Archive for November, 2013

Example above: My sequence with my dog when I get home after work – she usually whines because she just wants some love and attention after being alone all day. My tendency when I’m doing dishes or helping with dinner is to get frustrated instead of just kneeling down and giving her a few minutes of my attention and love. If I were talking to my child, I might say “Look. Dad does it too. I’m gonna work hard this week on breaking this pattern. I’m going to pet Bella for a few minutes before i start dishes every night”.

The success of this intervention with your child hangs on your ability to model it yourself. If your child can see that we all have these behavior patterns that need tweaking, they are much more likely to sit down with you and begin this process of awareness and change. I strongly suggest that you create a sequence cartoon for yourself to use as an example with your child. It’s a good ice breaker into using this intervention and also shows the child right away that you are all working on this together.


Addition 11/27/13: Air Your Dirty Laundry too. Children who exhibit difficult behaviors often receive a tremendous amount of negative attention. When it comes to asking them to identify challenges, they often refuse because they are so used to having all of their dirty laundry aired – they don’t want to add more to the line. Imagine for a moment what this would be like, always having your dirty laundry hanging for all to see and scrutinize. It would feel embarrassing, shaming, and like a constant expose. You’d want to hide from it too… pretend it wasn’t a problem. That is why I encourage parents to air some of their delicates as well -through sequencing.

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Please read my previous post on sequencing before continuing (https://spectrumshare.com/2013/11/07/repeating-sequences-awareness/).

I recently made this visual to bring all components of this new process of sequencing together. In the below image, you will notice a clearly marked “Challenge” with a time frame. Then you’ll notice the overall objective, which is to try and “BREAK IT” (the behavior pattern or sequence that keeps repeating itself in the lives of those in your family). Below is the actual cartoon sequence, made visual for child and family to see and discuss in sequential order (left to right). Below that is the “# of breaks” and the “total” number of times the sequence occurred over the time frame (two week period). Lastly, there is the celebration bar – where child and family find some activity to celebrate the successes or “breaks” together.

When I review the sequence each week with the family, I always ask for examples of successful breaks (moments where I and parents give heavy praise and recognition) and examples of struggle (chance to process what happened and to discuss that this is a “challenge” but that we are making progress).

In the example below, parents and child struggle with medication in the morning. This leads to argument/hiding medication, and then invariably being late for school. This causes daily tension and stress for all, so breaking this sequence is an important goal for the whole family to work on together.

This family chose to go out to dinner for their celebration activity. It is important that families decide how many breaks/total times constitute celebration. I always recommend starting out less rigid with this (if you repeat this sequence every morning and you have one break after starting this challenge – celebrate the one break). Don’t get in the way of gradual progress by setting expectations too high (4/5 days we need to break it in order to celebrate). You’ll get there, but not immediately. Remember that patterns have been in place for a long time and take time and patience to break.

I created this visual with the following apps:
– “JOT!FREE” for the cartoon
– “Comic life 2” for everything else.


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Man running in the woods in autumn

In my own life and in the lives of those related to me (my anxious family), the single best tool for managing anxiety is RUNNING!!!!!!! Hands down, without a doubt, the most effective (for me and family). Running not only exhausts the body, alleviating tension in the muscles, but also forces the mind to focus on the breath (a key component of regulation and a central tenant of meditation).

My brother is a writer and editor for the Huffington Post, contributor to the LA Review of Books, and many other publications. He recently wrote a funny piece about exercising alone – http://www.huffingtonpost.com/nicholas-miriello/work-out-alone_b_4282236.html. My sister is a singer songwriter in LA, writing songs for top pop and indie artists. My youngest brother is a Chef in Los Angeles, constantly creating new entrées to be tasted and critiqued by food-savvy LA eaters. My mother is a chef and personal trainer in Florida, and a long-time restaurateur. And lastly, my father is a contractor/builder in Connecticut, building structures that must be pleasing aesthetically and stand the test of time (and east coast winters).
All of these lovely people are bright, hard working and ANXIOUS. All have made running/cycling/or regular fitness a part of their lives – not simply for physical health, but also and probably more directly for mental health.

