Anxiety, self-harm and suicide are rising, finds survey of school leaders and teachers in England
More than eight out of 10 teachers say mental health among pupils in England has deteriorated in the past two years – with rising reports of anxiety, self-harm and even cases of suicide – against a backdrop of inadequate support in schools.
In a survey of 8,600 school leaders, teachers and support workers, 83% said they had witnessed an increase in the number of children in their care with poor mental health, rising to 90% among students in colleges.
Many described a sense of helplessness in the face of the crisis. One said it was “like a slow-motion car crash for our young people that I am powerless to stop and can’t bear to watch or be part of any more”.
Others complained that real-terms funding cuts in schools were making it harder to support pupils in need, with fewer support staff available. “We are at a crisis point with mental health,” one respondent said. “Much more anxiety, self-harming. Three suicides in three years in my school alone,” said another.
The survey of members of the National Education Union before their conference in Liverpool this week also asked about the support available in schools to pupils in distress.
Fewer than half said their school had a counsellor, three out of 10 (30%) had been able to access external specialist support such as NHS child and adolescent mental health services (CAMHS), fewer than 30% had a school nurse and only 12% had a “mental health first aider”, as favoured by the government.
More than a third of respondents (37%) had training in the past year to help with supporting young people with mental ill health, but there were complaints that it was often inadequate and ineffective. “Mental health first aid is a lip service,” said one. “Seven members of staff trained – nothing we didn’t already know and it does not make us mental health practitioners. Massive myth.”
There were also harrowing accounts of the suffering among pupils. “Sats pressure and general expectations are taking their toll on more vulnerable pupils,” said one respondent, adding: “We have nine-year-olds talking about suicide.”
Another said: “I am currently working with 15 children who have been bereaved, have anxiety, have PTSD or a parent with a terminal/life threatening illness.”
School staff who took part in the survey were also asked to pinpoint what hinders them from properly supporting young people experiencing mental health issues. They blamed real-terms funding cuts (57%), cuts to teaching assistants (51%) an “exam factory” assessment system (53%) and problems accessing external support services such as CAMHS (64%).
The government has made children’s mental health a priority with additional funding, and a new compulsory health education that is intended to teach children how to look after their mental wellbeing and recognise when friends are struggling.
The Department for Education said: “We are investing more in mental health support with an additional £2.3bn a year being spent by 2023-24. This means that by 2023-24 an extra 345,000 children and young people up to the age of 25 will benefit from a range of services, including new support teams that will provide additional trained staff to work directly with schools and colleges.”
• In the UK, Samaritans can be contacted on 116 123 or email email@example.com. You can contact the mental health charity Mind by calling 0300 123 3393 or visiting mind.org.uk
When he was four years old, Chris had a piece of blue cloth he took everywhere with him, which he called Boo-Boo. Now 60, a retired teacher, husband and father of three adult children, he still remembers the feeling of safety he found when he gently rubbed the soft fabric against his face or between his fingers. “My Boo-Boo provided me with the comfort and security I craved. I wanted it with me, a bit like I wanted my mum with me all the time when I was little,” he says.
Shortly before Chris’s first day at school, his mother told him that he could not take his Boo-Boo with him and that he should throw it into their fire. “I can see it now, the lounge and the open fire, my mum telling me that I had to throw this Boo-Boo in. I couldn’t have it any more, I had to grow up. I can’t remember whether I cried or not, I can just feel the anguish. I had a sense of loss, an emptiness, without understanding.”
This piece of cloth had meaning and power and was always with him, whether he was in bed, walking around the house or playing with friends – “a bit like Linus”, he says. It was through Linus, the best friend of Charlie Brown and the younger brother of Lucy van Pelt in the comic strip Peanuts, that the cartoonist Charles M Schulz popularised the term “security blanket” – Linus was rarely seen without his.
From the Schulz Museum in California, the cartoonist’s widow, Jean, tells me that this idea came from her husband’s youngest child, Jill, who used to carry a blanket everywhere. “In fact, she would get out of her bed and sleep curled up on the floor with her blanket outside of the parents’ room,” she says. “So, that’s kind of sweet – talk about security.”
The exhibition Good Grief, Charlie Brown!, on display at Somerset House in London until 3 March 2019, shows that Schulz had a profound understanding of loss, childhood and the human condition. His depiction of the attachment Linus feels for his security blanket touched something in his readers – and in Guardian readers, too. When we asked readers about their favourite earliest possession, we received stories and photographs of teddies and blankets that had been literally loved to bits.
Catherine Jones, 45, from Hull, has Teddy, whom she was given in her first year of primary school. Ian Robertson, 50, from Whistable in Kent, clung to Panda “even after my brother chewed one of his eyes out and spat it from the family Vauxhall Viva as we were heading up the M6”; he now occupies the best chair in his house. Rachel, 45, from Farnham in Surrey, was given Dog after her grandmother died, so he reminds her of precious family ties.
The origins of Ann Bradley’s Teddy are lost in family lore – it was a gift from either her mother or her grandmother – but she has gone on to comfort the 58-year-old from Swindon, as well as her daughter and now her new granddaughter. Flora, who is originally from Scotland and lives in London, has had a collection of muslin cloths, or Bubbys, for 25 years. She does not sleep as well without them, so she cannot see herself “parting ways with my beloved Bubbys any time soon”.
