Transcript CARFLEOPCarney

Catholicism,
Attachment theory, and the
Mental Health of our Students
Catholic Association of Religious and
Family Life Educators Ontario
Dr. Phil Carney
May 12, 2011
[email protected]
CARFLEO!
 “How does our Catholic faith tradition inform
our understanding of and approach to the
mental health issues of youth?”

Email from Bronek Korczynski, January 20, 2011
Dear Ruben:
allexperts.com/q/Catholics-955/2009/3/Mental-Illness-Deliverance.htm
I am sorry to hear about your and your son's affliction. We
will pray for your and your son. You can know that God
accepts your offering of your suffering and that
suffering is redemptive because God and the Church
teaches that....
While it is technically possible that a person can be
afflicted with a demon that causes some symptoms of
mental illness, there will be more than that usually to
indicate a demonic involvement.
Mental illness is usually caused by brain chemistry issues.
Also, mental illness tends to run in families.
Beautiful document
Could quote from every paragraph
APOSTOLIC LETTER
SALVIFICI DOLORIS
JOHN PAUL II
ON THE CHRISTIAN MEANING
OF HUMAN SUFFERING
Story of Job – problem of evil
Christ’s sufferings – redemptive, and we are not defeated
Good Samaritan
Beautiful document
Could quote from every paragraph
The parable of the Good Samaritan belongs to the Gospel of
suffering. For it indicates what the relationship of each
of us must be towards our suffering neighbour. We are
not allowed to "pass by on the other side" indifferently;
we must "stop" beside him. Everyone who stops beside the
suffering of another person, whatever form it may take, is
a Good Samaritan. This stopping does not mean curiosity
but availability. It is like the opening of a certain interior
disposition of the heart, which also has an emotional
expression of its own.
A template, perhaps?
Catholic Psychotherapy Association
“As a long time therapist with a re-awakening of my faith, I
was keenly aware of how (important ) Christ’s love is to
the healing of the human heart. I felt incredibly alone
with my desire to put this into the therapy I was doing,
especially working within a Catholic Church.”
Sandra McKay, President
Reported in Denver Catholic Register, April, 2009
Let’s get our bearings......
ROLE OF CATHOLIC EDUCATION
“In our own time, we hear a great deal about work
being done in Ontario’s schools to create ‘schools of
character.’ Society can only benefit from such efforts.
At the same time, however, Catholic schools must
continue to be schools of transformation, transforming
not only students but society as a whole, into the image
of Christ.”
Catholic District school Board of Eastern Ontario
“If you have a strong commitment to Catholic
education........”
Let’s get our bearings......
THE CHALLENGE FOR CATHOLIC SCHOOLS
Dennis Murphy
The challenge is to announce anew and in contemporary
fashion the Christian and Catholic answer to the
perennial search for our souls ....
(Note: ie, there are others out there doing the searching.
We better have answers! We have better answers!)
The goal here this evening
- The Catholic ‘brand’ and the brand loyalty challenge
- Locate mental health issues as developmental issues,
which are in turn Attachment issues
- Show how you can intervene most effectively on mental
health issues through your Attachment relationships
with your kids
- To show how our Catholic faith tradition brings
Attachment theory to life in a way the clinical world
cannot
Here’s the challenge.
Catholics in every profession live in culture of
THE AGE OF ENTITLEMENT
See in parish context. Selective self-exemption from ....
-Catholic Mission Statements (hospitals, school boards, etc)
-Church teachings
-Practice of the faith
-Specific needs of the kids (ie, passing by on the other side’)
Not alone with the temptation
Shoeless Joe Jackson
President of Ford Motors
”SAY IT AIN’T SO, JOE!!”
White Sox lost the 1919 World Series to the Cincinnati Reds
How long was that Lexus in the parking spot of
the President of Ford Canada?
What if a Catholic teacher
worked with kids in an environment committed to
“..transforming ... students... In the image of Christ”
but
Quietly was loyal to a different team – or no team
Chose not to display the brand
Teaching in a Catholic school does not make you a
Catholic teacher.
-
Just saying.
National Institute of Mental Health (U.S.)
Research shows that half of all lifetime cases of mental
illness begin by age 14.1 Scientists are discovering that
changes in the body leading to mental illness may start
much earlier, before any symptoms appear.
http://www.nimh.nih.gov/
Mental heath issues - data
Centre for Addiction and Mental Health 2006
About 1 in 5 children and adolescents in the US, symptoms
mental health disorder, in given year, and about 5 in 100,
serious emotional disturbance with functional impairment.
Canadian children and adolescents: prevalence of a mental
health problem ranges from 18 to 22 per cent, and is about 25%
among young adults.
Suicide, third leading cause of death, Canadian/ US adolescents
(after mva and other accident deaths).
Prevalence of mental health problems among young people may be
increasing (Adlaf et al., 2002).
