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Pre-Gaming and Reframing: Helping Families Return To College After a “Failure”

Mountain Valley interviews Lisa Rosen, PsyD, about how she helps prepare families for a return to college after an anxiety-based withdrawal.

MV: So, Dr. Rosen, in our last newsletter we discussed how Mountain Valley helps prepare residents and parents for the transition from high school to college. But today we want to hear about the experience of families who have tried college, and it just didn’t work the first time. What’s that like for a family to have to try again after a false start?

Dr. Rosen: Well, there’s no denying that this experience is painful and disorienting for the resident and the parents. The level of anxiety over trying again can be very high, which is why we really focus on “pre-gaming” the return to college very early in the family’s treatment experience. The more pre-gaming we can do, the better. Pre gaming means really digging into the initial experience of college and gleaning insights from that experience for this next attempt, an attempt that includes a whole new set of skills and insights that the young person, and her parents, did not have the first time around. Pre-gaming is our way of getting really practical and concrete about what steps to take to be successful in college. We do this with the resident as a part of their treatment, and we do this with parents to empower them to better support their child’s return to college. This includes teaching them how to navigate their own anxiety!

MV: What are some examples of this support?

Dr. Rosen: We provide two categories of support for the child. First, we explore the setting itself, asking questions together like what supports are available in that setting? Is there enough support at this college? Is this the right setting to optimize this particular young person’s learning? Is this the right school? This kind of analysis is part of the resident’s therapeutic journey at MV. We use the resident’s past experience to look at their future experience from all sides—the social emotional setting and supports, the academic rigor, the learning support. In other words, we have to help the young person become reflective and analytical about the setting they may return to. The other category of support involves, of course, reflection regarding the state of the resident when they had that initial college experience. How much of their struggle was simply driven by what was going on emotionally for them at the time, separate from the external environment. What new skills and insights do they have to bring to this or another college environment?

MV: So, it sounds like you kind of flip the initial “failure” on its head, looking at it as an important source of information and as the beginning of a process of understanding that can form the basis of a successful college experience. To carry your “pre-gaming” analogy forward, is this a little like debriefing an early season loss in sport so that you can improve and succeed going forward, viewing this “loss” as a useful and instructive beginning rather than as an unsuccessful ending?

Dr. Rosen: Yes, and that brings me to the parents. We talk a lot about cognitive distortions as a part of our work with our residents. But this is also very useful in our work with parents. Reframing is an important part of correcting cognitive distortions around what can feel, understandably, like a crisis. Parents may think “our child has been working toward this very specific goal of this very specific college for twelve years and we have had this very linear view of how life is supposed to unfold and suddenly the plan is upended, it’s a disaster.” We help parents reframe this “crisis” as a “challenge” and one that has yielded important data. In terms of empathy for these parents, we know that reframing does not mean denying their feelings—it’s really hard, we know, and it can still feel terrible to the parent and the child. But ultimately, it’s really an opportunity to revisit some initial assumptions, to learn about our patterns and our child’s needs, and craft a more effective strategy for reengaging college.

It’s a balance of empowering the young adult to own their experience and apply new insights to their college experience and it’s also a chance to help parents balance their own role as supports. They are still parents after all, and their college-aged child is part adult and part child and still needs engaged parenting. But we also need to allow space for the child to learn from their own bumps and setbacks.

The pregaming we do helps the parents not only reframe the initial setback of a college withdrawal, it also helps them reframe future setbacks with a more flexible attitude, viewing each success and each setback as an opportunity for growth and learning—as a new and useful data point and an opportunity to practice new skills. It’s a win-win. We win if our kid succeeds. We also win if our kid experiences a setback and is equipped to reflect and say, “you know, mom and dad, here’s what I really need to be successful, here’s what I really care about, here’s what’s not working for me on this campus.”

The years from 18 to 22 may be what we define as “adult,” but what do we really want as parents? We want our kids to succeed from 25 to 80! We have to learn to play the long game here. That’s what we want college to prepare our kids for—a long and positive adult future. With that perspective, what a great opportunity college provides as a relatively safe laboratory to prepare our children for the challenges and opportunities of adulthood. That’s at the core of our pre-gaming and reframing approach to returning to college.