Linus’s security blanket made its first appearance in Peanuts on 1 June 1954, three years after the paediatrician and psychoanalyst Donald Winnicott wrote his seminal paper on these “transitional objects”, as he called them; he would later ask Schulz for permission to use Linus’s blanket as an illustration of his theory.
The transition in Winnicott’s “transitional object” refers to the shift every infant must make, as he wrote, “from a state of being merged with the mother to a state of being in relation to the mother as something outside and separate”. Angela Joyce, the chair of the Winnicott Trust and a fellow of the British Psychoanalytical Society, explains that, for Winnicott: “There isn’t much distinction, from the baby’s point of view, between the self and the other; it’s a very merged-in space.” But as the baby develops, as his or her body, memory and interests in the objects and people around them mature, “many choose something that becomes special and is used at times of separation”.
A transitional object tends to be chosen in the first six months of life and to have qualities reminiscent of the mother: it is soft; it can be stroked, cuddled and bitten; and, on a symbolic level, it links to maternal care. This helps to smooth the edges of the mother’s absence. As gaps between feeds grow, Joyce explains, “space opens up between baby and mother, occupied by this special object”. Possessions such as Chris’s Boo-Boo help an infant to navigate the experience of difference and separation from the mother, inside whom they spent the first nine months of their existence, so that (with apologies to the Spice Girls) one can become two.
Winnicott also described it as “the first ‘not me’ possession”, but often the boundary between the self and the other can seem porous – as it did for Mike Graham. Graham, 72, is a retired teacher, pub landlord, political adviser and stained-glass window-maker, who lives in Cumbria with his wife and Ted, “not a teddy bear as such, but a green panda”, he explains.
“I was born just after the war when things were tight,” he says. “Because my mother couldn’t afford a teddy bear, one of her nursing colleagues made Ted out of the only material she had – a kind of green hessian, with black felt eyepatches. At present, he looks very dishevelled.” He has been in Graham’s life for seven decades: “He was a very, very significant part of my childhood for a while and he’s part of me.”
Until Graham was about eight, he chatted to Ted every night in bed. “I can remember I really thought I talked to him. He’s a superb listener.” He would tell him significant things that had happened that day, as a way of sorting things out in his mind, before falling asleep hugging Ted.
Although Ted faded into the background of Graham’s life as he grew older, his significance has never waned and reasserts itself at times of distress. Graham was living in the West Indies with his first wife, a diplomat, when he found out she had had an affair. He swiftly left the country. “I was very upset. I packed a suitcase – it wasn’t even full – and I packed him. I didn’t get the rest of my belongings for months. But he was a part of me and it was important that I didn’t lose him,” he says. Ted still represents “stability and durability. Things may change, but he won’t – and that’s still a source of comfort when times are difficult.”
In Winnicott’s theory, these possessions are about more than comfort: they lead to play, which is fundamental to the development of a healthy mind. In what he calls “the intermediate space” that opens up between mother and baby, occupied and stretched by the transitional object, the child’s imagination and creativity grow. “It is good to remember always that playing itself is a therapy,” Winnicott wrote.
Saskia, 32, works in IT in the south-east of England. When she was a child, her mother came home late from work one night with a rag doll, whom Saskia named Annie. “I quickly pulled off her hat, so I can only ever remember her being bald, and over a few years she also lost one eye,” she says. “I used to carry her around by her neck, so her head came off a few times and my nan had to sew it back on. She’s not the prettiest toy. They say, in [the Margery Williams children’s book] The Velveteen Rabbit, that once you’ve been loved you become real and you can only be ugly to those who don’t understand. That’s how it is with old toys.”
Saskia was happy and playful at home, growing up in a loving and supportive family, but school was difficult. She was highly academic, but struggled socially. In her 20s, she was diagnosed with Asperger syndrome. Annie was not only a comfort, Saskia believes, but also helped her develop her artistic side. “I was a quirky, creative kid. I talked to Annie, played games with her, wrote stories,” she says. This kind of play, she thinks, teaches children “to see the world through the eyes of someone else. I always wonder if the toys and stories helped me with empathy, which is difficult for a lot of autistic people.”
While Saskia and Graham no longer cling to Annie and Ted as they used to, Anindita Roulet’s need for her Kaporji remains as strong as ever. Roulet, a 46-year-old English tutor, lives with her husband and her two teenage children outside Paris. She was born in London but moved to India to live with her grandparents in the east Indian city of Jamshedpur when she was one year old, because her parents were struggling to manage. She has no memories of it, but says: “I’ve seen some photos and I certainly look like I was having a whale of a time. It’s quite an idyllic life and a deeply affectionate family. I suspect I was spoilt rotten.”
She explains how her Kaporji, which she translates from Bengali as Sir Cloth, came to be. “During that year in India, I slept beside my grandmother every night and she wore a white cotton sari loosely wrapped around her. It was the train of this sari I held on to as I slept.” When Roulet’s parents came to bring her back to London, the separation from her grandparents was painful for the two-year-old. But her grandmother packed a couple of cotton saris in her suitcase and Roulet’s mother cut out a large square for her to take to bed.
