What is Epistemic Trust?

Epistemic trust is a term with which many may be unfamiliar. It began as a term used in sociology before being adopted into the vernacular of psychologists in more recent years. The most basic definition is “one’s trust in communicated knowledge.” However, it can be more specifically described as “the capacity of the individual to consider the knowledge that is conveyed by others as significant, relevant to the self, and generalizable to other contexts” (Campbell, 2021). This communication can be in many forms, such as spoken words, non-verbal communication cues like body language, or reinforced messages communicated across a lifetime. The development of epistemic trust begins early in life as we interact and learn from those around us and is continually refined throughout our lives to adapt to our social environments.

Most of the psychological research studies on epistemic trust focus on personality disorders, specifically borderline personality disorder (Fonagy et al., 2015). However, more recent studies are considering epistemic trust as it relates to other kinds of psychopathology, and its implications for belief in conspiracy theories has even been considered (Tanzer et al., 2021). Unfortunately, due to the novelty of this concept in psychological studies, there is a shortage of available research to explore this topic further, especially in trauma-related areas. However, the recent development and validation of a questionnaire to measure an individual’s level of epistemic trust, mistrust, and credulity can aid in this area. This questionnaire allows for a closer and more standardized look at individuals’ epistemic trust and can be incorporated easily into future research (Campbell et al., 2021).

Considering epistemic trust and how it pertains to clients can also be useful in the treatment planning process. For example, one study highlighted that individuals diagnosed with personality disorders who had an elevated level of epistemic mistrust had poorer outcomes from their therapy experiences (Knapen et al., 2020). This may be the case for many that enter therapy with complex trauma backgrounds or other conditions that have reinforced a distrust in communication from others. This opinion can be supported by the argument that “epistemic trust may be the final common pathway through which aversive relational experiences in the past result in interpersonal dysfunctioning, which in turn result in dysfunctional therapeutic relationships, rendering it difficult for patients to trust whatever is offered to learn in therapy” (Knapen et al., 2022).

Little research has been done on achieving the restoration of epistemic trust, but it is believed that therapeutic interventions may be the most beneficial (Kamphuis & Finn, 2019). To date, there has been no known study that aims to investigate the relationship between trauma-focused therapy and restoration of epistemic trust. Such a study may prove to be a critical piece to understanding how epistemic trust impacts this population of therapy clients and whether trauma-focused therapy is an effective tool in the restoration of epistemic trust. As this concept continues to gain interest, we can expect a wealth of exciting developments in this area that will ultimately lead to improved therapeutic outcomes for clients everywhere.


References

Campbell, C., Tanzer, M., Saunders, R., Booker, T., Allison, E., Li, E., O’Dowda, C., Luyten, P., & Fonagy, P. (2021). Development and validation of a self-report measure of epistemic trust. PLOS ONE, 16(4), e0250264. https://doi.org/10.1371/journal.pone.0250264

Fonagy, P., Luyten, P., & Allison, E. (2015). Epistemic Petrification and the Restoration of Epistemic Trust: A New Conceptualization of Borderline Personality Disorder and Its Psychosocial Treatment. Journal of Personality Disorders, 29(5), 575–609. https://doi.org/10.1521/pedi.2015.29.5.575

Kamphuis, J. H., & Finn, S. E. (2019). Therapeutic Assessment in Personality Disorders: Toward the Restoration of Epistemic Trust. Journal of Personality Assessment, 101(6), 662–674. https://doi.org/10.1080/00223891.2018.1476360

Knapen, S., Hutsebaut, J., van Diemen, R., & Beekman, A. (2020). Epistemic Trust as a Psycho-marker for Outcome in Psychosocial Interventions. Journal of Infant, Child, and Adolescent Psychotherapy, 19(4), 417–426. https://doi.org/10.1080/15289168.2020.1812322

Knapen, S., van Diemen, R., Hutsebaut, J., Fonagy, P., & Beekman, A. (2022). Defining the Concept and Clinical Features of Epistemic Trust: A Delphi study. Journal of Nervous & Mental Disease, 210(4), 312–314. https://doi.org/10.1097/NMD.0000000000001446

Tanzer, M., Campbell, C., Saunders, R., Luyten, P., Booker, T., & Fonagy, P. (2021). Acquiring knowledge: Epistemic trust in the age of fake news [Preprint]. PsyArXiv. https://doi.org/10.31234/osf.io/g2b6k

The Intense Side of Healing

I have been at Psychological Counseling Services (PCS) since 2012. One of the most difficult parts of being a therapist is meeting a client in their current crisis and as you join and get to know them better, you realize there is a treasure-trove of historical harms that desperately need attention and may even be exacerbating the issue at hand. In a weekly or bi-weekly therapy model, however, there may be little time to excavate and address the root of the matter.

