Riding the Rapids

We recently spent a few days hiking up mountains, camping and white-water rafting in Wyoming and Montana, because isn’t that what people who are afraid of heights (me) and can’t swim (yeah, me, again) do for fun? And it was fun. It’s good to push out of the comfort zone.

Most parents and the other adults who care for and work with children are quite serious about helping them get out of their supposed comfort zones and into a healthier lifestyle. Recently, I was speaking to a group of adults about the topic, “Raising Mentally Healthy Children.” We spent our time focused on what we can do.

One problem that arises in these conversations – whether in a group, one-on-one, or with a family, is that making time for change seems impossible. The days are packed, and nothing on the schedule seems negotiable. Yet, in reality, what’s not negotiable is what humans need to be healthy and thriving.

What most kids need, and what we need, too, is more appropriately divvied-up time. For example, children and teens benefit from a solid two hours or more of physical activity every day. They need time outdoors, in nature, for their immune systems, Vitamin D, circadian rhythms and even their eyesight development. The near-and-far variation in focus that being outdoors elicits promotes healthy eyesight in young children; kids are supposed to go from crouching down to study a beetle to peering across the field to see if that’s a hawk in the tree and then taking off running to make sure. Optimally, they’re outside for at least two or so hours every day – more on weekends.

Kids need enough sleep – probably 9 or 10 hours a night, with an absence of screens. Recent research links high levels of artificial light at night (ALAN) with increased rates of cancer due to disruption of the circadian rhythm. An immediate risk with insufficient sleep is the attention system. Sleep-deprived people are irritable, inattentive, forgetful, disorganized and generally not fun to be around. Sleep-deprived drivers test as impaired, much like those with alcohol and/or drugs in their system. Think about inexperienced and sleep-deprived teenagers driving to and from school and work, often in the dark.

Kids, and we adults, need unstructured time. Most of the adults present had a creative hobby or two, and we all agreed that it takes time to shift gears into that hobby. It’s hard to walk in the door after work and immediately pick up a paintbrush, or guitar, or journal, or woodworking tools, and be in flow. The segue into creativity requires a sort of almost boring downtime – something many adults and children avoid compulsively through electronics. 

I can’t tell people what sacrifices have to be made for their family to have a healthier life. It varies from family to family, and it is never easy. It might be simple or quite complex, but it is never easy. However – after the white-water part, when you aren’t on nature’s roller coaster, there are always some smooth, easy times ahead. Thank you to all the parents who go for it – who strive to be sure their children to have the range of experiences they need to grow up resilient, curious and confident.

Ouch! Hey! and, Yay!

It can be hard for parents to make the changes they see would be best for their families. Every good idea seems like a Sisyphean struggle.

Sometimes it’s useful to start very small. Let’s begin with a short, very simplified review of behavior modification from Psych 101. We’ve got positive reinforcement (YAY), negative reinforcement (also YAY) and punishment by application – life does something to you (OUCH), or withdrawal, when life takes something away (HEY!).

Let’s say it is noonish on a pleasant day, I have a break, and decide to take a walk outside. I will enjoy the breeze, the birds singing, a chance to move and clear my head. I will come back to the desk feeling invigorated. I have been positively reinforced. I did an action, or stopped an action, that resulted in something good (my uplifted mood).

A few hours later, it will be about 3 PM and I may have the beginning of a headache. I glance at my water bottle and realize I am way behind on fluids, so I drink a few glugs of water. In short order, the headache dissipates. I have been negatively reinforced: I did a desirable action, and something bad went away.

Punishment, on the other hand, is entirely different. If, feeling a bit bored, I decide to scroll through the news of the day, I might feel depressed and then realize I have wasted my break reading bad news (HEY!).  Or, I may notice the beginnings of a headache and, instead of a drink of water, start with a few chunks of delicious, smooth dark chocolate and then (OUCH) my headache may well get worse.

The point of this little meander through intro psych lessons is that, when making changes, maybe it will progress better if you find ways to start with positive and negative reinforcement rather than what will seem like punishments.

