Category: Blog Posts

Do Infants Understand Emotion?

How Do Infants Understand Emotion? reveals early emotional awareness and development in online therapy Maryland and DC

From birth, infants are already emotionally aware, crying to signal discomfort, tension, or danger—demonstrating early self- and environmental awareness. Studies show that by as early as six months, infants can recognize and respond to facial expressions and distress in others, indicating emerging emotion understanding and social cognition. This article highlights research on emotional memory, body-based responses, and the brain mechanisms underlying infant awareness.

From the moment of birth the infant’s brain is fully capable of processing emotion and this skill enables them to respond to all of the experiences in their environment.  Infants cry as they come into the world because they are aware of the change from the protective nest of the womb to the unfamiliar open-air vastness of the world outside of the womb.   They cry to announce that they are in danger.  They sense that their protective environment has been dramatically ripped away and they know that they need protection.  In this sense, you could also say that they are self aware as well as aware of their environment.  They are solely dependent beings and they need to draw attention to themselves for survival.  Unlike other mammals, they cannot find mother’s milk on their own or cling to their parent for attention.  Their voice is the mechanism that lets them announce their need in an effort to be protected and survive.  A well fed and clothed infant if abandoned outside of a church or police station will immediately begin to cry.  They sense that their significant other has left them and know that they must find other caretakers quickly or they will be in danger.

Most adults are unaware of the significance of this truth that infants are emotionally aware and respond to emotional tone and changes in the environment.  When Mom and Dad raise their voices, the infant starts to squirm and fuss as a signal that their protective environment is being threatened.  They also record these events and encode them in non-verbal ways.  Many parents think that an infant will have no memory of their fights or that the tension in the house will go completely unnoticed.  While the infant will have no language to describe the fight or the tension, they will none the less have a memory of the stress and they will be influenced by the tension in the house.

Often, these memories are called body memories as they are stored in terms of muscle tension, internal discomfort and visceral reactions to the emotion in the room.  When you experience parents with their infant, you have probably seen the infant’s response when tension exists between the parents.  Invariably, the infant will move and fuss and show signs of processing the tension in the environment.  They make efforts to shift the parent’s attention away from the conflict and toward the needs of the infant.  This is a valuable survival mechanism.    

Infants are emotional sponges because they are dependent on the external environment for their survival.  They need to be aware of danger or tension in the environment and to respond with discomfort in order to get their dependency needs met.  They are announcing that they need the adults in the room to be focused on them and not go out of control or to hyper-focus on themselves.  An angry adult will not be a safe caretaker and an anxious adult will likely miss important signals from the infant. 

Infants are excellent barometers of family harmony and tension.  The fussy infant is often announcing that there is something lacking in the caretaking they are experiencing.  Unfortunately, we rarely take the infant seriously.  Too often we placate the parents or normalize the fussing as just something that infants do.  If we used these signals as signs that the environment needs to change then we could focus on providing the emotional environment that will enable the infant to thrive. 

As a culture we have clearly focused on the physical nutrition necessary for a healthy baby.  Now we need to focus on the emotional environment that the infant needs to develop into an emotionally healthy child. 

 

When we question Do Infants Understand Emotion?, it’s clear they do, through crying, body tension, and facial cues, infants communicate emotional states and respond to environmental stressors. If you’re in Bethesda, Silver Spring, or Washington, DC, I offer online therapy in Maryland and DC to support parents in tuning into their infants’ emotional needs. For deeper context, check out insights on infant emotional recognition from the American Academy of Pediatrics and explore early emotional development through UC Merced’s research on emotion and social cognition .

How Autism and Male Sperm reveals the link between paternal age and autism risk in Maryland and DC

As a Maryland and DC online therapist, I often discuss how science shapes parenting choices. Autism and Male Sperm explores Mount Sinai’s Jeremy Silverman’s findings, more paternal age at conception, more likelihood of autism, including among daughters, based on Israeli military records. Studies show that men over 40 are roughly 5.75 times more likely to father a child with autism compared to men under 30 . Research in clinical epigenetics also identifies sperm biomarkers linked to offspring autism with about 90 percent accuracy . For a broader view of paternal age’s impact, see this summary on the paternal age effect on Wikipedia. If you’d like to learn how online therapy can support expectant parents considering genetic risks, check out online therapy in Maryland and DC.

