Author: Dr. Gloria K Vanderhorst

Brain Wiring and Mediation: Keys to Successful Listening

How Brain Wiring and Mediation enhance creative cooperation in online therapy Maryland and DC

Understanding Brain Wiring and Mediation is essential when guiding families and couples toward cooperation rather than competition. As a Maryland and DC online therapist, I frequently see how positional stances in mediation stem from the brain’s built-in competitive wiring. This post, co-authored by Ellen Kandell and Gloria Vanderhorst, explains how listening deeply engages the prefrontal cortex and shifts negotiation toward empathetic resolution. For a helpful primer on collaborative mediation, visit Mediate.com’s full article. To discover how online therapy in Maryland and DC supports these brain-based skills, take a look there too.

Keys to Successful Mediation: Understanding Brain Wiring and the Complex Listening Dynamic
by Ellen Kandell, Gloria Vanderhorst
Supporting Effective Agreement
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Mediators know all too well that their clients can take positional stances that are hostile and effectively block the creative thinking necessary to reach an equitable settlement. Positional stances taken by clients and their counsel are a natural result of the brain’s dual wiring for competition and cooperation. These processes are in-born; however, the competitive tendency is slightly stronger than the cooperative one and the parts of the brain used for each are protected in very different ways. The competitive instinct is well protected between the temporal lobe and cerebral cortex hidden in the fold. The cooperative tendency depends on the action of the prefrontal cortex. Historically, our survival has depended on our ability to compete by besting our perceived enemy. Numerous studies indicate that we are not content to just get ahead of the other; we want to demolish the opposition. These tendencies are at play whenever we must negotiate with another. The challenge is to shift your clients from these positional/ competitive mindsets to more cooperative/collaborative thinking where creative and mutually beneficial solutions can be generated. Developing keener listening skills will enable you to help your clients make this shift.
Listening is often confused with hearing. Hearing is a natural experience that happens spontaneously unless there are physiological deficits. While hearing can be measured by audiologists, listening cannot because of numerous subjective factors. Listening requires work: focused energy, choice, active screening, plus both aural and visual concentration. When we choose to listen, we act to screen out external stimulation that could be equally salient and internal stimulation as well. Our temperature and blood pressure increase slightly as we use our energy to concentrate. The majority of the information that we use as we listen is actually visual detail and not aural detail. In fact 93% of our communication is non-verbal. (1) Visual cues enable us to interpret what we hear and to make sense of the communication from the other person. Over our lifespan, our listening efficiency decreases significantly as we become more occupied with our own thoughts and internal dialogue. Being a good listener is hard work that requires specific training.
One factor that is responsible for undermining our listening ability is our biases and historical frames of reference. Our histories shape what we hear. In intimate relationships, we tend to handle conflicts in the same way that we did as toddlers with blame, denial, avoidance, sulking, and temper tantrums. The thing that makes a toddler so irresistible is the Grand Human Contradiction (2): our competing drives for autonomy and connection. Autonomy is closely tied to our tendency to compete and connection is a function of our desire to cooperate and align with others. The toddler wants to be independent and assert his own will and at the same time he wants to be intimately connected and dependent on those around him. As adults, our intimate relationships often mimic this contradiction. When we have conflicts, we get stuck in the toddler mode where our amygdala sounds the alarm of danger and alerts us to prepare to defend and protect ourselves. We get stuck focusing on the attack we perceive and we react only to the perceived danger. Take the example of the couple mediating a divorce settlement where the wife has initiated the divorce. The husband has a history of depression that can be traced back to a severely neglectful childhood. When his wife starts a sentence with “I want…” he is automatically thrown back into the distant past where he has experienced himself as insignificant and unimportant. He assumes that her “wants” will be unreasonable and calculated to injure him in some way. So when she completes the sentence with “I want to be fair and even generous because I know you do not want this divorce”, he fails to hear the most important part of the sentence and responds in an angry rage.
The ability to listen and rationally examine what is actually said requires the action of the adult brain – the prefrontal cortex, which is not fully developed until the mid-to-late twenties. In the adult brain, you can see both perspectives at once. You can feel your own fear and pain as well as your partner’s empathy and care. You can hold these two realities in mind at the same time and know that the person who is causing you so much grief can also be the person who can offer healing. In this advanced part of your brain, you have a chance of working out what is best for both of you and achieving what you both want – a sense of mutual caring. To move the husband from his toddler brain to his prefrontal cortex requires careful focused listening.