For example, let’s say you think that at least one weekend afternoon of family time without devices would be a good start. Teens and even younger children may not agree. Wrestling their phones and tablets away is feasible, but they will consider this HEY!, and their resulting dopamine withdrawal symptoms to be OUCH for them; their miserable behavior may be a big OUCH for you.  But if a family activity inherently means no devices and then everyone has fun, we now have a big YAY in place the OUCH and HEY! What might that include?

Being outdoors in nature, where devices may not work properly anyway. A movie outing. A museum that requires devices be silent and away. Physical activities. Someplace where there is no phone or internet signal. Or just take a deep breath and impose device-off mode around a slice of a day and spend it in actively doing things that would not be improved by device distractions. Have fun. Don’t lecture about how fun it was (that’s an OUCH). If your kid mentions it was pretty fun, you can agree and take that as YAY – an invitation to repeat as possible.

Hard Changes

Most of us have some changes to make. And most changes are not so easy. That’s why people postpone them, or poke at the edges, or just pretend the problem will go away by itself. Sometimes people convince themselves there isn’t even a problem, really; that it just depends how you look at it. Maybe so. But maybe there’s something that needs changing.

Let’s say you have a teenage child, or a child approaching the teens. S/he is cranky, sullen, uncooperative with chores, sulks during family meals and resists being on time for school and other appointments. S/he wants to spend time alone, in the bedroom, with electronics. The child is depressed and/or anxious and/or obsessive and/or perpetually angry. You know the situation will change, one way or the other. Everything changes. If you do nothing, you are gambling that your child will continue down this road and somehow, at 18 or 19 or 20, wake up, shake themselves off like a wet Golden Retriever and come out of their bedroom, smile and say, “Wow! How could I have been so wrong?!”

Yeah, I doubt it, too.

If you have this situation and need to take it on, it can be hard to know where to start. Here’s a suggestion: if the situation is not a crisis, then the most practical first step may be to start with yourself.

You will have to change. Perhaps you have to start the change process by being sure that all the adults in the house are on the same page in your expectations. Perhaps you need to get yourself on the right path.

You go first. You get enough fresh air, and time in nature, and sleep, and healthy nutrition, and balanced physical activity. You strive to do interesting and challenging things in what little free time you have. You will, quite naturally and incidentally, spend less passive screen time. You’ll be leading from strength rather than being a target for adolescents’ favorite criticism: that we adults are hypocrites. You’ll be in a much better stance to steer positive changes for your tween or teen.  

Not another horrible day

A different day, another awful situation. 

A child, or teen, or young adult has been struggling with emotional turmoil and is tumbling into danger. They confide in a friend, or maybe a few friends.

They may have “met” someone in an online chat and now this person is their “boyfriend” or “girlfriend,” and they are planning to run way to meet this person.

Perhaps the young person has been “sexting” with someone they know personally, or “met” online, and now are being threatened with “sextortion,” that the images of them will be spread around, unless they meet some demand. This has recently led to many teen and young adult suicides.

Perhaps the young person shares that they are a victim of abuse.

Or, perhaps they stumbled upon, or were led to, the terrible misinformation that hurting oneself is a useful way to cope with painful feelings. The young person proceeds to experiment with self-harm, and posts online about it.

So-called friends hear the plan, listen to the horrible stories, or see the images of scratches, cuts or burns, and fail to turn to an adult for guidance.

Every parent I’ve ever spoken to is under the impression that their child would, of course, come to them if a friend were in grave danger. And sometimes that is true, but an awful lot of the time – in almost any of these kinds of incidents I’ve ever encountered in clinical practice or consulted on, as it happens – that was not the case. The case was, almost every time, that other young people knew about the plan to run away, or the abuse, or the self-harm, and did not seek the guidance of an adult.

