My interview with Bay Area Parent magazine

Bay Area Parent magazine published an article about my mindfulness lessons for families with children with Oppositional Defiant Disorder in their Sept. 2012 issue. Below is a transcript of the complete interview for readers who want the full context.

1. Please introduce yourself. How did you get into your line of work? What are your credentials? Where do you currently live and work?

Ellen McCarty, mindfulness instructor, www.ellenmccarty.com

An SFBA native, I earned my undergraduate and graduate journalism degrees in four years at Northwestern University. During that time, I began practicing meditation and yoga to cope with my stress-level. After graduating in 1997, I accepted a marketing job in Switzerland and signed up for a 1-week retreat with Buddhist monk Thich Nhat Hanh in Plum Village, France. That week changed my life. I had dedicated 16 years of my life to understanding the academic world and at that point, I decided I wanted to invest more time in understanding myself. A year later in 1998 I ordained as a temporary Buddhist nun in Burma. For me that ordination was secular in nature. As I saw it, I was beginning my studies in eastern psychology – an ancient understanding of the human mind. I spent 70 days on silent retreat and then returned in 2000 for another 21 days. When I returned to the States, I taught English to Burmese monks living in San Jose, Calif. and continued my meditation practice under their guidance. Working with children with severe emotional problems happened by accident. As a freelance journalist in my 20s, I also worked as a part-time nanny to supplement my income and discovered I had an ability to reach children whom others considered unreachable. I developed a secret code game for them based on my own mindfulness practice to help these children understand their minds. I now work for the Oakland-based non-profit Mindful Schools. I also teach my own private lessons and workshops. To date I’ve taught mindfulness to more than 700 children in the San Francisco Bay Area including those with Oppositional Defiant Disorder.

2. Can you please describe mindfulness for those of us who don’t know what it is?

Mindful Schools’ definition of mindfulness is “a particular way of paying attention. It is the mental faculty of purposefully bringing awareness to one’s experience. Mindfulness can be applied to sensory experience, thoughts, and emotions by using sustained attention and noticing our experience without reacting.” Mindful Schools also posts on their website the power of this practice: “Mindfulness creates space, changing impulsive reactions to thoughtful responses.”

I would add that mindfulness is not about becoming perfect. It’s not about being peaceful 100% of the time. Mindfulness is about knowing oneself as you are. The more we know about our own minds, the more we can help ourselves and others. Judgment of oneself and others can be incredibly destructive. When we learn to accept a moment of who we are with kindness and objectivity, then happiness, change and healing are possible.

3. How can a parent teach mindfulness? How is it different from teaching mindfulness to an adult?

A parent has to learn and practice mindfulness before teaching it. Intensive retreat is an ideal format for adults to learn mindfulness but barring that, lessons are the next best option. An effective mindfulness curriculum for children is simpler than for adults but just as powerful. When I first began teaching for Mindful Schools, I was surprised by how powerful the lessons were despite their simplicity. By teaching mindfulness to families as well as children, I’ve learned that every child and family is unique. My constant challenge is to teach specific mindfulness tools but also addresses individual needs and issues. It’s important to provide age-appropriate instruction and, especially for young children, keep it light and fun.

4. What, specifically, do you think kids can get out of learning how to live mindfully?

Mindful Schools, in collaboration with UC Davis’ Department of Psychology, just completed the largest study to date on mindfulness in education. The study of 829 elementary school students showed improvement in all four target development catagories: physical, mental, social and emotional. You can read additional research data at www.mindfulschools.org/about-mindfulness/research/.  I would add that from a happiness point-of-view, mindfulness teaches children how to observe their experience with kindness and objectivity instead of judgment and knee-jerk reactions. For children suffering from emotional extremes like rage and severe anxiety, mindfulness can be an extraordinary relief. It gives them a psychological road map they can understand and the means to navigate these difficult emotions.

5. Can you walk me through a mindful play exercise?

My secret code game can seem counter-intuitive because it does not judge children who misbehave and act out. Instead it allows children, through play, to first identify their mental states (eg: red = anger, yellow = fear, green = happy) and then understand cause and effect (what causes certain mental states) by experimenting with their own actions and words and noticing how it changes their color. During a mindful play exercise I always maintain a neutral, kind demeanor toward children no matter what their reactions. My job as a mindfulness instructor is to remain objective and non-judgmental. Ironically we cannot help a person change until we accept unconditionally who they are now. I’ll give you an example. Anger is a defense against pain. It’s there for a reason. When we judge a person who is angry, that person will hold on tighter to who they are because they feel attacked and need to defend themselves from more pain. Understanding lessens pain. When we accept unconditionally who a person is, tell that person we understand them and care about them even when they are “code red,” we create the loving space they need to face the difficult work of self-change. I gave an ED (emotionally disturbed) Special Day classroom the assignment to do a task the students didn’t want to do and watch how their codes changed during the beginning, middle and end of the task. One student said he cried the entire time when he did an undesirable school assignment because the discipline was so painful (he labeled this mental state “code red”). When he finished the work, he discovered he was code green! He was smiling and happy that he had completed the work. Had I or his teacher added judgment to that scenario, or a lecture about the importance of finishing his work, I believe the experience would’ve been too painful for him to try. Because the context of doing this task was a game, this student could push himself and face his difficulties. I believe that curiosity, laughter and fun are the best antidotes to resistance to self-change.