 

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Anxiety Goes to College!

Have you ever felt anxiety during a big vacation or dread at news of a new job or promotion?  Maybe a little (or a big) panic before a happy event like your graduation or wedding?  If so, that’s actually pretty normal!  Big life events generally involve transition and transitions are characterized by a disruption of routine and homeostasis—the predictable, familiar habits and circumstances that anchor us and help us feel calm and rooted. Big events bring big change, which is why even happy events can trigger an anxiety response—especially if you are already prone to anxious emotions.

One of the biggest transitions in young adulthood is leaving home to go to college. This transition, as traditionally navigated in the U.S., involves an instantaneous and wholesale change of virtually every aspect of a young person’s life and is, as a result, fraught with emotional obstacles. In fact, longstanding statistics indicate that about a quarter of all college students respond to these stressors by dropping out during their freshman year and up to 40 percent of all college students drop out over the course of their college experience and fail to earn a degree (based on six-year tracking). For young people with a history of anxiety, this wholesale transition can seem particularly overwhelming and can trigger staggering fear for both the would-be freshman and their parents!

So, we asked Mountain Valley therapist Sharon McCallie-Steller a question common among parents of college-aged young people: “How do you deal with anxiety when your child goes to college—both your child’s and your own?”

MV: Sharon, talk a little about what it’s like for young people who are getting ready for college. College should be a great thing, an exciting adventure. Why is it so scary and overwhelming for some?

Sharon: Anxiety is always focused on the anticipation, the uncertainty, about what might happen—fear around all the “what-ifs?” Since college represents a whole new life experience for a student—leaving home, leaving a familiar school situation, leaving friends, changing your whole environment and support network—there is a lot to process. It should be exciting, of course, but high levels of excitement often feel a lot like anxiety! So, for a student who is prone to anxiety, this very exciting time of anticipation can trigger an anxiety response.

MV: How can parents be helpful to their child during this time?

Sharon: Sometimes a parent’s well-intentioned and understandable impulse is to try to fix their child’s anxiety. They often make two mistakes. The first is to minimize their child’s emotional experience. Again, this is always well-intentioned, and it takes the form of trying to calm the child with statements like, “it will be fine,” “you’ll do great,” “just relax,” “everything’s going to be fine,” et cetera. This communicates to the child that they should not feel anxious, which can actually increase the anxiety and create separation between the parent and the young person. The reality is that it makes sense to be anxious in the face of so much change—it’s normal!

So a better place to start is to validate your child’s anxiety by simply acknowledging it: “Wow, yes, this is a big change. It sounds like you are really feeling anxious.” This immediately connects you with your child’s experience and creates room for helpful conversation. “Okay, mom gets it.” It makes you a safer ally. At this point, you might be in a better position to ease into the work that I call “planning to cope.” You can work with your child to dig a little deeper into the specific worries to  visualize real situations and discuss possible solutions: what if you struggle to find your classes, where can you can go for help and guidance, what do you want to make sure you’re involved in and how do you access that. But, again,  the first step for parents is to validate the childs experience.

MV: So the main points I’m hearing are: 1) validate the feelings—they are normal and acceptable, 2) visualize the specific points of anxiety, 3) discuss a practical plan for coping with those points.

Sharon: That’s right.

MV: So that covers how to help you deal with your child’s anxiety when they go to or go back to college. But what about your own anxiety as a parent?

Sharon: Yes, well parental anxiety around this time of year is often very high as well. I won’t see my child every day, I won’t be able to monitor their safety and wellbeing. Home like will change. I won’t have the same access to their friends. There are very real threats living on your own away from home and the familiar. You know as a parent that this transition is not all sunshine and rainbows. So just know that it’s normal and appropriate to have some anxiety. But as a parent you can reflect on what is, maybe, an outsized fear: what am I catastrophizing, what is my own anxiety and fear that I might be projecting onto my child, what is my own stuff that might be getting in the way of me being excited.

If significant fear comes up for you during this transition, it’s a great opportunity to do your own work, to seek support and growth. This can take the form of joining a parent group—which many colleges provide, or processing with your spouse, or joining a PTA group for parents of seniors. If the fear begins to interfere with your relationship with your child or ability to enjoy this adventure, you might consider therapy or parent coaching.