Sometimes these “friends” have an unflagging alliance, suddenly, to keeping promises (unlike the promises they have made to you, dear parent, about everything from cleaning their room to homework being done well to treating your automobile with respect). Sometimes they believe they are better equipped to help than an adult would be, although they cannot arrest an abuser, drive someone to the emergency room or help them connect with a mental health professional for counseling, and their capacity to manage extreme distress is probably not much better than the troubled friend’s skills. Sometimes they dread social disapproval for breaking the rule that you keep adults out of it, whether the “it” is someone self-harming, or sharing that they are a victim of abuse, or are planning to run away from home to meet up with the “boyfriend” they “met” online.

I urge you to have frequent, open conversations about these topics with your young people. Make them age appropriate; be calm and encouraging. If you are too stressed out, you may be misread as “angry.” Remember that adolescents go through a stage where their brain interprets almost every non-happy facial expression as “angry.” If that happens, the conversation will probably be a complete failure.

Be calm, be matter-of-fact, and be sincere. Ask questions, too:

How do the people you know handle things like a friend telling them this kind of stuff?

If this was your friend, what would you do?

If it were (fill in the blank for some close friend or family member), what would you want their friends to do in this type of situation?

Why do you think people are reluctant to ask adults for help with this?

What would make an adult seem safe to go to with this problem?

Don’t lecture; have the conversation. It may be a conversation that occurs for a few minutes at a time over an extended period. That’s okay; sometimes a few sentence and letting it simmer is what’s necessary.  

You may, without knowing it, be setting the groundwork to save a life.

Why Ask Me That? Third in a series on questions in the therapy room

Someone who is struggling with anxiety just wants to feel better. It’s understandable; anxiety feels awful. The physical symptoms, so often hovering just below full-blown fight-or-flight; a mind that won’t rest, a brain that hops from topic to topic like a rabbit in a vegetable garden. Add to this the fear that so many people have when they come to therapy:  will the therapist tell me I’m crazy?

No; no, I won’t tell you that, but I am probably going to annoy you with a lot of questions that may seem to be irrelevant to your suffering. My paperwork asks about your history, decade by decade; your losses; job satisfaction; health issues; your alcohol and drug use; your prescribed medications; your exercise and sleep patterns. I ask about screen time, social memberships, supportive relationships. I ask a lot of questions, and I can tell who thinks those questions are irrelevant by who leaves them unanswered, handing me incomplete paperwork and acting surprised when I follow up on the many blank places.

All these questions are important, and here’s a short discussion on just a few aspects and the explanation.

Your sleep patterns, and any difficulties, can both contribute to, and be worsened by, anxiety, stress and depression. If you need more, or better sleep (and most people do), figuring some ways to improve your quality and quantity of sleep can help across many categories of your life: focus, memory, energy, stress level, and mood. When these improve, relationships can often improve, as you might expect when you can pay attention and be less cranky.

If you have major health conditions that are not properly managed, these may contribute to problems with sleep, anxiety, or mood. For example, poorly managed diabetes, besides being physically very dangerous, impacts focus and mood. I would refer you to your physician to see if there are problems that require medical attention.

Social isolation is a recipe for loneliness and depression. Social media use tends to make this worse – something that seems weirdly contradictory. Lonely people eventually withdraw, and this creates more loneliness, isolation and possibly anxiety and depression. We need to explore ways to enter back into activities with others.  From my guidance counselor days: children who are isolated suffer. If you ask a child if s/he has friends, and then ask him/her to name those friends, and there is a flash of hesitation, you know you are dealing with a child suffering social isolation. Just so, adults who cannot identify some supportive relationships and what is good about those relationships is an adult who is emotionally isolated.

I ask questions that make sense to me; if they don’t make sense to you, please ask why I’m asking. Thanks!

Social Contagion

(This post mentions eating disorders, self-harm, substance abuse and suicide. Please reach out to your local emergency services if you or someone you know is struggling with any of these!)

When I was in 9th grade, I unwillingly, and briefly, attended our parish’s very small Catholic Youth Organization meetings (CYO.  The group comprised mostly boys, all altar servers, who played ping pong and pool with our associate pastor, a well-meaning middle-aged priest from Poland. The only other girls were the type of enmeshed best friends that are normal at that stage of life. Their shared passion was Bay City Rollers. They put together, in that era of typewriters with ribbons and no internet, a monthly fan newsletter with some success.  Life would have been oh, so easy, if only I could have mustered enthusiasm for the boys from Edinburgh.  I tried. But, despite the social costs, a Dylan fan I remained.

