Tuesday, March 19, 2013

Musings on Sheryl Sandberg's book "Leaning In"


“Miracles are to come. I believe in a remembrance of miracles”…e e cummings


Towards the end of my last year in high school, members of the senior class were asked to select personally meaningful quotes to be printed beneath our yearbook pictures. I chose this quote by e e cummings because I believed great things were ahead for me and also, to remind my classmates to be mindful of their own great moments.

Coming of age in the 1970s, riding the wave of the feminist movement with songs from ”Free To Be You and Me” and Helen Reddy jangling in my head, I was convinced Sandra Bem’s androgeny was the purest form of truth and that significant differences (aside from obvious anatomical ones) between men and women didn’t really exist. In my exuberent unexamined opinion, I was convinced that if a man could do it, I should be able to do it too. I was able to happily maintain this illusion through my college years during which I wrote my undergraduate thesis on a research study I performed entitled: “The Role of Attractiveness in People’s Attitudes Towards Sex-Role Inappropriate Behavior." 

However, in graduate school, it grew increasingly difficult to ignore the evidence that the lives of my female professors were quite different from those of my male professors. In particular, none of the women were married or had children. And they all seemed to work constantly and have “no life” outside of their careers. My favorite quote switched from e e cummings to one I read in a Frank and Ernest cartoon: “Don’t forget, everything Fred Astaire did, Ginger Rogers did backwards and in high heels.”

Undeterred, I was committed to dancing backwards in high heels and having no one notice I was doing anything different from the guys. I set lofty goals, although I prudently started paying attention to differences in how men and women behaved in the workplace. I watched the men and followed their lead. In meetings, I always made sure to sit at or near the head of the conference table. I voiced concerns when they came up without hanging back. Whenever I was at a conference with a large audience, I dashed to the microphone to ask one of the first questions. If a task came up that was usually assigned to a man, I volunteered first.  If the task was one traditionally fulfilled by a woman, I let someone else do it. I made a point of letting people know I loved math and science and computer programming. I was gracious but assertive and direct. I wanted people to know I was smart and competent and could handle any crisis.

Then I had children. Once I was juggling a profession and a family, my confidence faltered.  Regrettably, my first husband was not much of a partner. As a result, I was horrified to realize my reliability was not what it needed to be. My kids occasionally got sick. They had school functions I wanted to attend during work hours. When I traveled for business the logistics were daunting. Sometimes things at home would break and I would have to leave work to take care of them. I found myself joking with more than a mild degree of bitterness, “I guess everybody needs a wife!” My marriage deteriorated and ended in divorce, which felt like a dreadful personal failure on my part. Fortunately, after the divorce, I met a wonderful man who was committed to me personally and professionally. We were deeply in love. He was devoted to my children. He took pride in my career and my professional accomplishments. I chose to "lean in" and we got married. We adopted a child who turned out to have special needs. When faced with this challenge, my husband quit his job to stay at home with our children. My income and commitment to career were significantly higher than his. On his resume his job title for the 8 years he stayed home is "Mr. Mom to three kids." This arrangement was not particularly popular in socially conservative San Antonio, Texas. I found myself frequently rebuffed by other mothers in my neighborhood. I felt disapproval from my kids' teachers.  One neighbor approached me at a block party and with saccharin southern charm informed me that my daughter had been the only child in her class who’s mother had failed to attend a school event. In what I have come to consider to be one of my finer moments, my rejoinder was, “Oh my goodness, I didn’t realize EVERY OTHER child in her class had BOTH parents at the event. Had I known both parents were expected to attend, I most certainly would have been there. Or perhaps you are trying to let me know that my daughter was lucky enough to be the only one with her Daddy there? How cool is that? Thanks for letting me know.” This didn’t help me win any popularity contests in the PTA, but at least the neighborhood “ladies” backed off.

