Autism Awareness in 2017: How Much Progress Has Been Made?

Autism awareness is growing year on year, but 2017 has involved a wide range of coverage in the media, on the curriculum and in science. Here are the most impressive facts and figures from autism-related news stories in the last 12 months.

Autism Education

Schools are becoming more aware of additional needs for autistic pupils, but there is still work to be done. In September, the Department for Education revealed that 9,040 children with autistic spectrum disorder were excluded for a fixed term from their school between 2015-2016 – an increase of 25% since the previous year.

Last month, teacher Gemma Corby wrote a SENDCO column in the TES (Times Education Supplement) about the autism misconceptions many teachers have. She reminded readers that autism is a developmental condition, and that the National Autistic Society believes many autistic children don’t have difficulty learning. Autism awareness is vital for teachers, as they then pass it onto pupils in the classroom.

Autism and Scientific Advances

Research into treatment for autism, and research into its wider impact, continues to make the headlines. A new drug called NitroSynapsin showed promising results in early tests by scientists, suggesting it can correct many behavioural and electrical imbalances in the brain, which are found in patients with autism spectrum disorder. The findings were reported in Nature Communications. NitroSynapsin may also help sufferers of Alzheimer’s disease, by improving synapse function.

This month, the Southwestern Medical Centre in Utah announced that its preliminary research had found applying brain stimulation to autistic patients could correct some social behaviours. Using neuromodulation on the cerebellum and the cerebral cortex wouldn’t change the genetic cause of autism, but findings suggest it would improve social interaction and behaviour for those with autism. Read more about the study here.

Autism-Friendly Spaces

On 2^nd October, a nationwide quiet hour was instigated by the National Autistic Society. This raised awareness of the number of people on the autistic spectrum (thought to be 11 in every 1,000 people), and the problems that public spaces – particularly shopping centres – can cause for autism sufferers, who struggle with the sensory overload of queues, crowds, displays, lighting and music.

Over the Christmas season, autism-friendly Santa’s grottoes aim to minimise sensory stimulation, by reducing distractions such as strong lighting, decorations and noise, and training Santa to understand which questions and comments could upset an autistic child during their visit. Meanwhile, cinemas up and down the country now offer special film screenings for children with learning disabilities, including autism, all year round. These screenings happen in a safe and non-judgemental space, where autism awareness is a given.

Autism in the Media

A new children’s animated series, called Pablo, gently shows young children what it’s like to live with autism. Co-created by the BBC and RTEjr, it covers the different triggers that might distress someone with autism, such as going to brightly-lit, busy places like the supermarket, or being around strong smells and sounds. The programme was warmly received by parents and children – those with lived experience of autism and without – and the programme makers were praised for helping to raise autism awareness whilst being sensitive to the needs of ASD children.

Series Two of The A Word, an autism-focused BBC drama, was broadcast this autumn and winter and was a hit with viewers. The programme portrays one family’s journey through an autism diagnosis for their son, Joe, and his life after being diagnosed. It’s actually based on an Israeli drama, The Yellow Peppers. The A Word shows how Joe has certain needs that aren’t being met locally; despite his mother wanting him to remain in mainstream school with a learning support assistant, the family has to travel for miles to reach the nearest specialist school. For more information on how The A Word writer Peter Bowker worked with the National Autistic Society, click here.

If you’re seeking an assessment for autism, ASD or Asperger’s Syndrome, please get in touch to find out more about our work in this area.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

Child Poverty: Is a Child’s Success Dependant on a Parent’s Income?

 

The surge in child poverty has hit the headlines recently, and rightly so.

According to research from the Joseph Rowntree Foundation, there were 4 million children living in poverty in the UK in 2015-16. That’s 30 per cent of children, or 9 in a classroom of 30. Much has been reported in the media that appears to assert without exception that poor children do not reach the attainment levels of their richer peers.

While this may be true in many cases, it is not an absolute fact. It also insults low income parents who tirelessly make sure their children can access sufficient opportunities.

