How to Respond to Someone Dealing with Grief

How to Respond to Someone Dealing with Grief

In light of the sudden deaths of Carrie Fisher and Debbie Reynolds, it made me think about how are society reacts to death. Additionally, in doing research regarding grief for patients who have asked me what to say to grieving people, I found this information from the grief center. I think it is very good information and very easy to understand. Therefore, I will present the information in three sections.
The 10 Best and 10 Worst Things to Say to Someone in Grief
Sheryl Sandberg’s post on Facebook gave us much insight into how those in grief feel about the responses of others to loss. Many of us have said “The Best” and “The Worst.” We meant no harm, in fact the opposite. We were trying to comfort. A grieving person may say one of the worst ones about themselves and it’s OK. It may make sense for a member of the clergy to say, “He is in a better place” when someone comes to them for guidance. Where as an acquaintance saying it may not feel good.
You would also not want to say to someone, you are in the stages of grief. In our work, On Grief and Grieving, Elisabeth Kubler-Ross and I share that the stages were never meant to tuck messy emotions into neat packages. While some of these things to say have been helpful to some people, the way in which they are often said has the exact opposite effect than what was originally intended.
The Best Things to Say to Someone in Grief
1. I am so sorry for your loss.

2. I wish I had the right words, just know I care.

3. I don’t know how you feel, but I am here to help in anyway I can.

4. You and your loved one will be in my thoughts and prayers.

5. My favorite memory of your loved one is…

6. I am always just a phone call away

7. Give a hug instead of saying something

8. We all need help at times like this, I am here for you

9. I am usually up early or late, if you need anything

10. Saying nothing, just be with the person

The Worst Things to Say to Someone in Grief
1. At least she lived a long life, many people die young

2. He is in a better place

3. She brought this on herself

4. There is a reason for everything

5. Aren’t you over him yet, he has been dead for awhile now

6. You can have another child still

7. She was such a good person God wanted her to be with him

8. I know how you feel

9. She did what she came here to do and it was her time to go

10. Be strong

Best & Worst Traits of people just trying to help
When in the position of wanting to help a friend or loved one in grief, often times our first desire is to try to “fix” the situation, when in all actuality our good intentions can lead to nothing but more grief. Knowing the right thing to say is only half of the responsibility of being a supportive emotional caregiver. We have comprised two lists which examine both the GOOD and the NOT SO GOOD traits of people just trying to help.

The Best Traits
Supportive, but not trying to fix it

About feelings

Non active, not telling anyone what to do

Admitting can’t make it better

Not asking for something or someone to change feelings

Recognize loss

Not time limited

The Worst Traits
They want to fix the loss

They are about our discomfort

They are directive in nature

They rationalize or try to explain loss/li>

They may be judgmental

May minimize the loss

Put a timeline on loss

The above information is meant to be used as a guideline. Everyone goes through the grieving process in their own way. It is very important to understand that point. It is also important to remember while the above is a guideline, the most important thing is your intent. So if you say a worse thing but you said it out of love the person will understand. The guideline will hopefully make you more comfortable to offer support to your grieving loved one or friend. Because someone who is grieving need people to talk to without people feeling awkward.

Dr. Michael Rubino has over 19 years experience treating adolescents, children and their families. For more information regarding Dr. Rubino visit his website http://www.rcs-ca.com or on Twitter @RubinoTherapy

Families Dealing with Autism

Families Dealing with Autism

For families dealing with Autism there can be many challenges.  One of those challenges in mental health insurance.  Here is an option you might find helpful. 

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December 20, 2016

Happy Holidays from MHAIP!!

Then end of the year is upon us, it has been an exciting year filled with many surprises. May your holiday season be restful and happy. Enjoy the down time, and be ready to gear up for an active and exiting 2017!!

Open Enrollment Period-Affordable Care Act-Act Now

If you have an insurance plan (through an employer or elsewhere) that does not provide the benefits your family members need, now is the time to purchase a plan on the ACA exchange. Some families with children with autism may have self-insured plans that do not provide needed treatments. If this is your situation, and you live in a blue state (see map below), you may want to purchase a child-only plan on the exchange. If you plan on using more than 10 hours a week of ABA, you may want to purchase a Platinum level plan, as there are no deductibles and the out of pocket annual costs are lower. It is important to know with all the changes on the horizon, that ACA plans will be in effect for the 2017 year.   