Confident of my husband’s support on the home front, I decided to go into business for my self and opened my own clinical psychology private practice. I strove to be an innovator and never shied away from a challenge, particularly if it was one that was traditionally accomplished by men. As an inveterate techie, I embraced every technological advance that allowed me to run my practice efficiently and effectively. I maintained the same priorities as my male colleagues with the goal of providing excellent quality services while achieving ambitious financial goals and running my business in a way that was consistent with the highest ethical and professional standards.  I developed expertise in practice management for psychologists and mentored early career psychologists. I became a resource for others starting out in private practice.  I served as Treasurer of our local psychological association (BCPA), partly to highlight my abilities in math and business, strengths not typical of most mental health professionals. Then, I served as president of BCPA. When my term was up, I ran for the Board of Trustees of the Texas Psychological Association. When I won my seat on the board, I felt tremendous pride.

Last year, my husband had the opportunity to take a job in Colorado’s Vail Valley. This move would require me to start my practice over from scratch. Once again, I chose to “lean in.” I closed my San Antonio practice. What I had done once, I could do again. We sold our house and boldly moved on to the next chapter of our lives. We’ve been here in the Vail Valley for almost a year. I’ve continued to work with some of my San Antonio clients online while establishing my new practice in Eagle Colorado. I’ve been marketing my practice and networking to get to know my new community.  I’ve also been doing a lot of professional writing and participating in psychology at a national level. So far, everything is going well, even better than I had envisioned. This month, I was asked to serve as Treasurer on the board of the local suicide prevention coalition. I feel very proud.

My advice to female colleagues and clients appears simple on the surface. It mirrors the message of Sheryl Sandberg’s new book “Leaning In.” Be bold. Speak up. Aspire to greatness. Take risks. Cultivate equality and partnership at home. For the time being, we must take our professional lead from what works well for men, while remaining personally grounded in what it means to be a woman. We don’t have to pretend to be men, but we must embrace the standards of success in our culture as currently defined by men.  We must insist on our “place at the table.”

But...watch out world! After a 20 year hiatus, change is in the air and great things are ahead. “Miracles are to come and I believe in a remembrance of miracles.” It turns out to still be true, after all these years. Who would have guessed?



Sunday, February 24, 2013

Yes, There's an App for That: Useful Apps for Psychologists and other Mental Health Practitioners


If you've been wondering if there are any good apps available for use by mental health professionals, I have good news for you.  Here is a list of some top rated free smart device apps used by psychologists and other behavioral health care professionals. The choices come from recommendations made by psychologists on the APA Division 42 (Psychologists in Independent Practice) Listserv. I’ve downloaded and tested all of these app so I know they do what they promise and are easy to use. All of the apps on the list are available free from Apple’s App store and iTunes for use on iPhones, iPads and iPod touch. Some of them are available for other devices as well:

3D brain is a really elegant app that lets you navigate a three-dimensional graphic of the brain on your device. It can be very helpful for refreshing your knowledge of neuroanatomy as well as serving as a useful reference tool for helping patients and their families understand and visualize the brain structures impacted by neuropsychological trauma and injury. FREE 

Co-Occurring Conditions Toolkit is a resource published by the National Center for Telehealth and Technology to help clinicians identity common co-morbid conditions in mild TBI patients. FREE

PAR Assessment Toolkit is a utility produced by the psychological test publisher PAR as a handy reference for psychologists and other mental health practitioners who administer standardized tests. Features include a graphic of the normal curve with conversions, a stopwatch function, age calculator and compliance calculator. FREE 

Psych Drugs provides a comprehensive reference for reputable information about the major classes of psychotropic drugs including SSRIs, anitpsychotics, mood stabilizers, and ADHD, insomnia and anti-anxiety medications. It includes generic and brand names, class, indications, dosages, half-life and side effects.  FREE

PFA Mobile is a Psychological First Aid Tutorial developed by the University of Minnesota School of Public Health to provide a convenient resource for first responders and mental health professionals providing assistance following a traumatic event, natural disaster, emergency or crisis. FREE