Jeremy Silverman, M.D. interviewed on NPR re: his recent studies on AUTISM
Mt. Sinai School of Medicine:

He has been studying the effect of the age of the father at conception on the incidence of autism. He used the Israeli data base (every person in Israel has to serve in the military so the intake process makes for a huge medical and psychological data base.) and found that as the age of the father increases by 10 years the incidence of autism increases dramatically. The hypothesis is that the male sperm change in DNA structure or specific chromosome damage due to the age of the sperm is the causal factor in autism. He said that a thorough review of research on the popular notion that immunization causes autism has no supporting base to it. Sperm damage is the more likely culprit.

He also noted that autism is mainly a male disorder: 4 times as many male children as female children. However, as the father ages, the incidence of females with autism increases, again supporting some type of genetic, chromosomal damage in the sperm as the causal link.

When addressing Autism and Male Sperm, it’s crucial to recognize that paternal age and genetic mutations can increase autism risk, but it’s also possible to provide exceptional early support. If you’re in Bethesda, Silver Spring, or Washington, DC, I offer online therapy to guide expectant and new parents through understanding genetic findings, family planning, and developmental support. For more in-depth research, explore clinical epigenetics on sperm biomarkers and autism risk or learn about paternal age studies on ScienceAlert.

Divorce: Destruction versus Transformation

How Divorce: Destruction versus Transformation highlights collaborative divorce over litigation in online therapy Maryland and DC

As a Maryland and DC online therapist, I often hear clients describe their divorces as consuming and destructive, but the reality is, they can be transformed. Divorce: Destruction versus Transformation explores how a litigated divorce often behaves like a wildfire, devastating relationships, finances, and emotional well-being, while collaborative divorce offers a path toward preservation and renewal. To learn more about how the collaborative divorce process empowers families to stay respectful and private, visit the IACP’s Collaborative Divorce overview or explore details on the confidential, team-based Collaborative Practice method.

This article emphasizes transformation over triumph, steering families away from scorched-earth outcomes toward respectful co-parenting and long-term healing.

“The Ring of Fire” is one of Johnny Cash’s best known songs and while he was singing about falling in love, he could have just as easily been describing the experience of a litigated divorce. Litigation is a lethal force like a wild fire that consumes everything in its path: money, time, relationships, personality, children, friends, etc. A litigated divorce at best singes and at worst leaves nothing but scorched earth.

The legal process experienced by 50% or more of marriages in the United States is a process of destruction based in the English law system that defined women and children as chattel. Historically, the husband was the “owner” of the wife and the children thereby dictating their fate. The litigated divorce continues this practice by forcing the parties to prove that one of them is good and one is bad. When considering custody and access schedules, this mindset is particularly destructive as the parties attempt to prove that one is a bad parent and one is a good parent. The destruction that ensues leaves families with full thickness burns.

Numerous social changes have made the premise of litigation for divorce obsolete, yet we continue to use litigation as the main means of divorce. In our current society, parenting is more often a shared responsibility and roles are no longer gender specific. Women have developed their abilities and function in the work world as financial equals. Society no longer accepts male dominance as the norm.
In truth, the couple system rarely dissolves completely after divorce and clearly the family in terms of parenting does not come to an end. The process of parenting becomes more complicated, requiring clear lines of communication and decision making that may not have existed in the marriage. The parents are left with the task of developing two separate but interconnected families that must travel through life together. This new system is sometimes referred to as a bi-nuclear family.

In truth, when a couple desires to part and move in different directions, the family remains in existence whether or not they have children. Integral relationships have been built with in-laws, extended relatives and friends. Restructuring these relationships should be the work of the couple and not the court system that requires relatives and friends to choose sides, testify and too often exaggerate events to give one party the advantage in a pitched battle for resources and relationships. A litigated divorce is not seeking the truth; it is seeking victory for one party over the other. A litigated divorce does not recognize the importance of continued connection following the battle.

When children are present, our obligation to improve the divorce process and help families to create a new structure that will maintain the integrity of each parent and support continuing relational growth becomes even more critical. The numerous fires that are set in the course of a litigated divorce make this nearly impossible.

Our language and our processes have to change. Families need to find ways of restructuring themselves and not destroying themselves. In the rail yard when two cars are uncoupled, they continue to retain their individual integrity even as they move in different directions. In the court system when a marriage is dissolved, individual integrity is often destroyed as well. The family’s financial resources are often drained in the service of battle.

When a couple decides to go in separate directions, they move toward creating two new families that will continue to interface for the rest of their lives. New things get created. Parents need to focus on creating a bi-nuclear family that will enable their children to benefit from past and future relationships. The nuclear family must be transformed into a more complicated system that has room for new parents, new siblings, new places and new experiences.