A second and related factor that undermines our listening is our own biases. Before we can listen to others, we must first listen to ourselves and be aware of our own biases and the automatic thoughts that interfere with our ability to hear what the client is saying. To surface your own biases, make a list of ten small or big traumas in your own life. Now ask yourself how each of these traumas has influenced the way that you think about relationships. You may have to list several possible implications before you can recognize the salient impact for you. Traumas influence how we experience relationships and attachments. Our attachment beliefs are a part of our automatic thinking causing us to respond to situations in certain ways before we even have conscious awareness of our response or attitude. Once these automatic thoughts have been identified, write out how they could bias your thinking about the couples and cases in your practice. Share your bias with a colleague who can help you remain accountable to identify the impact of these biases as you work with couples.
Next, use your new self-awareness to help your clients discover their biases. One of the keys to moving a client from competitive thinking to cooperative thinking is to slow their thinking so that they have time to examine their own biases. Be willing to ask your client to slow down and go back a few steps. Typically, the client is willing to have each aspect of their thinking repeated. In the example above, the angry husband who saw his spouse as hateful and vindictive would be taken back to each of these thoughts, slowly and with repetition. As you do this review with the client, the pace of your own voice should slow by 20% to 30% and your volume should be below your normal speaking volume. The slow pace and low volume serves to encourage the client to slow their own pace. The brain’s natural tendency to “mirror” experiences functions to reduce the adrenalin that accompanied the rage and encourage the production of oxytocin which calms emotions enabling the client to be more engaged in the conversation. The repetition of the client’s thoughts and feelings 2, 3 or 4 times enables him to reflect and to modulate his response. As you repeat, “you are angry and hurt by her request for a divorce and you expect to be cheated” in a slow calm voice, the client’s prefrontal cortex has an opportunity to actually consider this concept and compare it to other perceptions that he has of his wife. Repeating this several times exactly or with some modification in phrasing may feel awkward at first; however, when you understand what the brain is doing with this repetition, you will quickly embrace the low, slow repetition as a means of turning on the prefrontal cortex enabling the client to adjust his thinking to a more rational perspective. Once the angry client has modulated his thinking and shared more rational thoughts, he is ready to hear what his wife actually said. If you were to skip this step and just ask the wife to repeat her message, the husband would likely hold onto his bias and not trust what she is saying. Consequently, he would be focused on winning and competing rather than on cooperating to create a mutually satisfying settlement.
Our competitive brain activity can be quite toxic. The competitive part of our brain uses more primitive defense mechanisms to keep us focused on winning. Those defenses include denial, interrogating, judging, accusing, counterattack, justification, withdrawal, betrayal and sabotage. Anyone who has helped a couple negotiate an issue will recognize these as very familiar processes that can easily undermine any negotiation. The cooperative part of our brain uses very different strategies: humor, brainstorming, reflection, questioning, investigation, experimentation and compromise. Obviously, the outcomes of any couple’s negotiations will be better served by the latter. Helping each party access the cooperative part of their brains is both a science and an art.
The science of accessing the cooperative, prefrontal cortex demands knowledge of brain anatomy and chemistry. We have already described the location of this part of the brain in the prefrontal cortex and noted that it is more vulnerable to injury. The prefrontal cortex is also easily distracted by internal and external stimuli. Our executive functioning is located here. Our clients may be prone to appear present in the room while mentally reviewing their grocery list or inventorying the home furnishings and jewelry. Such mental competition requires a process that uses “visual listening”. Remember that we noted earlier that 93% of listening is visual. Facial expression, eye position and clarity, muscle tension, breathing pace, body posture and movement are all visual cues that indicate the degree to which the client is productively engaged in listening. Changes in these cues are reasons to slow the process, review what has been said, take a break or seek the clients understanding of what is currently happening in the room.
In addition, the chemistry of the brain can be influenced by the physical arrangement of the room, the physical atmosphere, the available food and drink and even the number and types of breaks in the negotiation. King Arthur and the Knights of the Round Table were really onto something with the room arrangement. We tend to feel more engaged and equal when seated at a round table. Pastel colors in the pink and green family are also calming as well as vistas with a lot of nature in them. Breaks that take the client outside rather than into the hall do a better job of resetting them. If you are offering food and beverage, be sure that water is the main attraction. Water fuels the brain making concentration and problem solving easier. Other beverages encourage digestion taking energy away from the brain to the stomach. When offering food, concentrate on nuts, chocolate and guacamole (for the avocado) and stay away from pastries, bagels, breads and cookies.
Our brains are highly plastic and are constantly being rewired. That means that even the most resistant client can benefit from expert listening skills and changes in thinking can result. When you are tempted to write someone off as too rigid, immature, or difficult, remember that all brains are malleable. Your listening skills could be the key to a successful negotiation. The tools for moving from competition to cooperation are easily accessible to all who will understand how the brain works and use that understanding in the negotiation room. Look for specific trainings in your area to build your listening skills.
Footnotes
1. Louder Than Words: Non-verbal Communication. Mele Koneya and Alton Barbour, Merrill, 1976, Columbus, Ohio.
2. Stosny, Steven, “ Anger in the Age of Entitlement: Do You Love in the Wrong Part of the Brain?”, Psychology Today, April 22, 2011.