It is a fact that children succeed, (within their individual cognitive ability levels), largely because of the attention and input of their parents. This is true whether a parent is on Universal Credit or drawing a large corporate salary.

It is undeniably much more of an unenviable struggle for parents on benefits, but it is not a given that the better-off child will reach a higher attainment level.

There are major factors that position both of these parents’ children on an equal platform after the balance weights are adjusted. What propels children to future success is the ability of their parents or caregivers to provide a safe, loving and consistent environment, in which a child is stimulated and given the scaffolding needed to move forward.

Let’s not be under any illusion: poverty is often a significant barrier. Much more should be done to help families lift themselves out of poverty. However, the constant one-sided coverage about the lack of opportunities for poorer children slaps many diligent parents in the face. Parents who with limited funds provide their children with everything they need and more to propel their children forward – socially, educationally and cognitively. We must acknowledge that many poorer parents are resourceful, committed and multi-skilled in every sense of the word.

Parents who can stay positive while going to a food bank: that is a skill worth praising.

Parents who scour through innumerable charity shops, as many of our clients do, to provide stimulating toys to their children: that is selfless.

Parents who sift nightly through eBay listings to source a second-hand laptop for the kids: that is resourceful parenting.

Raising a child on benefit or a low income relies on skills that many successful executives would find a challenge if performed day in and day out without respite.

What these parents are modelling to their children is resilience and how to find solutions to life’s challenges. It is this resilience and determination that gets us all through the hard times. Many poorer parents have this in spades.

I was at breakfast in a hotel recently, and was struck by an obviously affluent couple. Mother, wearing a white fluffy bathrobe and slippers (presumably in readiness for the Clarins spa) was impatiently adding soya milk to a bowl into which she had carefully measured, several varieties of grains. Dad had his head bowed over a newspaper while absent-mindedly spooning porridge in the direction of their infant’s head. Their child, a boy, perhaps 4 or 5 months old, was propped up with an iPad for company, seemingly being entertained by a cartoon. The animated dog on the screen was getting more porridge than the child.  Neither parent noticed. There was no communication between the couple or interaction with the child.

Seriously, can anyone with a grain of cognition really believe that this child of better-off but distracted parents has a more favourable future than a child of the involved parent on benefits or a low wage? A child who receives a book or laptop from the charity shop and has an involved parent to interact with has a flat advantage over the Armani-dressed ignored child raised by a cartoon dog.

While poverty must be eradicated by assisting people to help themselves, it is also crucial that we applaud those parents who struggle and succeed every day to maximise their children’s chances. We need to be cautious about the black and white assumptions we make without considering the other variables that are in operation.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

How the Media Should Report Mental Health Stories

On Monday, the Virgin Money Giving Mind Media Awards celebrated the most supportive and accurate mental health reporting in the British media, including documentaries, radio shows, digital content and newspaper reporting.

Mind, one of the UK’s best known mental health charities, knows how important it is to report sensitively on any mental health news story or feature, because ignorant or distressing content can lead to genuine distress for mental health sufferers and their families.

So, what does responsible media content look like, and how are mental health organisations ensuring fewer damaging reports slip through the net? These are the key factors to consider.

Think Before You Write

There are many misused terms still used by reporters and editors for widely misunderstood conditions – words like ‘psychotic’, ‘bipolar’ and ‘schizophrenic’ are often used inaccurately. Furthermore, casual words like ‘crazy’, ‘mad’, ‘breakdown’ and ‘bonkers’ can also be used to generate headlines or clickbait. By sensationalising these stories, the media is reducing sufferers to stereotypes.

Good mental health content is inquisitive without being intrusive: it respects the emotional impact that comes with telling your story to a journalist or producer. It works with, not against, interviewees, and involves a high level of research to avoid offending or stigmatising anyone involved in the story. When reporting on a failure of care by health professionals, it demands answers for those affected, as was the case in Mind Media Awards winner Catherine Jones’ investigation for Channel 5 News.

Any content that could be triggering for readers, listeners or viewers is best ended with contact details for relevant organisations, such as the Samaritans. This has now become standard on episodes of television soaps, where hotline numbers or websites are displayed at the end of the episode credits. Online and print content is catching up, but there is still work to be done.