So it continued: “After one piece disintegrated, another would replace it – always a piece of my granny’s sari and no one else’s,” she says. “My mum would stick pieces in the washing machine to get it softer and softer, so that when I needed a replacement it wasn’t too stiff.” Her memory of the year spent with her grandmother faded, but her attachment to her Kaporji did not. When a sari ran out, her grandmother would send more or they would be collected during visits back to India every few years. “I’m still sleeping with it. I know it’s ridiculous, at 46, but I can’t quite give it up,” she says.
“It’s very soft and I hold it in a fist in my right hand. My fingers sink into it and it feels really reassuring. Most nights, I will lose it for a moment as I loosen my grip in my sleep, but I always retrieve it and wake up with it in the morning,” says Roulet. Her husband thinks it is hysterical, but she has never let any man come between her and her Kaporji. “I very clearly explained I’m not clingy when it comes to the person sharing my bed, but definitely when it comes to my Kaporji. I don’t think I left any room for argument,” she says, laughing.
She did not remain as close with her grandmother, whom she saw only every few years and who has since died from dementia, but they always shared this bond, although they never spoke of it. “At the end, she was forgetting things, but every time I visited she would open her drawer and take out a sari. She never forgot that,” she says. “I’m very grateful for the fact that I have this connection, this thread – several threads – that run through our lives together.”
The meaning of these transitional objects can resonate in adulthood for others, too. Occasionally, Graham will talk to Ted, who now sits on a bookcase near his chair. “Now and again, something will happen of significance and I’ll sit him on my lap and say: ‘What do you think about that, Ted?’ Or it can be a silent chat. I don’t have to say any words. It sounds daft, but I’m not ashamed of it; I realise what a part of me he is,” he says.
For Saskia, it is the memories evoked by her doll that have significance. “My mum working so hard, and late, still thinking of me on her way home. Family holidays, stupid games with my brother. My nan, who had arthritis, knitting her a scarf and trying to sew her head back on,” she says. “The older you get, the more meaningful these objects become in a different way.”
Even Chris, who lost his Boo-Boo before he was five, still carries a tissue around in his pocket and touches it for comfort from time to time. As our conversation is about to come to an end, he is suddenly startled by a memory. “It just flashed in front of me,” he says. “My youngest daughter, her favourite soft toy was a penguin. When she was about 10, we were walking by the seaside in Bournemouth and, unbeknown to us, she dropped this soft toy. About five minutes later, she said: ‘I’ve lost my Pingu!’ We were looking everywhere and all of a sudden I saw it drifting out to sea. My daughter became really distressed – she was saying: ‘I love you, Pingu, don’t go, don’t go, don’t go!’
“It was February and it was snowing and I had no towel. I stripped down to my underpants and went into the freezing sea; I swam out there and got it back, because it all came rushing back to me – I understood, I just knew where she was. Maybe I was reliving that loss, of throwing my Boo-Boo into the fire. Until this conversation, I’d never put the two together.”
The meaning of these objects lives on long after we have outgrown them – whether we realise it or not. What made Linus compelling, according to Schulz’s widow Jean, is that, through him, her husband was able to indicate that security is not just about a little child with a blanket. “There is one comic strip that I love,” she says – one that is on display in the London exhibition. “Linus is fighting with Snoopy for his blanket and when he finally gets it back, he says something like: “Security must be won over and over and over again.”
Compassion comes from the Latin word compati – to suffer with. It doesn’t just mean sending someone a Hallmark card with a baby pig wiping away a tear on the front and, inside, a message saying how sorry you are. That would be filed under “pity” or “patronising”. With compassion, the first step is to feel the pain of another; the second big step is to be motivated to relieve it. It’s the will to act more than just feeling someone else’s pain – to actually do something about it.
If I’m in pain and you just feel my pain, it’s not going to help my situation. How can you possibly help me if you’re in so much pain from my pain? Now I’ll need to help you to cope with my problem. Also, we sometimes jump at the chance to feel someone else’s pain for the wrong reasons; we don’t want to feel our own so we distract ourselves with theirs.
But when being compassionate, there are no rules. Any time you’re moved to do something to help, that’s enough. Even if you don’t do anything but are by someone’s side and stay present in the midst of their agony, that’s enough.
Yet if we don’t learn to be compassionate to ourselves first, we can’t feel compassion for others. A mother has to teach her child to soothe themselves, but she can only do that if she can soothe herself; otherwise, there will be two people drowning. Most people wince when someone talks about self-compassion. We’re so used to whipping ourselves with our own critical thoughts – “I should have … I didn’t…I’m a loser” – that we’re the last people we would throw a bone of kindness to. Some of us treat our pets better than we treat ourselves.
Once we feel unsafe, there’s no more Mr Nice Guy. We become terrified that, if we show any kindness, we’ll be taken advantage of. That’s why, in our culture, being nice isn’t highly rated. Toughness is in vogue and has been for a very long time. This could be why we have a fascination with other people’s misfortunes, why the videos that get a billion hits on YouTube are usually of a baby falling into a chocolate cake or “kitty gets pushed” (my favourite). In truth, we’ve always loved watching other people’s pain, from gladiatorial contests at the Colosseum to the humiliation and shame we see on The X Factor – which isn’t a million miles from a lion eating a slave. At least the slaves didn’t have to sing.
