Growing up today - a journey

Infants, Babies & Toddlers

The birth of a baby is a cause for celebration. It is not without reason that we term the condition of pregnancy as “expecting”. People expect a wide range of things from the birth of a child; from fulfilment to accomplishment, a feeling of completeness, and that sense of continuation. The miracle of the human condition is so complex!

We can be so unprepared for the trials and tribulations of a bundle of total dependency, and even less prepared for the shift to self-assertion that marks a move toward independent self-awareness.

One person’s experience

Mike has been a ‘doting dad’ since the birth of his daughter. He delighted in the smiles he received at 6 months when playing peek-a-boo and the delight he would feel when she would crawl to be near him at 8 months.

He felt protective when she would become distressed by strangers at 10 months and found her insistence on doing things ‘her way’ at 14 months to be the sign of a strong and capable personality.

But at 20 months, when she would throw herself on the ground for little reason, Mike felt he had met his match. Where once a trip to the supermarket meant special time together, highlighted by a treat that always brought a smile to her face, now there was usually a demand for something Mike wasn’t always sure he understood and a frustration at not being able to maintain a pleasant time together (not to mention the scorn of onlookers as her high-pitched squeals made sure the world knew her displeasure).

While ‘the wise’ kept saying “it will pass, it’s only a stage” Mike recognised that it wasn’t passing and the stage was going on too long — you see, this was a stage of development that requires coordination between the parent and the child. Mike sought help and found that he could do things to reduce the frequency of the tantrums while ensuring a smooth transition for his daughter onto the next stage of development.

 

Tantrums

  • Usually occur around 18 months of age
  • Are a sign of a developing independent self-concept
  • Vary depending on the infants temperament and experiences
  • Need a planned approach by the parent to reduce the frequency and severity
Children

The rapid pace of infant development begins to change as the child enters the first stage of formal learning. At approximately four years old many children go off to Kindergarten — excited anticipation for some, pure dread for others (and that’s not just the parents!).

At 5 years, 96% of Australian children are in Preschool. This is an important stage in development as the child takes the initiative interacting with the world around them. It is also now that they pit themselves against the demands of the world outside their families, especially formal education — schooling. For some children these years are a relative ‘breeze’, for others they are frought with feelings of shame and inferiority.

By about year three (7 to 8 years old) children have a sense of their academic ability compared to others, yet a lack of self-understanding. It is at this time that issues of learning and behaviour are most often brought to the fore with teachers and parents seeking ‘answers’ to this child’s differences. Minor variations in development can lead to significant difficulties for children outside the understanding and acceptance of a loving family.

One person’s experience

Bobby was born into a comfortable middle class home where he had an older sister, mum and dad. As a baby he had some sleeping and eating difficulties, but not enough to worry the doctors. He was always on the go though. If he wasn’t active then he was cranky — so of course he was given lots of chances to be active! He loved to run and climb and he was affectionately known as ‘the little monkey’.

At kindergarten and preschool he excelled at outdoor games, and could even sit still and listen to a story, for a while, but his favourite thing was racing cars around the carpet — no matter who got in the way.

With first grade came more structured work. Bobby wanted to learn to read and do his math. He tried hard but he hated sitting and listening to the teacher and he was often in trouble when there were out-of-seat activities. He loved lunchtime — running around the playground with his friends. In second grade his parents were informed that he was not doing as well as expected, but could do better if he concentrated on his work.

Bobby started to feel that school wasn’t that great, he was in trouble for talking in class, getting out of his seat and not remembering what the teacher had said.

By fourth grade Bobby had given up on learning, especially reading and spelling; he just went to school for his friends, even though he got into a few scrapes in the playground. Underneath, Bobby was angry, sad, and disappointed in himself.

Bobby wasn’t the only one to give up — teachers felt that Bobby was just a ‘naughty boy’ who wouldn’t listen and do as he was asked. He proved them right! Until his problems were investigated.