The new Mental Health Media Charter, created by campaigner Natasha Devon, calls on all parts of the media to commit to creating stigma-free mental health content. Signatories so far include the Metro, Grazia, Tes and Heat magazine. I can’t wait to see who else signs the charter and makes a stand against irresponsible journalism.

Reporting Suicide

When reporting suicide, or suicide attempts, the media should be particularly careful not to share graphic details which may encourage other suicidal people to imitate the methods mentioned. The charity Samaritans has issued useful guidelines for anyone reporting on suicide.

Friends and family members can often be hounded by the media in the wake of a loved one’s suicide, via incessant phone calls, ‘doorstepping’ (turning up at someone’s home to get an interview), or trawling social media profiles for signs of intent. This is deeply distressing and does not help with the grieving process.

When someone close to you commits suicide, you may fear you could have done more to help them, and you search for warning signs that could have been missed days, weeks or months earlier. However, people with mental health problems and suicidal thoughts don’t necessarily look depressed; they can develop coping mechanisms and present as upbeat and untroubled. CALM (Campaign Against Living Miserably), a mental health charity which aims to reduce male suicide, reminds us that ‘sometimes there are no warning signs because the person wants to keep their personal crisis private, and so will work hard at hiding their thoughts and feelings’.

The media needs to recognise there is no single pattern of suicidal thought or behaviour, nor is there a single ‘depressed’ or ‘suicidal’ stock image to be used alongside these articles (such as the dreaded stereotypical ‘head clutcher’, where a person sits with their head in their hands).

Crime Stories

Mental illness is often wrongly attributed as the sole cause for a horrendous crime, leading to media speculation that everyone with that diagnosis is a threat to society. One prime example is the Germanwings pilot, Andreas Lubitz, who deliberately crashed a plane in March 2015, killing everyone on board. Stories quickly appeared, speculating that, because the pilot had been treated for depression, depressed pilots posed a threat to their passengers. Mind quickly countered such arguments with a statement.

Unfortunately, the damaging stories in the UK and beyond were still read by millions of people. The World Psychiatry Journal published findings in October 2015 that ‘the plane crash did have a measurable impact on public attitudes towards persons with mental disorder’.

In reality, serious crime happens for a multitude of reasons: some environmental and societal, some caused by reactions to life events. Stastically, someone with a mental illness is more likely to be a victim of violence than a perpetrator. With one in four of us experiencing mental illness during our lifetime, imagine how many people you come into contact with every week who successfully manage a mental health issue. You shouldn’t fear these people. Being a pilot, or taking on a similarly intense job, involves regular medical checks, and we should trust that mental health can be responsibly managed, just like any other health condition, by patients, their therapists and health professionals.

Those diagnosed with schizophrenia can also be media targets. Every year, we see headlines around the world sensationalising the rare times when a schizophrenic patient becomes violent. This reportage doesn’t communicate how rare these incidents are, how much brilliant care there is for schizophrenia patients, and how many people with the diagnosis aren’t violent at all. Cal Strode, from the Mental Health Foundation, has blogged about this misrepresentation for the Huffington Post. The perceived threats suggested by certain parts of the media are both damaging and disrespectful.  

Body Image and Identity

Writer and activist Juno Dawson spoke at the Mind Media Awards about the need for the media to respect transgender issues when reporting on them. She cited the statistic (from the National Centre for Transgender Equality) that 40% of those who identify as transgender will attempt suicide.

High-profile transgender icons, such as Caitlin Jenner and Kellie Maloney, are helping to break the stigma, but the transgender community and the wider LGBTQI+ community is still not given the same respect when it comes to mental health media coverage. For example, it’s important to use the pronouns that the person identifies with (this could be he, she or they/them), and to use the correct terminology when conducting interviews or producing content.

