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Wednesday, 2 January 2019

The better way to discipline children

It may be the toughest part of parenting: learning how to discipline children.

As all parents know, or figure out, raising children isn’t just about feeding, changing diapers, sleepless nights, hemorrhaging bank accounts, or general chaos. It’s about raising them to be safe, kind, respectful, and productive human beings.

The word “discipline” literally has its roots in the Latin word disciplinare, to teach or train. Parents need to teach their children good behavior; it doesn’t just happen. And it is incredibly hard work, especially because when children act badly, it can get on a parent’s last nerve and trigger an angry response, like yelling or spanking.

According to a policy statement (Effective Discipline to Raise Healthy Children) recently released by the American Academy of Pediatrics, “aversive” discipline techniques like yelling and spanking are a really bad idea. Not only do studies show that they don’t work that well, they can have long-term negative effects.
The problem with aversive discipline

Children who are spanked have a higher risk of aggressive behavior (which makes some sense, as spanking teaches children that in some circumstances hitting is okay), mental health problems, intimate partner violence, and substance abuse. Although some of this is confounded by the fact that parents with mental health problems are more likely to spank, and having a parent with mental health problems puts kids at risk for all sorts of problems, studies show that corporal punishment like spanking is an independent risk factor for problems down the road.

The same goes for harsh verbal discipline. Just about every parent yells, I think. But when it’s consistently used as discipline, it leads to mental health and behavioral problems for children. Also, as with spanking, it hurts the relationship with the child. Think about it: how does it feel for a child when the person they love and need most in the world hits them or says bad things to and about them?

That doesn’t mean that every child who gets spanked or yelled at has problems for the rest of their lives, as many a well-adjusted, happy adult who was spanked or yelled at as a child will attest. But why take the risk, when there are better ways to discipline?
A better approach to discipline

The better way to approach discipline is in a loving, proactive way. Teach the rules ahead of time, rather than waiting for your child to break them and reacting then — and be as positive and empowering as you can. Here are some tips:

    Have realistic expectations. Babies are going to cry, toddlers are going to get into things they shouldn’t, school-age kids sometimes lie to avoid trouble, and teenagers — well, they do all sorts of things as they assert their independence. Not that you have to ignore or condone these behaviors (well, you might have to just deal with a baby crying, that’s not misbehaving), but it’s important to understand the stage your child is going through as you discipline. At each checkup with your pediatrician, talk about what to expect next in your child’s development.
    Set clear limits. No should mean no, and there should be house and family rules for kind, safe behavior. Each family will have slightly different rules, but they should be clearly stated and known to everyone. Not only that, but when it comes to rules you need to…
    Be consistent. If something isn’t allowed, it’s not allowed. If you give in sometimes out of sheer exhaustion or because you weren’t super committed to that rule, kids will pick up on that immediately. Which means that you need to choose your rules carefully (meaning: pick your battles).
    Have predictable and clear consequences for breaking rules. Giving kids a heads-up is helpful (“I am going to count to three, and I need that to stop or we will have a consequence”). The consequence should be something they don’t like — sending them to their room where they play with toys may not do the trick. “Time-out” is one option, where you put the child in a boring place for a minute for each year of age, and don’t interact with them. You can also take toys or privileges away.
    Reinforce good behavior. Say things like, “I love it when you…” or “That was so nice that you did that!” or “Because you behaved so well today, let’s read an extra story tonight.” Children like praise, and may be more likely to behave well when they see that it’s worth their while.
    Be mindful of your own needs and reactions. Parenthood is hard. Sometimes parents need a time-out themselves. If you feel yourself getting really upset, make sure your child is somewhere safe and then take some time to calm down.

It’s normal to struggle with discipline — every parent does, at some point. So ask for help whenever you need it. Your pediatrician can be a resource, as can family, friends, and behavioral health clinicians. It takes a village to raise a child; everybody needs help sometimes.
I understand why people embrace New Year’s resolutions: it’s a chance to wipe the slate clean and set annual goals with new focus and enthusiasm. But are they focusing on the right areas of their lives? Instead of setting resolutions, a better approach may be to conduct a health self-assessment. It’s a way to take an in-depth look at where you are now, so you can identify the parts of your life that need the most attention. “A self-assessment gathers the vital information you need to begin thinking more about your life and how you want to live,” says Susan Flashner-Fineman, Vitalize 360 Coach at Harvard-affiliated Hebrew SeniorLife, a comprehensive wellness program that promotes healthy aging.

