In So Many Words

Exploring Feelings
Cognitive Behavior Therapy to Manage Anxiety

by Dr. Tony Attwood
Future Horizons, 2004
79 pages

Winner of a 2008 Teachers’ Choice Award!

About the Book

Anxiety can be debilitating for anyone, but it can be especially confusing for a child. Learning about emotions helps children recognize connections between thinking and feeling, and helps them identify the physiological effects of anxiety on the body (sweating, increased heart rate, crying, etc.).

This book provides a guide for caregivers and then the workbook section allows children to identify situations that make them anxious and learn how to perceive the situation differently.

My Thoughts

From what I can tell, the book seems to be set up in a format that would be easy for a psychologist or other group leader to implement. The opening section provides a good overview of the goals and methods used, followed by a section with all the worksheets needed for the six sessions, and ending with a breakdown of the timeline and resources needed for the facilitator.

As Dr. Attwood explains, Cognitive Behavior Therapy (CBT) focuses on aspects of both cognitive deficiency and cognitive distortion, both of which are seen in people on the autism spectrum. To address these areas, the program starts with affective education, the goal of which is “to learn why we have emotions, their use and misuse and the identification of different levels of expression.” From there, it moves on to cognitive restructuring, which “enables the child or adult to correct distorted conceptualizations and dysfunctional beliefs.”

Another great strategy that is used is the introduction of an emotional toolbox, or collection of ways to fix the problems associated with negative emotions. There can be a variety of types of tools, including physical, relaxation, social, thinking, sensory, special interest, etc. Inappropriate tools are also discussed to help the participants learn to evaluate when and how a tool should be used (or not used).

I am extremely impressed by this book and could see it being used effectively with kids who have developed some skills in identifying their own emotions and who are willing to engage in group activities on this topic. At age 9, I don’t think my son would be quite ready for this, but I could see him benefiting from it within a few years (or possibly from a modified version now).

Discount Opportunity: If you order Exploring Feelings directly from Future Horizons, you can use the code INTERRUPTED to receive 15% off and free shipping in the continental US. There is also an Exploring Feelings workbook focused on managing anger.

Note: I received a review copy of this book for free, but all opinions are my own. I am an affiliate of Future Horizons and receive a small amount of compensation for any sales made using the promotional code provided. You can use the code INTERRUPTED when ordering books or other materials – or even conference registrations – to receive 15% off plus free shipping in the continental US.

I’ve been posting mostly about books lately, but I thought it would be good to write an update on how things are going with Michael so far this summer.

Michael with his Lego Creation

During his two weeks at the babysitter’s he only had 2 or 3 outbursts, and only one of those included aggression. And he has only had 3 aggressive incidents during the first four weeks of his summer program. This is a huge improvement over how school was going and is even better than he did last year at the same sitter and program.

As the summer progresses, I have seen a bit more whining and emotional outbursts, and he seems to be nervous about going back to school in a few weeks, but at least we are able to have conversations about it and talk about ways that he could handle how he is feeling. I was just sent a book to review from Future Horizons called Exploring Feelings: Cognitive Behavior Therapy to Manage Anxiety. It is by Dr. Tony Attwood and includes a workbook section that I am planning to do with Michael.

His summer program goes for one more week, and then he and I are going to the autism conference in State College the first week of August. It will be great for Michael to participate in their children’s institute, and then he will have two more weeks at the babysitter’s. Bob got off work the week before school starts, so we will have a short family trip and then they will go down to help with Bob’s mom for a couple of days, and somewhere in there we will schedule a visit to the school to meet the teacher and see his classroom for third grade.

I’m not sure what happened to all of my goals for the summer – we are only a third of the way through the summer packet and haven’t made any progress on keyboarding skills or even on tying his shoes. I’m not complaining, though, a relatively peaceful summer is a wonderful thing and I am truly thankful for it.

As I was catching up on some blog reading today, I came across a book review over at Whitterer on Autism that I was very excited to see.

The review was of a book called From Anxiety to Meltdown by Deborah Lipsky, and the reason I was so excited is that I saw Deborah speak last year at the National Autism Conference in State College, PA.

Deborah is a woman who was diagnosed with high-functioning autism as an adult and has added author, comedian and public speaker to her extensive list of accomplishments and roles in life. The talk is about an hour and is well worth the listen. She is extremely well-spoken and very funny, plus I think you will learn a lot from what she has to share about her experiences.

Here is the link to the archived webcast:

http://streams.wpsu.psu.edu/103-Closing_Keynote08062.html

(When I watched it again earlier, the sound didn’t always quite match up with the picture, but that may just have been my internet connection as it cleared up a few minutes in.)

Just in case the link doesn’t work, it came from the list of webcasted programs from the 2010 conference at http://www.outreach.psu.edu/programs/autism/webcasting.htm. Deborah was the closing keynote speaker, so her presentation is listed at the very bottom of the page.

Enjoy!

As I was spending some time online the other day reading about various aspects of depression and anxiety, I took a break to check my GReader and what did I see but Janice at 5 Minutes for Mom talking about her own experience with those issues. It’s amazing how many people struggle with some form of these disorders, myself included.