Ellen Kandell biography and additional articles: http://www.mediate.com/people/personprofile.cfm?auid=1140

Gloria Vanderhorst biography and additional articles: http://www.mediate.com/people/personprofile.cfm?auid=1290

Embracing Brain Wiring and Mediation helps clients move from reactive positioning into thoughtful, cooperative engagement. If you’re in Bethesda, Silver Spring, or Washington, DC, I offer online therapy in Maryland and DC to enhance these listening and negotiation skills in your family or professional relationships. For practical mediation techniques and research, check out Mediate.com’s guide and explore how brain science fuels effective communication.

Collaborative Divorce. Choosing a Healthier Path

Are You Divorcing? Learn collaborative divorce tools and online therapy support in Maryland and DC

Are you heading for a collaborative divorce? Before you jump into legal battles, consider the benefits of collaborative divorce. A recent Washington Post article highlighted Bethesda-based attorney Regina DeMeo’s shift from litigation to collaborative divorce after experiencing her own divorce.  As a Maryland and DC online therapist working with families, I encourage clients to evaluate options like mediation or collaboration first. For a comparison of these methods, check out the International Academy of Collaborative Professionals or see how online therapy in Maryland and DC can support you emotionally during the transition.

The following article appeared recently in the Washington Post and gives personal information from Regina DeMeo, a family attorney in Bethesda and a Collaboratively trained expert.

THE PROFESSIONAL
After a lawyer’s own split, a different approach to divorce
by Ellen McCarthy

It used to be all business for divorce lawyer Regina DeMeo. Her approach was always the same: “This is a partnership and the partnership is dissolving. What are the assets? What is the time-sharing arrangement you think is going to work best? Okay, come on,” she would think. “Get yourself together and let’s move on.” Then, after seven years of marriage, De-Meo went through her own divorce. “It was a very humbling experience,” she says. “All your dreams are shattered . . .
your whole world is rocked.” DeMeo began reading everything she could about what makes and breaks marriages, and she changed the way she practices law. Soon after the divorce, the
George Washington University Law School graduate became trained in a growing practice called collaborative divorce. Now when a potential client lands in her office, she asks to hear the story of the marriage and the reasons for divorce. When there’s even a hint of ambivalence
she’ll nudge the client toward a counselor. “If you can save this marriage, that’s what
you should try to do,” says DeMeo, 37. “Because I can tell you personally, I’ve been
down this dark path, and it’s not fun.” But if clients are sure that ending the marriage is the only solution, she’ll encourage them to consider collaborative divorce, a process that requires both spouses to agree not to go to court. Instead, they and their individual lawyers, along with
mental health professionals and a neutral financial adviser, meet to openly hash out
the terms of the divorce. The process requires that all relevant information be shared willingly — “so I don’t have to issue subpoenas to 50 different banks and waste time and money,” says DeMeo, a lawyer with Joseph, Greenwald & Laake in Rockville. The couple has to reach an agreement on every issue that needs to be addressed —including child-care arrangements, real
estate decisions and division of assets. And if they don’t reach a complete agreement,
both lawyers lose the case. The couple will lose all the money they’ve invested in the process and must start over with new attorneys. DeMeo, who is president of the Collaborative Divorce Association, a group that promotes the practice, says the process is less painful than a divorce that involves litigation. “There are no surprises,” she says. “And they feel like they own it because
they’re the final decision makers, as opposed to some person they’ve never met before who’s going to hear their case for six hours and make a decision for the rest of their lives.”
And maybe more important than that, she says, the collaborative divorce process forces two people whose lines of communication are broken to learn to work together and talk respectfully to each other. “Because if you have kids, you’re going to have to continue to communicate for the
next 20 years,” she says. About a quarter of DeMeo’s clients choose to conduct collaborative divorces, a percentage she hopes will grow significantly in the years ahead. But it’s not for
everyone, she realizes, and can run counter to what many lawyers are trained to do
regarding the protection of their clients’ information. Still, she remains in favor of anything
that can mitigate the emotional devastation that often accompanies divorce. But she knows as well as anyone that much of the pain has already been inflicted by the time clients reach her. “You can’t undo damage that’s been going on for the last five years,” she says. “Marriage is like a
plant, and if you don’t water it and give it sunlight, it’s going to die. You can’t just take it for granted.” DeMeo thinks her own experiences have made her a better, more empathetic
lawyer. “I really know what they’re going through,” she says. “But I would much rather have paid for the knowledge without having the pain.” mccarthye@washpost.com

Are you heading for a collaborative divorce? means choosing the process that supports your legal needs and emotional health. Collaborative divorce, with legal, mental health, and financial professionals on your side, is often less painful and more empowering. If you’re in Bethesda, Rockville, Silver Spring, or Washington, DC, I offer online therapy in Maryland and DC to guide you through separation with clarity and compassion. Learn more about collaborative processes from the International Academy of Collaborative Professionals .

Are You Divorcing? Choose the Right Path

Understanding Pro Se, Litigation, Mediation, and Collaborative in online therapy Maryland and DC

Are You Divorcing and unsure of where to start? It’s common to think of lawyers and court battles first—but there are more considered paths forward. As an online therapist serving families in Maryland and DC, I encourage clients to research options like Pro Se, Litigation, Mediation, and Collaborative Divorce before taking action. For an expert comparison of mediation versus collaborative divorce, see this helpful overview from Jackman Law Firm. To learn how online therapy in Maryland and DC can support you emotionally during separation, check out that resource as well.

Your marriage is in trouble and you want out. The first thing that you think about is finding a lawyer and battling your way through the process. Don’t be so quick to open the Yellow Pages. First, do some research. Divorce can be done in at least 4 ways: Pro Se, Litigation, Mediation or Collaboration.

Pro Se means that you and your spouse sit at the kitchen table and work through all of the issues of sharing custody, changing living arrangements, dividing property, setting up two new households and sharing time with the children. Once you have decisions on all of these issues, you can write down your plans, research the law in your area and petition the court for a divorce decree. The kitchen table has the advantage of keeping things low key, working cooperatively and maintaining a good relationship with the other person as you reconfigure your lives. The disadvantages of this method are that a power imbalance could put one party at a disadvantage, unfamiliarity with the law could result in some poor choices for the future, and incomplete processes could lead to litigation in the future.

Litigation is the most familiar and probably the most contentious method of divorce. Each party hires a lawyer to advise them and represent their interests. Most litigated cases end of settling without going to court; however, the process leading up to that point is generally one of battle, hostility and acrimony. Many times the family, extended family and even friends are injured in the battle. Often there is little or no recovery from the process. When a case does go to court, the decision making power is ceded to the judge and both parties may end of very unhappy with the outcome.