According to Flashner-Fineman, a complete analysis of your well-being should encompass five areas: physical, intellectual, social, financial, and spiritual. For each category, explore what you are you doing well and where you can improve. “This way, it’s not all about focusing on your shortcomings, but rather highlighting your strengths and building on them,” says Flashner-Fineman. Here is a look at the five categories for your health self-assessment.

1.   Physical. Instead of focusing on simply staying healthy, tailor your fitness to meet specific goals, says Flashner-Fineman. “Ask yourself, what level of activity do you want and what do you need to maintain it?” For instance, do you want to continue gardening, or have greater endurance to interact with grandchildren, or just improve your functional fitness so you can do daily chores and activities with less pain and risk of injury? “Connecting it with something you want to accomplish also can help you stay motivated and focused on your health going forward,” says Flashner-Fineman.

2.   Intellectual. Are you doing enough for your brain? It’s so easy to get trapped in the lull of repetitive activities that don’t work your memory and problem-solving skills. Learning something new is a great way to challenge your brain. For example, learn to play bridge, paint, or play a musical instrument. Interested in a particular subject? Take a class at your local college (many offer free tuition for older adults). You can also raise the bar on an existing skill. Love to cook? Try French cooking. Practice your public speaking at a Toastmasters club, or join a chess or book club.

3.   Social. How well do you currently connect with others like family, friends, and neighbors? And how often do you interact with them on a regular basis? “Think about how you can improve your existing relationships as well as make new connections,” says Flashner-Fineman. For example, make a point to call, write, or go out to lunch with a close friend once a week, or consider joining a club of some kind that has regular meetings and social events.

4.   Financial. Do you stress about money issues? A professional financial planner can help evaluate your current financial situation and devise a plan to prepare for the future. Lifestyle changes can ease financial strain and even make your life a bit easier. For instance, you could move into a smaller place that requires less maintenance and upkeep, buy everyday items more cheaply in bulk, or cut your cable and use the Internet for watching shows. “You don’t want to make changes that affect quality of life, but often we are afraid to make positive changes because we are used to a certain way of living,” says Flashner-Fineman. “But if you understand why the change is good — like freeing up more money to travel, for example — then it’s easier to do.”

5.   Spiritual. Studies have found that some level of spirituality and gratitude is associated with greater wellness. Some people do this through religion or a faith-based community, but others choose activities like meditation and interactions with nature.
Here we are at the end of December, and some of us are contemplating another chance for a fresh reboot. The infamous New Year’s resolutions are a common topic. Last year I wrote a blog post about an overall view of how to be successful when thinking about reaching a goal. Changing behavior is all about learning a new skill. Ultimately, you are teaching your brain that you can do a specific job, creating a new habit that eventually will be part of your weekly or daily routine. In a similar way that’s how we learn how to cook, and even how you learned to speak or walk. Acquiring a new habit requires a plan, practice, and reflection on how to improve. Let’s harness the teaching mode to make this learned skill part of your life in 2019.

“Start exercising” is what most of my patients say when I ask them what could make them healthier. Here is an effective way to incorporate physical activity into your weekly routine moving forward.

Do not skip any of the six steps. Make sure you write them down. Remember, this is a process.
Step 1: Reflect on the feelings you might have toward exercise

For some people, just thinking about exercising creates undesirable memories and anxiety. Let’s first deal with the ingrained thoughts and emotions related to exercising. It will probably take you around 10 minutes to write this down. Writing is better than typing, so grab a piece of paper. Do you feel helpless? Do you feel you do not have any guidance? How did you feel when you were not able to follow through on your plans in the past? How do you feel about going to a gym? What did you learn from your past experiences? Reflecting on your feelings and emotions will help you deal with the barriers you may encounter. Failure to recognize and to be aware of these thoughts and feelings may be one of the reasons many have a hard time reaching their goals.
Step 2: Go deep into the reasons why you want to move more

It is not because you need to exercise, but instead pin down why you want to start exercising. Having the reason you want to exercise written down is what you will revisit when you cannot get off of the couch. Is it because you want to be fit? Do you want to look better? Is it because you want to go on a trip where you will be walking several hours a day? Is it because you want to have less anxiety, or maybe you want to lower your blood pressure? If you are not sure of the reason why you want to do it, I would recommend more reflection, talking to your family and friends, or to your doctor. If you are not ready to make the change, I would suggest asking why. Why is exercising not that important? If you don’t move more, how do you see yourself 10 or 20 years from now? What do you want your health for? How do you see yourself after you start working out? What will you do when you feel stronger and healthier?
Step 3: It’s time to come up with a plan

