Mental Health on the Web Rotating Header Image

Are You in Counseling? Would You “friend” Your Therapist?

I have spent time lately training therapists and writing about a therapist’s boundaries online.  And so now I am curious from the other perspective, what people think about connecting with their therapist online via social media sites like Facebook, MySpace or other similar social networks?

I guess it might help for those of you who are not in the counseling profession, to talk first about our code of ethics- what we as therapists, counselors, psychologists, social workers and psychotherapists must carry out to remain ethical.  Regardless of the discipline, we all have a code of ethics that we are expected to follow, and with a few differences in intent and wording, there are some ethical tenents that remain universal.  Two of these tenents are with regard to confidentiality and dual relationships.

While most ethical codes have not yet addressed social media in their codes, some of us in the field have interpreted the existing codes as applied to social networking as follows:

Friending a client on Facebook or MySpace could potentially breach confidentiality. While the client may agree or even initiate the connection, others who are friends of the therapist and/or the client may “connect the dots” and assume or confirm that the person is indeed a client of the therapist.

Friending a client on Facebook or MySpace could be interpreted as a dual relationship. As a therapist I do not socialize with my clients.  I don’t meet my clients for coffee and I don’t go to their home for dinner.  Inviting a client to my Facebook page is like inviting a client into my living room.

Feedback anyone?  What do you think?

Have a beautiful summer day!

DeeAnna

Ten Reasons Not to Hit Your Kids

I have used this infomation for over 10 years helping parents modify aggressive parenting styles that include spanking and corporal punishment. In the years that I have been in the mental health field this has by far been the most controversial topic I have presented- whether to friends, family, colleagues or clients. I wonder if the pendulum has begun to shift at all?

Ten Reasons Not to Hit Your Kids
by Jan Hunt, M.Sc.

“Of all tyrannies, a tyranny exercised for the good of its victims, may be the most oppressive. Those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience.” - C.S. Lewis, 1952

In 24 countries around the world, it is illegal for a parent, teacher, or anyone else to spank a child, and 113 countries prohibit corporal punishment in schools.1 Yet in all of North America, physical punishment by a parent, as long as it is not severe, is still seen by many as necessary discipline, and condoned, or sadly, even encouraged.

For the past several years, many psychiatrists, sociological researchers, and parents have recommended that we seriously consider banning the physical punishment of children. The most important reason, according to Dr. Peter Newell, coordinator of the organization End Punishment of Children (EPOCH)2, is that “all people have the right to protection of their physical integrity, and children are people too.”3

1. Hitting children teaches them to become hitters themselves. Extensive research data is now available to support a direct correlation between corporal punishment in childhood and aggressive or violent behavior in the teenage and adult years. Virtually all of the most dangerous criminals were regularly threatened and punished in childhood. It is nature’s plan that children learn attitudes and behaviors through observation and imitation of their parents’ actions, for good or ill. Thus it is the responsibility of parents to set an example of empathy and wisdom.

2. In many cases of so-called “bad behavior”, the child is simply responding in the only way he can, given his age and experience, to neglect of basic needs. Among these needs are: proper sleep and nutrition, treatment of hidden allergy, fresh air, exercise, and sufficient freedom to explore the world around him. But his greatest need is for his parents’ undivided attention. In these busy times, few children receive sufficient time and attention from their parents, who are often too distracted by their own problems and worries to treat their children with patience and empathy. It is surely wrong and unfair to punish a child for responding in a natural way to having important needs neglected. For this reason, punishment is not only ineffective in the long run, it is also clearly unjust.

3. Punishment distracts the child from learning how to resolve conflict in an effective and humane way. As the educator John Holt wrote, “When we make a child afraid, we stop learning dead in its tracks.” A punished child becomes preoccupied with feelings of anger and fantasies of revenge, and is thus deprived of the opportunity to learn more effective methods of solving the problem at hand. Thus, a punished child learns little about how to handle or prevent similar situations in the future.

4. The phrase “Spare the rod and spoil the child” is not from the Bible but from Samuel Butler’s “Hudibras”, a 17th Century satirical poem. The poem, like his novel, The Way of All Flesh, was written to expose and denounce violence against children.