Mediation is a more civil process of using one trained mediator to help you work through all of the issues and develop a settlement agreement. This agreement is then taken to a lawyer for review prior to signing and filing for divorce. A skilled mediator can keep you focused on the issues at hand and reduce emotional conflicts in the room. However, the mediator is there to work toward resolution of the issues and is not trained in facilitating a change in the emotional dynamics. Because of this, mediation can feel more like the kitchen table with a guide.

Collaborative is a transformative process whereby a team of professionals assists in working through the practical and emotional issues. The team generally consists of a lawyer for each person and a coach for each person. The lawyer advises on aspects of the law as you consider different options and solutions. The coach addresses the emotional dynamics and assists in learning new ways to communicate your needs and resolve issues with the other person. For custody issues and shared parenting, an expert in child development acts as a neutral advisor to the entire team so that the children’s needs are presented objectively for everyone to consider as they problem solve. For financial issues, an expert in financial planning can develop projections and plans as a neutral advisor to the team. The collaborative process is focused on transforming the historical model of divorce as a battleground to a more realistic model of divorce as a reconfiguration of the family where relationships will continue in a new form. The couple retains control of all decision making and decisions are based on mutual interests and common goals and not on power dynamics.

By now my bias toward the Collaborative Divorce should be obvious. Reshaping the family is a difficult process. Even the most mature individual will report that during their divorce they were a bit insane at times. The stress of ending a marriage and making dramatic changes in the life style of your children and yourself is a major emotional event. The team approach can give you the best opportunity to make choices that are legally sound, financially wise and emotionally healthy. For more information on Collaborative Divorce visit the web site of the International Academy of Collaborative Professionals: www.collaborativepractice.com

Deciding Are You Divorcing? means choosing the process that best suits your needs, goals, and emotional wellbeing. Whether you lean toward a collaborative approach or mediation, I offer online therapy in Maryland and DC to guide you and your family through the transition. For deeper insight into the benefits of collaborative divorce, take a look at the differences outlined. Let’s work together to keep your emotional health a priority through this change.

Vote ‘Til the Cows Come Home: Family Decision-Making Tools

How Vote ‘Til the Cows Come Home frames family mission setting in online therapy Maryland and DC

In today’s fast-paced world, the classic phrase Vote ‘Til the Cows Come Home still rings true when setting family boundaries and roles. As a Maryland and DC online therapist specializing in family dynamics, I guide parents in using techniques like family meetings and mission statements to foster unity and authority. For a deeper dive into family communication strategies, see this article on the benefits of family therapy or learn more about online therapy in Maryland and DC.

In the 1960’s family meetings were the latest technique for including the children in the process of family decision making. I remember the experience in my own family with some fondness. Four children, two parents and the occasional “live in” school friend would participate in planning weekend activities and the family vacation with some parameters determined by the family budget. At times we were even privy to some budget discussions in an effort to get all of us to care about turning off the lights as we left the room. The promised savings were to be used for the ice cream truck when it came through the neighborhood. During one of our family meetings, the discussion was getting lively and we decided that this democratic process should be used to determine what we would have for dinner. As steak and veal were being bandied about, my mother rose from her chair with, “You can vote ‘til the cows come home, we are having meatloaf for dinner!”

Mother was a farm girl. Most contemporary families have not seen a cow except for the Turkey Hill ads and have no idea of the work involved in milking them. Mother knew when to take charge and assert her authority as the parent doing the work. Today’s families face social pressure to not just share authority but to often times abdicate to their children. Modern social pressures can be disorienting. When the sexual experimentation comes home at 10 years of age and the marijuana experiment begins at 12, the family meeting to empower the children is way out of its league. The modern family may require very different tools to stop the onslaught of contemporary life from undermining the family completely. The psychologist working with today’s family is also working with a very different configuration. The two parent household can easily be two moms or two dads. Many families are headed by single adults or singles with non-parenting live-ins.

The first part of treatment with families today requires gaining a sense of the goals and priorities of these families. To accomplish this task, I like to borrow a process from the collaborative law model whereby the parents develop a mission statement. The mission statement enables the parents and the therapist to clarify what this family is all about. Some simple questions (1) to answer are listed below:
What is the purpose of our family?
What are we all about in life?
What kind of family do we want?
What is our identity as a family?
What are the things that are truly important to us as a family?
What are our unique talents, gifts, and abilities?
What are our responsibilities in caring for one another?
How do we want to make a difference to our community?

As the adults are addressing these questions, the children may be working on their responses to the following questions:
What kind of home do you want to invite friends to?
What is embarrassing to you?
What makes you feel comfortable at home?
What makes you want to come home?
What qualities in your parent(s) are important to you? And cause you to be open to my/our influence?
How can your parent(s) improve?

The mission statement developed by the parents serves to anchor the family and leads to the development of an active and positive parenting plan. As situations arise in the family, the mission statement becomes a practical tool for decision making. With the mission statement clearly in hand, the children can see that their parent’s are thoughtful and not capricious. The mission statement also serves as an anchor that enables the parents to provide guidance and make decisions with confidence and without guilt.

