauma, I often want them to begin to play again. This signals to the children that life is not over, and that there will be happier times ahead, despite the death of a family member or the loss of divorce.

Play needs to be taken more seriously. Summer is a perfect time to start building some free time for play in your life, and seeing that the young people in your life get time to create self-directed play as well. Play helps us be happier, more relaxed, self-directed, and less moody. Let's play!

Running From Crazy

Last week, one film at the Irvine International Film Festival really captured my interest. The film is "Running From Crazy," and it is about actress/author/model Mariel Hemingway. She is the granddaughter of famed American writer Ernest Hemingway. Her grandfather fought depression, chronic pain following a near-death plane crash, alcohol abuse and finally committed suicide in 1961. There are 6 other suicides in the family history, including Ernest's father, two of his brothers, and Mariel's sister Margaux. That's quite a gene pool to inherit.

This film is beautifully made by Oscar winning director Barbara Kopple. It also showed at the 2013 Sundance Film Festival. It is an honest film about inheriting genes that carry mental illness and a tendency for substance abuse, and using your own personal power to keep ahead of it through education, openness, awareness, exercise, diet, counseling, being outside in nature, and getting good medical coaching. She is concerned not only for herself, but for her two daughters.

Mariel is interviewed informally in the film, sharing her own journey. She was born the same year her grandfather killed himself, but no one in the family told her the truth about it. Growing up in Ketchum, Idaho, she had two sisters. The girls were very competitive with each other. Her mother, who she was closer to, was very ill with cancer during her childhood. Her two sisters were closer to her dad, who Mariel suspects may have molested her sisters, but not herself.

Mariel had early success as an actress, starting at age 16 with a Golden Globe nomination for Lipstick, and later starring in Woody Allen's Manhattan, as well as other films. She is involved in the fitness industry, along with her current partner.

The film explores the "Hemingway Curse" of the legacy of the Hemingway family. Despite Ernest Hemingway being one of the most respected American writers, with a larger-than-life machismo persona, he was actually a very troubled soul. He had multiple marriages, estranged relationships with his children, and deep depression that he self-medicated with alcohol. Mariel says that her grandfather's wife at the time of his death in Idaho explained the death as an accident to the family. It was not.

In the film, Mariel is shown in the activist role she plays for a large suicide prevention organization, where she gives speeches about the need for awareness of the symptoms that a friend or loved one may be considering suicide. In 2009, suicide was the 10th leading cause of death in the US. It is more common in men than in women. Other risk factors include previous attempts, family history of suicide, physical or sexual abuse, guns in the home, chronic pain, family history of substance abuse or mental illness, and family violence.

"Running From Crazy" is an excellent film that helps us consider using our own power to manage our lifestyle and minimize the stresses that might turn risk factors into risk. Whether there is a history of anxiety, depression, suicide, or alcohol/substance abuse in your family, you still have the opportunity to be aware of the history, but do everything in your power not to succumb to it. You can't choose your family or the genetic predisposition, but you absolutely reduce the risk through awareness, education, avoiding alcohol and drug use, exercise, counseling, strong relationships, and good medical advice. Running from crazy? Aren't we all?

Children of Divorce

Children whose parents divorced are affected by that loss, and for a longer time than people often think. This was among the findings of a pioneer research psychologist, Judith Wallerstein, Ph.D., who passed away in June 2012 after making significant contributions to the research of mental health concerns for families and children after divorce.

Wallerstein wrote 60-70 journal articles and 5 popular books on the topic of helping families and children after divorce, several with her co-author Susan Blakelee, including The Unexpected Legacy of Divorce (2000), What About The Kids? (2003), and Second Chances:  Men, Women, and Children a Decade after Divorce (1989).

Wallerstein was the lead researcher on a 25-year longitudinal study on the impact of divorce on children. She followed 131 children from 60 families in Marin County, California beginning in 1971. She met and assessed the children again every 5 years for 25 years. Wallerstein has been criticized for not having a control group of children whose parents didn't divorce, as well as for not having a larger sample size.

Despite these critiques, she really did contribute to the knowledge base of mental health professionals and influenced changes in family law and custody in order to try to better meet the needs of children. She taught for over 30 years at UC Berkeley in the Social Welfare program. She lost her own father at age 8 from his early death, perhaps stirring her interest in the profound impact of parent-child bonds and attachment.