I’ll give you an example: A client enters therapy for their significant other’s betrayal, and they struggle to find strength and obtain positive traction. Underneath this recent trauma lies the fact they lost a parent in a car accident when they were twelve and maybe they were also severely bullied in high school, or their parents fought constantly and eventually divorced.

It’s not that they cannot heal in weekly therapy, they can; it will just take much longer. Not only because there may be a complex history of trauma, but also because “real life” just has the advantage. We are all familiar with the scientific word “homeostasis”, or as my beloved colleague, Marilyn Murray (PCS Trauma Consultant and author of “The Murray Method”) would say, “the baseline for normal”. It means we have formed a certain muscle memory around how things tend to be, and we become comfortable in that space and often resist change or the unknown. Therefore, it is common for a client to grab important insights within the confines of the one to two hours a week in a therapy office, but then outside the office the pull towards the “old baseline” wins out. They want to make changes but need a space and time to build traction and momentum in a different direction. It is then that intensive therapy becomes an appealing suggestion and opportunity.

The PCS Intensive Program

The PCS Intensive is a weekly offering built around “The Murray Method,” developed by Marilyn Murray in the early 1980’s. Clients begin the process on a Saturday, with Marilyn’s workshop and explore “The Scindo (Latin for “split”) Syndrome,” looking at how adverse childhood events cause “survivor” parts to develop, who try to cope and manage their powerless and painful circumstances, the Circles of Intimacy, helping to organize a hierarchy of healthy intimate connections, and lastly, the Trauma Egg, a document the client creates that chronicles difficult traumatic life events, so the client can understand patterns in negative internalized messages and coping styles.

From there, the client begins the weekly process of over 30 individual therapy hours, which include Family Systems, CBT, DBT, Emotionally-Focused Therapy, Art Therapy, EMDR, and other experiential therapies. Additionally, there are 25 group hours, that includes Equine Therapy, Psychodrama, Anger and Forgiveness, Compulsivity, Codependency, Emotional Regulation, Communication, Mindfulness, Boundaries, Courageous Living, and the Power of Positivity and Play.

The days are roughly 7AM to 7:30PM with a few short breaks in the middle, and the individual work ends Friday at 5PM. The intensive then concludes with a follow-up to Marilyn’s Workshop on Saturday morning (9AM to 12PM).

The groups are mixed-gender and incorporate individual and couple’s clients who are dealing with a broad scope of issues, including substance and process addictions, complex trauma, relational trauma and issues, betrayal, divorce, blended family concerns, grief, career concerns, and severe life crises.

No matter what modality is used, all the therapists speak the same language in terms of helping clients grieve what they needed and deserved, but did not receive. Clients are helped to grow a wise-minded, healthy, balanced Adult Self who can “parent” the parts of self that get activated in grief/sadness, over-functioning or over-caretaking, defensiveness, anger, rebellion, or deception.

A PCS Intensive works for those who are:

  • Highly motivated and want to jump-start their therapeutic process and utilize a program where sessions build off one another, creating a greater possibility of transformational change.
  • “Stuck” and desire a safe place to face their fear of what change will mean in their life, fear of the unknown.

Making some progress in weekly or bi-weekly therapy, but not the broader changes they are looking for.

Busy with work and home and find it difficult to keep consistent weekly or bi-weekly appointments and would prefer a shorter, but more intensive span of time to create movement.

Experiencing an intense current crisis and struggle to manage daily living, needing a space to stabilize and strengthen in grounding and coping skills.

Making some gains in recovery, but still experience relapses due to their need to process the deeper causal roots to their problematic or addictive behaviors.