TV reality shows are based on slinging out the loser and cheering as they endure the walk of shame – out of the building, never to be heard of again. (Unless they humiliate themselves in some new way, such as eating a cockroach on reality TV – that usually guarantees a sure-fire come-back.) Compassion doesn’t win many viewers.
We need to learn how to do compassion. It won’t grow by itself in our “every man/woman for himself/herself” world. If we don’t learn it, we’ll go straight back to our more savage, animalistic behaviours. Don’t forget that millions of years ago we evolved from reptiles. ( I’m sorry if there are Mormons reading this, but it’s true.)
I was in Cape Town recently to teach mindfulness to young girls from townships who had been badly abused. As soon as I started, I sensed that they were uneasy and the last thing they wanted to do was observe their thoughts. Mindfulness, in my opinion, isn’t appropriate for severe trauma. When the trauma is resolved, or has eased off, you can try it. Otherwise, it can reopen the wound.
I decided to change tack and asked if any of them had ever had a makeover. They hadn’t, but excitement ricocheted through the room. I came back the next day with my makeup. There they all were, lined up and totally focused, any sign of agitation gone. Here was something that made them feel important, as if they mattered. When I did their lipstick, I’m sure that touching their lips would have normally flipped them out. This was probably the first time someone had touched them without taking advantage of their innocence. They all took selfies and I could tell they didn’t just look but felt beautiful, maybe for the first time. I don’t do a lot of compassion in my life, but this really gave me a hit of happiness. I didn’t realise it was so easy.
ASTORIA, NEW YORK—Inside the Sesame Street studio in Queens, Elmo is playing “monsterball” with his friend, a new Muppet named Karli who has lime-green fur and two ponytails. (Monsterball, for what it’s worth, appears to be the same as soccer, but with a furry ball.) Puppeteers, with their hands raised high and their heads cranked to the side to stay out of the camera’s shot, run around, making Elmo and Karli kick, laugh, and throw the ball.
Outside, it’s a chilly gray December Monday, but on set the monsterball park is brimming with plant life, and butterfly puppets held up on long metal wires flap their wings. Looking on are Elmo’s dad—yes, he has a dad now, as of 2006—and two of what Sesame Street calls “anything Muppets,” puppets with no particular character attached that are made as templates and can be adapted as needed. These Muppets—a fuzzy teal monster in an athletic jersey and a gray monster with pink and purple feathers for hair—have become Karli’s foster parents, Clem and Dalia.
In between cheering for Elmo and Karli, Elmo’s dad (whose name is Louie) asks Clem and Dalia: “How has everything been going, since becoming her foster parents?”
Clem hangs his head and sighs. “Changes like this can be really rough for kids. And for adults, too,” he says.
Next to me, Kama Einhorn, a writer and senior content manager at Sesame Workshop, the nonprofit behind Sesame Street, drops her head and mimics Clem. “Things are really rough,” she says in a deep, exhausted voice. This, apparently, is not exactly what Einhorn had in mind.
Between takes, she confers with the puppeteer playing Clem, and gives him a note to pep it up a little. He was being too morose, Einhorn explains to me. That’s not the vibe she wants this segment to have.
In the final version of this video—part of Sesame Workshop’s new set of materials on foster care, released today—Clem’s head is held high, and a measured acknowledgment that sometimes things can be tough gives way to excitement when it’s decided that Elmo can join Karli, Clem, and Dalia for “pizza-party Tuesdays,” because as Louie says, “everything’s better with a friend by your side.”
The foster-care resources—which include an interactive storybook and printable activities, as well as videos featuring Muppets—are the latest in a series of packages that Sesame Workshop is producing to support kids going through traumatic experiences. These online resources—which won’t be featured on the television show—are intended for use by parents and caretakers, and also by therapists, social workers, and anyone else who works with such kids.
Sesame has been making various supplemental-resource packages for decades now, though they started taking their current, online form around 2010. Many of the packages on the site have nothing to do with trauma but are geared toward topics that affect every kid—healthy eating, tantrums, sharing, math. Starting in 2013, Sesame began to focus on tougher topics, starting with a package forkids whose parents are incarcerated. (All of these resources are available in both English and Spanish.) Over the past year or so, the organization has chosen three topics to focus on:family homelessness, the resources for which were released in December 2018; foster care; and substance abuse, the resources for which are slated to come out in October.
Through its Sesame Street in Communities initiative, Sesame Workshop partners with organizations around the country that work with young children. Sesame picked these issues—homelessness, foster care, and substance abuse—because it heard from these partner organizations that they didn’t have many resources addressing these things from a child’s perspective, a spokesperson told me.
“Historically, I think we’ve tended to believe that young children won’t remember or don’t really have the ability to make sense of what’s going on, and therefore it doesn’t impact them. And that’s clearly not the case,” says Phil Fisher, a psychologist at the University of Oregon who studies child development under adversity, and who was not involved in creating the Sesame Street resources.
