How to Respond to Someone Grieving during the Holidays

It’s the Holiday Season a time to spend time with family and friends. However, many people have lost a loved one this year or they are still grieving the lost of a loved from from last year or the year before. Grief has no time limits on how long it will last. I have had many patients ask me how to respond to a family member or friend who is grieving especially during this time of year. People ask me questions about grief because our society has a very difficult time with death and grief. We try not to discuss it and avoid the topic. However given the fact we have had 612 mass shootings this year and 110 shootings every day which involve one or two people, in addition to over one million people who have died due to Covid (CDC), there are millions of people grieving during this Holiday Season. Therefore avoiding the topic of grief is becoming very difficult to do.

While 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 a great deal of 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 is a psychotherapist who has over 25 years experience treating adolescents, children, their families, trauma victims and first responders. For more information regarding Dr. Rubino visit his website www.RubinoCounseling.com or his Facebook page

I Think My Teenager is Suicidal, What do I do?

I Think My Teenager is Suicidal, What do I do?

Since September is dedicated to preventing suicide, I decided to write this article for parents. Many parents ask me, if their child could be suicidal and what to do if their child is suicidal? This concern has increased since the CDC no longer ranks suicide as the third leading cause of death and now rates it as the second leading cause of death for kids 10 to 18 years old. Furthermore, since the quarantine for the Coronavirus there has been a significant increase in suicides and deaths from drug overdoses. As a result, parents are worrying more about if their teenager may be feeling suicidal. Additionally, before the quarantine, parents were worrying more about suicidal teenagers as we learned more about suicides of survivors involved in mass shootings due to survivors dealing with survivor guilt. The issue of suicide is very scary especially because we do not discuss mental health issues in our society. As a result, parents are not sure what signs they should be looking for or what to do if they feel their teen is suicidal. Parents are aware there is a teenage suicide epidemic, but have no idea what to do or how to get help.

A successful suicide attempt is definitely a tragedy for the entire family. However, an unsuccessful attempt can be a tragedy for the child and the family too. Depending on the method used, a child who has an unsuccessful attempt may have to live their entire life with major medical complications. They can cause brain damage which may cause them to lose the ability to speak or the ability to breath on their own. Therefore, they may spend the rest of their life on a ventilator. Guns are one of the top three ways teenagers attempt suicide. However, teenagers are not aware that guns jump when fired. Many teens who use a gun do not kill themselves, but they do shoot off their face. The result is they have to have numerous surgeries to reconstruct their face, but their face and life are never the same.

I read this very good article describing what to do if you think your child is suicidal. It provides the steps you need to take in a non-threatening manner. It also addresses issues parents often may not think about, if they are concerned about their child being suicidal. The most important step is don’t be afraid to ask your child if they are feeling suicidal. It is a myth that if you ask someone if they are suicidal that you will cause them to become suicidal. In fact, you may save their life by asking them if they are suicidal. By asking you let them know it’s ok to talk about their feelings. Also by asking you reassure them there is nothing wrong with them and that you are emotionally strong enough to cope with the situation. Therefore, you may save their life by asking, if they are feeling suicidal.

Another reason many parents do not ask their teenager about suicide is the negative stigma associated with suicide. Often when someone dies of suicide the family will give another reason. Many families also request suicide not be listed as the cause of death. The Lighthouse Project conducted at Columbia University is attempting to remove this stigma. The Project has also developed questions that family members, friends and first responders can ask a person who they think might be suicidal. The questions have shown to be very effective at identifying someone who is suicidal and having the person to get help. I am including the link to the Lighthouse Project so you can learn more about it and download the questions that are most appreciated for you, if you feel someone in your life maybe suicidal. http://cssrs.columbia.edu/. It is a very good list of questions and the research shows that the questions are very effective at identifying someone who is suicidal.

I have included the link to this article and I encourage parents to read it and to save it. What to Do if You’re Worried About Suicide |. https://childmind.org/article/youre-worried-suicide/#.W9PRyfwKel8.twitter.

Bottom line, if you feel your teenager is suicidal do not be embarrassed. Make an appointment to have your teen evaluated by a psychotherapist who specializes in suicidal teenagers. If you walk in on an attempt, call 911 immediately.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating suicidal children and teenagers. For more information on his work or private practice visit his website www.RubinoCounseling.com or Facebook page www.facebook.com/drrubino3.

Looking at the Lessons We Forgot 21 years After 9/11

Looking at the Lessons We Forgot 21 years After 9/11

Today is the 21st anniversary of the 9/11 attacks on New York City and the Pentagon. Our Country said it is a day we will never forget, however people in the early 20s were too young to remember and teenagers were not even born. They most likely have heard numerous stories about that day, but they did not experience the fear we all felt and the uncertainty we all were struggling with that day. 9/11 was the first time in history that the mainland of the United States had ever been attacked. It happened often in Europe but never here in the United States. On that day the safety we all were use to was destroyed. There will be a number of television documentaries this weekend about 9/11. Parents you may want to watch one of these documentaries with your children and discuss with them how they feel and answer any questions it may bring up.