The Mental Health Foundation:
mentally healthy individual is one who can:
-Develop emotionally, creatively, intellectually and spiritually;
-Initiate, develop and sustain mutually satisfying personal
relationships;
-Face problems, resolve them and learn from them;
-Be confident and assertive;
-Be aware of others and empathise with them;
-Use and enjoy solitude;
-Play and have fun;
-Laugh, both at themselves and at the world.
MHS Evidence Jan 2011
Quick tour through some of the diagnoses you will
deal with, and that compromise child development
Depression
Persistent sad mood; Loss of interest or pleasure;
Restlessness, irritability, or excessive crying; Feelings of
guilt, worthlessness, helplessness, hopelessness, pessimism;
Sleeping too much or too little; Appetite change;
Decreased energy; Thoughts of death or suicide, or
suicide attempts; Difficulty concentrating; Persistent
physical symptoms that do not respond to treatment.
While adults may experience depressed mood, children and
adolescents may display more irritable than depressed
mood. An adult who is depressed may experience weight
loss. Children, however, may not gain the expected
amount of weight for their age.
All About Depression.com May 2002
Quick tour.....
Childhood Anxiety Disorders
-Anxiety disorders: most common form of psychopathology
in children with an overall prevalence rate of 8–10% .
-Generalized anxiety disorder, separation anxiety disorder,
and simple phobia are among the most frequently
diagnosed (3,24).
-Childhood anxiety disorders are often associated with
other childhood anxiety disorders and with depression. It
is extremely important ... to be aware of these.
Susan Jo Perlmutter, M.D. 2000
Quick tour.....
Childhood Anxiety Disorders
Susan Jo Perlmutter, M.D. 2000
BEHAVIORAL INHIBITION -tendency to withdraw when
exposed to unfamiliar situations ;
SEPARATION ANXIETY DISORDER -become extremely
distressed when separated from a parent;
PANIC DISORDER -recurrent and unexpected panic attacks
- discrete period of intense fear or discomfort
SELECTIVE MUTISM -manifestation of a shy and inhibited
temperament and may be a variant of social phobia.
OBSESSIVE-COMPULSIVE DISORDER -recurrent obsessions
or compulsions that are time consuming or cause marked
distress or impairment.
Quick tour.....
Not a diagnosis, but a condition you will see a lot of:
ANXIOUSNESS
The child or youth is unsure of him/ herself,
Is defensive, won’t admit to things,
Everything is a justice issue,
Takes things personally,
Reluctant to try new or hard stuff,
Makes fun of other people,
Reluctant to join in
File under: Attachment issues
Quick tour..... Bipolar Disorder
What Distinguishes Bipolar Disorder from A.D.H.D. and O.D.D.?
Research has shown that approximately 7% of children
attended by physicians at psychiatric facilities can be
categorized as bipolar. According to the American
Academy of Child and Adolescent Psychiatry, up to 30%
of the 3.4 million children and adolescents with
depression in the United States may actually be
experiencing early onset of Bipolar Mania.
HelpYourChildWithAnger.com 2008
Quick tour..... Bipolar Disorder
What Distinguishes Bipolar Disorder from A.D.H.D. and O.D.D.?
While hyperactivity may exist in all three conditions, intense mood
swings are more indicative of manic-depressive syndromes.
Bipolar children seem to be in a chronic state of alternation
between abnormal behavior and normalcy. This kind of mood
and behavior changes is not present in other behavioral issues.
Another difference is a decreased need for sleep in bipolar
children.They are usually insomniacs requiring fewer than 5
hours of sleep. They also do not seem to suffer from
consequences of sleep deprivation. When manic, their energy
level seems unquenchable.
A third difference is the presence of manic elation which often
takes the form of uncontrollable and hysterical laughter for no
apparent reason. Episodes of elation can also appear as
unusually risky behavior undertaken because of a grandiose
concept of an invincible self.
A fourth presiding symptom is rapid and incessant talking without
listening to what others have to say.
Quick tour..... Personality disorders
Personality traits are enduring patterns of perceiving,
relating to, and thinking about the environment and
oneself. When significantly maladaptive and causing
serious functional impairment or subjective distress, they
constitute a personality disorder.
Personality disorders are not formally diagnosed in patients
younger than 18 years because of the ongoing
developmental changes.
Medscape Updated April 8, 2011
Quick tour .....
Conduct Disorder has been associated with:
Child abuse, Family conflicts, Genetic defects
Parental drug addiction or alcoholism, Poverty
More common among boys.
Prevalence? Qualities necessary to make the diagnosis (such
as "defiance" and "rule breaking") can be hard to define.
Behavior must be far more extreme than simple
adolescent rebellion or boyish exuberance.
Often associated with attention-deficit disorder. Both carry
major risk for alcohol and/or other drug dependence.