Go ahead, laugh. But you have faced the challenge of social contagion, too. You may even now be wearing a style of clothing you don’t actually even like. It’s just what’s “in.” As a teenager, you wore the right clothes, or pined after them; you strove for the right hair style. You wore the trendy colors even if they made you look ill, and were anxious for the approval of your peers.  It’s not just kids who follow the crowd; every married person knows that when your spouse’s friend circle comprises mostly divorced people, there may well be trouble ahead.

Over the years, we’ve seen waves of societal concern about the risks of contagion. Were young people teaching each other to cut or burn themselves (1990s), how to purge or starve themselves (ongoing since at least the 90s), how to get a so-called “high” from household items? Could a teen’s suicide lead to copycat attempts?  The answer to all of these is, yes.

Children now are not gifted with preternaturally adult-style brain development. The ability to sound sophisticated by parroting what you’ve read or heard is not the same as an adult brain with a well-developed executive function – something that takes into the early to mid-20s to acquire.  Your kid is not any more resistant to peer pressures of even the subtle type than you were when you were screaming in excitement over a band because all your friends were.  As it happens, they are more vulnerable, because peer pressure can surround them wherever their cell phone works. Odds are, you were free – as soon as you were off the school bus, there was some space for other influences to counterbalance the noise of adolescents striving to show their individuality by being as much like their desired group as possible.

Notice the vagaries of the teenage years: they move from music star to music star, aesthetic nomads in lockstep. No one wears jeans; then they all wear jeans. The games, the accessories, even the car you drive falls under the anxious eye of a child who wants to fit in.  It’s important for all of us to be attuned to the various social pressures to conform, because we want our young people to survive, and thrive, throughout these very turbulent times.

Cutting off Mom and Dad, Part 1

We were talking about families, generally, over breakfast.

“I don’t know why family therapy isn’t held in greater esteem,” my husband commented. “Look at what things are like for families…people are really struggling.”

I agreed with the struggling. And, yes, it would be nice if family therapy were more respected. It is rich with the integration of lifespan development, evolutionary psychology, personality, temperament, and culture. Family psychology and family therapy seem to be the neglected child in the world of mental health. Yet every theory of development, and most personality theories, see the family and early life experiences as foundational to the development of the adult person.  How we attach to others, the ease of trust, our expectations of the world, are all rooted in life experiences, particularly those early life experiences most often lived in the context of family.

Well, of course, if we emphasize family then we are saying family is important, pivotal, vital. And that, it seems, flies in the face of much of the mainline culture.

I will take one small slice for now: the bizarre movement to cut off parents who were not, and are not, abusive, neglectful, cruel, or so otherwise dysfunctional that remaining in active relationship with them would be endangering to one’s safety and/or sanity. There seems to have been, over the past few years, a growing movement in this regard. I have spoken with people, and read books by professionals, on both sides of these issues: the grieving parent and the disgruntled adult child; the professionals who attempt to help parents bridge the gap or, if that is impossible, to heal from the grief, and the therapists whose main lens is the toxic relationship that will only hurt you until you extricate yourself.

Are there cruel, abusive and destructively manipulative parents? Yup. And, likewise, selfish, cold and manipulative adult children, too.  And my somewhat limited professional experience (I’ve been in this field about 30 years) is that sometimes children who cut off parents did not have abusive, cruel parents. Sometimes, people cut off parents who did not do what the child wished, did not read their minds, did not feel obliged to agree and praise everything their child did.

And here we come to a piece of the culture guaranteed to undermine the family: the demand that people validate and accept whatever one thinks, feels, and does as indisputably “okay” because it is how we “feel,” etc. Well, now we have a problem that any family therapist could easily explain.