Bobby was experiencing the impact of Attention Deficit/Hyperactivity Disorder and subsequent learning difficulties. He found it too demanding to maintain attention to instructions and tasks. He was able to maintain normal attention for about 20 minutes before it all started fraying at the edges.

 

Attention Deficit / Hyperactive Disorder

It is difficult to establish prior to school when demands for sustained attention become important. Attention issues are four times more prevalent in boys but do exist in girls, affecting 3 to 5% of the population.

While inattentive characteristics can become less prominent after adolescence, unsupported children with ADHD often experience significant personal issues including learning difficulties, depression, anxiety, and social difficulties.

 

Possible Treatments

A range of treatments may be available for Bobby:

  • Neuropsychological assessment — testing Bobby in a range of important areas may help a psychologist build a good picture of what is going on. For example, it can help Bobby’s family and school understand how much of his learning struggles are due to poor attention, hyperactivity and challenging behaviours, and how much of what they’re seeing is due to the way he learns and processes information.
  • Paediatric assessment — to understand any medical and physical factors that may also be affecting behaviour.
  • Cognitive Behavioural Therapy and Neurofeedback therapies — a family may benefit from CBT and other therapies.
  • Behaviour management — armed with a new understanding of ADD/ADHD and a thorough behavioural and neuropsychological assessment, families can work together with a psychologist to set up a plan for managing and improving behaviour at home and school.
  • Medication — in extreme circumstances of severely affected children, a paediatrician may prescribe medication that improves attention and activity levels enough to allow a child to re-engage in learning, and help families implement behavioural plans that work.
Tweens

The rapid pace of change and the increase in technology have exposed children to unprecedented levels of information and experiences. One result of this appears to be an identifiable stage of development called ‘tweens’; that distinct period of development between childhood and adolescence. This period is recognisable by the onset of intense social interest focused on friendships and peer activity, and a growing interest in the trends and fashions of the day.

The ‘tweens’ is a difficult period for parents as their child moves away from the family and closer to friendships. It is a period that is both extremely important and challenging for families and individuals alike, as relationships change and the scene is set for the journey ahead into adolescence and young adulthood.

One person’s experience

Zach is an 11 year-old boy who lives with his mother Angela and 8 year-old sister Tameka. Lately, Zach has been getting into bigger and more frequent arguments with his mum, which has worried her enough to see a psychologist together with Zach.

Over the past six months especially, Angela has noticed real changes in Zach. As a sole parent working to provide for Zach and his younger sister, Angela has struggled with Zach’s increasing requests. Zach has begged his mum for fashionable hoodies, skinny jeans and street clothes, expensive brand-name shoes (that in her opinion look barely practical!), weekend outings to watch M-rated blockbusters with friends of his that she’s barely met, the latest and most expensive mp3 player on the market, and more recently, a mobile phone.

When Zach is denied these requests – either because Angela can’t afford them or she believes he’s still too young – the two of them usually end up locking horns. “It always ends the same way”, Angela explained to the therapist. “Both of us end up raising our voices, and eventually Zach storms off, but not before blaming me for his unpopularity at school, and insisting that I’m being unreasonable because every other parent has bought their children those things. The last thing I want is for him to be bullied or feel like an outcast, and at the same time, I just don’t think he’s old enough to do those things his friends are doing and have those things I can’t afford anyway. What do I do?”

With the help of a psychologist, Angela was able to make changes in her family that improved her relationship and communication with Zach without compromising her overall parenting values or breaking her budget. The process was different to what she imagined, but with an open mind and willingness, she had navigated this critical developmental stage in a way that left her feeling more prepared for the challenges ahead in raising Zach through his teenage years around the corner. She also now felt more confident about managing Tameka’s ‘tween’ years to come.

Adolescents

The transition period between childhood and adulthood – a time when personal identity and social understanding accompanies physical and emotional changes that are so rapid they are aptly called ‘growing pains’. The last time a similar phase of development occurred was in toddlerhood, when their brain developed sufficiently to distinguish themselves as an individual independent from their parent. The toddler tantrum is not unlike adolescent demands; while toddlers focus on “I want” as a way of evidencing their individuality, the adolescent catch cry is “Why not!?”. These words usher in a period of uncertainty, challenge and erratic behaviour.

