On Your Mind: Bed-wetting issues

on your mind

My son just started Kindergarten and he is still having issues with bed-wetting. Are there any mental health problems that could be causing this to happen to a 6-year-old? What can we do to help?

Response by Maya Damet-Powell, LCSW and Haden Shepherd, LPE-I

This is a great question and one that comes up more often than you probably think. While this can definitely be frustrating to deal with, the good news is that your family is not alone in dealing with bed-wetting issues, even at your child’s age.moon-1082759_640 (2)

The range of ‘normal’ childhood development is actually pretty broad. Unfortunately, understanding the issues underlying the behavior can often be more complex and not as well understood.

The first step in dealing with the issue would be to set up an appointment with your child’s pediatrician. The pediatrician will be able to help determine if there are any underlying medical issues that may be contributing to the bed-wetting your child is experiencing. Assuming the doctor determines that medical concerns are not contributing to the issue, the next step would be to consider any potential stressors your child is experiencing.

Have there been any major life changes or traumatic events that may have precipitated the bed-wetting? Even things that we consider to be a typical a part of growing up, such as starting school, can be especially stressful for children.

Do you notice any anxiety around bedtime? Are there nightmares associated with the bed-wetting? If these things are occurring in excess of what you would expect to be typical for your child, then they may indicate a possible mental health issue and consulting with a mental health professional may be appropriate. Taking the time to speak with a mental health professional would help you assess your child’s situation from a knowledgeable and objective standpoint, something that can be very important when dealing with an issue that is likely causing you as a parent stress and anxiety.

As for some simple ideas you may want to try out at home, avoid giving your child liquids a couple of hours before bedtime and have your child use the bathroom immediately before crawling into bed. You may want to try setting an alarm for the middle of the night for your child to get up and use the restroom (not an easy thing to do!).

If your child experiences fear of the dark, leaving a light on or having nightlights could be helpful.

Lastly, the most important thing you can do as a parent is to be available to help your child process any difficult emotions or thoughts that might be causing your child stress. Helping to normalize and validate your child’s emotions and experiences will help reduce any stress and anxiety that may be linked to the bed-wetting.

Your child is also likely to feel frustrated or embarrassed about the bed-wetting behaviors, so showing your child patience and understanding, rather than getting angry, shaming, or making your child feel guilty, will help to defuse the tension in a stressful situation. That way, the situation can get better before it gets worse.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: A mom’s mid-life crisis?

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

I’ve always heard jokes about people having a mid-life crisis. Now I’m wondering if I’m having one. I turned 41 a few months ago and I keep feeling periods of overwhelming dissatisfaction and sometimes sadness. I’m married with kids and there’s nothing in particular that’s going wrong, but I keep feeling like the best woman2 200parts of my life are already behind me. Then I feel guilty for thinking this way because I know other people have “real problems.” Is a mid-life crisis a real thing? Is this what I’m having? What can I do to get over it?

Thank you for submitting your situation. I think your question has the potential to interest many readers because most people reaching your age may feel this way at times. Thoughts and feelings can range anywhere along the continuum from pride and satisfaction to resentment and despair.

So, in short, yes, a mid-life crisis is an actual phenomenon that your letter appears to be describing as happening to you — at least in part. So how does a person “…get over it?” Realizing that every person is a unique individual, not knowing a great deal that is specific about you, and that there is no perfect answer that would satisfy every reader, I’ll offer these brief tips:

1)      Truly appreciate what you have.

2)      Be more in the present moment and practice acceptance.

3)      Think about living a value-driven life.

Let’s look at truly appreciating what you have. Ever hear of unfavorable comparisons? For example, one unfavorable comparison could be the 41 year old you comparing yourself (presumably physically) to the 26-ish year old you (or whatever age you feel was near your peak physical abilities). Another could be comparing your assets to “the Jones’” next door and the everlasting attempts to keep up. It sounds like you could benefit from a greater sense of inner contentment. While many would like to think about how things were or the various decisions they’ve made and come away with a smile, many come away with feelings similar to yours. This can occur when we think of lost opportunities or comparing where we are with others who appear to be more successful. It’s more beneficial to think about and appreciate those things that we have versus longing for things we think we want. This aspect of living ties in with another aspect called acceptance.

Be more in the present moment and practice acceptance. Being “mindful” refers to having complete awareness of the present moment while remaining non-judgmental — to fully experience what is happening around and to you by accepting your experience versus trying to manipulate things to give yourself a feeling that agrees with how you think the experience should feel.

For example, in Acceptance and Commitment Therapy, developed by Steven C. Hayes, PhD., he uses a metaphor (one of many) about a person (let’s name her Tina) inviting her entire family over to her place for a party. I will paraphrase here in the spirit of brevity, but all of Tina’s family shows up for the party, except Aunt Ida, who arrives later. Aunt Ida is known to complain about most everything, provides everyone with insults, and thanks no one for anything.