While the “rod” is mentioned many times in the Bible, it is only in the Book of Proverbs that this word is used in connection with parenting. The book of Proverbs is attributed to Solomon, an extremely cruel man whose harsh methods of discipline led his own son, Rehoboam, to become a tyrannical and oppressive dictator who only narrowly escaped being stoned to death for his cruelty. In the Bible there is no support for harsh discipline outside of Solomon’s Proverbs. By contrast, the writings in the Gospels, the most important books in the Bible for Christians, contain the teachings of Jesus Christ, who urged mercy, forgiveness, humility, and non-violence. Jesus saw children as being close to God, and urged love, never punishment.4

5. Punishment interferes with the bond between parent and child, as it is not human nature to feel loving toward someone who hurts us. The true spirit of cooperation which every parent desires can arise only through a strong bond based on mutual feelings of love and respect. Punishment, even when it appears to work, can produce only superficially good behavior based on fear, which can only take place until the child is old enough to resist. In contrast, cooperation based on respect will last permanently, bringing many years of mutual happiness as the child and parent grow older.

6. Many parents never learned in their own childhood that there are positive ways of relating to children. When punishment does not accomplish the desired goals, and if the parent is unaware of alternative methods, punishment can escalate to more frequent and dangerous actions against the child.

7. Anger and frustration which cannot be safely expressed by a child become stored inside; angry teenagers do not fall from the sky. Anger that has been accumulating for many years can come as a shock to parents whose child now feels strong enough to express this rage. Punishment may appear to produce “good behavior” in the early years, but always at a high price, paid by parents and by society as a whole, as the child enters adolescence and early adulthood.

8. Spanking on the buttocks, an erogenous zone in childhood, can create in the child’s mind an association between pain and sexual pleasure, and lead to difficulties in adulthood. “Spanking wanted” ads in alternative newspapers attest to the sad consequences of this confusion of pain and pleasure. If a child receives little parental attention except when being punished, this will further merge the concepts of pain and pleasure in the child’s mind. A child in this situation will have little self-esteem, believing he deserves nothing better. For more on this topic, see “The Sexual Dangers of Spanking Children” (also in French).

Even relatively moderate spanking can be physically dangerous. Blows to the lower end of the spinal column send shock waves along the length of the spine, and may injure the child. The prevalence of lower back pain among adults in our society may well have its origins in childhood punishment. Some children have become paralyzed through nerve damage from spanking, and some have died after mild paddlings, due to undiagnosed medical complications.

9. Physical punishment gives the dangerous and unfair message that “might makes right”, that it is permissible to hurt someone else, provided they are smaller and less powerful than you are. The child then concludes that it is permissible to mistreat younger or smaller children. When he becomes an adult, he can feel little compassion for those less fortunate than he is, and fears those who are more powerful. This will hinder the establishment of meaningful relationships so essential to an emotionally fulfilling life.

10. Because children learn through parental modeling, physical punishment gives the message that hitting is an appropriate way to express feelings and to solve problems. If a child does not observe a parent solving problems in a creative and humane way, it can be difficult for him to learn to do this himself. For this reason, unskilled parenting often continues into the next generation.

Gentle instruction, supported by a strong foundation of love and respect, is the only truly effective way to bring about commendable behavior based on strong inner values, instead of superficially “good” behavior based only on fear.

1 Sweden, Finland, Denmark, Norway, Austria, Cyprus, Croatia, Latvia, Israel, Germany, Bulgaria, Iceland, Romania, Ukraine, Hungary, Greece, Netherlands, New Zealand, Portugal, Uruguay, Venezuela, Spain, Chile, and Costa Rica. (Source: Center for Effective Discipline)
2 EPOCH Worldwide, 77 Holloway Road, London N78JZ UK
3 Personal communication.
4 End Violence Against the Next Generation (EVAN-G), 977 Keeler Avenue, Berkeley, CA 94708, USA.

Note: An earlier version of this article appeared as Appendix D in Alice Miller’s book Breaking Down the Wall of Silence (New York: Penguin USA, new edition 1997).

Use of Online Vision Boards, Collages and Scrapbooks as a form of Self-Help!

So I just had fun creating a collage at Polyvore! I thought I would try it out for ease of use and it is really cool! Seems to be geared toward fashion merchandise but one can also download images from the web. I used the stock items and created a simple collage that represents some important aspects of my life. I found out about Polyvore from a blogger who uses the collages as a way to heal from past abuse. There are other websites that allow the same sort of creativity with different purposes.