In the course of designing a mission statement, the parents examine their social, moral, ethical and religious positions in order to develop succinct, measurable criteria for tracking their parenting. While this process would be valuable for any family, the ADHD family benefits in particular ways. The mission statement gives the parent who tends to be impulsive a place to check their impulse and the ADHD child benefits from the consistency and care that follows as Mom or Dad go back to the mission statement for clarity and support. The following case will illustrate the process of forming a mission statement and the value of it in the ADHD family.

Carol and Dennis came to therapy when their son Derrick was in second grade. Derrick had been diagnosed with ADHD at the beginning of first grade and was currently being treated with time release Ritalin. The parents had become comfortable with the medication regimen but also tended to give weekend and summer medication holidays. They had one other child, a girl, who was in kindergarten and did not have any of the signs of ADHD. The mother reported that she saw herself as having ADHD as well but had never been formally diagnosed or treated. As the family went through the process of assessing Derrick, the mother’s history and current behavior emerged as very similar to Derrick’s. The father did not seem to have any of these characteristics though he reported that his mother would probably fit the diagnosis. He remembered growing up in a pretty disorganized household and was hoping to spare Derrick some of his early experiences.

Derrick had a love/hate relationship with his sister. They could play together for brief periods of time before the play deteriorated into shouting matches or tears. Derrick’s school performance was generally above average though he tended to lose materials and misplace completed assignments. Derrick seemed to be in constant need of stimulation even with the medication. He moved quickly from one activity to the next without finishing anything. In the classroom, he tended to get into the space of others, often called out in class, and had designated himself as the playground monitor for directing all forms of play and settling disputes between players. Of course, much of this self proclaimed oversight was not welcomed by his peers.

The parents were overwhelmed and sought therapy to try to gain some control over the household and hoped to provide better guidance for Derrick in school.

Carol and Dennis spent about 6 therapy hours developing their mission statement. In the course of those sessions, Carol decided to educate herself on her own ADHD and began to read Understanding Women with ADHD by Kathleen Nadeau, Ph.D. and Patricia Quinn, M.D. (2) Dennis identified his negative judgmental attitude as harmful to the family. Since he lived with two people with ADHD, he decided to reframe his experience and learn more positive language for relating to his wife and son. He found The Gift of ADHD by Lara Honos-Webb, Ph.D. (3) to be a valuable resource as he practiced more reframing. Dennis’s negativity is a fairly common problem. Most of us have trouble using positive language and doing the work of looking for the positive aspect of a difficult situation.

As Carol and Dennis began to come together with a vision for their family, they were struck by the power that they had ceded to current social pressures and dynamics. Video games, television, reality shows, rap music, even clothing had more sway over their children than they did. This realization led to one of the most powerful parts of their mission statement. They wanted to be the primary influences in the lives of their children before any contemporary social or cultural entities including the school. Their commitment to that vision led them to think more clearly about how to order their home life.

Their mission statement is as follows:

Recognizing the power of modern culture to undermine family connections and the tendency of ADHD to welcome this rapid paced stimulation, we purpose to strengthen our individual and joint connection to each of our children such that they will experience us as their primary relationship and seek out our counsel frequently and consistently. We desire to encourage thoughtful, compassionate characteristics in our children and to nurture the creative, inspirational aspects of our son’s ADHD. To accomplish these goals we commit to the following:
Daily individual time with each child of at least 30 minutes face to face.
Daily meal time with no TV, Radio or media devices of any kind and we purpose to use table time to share positive character qualities in our children and learn more about how they think and view the world.
Weekly family time of at least 2 hours of face to face activity in a noncompetitive format that enhances the quality of life for one of us or others that we may choose.
A monthly focus on a creative project generated by Derrick or his sister.

Once the mission statement was clarified, Carol and Dennis saw how afraid they had been to lead their family. This realization energized them to implement their mission and actually enjoy their role as parents. They were excited about their focus on relationship but knew that they had to confront old habits and routines that had been undermining their family. They decided to try some family meetings. Carol and Dennis needed to take back their position of influence in their family and not be afraid to confront the pull of the media culture that had taken their place. They had to stop being afraid of the cultural influences that were more lively, more exciting and more rapid paced than they could ever be. Their decision to not compete was critical to regaining parental authority and being able to nurture healthy relationships with their children.

Step 1. Carol and Dennis set aside 10 minutes each morning to read their mission statement out loud to each other. This focus on their positive goal strengthened their bond with each other and energized them for the parenting challenges of the day. They used this time to plan their daily “face time” with each child.

Step 2. Carol and Dennis used break time at work to write down the positive character qualities of each child with specifics that were relevant to the past few days and imaginings that could be applied to the next few days ahead. This prepared them for meal time. They brought their notes to the table to show their children that they were seriously working on rebuilding relationship and authority through respect.

Step 3. After dinner they required Derrick and his sister to spend 10 minutes together to read the family mission statement and to plan their monthly creative project. Carol and Dennis accepted that for the first few weeks their children would probably just argue with each other. However, they trusted Derrick’s creative side and their daughter’s emerging compassion to eventually help them to design a project.

Step 4. At the beginning of each week Carol and Dennis called a family meeting to discuss possible activities for the 2 hour non-competitive family time. They were pleasantly surprised by how their children responded and they allowed wild and zany ideas to morph into more practical possibilities. Derrick’s initial trial balloon of “let’s save an endangered species” evolved into exploring the neighborhood creek and bringing home some weird water creatures to identify.