Wallerstein was a pioneer in the early 1970s, as the divorce rate in the US was climbing, to begin to shift the focus to how this change was impacting the children involved, and what parents can do to minimize that impact, rather than increase the damage. Here are some important points from her life's work that Wallerstein leaves as a legacy:

1.      Parents divorcing is a significant and generally long-lasting loss for children.

2.      Grief impacts children differently, depending on their age and emotional maturity at the time of the divorce. The loss issues experienced by children can reappear at later watershed points in a child's development, triggering more feelings long after the divorce.

3.      One of the great risks to children is the alienation or abandonment by the father, emotionally, time-wise, or financially becoming disengaged.

4.      Both parents need to work through their own issues of loss, anger, resentment, etc. about the break-up of the marriage to avoid poisoning the children with the adults' feelings. I always recommend that divorcing parents work out their own feelings in personal therapy, or a divorce recovery program for this reason. Your children, no matter what age they are, cannot be your listeners to bad stuff about their other parent. It's not fair to put them in that position.

5.      Parents dating again, remarrying, and blending together families is challenging, and needs to be handled with a great deal of sensitivity and thought. Step-parents shouldn't be asked to replace parents where the parents both exist, they are simply another adult who should love the child, and leave the discipline to the biological parents. It takes a really mature grown-up person to love someone else's child. (Screen carefully!)

6.      Children of divorce can be vulnerable to depression or worry. They can feel especially concerned that they not experience a divorce in their own life as an adult. Parents should be watchful and get professional counseling support for the child if it is needed, to work through the child's grief.

7.      Each child has their own grief process about their parents’ divorce, independent from what the other children are feeling.

8.      The transitions back and forth between the parents' households often stir up feelings for children and teens. Many teens resent the impact on their own life with packing up and changing houses.

9.      Custody arrangements need to be revisited from time to time to make sure they are still working for the child or children involved.

10.  Children often later resent a parent who ruined their relationship with the other parent. While a child may initially join with a parent by fusing with what the parent is feeling about their former partner, this usually backfires down the road.

I had the pleasure of hearing Wallerstein present her findings at a conference for mental health professionals 20 years ago at UCLA. She was bright, caring, and deeply devoted to helping families through the divorce process and on to healing.

Judith Wallerstein was an important pioneer researcher about the impact of divorce on children and families, and got mental health professionals and parents thinking about the longer-term picture. While Wallerstein sometimes got criticized for her research methods or for her comments about questioning the necessity for the increasing divorce rate, ultimately she had the best interest of children at heart. Children are often the most impacted in a divorcing family, and their developmental and emotional needs should be at the center of every decision that is made. After all, the divorce wasn't their choice.

Good Mood Basics

How are you sleeping? How are you eating? Do you exercise?

When I am concerned about a client's anxiety or depression, these are some of the first things I want to know. If you are not sleeping or eating well, it can make your mood problems much worse. Exercise is a wonderful, natural mood stabilizer.

Sleep is a huge issue for most people in modern life. A number of studies show we still need as much sleep as our great grandparents did in 1900, but we get much less. We also sleep less than people did in 1950.

Many teens are especially short of sleep. Teens have major changes going on in their bodies, and need more sleep than adults. It doesn't help their moods when teens are overtired. Many teens are up past midnight on school nights, and then have a very difficult time getting up for school in the morning. Many teens send and receive text messages late into the night.

Sleep researchers recommend we gear down our brains in the last hour or two before bedtime. There are physiological challenges that we get from the impact of computers and television in the pre-bedtime hours. The light from each of these technologies can activate our brains, and make it harder to fall asleep.

Experts suggest that we downshift in the last hour before bed by doing something quiet, like reading, talking with someone, or listening to music. A relaxing shower or bath could also set the stage for a peaceful entry to sleep. Lowering the light intensity in the room during the winding down time period can also help ease sleep.