There was something else that changed that day too. We witnessed how our first responders all pulled together in order to help victims and secure the Country. They did not come together for a day, they came together for months and exposed themselves to deadly dust and the possibility that building may further crash in on them killing them. They thought nothing about themselves. They were only thinking about helping survivors and families who lost loved ones. It was also amazing to see how first responders from all over the Country came to New York City and Washington D.C. to help. They also planned on being there for as long as needed which was several months. Regardless of the length of time our first responders were working 24 hours a day, seven days a week and no one complained.

We also witnessed citizens volunteer to help the first responders. We even witnessed a plane of citizens sacrifice their lives in order to protect a plane that was planning on hitting the White House. We all came together regardless of race, sexual preference, socioeconomic status and worked together. We were all Americans and we were going to work together to prove to the terrorist and the world that no one could stop the United States of America. Besides the citizens who volunteered at the sites that were attacked, people from all over the Country donated money, clothes and supplies for homes. Many people had lost their homes, survivors had medical bills and the first responders needed food, clothes and places to sleep. The main point is we all came together as Americans so we could help protect and save Americans impacted by this attack.

We owe a great debt to our first responders and we still do. Our first responders are responding the same way to the ongoing pandemic and the floods and wild fires all over the United States. They are working 24/7 to help victims of the pandemic and to help families who have lost loved ones. Many physicians and nurses have not had a day off since the pandemic started. The first responders continue helping victims of the pandemic while having to also help victims of hurricanes, floods and fires all over the Country. They do not think about themselves, they only think about the jobs and the people they need to save.

While our first responders continue to selflessly respond to the needs of our country, the citizens of our Country do not. Instead we are fighting with each other about who is right. The part that is really disgraceful is we are fighting with first responders and essential workers. When they have asked people to follow guidelines which have been established many of them have been beaten and some even have been shot and killed. We have a pandemic that has killed over 650,000 Americans. The tragedy on 9/11 killed over 3000 Americans. What would have happened after the planes hit the Twin Towers in New York City on 9/11 if we argued with first responders and if we shot at the first responders? I am afraid to think what would have happened.

Parents if you compare what is happening in our Country currently with how people responded on 9/11, it is very disappointing. It seems like we have forgotten. We are not acting together as one Country, we are fighting with each other and we are emphasizing our differences. Parents try thinking back 21 years ago and explain to your children what it was like when we all acted together as one and we were all proud of our Country and that we were all working together. Maybe if we can explain this to our children and teenagers maybe they can start to work together and once again be proud about all of us being Americans.

Dr. Michael Rubino is a psychotherapist who has over 25 years experience treating children and teenagers and trauma victims including first responders. For more information about his work visit his website at www.RubinoCounseling.com or his Facebook page www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

Without Gun Control We will have a Generation of Anxious and Depressed Children

Without Gun Control We will have a Generation of Anxious and Depressed Children

During the past several months there has been a significant increase in mass shootings and people being killed by guns. In fact there has been such a significant increase that mass shootings barely make the news anymore. This weekend there were at least 11 mass shootings across the country. There were shootings at Coney Island back east and another in Bend, Oregon and another in Stockton, California just to name a few (NBC, ABC, CNN). A 10 year old boy in Chicago was shot and a 4 year old in Philadelphia, who was waiting for a haircut was shot too. Both boys were innocent bystanders just trying to live their lives as children.

How are children or anyone suppose to live their lives normally when so far in 2022 we have had an increase of 50% in the number of mass shootings compared to 2020 (Gun Violence Archive). Currently 2022 has the most mass shootings on record for a year and the year is not over yet (CDC, Brady Gunn Violence Campaign). Many children are afraid of attending school due to the mass shooting in Uvlade, Texas where 18 elementary school children and 2 teachers were killed. Can we blame children when every weekend there are numerous mass shootings across the country with numerous people being killed. Also the shootings are usually done with an automatic gun. The most common is the AR15.

As a psychotherapist who treats children and teenagers, I hear many children and teens talking about their safety at school and around town while they are playing or hanging out. I have had many children state they are afraid to go to school because they are afraid of being killed. Yes anxiety disorders and depression have increased significantly since the pandemic, however, anxiety and depression in children and teenagers were increasing prior to the pandemic. Anxiety and depression disorders started increasing as school mass shootings increased (CDC). I have seen this in public too. I was attending the play Oklahoma and when they shot the stage gun, the 12 year old behind me started having a panic attack and had to leave because they were afraid of being killed. It did not matter what the parents said or did. They automatically had a link between the sound of a gun and people dying. No child should have to be that afraid.

Teenagers are taking somewhat of a different response to the mass shootings. Many teenagers are also suffering from anxiety and depression disorders such as elementary children (CDC). However, many teenagers also seem to believe if they have a gun that will keep them safe. While researching this issue of gun violence, I read an article by Cody Fenwick regarding children and gun violence. His article was very alarming. Since there has been a significant increase in mass shootings, more teenagers have been trying to find ways to have access to guns. As I stated for some teenagers they say they feel safer if they can access a gun. However, the major issue is that suicide has been significantly increasing for teenagers over the years (CDC). Suicide is now an epidemic in teenagers and guns are one of the most popular methods of suicide for teenagers. Many children who are bullied are choosing guns for suicide too. Therefore, as we examine how mass shootings are impacting our society, it’s important to look at how easy access to guns is resulting in an increasing number of teenagers committing suicide.