Beyond transgender issues, body image can become too much of a fixation for tabloids and websites, who incessantly report on celebrity weight loss, dieting and weight gain. Media figures who speak out about eating disorders have often seen their bodies scrutinised by reporters, on top of the self-stigmatisation that comes with their condition. Magazines not only publish intrusive images, but also the weight, dress size and BMI of celebrities, and the ‘good’ or ‘bad’ foods they eat, reinforcing fears of weight gain.

Some health professionals also believe that trends like ‘clean eating’, often celebrated by the media, can fuel an ENDOS (Eating Disorder Not Otherwise Specified), by excluding multiple food groups and developing a restricted diet with inflexible self-imposed rules. Dr. Max Pemberton is just one of those speaking out. When clean eating gurus are praised by magazines and websites, their food ethos becomes both normalised and amplified.

Events like the Mind Media Awards remind us that progress is being made to destigmatise mental illness in our newspapers, magazines and other media. However, it would be refreshing if all media outlets used emotional intelligence, tact and sensitivity when creating content about mental health.

Written by guest contributor and mental health campaigner Polly Allen, for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

Black Friday and the Psychology of What We Buy

24^th November has long been called ‘Black Friday’ in the USA as a day for panic-buying Christmas shoppers but, for the last few years, it’s also been embraced by the UK.

You might remember seeing pictures in the papers of people fighting over wide-screen TV sets in British supermarkets, or queuing outside stores in the early hours to ensure they will be first in line for those Black Friday deals. We even have ‘Cyber Monday’, held the following Monday as an internet-only day of shopping deals, to add to the frenzy.

In the run-up to Black Friday, it’s important to look at the psychological drivers behind the things we buy. What makes us pick up that product that we didn’t know we needed until we walked into the shop, or until we clicked on a certain link online? And how can we be sure we truly want to buy it, whether as a Christmas present or at any other time of the year?

Black Friday: The Ultimate Special Offer, or a FOMO Trigger?

We live in a materialistic society: it’s a fact. Every day, we are bombarded with the new face cream that will change our lives, or the upgraded gadget that’s better than the one we currently own. The one-day deals of Black Friday, in particular, trigger FOMO (the Fear Of Missing Out) for consumers.

If we feel we’re missing out by not buying, especially if we could theoretically save money with a time-limited special offer, we are putting immense pressure on ourselves to get out our wallets at a certain time, whether or not we can truly afford to spend money.

There’s a lot of social pressure surrounding this: the one-upmanship and the desire to ‘keep up with the Joneses’ (or, indeed the Kardashians, who will happily buy a new car or house at the drop of a hat).

Children are also susceptible to the lure of new and trendy products, as they try to fit in with their peers, and become champions of ‘pester power’ when you take them shopping. A US-based study by brand building expert Martin Lindstrom, author of Brandchild, found that parents spent 29% more when they shopped with their children – food for thought if you’re on a tight budget, or your house is already full of must-have items.

Psychological Tricks Retailers Use

When you walk into a shop, retailers know how to get your interest. They invest in technology like eye scanners to test where shoppers look. Goods placed just by the entrance, or next to the tills, encourage spontaneous ‘add to basket’ moments.

Music and shopping have been interlinked by psychologists and marketers since the 1970s. More recent studies have shown that low music is better for shoppers, whilst Christmas music in shops can, unsurprisingly, invoke nostalgia. Add some spectacular window displays, in-store experiences and even scents pumped through the space, and you’ve got yourself a captive audience.

But who is the most susceptible to retailers’ tactics? The BBC’s Big Money Test from 2011-2013 found that certain types of emotional behaviour leave you more likely to impulse buy. Mark Fenton-O’Creevy, Professor of Organisational Behaviour at the Open University, worked on the survey, and wrote that ‘people who were high on impulsive buying behaviour tended to be people who had poor strategies for managing their emotions and were more sensitive to the highs and lows of positive and negative emotion. In other words, it seems likely that, for many people, impulsive shopping acts as a substitute for more effective ways of managing their emotions.’