Keeping the developmental level of the audience in mind,, Sesame Workshop puts a lot of work into conveying these concepts in ways that kids can understand.
Leaders at Sesame Workshop start by assembling a group of advisers, who work professionally on the topic at hand or who have a personal stake in it. The advisers get together with the Sesame team for a focus group and, as Einhorn puts it, “download to us what they know about the topic.” Writers at Sesame take the themes of these conversations and incorporate them into video scripts, activities, and a digital storybook. As the resources take shape, Sesame repeatedly sends them to the advisers for further comment, in a feedback loop that lasts up until the point of filming.
“We spend a lot of time fine-tuning language,” Einhorn told me. “How do our Muppets [portray] it? How do we make it playful? How do we have this light touch for a heavy topic without diminishing the topic?”
When talking to kids about any kind of traumatic experience, experts emphasize the importance of helping them name their emotions and understand that they’re normal. “Just like [how in order] to read you’ve got to know letters, if you’re going to talk about things that have happened to you, you’ve got to have feeling words,” says Ann Thomas, the president and CEO of The Children’s Place in Kansas City, Missouri, a treatment center for kids who’ve gone through trauma. Thomas consulted on both the foster-care package and more general traumatic-experience resources for Sesame Workshop. “They don’t know what this swirly uncomfortable stuff is. It’s like a knot inside of them. We have to start untangling that knot.” Sesame’s videos, Thomas says, not only give children those feeling words, but they model for adults how to help kids sort through their feelings out loud.
For example, in one of Sesame’s trauma videos, an adult named Alan, the proprietor of Mr. Hooper’s store, does just this for Big Bird, who arrives in the store looking upset. Alan asks how he’s doing, and he replies, “Not too good. I’ve got all these feelings.”
“Are they big feelings?” Alan asks. “Like sad, or angry, or confused? Anxious?” Big Bird responds “yeah” to each emotion. “It’s all those feelings, and they’re all mixed together, and I don’t know what to do!” the Muppet says. Alan goes on to teach Big Bird an exercise of imagining his safe place—his “comfy cozy nest”—in order to feel better.
For each topic, the Sesame writers boil down what they’ve learned from research and heard from advisers into bite-sized phrases such as “big feelings.” Avoiding overexplaining, Thomas says, is also key. For foster care, the takeaway phrases the writers settled on were: “You’re safe, you’re strong, you belong”—which the Muppets sing in song form in one video—and “for-now parents” as a kid-friendly synonym for “foster parents.”
Adriana Molina, an adoptive mom of two children—a daughter, 3, who was formerly in foster care and a son, 10, who is her wife’s relative—has learned to pay attention to the transitions in her kids’ lives. “When [our son] came into our lives, we thought he was going to come for a visit, and he ended up staying,” Molina, the director of Project ABC, a program in Los Angeles that works with young kids and their families, told me. “We didn’t know to give him as many of the words for This is what’s happening, or This is what’s changing.Whereas with [our daughter], she’d only been in one foster home her entire little life. We were able to ease into that process and do some visits in her space. Slowing things down was a very concrete learning” experience, she said.
Molina was an adviser for Sesame’s foster-care resources, bringing both her personal and professional experience to the process. “‘For-now parents’ is a lovely, neutral place to be,” she said. “The language of being in foster care is it’s where you are now; it doesn’t necessarily mean it’s where you will always be.”
But that concept of temporariness is often hard for young kids to grasp, according to Anderson. “Preschoolers have such a limited time frame and sense of past and future,” he said. “And something like homelessness, even if it’s temporary, it might be temporary in terms of months, which would seem permanent to a child. That’s a very difficult thing to deal with.” Ideally, he suggests keeping conversations with very young children in the realm of yesterday, today, and tomorrow. The idea that things are a certain way “for now” and might be different in the future is “not a real reassuring kind of notion because preschool kids really crave stability and security.” But, he says, “it’s honest,” and for kids going through something such as homelessness or foster care, “I guess that’s probably as good as you can do.”
After all, uncertainty creates anxiety even for adults. And trying to shield kids from the uncertainty shaping their lives, Molina said, doesn’t work. “Part of what creates the anxiety is when they’re being told one thing, but they have a sense of something else,” she said.
Thomas adds that if grown-ups don’t explain what’s happening to children, kids will create their own explanations, which might make them feel even worse than the truth. “When bad things happen, it’s very natural [for young kids] to assume they caused it,” she says. “It’s natural to have magical thinking at this age.” Her advice is similar to Anderson’s—don’t lie about what’s happening, even if you have to be ambiguous (telling them they’ll see their parents when they’re “bigger,” for example), and “grounding them back in what’s working today,” Thomas says.
The digital storybook about Karli addresses this magical thinking directly: “A lot of grown-ups are helping your mom,” Karli’s foster mom, Dalia, says in the book. “It’s a grown-up problem and it’s not your job to fix it. None of the bad things that happened at home were your fault.”
No character ever explicitly discusses why Karli is in foster care, but Einhorn told me that the Sesame Street team wrote the character with the idea that her mother is away getting treatment for substance abuse. Karli will be featured again in the substance-abuse resources that are slated to come out this fall, though they won’t reference foster care, and the foster-care resources likewise don’t reference substance abuse.