Many of us feel because we live in Pleasant Hill, Walnut Creek, Lafayette or Orinda that our children and teenagers do not have to worry about gangs or gun violence. Unfortunately, this is not the truth. According to a research study in the Journal of Pediatrics, guns continue to be the third-leading cause of death for Americans younger than 18 years old, killing around 1,300 children and teenagers a year in the United States. In addition, almost 6,000 children and teenagers are injured per year by guns. Many teenagers are permanently disabled from these injuries. For teenagers who commit suicide, guns are the second-leading cause of death. The CDC has recently moved suicide from the third-leading cause of death for teenagers to the second-leading cause of death. This is a scary fact that the rate of teenage suicides are increasing not decreasing.

The study in the Journal of Pediatrics examined data from the Centers for Disease Control and Prevention and the Consumer Product Safety Commission between 2002 and 2014. The study found that boys, especially older boys such as teenagers and minorities, were much more likely to be the victims of gun violence. The study did not say anything about where the boys lived. The facts are children who are male and teenagers, are at a higher risk for becoming a victim of gun violence regardless of where they live. Therefore, teenagers in our area are at risk of becoming a victim of gun violence.

The study does indicate there has been a decrease in accidental deaths such as boys cleaning a gun. However, the rate as a method for suicide has increased. I have mentioned before that suicide is no longer the third leading cause of death for 10 year old boys. It is now the second leading cause of death for boys 10 to 18 years old. This study confirms that statistic and indicates the preferred method of suicide for boys and teenagers are guns. According to Katherine Fowler, one of the lead researchers at the CDC, “Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children.” Understanding their nature [guns] and impact is a first step toward prevention.”

When we look at these numbers, can anyone argue against taking steps to protect our children? Can you imagine a 10 year old boy using a gun to kill himself? Can you imagine a 10 year old boy feeling that his life is so bad at the age of ten that death seems like a better option than living? At the age of 10, he has given up hope for a decent life. This is a sad fact. Can you imagine being the parent or sibling of a 10 year old suicide victim and finding your child’s brains all over the room? How did a 10 year old get a gun for suicide? How does a teenager get a gun to shot and kill people at their high school?

The study also indicates that in recent years guns were responsible for a large number of adolescent, males who were murdered. The study documented that deaths in the category of murder for boys under the age of 18 years old decreased to 53 percent. This is a decrease yet the rate is still 53%. The other causes of gun-related deaths include:

• 38 percent — suicides

• 6 percent — unintentional deaths

• 3 percent — law enforcement/undetermined cause

The study found 82% of deaths by guns were boys. This means 82% of gun deaths were boys who were children or teenagers. Putting it another way, this means these boys were not even 18 years old yet at the time of their deaths. The study also found that white and American Indian children have the highest rate of suicide using a gun. How did they get access to the guns?

We also like to think that the United States in one of the most advanced nations in the world. However, the statistics show that the United States has the highest rate in the world for children under 14 years old committing suicide. Again, the United States has the highest rate of children under 14 years old using a gun to commit suicide. That number scares me and is appalling to me. However, as an adolescent and child psychotherapist, I do not doubt it. I have heard 6 year old boys seriously discussing suicide.

Furthermore, I hear teenagers routinely talking about needing to carry a knife or gun with them for protection. They tell me you never know when you will be jumped or there will be a mass shooting and you need to be able to protect yourself. In fact, a few years ago a teenager was shot on his front door step in Danville over a marijuana deal which went bad. When I mention to teens the risks they are taking carrying a gun, they tell me there is no guarantee they will live until 30 years old anyway. They would rather die protecting themselves than doing nothing.

As a society, we need to look at these numbers and ask ourselves some questions. What are we going to do in order to improve gun safety? How are adolescent boys getting access to guns? Most importantly, why are children as young as 6 years old thinking about suicide? Also what are we going to do so that children who are suicidal have access to mental health care? This is our problem because it does happen in Pleasant Hill, Walnut Creek, Lafayette, Orinda and Danville.