Tina’s choice, as she watches Aunt Ida’s car pull up to her place, is to allow her Aunt to come in or try to keep her out. Remember, Tina invited her entire family! She can block her Aunt from entering, but that would keep Tina at the door, not enjoying her party, and disrupt the party goers who are wondering what Tina’s doing at the front door. Tina’s night would appear to be ruined. So, Tina can attempt to keep Aunt Ida out OR she can accept the fact that Aunt Ida has arrived, welcome her, show her to food and drink, and then go and enjoy the party as planned. Accepting Aunt Ida’s arrival allows Tina the freedom to do what’s important to her and what she wanted to do in the first place — spend time with the family. This brings me to the final tip — living a valued-woman flower200driven life.

Living a value-driven life means engaging in those things that you value, those things that are important to you. For example, if being close to family is something you value, then keeping in touch frequently, visiting frequently, and sharing your experiences and feelings with your family members is meaningful to you. If you follow through with these actions, this part of your life would presumably be fulfilled. Conversely, if being close to family is something you value, and you are not able to see them often or at all, not able to share meaningful time with them, you will probably not be satisfied with this aspect of your living. Value-driven living is not obtaining a goal; it is a way of living.

In sum, by truly appreciating all you have, being in the present moment and accepting your experience, and living a value-driven life, you have the opportunity to live a more fulfilling and happy life. However, if your thoughts and feelings continue to develop into feelings of overwhelming dissatisfaction, sadness, and guilt, please consider seeking out a mental health professional (MHP) in your community. It was my pleasure to respond to your concern.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: She feels more like his mother than his wife

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

Looking for answers and found you guys. I’ve been married for 13 years. We have 2 children, 9 & 10 years old. My husband never has conversations with me unless it’s about a grocery store run or a to-do list. I started noticing that, if I stop talking, he will walk around in silence. He can spend days on end never speaking to me. He also has no friends and never has had friends. He has acquaintances through work or a musical project but he doesn’t see the people outside of work and, once a music project is over, there is no contact with those people.  I have a lot of friends and he has always just come along for the ride if there was a party or gathering.  He has no hobbies or interests.  He plays guitar but hasn’t been in a musical project in 4 years.  I’ve bought him books, encouraged different outings, tried to give him ideas, talked and talked, even counseling but the future is what’s worrying me now. I get nothing in return.  He runs around doing endless lists, staying busy but not quality time with us. When we go on vacation he seems lost without anything to do. It isn’t fun for us. When the kids grow up, how will they develop a relationship with him? I feel like more of his mother than his wife. That is just wrong. Am I expecting too much from him?  Is any of this normal?

Response by Patrick Henry, LMFT, LPC

Your story is not as unique as you might think, and your questions are similar to those many others are asking. This doesn’t make it easier, but you are not alone. The good part of this is that you don’t have to beat yourself up or feel like you’re failing. Lots of spouses are trying harder than their partner without the desired results. In most marriages (even the really satisfying ones) one partner is working harder than the other at least once in a while over the course of the marriage. That’s what makes it work. None of us are at our best all of the time. It does sound like you’ve worked hard to pick up slack and support your husband. One spouse often has to do this temporarily, but what you are describing sounds like it has become the norm and has left you tired and worried about the future.

Is This Normal? (Defining Normal—Normal vs Healthy)

Normal is hard to define when you’re talking about marriage/family unless you go with the literal definition for normal which is “that which is usual, typical, average, common, or standard.” By that definition, much of what you’re sharing is normal-ish in the sense that your unfulfilled expectations and desires for more from your marriage/partner are common—that is, you aren’t alone and many are in the same boat or a similar boat as you.

Around half of marriages end in divorce and many marriages have a partner who is unsatisfied or yearning for more at least some of the time. The point is this– while this may be normal (not uncommon) it is not healthy rp_sad-depression-225x300.jpg(good for you) when this becomes what is normal over time.  Normal and healthy are two different things.

The questions you are really more interested in are 1) Is this healthy? and 2) Is it okay to expect more? Healthy is harder to define than normal when it comes to marriage as this seems to be influenced by things like culture and individual expectations and desires. So let’s just say that what’s going on in your marriage/family isn’t working for you and is not healthy for you in that you’re working very hard at it and getting little in return…….and, yes, you can and should expect more from your mate.