Mommies, generally, give children the majority of early care.  They provide unconditional love and approval because, as Dr. Jordan Peterson often points out, infants are “always right.” If the baby is crying, the baby is right: something needs attention, swiftly, lovingly and gently! That loving care must come even if baby is colicky, pukey, poopy, or otherwise quite disagreeable.  The baby is, after all, always right. However, this stage of life passes, and then Daddy’s influence increases: Daddies specialize in unconditional love with conditional approval. “I love you, and the room is a mess. Get going on it, kid. Here, I’ll give you a hand.”

This coordinated approach works great: it prepares children for the real world, where people have expectations and you can’t just do “whatever” and then complain it’s how you feel, and have everyone act shame-faced, shrug and say, Oh, OK. If that’s how you feel. Whatever.  Children benefit from the solid backing of both parents’ love, and the experience that disapproval of how I behave does not mean I am not loved. It means my behavior probably needs improvement.

The world, or the part of it to which children and young adults are often exposed, plays another tune. The modern message is that the relentlessly approving gaze of a nursing mother ought to be the perspective of parents forever, across all circumstances. That is a set-up to disrupt and undermine the family.

And it appears to be working terrifically.

A child goes off to college and is enlightened about…it matters not.  Politics, nutrition, whatever. They realize their parents are abject idiots. Worse, their parents may be bad and ill-intentioned because, look! A younger sibling is being raised in a religious/liberal/conservative/omnivore/vegetarian/whatever home. Big sibling becomes disrespectful towards the parents, dismissive, and undercuts them in an attempt to rescue little sibling from the fate of growing up in the same family.

Or, a young adult who is apparently sliding along, perhaps in perpetual adolescence, shifting from goal to goal, engaged with street pharmacology or alcohol, resents the parent who dares express concern and perhaps even the intent to turn off the money tap. Anger, resentment, and accusations flare; the young person demands parental fealty, blames the parents, and the parents, afraid of losing the relationship, are tempted to cave and pretend that a ten-year cycle of major changes in undergraduate school is just okay. It wouldn’t be okay even if the young person was the one financing it with their series of so-not-serious jobs; it would still be a waste of talent and youth.

In short, the mainstream culture offers the illusion that new-mommy bottomless approval is what is normal for adults. Do parents contribute to the problem of parent/child alienation? Absolutely; and that will be a story for another day.

I could tell you, but you’re not going to like it: Anxious Youth

As you know, this column isn’t intended as psychotherapy or professional advice. It’s information and entertainment, and, I hope, the spark for some conversation with someone who can help with a problem. The problem here is anxiety in all its forms.

According to the Anxiety and Depression Association of America, about 31.9% of youth have some sort of anxiety disorder.  This would include diagnoses such as generalized anxiety, separation anxiety, panic disorder, and trauma disorders. It’s hard to believe this is accurate; if it is, then as a culture, things have gone horribly wrong. 

We know a lot about what works, and what doesn’t work for anxiety.  Isolation, the vortex of doom the internet can be, the misguided or malevolent support of random strangers online, endless social networking, and a sedentary, sleep-starved, junk-fed existence don’t work.  Overscheduling doesn’t work. Avoidance doesn’t work. Irresponsibility doesn’t work. So do the opposite.

Get off the devices except for schoolwork.

Get enough sleep. Go to bed at a set time, get up at a set time. Every day, even weekends.

Cut down on activities.

Read real books. Learn about other people’s interior lives via good fiction (that’s a primary reason that we read classic literature in school; to understand more about how other people think, feel, and respond to life’s events). Then talk about them. That means parents should read them, too.

Get physical activity.  A healthy young person needs at least two hours of activity a day, and ought to be standing, moving around, and active a big chunk of the rest of the time.  

Learn useful skills.  For example, everything it will take to manage one’s own money, car and home.

Socialize in person, often while doing something purposeful (whether that’s a sport, volunteering, or other activity).

Spend a lot of time in nature. If it can’t happen just about every day, plan a four- or five-hour chunk on the weekend.

Have chores and responsibilities for young people.  No, “school is not their job” and therefore nothing else is to be done around the house. How are they going to learn necessary life skills? Plus, who wants a spouse or roommate who thinks going to work covers them for any contribution to home and family life?