The ‘Social Proof’ Concept

‘Social proof’ is big business for retailers: the idea that your friends, family or your fellow shoppers have already bought and loved a particular product, therefore it must be good. What’s more, you don’t have to know the people who have bought a product already. A car salesman might casually mention his sister has the same car you’re considering, and she loves it. An idea has been planted: this car must be a sound investment.

Online retailers are very savvy with social proof, too; think of the alerts on a travel website telling you ten people are looking at the same hotel right now, and that five people have booked it in the last hour. Meanwhile, all kinds of products and services, from books and clothes to plumbing work, carry online consumer reviews. If all those reviews are graded as four or five stars, it’s unsurprising you’ll feel more reassured in choosing a particular option.

When you’re faced with glowing reviews, it’s important to remember we all have individual tastes. What works for one person may not work for you. Your gut instinct is still important, so don’t ignore it.

How to Think Clearly When Shopping

When you’re being pushed towards a product, stop and think:

• Do you actually need it – will it make a difference to your life?
• If you’re buying clothing, how many items in your wardrobe can you wear it with?
• When the next version of the product is launched, will you still use this one?
• Is there a cheaper or more sensible alternative – for example, if you’re buying a DVD, could you borrow it from your local library, borrow from a friend, or stream it online instead?
• If the item is reduced, would you have paid full price for it in theory?
• Would you have bought it without the brand name attached?
• Are you buying it to cheer yourself up, as a distraction, or to mask other emotions? If so, is there another way to deal with your feelings, such as reading a book, having a bath, or arranging a therapy session?

Armed with these questions, you should feel better equipped to navigate the shops and make informed decisions, whether on Black Friday or during the rest of the year.

Written by a guest contributor for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

Disclosing a Mental Health Issue at Work: When and How to Do It

With one in four people likely to suffer a mental health problem in their lifetime, it’s never been more important to know about disclosing a mental health issue when you live with a diagnosis that affects you day-to-day.

Whether you’re job hunting and worried about discrimination, or you’re employed but struggling to cope, this is what you need to know about mental health in the workplace and the ins and outs of disclosure.

Disclosing a Mental Health Issue: Guidance from British Law

The Equality Act (2010) protects you from discrimination for nine characteristics, including age, race and sex. Disability is another characteristic, but many people don’t realise ongoing mental health problems that significantly affect your day-to-day life actually count as a disability. This means you cannot be discriminated in the workplace for having a mental health problem, unless an employer can prove a lawful justification for their actions – for example, if other workers’ health and safety is at risk.

The exact wording from the Equality Act refers to ‘a physical or mental impairment that has a substantial, adverse, and long-term effect on your ability to carry out normal day-to-day activities’. In the case of mental health, this would mean a condition that’s affected you (or likely to affect you) for 12 months, either ongoing or recurring. It also applies to conditions that affected you in the past, so you are protected even if you haven’t had an episode of depression, bipolar, or another mental health condition.

Your employer must make ‘reasonable adjustments’ to the workplace to help manage your condition; these might include a change to your working hours, having a quiet room to go to when you need some time alone, not needing to ‘hot desk’ (find a desk at random rather than be allocated a set space) or changing some of your responsibilities. Shaw Trust, which helps disadvantaged people into work and training, has some useful online resources and face-to-face employability services.

Support in the Workplace

You may need support from occupational health, which an employer can refer you to, or you might choose to get support outside the workplace. It can be tricky to find talking therapy that fits around your working hours, but do outline any concerns to your therapist and they will try their best to find an appointment time to suit you, perhaps an early morning or evening slot, or a lunchtime session. Depending on your job structure, you may be able to work flexibly around an appointment in working hours, or perhaps work from home on the day of your regular appointment.

It can be more difficult to feel supported in a smaller workplace, where there is no Human Resources department. As an employee within a small team, you may also feel more overstretched and find it harder to speak out about your condition, for fear of increasing other people’s workloads or stress levels. However, all employers must abide by the law, and they still have a duty to make some of those ‘reasonable adjustments’, which will vary according to your needs, where possible.