There is plenty of research substantiating the claim that running/exercise reduces and helps manage anxiety. My intention in writing today is not to point to that research (although I’d be happy to send some great articles your way), but instead to share my personal #1 method for managing anxiety (and my wonderful families).

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Making visual a boys “nervousness” during Physical education. I look forward to seeing how he fills this in. This visual also works to help this boy become more aware of how his thoughts effect his body, and then his behavior (the anxiety cycle).


This is for a father and son who routinely struggle with one another around transitioning/leaving. By reviewing this sequence with the boy, we will be working towards giving him more awareness of this behavior pattern while also allowing him to step back and see his fathers point of view. In addition, this shows the boy that we see or understand his struggle, giving us a chance to normalize his experience. Names have been blanked out.

This visual is for a girl who struggles with taking the first step – engaging with peers. This makes her goal visual – allowing her a clear understanding of what we are working towards.


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Helping kids label, recognize, and externalize self-bullying thoughts through simple cartoon illustration. I love doing this with kids and having them draw and name their self bully character. I then ask them to be mindful of when this character makes an appearance in their thoughts (I’ve named him Judge Meano for this example but I’ve had kids name their characters Simon Cowell, Mr. Stinker, and other silly and creative names). By externalizing this negative thought process, we make it much easier for the child to talk about.


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Below are a few points by Brene Brown, vulnerability and shame researcher, that I took away from this talk and really appreciated:

"Do you have the courage to be imperfect".

A parent's job is not to tell their child that they are perfect or that they should strive for perfection, but to let them know – "You're imperfect and you're wired for struggle but your worthy of love and belonging".

When we avoid vulnerability, we numb, we become “certain” (often blame those who do not hold that same certainty), strive to be perfect, and pretend (that what we do doesn’t have an effect on others).

Blame (defined)- a way to discharge pain and discomfort.

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Repeating Sequences- Awareness

This week I worked on a new intervention I call sequencing. First I ask the family to call out repeating (daily/weekly) conflicts. As they do, I jot them down on a visual like:


After identifying repeated patterns/sequences, I then ask the family to rate each sequence on a scale of least to most severe (this you can see to the right of the above visual as thumbs up, thumbs middle, thumbs down). Issues rated “thumbs down” are the first to be addressed and drawn out. I then draw the sequence out in 4 simple boxes – representing what is happening visually and in order.
The first image is a sequence in which a young girl and her parents struggle regularly with transitioning from television time to bath/get ready for bed time.
This image represents a father’s struggle with his son repeatedly crashing into his brother’s toy after being told no. The sequence ends with the boy upset in his room.
This image involves a teen who becomes defiant when its time to leave the water and go home.
This last image shows a boy on his IPAD who struggles to transition to bath/hygiene time.

Its not a coincidence that these troublesome sequences often happen around transition times. As many of us know, children on the spectrum and/or who tend to hyper focus have extremely difficult times transitioning.

After the sequence is drawn, with humor and silliness being a must, I review it for potential errors with the family and then ask them to print a copy and label when the sequence occurs over the next week. I get a commitment from the whole family that they want to see this pattern change and that it will require effort from all, not one (I have them raise their right hand and say a pledge). I then share with parents some language they might use to identify the sequence, like: “Oh man. We’re doing it again. Look. I don’t want it to end like it usually does. Let’s try to break this pattern.” I ask all involved not to use the pattern as a shaming device but instead as a collaborative tool to build awareness around behavior patterns and foster change.

After the family reports back one week later, I ask them to start counting the number of times they fall back into the sequence and how many times they are able to break it.

The following week (two weeks in), when they report back with the number of breaks/total,I ask them to celebrate their success with some fun activity as a family. This allows the child to see that their hard work is being rewarded and that it is not only them but the family that can make change and celebrate. Once the sequence is reduced in frequency and intensity, we move on to another behavioral sequence.

* I find this process is most effective when the parent can share and draw up their own faulty and repeating sequence (ex: “I always get cranky in the morning and then lose my temper during breakfast”). This shows the child that it’s not just them that is working on changing patterns.

Dad’s example of giving an expectation and then getting frustrated within seconds when it’s not followed (notice the clock)

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