6. You work with children with Oppositional Defiance Disorder. What are some common themes that you see in kids diagnosed with ODD?

My theory as a mindfulness instructor is that children with ODD have trouble understanding cause and effect. They perceive themselves as the victims not the perpetrators at all times even if they initiate a conflict. As a result they feel a constant need to defend themselves. Life is exceptionally frustrating and painful for these children and they tend to be intense and have difficulty accessing their sense of humor and playfulness. Defiance cuts across all socioeconomic catagories. My work began with the children of wealthy families and continues today with children from a range of economic backgrounds. Caring for a child who is emotionally disturbed can be overwhelming for a parent so when I think of someone with ODD, I think of them as part of a family ecosystem where everyone needs help, especially if the parents and siblings have been dealing with this for a long time and are experiencing burn-out and negative emotions themselves. If the family is judging the child or reacting harshly, it’s my belief that the child will not progress. Not judging the family is important for the family’s healing process as well so I try to provide them the mindfulness tools they need to process negative reactions in a way that doesn’t communicate judgment to the child with ODD.

When children with ODD feel judged (even though it may be judgment that arises as a result of their cruel speech or actions), they increase their defenses and react with greater negativity. The instinct at that moment at home or in the classroom is to label the child as “bad” and try to drill into them the idea that they need to be “good.” I believe this backfires because it creates more pain in the child. If an adult has aversion to a child and wants to “fix” the child or get rid of a problem, typically this only exacerbates the situation and the problem gets worse. This doesn’t mean that acceptance is easy. That’s where I come in. As a secular meditation practitioner for 15 years, I am not overwhelmed by extreme emotions. I can come into that ecosystem with the objectivity, kindness and spirit of fun that I believe is necessary for change to occur. One analogy is to think of how you would feel if you had the following choice. You have a big problem. In one room are a group of people (big adults) who love you but hate your problem and want it to go away and who react to it negatively. You know they are unhappy to see you and your problem. In the next room is a group of smiling adults who are happy to see you even when your problem manifests and want to help you with a spirit of patience and fun. In which room would you be more able to face your problem and change? Which room would you choose? Unfortunately rejection of a person’s problem always feels like a rejection of the person. The challenge then becomes to set firm boundaries while not sending a message that you are rejecting the child.

7. What are the major differences in the way that you approach ODD kids compared to other therapeutic methods?

I cannot speak to other therapeutic models because I’m not trained in them but I believe that mindfulness is an excellent tool that is compatible with traditional family therapy. The Nelson Textbook of Pediatrics, 19^th Edition, states that ODD is characterized by “a persistent pattern of angry outbursts, arguing, vindictiveness and disobedience generally directed at authority figures such as parents and teachers. The patient with this conductor disorder typically shows little concern for the rights or needs of others.” The textbook goes on to say that parent management training for addressing ODD includes “developing a warm, supportive relationship with the child, child-directed interaction and play and providing clear and consistent rules with consistent consequences.” My mindfulness game helps create that healthy system of parent management of children with ODD. On this front, medical science and mindfulness are in agreement. You do not need to raise your voice or criticize a child to lay down the law. You can set boundaries with a smile and sweetness and this makes boundaries less threatening and less painful. I believe mindfulness goes a step further in that if the child takes to my secret code game for example, they are now applying the scientific method to potentially all of their interactions with the world and have a concrete way to measure the results of their choices and actions before, during and after an action takes place. This self-awareness empowers the child to see that being a good person doesn’t mean letting go of the need for self-preservation and self-defense. With mindfulness, children directly experience that being good makes them happy. In other words, being good can be its own defense.