Finally, we are only in the month of August and the number of Americans killed to date is more than in 2019 (CDC). We are seeing mass shootings increase, violence against Asian Americans and Jewish Americans, Transgender teenagers and police killings. What is happening in the United States? We are the only Country in the world dealing with mass shootings? However, we claim to be the most advanced nation in the world. Maybe Congress needs to look at these numbers and think about their actions. For example, Republicans stating the attack on the US Capital was not violent is crazy. It was violent. Several police officers were killed and they wanted to hang the Vice President. I think that qualifies as violent. We have videos of people assaulting the Capital Police and demanding to hang the Vice President. The Republicans in the House of Representatives remove Represetative Cheney from her leadership post because she won’t lie and say that Biden did not win the Presidential Election. Finally, you have a Republican representative comparing the requirement to wear masks in the House Chambers because everyone in the House of Representatives are not vaccinated. Someone who speaks the truth is removed and someone who makes racist, homophobic and anti Semitic statements is praised. This may be one part of the issue. We need to support people who are treating other people appropriately and we need to speak out and refuse to allow people who are treating people like garbage to continue to be allowed to treat people like garbage. Bottom line, we can no longer ignore the public health emergency created by guns and we must act an enact sane gun laws. People have to wear seatbelts in cars but you can still drive. You need to be 21 years old to drink or buy alcohol, but this law has not prevented adults from using alcohol. Therefore, sane gun laws will not take away guns from everyone! We are a nation of intelligent people please start using your common sense regarding guns.

If we don’t start to address this public health issue, we are going to continue to have children and teenagers who have severe anxiety and depression disorders and suicide rates for children and teenagers will continue to increase. By not controlling guns, mass shootings and the other violence, such as hate crimes, we are expecting children to grow up in a very scary, unpredictable world. Anxiety and depression are the sane responses. Are we going to allow mass shootings to continue or are we going to enact sane gun laws and provide children with a safe place where they can grow up? We owe it to the children.

Dr. Rubino has 25 years experience as a psychotherapist working with children and teenagers. For more information about his work or private practice visit his website at www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3.

Coping with Teenagers Driving during the Summer

Coping with Teenagers Driving during the Summer

Its summer time and many things are reopening and many teenagers are looking forward to spending time hanging out with their friends. Many teenagers want to drive around town or go to Santa Cruz with their friends. Many parents worry about their teenagers driving other teenagers around and they worry about what the teenagers may be doing before driving. Parents worry about teens drinking and driving and driving late at night because typically teenagers still have a great deal to learn about driving. Parents have a right to be concerned because most motor vehicle accidents tend to involve teenagers (CDC). In other words, teenagers have the most car accidents. Therefore, parents worry about how their teenagers drive, who they are driving with and what they are doing before they are driving.

This is the reason that I have always stressed behavior contracts with teenagers. It gives parents a chance to discuss their concerns with their teenagers and to also set limits regarding appropriate behavior. No parent wants their teenager to fail school or to get hurt while out with friends. Since the prefrontal cortex of a teenager’s brain is not fully developed, at times they have difficulties making appropriate decisions. Again they may physically look like an adult, but mentally they are still very impulsive and at times act more like 5th graders. This is why contracts can help teenagers understand where their limits are and what will happen at home if they violate the limits.

Besides a contract regarding school and homework, a contract regarding driving is very important. Due to the new laws some teenagers are not driving at 16 years old and waiting until they are 18 years old. When they are 18, many of the new laws do not apply to them. However, whether they are 16 or 18 years old, they are driving your car so you are financially responsible if they are in an accident. Additionally, whether they are 16 or 18 years old, no patent wants their child seriously hurt in a car accident. With that being said, below is the contact I recommend patients use for their teenagers regarding driving. I recommend you use this contact whether they are 16 years old or 18 years old. Below are the essential parts of a driving contract that I recommend:

1. Have some baseline rules.

The driving contract for new drivers should include baseline rules to discourage behaviors that lead to accident and injury or death. These behaviors should include never driving under the influence of alcohol or drugs, never using a cell phone while driving, never speeding, and always wearing a seatbelt.

2. Include consequences.

The teen driving contract should also include specific consequences for violating the rules. Parents must be willing to enforce the rules in the teen driving contract. Otherwise your teenager will have no real incentive to follow them. Making the consequences specific—you will lose access to the car for a week, if … —is helpful. That way, everyone will be on the same page about what will happen if the rules are broken.

3. Always offer a “Safe Passage” clause.

Parents should institute a “safe-passage” clause in their contract. If they are ever concerned about getting into a car, as a driver or a passenger, you will pick them up. No questions asked. Save the discussion for the next morning or, better, yet several days later.

4. Be willing to enforce the contract.

The effectiveness of the teen driver contract directly correlates to your enforcement of it. These kinds of rules encourage teenagers to take the responsibility of driving seriously, while also helping them resist peer pressure.

The contract is basic and everyone understands the consequences if the contract is broken. This can prevent a lot of arguments. I recommend that parents and the teenager all sign the contract and all receive a copy of it. This is an example of a contract for driving, but you can use contracts for many issues such as homework. I have found that many parents become overwhelmed trying to write a contract. Therefore, I have included this link https://adayinourshoes.com/behavior-contract-templates-elementary-teen/. It has templates to over 27 behavior contracts you can use with teenagers and they are free to download. Hopefully, this will make using contracts easier.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers and trauma victims. For more information regarding his work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

When Will We Value the Lives of Children?

When Will We Value the Lives of Children?

Do we have our priorities straight? On May 24, 2022, 19 children were brutally murdered at their elementary school by a mass shooter. The children’s bodies were so torn up by the assault weapon that parents had to provide DNA samples so the corner could identify the bodies. All the funerals had to have closed caskets because the children’s bodies were too mutilated to have an open casket. Today is only June 5th and there have already been over 300 mass shootings since the shooting in Texas on May 24th (Gun Violence Archive). Even with these numbers of shootings and people being injured and killed, the Republicans in the Senate cannot vote for safer, sane gun laws.