A PCS Intensive does NOT work for those who are:

  • Signing up because someone else in their life is making them do it, and they otherwise would stay home.
  • Pointing the finger in defensiveness and blame, struggling to face what makes them difficult to those around them.
  • Using the intensive as a checklist, and uninterested in making genuine changes.
  • Resist transparency and are not ready to tell the truth.
  • Experiencing severe mental illness, including auditory hallucinations, extreme paranoia or delusional thoughts.
  • Actively suicidal or homicidal.
  • Continuing to act out or use substances.

The Process

The work I get to do with intensive clients is a unique and fulfilling aspect to my job, because I typically get to help heal deep, difficult life experiences and I get to do that work as part of a therapeutic team. Each intensive has a Case Manager and a team of 4-5 additional therapist who are assigned different areas of focus, such as a genogram, a trauma egg, setting up targets and processing with EMDR (Eye Movement Desensitization and Reprocessing), somatic experiencing, experiential work, addiction and relapse prevention work, relational processing, understanding offensive behaviors and patterns, healthy intimacy, boundary-work, and health and wellness work.

Typically, clients arrive guarded, unsure and at times, overwhelmed. Still, the process begins very quickly by excavating their history and significant life experiences, in order to understand patterns and themes that have impacted their lives. As clients gradually begin to open-up, they start to positively affect each other and instigate change. The bonding begins early with Equine Therapy on Sunday evening and intensifies as they experience their first Psychodrama Group process, where they help a volunteer from the group put a piece of their story in action with the goal of experiencing catharsis and resolution. By Tuesday morning, they typically are ready to share in a meaningful way in their first processing group. The more clients talk about what is uncomfortable to share, the more they inspire others in the group to do the same. The sharing is spiritually powerful and moving, because clients are allowing themselves to be vulnerable and experience real connection; a connection they are encouraged to replicate with the important and healthy people in their lives.

Many clients will express how much they “get it” in an intellectual way. However, what frustrates them is how much they do not feel it. The most satisfying aspect of my job typically happens closer to the end of the week when I witness a client fundamentally shift what was once intellectual, into a “felt” experience; they no longer know they are lovable, deserving, worthy, good-enough, empowered or trust-worthy, they feel it.

At the end of my first week at PCS, I saw a client from the East Coast who completed a 2-week process, smiling, whistling and practically skipping to his car. He jumped in and was headed to the airport – back home, back to his family. I don’t think his journey ended that day, in fact, he was really at the end of the beginning, but it was awesome to see how good he felt!

Transitioning from Partnership to Parenthood


Making the decision about who is going to be responsible for what within the context of your
family system can already be a tricky task to navigate. Throw a baby into the mix—this becomes
even more complicated. For most, having a baby means taking on a whole list of new
responsibilities while maintaining the responsibilities you’ve had all along. Whether you’re
talking about who is going to do the grocery shopping, to work outside the home, or to get up in
the middle of the night when your baby wakes up, it’s important to make at least some of these
decisions on the front end so as to ensure that both you and your partner feel a sense of
partnership and equality. If this is not done ahead of time, or at the very least discussed
intentionally once your baby arrives, you set yourselves up for what I like to call, defaulting.
Defaulting is a fairly common occurrence where one parent, we’ll call them “Parent B“
(generally the parent who IS NOT primarily responsible for feeding) tends to make the
assumption that the other parent, “Parent A” (generally the parent who IS primarily responsible
for feeding), has whatever the task is on hand covered. This is not done from a place of mal
intent but from a place of Parent B’s lack of awareness.


The reality is, parenting has a steep learning curve where most develop a system on the go.
Parent A completes tasks because they simply have to be done and Parent B often falls short in
stepping up to the plate because it seems as though Parent A has it under control. The result: a
big ball of resentment. While I am talking about the importance of delegating the big
responsibilities, I’m also talking here about the importance of discussing the seemingly smaller
ones. These are the ones that tend to be overlooked and as a result, add up over time.
Responsibilities like who is going to sit next to your baby at dinnertime, who is going to carry
your baby up the stairs when you get home, and who jumps out of bed to pop the pacifier back in
at night are just a few examples of such seemingly small tasks that when one parent finds
themselves having to perform each and every time, can lead that parent to wonder whether they
are in this alone. So moral of the story, sit down with your partner before your baby is born and
regularly thereafter. Discuss potential tasks and who will take primary responsibility for
performing them. Regularly check in after your baby is born to assess for new tasks that are
likely to pop up and your partner’s willingness to continue performing tasks they have previously
committed to. Most importantly, whether you are Parent A or B, please take note of all the big
and little things your counterpart does on a daily basis and ask if they could use a hand or a swap
out from time to time. Don’t just assume that your partner will do whatever needs to be done and
even if a particular task has been clearly designated your partner’s responsibility, regularly
express appreciation and gratitude to them for what they are doing. At the end of the day,
whether you are Parent A or B, doing these few simple things will likely result in your partner
feeling more appreciated and seen.

