http://www.huffingtonpost.com/jane-shure/lessons-from-my-life-as-a_b_732616.html

The recent U.S. Senate decision to pass a resolution naming September as National Childhood Obesity Awareness Month, gives this former fat kid much reason to pause and question. Hailed by many as a significant step forward, there are many out there who have good reason for concern. As I and any other person who has lived childhood as a fat person knows, being singled out and made to feel bad about oneself, erodes self-esteem and promotes inner criticism - two ingredients that harm far more than they could ever help.

The Association for Size Diversity and Health (ASDAH) http://www.sizediversityandhealth.org/content.asp?id=34&category=Children/Teens# results urges all of us to caution, encouraging us to take a less divisive and more positive approach to childhood physical and mental health. Their concern is that the process of singling out fat children further stigmatizes kids that are already marginalized. Citing research findings in the Journal of the American Medical Association and Lancet, a British medical journal, they suggest that despite significant cost in time and resources, there is little evidence that the current efforts focused on childhood obesity have any positive effect on children’s health and well-being. ASDAH, A Chance to Heal, http://achancetoheal.org/our_foundation.html and many other groups and individuals, worry that the well intended efforts of mandatory screening, reporting of children’s BMI (Body Mass Index), banning of “junk food” in school cafeterias, and promotional campaigns emphasizing the dangers of excess weight, are actually doing more harm than good.

As I know from my over thirty years as a psychotherapist with expertise in eating disorder treatment and prevention, worry over weight, shape, and appearance puts one at risk for developing unhealthy weight control practices and strengthens negative body image. Chevese Turner, Founder and CEO of The Binge Eating Disorder Association says that “we have seen evidence that this sort of intervention sets children ever earlier on the road to yo-yo dieting, poor body satisfaction, low self-esteem and disordered eating.”

I have often wondered how I was spared from developing an eating disorder. As a fat kid needing to shop in the “chubby department” (yes, that’s what it was called in the late 50’s and 60’s) I knew that I was different from my friends. I also knew that it was painful for my mother (a fashionista in her day) to see her daughter have few clothing options to select from - yet she kept her mouth zipped and never said a disparaging word. As a mother of two grown daughters, and a therapist specializing in boosting women’s self-esteem and leadership, I know that my mother’s willingness to hold her frustration in check and refrain from expressing criticism, saved me.

I also know that I was most fortunate in that I didn’t have to endure the humiliation of someone calling out my weight for all of my peers to hear, and that I was  protected from experiencing the shame of a letter sent home proclaiming me with an official stamp, confirming my status as “unacceptable.” I was left to my own internal voices, none of them armed with the hurtful words of people who mattered to me.

Concerns about obesity are real, as are concerns about eating disorders. What I know from arming people with the tools to change their lives, is that shaming children never helps. Emotional humiliation causes human beings (child and adult alike) to freeze up internally, shut down self-compassion and run for whatever substance or behavior will help us numb out. Now that we do have a National Childhood Obesity Awareness Month, let’s use it to think outside of the box and find better ways to empower our kids and families.

For more info of these issues, see http://janeshure.com/blog & http://selfmatters.org

Author of Can Preschoolers be Depressed? Pamela Paul, speaks to the complexities of diagnosing depression in young children. She says that while there are many reasons for refraining from categorizing developing children, it is useful to know that there are interventions that might help.

Having over fifteen years of experience using EMDR for treating symptoms of mood, spirit and body, I absolutely believe that there are creative approaches to activating the brain’s neuroplasticity during the early years - in such ways that may offset the neural tendencies that direct depression. Paul points out that “the brain literally changes course when you prod it in a given direction,” and it does. May we derive some hope here that as we continue to learn more about the healing powers inherent in the brain, we come to discover new ways to empower children and their families.