Blue States include ABA as an essential health benefit in the Health Exchange 

Map courtesy of Autism Speaks

You are in a “grandfathered health plan” if the plan covered you or your family on

March 23, 2010 and has largely remained the same since then, or if your employer has not made significant changes since then. You can find out whether your plan is grandfathered by checking the plan materials or asking your insurer or employer. If you have a grandfathered plan and a child with a significant mental health condition, and you expect that your child may need substantial mental health treatment in the coming year, now is the time to purchase a plan for that child. New plans will all have the protection of the Federal Mental Health Parity and Addiction Equity Act and must provide intermediate forms of treatment, including residential, partial hospital, and intensive outpatient care.   

End of year is time for Giving and Reflection

We at MHAIP have had a busy and exciting year. Some of the things that we have done with your generous donations include:   

Fielding your questions via phone and e-mail from families and providers. We get approximately 2 phone calls and 2 e-mails a day from the general public. We make an effort to return every phone call and e-mail that we get.

Working on a new website with updated information –it should be unveiled early in the new year.  

Giving over 20 presentations in the community and at relevant conferences, training families, providers, family resource workers, physicians and others on how to work with insurance.  

Building a network of skilled attorneys with whom we consult and hand off challenging cases.

Helping families with Medicaid access behavioral health services and speech therapy.

Working with attorneys to help make Wilderness programs a covered benefit. 

In the new year, we want to continue all of these important projects as well as work with legislators at both the state and federal level, to make sure that important aspects of health care reform that have helped our families, remain part of the law.  

If any of these things are important to you, please contribute!!!

WAYS TO GIVE

Holiday shopping is easy with Amazon’s Holiday Gift Guides. Click on below image and begin shopping for your holiday gifts—Amazon will donate to Autism Health Insurance Project Inc.(select us as your charity).   

You can also always donate through through the Pay Pal link below or on our website.   

OTHER WAYS TO SUPPORT MHAIP

We are excited to be a part of several employer based fundraising programs this year. Through these programs, you can donate to our organization easily through payroll deductions set up with your employer. CA state employees may donate here through the CA state campaign, or with our code 29208. We are also a recognized cause through the corporate employer-matching philanthropic site Benevity (as Mental Health and Autism Insurance Project). We are a write in charity (as Autism Health Insurance Project) through the United Way of the Bay Area.

 We appreciate your support! 

Wishing you a very Happy and Healthy Holiday Season! 

Sincerely, 

Karen Fessel

Executive Director & Founder

Mental Health & Autism Insurance Project

Mental Health & Autism Insurance Project | | karen@autismhealthinsurance.org

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Christmas After Divorce 

Christmas After Divorce 

Wevorce is a mediation company who tries to make divorce affordable and tries to minimize the negative impact of divorce on children.  It is a great company and I am happy to be affiliated with them.

They ran the following blog about Christmas after a divorce and I think it can be helpful to many people.

It’s not unusual for the holidays to sneak up, catching us unprepared and, worse yet, without the spirit. We all know what dates to prepare for; we feel the changes in the weather. But, suddenly, we are at the store and there it is: aisle after aisle of Christmas decorations while Jingle Bells plays in the background.
For many of us, we’re never ready for the hustle and bustle nor the spending and trending that comes with the season. And if you’re going through a divorce, or are adjusting as a newbie co-parent, the approach of the happiest time of the year can be anything but.

Perhaps you consider yourself a traditionalist and believe in the old-fashioned ideal of family consisting of two married parents in their first marriage “’til death do us part.” Well, in today’s world, the typical family structure has become more complicated than that. But less traditional does not mean your family is less in any way. Merely different. So, for the children’s sake, we believe in embracing those differences.

