Interview: Pat Harvey – Parenting a Child Who Has Intense Emotions

March 13, 2013

Book413-2_intenseemotionsEnjoy this interview of Pat Harvey, who has written one of our top-selling books, Parenting a Child Who Has Intense Emotions.

Megan Hunter:  Pat, your book, Parenting a Child Who Has Intense Emotions, that you co-authored with Jeanine Penzo, has been a popular seller at Unhooked Books and one receives a lot of positive feedback. People tell us that this book helps them where no other books on parenting have helped. So, on behalf of our customers, I’d like to start by saying thank you for putting your efforts toward helping parents and children!

Can you first tell us a bit about what your background and how it led you to write this book with your co-author, Jeanine?

Pat Harvey: I’ve been a clinical social worker for more than 30 years and always had a strong interest in families. Parents have especially always been a sidebar because I’ve worked with kids and adolescents that have significant emotional difficulties and mental illnesses. I’ve recognized the difficulty and pain that the parents experience that is not often really addressed. I heard this once back in the 1980s where a parent said to me, “I sometimes wish that my child had developmental mental disabilities because other people understand that and other people don’t understand what mental illness is and so we feel blamed.” I’ve always had an interest in how I could provide that kind of support to families.

In 2000, I started running groups homes and they began to teach me DBT (dialectical behavior therapy), which they realized was going to be very helpful for individuals who had emotion dysregulation and emotional difficulties. While the kids in the program had a DBT therapist and a family therapist, I decided that it was really important that the parents began to learn what the skills and language of DBT were about so they could use them. So I began running a group once a month for parents, using the same DBT format that was used for the kids. I found that skills were really important for parents, not only in how to manage their kid, but I began to really listen to what their lives were like and how these skills could be helpful in their lives in general and I began to also realize that parents needed to be able to take care of themselves because when you have a kid with emotion dysregulation, no matter what age the kid is, you lose sight of yourself and taking care of yourself which does not make you a more effective parent; in fact, it makes you a less effective parent.

What also happened during the course of this group was the parents began to talk to me about their experiences and what it was like for them to have kids in a system of mental health care where people didn’t understand the parents point of view and where the kids and the parents would go from provider to provider, without any say of who their family therapist was, so they had to keep repeating painful, painful stories. I began to realize there was a need out there for somebody to really attend to the parents, not only as a partner in helping their kids but who could really listen and be accepting and understand of the parents.

In that group I met Jeanine Penzo, the co-author of the book, and she taught me a lot about her experiences about having a daughter who had emotional difficulties most of her life. She talked about what it was like when her daughter was suicidal and when her daughter went in and out of programs. So when I left the program and moved to Maryland, there was still this idea that I had really been sensitized to the need for parents to have somebody that understood them. So my practice down here is almost solely for parents. Jeanine and I began to talk about the possibility of reaching out to more people and providing not just the support and validation but some very specific skills about ways that they can be less reactive. The book was generated from the groups I run and from the need that we felt to provide something for parents.

Megan: The feedback we’ve heard about this book is that it helps parents in a way that no other book has. They say the skills learned through the book have resulted in progress and success in relationships with their children. What is it that makes this book different?

Pat: It came from a place where we were very sensitive to parents and their needs. The focus was not just ‘how you can help your child’; instead, it is how can we help you. Along with providing very specific details about how you go step-to-step, which was generated not only from work with groups but from questions parents asked in those groups. I used a lot of what parents were unclear about and provided that clarity in the book. There is also a sense of acceptance for parents so they don’t read it and say, “Oh my goodness, I’ve blown it or I’m a terrible parent.”

We say in the very early stages of the book that you are doing the best you can as parent of this child and what we want to do is help you be a little more effective and do it a little bit better, but we recognize that you’re doing the best you can. They read it with less emotionality and less defensiveness. Overall we’ve tried hard to make it very clear and very practical. We tried to take parents step-by-step, knowing what the parent might be thinking and feeling when facing situations with kids, and acknowledgement of that.

Megan: What are parents missing when trying to deal with temper tantrums, mood swings, and extreme emotions? I suspect that many focus on an out-of-control child but might fail to reflect on their role and how it could be done differently.

Pat: What happens most of the time when kids have mood swings or extreme behaviors is parents get angry and think the child is being attention-seeking, manipulative, or trying to get their way. When parents think in those judgmental terms, they get angrier and angrier. I try to teach parents that kids aren’t behaving that way intentionally to get something from them but it is because their emotions are out-of-control and they don’t know how to manage it. Kids are trying to figure out what to do with internal struggles that parents can’t see, so parents don’t know those struggles are there.

