Being the most common feature in our times qualified our times to be probably called an era of anxietyowing  to  its  contradictions  and  challenges,  the  lack  of  opportunities  for  self-fulfillment,  over  stress  and  poor social  relationships  and  values,  which  leads  to  a  sense  of  tension  and  anxiety  associated  with  our  inability  to predict what will happen in the future.

Future anxiety is one of the anxieties that simultaneously emerged with Toffler’s launching of the term Future  Shock  (1970);  Zaleski  (1996)  indicated  this concept  which  refers  to  a  state  of  apprehension,  fear, uncertainty  and  anxiety  of  undesired  changes  expected  to  occur  in  the  future.  This  fear  of  the  future could include a variety of anticipated threats including physical threats, such as illness or accident, or emotional threats, for example the loss of one of the family members. These threats vary in terms of severity, and future anxiety may include the individual’s fear of failure in achieving his/her goals and aspirations.

Full story at Institute of Education Sciences

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Make it a habit to glance at your expression in the resident’s dresser or bathroom mirror. You be the judge. Ask yourself, “What am I reflecting to this resident as they perform this ADL?” “What am I reflecting to the rest of the world, as far as that goes?” What do you see as you glance at your face?

So what can you do, if you feel that you need to change?

Here is technique, or how-to, number one. As you look in the mirror, divide your face into the upper brow region and the lower half, your mouth and cheeks. As you look at yourself in the mirror, first look at your upper face, your brow. Is it furrowed, perhaps indicating to your resident stress or displeasure? Or is it smooth? With age, unless we are movie stars who have had face lifts, we all have wrinkles, lines, and creases. I am not talking about natural aging or character lines. I am talking about the lines that you create yourself by tensing your brow ridge. Experiment with this, and note the dramatic difference in what you project by tensing up and pulling together your eyebrows.

Now, relax your eyebrows and concentrate on flattening or relaxing your brow ridge. Raise your eyebrows slightly. It almost feels like smiling with your forehead, because it reflects calmness in those muscles.

Furrowed, tense brows to your resident reflect an unfriendly, stressed person who seems unapproachable and unwilling to really help, no matter what their words say.

Question #2: To reflect calm in the upper portion of your face, concentrate on doing what with your brow ridge?

Now, let’s look at the lower half of your face, your mouth and cheeks. Have you ever received an insincere smile from someone? Yes, unfortunately we all have. Like the fast food clerk that hates his or her job and hands you your bag of food through the drive up window, smiling with an all too toothy smile, while blurting out, “Have a nice day!!” What’s wrong with their smile? The corners of his or her mouth are turned up, so doesn’t that qualify as a smile? Why does it come across as painfully insincere? Well, it’s because the smile is not reflected in their eyes.

Try another experiment with a mirror. Lower your lids to one-quarter or one-half of the way closed. Then smile. You look something like Bugs Bunny, don’t you? The top half of your face doesn’t match the bottom half. Think about how receiving this insincere Bugs Bunny-type smile feels to your resident as they are doing their best to put the button through the hole as they dress. If your eyes don’t match your smile, they know in their heart that you don’t really mean what you are saying.

Now look in the mirror and think of something wonderful, maybe a rainbow or a beautiful summer day. Or, think of someone or something that you really care about, maybe a car, a dog, or a significant other. Look in the mirror. Look straight into your eyes and smile. Do you see what your eyes are doing? They are open naturally, with a warm energy coming out. They match your smile.

That sincerity is what creates the kind of bonding relationship between a care giver and a resident. This helps the resident to see that you respect their efforts to risk trying and failing. They see that you really care. It’s easy to have someone do something for you, because you don’t have to risk failure. Obviously, none of us want to fail. We all want to succeed and have the feeling of being accepted just as much as our residents do.

Question #3: A Bugs Bunny insincere smile occurs when your what does not match your what?

In your ALF, it’s up to you to provide that feeling of acceptance and support for your resident. You have to encourage them to try, to cheer and root them on with a warm caring expression of support on your face.

Non-Verbal Prompt #2, #3, #4, #5 and #6 go to Geriatric & Aging Course

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#1 Dissociation
As you are well aware, there are many kinds of dissociation.  However, I have found that, fundamentally, dissociation refers to a disconnection between experience and emotion, or between mind and body. See if any of these dissociative remarks sound familiar:

Here is grieving client observation
— Number One:
“It’s like I’m outside of my body looking in.”
– Number Two:
“I have no idea what I’m feeling”

Dave, age 17, made a third dissociative observation when he stated, “I knew I should have felt something, but I didn’t feel anything.”  Dave was referring to an accidental cut to his hand which happened several days after his best friend, Jeremy, died from a drug overdose.  Dave stated, “It was a deep cut.  The doctor gave me 9 stitches.  At first, I just watched the blood flowing out.  I didn’t feel any fear or pain.  I knew what was going on,  I just didn’t care.  Then my mom saw it and she freaked.  Her scream sort of woke me up, I guess.”   Later on this track, I will describe a technique I suggested Dave use to avoid similar dissociation.

For #2 and #3 ‘D’s of Grief go to Grief Course.

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Technique #1. Unmasking the Critic’s Purpose
The first step to destroy the critic permanently is unmasking the critic’s purpose.  I asked 17 year old Josie to look beyond the consequences of her critic and try to uncover the motives behind the critic’s statements.  For Josie, this meant analyzing her own social incompetence.

She stated “I recently have had trouble at school with friends.  Actually, I don’t have very many.  I just recently realized that I was comparing myself to my friends.  I had to be as good at basketball, or be the president of NHS, or captain of the speech team.  There was no room for second place.  I realize now that that was my critic talking, telling me to work harder.  At some point, I realized I could not work any harder.  If I did, I would kill myself.”