Carol and Dennis have redefined the family meeting. Instead of the 1960’s notion of empowering the children, their family meetings have become a means of restoring their authority and influence as parents. They are no longer afraid of coming home to chaos. The old tool has become a new resource to help families reorder their lives. My mother would be proud of them even though they don’t own any cows.

References

Tamara Rounds, L.C.S.W. Creating the Mission Statement, Collaborative Divorce Team Trainings, 2008.
Kathleen Nadeau, Ph.D. & Patricia Quinn, M.D., Understanding Women with AD/HD. Advantage Books, 2002.
Lara Honos-Webb, Ph.D. The Gift of ADHD. New Harbinger Publications, Inc. 2005.

With Vote ‘Til the Cows Come Home at your center, family decision-making becomes deliberate and empowering. Whether you’re in Bethesda or Silver Spring, I offer online therapy in Maryland and DC to help families craft mission statements, set healthy boundaries, and build consistency. Learn more about the benefits of family therapy and how it can restore your authority and connection at home.

Neurocognitive Psychotherapy for ADHD Treatment

How neurocognitive psychotherapy supports children with ADHD through online therapy in Maryland and DC

Neurocognitive psychotherapy is a powerful, brain‑based approach to ADHD that blends cognitive‑behavioral therapy with cognitive rehabilitation. As an Maryland and DC online therapist for children and families, I use neurocognitive psychotherapy to help kids understand and harness their own brain strengths. Beginning with a comprehensive neuropsychological evaluation, we map executive function, memory, processing, and emotional coping skills. This personalized approach aligns with current research into the brain’s executive function deficits in ADHD. If you’d like to learn how online therapy can integrate these assessments remotely, check out online therapy in Maryland and DC or explore strategies from Verywell Mind on types of therapy for ADHD.

Neurocognitive Psychotherapy is a brain-based treatment approach that is a unique blend of cognitive-behavioral therapy and cognitive rehabilitation. This approach is a team approach based in the most recent research on brain functioning and ADHD. This article is the first in a series that will illustrate how neurocognitive psychotherapy is applied in treating children with ADHD.
The key to building a treatment plan is to understand how the brain works in general and to discover how the brain of a particular child is functioning specifically. This brain based approach starts with a neuropsychological evaluation that enables us to measure various aspects of executive function, memory function, and processing abilities. This evaluation may also examine emotional strengths and resources that the child has been using to cope with the stress of learning and living.
Once a diagnosis of ADHD has been made, educating the child about the specific strengths and weaknesses in their brain is the next step. I will use a variety of techniques to help the child see and understand how his or her brain is functioning. Pictures of brains from web sites showing fMRIs have been very helpful. With the fMRI, we can see different areas of the brain light up as one thinks and problem solves. You may want to log on to www.amenclinic.com to take your own tour of different brain images. We may also use brain models, or build our own using found objects in the office. Sometimes we will make drawings or abstract art that represents the various functions of the brain and how they interact with each other.
As a child comes to understand how his own brain is working, he is encouraged to present his understanding in a family session as a means of educating others in the family. In this way, the child is given power over the ADHD. The stigma that has been associated with inattentive or hyperactive behavior is replaced by knowledge that empowers the child to take more control over his life. The earlier this empowering process can begin, the more opportunity the child has to build compensating strategies, make changes in his environment and develop supportive relationships. Educating the child about his own brain, how it works, and how he can help make it work best is a central part of neurocognitive psychotherapy – de-stigmatizing the brain patterns we refer to as ADHD and giving the child a sense of understanding and control.

Understanding how a child’s brain functions empowers the whole family toward targeted interventions. If you’re in Silver Spring, Bethesda, or anywhere in Maryland or Washington, DC, I offer neurocognitive psychotherapy via online therapy throughout MD and DC. This brain‑based treatment helps reduce stigma, build coping strategies, and reinforce emotional resilience. For more ideas on ADHD treatment options, check out Verywell Health’s take on untreated ADHD in adults or insights into neurofeedback treatment for ADHD, which can complement a neurocognitive approach.

How Online Therapy in Maryland and DC Supports Father-Child Connection

My dad always kept his old baseball glove in the trunk—ready for a catch anytime, anywhere. As a Maryland and DC online therapist focusing on family and adult therapy, I’ve seen how small, consistent moments like these shape children’s growth and emotional security. Studies show that even brief quality time with dads boosts academic success and reduces risky behavior. If you’d like to see how online therapy can support father engagement, check out online therapy in Maryland and DC or explore this research on the science behind fatherhood benefits.

My Dad carries his baseball glove in the trunk of his car. It is very old and battered. The padding has become thin with age. The fingers are short and stubby, not long and laced as in today’s gloves. Today’s gloves are made to reach above the fence and snatch a home run away from the batter. Dad’s glove was made for catch and from the trunk of his car, it was always at the ready. He tore his rotator cuff about a year ago, swinging an ax. So, I doubt that he could toss a ball anymore, but the glove still travels. The potential is there.
The research on fatherhood shows that children listen more easily to the voice of father than they do to mother. Something about the tone or quality of the voice communicates a seriousness that is easily processed by even the youngest child. The research also shows that girls who spend more time with their father are brighter in school and more successful in math and science. Fathers are designed to have a powerful impact. Think of the wisdom to be imparted or the fun to be had. Yet, on the average, fathers spend only minutes with their children each day. Father’s rarely say “I love you” to their children, especially after the child becomes school age.
Inside of each of us is the desire for a Daddy. “Daddy” is someone who will be there all the time, someone who will know what we should do in this difficult situation someone who will support us and love us. We look for him first in our own fathers and if we don’t find him there we look in one relationship after another, in search of the strength and acceptance that we need.
We formulate our idea about a supreme being based on our earthly experience with father. That is a heavy burden for any Daddy.