Stress and the Holidays

This time of the year can be stressful for separated or divorced adults. So imagine what it might be like for kids of divorced parents. It’s often difficult to empathize with others when we are experiencing our own pain, but it is crucial for parents to focus on their children’s wellbeing during challenging transitions. Typical signs your child may be having trouble emotionally are:

long periods of sadness or depression

uncharacteristic outbursts and getting into trouble frequently

spending more time alone in their room

missing classes and grades suffering

lack of interest in extracurricular activities

pretending to be sick

If you see any prolonged changes in your children’s behavior, arrange for them to see a counselor. Assure them it’s OK to talk about the divorce and their feelings, whether it’s with you, your co-parent, or a trusted adult.

The Comfort of Traditions

The observing of traditions feels much like wrapping your favorite blanket about the soul. They can soothe anxiety and stress as happy memories rush in to produce a Zen-like calm inside us. Perhaps it’s decorating and lighting the Christmas tree, complete with holiday music, cookies, and plenty of laughter, with the finale being the placing of the Angel — lovingly passed down for four generations — in her honored spot atop the tree to watch over everyone during this special time of the year.

Sometimes the simplest of habits become rituals important beyond measure, acts that bind us and provide continuity to our lives. But what if you can no longer duplicate a beautiful memory? What if your family dynamic has changed and it is no longer a possibility? It happens, especially in two household families. Maybe now you alternate holidays as co-parents or split the days of celebration between you? Or, perhaps it’s simply the absence of one parent that changes the picture dramatically.

But all is not lost. Just as life isn’t black and white, your family’s important traditions don’t need to be, either.. Here are some practical ways to rethink your family traditions.

Always Keep Your Children’s Happiness in Mind

As we’ve have mentioned many times to divorced parents: always consider the best interest of the children. In a weLife article, Divorced Parents: Kids And The Holidays, we talk about this very topic.

“If ever there was a time to think about peace on earth and good will toward men (and women), it’s the holiday season. Yes, that applies to the ex as well. If possible, keep the important traditions going. You may have to tweak them a bit or reinvent them altogether. This is a great time to start new traditions with your children, but don’t be too quick to abandon the old ones just because it may not be the same for you. Remember, it’s about how your children feel. It’s not about you or the ex.”

You may need to keep this thought in mind when it comes time to help your kids buy presents. In another weLife article, Help my Child Buy My Ex Gifts?, we offer some helpful hints to ensure even this simple act is done with kindness.

“It should be a goal to make every divorce an amicable one. It is with this spirit we answer this question: yes, yes, yes. Want to give a lump of coal to the ex for Christmas? Don’t. Take the high ground. It’s about your children and their love for the other parent, it’s not about you and your ex’s relationship.”

Terry Gaspard talks about the post-divorce family and the holidays in an article, 7 Ways to Create New Traditions For Your Family Post-Divorce. “Most children of divorce experience loyalty conflicts during the holidays and this can last into adulthood. The holiday season can remind them that their family is now divided and they may feel they are pulled in every direction and will ultimately disappoint both of their parents. As a result, you need to do everything in your power not to intensify your children’s feelings of being stuck in the middle between their parents’ two worlds during the holidays.”

Gaspard goes on to say, “Modeling responsible behavior toward your former spouse is key to having a successful holiday. Children pick up on both verbal and non-verbal signs of anger, so do your best to keep these feelings in check. Never badmouth your ex and model respectful communication in front of your children. Studies show that children adjust better to divorce if their parents minimize conflict and are cooperative with each other.”

Look at the Holidays From Your Kids’ Perspective

As outlined in our previously mentioned article, Divorced Parents: Kids And The Holidays, here are some thoughts and common-sense practices to consider to make this time of year easier for your children.

Plan ahead. Be very specific with dates and times; even go as far as writing down what is going to happen step-by-step. Kids like knowing exactly what’s happening. Yet, you must also be willing to change carefully laid plans at the last moment. Kids, especially the littlest ones, can be unpredictable. Be flexible and be patient.

Be flexible but firm. Kids like to be included in making plans, but don’t go overboard. Listen to their ideas and consider their input, but in the end, it is your decision as the adult. Don’t let them take advantage of you because of divorce guilt.