18 Years Ago

When my son was born 18 years ago, it seemed like the year 2022 would be an eternity away…how could my preemie baby boy, just 5 pounds 3 ounces, ever grow up to be 18?  Even though it was my hope that he would go off to college someday, how could it now really be happening? That he would be leaving.  Leaving us, leaving our family (leaving…me)?

Throughout the whole college application process for my son, I stayed logical and “in my head” (what therapists say when people are operating from the thinking part of their brain and are disconnected from their emotions and their heart).  I encouraged my son to apply to schools out-of-state as well as in-state, offering what I thought at the time was good advice that “It’s important to keep your options open.”

When April came and it was decision-making time, I was so relieved when my son said he was  “80% sure” that he would attend one of the two in-state universities—one that is 20 minutes away or one that is 90 minutes away.  The advantages were abundant:  if he got sick, he could come home to be nurtured back to health or we could go to him to help; if he was struggling emotionally or dealing with friend/dating/academic challenges, he could come home (to be nurtured back to emotional health); if he needed to do laundry, he could come home (his laundry he’d need to do himself but I’d make him a yummy meal!). 

You can imagine my surprise (shock) mid-April, after my son returned from an out-of-state college tour, encouraged by me (insert mimicking tone: “Keep your options open!”), when he declared that he made his decision to attend this out-of-state school that requires a whole air travel day one-way or 25 hours by car.  All those “advantages” of being so close logistically were now gone—poof!—replaced with a panic inside of, “If I can’t be there if he needs help, what will happen to him?”  My son, sensing my anxiety, responded wisely and compassionately, “Mom, I’ll figure it out!” and “Mom, you can still support me by phone!”  While I appreciated his words and intentions, it was hard to trust that this was the right decision.  In June, however, my husband and I attended this out-of-state university’s parent orientation.  Just like my son was won over by this school, I actually was as well (my husband, too); we were able to see different advantages of him going there.

At this point, excited for this opportunity for my son, I got back “in my head,” making lists of what he needs for his dorm and reviewing with my son the Ready for Adulthood Checklist (yes, that’s literally the name of it) to make sure I had done my job as a parent…haha, if only it were that easy!  (By the way, high school graduation gifts provided a nice opportunity for him to solidify his learning of the following Checklist item: “When and how to write thank you notes and how to address an envelope.” I also discovered that neither of us was really clear on “Steps to take if you’re in a car accident.” Yikes!).

It is now 2 weeks away from when my son will leave (me).  Earlier this week, I came across the song, “Last Days of Summer,” by Lucy Kaplansky.  I think it was actually a message from my Higher Power to encourage (force?) me to tune into my emotions about my son’s going away to college.  The artist, Kaplansky, sings of exactly what I am feeling…how 18 years ago her daughter was born and she is now moving to college:

KAPLANSKY: (Singing) But I’ll miss that girl in her room, safe and mine. Life is a circle strewn with goodbyes. After 18 years, how can it be just one week more till we carry those boxes to her new room on the seventh floor?

Music can be such a powerful way to connect with and process our emotions.  I am thankful for this song as it has provided the avenue for me to acknowledge my sadness, to somehow give me the message that it’s OK to cry, and to remember that within my grief there is gratitude for the circle of life and for what adventures lie ahead for my son.  It comforts me to know that I’m certainly not the only mother to feel this way.  Perhaps most importantly, it gives me hope:  If the songwriter was able to get through it, so can I!

As I vacillate between allowing myself to feel my emotions and getting back “in my head,” I am now making my list of things still needed to review with my son from the Ready for Adulthood Checklist (e.g., “How to tie a tie” and “How to fix a running toilet”) and talking about how to be a “good dorm roommate” as recommended from the parent orientation.