Can be an early sign of depression or bipolar disorder
Children with conduct disorder tend to be impulsive,
difficult to control, and unconcerned about the feelings
of others.
Medline Plus January 2009
Quick tour ...
Oppositional Defiant Disorder (ODD)
All children are oppositional from time to time. However,
openly uncooperative and hostile behavior becomes a
serious concern when it is so frequent and consistent
that it stands out.
Oppositional Defiant Disorder (ODD), ongoing pattern of
uncooperative, defiant, and hostile behavior toward
authority figures that seriously interferes with the
youngster’s day to day functioning.
American Academy Child and Adolescent Psychiatry June 2009
Quick tour ....
Oppositional Defiant Disorder (ODD)
Symptoms of ODD may include:
Frequent temper tantrums
Excessive arguing with adults
Often questioning rules
Active defiance, refusal to comply with adult requests and rules
Deliberate attempts to annoy or upset people
Blaming others for his or her mistakes or misbehavior
Often being touchy or easily annoyed by others
Frequent anger and resentment
Mean and hateful talking when upset
Spiteful attitude and revenge seeking
American Academy Child and Adolescent Psychiatry June 2009
Quick tour ....
Aftermath
So what is it we are supposed to do then?
Be therapists?
Love them to death?
Cut them a lot of slack?
Read up on all the disorders – or at least the most frequent
ones?
Pray for them?
Use our relationship with them?
Tremendous Resource #1
Dr. Gordon Neufeld
Dr. Gabor Mate
Tremendous Resource #2
Dr. Gordon Neufeld
Attachment therapy
Gordon Neufeld - Introduction
Names and descriptions of syndromes of behaviour and
learning problems have multiplied (eg, ODD, CD, bipolar,
ADHD).
They present a problem in that they tend to describe, not
explain. They do not help us make sense of the child from
the inside out.
Consequently we are left to deal with what we see.
Attachment therapy
Gordon Neufeld - Introduction
“Are there really all kinds of separate learning and behaviour
problems or is there an underlying cause or common
denominator? I am increasingly convinced that underlying
(it all) is a singular condition. Like the immune system
dysfunction that underlies a myriad of medical symptoms,
syndromes, and sicknesses, there is also a psychological
condition that underlies a diverse array of learning and
behaviour problems. ……
Attachment therapy
Gordon Neufeld - Introduction
“ ………In a nutshell, the problem is one of developmental
arrest or psychological immaturity, what I shall refer to
more simply as stuckness.”
All kids qualify for ADHD, bipolar, ODD, CD. These
patterns initially have to do with their immaturity. When
the kids do not grow out of their developmental deficits,
then they are at risk.
Attachment therapy
Gordon Neufeld - Introduction
“Not everyone who gets older grows up….. Those kids who
are stuck are also prone to an assortment of problems and
disorders which in turn distract us from the root problem.
Attachment therapy
Gordon Neufeld - Introduction
If there is a common denominator, then there is a singular
approach. And that is to understand and work with the
relationship context
Attachment is the default approach for developmental
immaturities. Most handicaps can be at least mitigated by
an attachment approach.
In all species, the more significant the handicap, the more
attachment is implicated in the answer. No meds or pills
will help a kid grow up. Rather meds help kids avoid
blowing apart their primary attachment.
Concise History Attachment Theory
Journal of Consulting and Clinical Psychology 1996
London family psychiatrist John Bowlby: attachment
behavioral system having primary and immediate
responsibility for regulating infant safety and survival ....
This system is ..... equal in import to systems guiding feeding
and reproduction and as leading the infant to
(a) continually monitor the accessibility of one or a few
protective, older "attachment figures" (usually but not
necessarily biological relatives) and to
(b) flee to these individuals as a haven of safety in times of
alarm.
Allan Schore: Attachment in context of brain
development
The baby’s brain growth literally requires brain-brain
interaction which occurs in the context of a positive
affective relationship between mother and infant
(Trevarthen)
The child is using the output of his mother’s right cortex as
a template for the hard wiring of circuits in his own right
cortex that will come to mediate his expanding cognitiveaffective capacities
The right hemisphere is dominant in human infants, and
indeed for the first three years of life
ATTACHMENT
Attachment empowers by facilitating dependence
Attachment and vulnerability go hand in hand. A child
cannot attach without becoming capable of being hurt and
wounded – especially by experiences of separation.
Allan Schore: Attachment in context of brain
development
The loss of the ability to regulate the intensity of feelings is
the most far-reaching effect of early trauma and neglect
(van der Kolk)
The infant’s transactions with an emotionally misattuned and
unresponsive caregiver are stored in the infant’s
developing corticolimbic circuitries as imagistic, visceral,
and nonverbal procedural memories. They act as severely
dysfunctional templates for how the word works.