All the packages are self-contained, so kids won’t need to see both in order to make sense of Karli’s story. Though as Einhorn put it, “trauma is trauma,” and there are some recurring themes in the content. Many of the resources emphasize the importance of relying on a broader community for support. And activities such as breathing exercises or artistic expression show up repeatedly. Karli draws out her feelings in the foster-care storybook, and colors a concentric heart in one of the videos to show that “a heart can grow” with love for her foster parents and new friends, even as she feels sad about missing her mom. In one of the homelessness videos, a Muppet named Lily draws dots on a chalkboard to represent all the people who love her, and connects them to form a heart.
Fisher, the University of Oregon psychologist, looked at the homelessness and trauma resources before we spoke, and said that “the messages that were employed were trauma-informed and evidence-informed, and have been found to be effective.” What’s less clear, he said, is if exercises that are effective in a therapeutic context will still work when delivered through a screen.
That’s something Sesame Workshop is studying—a spokesperson told me that the organization is currently conducting a randomized controlled trial on the effects of their trauma resources, but the results won’t be out until later this year.
“The Muppets can often do what humans can’t,” Einhorn said. “They’ve got this special power.”
I met Molina and her son on set in December when the foster-care segments were being filmed. (Several advisers were invited to the taping.) Her son was shy when I asked him what he thought of the monsterball scene we had just watched. “It’s pretty cool,” he said. He perked up as his mom described to me the process of adopting his sister from foster care, and he interjected a few times to add details to the story. Still, the Muppets made an impression, it seems. Recently, Molina told me that when she and her son got home from the trip to New York, “he spent two weeks trying to perfect his Elmo voice.”
Lady Gaga delivered a passionate speech on mental health and suicide, saying “we are losing a generation of young people”.
The ‘Shallow’ singer addressed the SAG-AFTRA Foundation’s 3rd annual Patron of the Artists Awards, at which she was honoured. Her 23-minute acceptance speech for wining the Artists Inspiration Award covered her own mental health issues, her fears for young musicians and artists struggling to voice their struggles, and her plans to build future programmes.
“We are losing a generation of young people who do not believe that their voices are worth hearing, that their pain has no end,” she said. “And that their contributions are not valuable enough to move the needle in society and culture. We are facing a crisis of epic proportions and the cause of that crisis is our inability or unwillingness to be open and honest about one thing – mental health, today.”
While the singer urged people to focus on kindness, she also noted the reluctance people still have to discuss mental health issues publicly.
“When I give speeches about kindness, people have lively engaged discussions but when I speak about mental health, even or especially when I’m speaking about mine, it is often met with quietness,” she said. “Or maybe a somber line of fans waiting outside to whisper to me in the shadows about their darkest secrets.
“We need to bring mental health into the light. We need to share our stories so that global mental health no longer resides and festers in the darkness. It is dangerous and we know this because amongst other shootings and acts of violence.”
This isn’t the first time Gaga has spoken out about mental health. In October, she penned an emotional essay about the urgent need for more mental health services across the globe – as well as calling for the stigma surrounding mental illness to end.
At the awards ceremony, Gaga set out her plan for a specific mental health programme that doesn’t simply respond to emergency situation or focus on medical answers.
“By the year 2030, I wish for everybody to have their person that they can talk to who is an expert and can help them. I am beckoning for this because it is perceived by many that mental health is only talked about in the midst of crisis or when something needs to be fixed. I want teams in place to provide prevention.
“We need to not only think in terms of doctors, billable hours and hospital stays but protective and preventative care for ourselves and each other, holistically. Do you have a mental health team? Who is on it? Who are the people you can turn to? What are the activities that can reduce our stress?”
She also paid tribute to her mental health team, saying “I have learned now are treatable and I can stop living in fear and begin living with bravery.”
“And after working as hard as I possibly could to achieve my dreams, slowly but surely the word “yes,” “yes,” “sure,” became too automatic,” she continued. “And my inner voice shut down which I have learned now is very unhealthy. I was not empowered to say no.”
Read more at https://www.nme.com/news/music/lady-gaga-speech-mental-health-2400575#TitD8ZBT20RjsFBU.99
Summary: Music specially composed for preterm babies helps strengthen the development of neural networks and may help to limit neurodevelopmental delays often experienced by those born prematurely.
Source: University of Geneva
In Switzerland, as in most industrialized countries, nearly 1% of children are born “very prematurely”, i.e. before the 32nd week of pregnancy, which represents about 800 children yearly. While advances in neonatal medicine now give them a good chance of survival, these children are however at high risk of developing neuropsychological disorders. To help the brains of these fragile newborns develop as well as possible despite the stressful environment of intensive care, researchers at the University of Geneva (UNIGE) and the University Hospitals of Geneva (HUG), Switzerland, propose an original solution: music written especially for them. And the first results, published in the Proceedings of the National Academy of Sciences (PNAS) in the United States, are surprising: medical imaging reveals that the neural networks of premature infants who have listened to this music, and in particular a network involved in many sensory and cognitive functions, are developing much better.