I will also be hugging him a bit more tightly each day before he leaves while I intentionally remind myself to trust that he is guided by his Higher Power on his life’s path.  I have room inside me for both the sadness of this closing chapter of him being “safe and mine” and the excitement of what lies ahead for both of us—but especially him—as we each turn the page of this new chapter in our lives.

Below is the beautiful song by Kaplansky…be sure to have a couple tissues ready!

Hear It First: Lucy Kaplansky, ‘Last Days of Summer’ – Folk Alley

Embrace the Mess

Recently, my family was together to celebrate my youngest daughter’s graduation. My two adult children, who flew in from out of state with my oldest son’s girlfriend, three teenagers, my wife and I, piled into the house for four days stuffed full of family fun. I had visions of laughter, silliness, tenderness, and meaningful conversations. The plan for four days was detailed, allowing for all of these expectations to be fulfilled. Day one: graduation and celebration. Day two: relax, order pizza, and go to a movie. Day three: paddle boarding down the river, and dinner with family and grandparents. Day four: relaxed morning with a big breakfast and then a family farewell to those returning home. Not too much. Not too little.

The plan crumbled. Sure, we accomplished the tasks, but not with the ease I had anticipated or wanted. On graduation day, much of the time was spent apart was we needed to separate in order to save seats. Pizza and movie night ended up rushed, with a few family members not interested in the chosen movie. Paddle boarding was crowded by hundreds of other people who also thought of joining us on the river, which led to being separated, and two of us exiting the river two miles too soon. There were sunburns, and lost water bottles, sun glasses, and ball caps. There was frustration, boredom, eye rolling, arguments, and hurt feelings. Coming home, we planned to watch a new television series to end the night, but some were so tired they decided to go to bed. The day ended with a fizzle.

Now, I sit reflecting on our few days together. I see piles of laundry, dishes, and bed linens. Those of us still at home are quiet, in our rooms, catching a breath after a tornado of activity and chaos. Not quite what I was hoping.

But, the messiness is it. The messiness is living. Messiness is the adventure. I make plans and hope for magic moments. I miss the magic of the mess. I want a photoshopped glamour reality and get a blurry, creased black and white photo.

Then I pause. I look passed failed plans and remember the moments of sharing memories, trying something new (even with some frustration), “I’m sorries,” and teasing that can only happen between siblings. I know everyone in my family a little bit better. We barely started those meaning conversations I had planned to have, but they are started, and we will look for opportunities to continue. We are figuring out life and it is not easy. We — every person on the planet — are trying to figure out life, in all its mess, just like people have done since the beginning.

Families are messy. There is conflict, sadness, failed plans, and frustrations. There are also the bigger struggles of depression, trauma, addiction, and divorce. There are nights when screaming at the moon seems like the best option. There are also accomplishments, small victories (like getting out of bed), and big victories (like graduating). You are not the only one whose life is messy — despite what social media suggests. Breathe. Look for the moments in the midst of the chaos. Sometimes they are hard to see, but those moments are there. And when you cannot see them, ask for help. I know there are times I need it. 

Navigating Social Media as a Parent

Social media has changed the way we communicate, socialize, obtain information, and shape our opinions about the world, others, and ourselves and while this is very much a profound influence on our lives, many of us haven’t figured out how to effectively parent our children in relationship to it. 

Here are some tips that may help: 

1.    Accept that social media is here to stay. It is understandable that many parents are fearful and therefore are not fully embracing of social media.  However, coming from a place of fear doesn’t promote understanding, and the reality is that similar to things like pornography or drugs and alcohol, wanting these things to go away or trying to altogether avoid conversations about these things does not work. At some point young people will be exposed to them and there is no magic social media, sex, or drug/alcohol fairy that shows up when kids need guidance. As parents, we need to show up in that role. 

2.    In order to effectively manage your child’s social media use, you have to expose yourself to it, engage with it, and understand it.  Have your child introduce their favorite app(s) and tell you what they like about it and teach you how to use it. Make it fun.  Try to avoid criticizing social media, as this will reinforce the attitude of, “My parents just don’t get it.” This does not mean as parents we have to agree with all of what our kids are doing, or posting, or sharing – it is more about wanting them to see us as willing to listen and learn and maybe to consider that as their “old, out of touch” parents we might actually know a little bit of what we’re talking about. Judgement will only get in the way of what you really want — to have a closer relationship with you kids.  