Respect traditions but be willing to make new ones as well. The first holiday without both parents will be the hardest for the kids. Be sure they know it’s okay to share their feelings and that you understand. Listen, then validate … that may help ease their sadness. In general, kids don’t mind the idea of celebrating everything twice. But keep the drama out of it. If old traditions aren’t working or cause pain, create new ones — make it a fun process for the family.

Remember, what goes on in the other household is no longer your business. No grilling the kids for information. And if the children do talk about the other parent’s home, keep your adult emotions under control. Don’t overreact; your child’s comments are their version of the truth, which can be unreliable. But under-reacting is not healthy either; you need to let them know that it’s okay for them to talk about their time with the other parent. After all, they love you both.

Pool resources, if possible. Again, don’t leave room for surprises at this time of the year; leave big changes for another time. But speaking of big, it’s a great time for co-parents to consider going in on the bigger gifts together. Getting a gift from Mom and Dad shows the kids that even if you are no longer together, you will both always be their parents, united in your love for them. This is a terrific thought to reinforce in their minds and hearts.

If you are facing being alone for the holidays and anticipate missing your children, there are ways to prepare yourself. The article continues: “Do something different, unexpected, avoid letting it be a sad and terrible time for you … your kids will know and feel guilty if you are all alone. The goal is to never expect them to choose one parent over the other. They love you both.”

Keep as Much of the Old, but Usher in the New

Even after you’ve transitioned into a two-household family, it can be good to maintain some of the old family traditions if possible. But when it’s not, it may be time to change them — sometimes a little, sometimes a lot. Don’t be afraid to explore new ones and create something uniquely yours and the kids’. Let them look forward to and enjoy separate celebrations in each household so they will be filled with cherished memories to pass on to their own families one day.

After all, it’s all about instilling belief in our children’s hearts by keeping the holiday spirit alive. Don’t forget the laughter; there is no better way to spread the joy of the season. Practice hope and faith in a time we so often lose sight of what is truly important in our lives. Instill a sense of goodwill toward men by giving and doing for others less fortunate. And, as co-parents, teach them that peace on earth begins within family.

– See more at: https://www.wevorce.com/blog/articles/rekindling-joy-creating-new-family-traditions-for-happier-holidays#sthash.Jtap55bV.dpuf

How to Have A Happy Family Christmas 

How to Have A Happy Family Christmas 

The Holiday Season is here and people are stressing about buying gifts and spending the day with relatives. For many people this Holidays are a happy time and for others it is a stressful time. The Holidays can be stressful because they may bring up family issues that have not been resolved yet or everyone is trying to make the day prefect that it becomes a stressful day not a happy one. Also parents are concerned how their children will act around the entire family and what will happen if their child receives a gift they do not want?
Thanksgiving has passed and now we have Christmas. Parents you can start by looking at what occurred on Thanksgiving. Overall we’re you happy with it or are there somethings that you would like to change?

Next after you have assessed how the day went sit down with your children and ask for their opinions. Also ask about what their expectations are for Christmas. It is especially important to discuss this point with teenagers. Are they expecting to spend Christmas Eve and Day with the family or are they expecting to spend time with friends and girlfriends or boyfriends. It is important to settle this issue before Christmas. By discussing expectations and trying to accommodate everyone’s wishes, you can avoid arguments. However, many times you cannot accommodate everyone’s wishes and as the parents you may need to make the judgement call. If this occurs explain to your teenager you know they may be mad, but you hope they can understand and you would appreciate their cooperation. May be you make arrangements for them to spend time with their friends the day before or after Christmas.

The next discussion is gifts. Explain to your children the point of Christmas is to appreciate and to be grateful for the people in your life and what you do have in your life. Therefore, if your grandparents give you something you do not like, be grateful that they thought about you and say thank you. Try not to make faces or act disappointed and hurt your grandparents feelings. Again remind them the Holidays are a time to be grateful for what you have in your life. 

Reminding your children about being grateful leads us into the next tip for decreasing Holiday Stress. Lori Lite who writes about stress uses the acronym G-R-A-T-E-F-U-L as her Holiday stress guide. It helps her and others get through the day in a peaceful manner. Each letter reminds you of something to do or a way to view the day so you do not get upset.