These shootings are not new to our Country. In 1999, there was the Columbine High School shooting, then the Sandy Hook Elementary School, then the Parkland High School shooting and now the Robb Elementary School shooting in Texas. This is not a complete list of school shootings. Besides schools there have been mass shootings in churches and shopping malls. Every time we see this is enough and we need to reform gun laws. However, the Republicans in the Senate have continued to debate gun reform laws or to vote on any gun reform laws to protect children. All they do are to offer thoughts and prayers. Thoughts and prayers are not going to solve the problem. It reminds me of the man who drowns and he asked God, why didn’t you answer my prayers and safe me. God said I sent a two boats and a plane but you refused them. We cannot expect God to take care of everything. We have to take action to solve the mass shooting issue too.

While we are not discussing how to protect children, there is a bill in the Senate to provide more protection for judges from mass shooters. Last year a judge’s, 20 year old son was shot at their house. Last week another judge was shot and killed at his home. The judges do not deserve to be shot, but they are public servants. People getting angry at them is part of their job. Yes they need added protection so they are not being killed, but the school children should be protected first.

The bill is being delayed in the Senate because Republican Senator Lyndsey Graham, who states the school shootings do not require gun reform, wants members of the Senate including in the bill in addition to the judges. They won’t discuss gun reform when childrens lives are at stake, but when it involves their lives we need gun reform and can discuss it.

In my opinion this is disgusting. The parents in Texas had to give DNA samples because their child’s body was so torn up that the corner could not identify them. This is happening at all the mass shootings. These AR15 guns are weapons of war and the bullet explodes inside the body tearing the body to pieces. No child deserves to die this way and no parent should have to hear we need DNA to identify their child. The Senators and judges are public servants and people do make threats against them. It is part of their jobs. Given this fact, we should be protecting our children first.

However, we are not protecting our children. The Republicans in the Senate are using their positions to protect themselves first and the children may be one day. Remember Columbine occurred in 1999. We have been waiting since 1999 for gun reform to protect children. A judge’s son was killed 23 months ago and there is already a bill on the Senate floor. Children and families have been waiting for 23 years for the Senate to protect children. The judges and Senators only had to wait less than 2 years. What is wrong with our priorities when we will allow children to die for 23 years and not doing anything seriously to protect children, but when the Senators and judges are at risk, they move with lightning speed. No one is just offering judge’s thoughts and prayers. The Republican Senators are acting to protect the judges, but do nothing for the children.

Parents need to act. Parents need to call Senators and demand that they put the children first. The must demand that the Senate pass safe, sane gun reform that will protect children. They need to focus on the children before they focus saving their own lives. Look at how many mass shootings have been occurring. Do you want a corner to ask you for a DNA sample so they can identify your child’s body. It can happen easier than you think. Look at how many mass shootings have been occurring and they are happening every where. We need safe, sane gun reform today! Please do not let the Republican Senators drag their feet. The next shooting may involve someone you love and then it will be too late.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children, teenagers and trauma victims including first responders. For more information about Dr. Rubino’s work please visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

Dealing with Father’s Day when Dad is gone

Dealing with Father’s Day when Dad is gone

Many people assume Father’s Day is a happy day for people because they can honor their father. However, due to the pandemic and deaths due to the pandemic, Father’s Day this year maybe a very difficult day. We have many adults and children who are grieving the death of their father or grandfather due to the coronavirus. Therefore, making it a sad day for them. Remember over 1,000,000 Americans have died due to the Coronavirus. Many people who died were fathers and grandfathers so there will be a lot of grieving families this Father’s Day. Additionally with the number of mass shootings, people may be grieving the death of a father or grandfather. Also if it was a school shooting, fathers may be grieving the lost of a child or a spouse. Again making Father’s Day a difficult day, not a happy day.

In addition to the Coronavirus, there are other reasons that Father’s Day maybe difficult for people and children. For some people their father may have died when they were children. For some people their father may have left them when they were children and they had to live in foster care. For others, their parents separated and their mother raised them and they rarely or maybe never saw their father. Finally, many people have lost their fathers, grandfathers and uncles over the year due to cancer, heart attacks and other diseases. Therefore, Father’s Day may not be a happy day. Also for children who were raised in foster care all their lives, today typically is a very difficult day. They were raised without biological family and feel left out of Father’s Day.

While this may not be a happy day for adults, it also can be a very difficult day for children too. Some children may be dealing with the recent death of their father. As I stated above, some children may have a father who died from the Coronavirus, cancer or in a mass shooting. Other fathers may have left the family due to a drug problem and are not involved with the family any longer. Seeing television commercials or having other family members tell them that it still can be a good day can be difficult for them. Also if their school or summer day camp are making Father’s Day gifts it can be difficult for children whose fathers have died or left the family.