Medscape from WebMD is a popular and well-respected medical resource app used by millions of health care professionals.  It provides comprehensive reference data about prescription drugs, diseases, conditions, procedures, medical terms and medical calculators (like BMI). An added feature is daily updates about medical news and critical alerts. It also allows searchable access to Medscape News and MEDLINE databases. FREE

ICD 10 Lite 2013 gives you convenient free access to the complete ICD 10 right on your iPad or iPhone. FREE

Check out my website: www.drjillsquyrespsychologist.com

Saturday, January 19, 2013

Lessons From Sandy Hook: Put A Psychologist In Every School Before That Armed Guard


I was glad to see Don Roger's column "Mass Murder's Myths" in my local paper, the Vail Daily on 1/18/13. 


The article does an excellent job of clearly explaining some key points about risk, safety and the homicide rate.    As a psychologist, I especially appreciate Jeff Mariotte's quote "Put a psychologist in every school before that armed guard."   Because mental health services are often undervalued, it might actually cost fewer tax payer dollars to add psychologists to school staff than it would cost to hire full time armed guards. 

Upon reflection, maybe it could turn out to be quite a shame that most psychologists are opposed to "packing heat". At the rate things are going it wouldn't surprise me to hear someone suggest that the most economical option would be to hire armed psychologists.  When they aren't counseling students they could function as security personnel. Now, that would convey an interesting message to school children, wouldn't it? 

On a serious note, I feel privileged to practice in a profession that has so much potential to make a positive difference in people's lives. We will never know how many mass murders never happened because a potential assailant was helped by a psychologist before things got to the breaking point. As discussed in the column, we do know that mass murders have happened with armed security personnel on site. I'm pleased to see a dialog about adding psychologists along side discussions about having teachers carry concealed weapons and requiring armed guards in every school.  

Of course, there was a psychologist on staff at the Sandy Hook School and sadly, she was one of the victims. My entire profession is very proud of the effort she made to intervene with the shooter, even though it cost her her life.  Psychologists may not carry guns, but we carry the ability to help people who are troubled and improve lives. And as evidenced by the actions of Mary Sherlach, the school psychologist killed at Sandy Hook School that day, we can be pretty brave too.


Friday, January 18, 2013

Redefining yourself and embracing possibilities or why exactly did I move from Texas to Colorado anyway?


This spring, my family and I moved to our own little corner of paradise. After 22 years in San Antonio Texas, I relocated to Eagle Colorado, a small town in the Rocky Mountains near Vail. We’ve been here for almost 9 months. I still wake up each morning with a smile on my face and the vague desire to pinch myself to prove I’m not still asleep and dreaming.  “Yes, I REALLY do live here.  WOW!”

When I was young I thought a lot about where I wanted to live someday. My dream was to live someplace with no winter where professionally I could be a “big fish in a medium sized pond". I also wanted to have a really great house, something I came to jokingly refer to as "house lust."  Of course, I also wanted (among other things) a wonderful husband, wonderful kids, wonderful friends, good health, money in the bank and career success.  But this second list was more general because it wasn’t location specific.  

I knew I couldn’t have everything on my list if I stayed in California.  San Antonio appeared to fit the bill reasonably well so I moved there in 1990.  Over time, I found myself growing tired of the constant heat, the rather generic suburban life style and engaging professionally in that “medium sized pond”.  It was time for a little soul-searching and I began re-evaluating my dreams.  I’d always thought of myself as a beach person.  When I lived in California, I was only a short bike ride away from the Pacific.  Of course, when I settled in San Antonio, I had to make peace with the fact that it took much more effort and planning than hopping on my bicycle to get to the coast.  I came to accept that while I did indeed love the ocean, it was pretty easy to visit wonderful beaches so it was perfectly fine not to live near one.