So here is how to use Gratitude as your Holiday Stress Reliever.  

G- Gratitude is the opposite of stress. It is difficult to feel stressed out when we are feeling gratitude.
R- Relax your expectations and let the day unfold. You might be surprised by the outcome.
A- Acceptance is the opposite of judgment. If we accept our family member for who they are and what they are capable of we can relax and enjoy ourselves.
T- Teens can be a part of the Holidays. Ask them what they would like to contribute to the evening or day. Let them what they feel they can contribute.
E- Empower children and let them help with age appropriate assignments. Putting the nuts out or making the centerpiece. Let them do it their way…not your way.
F– Focus on family for this day. Put all work and worries on the shelf
U– Unplug the electronics for dinner so that everyone can be fully present.
L- Love is often overlooked when we are busy. Be present with love… Speak with love… Show your love and gratitude for your family during this Holiday time.
This might seem very simple and obvious, but at times the best solutions are rather simple. Also you may want to practice using this in your daily life. It may seem simple, but it may be harder to do than you think because you are accustomed to doing things and viewing life in a certain way. This idea may challenge you to reassess how you approach life in general.  

Many of us are not use to looking at our lives in terms of what we have to be grateful for. Also many of us have a hard time relaxing and not worrying about work or other things we need to do. I have found that just being in the moment is difficult for most people. Most of us believe we always have to be doing something. This creates stress and disappointment. Finally, since we feel we must always be doing something, disconnecting from cellphones and other electronics can be very difficult for the children and for adults too. However, think about it? How can you have fun and enjoy the day with your family, if your mind is not fully present? You can’t. Furthermore, this can create tension for others because they feel ignored and for you because you feel they don’t respect how important what you are doing at the moment is to you. As a result, you have stress which can turn into an argument and everyone is upset. A day of happiness becomes a day of anger and disappointment.
If you notice you are getting angry or your teenager is getting angry use the acronym HALT:
H – hunger, do not try to discuss a difficult situation if you or your teen are hungry.
A – anger, if it is obvious someone is angry give them time to calm down before discussing an issue. Pushing a discussion when someone is angry will only result in making a bad situation worse.
Lonely – lonely, if someone is feeling down or alone again pushing them to talk can make it worse. Let them know when they are ready you are there to listen.
Tired – tired, trying to have a conversation with a tired teenager can turn into an argument fast. Wait until they are ready to talk. There is no need to make a bad situation worse.

Therefore, in order to avoid the possibility of an unpleasant Holiday for everyone try to

 use the words GRATEFUL and HALT as guidelines for the day. What do you have to lose?

Dr. Michael Rubino specializes in working with children, teenagers and their families. He has over 19 years experience. For more information about his work or private practice visit his website at http://www.rcs-ca.com or visit his Facebook page at http://www.facebook.com/drrubino3.

The Truth about The Holidays and Depression

The Truth about The Holidays and Depression

The Holidays and depression. Many people assume they go together and that suicide rates increase during this time of year. Well according to the statistics from the CDC, suicide rates actually drop during the Holiday Season. The study by the CDC is not sure why they drop but they do. May be they drop because during this time of year we pay more attention to depression and suicide. There are a number of ads and social media posts where people can call if they feel suicidal.
What the CDC did find is that loneliness increases during this time of year. During the Holidays there are songs and plenty of television shows regarding getting together with family and friends. You also have people talking about all the Christmas parties that they have to go to. However, this is not the case for everyone.

If you are a military family a loved one may be stationed overseas and won’t be home for Christmas. Also during the year some close friends or loved ones may have died during the year. It is during this time when most people are talking about family and friends that you remember the people you have lost over the year. The first Holiday Season without a close loved one or friend can be very difficult. You may not feeling like celebrating or you may have to change Holiday traditions which can make some one feel sad and lonely.

Another common difficulty during this time of year is money. Many people feel like they need to spend a great deal of money to show love. They may just be able to pay their monthly bills and cannot afford Holiday gifts. Why do we need to spend money to show that we care? What if you write a letter to someone telling them how important they are to you and how much you appreciate them. Isn’t that the real purpose of the Holiday Season? Isn’t this the time of year we take to tell people in our lives how much we appreciate them. Also it’s an opportunity to tell people we tend to ignore, people sleeping on the street or who are dealing with mental illness that they are important too?