If your employer can’t afford to make the kind of adjustments needed, you may be entitled to funding from the government’s Access to Work scheme. This might involve help with transport, or access to a support worker. Local and national charities can also offer advice. If you’re in Scotland, Wales or Northern Ireland, the Royal College of Psychiatrists has a list of resources that could help you. Should you be caring for someone with long-term mental health issues, don’t forget you are also protected against discrimination by association. Mind has a useful resource on the types of discrimination here.

Your Right to Privacy When Disclosing a Mental Health Issue

Some people don’t want to disclose their mental health condition and, if it doesn’t put health and safety at risk to non-disclose, you can choose not to inform your employer. However, this may make things harder if you do need to make changes in the workplace down the line.

When you’re applying for most jobs, you don’t need to disclose any health conditions, mental or physical, unless you want to. Certain public-sector jobs, such as being a teacher or a doctor, have different regulations, and you would need to disclose in these cases. It’s also important to inform the DVLA if any medication for mental health issues is affecting your ability to drive, whether or not driving is a necessary part of your job.

The majority of companies should only ask for health disclosures after a job offer has been made, but – aside from exempt professions, such as teaching, mentioned above – you are still not legally bound to reveal your diagnosis. Once you have disclosed, your employer should still respect your privacy, so if you only want your manager and the HR team to know about your diagnosis, it shouldn’t be discussed with other members of staff.

Written by guest contributor Vikram Das for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).

A Cup of Tea in the Hour of Need

It’s more than a cup of tea – it’s a cup of CALM.

A cup of tea.  How many nasty situations have been calmed by a cup of tea over the years?  I could not begin to guess; could you?

In 2015, an article in the Telegraph stated that the average British person enjoys 876 cups of tea each year: enough to fill more than two bathtubs.

Further research seemed to conclude that we Brits drink so much tea because it is associated with comfort.

Whether you take it with milk, lemon or two sugars, the fact remains the same: the presence of a hot, steaming china cup or mug of tea gives a feeling of safety and warmth, and it restores a sense of calm. This is no more true than in difficult circumstances or hard times.

A cup of tea – it really is a British institution. The bedrock of restoring calm.

So, today, when London has been rocked by another terror attack, it is no great surprise – although a welcome one – that the compassion of our capital city is shown by Londoners opening their homes and apartments, offering tea to total strangers.

A simple enough gesture, perhaps, but offering tea in this situation is actually a very powerful outward show of solidarity. It demonstrates care for total strangers who, away from home, found themselves caught up in a trauma they could not imagine.

A cup of tea in the aftermath of terror

These small acts of human kindness are extremely powerful. They are grounding and calming at the same time. Provided by strangers of all ages, these simple gestures will in fact prevent many of those poor people caught up in this latest atrocity from developing ongoing symptoms of trauma.

Coming to terms with trauma alongside others who are similarly affected, makes perfect sense. Basic human warmth, cohesion and generosity is sometimes much more powerful than anything psychology, religion or government can offer.

Making sense of an awful situation with the comfort of others is a powerful, calming influence, and bonding over a cup of tea will undoubtedly help.

Who would have thought that the humble cup of tea could be so necessary?

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

Easy Back to School Tips

The back to school routine can be a little stressful for some children. Change is often positive, but it is a journey into the unknown. Anxiety reduces in all of us when new things or places become familiar, so the feeling of butterflies in the tummy at the beginning of term is a good example of being confronted with change.

Children are starting new classes with a little-known teacher, new desks, different lockers, etc. The map they had in their head no longer works. They need a little bit of time to create a new mental map of how things work.

It’s trickier when it’s a new school and it is all a little different, but the basics of reducing the anxiety remain the same. These easy tips for ‘back to school’ time will help kick-start a great new term.