As part of your own work, this can be a great opportunity to reflect on what you know about your child’s capabilities and to anchor yourself in that. “She’s spent so much time preparing. She got into college based on her abilities. She has these attributes and abilities.” And like you’ve now done with your child, you can create your own practical coping plan for addressing concerns that cause anxiety.

MV: So, the plan for dealing with anxiety when your child goes back to college is much the same for the parent as for the child?

Sharon: That’s right. Validate and normalize the feelings, right-size the threats—gauging anxiety against reality, make a coping plan, and use this as an opportunity to work on yourself and build a support network.

MV: So if, after doing all this preliminary work, your child’s anxiety remains very high, how do you know if it might be smart to pause and get some help before?

Sharon: The question to ask is if the anxiety is interfering with daily functioning. Is my child making it to work, engaging socially, doing the things necessary to prepare for college like packing and planning? Or are they avoiding, staying in their room, not getting basic tasks done. If the latter, they might not be ready and you might consider speaking with your child, and a professional, to assess whether to hit pause and get some help addressing the anxiety itself. One thing to consider is whether deferring is, itself, an avoidance strategy or just a wise decision to prioritize growth and increase the odds of success. Conversation with a parent coach, educational consultant, or therapist can help you assess this question. Many parents and students choose to defer for these reasons and most colleges are set up to accommodate such a decision.

MOVING MOUNTAINS

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Proprioception and Anxiety Grounding

Ever feel “out of your body” when severely anxious? Ever experienced the grounding effects of big a hug? What happens to our sense of body awareness when we are anxious? And how can we engage our sensory system to manage acute feelings of fear? 

Most people are familiar with the classic five: smell, touch, taste, sight, and sound.  However, many people are not aware of the other sensory systems that are essential to our human experience. One of which is proprioception.

Proprioception is your sense of body awareness. Within our skin, muscles, and joints, live tiny little receptors called proprioceptors, who are responsible for perceiving our body position and our movement. These receptors send signals to our brain, telling it where our body is in relation to itself or the external environment. This is the sense that allows you tell how far away something is when you go to grab it or whether your arm is in the right position to catch a ball. 

Like all other sensory systems, our proprioceptive system is directly related to autonomic nervous system, and therefore plays a role in sympathetic arousal (“fight, flight, and freeze”) and parasympathetic arousal (“rest and digest”). Research has shown that when our sympathetic system is engaged, our sense of proprioception is impaired. This would explain that “vertigo” and “out of body” experience people often describe during high states of anxiety. However, the inverse relationship is also true, and when proprioceptive system is engaged, it stimulates our parasympathetic nervous system, helping us to move to calmer state of being. 

So how do we engage our proprioceptive system? Here a few quick tips:

Do “Heavy Work” – to engage the proprioceptive system, we need to engage the muscles, tendons, and joints of our body. One of the easiest ways to do this is through “heavy work”, such as: 

  • Lifting weights 
  • Using resistance bands  
  • Push/Pull activities 
  • Yardwork/gardening tasks (shoveling, moving a wheel barrel, lifting heavy objects, etc.) 

Apply Deep Pressure – Another way to get input to the muscles, tendons, and joints of your body is to apply pressure to them. So yes, your deep tissue massage can help with your anxiety! Here is a list of few examples:

  • Massage 
  • Weighted items (weighed blankets, vests, etc.) 
  • Stress balls or thera-puddy (pressure to the hands) 
  • Chewing gum (pressure to the jaw) 
  • Hugs

Foster Body Awareness & Coordination  finally, activities that require one to coordinate their body in space also inherently engage the proprioceptive system. These activities may include: 

  • Yoga
  • Tai Chi
  • Body scans 
  • Climbing 
  • Hiking (especially on uneven terrain!)