8. How can parents use mindfulness to help children suffering from ODD?

There are three main mindfulness tools for parents dealing with ODD. The first is objective communication (rather than judgmental or accusatory communication). The second is creating consistent and firm boundaries with a neutral tone of voice. This is far more effective than authoritarian overly-harsh discipline or no discipline at all. Finally parents need to develop patience with negative emotions in themselves and their children and cultivate the mindfulness skill of observing instead of reacting. If a child’s extreme emotions cannot derail you emotionally as a parent, then the child will start to see that the emotions are not so powerful. This is a benefit for two reasons. Firstly if a child is manipulating adults with extreme emotions in order to be able to do whatever they want, the parental ability to stay present with those extreme emotions and demonstrate that the emotions don’t bother them sends a message to the child that their extreme emotions are not a form of power. If a child is indeed manipulating a situation with extreme emotions, when suddenly they react and don’t get what they want despite their emotional outbursts, eventually the child will understand that their emotions are not powerful and will let go of those extreme reactions in favor of healthy behavior that is rewarded. This takes time however and depending on how deeply entrenched the habits have become, a parent may have to stomach negative reactions for a long time in order to prevail. The second benefit is that if a parent treats these negative emotions as no big deal, everyone relaxes (including the siblings of children with ODD). If a child’s extreme emotions are sincere, they can frighten that child and siblings. If a parent demonstrates that the emotion is okay and that they can handle it, the children will be less afraid of their own difficult mental states and stabilize enough to begin navigating them effectively. This said, it can take years to teach mindfulness effectively. If you haven’t practiced mindfulness or been trained to teach it, then trying to apply these mindfulness tools will most likely not be effective. Like yoga, mindfulness is a skill that involves the physical body. Although we can read about it, applying mindfulness is not an intellectual, analytical exercise. As a mindfulness instructor, I have the ability to teach children about cause and effect while also modeling for them the emotions I want them to try out themselves. It helps if the parents are willing to acknowledge to the child their own negative emotions and communicate about them in an objective, fun way. “I feel a lot of anger in my body right now. Isn’t that interesting? What should I do?” This empowers the child to let go of defenses and inspires their curiosity so that they are more likely to investigate their own severe emotions as well.

9. What can parents do at home with their children — whether or not they have ODD-- to help foster mindfulness?

Take one deep breath and watch that breath from the very beginning (the “in” breath) until the moment it ends (the end of the “out” breath). After you concentrate on one entire breath, notice how your body feels. Then take another breath. Notice your body’s reaction. Have your children tell you what they notice. Don’t judge what they say. Just listen and say something like, “Wow, that’s so interesting. I wonder if I can see that in my own body as well.” If your child enjoys this exercise, begin a bedtime ritual where your child watches her breath as she falls asleep and you sit nearby on the floor or in a chair and watch your own breath, one breath at a time. Even five minutes a day of mindful breathing can be transformative.

Working with Rage in Children

Mindfulness provides a non-judgmental context for children to understand their rage and other overwhelming emotions. While most educational modes of addressing Oppositional Defiant Disorder revolve around children admitting they are “bad” and repeating “I will be good” statements without a psychological road map they can understand, mindfulness helps children grasp that being a good person doesn’t mean letting go of the need for self-preservation and self-defense. With mindfulness, children directly experience that being good can be its own defense.

One of the first things I say to children with Oppositional Defiance Disorder (ODD) is “I’m not here to take away your anger. It’s okay to be angry. Sometimes I need to be angry too.” This statement often results in stunned looks among the children and a visible relaxation of their bodies. To an outsider, this might seem counter-productive. How do you change a child’s behavior by accepting it? I would argue that acceptance is the key to changing a child’s behavior. The next time you are angry and someone says to you “let go of your anger” or “be happy!” notice your reaction. Someone judging your anger will probably make you even angrier. The same is true for children.

Anger is a defense against pain. It’s there for a reason. To change a child’s anger, you have to help the child understand why the anger is there – by helping them identify their pain – and then exploring various ways to resolve that pain without a lecture. An adult who judges a child’s anger as “bad” creates more pain in the child and therefore increases the need for defense, resulting in an angrier child at worst and at best, a confused child. A child who needs to defend themselves everyday may not even understand what being good feels like and may not feel it is safe to be good (something that may be perceived as weak). Children of any economic strata may need to defend themselves against neglect as well as physical, emotional and/or sexual abuse. Telling children they should “be good” simply because that is what is expected of them doesn’t resolve their need to defend themselves from pain. It’s especially important to remember that if a child faces detrimental adults outside of school, it’s likely that those children will be unable to trust any adult, even if that adult is the most benevolent teacher in the world. Children who have good parents may struggle with mental illness, which I will address here as well.

You can begin to earn a child’s trust by communicating that you understand their need to defend themselves. Understanding lessens pain. The less pain a child feels, the less they need their defense. The next step is also simple. Angry children are often communicating with their behavior that they need greater control. This need for control may be the result of a horrible real world situation or an overwhelming mental condition. Either way, their world is spinning out of control. One of the greatest gifts you can give a child is the opportunity to teach you (thus wield some control). After communicating my understanding and lack of judgment, I will ask children with ODD to teach me what they notice about their anger. I use my secret code game (written about in its most basic form in an earlier blog) to engage children in this dialogue. One boy recently said to me, “I would rather be code red (rage) than code yellow (which he defined as afraid).” When a child has this kind of insight into themselves, I don’t lecture them about the benefits of not being angry. They’re not ready for that and I want them to learn this truth through direct experience, not simply because I said it. Instead I praise students for noticing what’s really happening and reinforce that they are not bad people for preferring to be angry. The less a child is judged and the greater the opportunity a child has to teach an adult, the more they will open up and begin the process of cultivating self awareness and wisdom. Children – no matter how violent – are pure of heart. Their intentions are pure. They are simply trying to get what they need. Children with ODD often don’t understand the best way to get what they need.