Eight Back to School Tips for Parents

1. Talk to your children about the new term. What are their hopes? How do they see the term ahead? Their concerns will also pop out at this time. Talk about the funny things you remember about first days at school and how you coped. Be positive – Being positive is contagious.
2. If it is a new school – do a few practice runs so that the journey and lay out of the building is familiar. This might be on foot, on the bus or the train.
3. Have a few earlier nights during the run up to the new term. It won’t be quite so hard to get them up this way.
4. Make sure the uniform and all kit is ready, involve the children in the school preparation so they feel in control.
5. On the afternoon of the first day of term do something they enjoy however simple. This will continue the feeling of summer fun for a while and ease in the transition back to school.
6. Ask them about their day – what went well and perhaps in cases when it didn’t go so well, what could your child do to make it feel better tomorrow?
7. Be prepared that your child may be a little grumpier or quieter than normal. This is expected as she or he comes to adjusts to the new routine.
8. On the first day back, don’t forget a special breakfast and take some photos (younger children love this yearly ritual.)

Going back to school produces very mild anxiety for most children. However, new term anxiety will reduce by talking things through and getting things ready in good time before school starts.

More information about managing the return to school when your child has special needs or autism is available on this site.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

To Smack or Not to Smack? A Sting in the Tail

To smack or not to smack?  The debate rages on. Max Pemberton, a journalist and NHS psychiatrist, has caused a bit of a stir. He claimed that smacking doesn’t cause deep-seated psychological damage to children.

The issue was also aired on the TV show Good Morning Britain, on Tuesday 15th August. ‘Parenting Guru’ Sue Atkins and pro-smacker Katie Ivens both argued their cases, amidst some input from Jeremy Kyle (read more about the debate here).

In the wake of these opposing media views, I’d like to invite Dr Pemberton and Ms Ivens to shadow me on a working day. A working day where the effects of child violence, often verbally disguised as discipline, are all too poignantly seen. In a few cases, with tragic consequences.

The legal position on smacking: UK, Wales, Scotland and Ireland

Currently, smacking a child is legal in the UK as long as it doesn’t result in visible injury, but some members of the Welsh government and Scottish Parliament are lobbying for change. In December 2015, Ireland removed the ‘reasonable punishment’ exception and made smacking illegal.

In theory, many would agree that the occasional controlled smack, carried out by a loving parent, does not harm kids in the long term.

Imagine a situation where your toddler suddenly runs into a busy road.  There’s no time call him back.  Instinct ensures that you grab him, often roughly, by the nearest part of his body to prevent a tragedy.

This is necessary manhandling, fuelled by adrenaline. Most of us have done this and followed it up with a hug of relief, thankful our child is safe.  When a smack follows, rather than a hug of relief, what is it really about?  Is it to teach? Is it an outward expression of parental rage, a venting of feelings of failure for taking the eye off the ball so to speak? Is it perhaps an asserting of adult control over a smaller individual?  Is smacking for the good of the child, or to soothe the bruised adult ego?

In spite of this argument, there may be a case for smacking, but consider this. If all parents’ had adequate ego control, positive coping strategies and good emotional regulation, perhaps controlled smacking might be acceptable on some occasions.

The line between a controlled smack and physical abuse

The hard truth is, the abused children we clinicians meet up and down the country have never experienced a controlled smack in an environment of care.

The reality is that many children are physically abused daily under the pretence of smacking and good discipline.

When a parent loses control and physically chastises a child (which is often how smacking happens), it is often explained as disciplining an out-of-control child.

The situation is often that the parent has snapped, has in the moment lost parenting skills, and has instead reacted physically to the child’s behaviour.

Smacking would be okay, perhaps, if all adults could remain rational, calm and in control of their emotional regulation in times of stress.

The huge number of physical abuse cases show that many parents have neither the emotional resilience or practical skills to manage their children’s difficult behaviour and resort instead to physical punishment.  A smack in the hands of an angry and out of control adult can escalate into extreme violence. This is often under the misguided notion of discipline.

Physical abuse is one of the primary causes of both attachment difficulties in children, and more enduring mental health conditions. This is a primary reason why smacking is not acceptable. Smacking is the thin end of the wedge.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

Words Were Originally Magic - Why Trump Needs to Read de Shazer

Words Were Originally Magic is the title of an acclaimed book on solution-focused brief therapy, written by psychotherapist Steve de Shazer.