For those who commented on yesterday’s post about taking Michael to a psychologist, I am going to follow up on it soon, but in the meantime I wanted to talk a bit about a recent therapy session of my own. I have been seeing this particular therapist for several months, but hadn’t been in for a few weeks, mainly due to the busyness of the holidays.

When he asked how things were going, I had plenty of things I could talk to him about that either had already happened or that I was anticipating coming up in the near future. But I have been feeling a bit like a hamster on a wheel and afraid that, if I can’t keep going fast enough, there will be a horrible crash at some point. I really needed more than to talk through one or two specific situations.

So I asked him if he could tell me what I needed to do to get to the point where my moods would not be so driven by circumstances and other people’s words and actions, where I could just be me and have control over myself, even when things may be out of control.

His response was fairly simple — Know your limits, and accept them.

As he put it, some people don’t know what their limits are and so they just keep taking on whatever comes their way without even realizing that it is more than they should expect from themselves. The first step is to become aware of your own limitations in terms of energy, time, resources and ability.

That’s hard enough, but then comes the even trickier part – accepting your limits.

Some people can see their limits but refuse to accept them. So they will keep shouldering more commitments and responsibilities even though they know it will add too much stress to their lives. It’s not enough to know your limits, you have to accept them – even when that means becoming your own advocate with others who want you to perform for them.

That was a surprisingly new concept for me, that I need to advocate for myself just as much as I advocate for Michael.

It really comes down to examining each thing that comes your way and identifying what control you have over it and whose responsibility it is. If it’s someone else’s responsibility, all you can do is pass it on to them and let it go. If it’s your responsibility, you need to decide if it’s within your limits to take care of right now. If that’s not possible, the next step is to figure out when you could do it or get someone else to handle it.

I’m just starting to think through all of this, so I’m probably not repeating it exactly right or in a very eloquent manner, but I can definitely see how it gives me the control that has been so easily given away to other people and circumstances in my life.

What do you think about his answer? Do you know your limits? Have you accepted them?

I have been feeling lately like I am fighting depression, which is an especially scary thing if you know how deeply this has affected me in the past.  I hate the feeling of being aware of it hovering in the air, almost waiting to descend upon me if I am not vigilant to hold it at bay.  I was expecting to feel this way around the holidays but I didn’t this year, so having it come in January was a bit of a surprise (guess I thought I was completely over it).

Anyway, I am finding that even with the level of anxiety and stress I am feeling, I am still have more energy and motivation than I usually do when I am struggling.  I have been able to do a load of laundry each day for the last few days, as well as catch up on the dishes and make meals (albeit simple ones) for my family.  I have been able to finish up a few writing projects to which I had committed and I was able to pull together and prepare for a team meeting at school.  Even the desire to do those things has often been lacking in my life, let alone the ability to actually follow through on them.

Today I spent the entire time I was at work following up on and responding to emails from the person who took over for my coworker out in Wisconsin who had her twins a week and a half ago. (For those who haven’t heard this in some other forum where I hang out, they were 14 weeks early and one of them didn’t make it.)  So I completely understand that the other person was not at all ready to step into her shoes, but I have to admit it was a bit tiring today.  Tomorrow I am going to have to focus on a couple of other priorities and limit my time with her stuff to about half, if I can.

Tonight I need to do a couple of things still for ASD HOPE, so I’d better get to it.  I think I may have to break down and purchase Microsoft Office soon, or at least Microsoft Word.  Since I got my laptop, I have just been using Open Office, which is free, but I am finding that there are a few things I do where OO just won’t cut it due to formatting issues.

Thanks to everyone who has been sticking around while I whine and complain about my life.  I really do have a positive side; it’s just that sometimes I have to get it all out to have any hope of moving on.  One neat thing – as of today, I have officially been blogging for one year.  I started Another Piece of the Puzzle on January 26, 2008.

Over the past few weeks, I’ve thought about things I wanted to write about or share here and just haven’t been able to get them down on paper, so to speak. Looking back, I realize that I let myself be completely overtaken by my anxieties about Michael starting kindergarten.

While trying to be proactive about the implementation of his IEP, I seem to have alienated the learning support teacher, who is his case manager, and couldn’t get anything out of the classroom teacher other than, “He’ll be fine.” Suffice it to say, that made me even more frustrated. I finally got to talk directly to the speech therapist last Thursday and we were able to connect really well.

It turns out the SLP has the most contact with him anyway, other than the classroom teacher. She has also been gradually talking to each of the special teachers (gym, art, etc) about what information to write on the daily report and giving them some ideas about how to help him understand what they are teaching or directing him to do. I felt a hundred times better after talking to her, and I am also seeing that the classroom teacher is beginning to understand how he takes in information and handles difficult or confusing situations.

Since then, I have been feeling so much better about school and have a lot more peace about everything. As things come up, I am taking note of them and also the different solutions we come up with so I will be even more prepared the next time we write an IEP. (Yes, I know we can change the existing one and we will if it becomes necessary.)

And I even pulled myself together enough to schedule respite for tomorrow night so that hubby and I can get out of the house for a little while! We are hoping to see the play at our church if there are still tickets available, but a movie will be good too if they are sold out. Unfortunately we didn’t know last weekend if we could make it, and his meeting last night went so late that when he made it from the prayer center to the main building, they weren’t selling them anymore. Either way, I’m sure we will have a good time.