What I try teaching parents is to understand these behaviors are ways of regulating painful, difficult, and confusing emotions. When you can understand the kid is trying to do their best they can but they don’t know what to do with conflicting feelings that no one else understands, that leads to more behavioral problems. If a parent can acknowledge to their child that you recognize that their having difficulties, they will be able to get in behavioral control faster. It is most important that parent’s do not judge these behaviors and try hard not be emotionally reactive to them. To understand that their child is doing their best, they can acknowledge the pain and confusion.

I give an example in the book where a kid comes home and says to the parent, “I’m a loser, I have no friends, and everything is terrible in my life.” The natural instinctive response from parent is, “Of course you’re not a loser. Of course you have friends. You had them over yesterday.” That kid is probably feeling distress and discomfort, so they begin to act on it. So instead of dismissing the child’s feelings, you validate them and say, “Wow, you must have had a really awful day in school today, what can I do to help you?” This might cause less out-of-control behaviors because sometimes they want to be heard. Parents tend to go into reasonable mind, where they try to explain and defend themselves. A child in the throes of emotion dysregulation and temper tantrums cannot hear reasonable and rational explanations. So what parents have to do besides validating is to help their child to de-escalate. Then they can talk to child about why they can’t act that way.

Megan: You focus on DBT (dialectical behavior therapy), validation and mindfulness. I’m a big fan of DBT. What is it and how does it help families?

Pat: DBT was originally designed to help individuals who had suicidal and self-harming behaviors. The creator of DBT, Marsha Linehan, realized that asking people simply to change wasn’t enough. That, in order for people to change they had to feel accepted first. They had to have people believe they were doing best they could. This is such an important concept in families.

What parents learn first is the child is doing best they can in this moment. It takes a lot for parents to believe that and yet it’s really essential that the kid feels they accepted and understood. This model is very valuable for kids and for parents. The more and more we add parents to groups in our work with adolescents and young adults, the more we see them function better. The parents are first developing insights about their own reactions to kids, and they become aware of themselves and moments. What parents report back is that they’re becoming aware of when they are emotionally reactive. They’re learning through mindfulness and acceptance to slow down their response time and think about what they want to do that will be effective. They develop an awareness of when they’re getting caught up in the emotional cycle with kids and are better able to pull themselves out.

The other piece in the module for DBT, distress tolerance for example, is what kids use when they want to use unhealthy behaviors. We teach them how to distract themselves from those feelings, emotions, and behaviors. Well, the same is true for parents. The self-esteem of the parents goes down so they need to build things in their lives to feel good or feel better. Parents will say, “We don’t have time for it,” but they have to have time for it. If you aren’t taking care of yourself, you cannot take care of your child. A good example is flying on an airplane; put the oxygen on yourself first in order to better help your child. I also try to help parents understand they important, too, and they must take care of themselves, just for themselves, and that’s okay.

Parents have a lot of ‘shoulds’. They ‘should’ get their kids to behave. They ‘should’ get their kids to do homework. Those ‘shoulds’ create anxiety in parents, which comes up against their kids emotion dysregulation, so I help them through DBT skills to think differently; to be more accepting of themselves; and be more accepting of limits. It’s not only amazing for emotion dysregulation in kids, it’s really important for parents also. Parents tell me that this helps them with their other kids as well. They report that they learn to accept, validate, and slow down their response time. They also report that it helps them in other parts of their lives – as bosses and as employees.

The essence of DBT is that they are incredible life skills. They’ve changed my life and I share that openly with parents. It helps me be a calmer parent, person, more accepting of things I don’t like but can’t change. Invaluable in my own life and that’s why I think it’s important for families.

Megan: I’m also a big fan of validation. What is validation and why is it so important?

Pat: Validation is a way of telling a child I’m taking you seriously and I get you. DBT comes out of the biosocial theory which is that kids have an in-born, biological emotion dysregulation, and parents, in their attempt at helping kids feel better and not feel so much difficulty, tend to dismiss their kids. We say, “Don’t worry about it, it’s not a big deal, tomorrow will be a better day.” We say a lot of things as parents to try to help our kids feel better and get over the hump. Or we try and fix it, “did you try this or did you try that?” For a kid who is emotionally dysregulated, they experience that as invalidating.