Good sleep hygiene also includes keeping your bedtime and waking time as consistent as possible, 7 days a week. Big variations in either time frame can mess up your sleep cycle. Getting into a good sleep pattern will help your mood. If you have trouble staying asleep, don't lie in bed tossing and turning. If you can't get to sleep after 20 minutes or so, get up, change rooms, and do something quiet, like reading until you feel sleepy. Go back to your bedroom when you are tired. We want to associate the bedroom will peaceful sleep. This is why it's best not to study or keep a home office in your bedroom.

What about stabilizing your mood with good nutrition? Many people skip breakfast, and begin their day with nothing in their stomachs. Other people skip meals. We do best with something nutritious every 3-4 hours. If you have a busy day planned, pack up some portable healthy snacks and take them with you to work or school. You can also stash some snacks in your car trunk.

Many teens eat no breakfast, and then skip lunch at school. If your teen has a tendency to do this, you may want to take them grocery shopping with you to pick out healthy, portable options. You may also want to make the 3:00 or 4:00 time frame the main meal of their day, as it is when many teens are at their hungriest.

If you are not sure what you should be eating, or what number of calories you should be eating, even one session with a good registered dietician can be extremely informative and helpful. My favorite dietician is able to help you make a grocery list of snack and meal items that fit your lifestyle, and are easy. Eating well can help reduce anxiety and depression symptoms.

Limiting your intake of alcohol and caffeine is also key to stabilizing your mood. Alcohol is a depressant, which can make depression worse and complicate any medication you may be taking. Caffeine is a stimulant which can make an already anxious person more anxious, and interfere with your sleep cycle. Limiting sugary foods will also help you get off the mood roller coaster!

For my patients that are anxious or depressed, I also want to make sure that they are exercising if their doctor has given them clearance to do so. It's amazing what a 30 minute walk a day can do to increase endorphins, and give people a needed mood boost. It can also help you sleep better.

Feeling bad? Start with the basics of sleep, eating well and exercising regularly. They are simple ideas, but they each have a huge impact on how you are dealing with your emotions, relationships, and life challenges. If you need more help, consult a good therapist who does cognitive therapy to reduce depression and/or anxiety symptoms.


  

Most Effective Treatment for Depression and Anxiety

Signs of depression or anxiety are often concerns that bring people to meet with a therapist.You may be having sleep difficulties, either getting to sleep initially, or waking up in the middle of the night,and not being able to get back to sleep, or sleeping more than is normal for you. Perhaps it is hard to concentrate at work or school.You may notice that you are not looking forward to anything or not enjoying life as much as you used to. Gaining or losing weight, or having difficulty relaxing, could also be indicators.

In the July,2010 issue of Consumer Reports there is an article with survey results of their readers who have sought professional help for depression or anxiety. Here is a summary of their survey results from consumers:

1.Talk therapy helps.Those people who did participate in at least 7 sessions had as much improvement as those who took medication.Those people who did both talk therapy and medication did even better.Almost always, talk therapy is a good place to start, and that therapist can refer you on for medication if you are not improving after a few weeks.

2.Cognitive behavioral therapy is the best treatment of depression, anxiety, and those who have a mix of the two. CBT teaches you to retrain your thoughts, identify thoughts that are making you feel worse, and develop healthier behaviors and automatic thoughts.

3.Type of therapist doesn't matter. In the Consumer Reports survey, different mental health licensures( MA,PhD,MSW)all received equal helpfulness ratings.The quality of your relationship with the therapist and their knowledge of cognitive therapy and other effective methods is more important.

4.Talk therapy is a good investment in yourself. It has no side effects, and teaches you longer-term strategies for managing stressors.Individuals who stuck with talk therapy for 7 or more sessions did signifcantly better than those who went 6 or less times.

5. Some medications are better than others.Each person can react differently to medication, and side effects can occur. If medication is needed, a doctor who can closely monitor your use of it is very important.

6. Be selective in finding a therapist to treat you or a loved one. Asking other trusted medical providers, friends or family for personal referrals usually gives a better result than cold calling a therapist from the phone book.


Children can also suffer fom depression and/or anxiety, it just presents differently.
Depression and anxiety both respond well to treatment, so there is no reason not to get professional guidance. Most of us wouldn't do our own car repairs, either. I see it as a sign of strength to know what your limits are, and seek help when you reach them. You are worth it.