Another is the vision board applications online. A vision board is a simple yet powerful visualization tool that activates the universal law of attraction to begin manifesting your dreams into reality. Many people attribute the concept of a vision board to the concept of law of attraction but a vision board can also be a way of demonstrating what is important in your future in a visual display.

My next creative discovery to display meaningful events is to use scrapbooking websites like Scrapblog where you can create multimedia scrapbooks. Whatever your means or method, this is an artistic and creative outlet to express yourself! So consider trying this free self-help!

Wishing all of you the best!

DeeAnna

Monitoring Your Teen’s Text Messages- Should You?

I ran across this web article on how to monitor your teen’s cell phone use and I think this article offers a very well-balanced view on how parents can act responsibily yet allow teens the freedoms they want.

Of course it is possible to actually tap into, monitor and record every keystroke and text message your teen makes on a computer or cell phone but violating privacy has to be weighed against the potential loss of trust between parent and child.

Programs such as MyMobileWatchDog.com exist and can provide a way to track your child’s mobile phone usage but the key to using this sort of program is being honest from the beginning with your teen/tween about the fact that you are using a monitoring device.

Begin teaching your child boundaries about cell phone usage and the internet early on. With our lives so influenced by technology, teaching your child how to be responsible in cyberspace is just as important as teaching your child proper boundaries and responsibility in real life.

A belated Memorial Day celebration to everyone!

DeeAnna

Sexting…Do You Have Your Eye on Your Teen’s Mobile Phone?

With all of the news about sexting, many parents are up in arms wondering if their children are engaging in this new phenom.  Sexting is the act of sending provocative pictures via one’s cell phone to another….and the aftermath can be serious.  Let alone the legal implications (such pictures are considered child porn and have resulted in arrests), the emotional aftermath of sexting can be devastating.  Young girls send pics of themselves to their boyfriend or wanna-be boyfriend and before they can say, “Oh maybe I shouldn’t have done that…” the pics have been spread to everyone in the school.

So, what is a parent to do?  Begin early on talking about technology- the good, bad and the ugly.  Talk about the internet and texting, cell phones and sending pictures- talk about the permanency of communicating via mobile and the internet.  Give examples of how sharing intimate information and pictures can be harmful and that once it is out there, it cannot be retrieved.

Reader’s Digest has a feature article in the May issue and it truly is a must-read- very informative and timely.  Take time and read this!

Best to all,

DeeAnna

Parent Alert: Teens and Porn

Porn has gone interactive–and your kids are at risk. From “sexting” to video chats, how to fight back.

In Treatment: Have You Tuned In?

In Treatment is a series on HBO about psychotherapy. The show, now in season two appears to be a hit.  Gabriel Byrne received a Golden Globe award for his portrayal of Dr. Paul Weston.  It is Sunday and In Treatment airs tonight.  My colleague in the UK forwarded an article that appeared in today’s Guardian. So I thought I would round off my new obsession with a blog post!

Most of the time when I watch films or television and a therapist is portrayed, I grimace, hold my breath, and sometimes shout my dismay aloud.  How many times has a therapist had sex with the client or breached confidentiality on the screen?  Boundary violations, dual relationships and other unethical nuances usually abound when mental health practitioners are weaved into movies and television shows.

In Treatment is not much different. But what makes the experience complete is that the near ethical scrapes are brought into the forefront and interwoven into the dialogue- last season even found Dr. Weston meeting with his clinical supervisor.  His character openly discusses amorous feelings for a client and he rasply says he is burned out.  All the while, we see his therapeutic work, sometimes on the mark and sometimes not so much, as we the audience peer in on sessions and glimpse ever so briefly into his private life.

The story line is entertaining; nonetheless during certain episodes, I feel like I am viewing a day in the life of my own work.  But overall, In Treatment provides a rich snapshot into the world of a psychotherapist, and with the intensity of a 25 minute one-act play.  The show is not one that is tolerated in dribs and drabs- one episode here and there does not do it justice, so if you decide to give it a whirl, tune in for at least two or three episodes in succession before you decide if this series is for you.