The Neonatal Intensive Care Unit at the HUG welcomes each year 80 children born far too early – between 24 and 32 weeks of pregnancy, i.e. almost four months ahead of schedule for some of them. The vast majority will survive, but half will later develop neurodevelopmental disorders, including learning difficulties, attentional or emotional disorders. “At birth, these babies’ brains are still immature. Brain development must, therefore, continue in the intensive care unit, in an incubator, under very different conditions than if they were still in their mother’s womb,” explains Petra Hüppi, professor at the UNIGE Faculty of Medicine and Head of the HUG Development and Growth Division, who directed this work. “Brain immaturity, combined with a disturbing sensory environment, explains why neural networks do not develop normally.”
A tailor-made music
The Geneva researchers started from a practical idea: since the neural deficits of premature babies are due, at least in part, to unexpected and stressful stimuli as well as to a lack of stimuli adapted to their condition, their environment should be enriched by introducing pleasant and structuring stimuli. As the hearing system is functional early on, music appeared to be a good candidate. But which music? “Luckily, we met the composer Andreas Vollenweider, who had already conducted musical projects with fragile populations and who showed great interest in creating music suitable for premature children,” says Petra Hüppi.
Lara Lordier, PhD in neurosciences and researcher at the HUG and UNIGE, unfolds the musical creation process. “It was important that these musical stimuli were related to the baby’s condition. We wanted to structure the day with pleasant stimuli at appropriate times: music to accompany their awakening, music to accompany their falling asleep, and music to interact during the awakening phases.” To choose instruments suitable for these very young patients, Andreas Vollenweider played many kinds of instruments to the babies, in the presence of a nurse specialized in developmental support care. “The instrument that generated the most reactions was the Indian snake charmers’ flute (the punji),” recalls Lara Lordier. “Very agitated children calmed down almost instantly, their attention was drawn to the music!” The composer thus wrote three sound environments of eight minutes each, with punji, harp and bells pieces.
More efficient brain functional connections through music
The study was conducted in a double-blind study, with a group of premature infants who listened to the music, a control group of premature infants, and a control group of full-term newborns to assess whether the brain development of premature infants who had listened to the music would be more similar to that of full-term babies. Scientists used functional MRI at rest on all three groups of children. Without music, premature babies generally had poorer functional connectivity between brain areas than full-term babies, confirming the negative effect of prematurity. “The most affected network is the salience network which detects information and evaluates its relevance at a specific time, and then makes the link with the other brain networks that must act. This network is essential, both for learning and performing cognitive tasks as well as in social relationships or emotional management,” says Lara Lordier.
Premature baby listening to music.. The image is credited to Stéphane Sizonenko – UNIGE HUG.
In intensive care, children are overwhelmed by stimuli unrelated to their condition: doors open and close, alarms are triggered, etc. Unlike a full-term baby who, in utero, adjusts its rhythm to that of its mother, the premature baby in intensive care can hardly develop the link between the meaning of a stimulus in a specific context. On the other hand, the neural networks of children who heard Andreas Vollenweider’s music were significantly improved: the functional connectivity between the salience network and auditory, sensorimotor, frontal, thalamus and precuneus networks, was indeed increased, resulting in brain networks organisation more similar to that of full-term infants.
When children grow up
The first children enrolled in the project are now 6 years old, at which age cognitive problems begin to be detectable. Scientists will now meet again their young patients to conduct a full cognitive and socio-emotional assessment and observe whether the positive outcomes measured in their first weeks of life have been sustained.
“When people talk, listen completely. Most people never listen.” ~Ernest Hemingway
The chances are good that at some point in your life you had to deal with a loved one who consistently frustrated you. They were caught in a destructive pattern of behavior that made life difficult for them and everyone around them. How do you cope when this happens?
Perhaps you start avoiding them. And when that’s not possible, you choose to check out of any difficult conversation or interaction you’re having with them. You resign yourself to the belief that your loved one cannot and will not change their behavior.
Or perhaps you attempt a more active approach to the situation. You try to analyze your loved one the way a therapist might. You develop what you believe are perfect solutions for their problems and present them in the most convincing way you know how. Then you get frustrated when they reject your sage advice out of hand.
Here’s the thing: It’s not about changing or fixing them; they are your parents, siblings, or partners, after all—not broken machines in need of repair. And the best thing you can do in these situations is to give your loved one the space to expand their capacity for change.
I learned this the hard way with my mother. She’s struggled throughout her life with unchecked anxiety. She’s caught in a pattern of pessimism, which she frames as “realism.”
There’s rarely a day that goes by when she’s not consumed by one worry or another. And once she latches on to a concern, she can’t seem to let it go. It has to run its course. She’ll vent endlessly about her latest worry to any family member who happens to be available.
As a problem solver by nature, I’ve tried to offer advice and suggestions that I believe will help her to deal with her anxiety more effectively. Unfortunately, it’s an approach that has often backfired. My mother can get extremely defensive and lash out in ugly ways when confronted with the negative consequences of her behavior.
I remember a time when I suggested she’d benefit from the support of a counselor or therapist. Her memorable—and intensely hurtful—response was: “Therapy? Look at you! Ten years of talking to a shrink and you’re still a crazy bipolar!”