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Origins & Motivations

Origins & Motivations

Some people have asked me about the motivations behind establishing Mountain Valley. I do tell them about the data: from the almost 10 million children diagnosed with an anxiety disorder in the United States (NIMH, 2012); to the 700% increase over the last forty years (Gray, P., 2010); to the treatability statistics of CBT and anxiety disorders that would make even the biggest skeptic give you a high five. I do tell them about the benefits of exposure therapy, how the victim of the fight and flight response can heal more rapidly in an environment where there is no one to fight, and nowhere to flee. I do tell them about the concerning shortage of anxiety disorder treatment programs, and how anxiety is an epidemic, so I think we should be doing more.
I do not tell them about how my life as a teenager was circumscribed by anxiety, and the decisions it made for me. I do not tell them about the America I lost at 17 years of age because “tough it out” was not the panacea I needed. I do not tell them about the Mountain I climbed to overcome panic, and the Valley of recovery I was fortunate to find; a Valley where I became more the arbiter of real threat and less the victim of perceived danger. While my own experience inspired the design of Mountain Valley, my frustrations as a clinician treating anxiety provided equal motivation. I was frustrated that however “in the zone” I was, the benefits of the 50 minute hour wore off on my clients almost as fast as the euphoria I felt after hot yoga. I was frustrated by parents who saw medication as the first line of attack, and rarely as an adjunct to therapy, or the “if all else fails” scenario. I was frustrated by how my clients’ fear, and their fear of fear, made “no-shows” as frequent as I remember it raining in London. I was frustrated by my attempts of social anxiety skills groups and panic attack support groups, where six were scheduled to attend, and only one showed. There is nothing like five empty chairs, and decaffeinated herbal tea, to make a 17 year old feel like he is the only one. I know that you probably know that movement and change is tough without the normalization and empathy from a student’s peers; the power of, “I know exactly what you mean,” and, what I heard a student say on her graduation from Mountain Valley last week, “guys, if I did it, I promise, you can, too.”
Anxiety was once a mechanism to solely prepare and protect us from harm, but it seems to have evolved into something annoyingly unnecessary at best and pervasively destructive at worst. While the complex story of the origin of anxiety disorders needs to be told, it is important for our anxious teenagers to know that the experience of it is just an experience; a series of symptoms, and a symptom itself. Mountain Valley helps our residents to understand that they are not defined by their anxious temperament, or the anxiety they experience, but more by their response to it. Denial, apathy, and avoidance are responses and strategies that provide some immediate relief, but overtime, become equally as damaging as the anxiety itself. Severe anxiety is like a weed -it grows fast, damages the garden, and if not removed by the roots, has a tendency to return. Symptom reduction is merely the beginning of the Mountain Valley journey. It is the origin that provides the motivation for our teenagers to address anxiety at its root; from enmeshed relationships with a parent, to years of teasing and bullying, to sibling rivalry. I know you see this all the time. This is not to downplay the influence of “genetic vulnerability” and “biological predisposition” in the origins of anxiety; merely, let us focus more on what we can change, and less on what we can not. In our daily challenges working with students in need, I think they need to know that just as much as we do.

Daniel P.Villiers,Ph.D. Founder & Director of Admissions

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Eleven Residents Complete MVTC Biathlon

Yesterday afternoon at approximately 5:00 p.m., eleven very tired, but extremely proud, Mountain Valley teenagers completed the first ever MVTC Biathlon. This grueling event commenced on Sunday with a 25 mile mountain bike trek from Plymouth, NH to a “wilderness” campsite in nearby Beaver Meadows. After a wonderfully restful night’s sleep in tents of various shapes and sizes, our adventurers then loaded eight canoes onto the Upper Valley Stewardship Center’s boat trailer and rumbled north to Monroe, NH where they entered the mighty Connecticut River at picturesque Dodge Falls. The six hour paddling journey included water safety and canoeing refresher mini-courses, a sandbar lunch break, Connecticut River history lessons, violent rainstorms, warm water swims, occasional sunshine, multiple Bald Eagle sightings, white water rapids, great attitudes, and very little, if any, complaining!

Our residents and their impressed (and impressive!) Residential Faculty were treated to a special dinner upon their return to the Farm House’s Biathlon Base Camp, during which our tired teens, sporting well-earned senses of self-accomplishment, regaled themselves with tales of biking mishaps, deep woods animal sightings, and near capsizes. A good time was had by all, and we thank Alicia Huysmans, Team Leader extraordinaire, for organizing what is sure to become a tradition at Mountain Valley.