Validation is a way that way we say to our kid, ‘we get it’ and we are trying to understand some of what you’re dealing with. Part of the importance of validation is not just in parenting, but that parents have to validate each other. It’s invaluable as a family to understand what someone else is experiencing. We don’t have to agree with them or like it, we just have to get that there’s something going on. Parents ask me a lot how to validate their kids when the kids are telling them they’re the worst parents in the world? I tell them they have to sort of go underneath the world. The kernel of truth is the kid is really angry at you for something you’ve done. You can genuinely say to your kid, “I can see that you’re angry at me. Now, how are we going to go forward from here?” That acknowledgement is so powerful because it can de-escalate the situation.

Megan: Although I’m not as familiar with mindfulness as I am with DBT and validation, I’m interested to learn more. What is it and why is it important?

Pat: Mindfulness is conscience awareness in the present moment. It’s about observing, feeling and being in the present moment with all of your energy. Figuring out what’s effective….what do I have to do here?

In DBT, we talk about three states of mind: emotion mind, reasonable mind, and wise mind. Wise mind is where you are centered and have the big picture, where you understand and know what you have to do. Wise mind is where a very hard decision is easy to make. Wise mind and reasonable mind have to integrate so that painful decisions can be made by parents. Mindfulness practice is about focusing your energy and focusing your thoughts. It’s about letting go of judgments and being present in the moment.

One thing that makes parents anxious is their worries about their kids’ future. These end up distracting them in the present. Mindfulness focuses on understanding that they can’t change the past and to only accept that they did the best they could and come back to the present. In the present, you see many more opportunities and it helps them get out of the family dynamic dance. They have to focus on: “What am I going to do in this moment that’s going to work and what is going to be effective?” The more I teach it, the more incredibly relevant I see it’s going to be for families. Taking that moment for parents is incredibly important.

Megan: If you could give parents one piece of advice when dealing with their emotionally intense child, what would it be?

Pat: To slow down. Part of me says it’s to validate, which it is. Part is to understand where the child is in that moment. You have to take the deep breath…settle down….and really see your child. Two major skills parents must have is non-judgmental language and the ability to validate. They have to be able to calm themselves down. Think about what they want to say so they’re able to remain non-judgmental.

The reason I give that response now is because parents in my groups are talking to me about how important it’s been to be aware of themselves and slow themselves down in the moment.

Megan: You’re getting ready to release your second book, DBT for At-Risk Adolescents for Practitioners. This is obviously for practitioners instead of parents this time. Can you tell us a bit about it?

Pat: This book was written with a colleague whose practice focused on adolescents. He spent a lot of time figuring out how to use DBT in his practice. We put together a group of professionals to discuss DBT implementation and realized from it how many dilemmas they encounter in understanding DBT and adolescents, and how to implement it into their practice,

The unique thing about this book is the focus on parents. Throughout the entire book are messages to practitioners about being validating about the parents, too. When you’re working with a kid who has problems, you want to create change for the kid and the parents. We say in this book that parents need validation so they can help their kids. A significant part of the book is about DBT. We think DBT is to helpful, we wanted practitioners to incorporate elements of it into their practice so they can spend more time actually using it with clients rather than trying to figure out how to use it. (The book is expected be out in January 2014.)

Megan: You had a co-author on Parenting A Child Who Has Intense Emotions, Jeanine Penzo. What was her role and motivation to write this book with you?

Pat: For Jeanine it was a personal thing to give back after dealing with a child who had emotion dysregulation. She wrote it very personally to help other parents with lessons she’s learned with her own child.

Megan: Any last thoughts?

Pat: My passion these days is parents. It’s making sure they’re not blamed by others and that they don’t blame themselves. The earlier parents can begin to validate their children, the less they’re going to have emotional reactivity going forward. The lessons are how to validate and understand younger children.

It’s so important that if parents can learn to understand and step back and validate them early on, I think there will be less emotion dysregulation going forward. We should teach validation to all parents — not just parents who have kids with intense emotions. I believe the power of validation is important for all kids. Parents should ask themselves, “How do I validate all my kids? How do I see things from their perspective?” That will lead to healthier families.

Megan: Thank you for your kindness in sharing your time, passion and expertise with us. Your dedication to helping families is clearly evident and we are grateful that you’ve dedicated your career to helping parents better understand how to help their children. We look forward to your next book and more from you down the road.


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