His stuff vs Ya’ll’s Stuff

So, how much of this is his stuff versus your(relationship) stuff? It’s hard to see your “pattern” or your relationship dynamics in a paragraph but there probably are some things you/he can do differently to affect change in the other. Often a Licensed Marriage and Family Therapist can be helpful in identifying unhelpful patterns as well as more helpful ways of interacting. However, in your story his withdrawal/isolation seems to be there regardless of whether you pursue him or leave him be. This is not what you’d expect to see in a typical pursuer-distancer relationship (a relationship where the more one spouse pursues, the more the other distances/isolates. Often when the pursuer stops pursuing so much, the distancer does less distancing and starts to initiate more interactions).

What you’re describing is a more uncommon relationship pattern (or not a pattern at all). And by that I mean that his withdrawal may not be most effectively treated as though it’s a function of the relationship. Isolating from others, loss of interest in things previously enjoyed, lack of depth in most relationships (no friendships), seeming “lost” on vacation (those are supposed to be fun!), and over-attention to tasks/lists at the expense of relationships and quality time (anxiety/control) are symptoms frequently associated with several common disorders.

If the counseling he participated in previously was couples therapy, then he (and your marriage) may benefit more from him going to see a counselor as an individual to work on his stuff. Don’t confuse his stuff with yours. He may need you to give him a little motivation to seek out a counselor for himself, but in the end he may benefit from it greatly. You may benefit from going on your own as well so that you can process your own emotions, organize your thoughts, determine what you should/shouldn’t be responsible for, and think through what your next steps may be.

What You Can Do

Pushing harder and over-functioning probably won’t work. You only have control over what you do. And you’re not responsible for his relationship with his kids—that’s up to him. It’s hard for you to watch him missing opportunities with his kids and working less hard at this than you. Just keep doing your own part and be careful not to take responsibility for his.

You have to make room for him to grow. If you over-function, then he will under-function. You’re probably worried that if you let up, then the divide will grow even larger. But often this is not the case and many see the opposite effect. Be sure not to over-pursue him. You may even want to let him know that you’re not going to pursue him more than he pursues you and that you’re leaving the ball on his court. Tell him that his rejection and lack of response to you hurts you deeply and rather than set yourself up for more heartache, you’re going to wait for him to be the pursuer.

Assertively communicate with him and set boundaries while making clear the expectations that he work on himself. It’s important to tell him about your primary emotions (hurt, fear) rather than showing anger (or that’s all he’ll see). Hurt and fear are at the center of what you feel and he will respond better to you expressing those emotions than he will to anger (a secondary emotion which results from those primary emotions) which is likely to motivate defensiveness and more isolation. Do some things that are good for you. Don’t forget about your own self-care. Get out and do something fun with friends or with the kids.

Saving your marriage will not be easy. It’s worth fighting for but you have to be smart and you need a good game plan. A professional may be just what you need to help you identify the smartest ways to fight for your marriage while taking care of yourself at the same time. Best of luck to you.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: Childhood trauma has led to issues in adulthood

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

 I grew up in a dysfunctional home and suffered sexual abuse from an older brother for about two years. I was also exposed to pornographic magazines that my brother had laying around and also saw some pornographic videos my dad watched late at night when he didn’t know I was awake and watching. In high school I told my parents about the past sexual abuse from my brother but nothing was really done about it. My parents were very strict with me and I rebelled by getting in trouble, running with the wrong crowd and eventually dropping out of high school. I’ve gone through a series of bad boyfriends, one of whom was also a porn addict. I would smoke pot and sleep a lot to cope with how I felt. I constantly feel tired, anxious and unable to connect to anyone. I don’t know how to help myself. What should I do?

Response by Kristin Lehner, Licensed Professional Counselor at Ozark Guidance

Childhood sexual trauma can have a large impact on the victim’s life, continuing to influence one’s life in many difficult ways even in adulthood. The effects can be even more significant if the abuse happens in one’s home by a trusted family member.

sad girl 250When children “reach out” to their parents for help and protection from an offender, and the parents fail to do so, that child may be left wondering who can be trusted and who will ultimately protect him/her. And, without intervention, that distrustful and fearful child can then become a rebellious, troubled teenager, and later then he/she may become an anxious, detached, and depressed adult who self-medicates and has difficulties forming healthy and meaningful relationships.

It seems that for your own journey you have reached a point where you are ready to get professional help. Fortunately, there are people in the community who are empathetic and knowledgeable about your past and current struggles and who are experienced at working with people who have had abuse occur in their pasts. I think you would benefit from finding a mental health professional that has experience working with individuals who have been sexually abused.

I do feel obligated to inform you that trauma work is a difficult therapeutic process, but the process does work if you are able to trust the process and your mental health professional. So there IS hope! And I commend you for taking the step and asserting yourself and your needs in the midst of a very difficult situation.

I also wanted to share some tips for things you can do that can help. Deep breathing techniques can help you relax during times when you feel especially anxious. Meditation and mindfulness practices can make you feel more “in control” and can also bring you more self-awareness which will be beneficial to you before, during, and after doing your trauma work. This increased awareness will also assist you in establishing clearer emotional and physical boundaries with others that will also heighten your level of felt safety. Support groups also exist both online and in person, whether they be held in churches or by other establishments.