TOSS A BALL
Sometimes on long car trips we would stop at a roadside park for a break and Dad would break out the glove. We would toss the baseball to him, chase after high flies and dive for grounders. The energy and relaxation in those brief moments was exciting. That glove represented the potential for relationship, any time and any place. He was always ready.
As we got older and moved away from home, the relationship did not change. Daddy was always there to listen and to guide.

TAKE A FALL
Dad’s are more likely to act out their feelings of love than they are to say it. Something about the words causes their tongues to get stuck or twisted. When they do fall out, they often get embedded in sentences like, “you know that your mother and I, we love you, don’t you son?” If he was familiar with that concept, why would you have to ask such a stupid question? When will they fall out in simple, direct form and just say “I love you”. Daddy must have practiced in the mirror or something. It always sounded so right.

ACCEPT THE CALL
Dad’s are special. They have a big responsibility. Their voice is often the one that we carry in our heads when big decisions are to be made. Fulfilling that responsibility takes a plan. One cannot be a Daddy without planning and setting the time aside to be in relationship. Too often, men are caught up in building castles for their families or inheritances for their children, rather than in building relationship. Being a Daddy takes a vision. What is your picture? How are you doing? When you review the year, can you list the times that you connected with your children? And a year from now, what will the picture include? Do they still call you Daddy?

Daddies leave lasting impressions through both actions and words. Whether you’re in Bethesda, Rockville, or Silver Spring, I offer online therapy throughout Maryland and Washington, DC to help fathers deepen relationship, build routines, and foster emotional connection. For practical tips and research on father engagement and child well-being, see this helpful article from Science Times on the “father effect” or visit my therapy resources in Maryland and DC.

Effective Online Therapy Strategies in Maryland and DC for Family Conflict and Boundaries

Every family has that prickly relative who tests our patience. As a Maryland and DC online therapist specializing in family and adult therapy, I support clients in navigating challenging relationships with empathy and healthy boundaries. In this post, we explore how to stay calm, curious, and firm with difficult family members. For more on setting emotional boundaries, check out this article on how to set boundaries with relatives or learn how online counseling in Maryland can support your mental health and relationships.

Every family seems to have that one relative that is difficult to approach or be with and seems to have very hard edges. Of course, that person is never you! She could be your sister: the one who never calls unless she wants something or wants to let you know that you have really made her mad. It could be your brother who seems to know all of the vulnerable spots and takes advantage of this knowledge to hit you when you’re down. Sometimes it is the busy body aunt who seems so sympathetic and really understands what you’re going through, but next week when you hear your story coming back around through the grapevine, you realize that she was just out to grind the gossip mill.
So, just what is a body to do when the bad egg is on you?

DON’T BOIL OVER
My husband tells me that if I want to boil an egg, I should let it warm up a bit before immersing it in the water. I have never had the patience to watch an egg warm up. I plunk that sucker into the pot, cover it with water and turn the flame up to just below ‘trigger the smoke detector’. Then my usual routine is to go get into something else and forget about the 3 minute rule. Maybe Mr. Perdue will one day invent an egg with an alarm built in. By the time that I return to the pot, a white stringy scum indicates that the shell has cracked allowing the white insides to leak out into the boiling water. The chemistry here invariably causes the pot to boil over creating a gooey mess on the spill tray under the burner. Suddenly my three minute egg has turned into a half hour scouring project. Eggs are like toasted cheese. Yes, I manage to burn those all the time too!
The mess created by the rapid boil takes more time to clean up than watching the egg warm. Maybe I could learn to warm up to that prickly relative too.

DON’T CRACK UP
Do you check the egg carton before you leave the refrigerated case? Turning each egg to be sure that none are stuck to the carton because of a hair line fracture? Not me. Oh, I flip the lid alright to be sure no oozing mass is in there, but jiggling each egg seems to be a bit much. It’s not the time that it would take that gets to me, its more the looks from the other cart drivers.
Sometimes I care too much about what someone else might think. The prickly relative brings out the same dynamic. If I talk to her for too long at the reunion, someone will think that I like her or that I might be on her side in the next dispute. Truth is that I need to spend that time with her to learn what it is really like for her. Underneath all of the difficulty, she is fragile just like me. I could gently check out how she thinks or feels rather than slamming the lid shut with my assumptions.

DON’T TURN GREEN
Remember the Dr. Zeus book about green eggs? What a disgusting thought. Same feeling waves over me when that prickly person is on the phone or looking to visit. A green sickness comes over me and inside of 3 seconds, I have run a complete video of how this weekend will go. It’s the Titanic in fast forward. That rush to disaster makes it hard to come back to the present and prepare for the visit.
Have I ever been curious about this person’s history or hopes or needs or longings? If I can stop feeling sick and start being curious, this visit can help me see her as a complex person rather than a vile entre’.

When you find yourself dealing with a “bad egg,” remember that compassion, curiosity, and clear boundaries go a long way. Whether you’re in Silver Spring, Bethesda, or DC, I offer online therapy throughout Maryland and Washington, DC to help individuals and families improve communication, resolve conflict, and restore emotional safety. For practical strategies to strengthen your relationships, you might also consider family therapy techniques or consultation. Together, we’ll support you in creating healthier dynamics and peace of mind.