3.    Find ways to connect vs. reject. One way to do this is to make it fun! Send messages through snapchat, tell them to make their bed with a goofy face filter, or try not to embarrass yourself doing a TikTok dance. One added benefit, is that when children realize they cannot so easily get away with things online, they are more transparent. Also, this can promote kids thinking twice and editing before sending a message or posting something inappropriate. If not, you will be there to help them manage it.  Young people are uniquely sensitive to the judgment of parents, teachers, friends, and the digital community. It might be that social media heightens this sensitivity and drives impulsiveness or pre-occupation with popularity, acceptance, or body image, but it did not create these issues. Yes, it can make it harder and more pressure-filled for kids, but if we make it all about social media, we are missing the big picture.

4.    Set up a plan – talk to your kids about what they might be exposed to ahead of time. Let them know they might see things that confuse them, upset them, or even scare them. Work to establish yourself as a person who they can turn to without fear of losing the privilege. Losing access for a time may be a necessary outcome, but do your best to not threaten it and to first understand what happened without shaming.  One tip is to avoid taking phones or social media away as a punishment if the problematic behavior was not related to that social media use. Remember the long-term goal is for our kids to learn how to avoid the pitfalls of social media use for themselves. Lastly, make sure to talk to other parents, therapists, or attend meetings/webinars on the subject. Do your best to stay informed so you can meet the needs of your kids. 

Sam Hardwig MA, LPC, CSAT CANDIDATE

Educating our Children about Pornography: An Important Piece of Sex Education

Please watch the following New Zealand public health advertising campaign targeting pornography and kids:

Porn ad designed to protect children

Early in my career I did research about sex education.  I learned that in the United States we are not doing a good job preparing our young people to make decisions regarding their bodies and their sexuality. In the US, we begin sex education at a much older age than European countries with the end result being US teens are less prepared to make healthy decisions regarding their sexuality.  When we teach kids math, we begin at an early age with counting and then proceed to adding, subtracting, multiplying, etc., before we present them with complex mathematical problems.  Without a basic understanding of human sexuality, kids lack the ability to talk about their body, their experience of their own body, and how to make healthy decisions around physical intimacy.  Because of the availability of information via the internet, it is more important than ever that parents take an active role in educating their children about sex and about sexual intimacy. 

Research suggests that the average age children first see pornography is between ten and thirteen years old.  Some children actively search for pornography, but often a simple search word will result in sexually explicit language and images.  Cell phones enable children who may be simply joking about “bad” words to search for the word and then be exposed to sexual content that they are not mature enough to understand.  Children need to be taught that there is misleading information out there—including pornography—and then provided accurate information regarding healthy sexual intimacy. 

When receiving information about sexual intimacy through pornography, kids don’t know that what they are watching is not real, but staged.  Pornography doesn’t model a real life intimate relationship of which sex is one part.  Pornography doesn’t model consent, how the person decided to engage in a particular sexual act, or what the person feels before, during, and after sex.  Moreover, pornography can be a dangerous fantasy or preoccupation leading to problems with sexual intimacy including pressure to perform in a certain manner. It can be shocking for parents to learn how much dysfunctional sexual information is taught to teenagers via pornography.

Making decisions regarding sexual intimacy is a complex process.  It is important for children to have good information, are comfortable with their body, and are clear about their needs, wants, emotions, and beliefs.  The best information your children can receive will come from you.  Please take time to educate yourself and find resources to help you talk to your children about healthy intimacy and the risks of pornography on their sexual health and well-being. I also encourage you to talk to other parents to support each other, to share resources, and most importantly so that your children are getting similar messages that they can share with one another.

Resources:

Should I talk to my 7-12 year old kids about porn?

Tricky question, right?!


If it’s not an issue, why should I bring it up? I don’t want to plant any
ideas in their head. After all, is there any real danger if I set the
parental control on technological devices?


On the other hand, kids are spending more and more time online for school, play, or socialization which increases the possibility of their exposure to inappropriate content, whether by accident or by friends. And then what?! Exposure to pornography in early age might impact a child’s perception of touch, love, sex, and body image. These effects can create a distortion in expectations of self, partner, and relationships later in life. In addition, more curiosity about porn might lead them to secrecy, using porn as an outlet for stress, and as a potential unhealthy coping skill. Sitting down with your child to talk about porn is like the new “stranger danger” conversation. I wish it could be avoided, but the internet has become the modern version of the neighborhood playground, which makes this conversation almost inevitable.