I work with many of these children, I described above, in psychotherapy. Many don’t express their feeling, but they tend to deal with the emotional pain by acting out. They may be very oppositional during the week and on Father’s Day as away to express their feelings. Other children may isolate themselves and not want to be involved with anyone or anything having to do with Father’s Day.

I have had parents ask me how they should handle Father’s Day when a parent has passed away or left the family. They understand that it is a difficult day, but they do not know what to do in order to help their children.

My recommendation is let the child cope with the day in the way they need to. Try not to make an issue about the day. The other thing I recommend to a parent is to talk to their child. Acknowledge that Father’s Day may be difficult but it is just one day. They may have a rough day today but tomorrow is another day. It is important that you understand that Father’s Day is difficult for them and you understand if they are upset or don’t want to do anything. I also recommend to a parent, when a parent has passed away, to ask the child if there is anything they may want to do to remember their father. A child may want to release a ballon with a note, they may want to visit the cemetery or they may want to do something for an uncle or another male role model in their life. If they do have an idea, go with what they want to do. If they don’t have an idea, let them know that is okay. If they come up with an idea then you can do it. If they do not have an idea, then remind them it’s just one day that you all need to get through and tomorrow will be better.

This approach can help children whose father has left the family too. Many children may believe their father will return one day. Confronting this belief around Father’s Day is not the time to confront it. However, if they have an idea regarding how they want to honor their father, allow them to do it.

Hopefully this will help parents understand the issues their children may be dealing with on Father’s Day and make it easier for everyone.

Also as I stated above, with the mass shootings many fathers may be grieving the loss of their child or spouse. They may have had their child’s funeral the day before. Again, remember this is a very difficult time for a parent or spouse so allow them the freedom to deal with the day the way they want. Being there and being supportive is the best thing you can do for Fathers who are grieving and for children who are grieving.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers. For more information about Dr. Rubino’s work or private practice visit his website www.RubinoCounseling.com or on Facebook at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple.

How to Help Kids and Parents Cope with the Mass shootings

How to Help Kids and Parents Cope with the Mass shootings

Unfortunately, with a mass shooting occurring every day in the United States (CDC), adults, teens and children are having to deal with grief on a regular basis. In addition to family members and friends, first responders such as EMTs and Emergency Room staff are dealing with grief due to these mass shootings. Adults may have an idea how to deal with grief, but teenagers and children do not. Our society does not deal with death in a healthy manner. Therefore, many people do not know what to do for or what to say to someone who is grieving. Many patients have asked me about what to do in these situations. While doing research regarding grief for patients, I found this information from the grief center.

This last week and this weekend have really shined a light on the problem of mass shootings. There was the mass shooting in Buffalo, New York, another one at a church in California and the most shocking one the shooting at the elementary school in Texas killing 21 mostly 10 year old children. Additionally, we have already had another 3 mass shootings during the Memorial Day weekend. To add to the trauma, the NRA held their convention in Texas near the elementary school and had the nerve to tell people that we don’t have a gun problem and we are imagining it. This type of insane rhetoric only make the grief and trauma that people are experiencing worse.

Since all of these shootings have been being covered by the news, children are well aware of these shootings and are asking questions and having emotional reactions. These mass shootings are a very hard subject to explain to kids who are asking about these shootings and are they safe. As I researched this topic, I found information from the Grief Center and I think it is very good information and very easy to understand. Unfortunately, it is needed at this time as we grieve for victims of the current mass shootings especially the elementary school shooting. As a result, many children and adults are feeling overwhelmed and do not know what to do right now. Therefore, I will present the Grief Center 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. The main point of grieving is rebuilding your life without your loved one being physically present anymore. Also since these incidents have created trauma, we have to find away to continue to live our lives without letting the fear paralyze us. It is very important to understand these points. 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 needs people to talk to without people feeling awkward. Also everyone is around immediately after the death and through the funeral services. Most people then go back to their normal lives. However, those who were really close to the person are still grieving and trying to figure out how to proceed with life. So don’t forget the person who is grieving can use emotional support for the first year especially. Therefore, do not forget to call, send a card or stop by occasionally. Especially around the holidays and birthdays.

These mass shootings have destroyed the illusion that we are safe at home. Also since there were children killed, other children may experience a traumatic response. Children may start to have nightmares, be afraid to be left alone, be afraid of their parents going to work or they may become very quiet and just want to stay at home. The point is there are a number of reactions they can have to these events. If you are noticing a reaction, talk to them. Do not ignore their reactions. Ignoring the reactions only increases the anxiety. Remember, children have very vivid imaginations. Reassure them that you will do everything you can to keep them safe. If you are concerned about the reactions you are seeing, schedule an appointment with a child psychotherapist. Schedule an appointment with a psychotherapist who specializes in treating children and trauma victims. Talking about their fears is very important. When you do not talk about their fears openly and calmly, children take this as a sign that you are too afraid to tell them how bad the situation is and their imaginations go wild. Therefore, as hard as it may be because you are worried too, talk to your children about the events.