 I found myself waxing nostalgic about fall and spring and bright clear winter days.  In particular, I yearned for the crunch of leaves underfoot and cool autumn nights hinting of a winter that was just around the corner.   I missed the warmth of toasty fires in the fire place, the wonder of snow flakes falling, the fresh clean smell of coldness and the pleasant feeling that comes when chilly cheeks begin to warm upon stepping into a heated house.   I longed for the promise of a spring filled with young plants emerging from cold damp soil, gentle rain, burgeoning flowers and that clean fresh scent of newness that permeates springtime air.  I missed the comforting rhythm of the seasonal march and the pleasant anticipation of the changing weather, activities and scenery that come with each new season. I came to realize that I was ready for four seasons again, so long as winter wasn’t bitterly cold. I’d always loved playing a mental game in which I would ponder questions like, “beach person or mountain person”? Well, I’d enjoyed the beach when I was young, now I wanted the mountains.  Specifically, I wanted scenery and skiing.  

The other locale question I’d often asked myself was “urban vs rural.”  When I was a child, living in New York City, I had always dreamed of living in a pretty suburb or a small friendly semi-rural town.  When I made my decision to move away from Los Angeles in my 20s, San Antonio had seemed to offer a very nice compromise.  It is a big city that feels like a small town.  We were fortunate enough to live close to where we worked with woods in back of our house and a park with hiking and biking trails just one block away.  But, it was still very suburban in what I eventually came to see as rather bland. I was ready for something a little more rural where I could be closer to nature.  I’d never lived in a small town but  I’d always been charmed by them. I am very happy to be living in one now. So far, its all I had hoped it would be.

Making a life transition of this magnitude involved a great leap of faith.  We had comfortable lives and successful careers in San Antonio.  Sometimes though, you have to take a chance and try something new.  I don't recommend taking foolish and ill-consdered risks. But, I also don't recommend sticking to what you know simply because its comfortable and you've never made the effort to question where you stand and consider alternatives.  Ideally, you should be happy where you are, but you should still maintain your sense of possibility and wonder. Be open to options you haven't yet considered.  And if all roads seem to point in the direction of change, be brave and take a chance.  At the end of their lives, most people don't regret the things they did, they regret the things they didn't do.  So dwell in possibility and try something new if it seems right for you, even if it involves risk and change. Of course there are no guarantees in life, but if your experience turns out anything like mine has, you will be so glad you did.


Friday, December 14, 2012

How to talk to your kids about tragedies like the Sandy Hook Elementary School shootings


My heart is breaking for the children, families, community members and professionals affected by the tragic shooting today at Sandy Hook Elementary School in Newtown Connecticut.  Why horrific events like this occur is a complicated issue for another day.  Right now, many parents, teachers and loved ones are faced with explaining what happened today to the youngsters who trust them.  Here are some suggestions.

First of all, turn off the news when your kids are around.  Young children are not equipped to make sense of the ongoing news coverage of tragedies like this one.  In fact, if YOU are having trouble coping with something you see on the news, you can be sure your children will have trouble with it too.  Little kids often can’t tell the difference between what is real and what isn’t on television.  Also, because a child’s sense of time and reality is different from adults, a child watching ongoing news coverage may fail to understand that the terrifying event has ended.  The child may think the shootings are continuing and may be confused and upset about why adults and police are doing nothing to stop it.

Toddlers and preschoolers will rarely comprehend what has happened so it’s usually best to only discuss traumatic events if your child spontaneously brings them up.  Very young children’s ability to tell fact from fiction on television is very limited and even very tragic events that don’t directly touch their lives are unlikely to effect them very much.  However, their emotional radar is very sensitive so they may pick up on your sadness, grief and horror.  If you are feeling emotional don’t just brush it off.  You might explain to your child that something sad has happened and you are feeling sad about it but you will be OK.  Accept a comforting hug, the loan of a favorite stuffed toy or cup of water offered by your child and let them know they are helping you to feel better.

When discussing traumatic events with school aged children it’s important to consider your child’s developmental level.  Your child will usually give you clues about how much they can handle.  Children do need to understand that there are bad people in the world and sometimes those bad people do bad things that hurt people.  If your child doesn’t bring the topic up on his own, you might start out with a general statement, such as, “A bad thing happened at a school in Connecticut today. Have you heard about it?” It’s important to listen carefully to your child’s answer.  Don’t hurry the conversation.  Maintain good eye contact and use hugs and other kinds of touch for comfort.  Answer any questions they have as gently as you can. Don’t lecture or provide excessive detail but strive to be as honest and direct as you can.