If you do decide to have “the talk,” please be mindful about your child’s age, personality, and emotional development. The approach and even the words you choose can make a difference.

What do I say?

Well… before the “what” comes the “how”:

Some parents feel awkward, not to mention tongue-tied, talking with their children about sex. If you are one of these people, remind yourself how amazing you are for placing your child’s best interests before your comfort zone.

Set an intention to be calm, loving, and open. The idea is to create a safe space for your child, where it’s okay to talk about uncomfortable issues, ask questions, and learn tools. In this conversation, you model to your children that there is no topic in the world that can come between you, that you are always there for them, and that they’re never alone. It is important to talk about our bodies, nudity, and sex in a positive way. Be mindful of using positive words and having open body language. We want to encourage kids to accept themselves as sexual beings rather than to feel shame.

In order to differentiate between what is appropriate and inappropriate, acknowledge that sex is a good thing when done at the right age, with the right partner, in a respectful, consensual, and safe way.

Okay I get all that but… how do I actually say it?

Express the reason for this conversation – “There is something I want to
talk to you about because I love you, care for you and want to protect you.
It might sound weird or uncomfortable but I believe it is important to
guide you just in case. Are you willing for us to talk about the internet
and pictures/videos of nude people?”


Normalize – “it’s very normal to be curious about nudity. Most people,
even kids, will want to keep watching. There’s nothing wrong in feeling
that way.”


Invite – It is important to emphasize that even if your child has already
been exposed to porn or nude images – you will not be angry with them and
they are invited to share with you now or anytime in the future.


Model active listening – what types of things have you already seen? If
they are not ready to share right now, agree on some later time to continue
the conversation.


Explain – “Some games, videos, and websites are appropriate for your age
and some are not. The inappropriate ones include nude people or private
parts”. You can ask your child to name male and female’s private parts, or
you can name them yourself. Be mindful of using the correct anatomical
words, so your child will learn there is no embarrassment in doing so. The
conversation can be simple but make sure it’s clear.


Emphasize the concern – “The thing is, a lot of these videos present
disrespectful relationships, sometimes even violence or humiliation. It can
be uncomfortable to watch and very confusing, because some of it might feel
good while some of it won’t. These videos usually don’t reflect the truth
about love, care, and relationships but they might make the viewer believe
it to be true. That’s why it is unhealthy for you to watch this. It might
impact your view of sex and sexuality in a negative way and you don’t
deserve that“.


Offer a road map – “So, let’s say you happen to see something by accident
or someone shows you inappropriate content. Overcome your natural curiosity
and stop watching. You can be the responsible kid that you are by taking
care of yourself and doing the right thing for your healthy development.
If you do get caught up in watching it, please talk to me/us about what you
saw and what kept you watching it.


Summarize – “Again, you are always welcome to tell me if something has
happened so I can help you. I promise I will not get angry with you. I
expect you to take care of yourself and not engage with porn in the same
way as I expect you to avoid engaging in violence”.


Ask – “Do you have any questions? How do you feel about what we’ve talked
about?”


Model active listening – Understand and validate your children’s feelings,
then answer their questions.

At this point, I invite you to check in on how you feel, thinking about
having the conversation. Remind yourself that having the conversation
prepares your child for an unexpected reality in a loving way.

Approaching 2020 with Open Arms and Hearts

Do you ever wonder what you can tangibly do to get ahead for the New Year? As I reflect on 2019, I think back to many moments during the year that included positive growth, hardship, connection, and loss. I started a life changing internship (Thank you PCS!), while continuing to take classes and work on my Master’s program at ASU. I moved to a new state away from my family and friends. I lost and gained friendships. I felt homesick and leaned on others. With all of this, I will be the first to tell you that I was not prepared for much of what 2019 threw at me! While being unprepared might have served a wonderful purpose (as I grew immensely as a person), I continue to embrace the importance of being present, grounded and mindful when looking forward and taking on new challenges and A NEW YEAR!