I commend you for your bravery in asking for help with a difficult situation, and I hope the very best for you.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.

On Your Mind: Dealing with a parent’s mental illness

on your mindNOTE: The question below reached us through our “online hotline” button which lets anyone send a question to a local counselor at Ozark Guidance — in a completely anonymous way. The email comes in with no email address and no identifying information. We set it up this way so women would feel free to write about anything on their mind.

I have a mentally ill, but thus far undiagnosed, mother. It is becoming increasingly difficult for me to be around her because of her insistence on continuously talking about her paranoia and delusions/hallucinations. I already struggle with feelings of anxiety and depression, and while I want to be a part of my mother’s life, I am finding that my own problems are exacerbated during and after contact with her. What is the best approach to dealing with this issue?

Response by Libby Bier, MA, NCC, LPC, LADAC

Thank you so much for taking time to submit this question. You might be surprised to learn how many  have similar struggles. You raise several important issues including diagnosis and treatment for your mother, as well as care for yourself and the impact her illness is having on your relationship.

Before I address these, I want to start off by saying that if any of your mother’s symptoms put her or anyone else in danger, she may need to go to the hospital. If the danger is immediate, call 911. (Once she’s in treatment, there may be some other options you can explore with the treatment team that can help with accessing care.)

Let’s start with you, though, and first look at the importance of self-care. You mentioned you already struggle with your own anxiety and depression. An important component to addressing your mother’s issues is making sure you’re in a good place yourself. Are you familiar with coping strategies for yourself such as relaxation, positive thinking, healthy support systems, and setting limits or boundaries? Are you taking care of yourself by sleep bedtaking care of the basics: relaxation, exercise, diet, sleep, and spending time with others who aren’t caught up in this challenging situation? If you are and it’s not working, have you looked into treatment for yourself?

When you’re doing all of this for yourself, then you’re better equipped to begin addressing the concerns you have for your mom. This will also improve your ability to be in a relationship with someone who may need some ongoing support to manage potential psychotic symptoms. I say “psychotic symptoms” rather than a specific mental health disorder because there are many reasons as to why someone may have paranoia, delusions and hallucinations.

This leads to diagnosis and treatment. A lot of information is needed to determine if someone is psychotic due to a mental disorder or if there’s some underlying medical issue. A good first step in getting your mother care is a medical evaluation by a primary care provider. It’s ideal if it can be someone with whom she already has a trusted relationship (to help with any reluctance or paranoia on her part). If no underlying medical issues are found, then being evaluated by a mental health care professional would be important.

It’s really important for whoever is working with your mom to have a complete picture of how her symptoms are affecting her functioning. This will help with diagnosis and the development of a plan of care.

Research tells us that many people are not even aware they have mental health symptoms. This can make it really frustrating when the person does not believe they need help and can put additional strain on the relationship. Sometimes it’s not helpful to challenge the delusions or hallucinations while you’re trying to first connect her with treatment. The insight that she is experiencing symptoms of an illness may not come until she has been in care for some time. Even as a professional, I have to sometimes remind myself to not take it personally when someone becomes agitated or mistrustful. This helps take the pressure and focus off of me or the individual and instead puts emphasis on them and recovery.

To summarize, here are your next steps:

1. Take care of yourself so you can be there for mom (the commonly used analogy is that if you are flying, the pre-flight instructions always include putting the oxygen mask on yourself before taking care of others around you).

2. Work with mom to connect with primary care and, if necessary, mental health care.

3. Try not to take mom’s behavior personally. It sure can feel personal, and some of the things people do when they’re sick can even seem like an attack. But remember, these are not things mom would be doing if she were feeling better.

One last thing to remember about this is it may not be possible to immediately “force” mom into getting help, (hence all the talk about taking care of yourself). There are some steps that can be taken if there is danger to self or others or if there’s some long-term impairment that prevents her from taking care of herself. However, delusions and hallucinations are not always, by themselves, enough to secure care for someone against their will.

I hope this has been helpful. If after your mom has seen a primary care provider, it’s determined that she  needs a mental health care provider, the staff at Ozark Guidance would be happy to assist with an evaluation to determine what services are needed and to connect her with resources within our agency and in the community.

Therapists at Ozark Guidance would be happy to answer your questions and read what’s on your mind. Click the butterfly icon below to fill out an anonymous submission form with your question or concern. The form contains NO identifying information and is designed to give local women an online place to share concerns with a person qualified to offer feedback.

Disclaimer: This RESPONSE does not provide medical advice It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on nwaMotherlode or Ozark Guidance websites.