Allow your child to talk out their worries and concerns and provide responses that will help your child feel safe, secure and taken care of. Avoid making promises that you can’t keep but be as reassuring as you can.  The conversation might go something like this: Child: “Why would someone go into a school and shoot up a bunch of little kids? Schools are supposed to be safe!  Why didn’t the police and teachers keep him from hurting those kids?” Your responses might be “Most people are good and most people would never harm a child or shoot anybody.  There are bad people who sometimes do bad things.  Often there is something wrong with these bad people but sometimes nobody knows what’s wrong with them until it’s too late. Most of the time, adults keep children safe and nothing bad happens to them.  Schools are usually very safe and it’s very rare for any child to be harmed in a school.  Teachers and principals do everything they can to take care of school children and keep them safe.  Policemen usually keep bad people from hurting other people. The bad things that happened today are very unlikely to happen here.  I will do everything I can to keep you safe and prevent bad things from happening to you. It’s also important to think about all the good people today who did great things to help.  Most of the children and teachers were not hurt.  The police came and did a good job today. Do you have any worries about your own school or your teachers or friends?” Listen to the child’s answer.  Then ask if there is anything they would like to do to help the children families and people in the community where the shootings occurred.  You and your child can draw and mail condolence cards, send money or toys, or light a candle and say a prayer. With the holidays upon us, you also might discuss if there is anything you and your child want to do to contribute to the victim’s families for the holidays. Children have very generous hearts and helping them help others can be a particularly beautiful way for them to cope with tragedy and help themselves as well.

Your child may regress. Children may start wetting the bed or having nightmares.  Handle these occurrences calmly and provide support and comfort.  Encourage the use of “transitional” objects such as blankets or stuffed toys if they help the child feel safe and secure.  If your child starts having angry outbursts or tantrums, be as patient as you can and help the child understand their feelings and talk them out. Violence or aggression is not acceptable and should be discouraged and appropriately consequenced in a way that is consistent with your values and family rules.

Older kids and teens may raise some very difficult questions.  If you don’t know how to answer a question it’s OK to admit it.  Moral, spiritual and faith-based discussions and prayers can be very helpful and comforting. If you are unsure how to handle a situation have the child talk to a counselor or religious leader about their concerns. You can still be a loving caring parent without having all the answers! You aren’t required to know how to handle all situations but you are responsible for finding the resources your child needs when you aren’t sure what to do.

It’s always a good idea to discuss safety issues with your children.  To effectively address your child’s fears and worries, have a discussion about how they can respond if something bad happens or if they find themselves in a dangerous situation.  Be practical and realistic. While you don’t want your child’s response to trauma to be a life ruled by fear and worry, you do want a child who knows how to keep him or herself as safe as possible in a world where bad things sometimes do happen. We all want to raise children who make good decisions and know how to stay calm and handle adversity well.   

Be sure to bring the focus back to the positive aspects of family, community, comfort, caring and faith. Draw the child’s attention to all the heroes of the day. Help your child do something positive and constructive to help the victims.  Teens in particular may also be interested in participating in political or community action to help prevent future re-occurrences of similar events. Artistic or written self-expression and music can help your child process the experience and the deep feelings it may have evoked. Religious services, vigils, memorials and community ceremonies can be very comforting so participation should be encouraged if the child wishes.        

Sadly, coping with your child’s reaction to traumatic events can be a long-term process.  If your child has been directly affected by tragedy, expect ongoing conversations.  Your child will be unable to process everything you tell them the first time they hear it.  Be open to your child’s feelings and reactions.  Validate their feelings. Listen, give lots of hugs, provide comfort and have confidence that things will get better.  Most children are resilient so with love and the right kind of support, they will be fine.