Here are some tips for starting your New Year on the right foot:

  1. Reflect (with Self-Compassion): It is important to begin with self-reflection about how you showed up in the last year for yourself and for others. What went well? What could be better? If 2019 felt like a hard year, this is especially important. Giving yourself compassion for the hardships endured or where things fell short allows you to open the door to change for the coming year.
  2. Compassion for others: As you grow your compassion for self, extend this to others.
  3. Get Grounded and Set Intentions: What do you wish to be different for your New Year? This could look like creating a mental or physical list of what you want to accomplish or change. Even if you had a spectacular year, we can always push ourselves!
  4. Get Specific: How will you act on these intentions?
  5. Seek Support and Connection: We are not meant to do this all alone. There are people who will support you in your efforts to create change in your life. Seek these people out and watch the team effort unravel positive growth.
  6. Appreciation and Gratitude: Studies have shown that showing gratitude positively effects one’s social and psychological well-being. Showing your gratitude will also allow your connections to grow.

From all of us at PCS, we wish you a joyful and prosperous New Year!

Article by Kaitlyn Beckham, BA, Intern

Kaitlyn is a Master of Counseling student at Arizona State University graduating in May 2020. She enjoys working with adults who have experienced trauma, as well as those who struggle with anxiety, depression, relationship issues and self-esteem issues.

Siblings of Children with Health Issues

When our children are struggling, or in pain, we scramble for answers, support, interventions — whatever we need to do to get them help, even more frantically when they are fighting for their lives. As adults, with all of our internal and external resources, it is still exhausting, desperate, and heart wrenching. It becomes easy to focus on the next treatment, therapist, or doctor appointment, just to get us through to the next day. With all this energy spent in helping our child, we sometimes lose sight of brothers and sisters. This is especially true when the sibling is cooperating, helping, and being supportive. It is easy to forget, that they may be struggling just like we are, and that they may be internalizing the experience. 

Common experiences for siblings of children with chronic health, or mental health issues include: 

  • Feelings of loneliness and isolation.
  • Confusion over what their sibling is experiencing.
  • Guilt that they are healthy, or that it is their fault (particularly for younger children).
  • Resentment of added burdens such as chores, or lack of opportunities such as lessons, or sports because of time, or financial limitations.
  • Jealousy of the attention the sibling is receiving.
  • Embarrassment of situations where medical equipment is needed in public settings, or of attention drawing behavior. 

As a child, many of these thoughts and emotions go unexpressed, ultimately growing into a burden that we as adults even we have difficulty carrying. Their silence is often praised with words of affirmation, such as “she has been a trooper,” or “he is so helpful,” which encourages the silence.

So, what can we, the parents, do? 

First, you don’t have to do it alone. Enlist the support of family, friends, faith communities, and health care providers.

Second, encourage your children to ask questions and share feelings, by modeling. Let them hear you talk about your feelings. While you should not lean on them for support, it is still okay to say, “I know this is hard, I feel sad sometimes. Do you feel that way, too?” Then, simply listen. If they don’t have anything to say, keep the door open, and revisit on occasion.

Third, reassure them. They did not cause the issue and even though it is difficult for everyone, you will take care of them, and they don’t have to worry about you.

Fourth, try to spend alone time with each child. You may not be able to spend the afternoon together, but you can make a quick run to get an ice cream cone, sit on the end of their bed for 15 minutes after school, or walk around the block. A few minutes of attention can do wonders.

Fifth, get to know each child — their personality, favorite food, interests, names of friends — and start conversations about those things.

Sixth, be honest about information. In my experience, secrecy does more damage than honesty — even with difficult information. If a child can count on a parent being strong for them, it is better to have information than be surprised, or worry. If you have questions about how and when to share age appropriate information, speak with a health care provider.

Also, let go of the small stuff. If the choice is picking up a pizza and being able to have 20 minutes with your son verses making a dinner which takes an hour to make and clean up, choose him. If the house is a mess and your daughter is sitting alone playing video games, take 15 minutes to join her. Finally, take care of yourself, sleep an extra half hour rather than reading another article on the issue. Turn your volunteer responsibilities over to other people. Eat regularly to sustain your energy. And, to restate the first suggestion, ask for help from friends and family with dinners, transportation, over nights, cleaning, and a listening ear. When you care for yourself, you have more reserves to care for your children.

Helping our children through chronic, or life threatening health issues can be overwhelming. Remember, as you help the child who is dealing with the illness, their siblings are there and they also need your love and support.

Article by Douglas Withrow – MDiv, LMFT, MSC, S-PSB

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