Randall, her father, took part in unmasking her critic.  He stated, “I know when she’s stressed.  It’s easy to tell.  She gets really irritable, so when I see that, I’m thinking ‘Critic’s talking again.’  I sit down with her and we both go through her feelings and activities together.”  As you can see, her father is taking an active role in repairing the damage his own drive for perfection has done to his oppositional defiant teen.

For Technique #2  and #3 go to  Parenting Course

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# 1 – Relieve Anger
As you probably have observed, self-mutilating clients tend to live with the myth that when someone gets mad, somebody has to get hurt. Usually, this stems from a childhood home that valued repressing angry emotions.

Crystal, age 16 stated “My family almost never showed any anger, but when they did, it sure got bad. My fantasies are that I want self-injury to the point of death. Sometimes I feel like if I self-injure, maybe someone will notice me.” Crystal’s emotionally repressive family left little room for self-expression. I felt Crystal’s need for someone to notice her is a way for her suppressed emotions to make themselves known. Many times, Crystal believed that it was better for her to hurt herself than to hurt someone else, or to let someone else hurt her first.

# 2 – Indirect Means of Retaliation
A second reason for self-mutilation in addition to a “notice me” kind of anger is it can serve as an indirect means of retaliation. In this case, self-injurers who have been abused as children think that mutilation of themselves will cause pain to their aggressor. Unable to express their feelings of wrongdoing coupled with their belief that those feelings would be ignored, clients like Sylvia repress their emotions until they’re released through self-injury.

Sylvia, age 19… was abused by her father when she was 7. She stated, “My parents never publicly recognized the abuse. Every time I confronted them, they denied the whole thing. They really never addressed my feelings of betrayal or loss of trust. I thought ‘I’ll show them’ and that’s when I started cutting.” At the end of this track, I will discuss how I how I utilized a “Fantasy” exercise with Sylvia’s feeling of indirect retaliation.

# 3 – Means of Control
A third reason for self-mutilation in addition to a “notice-me” kind of anger and indirect retaliation, I have found clients sometimes use self-mutilation as a means of control. Generally, this is a result of an abusive or traumatic childhood.

As you know, clients who experienced sexual manipulation have lost a sense of control of their environment and self-mutilation is a way to regain it. They decide when and how long the pain will endure, not their aggressor. Sylvia stated, “I felt that when I inflicted pain on myself, I was reclaiming what I had lost.” Sylvia described her pain as a way of forcibly establishing a line between herself and her aggressor, in this case mainly her father.

# 4 – Test Loyalty
A fourth reason for self-mutilation: Sylvia also used her self-injuries to test a person’s loyalty to her. She would be very open about her self-mutilation. She stated, “One pattern in my life that I’d like to change is my need to sort of poke at people in order to see how much I can trust them and whether or not they’ll leave me.” Her loss of trust as a result of her childhood abuse caused her to feel alone and helpless.

# 5 – Engage Caring Responses
Cutting herself and talking openly about it was her way of protecting herself from a second loss should someone she trusted betray her. As you are aware, many times, clients who reveal their self-mutilation in public also want to assert a personal declaration. Tony, age 17, stated, “I liked the attention I got from people. I felt like I was different or tough. I told myself that I was strong enough to take it and everyone else was impressed with my strength.” In addition to relieving anger, maintaining control, indirect retaliation, and a test of loyalty, clients use self-mutilation to engage people’s caring responses.

For “Fantasy” Technique, 2 Steps go to Self-Mutilation Course

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Role-play at Home
Role-playing is a good way to teach children with Aspergers how to act in social settings. Parents can guide their children through conversations and show them the appropriate ways to act in certain situations. Children with Aspergers have trouble in particular with making small talk and smoothly changing from one topic to another during the normal course of a conversation. Parents should also show their children acceptable ways to talk to others since children with Aspergers are prone to talking obsessively about one topic without realizing that the other person has lost interest.

Encourage Socialization
Although children with Aspergers have a lot of trouble learning social skills, having them work at it gradually but consistently can help them make progress. Parents should have their children play with others who are around the same age. For the best results, regular socialization should be started at an early age so that children will have a better understanding of social skills by the time they start school. This also gives them plenty of opportunities to practice using the skills they’ve learned. Parents should supervise these play sessions closely in order to step in and correct their children’s behavior when needed.

Teach Verbal and Nonverbal Cues
Children with Aspergers usually fail to notice nonverbal signs that other people use in social settings. They typically don’t realize when other people have become bored with the current topic of discussion. They also need to be taught verbal cues that most people take for granted. Many children with Aspergers don’t understand sarcasm so they tend to take humorous or joking comments seriously. Since this type of misunderstanding can make them anxious or lead to inappropriate responses on their part, it’s important to help them learn to recognize verbal cues.

Use Pictures
Parents can help their children with Aspergers learn how to act properly in social situations by showing them drawings or books that illustrate these concepts. Visual imagery can help them understand things like sharing, which might be difficult to explain verbally. Using pictures can also be a less intimidating way for children with Aspergers to learn social skills. Instead of being put on the spot by having to interact with other children, studying pictures and listening to their parents’ explanation of them gives them a calm and safe environment to process what they’re learning.

Minimize Anxiety
In order to make it easier for children with Aspergers to learn social skills, parents should do what they can to reduce their child’s anxiety. Children with this condition do better when their daily lives are structured.

related course:
http://www.onlineceucredit.com/ceus-online/ep-asperger/continuing-education.html

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