Dr. Michael Rubino has over 25 years experience as a psychotherapist treating adolescents, children, their families and trauma victims including first responders. For more information regarding Dr. Rubino visit his website www.RubinoCounseling.com or his Facebook page www.Facebook.com/drrubino3 or follow him on Twitter @RubinoTherapy

My Teen is Extremely Anxious, What do I do?

My Teen is Extremely Anxious, What do I do?

Over the years children and teenagers have been exposed to stressful life events especially the last two years. The teens today have grown up with daily school shootings and mass shooting drills. Imagine being a second grader having to rehearse a man with a gun is on campus and you don’t know if you are going to live or die. Teenagers today have also grown up with terrorist alerts and having to be searched anytime they went to a concert or places such as Disneyland. Finally they have had to cope with COVID. Over 1,000,000 Americans have died from this virus (CDC). Many children and teenagers have lost grandparents, siblings and parents to this virus. We thought we had turned a corner regarding the Coronavirus and we find out we are back at the beginning. There are still people being diagnosed daily with the Coronavirus and a number of these people have been vaccinated. However, most are not fully vaccinated. Additionally, this time the virus is effecting teenagers and children. Since schools have resumed on site classes at least 1,000 children have died due to the Coronavirus virus (CDC).

This is a lot for a child or teenager to have to adjust to. Remember, their brains are not fully developed yet. Therefore they cannot understand things like adults do. Furthermore, they have very active imaginations which are fueled by misinformation on social media or from people such as Tucker Carlson on Fox. Having to cope with all of this together has resulted in a significant increase in depression, suicide, drug overdose and anxiety disorders. At my office we get at least 20 requests daily for teenagers seeking psychotherapy due to anxiety disorders.

The fact that we thought we were on the right track with the Coronavirus and now we have another spike which is similar to the numbers a year ago is confusing and irritating to teenagers. Just as somethings were opening up and returning somewhat to normal, we had another spike and needed to adjust our lives again. As a result, many things had to be closed down again, there were definite rules regarding wearing masks and teens were not able to freely socialize with their friends. Again we are not able to give children and teenagers any definite answers regarding when life will return to something normal. Now we have changed the rules again and masks are not required but recommended for events inside.

With everything teenagers have had to cope with growing up, terrorist attacks, war, the economy collapsing, mass shooting and now the Coronavirus, we failed to make plans for their mental health care. Yes hospitals were running out of beds and physicians have become exhausted, but we are also running out of psychotherapists. Also psychotherapists are exhausted because they are dealing with adults and teenagers daily who dealing with depression, suicide and anxiety. However, psychotherapist do need some breaks so they can keep going. Finally, more and more insurance companies are declining claims or raising copayments so high that families cannot afford their copayments.

This lack of mental health care is unacceptable in the United States. Parents call the Human Resource Department at your work. They negotiate your benefits with the insurance companies. Therefore, they can renegotiate your coverage so you receive the benefits your family needs. Also call your Senators and demand that insurance companies need to provide mental health care.

As a result, many parents have asked me how to determine if their child is coping with anxiety and what to do if they are coping with anxiety. I can understand why parents are concerned especially because many children tend to try to hide their anxiety because they don’t want to worry their parents. Additionally, parents are trying to find psychotherapist who can treat children and teenagers are parents are trying to figure out how they can afford therapy with the cost of living increasing and insurance companies restricting coverage.

Therefore, the APA (American Psychological Association) developed guidelines that parents can use to determine if their child is dealing with anxiety and what to do if they are dealing with anxiety. You can also use the guidelines for depression too. I have provided an outline to the APA guidelines below:

The American Psychological Association (APA) offers the following tips to recognize if children may be experiencing stress or anxiety:

• Withdrawal from things the child usually enjoys

• Trouble falling or staying asleep

• Unexpected abdominal pain or headaches

• Extreme mood swings

• Development of a nervous habit, such as nail-biting

Parents can actively help kids and adolescents manage stress by:

Being available

• Start the conversation to let kids know you care about what’s happening in their lives.

• Notice times when kids are most likely to talk – for example, in the car or before bed.

Listening actively

• Stop what you’re doing and listen carefully when a child begins to open up about their feelings or thoughts.

• Let kids complete their point before you respond.

• Listen to their point of view even if it’s difficult to hear.

Responding thoughtfully

• Resist arguing about who is right. Instead say “I know you disagree with me, but this is what I think.”

• Express your opinion without minimizing theirs – acknowledge that it’s healthy to disagree sometimes.

• Focus on kids’ feelings rather than your own during conversation.

• Soften strong reactions, as kids will tune you out if you appear angry, defensive or judgmental.

• Word swap.

o   Say ‘and’ instead of ‘but’

o   Say ‘could’ instead of ‘should’

o   Say ‘aren’t going to’ instead of ‘can’t’

o   Say ‘sometimes’ instead of ‘never’ or ‘always’

Consider

• Model the behavior you want children to follow in how they manage anger, solve problems and work through difficult feelings. Kids learn by watching their parents.

• Don’t feel you have to step in each time kids make what you may consider a bad decision, unless the consequences may be dangerous. Kids learn from making their own choices.