Attachment therapy
Gordon Neufeld - Introduction
The human brain is pre-programmed for:
Becoming viable as a separate being (Emergent process);
Becoming resilient and resourceful (Adaptive process);
Becoming capable of civilized and considerate relating
(Integrative process)
No child is born with these characteristics: they need to be
developed.
Attachment therapy
Gordon Neufeld - Introduction
Goal of the Emergent process is viability as a separate entity.
Sense of self is here!
– be full of own ideas, initiative, interests, etc. Able to
take responsibility, evaluate own efforts
The essence of Adaptibility is the registration of futility.,
The secret in the maze is NOT in knowing the way
through, but in recognizing blind alleys – something coming
to an end before a new pathway opens up.
Attachment therapy
Gordon Neufeld – Introduction
Everyone is born with potential to become civilized,
cooperative, patient, fair, balanced, etc
No-one is born with these attributes, but are rather
uncivilized, inconsiderate, impulsive, unstable, lacking selfcontrol, etc etc
We cannot command the attributes into existence, nor can
they be assumed at will. They develop in the attachment
context.
Remember? Want to notice the connection
between development and mental health.
A mentally healthy individual is one who can:
-Develop emotionally, creatively, intellectually and spiritually;
-Initiate, develop and sustain mutually satisfying personal
relationships;
-Face problems, resolve them and learn from them;
-Be confident and assertive;
-Be aware of others and empathise with them;
-Use and enjoy solitude;
-Play and have fun;
-Laugh, both at themselves and at the world.
MHS Evidence Jan 2011
Emergent process
The non-emergent have a tough time with ownership! Have not
achieved a sense of self that can monitor, and take responsibility.
Adaptive process
The non-adaptive have a tough time with frustration! Do not get to
‘futility’ and ability to move on to new direction.
Integrative process
The non-integrative have a tough time seeing other points of view!

EMERGENT, ADAPTIVE, INTEGRATIVE
EMERGENT, ADAPTIVE, INTEGRATIVE
EMERGENT, ADAPTIVE, INTEGRATIVE
Working with Stuck Kids
Three-pronged approach for creating a context of attachment:
Collect the kids; Protect the relationship; Create a village of
attachment.
Engage the attachment instinct (their dependence on you)
by COLLECTING the child:
1. Get in the child’s face or space) in a friendly way, collecting
the eyes, smiles and nods (the ‘greeting ritual’);
2. Provide a ‘touch of proximity’ for the child to hold on to
(in the palm for infant, warm, soothing tone);
3. Invite the child to depend upon you, NOT pushing them
away. (Independence emerges from dependence);
4. Act as the child’s compass point (act as their guide, point
things out, help orient them. We all have instinct to stay
close to our guide).
Working with Stuck Kids
Three-pronged approach for creating a context of attachment:
Collect the kids; Protect the relationship; Create a village of
attachment.
When you Engage the attachment instinct by COLLECTING
You let them know the relationship with you is a safe place
You let them know everything about them matters to you
You calm their anxiousness (root, many mental health issues)
You are able to focus on relationship-friendly consequences,
not punishments
You create a trusting environment in which they follow you
and become teachable
You facilitate Emergence, Adaptability, Integration
Canadian Mental Health Assoc Mental Health and High
School Curriculum Guide
Goals are to help teachers and staff to:
-Promote students’ awareness of mental health issues and
reduce the stigma associated with mental illness;
-Provide a safe and supportive environment in which all
students can maximize their learning;
-Remain accessible and responsive to students’ needs;
-Help students develop their abilities to cope with
challenges and stress;
-Identify those students in particular need of assistance
or support.
NOT COLLECTING
NOT COLLECTING
NOT COLLECTING
COLLECTING
NOT COLLECTING
COLLECTING
COLLECTING
COLLECTING
(Eyes, touch of proximity)
-What can our Catholic faith contribute to this
understanding of preventing and treating mental health
issues?
-Wouldn’t you know, our God got to collecting long before
we thought of it ............
Teachers, People Of God
This is the model for our collecting
There are no bad days for our God who collects us. God is
there today, God will be there tomorrow.
We do not have to wonder whether we will be heard,
whether we will be loved, whether we will be held.
We just will be. Burdens become lighter even as we
approach, since we are so confident this is true.
This love is about our growth, our healing, on this life. It is a
taste of what we have to look forward to in the next.
When you Collect your kids, you not only prevent and heal
mental health issues,
You bring your children God. They will know that one day,
and remember it was you who did that for them.
Teachers’ Context: People Of God
Challenges!!
Teachers before you have passed the Catholic flame to you.
But conditions are not the same. Kids are not going home to
prayer, Sunday Mass, or even just plain being held.
Still yours is the Catholic educational heritage.
In this and any other heritage, the first thing kids see is you.
Pretending is not possible
Because the kids see right through you.
They need to hear you tell of this heritage of faith,
see you show this heritage,
experience you living it.