But there is no one path for adolescent development – every individual changes at their own pace and time and in their own context.

At a time when developmental, social and personal challenges are at their greatest, it is no wonder so many teenagers succumb to the stresses. Adolescents are often hypersensitive observers of the physical and social development of themselves and their peers. The impact of these comparisons on their own self-image and identity will heavily influence the satisfaction they feel in their daily life, compounding into adulthood.

The physiological changes (such as changes in appearance and hormonal changes) as well as the emotional rollercoaster and the development of morals and abstract thinking capabilities drive the adolescent to reconstruct relationships in new and meaningful ways. The pressure on adolescents to manage this period well is only magnified by the media’s simplified, romanticised and skewed portrayal of “successful” adolescents and adults. Parents find themselves dealing with a shift from the inquisitive ‘why?’ of childhood years to the demanding ‘why not?’ in adolescence.

Identity clarification – especially sexual identity – is the paramount psychological task for adolescents. The first task of adolescence is the discovery of ‘self’ – I am a person with my own mind, my own heart, my own personality. Then there is the discovery of freedom and the responsibilities that come with it – I am autonomous, free to take my life in the direction I want to. Finally there is the establishment of values and beliefs that will take them throughout their life. Professor David Isaacs proposed that until adolescents effectively develop these commitments they do not leave this phase of life.

While the doors to the wider social world are opening, and the adolescent has a glimpse, their egocentricity and limited experience make the transition a challenge not only for themselves, but also for those who love and care for them. It is also at this point that many biologically-influenced psychological issues begin to be identified. These include depression.

Sadness, discouragement, pessimism, and a sense of hopelessness are emotions experienced by all people at one point or another. In children and adolescents, depression often appears more as irritability and a diffuse anger, rather than the sadness we normally think of when we hear about ‘depression’. For most adolescents and adults alike, the experience is short-lived. Research shows that normal mild depression lasts long enough to ‘adapt’ to new situations (e.g. after the death of a loved one). This capacity to experience depression is beneficial. However, when the experience persists, invading daily life and impacting on the capacity to continue functioning as well as usual, then it is time to act. The need to seek help is even more important in adolescents, as depression left untreated during this intense period of growth can hinder the acquisition of skills and development in areas that pave the way for sustained, healthy adult functioning.

Mood disorders (of which depression is one) are complex, invasive variations of our regular mood patterns. The complexity usually varies on three dimensions – severity, type (up or down), and duration. The common thread is extremes of emotion.

 

Major Depressive Disorder (Depression)

is a Mood Disorder experienced by approximately 10% of the general population at some stage. While 39% of boys and 55.6% of girls between the ages of 12 and 16yrs report experiences of depressive symptoms including negative feelings about the future, bouts of sadness or anger, changes in sleep and eating patterns, and negativity about themselves.

An episode is characterized by at least two week of loss of interest or pleasure in most activities. The mood may be irritable rather than sad and is accompanied by changes in appetite or weight, sleep, activity levels, as well as decreased energy, fatigue, feelings of worthlessness or guilt, difficulties thinking or concentrating, or recurrent thoughts of death or suicide.

It is important to attend to these symptoms and not to put them down to “hormonal adolescence”. While each of these characteristics may be present at any one time in regular development, a combined pattern is a sign of more pressing issues.

One person’s experience

Maddie has had a comparatively settled life. Her parents owned a small business which has provided well for the family, until her father found the pressure too much and was hospitalised following a ‘break down’ when she was 13. Since then he has returned to work for someone else and the family has settled into a new routine.

Maddie wants to do well, her parents think a good education is important and have encouraged and supported her desires to go on to tertiary studies.

But lately Maddie has felt that it doesn’t matter what she does she can’t get the grades. She can’t write the way the teachers want, she can’t figure it out, she can’t think straight, she feels dumb. She’s been feeling tired and lethargic which she puts down to studying late at night.