• Pay attention to how children play, the words they use or the activities they engage in. Young children may express their feelings of stress during play time when they feel free to be themselves.

• It is important to explain difficult topics in sentences and even individual words kids will understand. For little kids it might mean saying simple things like, “We love you and we are here to keep you safe.” For adolescents, it’s important to be honest and up front about difficult topics and then give them a little space to process the information and ask questions when they’re ready.

Call your child’s or adolescent’s health care provider or a psychotherapist who specializes in treating children and teenagers, if stress begins to interfere with his or her daily activities for several days in a row.

You can find additional helpful information about kids and stress by visiting the Centers for Disease Control and Prevention’s Helping Children Cope webpage at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/for-parents.html.

Dr. Michael Rubino is a psychotherapist with over 25 years experience treating children and teenagers. For more information about Dr. Rubino’s work visit his website at www.RubinoCounseling.com or his Facebook page at www.Facebook.com/drrubino3 or his podcasts on Spotify or Apple or on Audible.

There is No Reason to be Ashamed of Mental Health

There is No Reason to be Ashamed of Mental Health

Mental health is a topic we tend to avoid in our society. We avoid it so much that the month of May is dedicated to Mental Health Awareness. Many people are afraid that if other people know they are feeling down or anxious that people will think they are crazy. Many people think of someone living in the streets when you mention mental health. This is not reality. This negative stigma makes it difficult for adults to seek help for mental health issues. This negative stigma also makes it very difficult for children to ask for help when they feel depressed or anxious. They are afraid their friends won’t understand and won’t want to be friends with them. They are also afraid their parents will think they are crazy and be disappointed with them. These ideas are incorrect, but if mental health is overwhelming for an adult, imagine how it can be for a child.

It is very important that children and teenagers do ask for help when they are experiencing mental health issues. The CDC estimates 1in 5 children need psychotherapy for a mental health issue. Furthermore, the CDC has stated that Suicide is an epidemic for children between the ages of 10 and 18 years old and is the second leading cause of death for kids 10 to 18 years old. Cutting, self-harming behaviors, are also now at an epidemic rate in children. Most teenagers I work with, as a psychotherapist, have had suicidal thoughts and have cut before starting therapy with me. They also tell me about many of their friends who are feeling suicidal and cutting. According to the CDC, the Suicide rate and the number of teenagers engaging in self-harming behaviors has been increasing every year for the past twenty years.

While the need for teenagers needing psychotherapy is increasing, the reluctance to attend psychotherapy is increasing. Most teenagers I see for psychotherapy are afraid that their friends would stop being their friends if they knew they were going to therapy. They are afraid it makes them crazy and nothing will help because they are weak. They blame themselves for the feelings they are having. They are shocked when I explain that they are not weak and it is not their fault.

We need to change this stigma associated with mental health. Mental health should be treated the same way a physical health because they are the same. Clinical depression is caused by a chemical imbalance in the brain. If some one is diabetic, do we call them crazy or weak because their pancreas is not producing the correct level of insulin? No we do not. Therefore, when we have numerous research studies which show a link between physical health and mental health, why do we continue to view mental health so negatively? By doing so we are causing a number of teenage deaths. Suicide use to be the third leading cause of death for teenagers, however now according to the CDC it is the second most common cause, as I stated above. Many teens also die every year from eating disorders. Eating disorders occur in both girls and boys despite the belief girls only have eating disorders. Bullying is a severe problem and many teenagers are opting to commit suicide rather than discuss the pain and torture they are experiencing due to being bullied. This does not make sense that teenagers should be dying because the teen or their family are embarrassed to seek treatment.

I was researching this subject and found a video by the Anna Freud Institute. It is called, “We all have mental health.” It is a short video directed at teenagers and middle school students. It discusses the issue in a very relaxed manner and provides teenagers with options for how they can talk about their own feelings. I encourage parents, teachers and anyone who deals with children to watch this video. You may want to watch it with your teen and begin a discussion about feelings. The link to the video is https://youtu.be/DxIDKZHW3-E.

We need to start to change the negative stigma associated with mental health. Besides causing the deaths of teenagers, this stigma effects an entire family. A death impacts everyone in a family. Not being able to talk openly about a death because it was related to a mental health issue, creates more problems for the survivors. Nothing will change until we start to approach mental health differently. I also encourage you to look at the foundation started by Prince William and Henry, Heads Together. It provides a number of ways we can start to change the negative stigma associated with mental health and save lives.

Furthermore, at this time in our world, when we are in the middle of a pandemic which besides killing thousands of people daily, it is creating mental health issues for those in quarantine, those with the virus and our first responders. These issues will not disappear quickly just like the virus will not disappear quickly. As a result, we will have even more people needing mental health care. How will they receive it if they feel ashamed for needing treatment or if we continue to treat mental health as a disease? Mental health and physical health go hand in hand, when will we treat them equally?

Dr. Michael Rubino is a psychotherapist with over 20 years experience working with teenagers and children. For more information about his work or private practice visit his website http://www.RubinoCounseling.com or his Facebook page http://www.Facebook.com/drrubino3.