Helping Children Grieve

Even very young children are aware of loss and have their own process of grieving based on their understanding. Because children look to their caregivers to learn how to process their losses, caregivers can inadvertently shut down a child’s ability to grieve when they assume the child does not know or is not reacting to the loss.

Children’s television and literature cover common topics of loss like changing schools, moving away from a friend, and losing a pet. With these kinds of losses, caregivers can leverage the child’s understanding of how their favorite characters went through their loss.

The most common temptation for caregivers is to help move the child through the process. Resist the urge to tell the child how much nicer it will be at the new school or that they will make more friends soon. Help the child learn how to be sad in appropriate ways, express their anger at the situation, and find ways to honor their loss.

The topic of death, particularly parent or sibling death, is not common in children’s media. Unless you purposefully seek out these books, you are not likely to find them at your local library or bookstore. Grandparent death is a more common topic, but again not always available on the shelves.

A key difference with parent or sibling death is that you as the caregiver are likely processing your own grief through the process. It’s very different from helping a child deal with their emotions through changing schools since you as the caregiver are not also changing schools.

Children need to know that it’s okay to express their grief with you, and they often want to know that the loss matters to you too. Younger children often want to tell the story of their loss over and over, and this can be an opportunity for you to craft a story together of what you have lost and how you are grieving together.

Silence and Solitude

My new course on the Foundations of Mental Health has been a wonderful opportunity for me to practice the basic skills and habits as I am writing about them.

Two of these practices are silence and solitude. When I worked in the high school, many of my students would tell me they actively avoided silence because they didn’t want to be alone with their thoughts.

Adults avoid silence too. We use media, busyness, and action to fill our time and our thoughts. Even people who crave silence and solitude- parents of small children, caregivers, those sharing a room or a home with others- will fill time spent alone with other things.

Not to say that media, busyness, action, parenting, caregiving, or any of these things are bad or wrong. Only that mental health and wellness depend on having a rhythm that includes both busyness and stillness, loud bustle and silence, togetherness and solitude.

I recently noticed that my life felt hectic and overfull. During the past week, I have engaged in intentional times of silence and solitude to refresh my soul.

This looks different for everyone. I am still growing my private therapy practice so I am not able to take time away for a week long mountain retreat. But I have been waking up earlier to have time separate from everyone else in the house, time without music or media or books or anything else to give myself space to sit alone in silence and see what comes up.

It’s a life-giving experience. Today as you are reading this, I would challenge you to examine your life and its rhythms. How much space do you allow for silence and solitude?

If you feel like you need help starting a practice of silence and solitude, or the thoughts that come up for you are distressing, therapy can help. Call 831-531-2259 or email for a free consultation. Interested in the Foundations of Mental Health course? Follow my Instagram @leftcoastmft or join my Patreon to keep up to date with the release.

Anxiety, OCD, and Eating Disorders

Did you know that researchers consider OCD, anxiety, and eating disorders to be related?

According to research by the International OCD Foundation, there is a strong connection between these three disorders.

Ever since 1939 researchers have speculated on the parallels between OCD and eating disorders. Numerous studies have now shown that those with eating disorders have statistically higher rates of OCD (11% – 69%), and vice versa (10% – 17%). As recently as 2004, Kaye, et al., reported that 64% of individuals with eating disorders also possess at least one anxiety disorder, and 41% of these individuals have OCD in particular. In 1983, Yaryura-Tobias and Neziroglu proposed that eating disorders may be considered part of the OCD spectrumm but since then the boundaries among anorexia, nervosa, bulimia nervosa, and OCD remain blurred.

Fugen Neziroglu, PhD, ABBP, ABPP and Jonathan Sandler, BA

The emotions around eating disorder behaviors are very similar to those around the characteristic obsessions and compulsions of OCD. Pervasive thoughts interfere with daily life in both disorders. Rituals around food and eating could be part of either disorder, or even both.

Diagnostic criteria look at the fundamental reason for the behavior. If the food rituals are designed to limit intake or monitor consumption, the primary diagnosis is given to the eating disorder. Restrictive eating that leads to extreme weight loss due to excessive compulsions that get in the way of sufficient intake is a sign that OCD might be the primary diagnosis.

What does it matter? If both are relevant factors, why bother having separate diagnoses? The key is that the purpose of diagnosis is to inform treatment. Good therapy will address the root cause of the behaviors, so it matters whether the behavior stems from body image weight concerns or obsessive thoughts resulting in the compulsion.

Beyond that, it may not really matter. Treatments for anxiety, eating disorders, and OCD focus on mindfulness, emotion management, and thought management.

If you are struggling with OCD, anxiety, or eating disorder please know you are not alone. You may be realizing that you have the wrong diagnosis, or possibly multiple diagnoses creating the same behaviors. OCD or anxiety contributing to your eating disorder might be a factor in why residential eating disorder treatment didn’t work out as well for you as it did for others in your cohort.

What do you think? The intersection of anxiety, OCD, and eating disorders has not been studied as much as other co-occurring disorders. It can be difficult to find a professional who has training in how these interact. If you’re interested in getting therapy for any of these behaviors, contact me at or 831-531-2259 to schedule an appointment.

5 Things You Might Not Know About Therapists

Ever wonder what it’s like being a therapist? In this guest post, Steph Iles of Counseling Dynamics explores five things you might not know about therapists.

Hey, guys! I’m excited to introduce today’s guest post by a colleague of mine named Steph Iles. I met Steph in graduate school, and she does AMAZING work with teenagers over at Counseling Dynamics. There’s a lot of mystery around therapy, and we hope that this post gives you a little insight into what your therapist might be thinking. With that said, let’s get into her post!

  1. Therapists love their clients (at least I do).  That being said, we are so proud of them when they “graduate” from therapy.  When a client leaves, we are so happy for them, and hope the tools they gained will take them far.  BUT! We are also proud if they come back when times get rough.  We know it takes courage to do that too.
  2. If we could afford to, we would not charge anything and we would try to help everyone.  Sadly, that is not sustainable. We have to be constantly educating ourselves and staying current.  We have to attend conferences and take classes for our license.  We spend hours outside of session consulting, writing reports, studying… We know it’s expensive to go to therapy, because most therapists have their own therapist, but it’s how we pay our bills.
  3. We meet a lot of great people when we are at work, some we could even imagine as a friend, but ethics will not allow us to be friends with clients.  Even after the client graduates, we must continue to maintain a safe environment for that client to come back if they need it.  That means we continue to see all our “ex-clients” as clients.  If we see you in public and don’t say “Hi” we do that to maintain your confidentiality, not because we are snubbing you.
  4. Sometimes we feel strong feelings carrying around all the stories, but it is also an honor.  We don’t want our clients to ever apologize for sharing any part of their life.  An open and honest client is the best kind.  A side effect of this, is some therapists have a very dark sense of humor about mental health.  I’ve heard doctors, nurses and other helpers also use dark humor to process some of the more painful things they experience.  We are not belittling anyone’s experience; we are just trying to release some of the pain.
  5. Sometimes clients want to give a gift and a therapist must ethically decline anything lavish.  The best kind of gift is something that isn’t tangible.  My favorite gift was a picture of a flower sent as a text with some kind words of the client’s success.  A card is plenty and makes a therapist very happy (and don’t be surprised if pictures or cards are nowhere to be seen in the office; they are still confidential.)

What do you guys think? There are a LOT of weird rules about how therapists can interact with clients, but it’s all designed to protect you and your confidentiality.

Note that this information is current and updated regarding laws and ethics in the state of California as of the date of publication. This information should not be taken as legal or ethical advice, and it may not remain accurate as new laws and ethical standards come out.