Helping Kids With School Anxiety

Starting school is a major milestone, but for many children, it’s also filled with invisible fears. As a Maryland and DC-based online therapist for families and children, I often help parents decode their child’s anxiety through stories and drawings. This post shares one mother’s experience navigating her daughter’s school fears and offers guidance on how to handle anxiety before the first day. For more information on how online counseling works, you can also visit this helpful guide or learn more about school anxiety and mental health from the Child Mind Institute.

A mother’s story:
She is 5 years old going on 6 and first grade is just around the corner. The summer will soon end and the serious business of school will begin. She knows where she will be going because we drive past the building regularly. Each time, I cheerfully point to the sprawling brick façade announcing that she will soon be in first grade. I describe my first grade teacher with fondness in hopes that her fears will be calmed. She usually sits quietly in the seat next to me staring straight ahead. Occasionally she will boldly announce that she is not going to school. She sees no need for the exercise. She is perfectly content learning at home from her siblings or neighbors. She already knows how to read and assures me that she can learn anything that she needs on her own. I sigh and steel myself for the battle that I know will ensue in the fall.
Lately, she has been drawing pictures of the school building. It is usually quite large on the page and the basement windows are particularly menacing. The latest version has a black figure oozing between the bars on the windows. The fingers are pointed, the mouth is full of teeth. This is the witch that lives in the basement of the school. I try to explain the modern construction technique of slab building that eliminates the need for a basement. I know that the building has no basement, but my arguments are to no avail. Someone has convinced her that a witch lives under the classrooms. I go looking for her brother.
At first he pleads innocent then admits that it was a great tease. He knows that she is afraid of beginning first grade and he just couldn’t resist the story about a witch living in the basement. He defends himself by saying that a few of his elementary teachers were witches so it is not really an exaggeration. This is going to be a long year.

DRAW ON YOUR OWN EXPERIENCE
Reflect on your own experience of elementary school. Tell the stories that you haven’t thought of for years. My second grade teacher put a large wire cage in one corner of the room. In that cage we watched “Bitty Hen” live and lay eggs and hatch baby chicks. It was marvelous! Looking back, I do not know how “Bitty” survived the stress of all of those voices, and noses pressed against the wire each morning. For all I know, the teacher may have gone through numerous chickens without our knowing. “Bitty” was the center of attention and our class was the talk of the school.
Even if your stories are tragic, they are worth telling. Your child will take comfort from knowing that they are not the only one who has ever been afraid of school.

DRAW OUT THE FEAR
The witch in the basement is more than a brother’s tease. The child who is afraid of separating from mother or afraid of performing in school is trying to communicate that fear. Your child’s fear should be taken seriously. Listen to the fear and draw out more information by saying “tell me more”, ” tell what will happen next”. Using these specific phrases will encourage your child to explore the fear and help your child to feel secure because you are taking the fear seriously. Leave questions behind. They demand rational and specific answers. Fears are usually not rational or specific. You will learn more with the “tell me” approach.

DRAW A BOUNDARY
Once you know more of the nature of the fear, you can draw protective fences to create a sense of safety and comfort for your child. You may want to consult with the school psychologist before school opens to get more ideas of how to create a sense of comfort that your child can carry from home to school. The child who is afraid of leaving mother behind, can be comforted by taking some specific token or symbol of Mom to school. These treasures can help to calm a child’s fears and refocus the child on the task at hand. The child with learning problems or fears of performance can be comforted by clear expectations that are easily attained. Do not be afraid to set lower expectations at first and gradually raise the bar as your child’s comfort increases. Stay away from asking your child to do his or her best. Make the expectation specific and concrete. At the end of the day, you should both be able to easily see that the child has been successful. Even the simple task of bringing your lunch box home can be a mark of success for the first week.
If the fear persists beyond week 2, consult a professional. Early intervention will save a lot of heartache for you and your child.

If your child is expressing fear about school, take it seriously and respond with patience, structure, and empathy. Whether you’re in Silver Spring, Bethesda, or Washington, DC, I provide online therapy throughout Maryland and DC to help families manage anxiety, transitions, and emotional challenges. For more tips on how to approach emotional readiness, check out my therapy resources or explore this article on how to support children with anxiety.

Understanding ADHD’s Impact on Society: Why Early Identification Matters

In Maryland, Washington, DC, and across the country, the emotional and financial toll of undiagnosed ADHD is far-reaching. As a licensed psychologist specializing in online therapy for adults and families in DC, I often see the long-term effects of delayed diagnosis. In this post, I examine the societal cost of untreated ADHD, the barriers to early intervention, and why timely support is essential not just for individuals but for our communities at large. If you’re wondering whether therapy might be the right step, I invite you to explore my therapy FAQ for Maryland and DC or review this summary from the CDC about ADHD in children and adults.

If you or someone you care about is struggling with attention, focus, or impulsivity, early evaluation and support can make all the difference. I offer secure, confidential online therapy throughout Maryland and Washington, DC for individuals and families facing challenges like ADHD, anxiety, and trauma. To learn more about how I work, visit my therapy for anxiety and trauma in DC page or schedule a consultation today. If you’d like to better understand how ADHD manifests in adults, I also recommend this article from CHADD (Children and Adults with ADHD). Together, we can reduce the emotional burden and improve long-term outcomes—starting with a conversation.