Here are some exerpts I found of interest:

• “Depression was originally seen as an adult problem with origins in childhood, rather than something that existed in children. The psychoanalytic view was that children didn’t have the mental capacity for depression; their superegos were not sufficiently developed.”
• “One of the most important mental-health discoveries of the past 10 to 20 years has been that chronic mental illnesses are predominantly illnesses of the young,” says Daniel Pine, chief of the emotion-and-development branch in the Mood and Anxiety Disorders Program of the National Institute of Mental Health. They begin when we are young and affect us, often profoundly, during the childhood years, shaping the adults we become.
• Controversy over whether major depression could occur in teenagers, something we now take as a given, persisted until the 1980s. First adolescents, then grade-school children were considered too psychologically immature to be depressed. Stigma was a major fear. “There was this big worry that once you labeled it, you actually had it,” explains Neal Ryan, a professor of child and adolescent psychiatry at the University of Pittsburgh. By the early 1990s psychiatrists had come to recognize that depression occurs in children of 8, 9 and 10.
• Still, in 1990, when Luby first broached the subject of whether children could be depressed even before they entered school, her colleagues’ reactions ranged from disinterest to hostility. Then in the late ’90s, the study of early childhood entered a kind of vogue among academics and policy makers. This was the era of President Clinton’s White House Conference on Early Childhood Development and Learning, and there was a wave of interest in the importance of what was termed “0 to 3.”
• “We realized, Gee, maybe we better look more carefully at preschool, too,” Pine says. “And that’s where we are today. The issue of diagnosis of depression in preschoolers is being looked at very carefully right now.”
• Diagnosis of any mental disorder at this young age is subject to debate. No one wants to pathologize a typical preschooler’s tantrums, mood swings and torrent of developmental stages. Grandparents are highly suspicious; parents often don’t want to know.
• Some in the field have reservations, too. Classifying preschool depression as a medical disorder carries a risk of disease-mongering. “Given the influence of Big Pharma, we have to be sure that every time a child’s ice cream falls off the cone and he cries, we don’t label him depressed,” cautions Rahil Briggs, an infant-toddler psychologist at Children’s Hospital at Montefiore in New York.”

To read the entire article on NYTimes, click here.

http://www.huffingtonpost.com/jane-shure/reflections-on-the-doctor_b_680001.html It’s complicated.

The relationship between a therapist and patient — it’s really complicated, as is the journey to healing our childhood wounds. Last week, in the New York Times Magazine, Daphne Merkin self-disclosed of her life in therapy, opening us to a much needed public dialogue.What helps one person deal with their inner life may not be effective for another person. We do not conform to cookie cutter categories — we’re diverse. Such is the case when one considers the best way to approach psychotherapy. There isn’t only one way to do it and there isn’t necessarily a “best” way. Certainly, the field has evolved significantly over the second half of the last century, providing ample evidence that there are many ways to achieve deep levels of change and increase satisfaction in the life one lives.

Merkin’s article reminds me of how the psychoanalytic approach to healing “neurosis” and other “maladies” of the psyche can be limiting and risk leaving patients more vulnerable to having the self disregarded, even rejected. Steeped in the belief of therapist neutrality and the need for relational distance, the traditional model doesn’t hold up for most of us living in the twenty-first century.

Far beyond the issue of “who has the time or money required for several days of analytic treatment,” is the recognition that people change within the context of feeling connected to a real person and when they have experiences that challenge their belief systems. I was disheartened to read that the author was never told about her therapist’s cancer, thereby never able to say goodbye or get any sense of “closure,” and disturbed to know that she was never given permission to leave therapy. These actions are certainly not unique to those practicing in the analytic tradition, but they are more common in the hierarchical structure of the analyst-patient relationship.

I remember years ago having lunch with a good friend who revealed how strange and off-putting he found his former therapist’s unwillingness to share anything about herself, such as where she was going on vacation. I was struck by the irony of how the distance maintained by the therapist created a sense of alienation rather than one of connection, and wondered why that type of therapeutic approach continued to be promoted in psychotherapy training at the time. For me, it was one of many moments in my professional development when I paused to take in the feedback from a person in the patient position, feedback that has often been discrepant from the feedback given by those of us in the so-called “expert” position. We’ve come a long way since those days close to 20 years ago, but reading Merkin’s article, I’m saddened to say, reminds me of how much further we have to go.

I believe it’s authenticity that heals us. When we can be ourselves, supportive of our strengths, and accepting of our shortcomings, we grow in self-confidence, engage in more healthy relationships, and overall, feel better about ourselves. As a therapist, I’ve had to seek coming to know my own authentic self, questioning the rules and wisdom passed down from one generation to another.

It continues to be time for all of us to reevaluate traditional models of psychotherapy, and continue to update our understanding of what promotes emotional healing, resilience and interdependency in relationships. We all need to do so — therapist, patient, parent and anyone else interested in promoting a sense of greater well-being in children and adults.