De Shazer’s solution-focused approach believes that the solutions to most problems can often be found in the words we use. This may, at first, appear naive.

In essence, to develop a more positive life, we each need to closely examine the words we use daily: we need a new story or narrative. Words offer the magic that is needed.

This belief system maintains that our problems persist because we keep on using the same old solutions; solutions that never worked in the past to solve our issues. Put even more simply, we usually try to solve our problems by putting the same wrong key in the front door and then wonder why it doesn’t open.

By using different ‘words’ or ‘change’ talk about the future, by visioning or thinking about it differently, we are on the way to changing a situation. This is where the magic of words comes into play.

The words we use, or do not use, are central to future outcomes.

This mode of thinking is also central to the belief of many seminal thinkers and the founders of existential psychology, such as Husserl, Morleau Ponte, Heidegger and Foucault.

Essentially, we create our future reality and eventual fate, good or bad, through the narrative we use.

But what if the narrative we use is wholly negative? It could be a narrative filled with threats, and driven by megalomania and narcissism. This, then, suggests that words may also have the potential to become ‘black magic’. In such cases, we need to use a great deal of awareness and cognition to examine what is about to leave the lips.

The President of the United States, Donald Trump, is spewing very frightening words directed at North Korea. The words are becoming darker.

In this blackening of words, there is an even bleaker construction taking place: a construction that threatens much of humanity. Words have the potential to become reality.

Now, more than ever, it is time words were thought about with just pause and contemplation.

All humanity holds its breath.

De Shazer, Steve (1994) Words Were Originally Magic, Norton, London.

Written by Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk). 

Rare Disease and Not Being Heard by Your GP

Living with a rare illness is a struggle, but dealing with an ignorant GP increases that struggle.

Those feelings of not being listened to increase the isolation, ramp up the stress and contribute to disease progression.

I do not use the term ‘ignorant’ as an insult, rather I chose it to reflect the true meaning of the word. Ignorant means ‘destitute of knowledge’: in this case, a GP who doesn’t know what it means to live with your rare illness day in, day out, and doesn’t know how debilitating its symptoms can be.

Rare Diseases and GP Treatment

A GP’s case load normally consists of the everyday ailments of living, plus a few rarer ones.  GPs are not trained to know about the rare diseases that patients present with, and this is where the problems can start.

Trying to inform your GP about your rare disease and the tests you currently need is often akin to tip-toeing through a volcanic minefield. Why is this? It’s rather simple. The majority of GPs have been conditioned to believe they know most things about our health. Repeated consultations with grateful patients reinforce this belief.

GP’s can occasionally become omnipotent. Faced with a patient who knows more than them about a certain condition (as we rarities must do in order to survive) can be threatening to their self-perception. They do not like to feel small, and may immediately and unconsciously deflect or project on to us.

When this happens, the patient comes away feeling a hypochondriac, or a time-waster. The patient shuffles away feeling awful and the normal power inequality is restored. What has just happened is rarely questioned, except perhaps in a therapist’s room.

How to Assert Yourself With Your GP

It can be very helpful to take a second when you feel talked down to and patronised. This is your moment to regroup and have another go. Remember these three simple steps – you could even write them down and read them before your consultation.

1. Hold your ground.

2. Repeat your requests slowly and clearly, in a non-defensive tone.

3. Remain measured and stay in adult mode.

Your GP will feel less threatened and reduce the superior tone. He or she will have no choice but to operate in ‘adult mode’ as well. This normally produces a win-win situation. You, I and our families lose when we walk away feeling stupid.

It is also critically important to research as much as you are able to, and make sure your information is correct, to help yourself. Fortunately, there are many great blogs available online, where people with a rare illness have described the same symptoms and GP frustrations as you. Try typing the name of your illness, plus the word ‘blog’, into a search engine: for example, ‘chronic fatigue syndrome + blog’.

Lastly, I recommend getting a book on assertion if it is hard for you to stay in control in difficult situations; alternatively, you can find some great internet resources on how to be more assertive in general.

Written by a guest blogger for Christine Tizzard Psychology (ctpsy.co.uk).