After a number of these unpleasant interactions, I decided enough was enough. I had to step back if only to preserve my sanity and well-being. I avoided getting into anything but the most mundane conversations with my mother. I didn’t talk about politics, religion, or other potentially divisive issues. And when she chose to rant about the way the world was conspiring against her, I’d tersely say, “Okay, Mom” or “whatever” before recusing myself from the discussion.
But this coping mechanism was only viable for a limited time and had diminishing returns. I certainly didn’t want to see my mother in a near-constant state of emotional distress, trying to swim against an overwhelming tide of anxiety.
I had to do something different than what I’d done in the past. So instead of jumping back into the fray, I paused. I used the time to examine how my behavior in our past interactions contributed to the problem. I took ownership of the part I’d been playing.
I realized that a lot of it came down to the way I’d been listening to my mother. Or, more accurately, the fact I that I wasn’t listening to her. Here’s what I needed to learn: sound listening skills can give a loved one the room to change destructive behaviors that adversely impact their lives—and yours.
Are you listening?
Do you think of yourself as a good listener? I certainly did. Unfortunately, if you’re anything like me, odds are that you overestimate how much listening you do during a conversation.
Here’s a test. The next time you find yourself in a difficult conversation with a loved one, approach it mindfully. When they are speaking, are you really paying attention? Or are you formulating your response before they’ve even finished their sentence?
If you catch yourself doing this, don’t be too hard on yourself. It’s natural to want to share insights and suggestions that we believe will help loved ones in emotional distress. Unfortunately, our caring and concern can become impediments to the best, and often only, help we can offer them—our ability to listen.
When my mother would pour out a tale about her latest worry, I’d too often be preoccupied with crafting solutions for her problems.
Sometimes I’d interrupt in an attempt to keep her from dwelling on negative thoughts. I thought I could save her from getting caught in a downward spiral by offering suggestions for better managing her anxiety; for example, “Hey Mom, instead of fixating on the inevitability of worst-case scenarios, why not concentrate on what’s happening right now?”
I couldn’t understand why my advice was often met by resistance (“That will never work, I know it”) or even defiance (“That’s easy for you to say! You’re not the one dealing with this terrible situation”).
But here’s what I had failed to understand in that interaction and many others: My mother wasn’t asking for advice. She just wanted me to listen. And she absolutely did not want to be lectured about managing her emotional reactions to anxiety.
I learned some important lessons when I took the time to examine my actions, and I knew that my behavior had to change if I expected my mother to embrace change as well. And I needed to start by listening more effectively.
Message Received, Loud and Clear
When my mother is in the grip of anxiety and reaches out to me, I’ve learned to remind myself that in many cases, the less said, the better. It’s about being present, being mindful; this is what listening is all about.
Here are just a few ways to improve your ability to listen to a loved one:
1. Acknowledge and validate.
Sometimes a simple nod of the head can be a powerful and validating signal of support for your loved one. The same goes for a well-placed “Mm-hmm.” These seemingly small acts show that you’re focusing on what they are saying. They also indicate that, at least for the moment, you are prioritizing their feelings over your own. And they are subtle enough expressions to avoid interrupting their train of thought.
I’ve found it helpful to remember that validation does not equal approval. I’ve learned that I don’t have to agree with my mother or approve of her behavior to effectively acknowledge her feelings.
2. Take a breath.
Notice your breath as you interact with your loved one. Are you holding it in as you anxiously await your turn to speak? If you’re out of breath when you respond, it can change your tone and perceived meaning. There’s a good chance you’ll sound harsher or more impatient than you intend to be.
In the past, I’ve noticed myself running out of oxygen in the middle of challenging conversations with my mother. I’ve since learned to take it as a sign that I need to take a step back and bring myself into the present.
3. Sometimes the best advice is none at all.
It’s not easy to resist the temptation to dispense advice to a loved one who we perceive as needing the benefit of our counsel. But the danger of offering unsolicited advice to a loved one is this: it shows a lack of faith in them. And the more advice you dispense, the more you are suggesting that your ideas and solutions are better than any they can come up with themselves. You also risk condescension, no matter how noble your intentions may be.
My well intended but untimely suggestions for my mother came across as directives and judgments. My mother interpreted them as challenges to her competency and doubts in her ability to manage her life. I was indirectly telling her that I didn’t believe in her capacity to change.
As I learned, our faith or lack thereof in our loved ones changes our behavior, often in significant yet subtle ways. And a change in our behavior can lead to a corresponding change in our loved one. When they know we are in their corner, they begin to develop a belief in their ability to grow.
Seeing is Believing
I’ve seen some encouraging signs of growth in my mother since I decided to examine and adapt my behavior. While she still struggles with anxiety, she’s taken some big steps toward better managing it. She’s taken up meditation. She has a yoga practice. And yes, she’s even been willing to talk to a therapist.
I certainly can’t claim credit for her decision to take her emotional and mental health more seriously. But I don’t think it’s a coincidence these developments have come during a period in which I’ve given her the room to change.
So pause. Take a breath. Relax. And the next time a loved one is about to drive you out the door, give them some space to speak and express their emotions. Listen and be present. Trust your loved one to do the best they can at that moment. Embrace the notion that just like anyone else, they can change and yes, they even have a right to do so. Just like you.