One approach to helping families restructure themselves and stay out of court is the collaborative divorce process. In this process, the parties are supported by a team of professionals as they work to examine all of the parts of their relationship that need to be transformed. This team consists of lawyers experienced in divorce law who advise the parties and work together to educate the parties on the law as it applies to their specific situation. The team uses a financial expert who serves as a neutral person who meets with the parties to help them disclose all of their finances to each other, understand their finances in the present and the impact of their financial needs in the future. The team may also include a child specialist who meets with the children to identify the needs of the children and the sibling system in order to give the parents clear, objective information that they can use to develop parenting plans for the future. And the team includes mental health professionals who serve to coach each party on how to process and manage their feelings as well as identify their needs and interests as they build new lives in the future. Each member of the team is bound to avoid court. Even if the collaborative process breaks down and the parties begin litigation, none of the team members may be called to testify or produce any work product related to the collaborative process.

In the collaborative process the parties are given the responsibility of working together to transform their relationship and develop competent plans for the future. Each person is treated as valuable and important and the needs of each are considered side by side as plans and solutions for the future are developed. This process acknowledges that each of them has contributed to the need to separate and divorce. No one is good while the other is bad. They are asked to draw on their best selves to generate options for meeting the needs of the future and to recognize that they will continue to interface with each other in important ways.

Through the collaborative process, the couple often experiences an opportunity to heal their wounds and establish a better understanding of each other. As they appreciate the concerns that each has for themselves and their children, they develop a dialogue that leads to creating ways to meet those needs respectively. The attack/defend mentality of litigation is replaced with the explore/comprehend thinking that leads to creative problem solving. The families emerging from the demise of the marriage have the opportunity to grow into respectful neighbors creating a sense of safety and support for the children who will continue to move back and forth. No ring of fire. More of a ring of hope.

When considering Divorce: Destruction versus Transformation, remember that divorce doesn’t have to end in devastation. Collaborative divorce, with legal, mental health, and financial professionals guiding you, helps maintain dignity, control, and connection after separation. If you’re in Silver Spring, Bethesda, or Washington, DC, I offer online therapy in Maryland and DC to support your transition. For in-depth information, check out IACP’s comparison of collaborative and litigated divorce or read a thorough breakdown of the process on Psychology Today’s guide to collaborative divorce and discover how these family-centered methods mitigate conflict.

Co-Parenting: Can It Be Done?

How Co-Parenting: Can It Be Done? promotes stability and cooperation in online therapy Maryland and DC

Co‑Parenting: Can It Be Done? explores how divorced parents can shift focus from separation to raising confident, connected children across two households. Co‑parenting avoids the confusion and conflicting agendas of separation and supports children’s emotional health. As an online therapist serving families in Maryland and DC, I guide split parents through developing a clear parenting mission, coordinated schedules, and mutual respect. Studies show that cooperative co‑parenting enhances children’s self‑esteem, academic performance, and emotional resilience (Verywell Mind on co‑parenting), while joint custody supports well‑being akin to intact families (Wikipedia on joint custody).

When Mom and Dad divorce, the children frequently lose their parents in important ways. In the course of the divorce, the parents have frequently destroyed any good will that may have existed between them and they are now faced with moving into a world complicated by two households, confusing schedules, difficult communication and varying agendas. The idea of saying “No” to the marriage and “Yes” to cooperative parenting is foreign to most people.

The focus of the divorce was to create distance from this adult that you no longer love or respect or desire. The focus of parenting is to give your children an atmosphere for developing their character and preparing for life as a connected, confident being. While divorce creates distance, parenting creates an integrated system as you engage in the business of raising children. These are wildly different tasks. The divorced couple often confuses one with the other and acts to create distance between the children and the spouse they no longer desire. As this action continues, the children are harmed by failing to develop attachment bonds to each parent and to benefit from exploring the parts of themselves that have been influenced by each parent.

Co-Parenting acknowledges that each parent is still vitally interested in the well-being of the children and that the children can benefit from continuing to develop relationship with each parent. The two contra-indications for co-parenting are active addiction and domestic violence. While mental health issues or character flaws of a parent may place some limits on their ability, the children can continue to benefit from the parts of parenting that can still be provided by this person
The key to co-parenting is to develop a plan that focuses on the present and the future with a clear sense of the needs of each child. Assessing the individual needs of each child may require some research with teachers, pediatricians, coaches, or other knowledgeable and significant people. This assessment will be repeated at various developmental stages. With this information in hand, the parents can examine ways to meet the needs of each child and they can assess their own capabilities in these areas. As in the intact family, each parent does not have to do everything.