A third way I establish a connection of trust with a child is to tell them how happy I am to see them. When a child gives me a stunned expression, I know that I may be the first adult in their life to tell them that they make someone happy, that their presence is valuable. I tell a child I am happy to see him for two reasons. Firstly I am creating within the child the foundation of self-confidence and self-worth necessary for the work of self-change. I am also teaching a core value of mindfulness – the notion of non-judgmental attention. When I say to a child who is code red, “I’m happy to see you even when you’re code red,” I am communicating a child’s value to that child. I am separating what the child feels (temporary) from the child’s worth. Too often we criticize children at the very moment when they need our kindness. What is most remarkable about communicating this is that the child will begin to conform to my expectation of him. He will drop out of code red more easily and put more effort into calming himself down in my presence. My unconditional acceptance of who he is makes it safe to change mental states. He doesn’t need to defend himself from me. I become a neutral background to his own process of self-change. Please note: I never tell a child that I am happy to see him if I am not. Children can sense emotions in adults and will know immediately if you are lying. This will backfire.

After I have children share what they notice about anger (code red), I have them pay attention to other mental states and actions. Again I praise their participation. I ask children who are angry to notice the temperature in their bodies, the way their muscles feel and any other sensations. If a child is able to sit still in code red (rather than act out their rage eg: by hitting someone) I praise that even if they can’t yet calm themselves down. I might say, “I see you’re able to sit still and watch the temperature in your body and that is such a beautiful thing to see.” I’ll tell them that if they want to continue watching the temperature in their bodies, that’s okay but if they can, to try to watch their breath and notice if it changes the temperature in their bodies. This triggers their natural curiosity. For children who have developed a life-long habit of rage, shifting mental states will be very difficult. Any adult who is mindful when angry can easily recognize how difficult it is to let go of this emotion. Curiosity is the best antidote to a child's resistance to self-change.

Those children who can watch their breath will notice that the temperature in their body cools but don’t tell them that. Let the children teach you. Don’t give away the answers or it will be another meaningless lecture rather than a direct experience of truth. For those children who watch the temperature only, their anger will become more painful. They may start to hit themselves or react against another person. To avoid that, tell the class, “for those of you who do not want to watch your breath, try to notice if code red gets more or less painful.” When children say “It gets more painful” I’ll praise them again. “Great! You noticed that. Now try to see what happens to code red when you watch your breath.” Through this exercise, children have the chance to see that anger is actually painful. Something they thought was defending them from pain is actually exacerbating it. Once children articulate that “ah-ha” moment, you will then have an optimal foundation to introduce experiments with kind behavior. Without giving away the answers, ask the children what they think kindness feels like compared to anger. Before the experiments, children will often say that anger is power and kindness is weakness. To which you can reply, “Wow, I’m so glad you shared that with me! Over the next week, try to be kind either to someone in class or someone at home and notice the different codes kindness makes you feel.” Children can use the basic green-yellow-red code I've written about in an early blog or create their own unique color code. Before they do the experiment, children may say “I feel code yellow” and I’ll remind them gently that they won’t know how kindness makes them feel until they’ve actually tried it and observed how they feel after they are kind to someone else.

Once children learn how to experiment with behavior and notice their codes, they will begin to apply this game to potentially every area of their life. One student asked me, “Is there a way to watch TV mindfully?” I said, “Yes – we can be mindful of anything. Notice what code you are before you turn on the TV and what code you think you will become by watching TV. Then turn on the TV and notice what code you are when you’re actually watching TV. Notice if your code changes when you turn off the TV.” The student anticipated the result of watching TV by saying, “I’m going to be code green (happy, calm)!” but the next week reported that he was surprised to observe that he felt “code yellow” when he watched TV (yellow being an unpleasant emotion of some kind that is not rage or extreme upset). I asked him why he felt code yellow and he answered that he felt bad that no one was helping his mom. He decided to turn off the TV and go help his mother which he was surprised to notice made him feel “code green.” This child who had received countless lectures about the benefits of being good had finally discovered those benefits for himself.

Ellen McCarty is a mindfulness instructor in the San Francisco Bay Area. Learn more at http://www.ellenmccarty.com/ or follow her status updates on Facebook at "Ellen McCarty, Mindful Youth." Copyright 2011 by Ellen McCarty