DeeAnna

DeeAnna

Funny What Life Brings…Coming Full Circle

When I was in High School I loved American and English Lit classes.   In my senior year I enrolled in the local community college as an early entry student and took a writing class.  People would casually comment on my writing, and I made decent grades in most subjects if I could use words. I was one of those that hoped the test would be essay…

But I did not major in english or journalism.  I was a music major. I didn’t really like the music classes and the math of music never came easy for me. In fact, the desire to learn an instrument did not make the learning any easier.  But I loved to sing and studied voice from an early age so it made sense that I would choose music as my major.  I couldn’t find my niche in music academe though and so I got my music jollies out by joining a band. 

Eventually I found my way back to college majoring in mental health.  I wrote many papers on everything from co-dependence to existentialism. Professors noted my writing skills.  I remember one particularly influencial person at that time in my life. She handed me a blank notebook and very simply said, “Write.”  I would write in my journal, dabble in poetry, dig into term papers and ace those essay tests.  Graduate school was more of the same, writing and researching.  

Throughout my vocational journey people would whisper, suggest or shout that I should write.  I remember saying more than once, “Write WHAT?”  Years ago, a dear friend having received a letter from me, suggested  I should write a book of letters (Ok, so how does one do THAT, I thought…). Writing had always been a passion of mine, somewhat primordial for me.  I never gave it much thought- I just did it in the course of my day, my life, my work. 

The years passed and my writing skills continued to serve me well; I would use my skills in mental health centers and as a private practitioner writing lengthy psychosocial reports and forensic evaluations.  In the late 90’s I discovered a new way to deliver therapy online with email and chat and it was such a natural fit for me. Using the written word to communicate with and not just about clients was great!

And so now I find myself well into my career, loving my work.   A self-reflective,”huh…” I recently said to myself. Imagine that. All these years later, I am doing what I was apparently called to do.  If someone were to ask me, “What do you do for a living?” my answer would not be, “Oh, I am a writer.” But it dawned on me recently that indeed I am.  Funny that.  My career has been shaped around a core desire.  Now most of my work involves writing- from writing this blog to writing client reports. But mostly, I write to clients through email and chat and I find the work amazingly rewarding. And when I am not writing to clients, I am writing about online therapy and the merging of mental health and technology; books, articles, blogs, tweets….

So who am I? I am woman, wife, daughter, friend, psychotherapist, singer…writer.

Today I celebrate the writer in me.  Snoopy dance.

Blessings to all this Passover and Easter!

DeeAnna

My Favorite Self-Help Books!

Hi Everyone!  I hope people are enjoying the spring weather and looking forward to the lazy days of summer!  I know I am! 

I decided  I wanted to consolidate my list of favorite self-help readings but have been puzzled as to how to give a list that was not unwieldy.  Just listing off dozens of books in a column did not seem too user-friendly to me. So I decided to create a book store through Amazon.  It is very basic and having just begun the listings, fairly sparse, but some of my absolute must reads are already listed!  Right now I am concentrating on self-help books but I hope to add my favorites for professionals as well. 

So, take a peek. You might find something you like!

http://www.deeannamerznagel.com/id96.html

Best to everyone!

DeeAnna

Workshop and Training Schedule

Hi everyone! Many of you have asked for my training schedule- if I am presenting any workshops and where- so I thought I would post the information here.  I will keep the list updated.  Generally my trainings are about something to do with mental health and technology- online therapy, therapist’s ethical use of social networks and other similar topics. 

Hope some of you are enjoying spring weather (not so much here in NJ yet!)

Interested in Feedback…Would You Consider Online Therapy?

Hi Everyone!  It has been awhile since I posted here - I took a little bit of a spring break!  I wanted to ask readers who are not therapists- would you consider online therapy?  Why do I ask? Well, of course, online therapy is a service I offer, and comments I have received from clients and through training therapists over the years is that people generally like the experience of using email and chat, webcam and voice.  So that is my curiosity. At least that is where it starts.

I read an article this week about online therapy and whether or not therapists should be able to offer therapy across state lines.  For instance, if you are seeking a therapist online, are you more inclined to search for a therapist in your own state or would your search be broader?  Would you have concerns about receiving therapy from someone who may be licensed in another state?  

I have cross posted reference to this article and if you are interested in reading more, please read my latest post at the Online Therapy Institute blog.  Please do post comments here as I would love to know what folks are thinking.

Happy Spring!

DeeAnna