Learn mindfulness meditation skills, to slow down the stress response and “step back” from anxiety-provoking thoughts. This facilitates the cognitive restructuring of cognitive-behavioral therapy, in which new ways of thinking and behaving are identified and rehearsed.

…and try cognitive behavioral therapy (CBT), preferably with at least one parent learning, too, to be coach and to help the parent. Anxious parents tend to teach their children fear-fueled ways of thinking and behaving, and anxious parents are apt to facilitate avoidance.  Avoidance is like jet fuel for anxiety. Find a licensed mental health professional who will work with you as a family to teach the skills. Keep in mind that CBT will work much better if the other parts of life are in healthy, working order – proper sleep, nutrition, exercise, etc.

To expand on an earlier point: parents, often your anxiety feeds your child’s anxiety. If you are behaving as if the world is a terrible, dangerous place, do not be surprised if your child responds the same way.  Making changes together to have a healthier, less anxious lifestyle will help the whole family.

I could tell you #3: Screening the Screens

#3 in a series: I can tell you, but you’re not going to like it.

Once again, I’m the fun-killer, offering information for your recreational purposes that you might not like hearing.

Thus far, I’ve discussed getting more sleep and more physical activity as ways to help children who seem restless, unhappy, unable to focus (except for electronics, usually).  If you have been experimenting with those changes – perhaps for your children, perhaps for yourself – and a few weeks have gone by, I suspect you have noticed a few changes.

You may be sleeping better and waking up more rested and alert. You may be naturally less reliant on caffeine and high-sugar foods to wake up or to get through your day.  If you were tracking it, you might also notice that you are spending less recreational time with electronics. If you were managing these changes for a child, you experienced some degree of pushback, possibly to the level of an addict being denied their drug of choice, because the brain becomes addicted to the rewards of social media, video games, etc., and it will take time to replace that addiction with healthy patterns.  If you were able to persist, within a few weeks you probably noticed positive changes in mood and behavior.

Some studies have supported the approach of adding positive changes before taking things away. For example, if a person needs to quit smoking, eat healthier and exercise, success is most likely to accrue if exercise is added first. This becomes an additional reward and incentive, and can help buffer the withdrawal from nicotine as well as withdrawal from addictive, highly processed foods. In that spirit, it seems it could be easier to have begun helping a child heal from the cultural damages that contribute to anxiety, depression, attentional problems, etc. by adding positive things (sleep, exercise and play) before directly taking away negative things (specifically, the largely unsupervised world of the online universe).

If your child has any unsupervised screen time, it is almost guaranteed they are seeing things you do not know they are seeing or want them to see. End of story. You think you have adequate controls, and firewalls; and somewhere far away, people with far more expertise in technology than most of us are busily creating pathways to circumvent parental controls.

As I have shared in other columns, one of my little escapes in a long work day may be a two to four-minute clip off the internet of some old movie: a dance scene from Mary Poppins, a short scene from Much Ado About Nothing, a few moments of Branagh’s Henry V, the latter not cheery but stunningly well done and quite grounding, as examples. These are my typical fare: dancing penguins, singing suffragettes and Shakespeare, but sometimes up will come next some horrible thing – R-rated, violent, hideous – so terrible that even shutting it down immediately is too much exposure.  From this I hypothesize that if you think your kiddo is happily watching perfectly clean children’s videos and do not supervise, you don’t know. You do not know whether some horror or corruption that was carefully created and marked with the right key words to intrude on that corner of the market is slipping into the stream.

Under the best of circumstances, if it were an hour or two of tap-dancing penguins, it is on too much time to surrender to passive entertainment without being selective. Most people will not just absent-mindedly pick up any book and read it for a couple of hours and then look up, surprised and resentful, when interrupted for food or water or homework. The internet, however, is something else: the endless parade of “talking” kittens, so-called “influencers” and worse contrive to steal time every day from many people. It’s not all bad, of course; I listen to educational lectures when I’m on the stationary bicycle six days a week. I’ve encouraged people to watch “The Chosen.” I’m in favor of well-researched educational programming. I’ve done car repairs under the tutelage of a mechanic on Youtube and am still stumbling through beginner Spanish with the internet, too.