Co-parenting may be facilitated by contracting with a Parent Coordinator who is trained in helping parents develop plans, resolve disputes and learn new parenting skills. Periodic meetings with the Parent Coordinator will help both parties to remain focused on the children and to support the value that the other parent brings to relationship with each child.

Co-parenting is often a more thoughtful process than parenting as an intact couple. One of the tasks of co-parenting is to consciously develop a mission statement for parenting. This process of careful thinking about values, interests, hopes, and wishes may be new to each parent and can facilitate a clear focus on the important task of guiding your children. A written statement of values can easily lead to self-examination as you think about what you need to do to facilitate the development of these values in your child. If you value honesty then some thoughtful examination of how this is communicated to your children is in order. Many are probably familiar with the television ad where the police officer pulls over the speeding car and asks the father in the driver’s seat if he knows how fast he was going. As the father says “well no officer, I don’t know”, the pre-teen son in the back seat leans forward with “87 Dad, you said you were going 87”.

A conjoint mission statement can hold both parents accountable to address changes that they need to make in order to provide a better model for their children.

The conscious development of a mission statement can lead each person to examine strengths in the other. All of us have certain talents of interaction and the co-parenting process requires us to make those clear to each other as we assess our strengths and weaknesses. Remember that each of your children has developed an attachment to the other parent and has acquired some of that parent’s demeanor, or way of being that they like to imitate. Working together on keeping the healthy or endearing ones and reshaping less admirable ones can be a powerful process for everyone.

The basic elements of a parenting mission statement require answers to the following questions:

1. What is the purpose of our family?
2. What are we all about in life?
3. What kind of family do we want?
4. What is our identity as a family?

Questions to ask your children are as follows:
5. What kind of home do you want to invite friends to?
6. What is embarrassing to you?
7. What makes you feel comfortable at home?
8. What makes you want to come home?
9. What qualities are important to you so you are open to our influence? How can we improve?

Questions that may be different within each family are as follows:
10. What are the things that are truly important to us as a family?
11. What are our family’s highest-priority goals?
12. What are our unique talents, gifts, and abilities?
13. What qualities do we want our family to operate on?
(trust, honesty, kindness, forgiveness, respect)
14. What are our responsibilities around caring for one another?
15. How do we want to make a difference to our community?

Imagine the benefit to your children if you were to approach parenting in this thoughtful way.
Co-parenting can be done and done well when preparing your children for the future takes precedence over distancing yourself from your past marriage partner.

Co‑Parenting: Can It Be Done? absolutely, with intentional planning, consistent communication, and child-focused mission statements. Whether you’re in Silver Spring, Bethesda, or DC, I offer online therapy in Maryland and DC to help parents navigate schedules, create shared values, and prioritize their children’s well-being. For more insight, read about cooperative co‑parenting benefits on Verywell Mind or explore how joint custody supports children’s development on Wikipedia.

Brain Wiring and Mediation: Enhancing Negotiation with Brain Science

How Brain Wiring and Mediation support cooperative listening in online therapy Maryland and DC

Understanding Brain Wiring and Mediation can transform tense negotiations into creative, collaborative solutions. As a Maryland and DC online therapist, I’ve seen how the brain’s wiring often pushes us toward competition and blocks empathy. This guest article by Ellen Kandell and Gloria Vanderhorst explains how awareness of brain function—like engaging the prefrontal cortex and boosting oxytocin—can help clients shift from hostility to cooperation. For a comprehensive version, read the full article on Mediate.com or explore how online therapy in Maryland and DCstrengthens these skills.

Your Brain on Conflict

You are heading for a mediation session about a workplace issue and you know it will be tense. Your heart is racing a bit and you take some deep breaths to calm your nerves and prepare to stay in control. The outcome of this mediation is important to you and you do not want to lose control. Then you walk into the conference room and see your nemesis. Somewhere inside a switch is flipped and your fury is about to burst into the room.[1]

What is your brain doing?

We come into the world with a brain that is prepared to serve as our moral compass. The insula is a small part deep in the center of our brain that will automatically react to our world to discern unpleasant and pleasant sensations. This ability at higher levels enables us to discern five kinds of moral intuition: harm/care, fairness/reciprocity, ingroup/loyalty, authority/respect and purity/sanctity. You can imagine that your brain is sensing and processing hundreds of data points in the room and your demeanor and tone in negotiations is being influenced by this data. You are also bringing a history of interactions into the mediation room and these can get in the way of being completely present for the current mediation session.

What happens when you feel threatened?