Her mother has noticed that she often withdraws to her room to listen to music that ‘makes her sad’, but when she tries to talk to her about it, through her tears Maddie tells her mother she’s OK.

At other times Maddie gets as angry as hell over things – like the time her parents wouldn’t let her go to town to meet her friends on Friday night. She fumed over that for months and every chance she got she let her parents know she felt they didn’t trust her, before she burst into tears and ran off.

Her boyfriend also wants to go on to tertiary study, and he’ll get there for sure. Maddie worries about this because she thinks that he will meet someone better than her and she’ll be alone.

She’s tried to talk to her teachers but they tell her she’ll be all right and to get more rest. Her friends are getting sick of her being ‘down’ and told her to get a grip. Even her boyfriend is starting to wonder about their relationship. Maddie feels like nothing can make it better.

 

Other mood disorders

  • Depressive & Bipolar Disorders
  • Eating disorders – anorexia and bulimia
  • Disruptive behaviour disorders
  • Anxiety disorders
  • Substance related disorders
  • Attention Deficit Disorders
  • Phobias

 

Psychological conditions reflected through physical symptoms

  • Somatoform Disorders
  • Personality Disorders
Adults

One person’s experience

Melissa came to therapy shortly after her 24th birthday, saying that she felt “lost” and “trapped”. She talked to her psychologist about how she often felt as though she was adrift, and her greatest fear was waking up one day at 30 or 40 years old and still feeling her current sense of aimlessness and unhappiness with her life circumstances. Melissa explained: “I wasn’t one of those students that left high school knowing what they wanted to do for the rest of their life — but I figured hardly anyone has that stuff figured out at 17. I remember, at my 21st birthday, my friends were excited about how the world was our oyster, and my aunty joked about how she’d do anything to be that age again. But all I felt was this urgency to at least be in a job that I liked, if not have enrolled at Uni or moved out like some of my girlfriends. Now I’m 24, I’m still living at home, lots of my friends have been overseas and I’ve barely crossed the state border. My most serious relationship ended after 8 months, and that was ages ago. I don’t mind my job, but it’s just not ‘me’, and I don’t make enough to have saved very much at all. I’d go to Uni or TAFE, but what would I study? I’m starting to cringe when people at parties ask me where I work or what I do or where I live. If I don’t get this sorted soon, I can just see myself still like this in 10 years’ time.”

Families

One family’s experience

John and Mary have been living together for 8 years and have two children, 6 year-old Tina and 3 year-old Angelo. John and Mary would describe their relationship, family circumstances and general living circumstances as fairly typical of a working family living in suburbia. Over the past 18 months, the reality of juggling a hectic lifestyle of two working parents with two boisterous sons was beginning to take its toll on their relationship, and it had begun to affect their family’s wellbeing.

John and Mary had begun to argue more over the past year especially. They spent little time together, and when they did get opportunities to see each other, most of their discussions revolved around the practicalities of work and seeing to their children’s needs. Both parents were becoming increasingly concerned with their son’s fussiness and agitation at home, and recently Angelo’s day care had been reporting his growing aggression at school. Tina, who began school this year, had unexpectedly started to slightly lag behind other children with some aspects of her numeracy and literacy. Between the stress of John’s self-employment venture, Mary still adjusting to returning to work after maternity leave, Tina’s new schooling problems, Angelo’s escalating behaviour, and the growing strain in Mary and John’s relationship, the family decided it was time for help.

 

In therapy, Mary and John first took steps to identify and prioritise the multiple issues which they could see were getting in the way of their family’s functioning. The psychologist then worked with the family to come up with a plan to address these issues, making realistic and practical changes that didn’t further overwhelm the already struggling family. Some of the larger changes did take time, but Mary and John both agreed that the time and effort they invested into making those changes had been worth it.

In their final session with the therapist, Mary said, “I know we still have a way to go — and John’s business will always be a source of stress until it gets off the ground. But seeing the changes in Angelo and Tina over these past months, and feeling like John and I can once again talk constructively about those bigger issues over a quiet dinner… That’s what’s important to me”.

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