If you are unconvinced about the use of the internet, watch the documentary, “The Social Dilemma.”

Cutting back on tech time is hard. You’re probably not, initially, going to like it, and odds are your child will fight you – hard.  We’re talking about your child’s well-being: their physical health, mental health, intellectual development and social skills. It’s worth the trouble. Try adding the deliberate reduction of entertainment with electronics to the improved sleep and physical activity habits.  Then see what happens.

My child is “hyperactive” Part 2: Move it!

Post 2 in a series: I COULD TELL YOU, BUT YOU AREN’T GOING TO LIKE IT © 2023

Once again, for purely entertainment purposes, I foray into the world of possible changes to be made to your, and perhaps your child’s, routine to maximize well-being. Be sure to consult a health professional before undertaking new activities.

My child is hyperactive, part 2:  Move it!

I am using “hyperactive” in quotation marks because, over the past 25+ years, many parents have offered this as their diagnosis of their children. When asked to describe the behaviors, they talk about poor attention, disorganization, disobedience, moodiness, lost homework and missing sports equipment, etc. It is this type of description, not the medical diagnosis per se, that I address here.

Human beings are designed to move: to walk, bend, stretch, jump, hop, climb, and more. We are able to throw things, build things, swim, dance, and then, when weary, sit and rest.  Follow a healthy preschooler around for a few hours and you’ll get the idea:  explore, play hard, stop when you’re ready to rest. Modern life seems to have it backwards:  most people’s lives involve a preponderance of sitting and far too little standing and moving. This is unhealthy for most people (of course, some people have serious health limitations) and even worse for healthy children. To expect children to sit still for many hours is a recipe for attention and behavior issues as well as developmental challenges.

My paperwork for new clients includes questions on sleep, exercise, and basic health, because these habits help shape mental health, too. These also can highlight if mental health care needs to be coordinated with their physician due to physical conditions that can impact mental health.  Obviously, we function best when our habits encourage physical and mental well-being.

In my last post, I challenged parents to take a hard look at their family’s sleep habits and work towards healthy changes. Perhaps by now you and your child have been experimenting with getting adequate sleep.  A second step towards a healthier, happier child with better focus, memory and mood is physical activity.  The American Heart Association recommends at least one hour per day of moderate to vigrous physical activity for children and teens. That means running, jumping, playing games, riding a bicycle, dancing, etc. It doesn’t mean a two-hour practice in which they spend 30 minutes on the field and 90 on the bench, waiting their turn.  Ideally, it includes plenty of free interactive play with other children and some with parents. It is this play, which requires physical activity and complex social skills, that enhances brain development the best and prepares children for the increasingly complex world of the workplace.  It includes the kind of rough-and-tumble play children traditionally have had primarily with fathers, in which the father would model how to pause and calm down before things get out of hand. Rough and tumble play without limits becomes “The Lord of the Flies” and grotesque gang violence. Life without play leads to passivity, poor social skills, poor physical health and higher risk for anxiety, depression, insomnia, and loneliness.

If your family pediatrician has cleared your child for physical activity, it is imperative to get moving. Your next task will be to find ways for your child or children to have more unstructured play time with children, and more outdoor activities with you, too. That will seem inconvenient, especially if you have your children overscheduled and accustomed to being moved from place to place and activity to activity, their entire lives carefully curated to keep them under the direct management of adults.

Go to the park and get on the swings, use the jungle gym, the climbing wall, the workout stands around the periphery. You might have to participate at first, just to show them how it’s done.  Take nature walks. Put the phones away; have yours along to take pictures of interesting animals and plants to look up together later, after you’re home.

Like the change to the sleep routine, expect push-back. Be consistent and see what happens. I suspect that, once your child is on a normal sleep schedule for a few weeks, and has adequate active play, you will see some interesting changes in behavior.   As a side benefit, screen time naturally is reduced:  children who are active outdoors and getting enough sleep have less time to be drugged by their screens.

Have fun playing!