When we feel threatened, our brain moves from higher order thinking to lower order thinking. In lower order thinking our moral compass doesn’t work very well. We move from being able to use our frontal cortex to consider options to using our lower brain to seek protection through “fight/ flight/freeze.” The brain can be overwhelmed with data input, whether from an external source, such as other people talking or internal, such as the internal dialogue in our heads.

When the brain is overwhelmed with data, the primitive mechanism of “fight/flight/freeze” is triggered. This implicit response is called low road thinking. In this mode, thoughts and feelings from the past can inject themselves into the present automatically causing us to careen off target. In the mediation this is when a mediator may suggest taking a break, getting a drink of water or going for a brief walk around the block. You may think that those suggestions are a waste of valuable time but they actually help to reset the brain. The cross lateral movement of walking enables your right and left hemisphere to come back into balance and the drink of water helps to oxygenate your brain!

How does the brain cope?

The brain is constantly taking in sensory data for us and sorting it, prioritizing it and sending it to the cerebral cortex for action and understanding. Our brains contain more than 100 billion neurons and each neuron is capable of receiving 10,000 messages per second. Imagine receiving 10,000 emails per second! Seventy percent of these connections change daily. The brain is highly plastic and one’s ability to be effective in the mediation process is dependent on accessing this plasticity. With each experience that we have a connection is formed. Each experience changes our brain moment to moment. When experiences are repeated, the connections between neurons are strengthened. As experiences repeat, more of the brain area is devoted to that experience and that part of the brain grows physically larger. When experiences are intense, the connections are powerfully wired together. We can easily think of experiences that have repeated to the point of automaticity: reading, writing, typing, bicycle riding and driving to name a few.

Now think about stress experiences: the employee who has been verbally abused by his colleague or siblings with a long negative history expect negativity each time the abusive person speaks such that he fails to hear apologies or offers of conciliation. Therefore, repetition of these positive offers will be necessary before they can be heard. The role of the mediator is to slow the communication and use repetition so that the parties in a mediation can hear these new messages.

How does one move from competition to cooperation?

The brain is wired for competition and cooperation. The anterior insula is a region of the brain deep in the fold between the temporal cortex and the prefrontal cortex. This area has been observed through fMRI to be active when a person is feeling competitive. What we are interested in knowing is how this competitive part of ourselves is triggered during a negotiation. In a mediation, two people must either cooperate and gain equally or compete and gain advantage over the other. Studies show that gaining advantage is more salient than cooperating, especially for men. For either sex, when one person senses that they are being treated unfairly or are at an unfair advantage, their response is powerfully negative.

Decisions to trust others are enhanced by oxytocin, which may dampen the fear of betrayal by suppressing amygdala activity. The question is how to increase oxytocin in a mediation. Increasing oxytocin in clients is a good idea if we want people to be more cooperative and trusting in negotiations. Oxytocin functions to reduce adrenalin, thereby reducing the fear response of “fight/flight/freeze”.

The mediator has access to some powerful tools for increasing oxytocin: gentle touch, mentalizing cooperation, images of cooperation and even some foods such as chocolate, cheese, nuts, olives and avocados. Touch enables the brain to process acceptance through the largest organ in the body: the skin. Stories of successful mediations and conflict resolutions can help the clients to image their own situation with a mutually satisfying outcome. A round table and pictures of cooperative interactions can also increase the probability of a cooperative outcome. If you have ever wondered why every collaborative negotiation has food in the center of the table, now you know. Our brains are wired for mutual cooperation and the mediator who understands how the brain works can be instrumental in helping us get there.

 

 

[1] Social rejection shares somatosensory representations with physical pain. Ethan Krossa, Marc G. Bermana , Walter Mischelb , Edward E. Smith, and Tor D. Wagerd, PNAS | April 12, 2011 | vol. 108 | no. 15 | 6275
[2] Dr. Vanderhorst is a psychologist in private practice in the Washington, DC area who specializes in working with couples and individuals. Her 30+ years of experience and training have taught her that positive change is possible at any point in life.

TIPS:
To maximize brain function in conflict situations try the following:

• Have water and food easily available in a mediation
• Take frequent breaks to reset the brain
• Use a round table if possible
• Use gentle touch
• Make sure offers and acknowledgement of feelings are frequently repeated
• Slow down the process

 

When Brain Wiring and Mediation come together, they equip clients to move beyond reactive conflict and toward thoughtful resolution. If you’re based in Bethesda, Silver Spring, or Washington, DC, I offer online therapy in Maryland and DC to help families, couples, and professionals develop these vital listening and negotiating skills. For more neuroscience-informed mediation tools, visit the full article on Mediate.com or browse conflict-resolution tips on Harvard Business Review’s “Calming Your Brain During Conflict”.

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.