You can either write or type into a computer. If you type, make sure to print the program and put it in a place where you can see it every day. It can be your fridge, your office, a spot you pass frequently. Choose the exercise and how much time you will allot per week to do the task. Come up with a realistic plan to fit your schedule. Don’t create an unreasonable plan to work out an hour a day, five times a week starting January 1st if you are sedentary, have a full-time job, and still have to take care of your family when you get home. You are setting yourself up to fail. This is the biggest mistake I see when people are trying to incorporate a new habit. Failure can be very frustrating, and it is one of the main reasons New Year’s resolutions do not develop into habits. Take a look at your schedule and choose an exercise you enjoy and that is doable. It is okay to start walking at a fast pace 10 minutes twice a week, or do a seven-minute workout routine, but make sure you block out the time to do so.

Now that you have reflected on your emotions, written down the reasons why you want to start exercising, selected the type of exercise and the amount of time you will devote to get moving, let’s come up with a more detailed plan, so exercise is part of your routine in 2019.
Step 4: Develop a detailed plan based on time, rest, and intensity

Let’s say that you decided you will start walking at a fast pace for 20 minutes per week, two sessions of 10 minutes each. You eventually want to get to the standard recommendation of 150 minutes of moderate exercise per week, or 75 minutes of vigorous physical activity per week. You will do this very slowly, and it will take several months. To get there, you will adjust three variables: the amount of time per week (volume), the amount of rest you will have between sessions, and the intensity of the exercise. You will change only one variable at a time every two months. Remember that you are teaching your brain that you can do a particular activity. If you manipulate all three variables at the same time your brain gets confused. For example, if you want to change the volume (duration and distance), add 10% to 20% of the time to each of your two weekly sessions, walking at the same pace. Do not start to run (intensity) and add time all at once, for example. If you want to go a little faster instead, continue training twice a week for 10 minutes. If going faster is too subjective, consider buying a heart rate monitor and increase your heart rate by about 5% to 10% after each session. You could also reduce the amount of rest between your sessions, adding another 10-minute session in the middle of the week, using the same pace.
Step 5: Adapt your plan using four-session cycles

If you feel too tired midway through your exercise, there is a chance you are changing the variables too fast, and you could be overtraining. People who overtrain get injured and are less likely to continue the learning progress. You do not need to reach your goal too quickly; learning takes time. Slowly ramp up your routine, either increasing volume and intensity or reducing rest. After ramping up your workout for three sessions, just repeat the same workout for the fourth session. So for example. If on Day 1 you walk 10 minutes, Day 2 you go up to 12 minutes and Day 3 you walk for 14 minutes, on Day 4 just repeat the previous day, walking again for 14 minutes. That way you are teaching your brain that you know you can do that task well, without getting exhausted. For the fifth session, you can continue the ramp-up. Keep doing this system of four-session cycles where you increase one variable every three sessions and repeat the last one.
Step 6: After each workout, take the time to reflect on what you just did

Incorporate the sense of accomplishment and how rewarding it was to do it. Hold onto these positive feelings for 10 to 20 seconds after the workout. It’s helpful to think about this throughout the day. You could even journal about these emotions. The more you think about and feel that sense of accomplishment throughout the day, the more brain connections it creates. You are teaching your brain about the importance of exercise and that you can actually do it. Think about the reasons why you are exercising. Does this make you feel good about yourself? Is this helping you deal with some medical problems you might have? Is this making you stronger? Do you have more energy to go on with your day or play with your kids?
Bringing it together

It is through continuous practice and reflection that we learn everything in life. Being aware of your emotions, reflecting on your motivations, practicing the skill, making small changes, and improving what you already know is the recipe to make exercise part of your life moving forward. That’s how you adapt the brain to learn a new habit. That’s how you teach the brain to do that exercise for that amount of time at that specific intensity. Don’t give up — be aware of the feelings and emotions that might undermine your goals and objectives. January 1st is just another day in the calendar, you can try this any day of the year. Don’t wait for 2020 if your plan does not go as expected. Learning a new skill is a journey. Happy 2019 and best of luck.

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