As a psychotherapist, I have seen that people dealing with mental illness feel lonely and out of place during this time of year. They don’t often feel the joy of the season. Sometimes they struggle just to make it through the day. Also mental illness is something we don’t discuss as a society. We tend to act like it doesn’t exist so we ignore the issue. Also since it is an uncomfortable issue for many people the feelings of shame and embarrassment become associated with mental illness. This makes it less likely for people dealing with it or families who have a family member dealing with it to talk about it or seek help. This can make people feel lonely and isolated especially during this time of year.

We seldom acknowledge the daily struggle that people and families dealing with mental illness go through on a daily basis. It is important to acknowledge that mental illness is not a weakness it is a medical condition. There is no reason to look down on someone with mental illness. We offer encouragement and support to people with cancer, why can’t we do the same for people with mental illness?

I have included a link to a video where a teenager discusses dealing with depression https://youtu.be/dAzqGcOLXBs. Listen to what he has to say and answer the question, does he deserve to be looked down upon because he is depressed?

Also remember the Holidays can be a lonely time for people. So if you see someone who looks like they are having a hard time or know someone who is struggling during this season, try to help. Do something kind for them. Another thing to remember, being kind to people should be a year round activity for all of us. We should not just be kind during the Holidays. If we try to be kind all year, we may be able to decrease how many people feel lonely and depressed. Also if we are kind and offering support year round may be we can eliminate the negative stereotype associated with mental health.

Dr. Michael Rubino specializes in treating depression and suicide especially depressed and suicidal children and teenagers. For more information about Dr. Rubino visit his website at http://www.rcs-ca.com or his Facebook page http://www.Facebook.com/drrubino3     

Christmas and Divorce

Christmas and Divorce

The Holiday season is usually a difficult and stressful time for many families. Everyone trying to make plans and trying to see grandparents and other family members. It can be especially difficult for divorce families. After a divorce the issues often become even more stressful.
One thing that parents need to remember is that they decided on the divorce the children did not. I often hear arguments about parents want their time or wanting to continue their family’s holiday traditions. However, they often ignore what the children want to do.

Many times a divorce may be finalized, but the parents are not done fighting with each other. Therefore, the use Christmas as a reason to continue to argue or try to hurt each other. What they forget is they are really hurting their children more than each other.

Based on dealing with families who are divorced, I would make the following recommendations to parents. First, parents need to remember that Christmas is more about the children not them. Next they need to develop a plan together regarding the Holidays. The first step is for the parents to talk together about what the children seem to enjoy the most about Christmas. Also parents should also ask the children what they enjoy most about Christmas.

After you have this information then sit down civilly and see how you can allow the children to do what they enjoy most about Christmas. Another thing to remember is the children should not be forced to choose between Mom and Dad. Come up with a plan where the children have equal time with both parents. Also they should have equal time with grandparents, cousins and other Extended family from Mom and Dad’s side. 

The other thing is don’t turn Christmas into a competition. Gifts should not be used to influence the children. You should discuss with each other what your children want and what you plan to get the children. When you were married you discussed what to get them so even after the divorce you can coparent and discuss what is realistic and what is not.

Finally, remember Christmas time is a time to get together as a family and enjoy each other. Therefore, for the sake of your children put your divorce aside and decide how this can be a happy family time for everyone. If you can do things together, that would be the ideal situation. If you can’t then being kind to each other and making the Holiday season fun for the children is the goal for you as parents. Stated another way, the children should still feel like they have one family at Christmas not two. Maybe things are being done a little differently because of the divorce but they still have a mother and father.

If you achieve this goal, it will make you feel better too. A divorce should not wreck your lives. Obviously, your lives will change after a divorce but you can still be a family.

Dr. Michael Rubino has over 19 years working with children/teenagers and families. For more information about Dr. Rubino’s work or private practice visit his website at http://www.rcs-ca.com