OPERACIÓN “VUELTA AL COLE”: CONSEJOS PARA UNA MEJOR ADAPTACIÓN

Operation "Back-to-School": Tips for a Better Adaptation

A new academic year is about to start. While the children take the opportunity to take the last dips of the summer season, parents start preparations for back-to-school: uniforms, books, school supplies… Back to routine!

Many families have difficulty getting their children back into the habits and schedules of the school year and, as a result, the first few weeks can be difficult.

From Sinews we offer you some tips to help your children adapt to the routine more easily:

  • It is essential to start incorporating the school schedule at least one week before the school year begins, that is: set the alarm clock at the indicated time, eat at the time they usually do at school and go to bed early. In this way, the first week of school his biological clock will be more accustomed to the new schedule and early mornings will not be so difficult.
  • Involve them in the process, making them part of the preparations. A good idea is to go shopping with them for school supplies and give them some freedom of choice.
  • It would also be interesting to make a schedule together, in which we can include: the subjects of each day, extracurricular activities, the stipulated time for homework and leisure time, bath time and bedtime. Ideally, it should be placed in a highly visible area of the house, so that the child gradually becomes familiar with it.
  • Finally, we cannot forget the importance of talking with them about the upcoming school year and the new experiences that await them: the joy of reuniting with classmates and fun times, their new subjects, possible difficulties related to academic content … Home should be a safe environment where they can share their concerns.

By putting these tips into practice, we will achieve a better adaptation to the new school year.

Last but not least, we remind you that in the case of those students who have difficulties keeping up the with the academic pace, Sinews offers an specialized academic support service, in which our professionals will help them to assimilate the contents and will teach them a series of strategies and study techniques in order to improve their performance.

Written by Alba Ferrero, responsible for specialized academic support services – study coach


Hooked to New Technologies

Hooked to New Technologies

When we talk about addiction to new technologies, it is frequent that, automatically, we bring to our mind the image of a boy or girl with any electronic device.

It is not uncommon nowadays to take a look around a restaurant and see parents slow down their children's activity through a device, be it tablet, mobile or other. The effectiveness of this technique is unquestionable.

As a sedative for children and parents, keeping children absorbed in digital activity reduces their activity, as we have been saying, but also our involvement in managing their behaviors. However, the victims - yes, victims - of this strategy are not only children, but also adults, the subject on which this article will focus.

In summary, we could describe addiction to new technologies as the excessive use of electronic devices, added to the need to use them when we have been a long time (or not so long, in some cases) away from them, and with a powerful calming function and / or pleasant sensation that is, sometimes, difficult to recognize.

In the era of hyperconnectivity, it is expected that many of our activities will be done through new technologies like meeting our friends, getting informed about something quickly or buying a product in a matter of seconds. The utility is more than evident.

However, the dark side of this utility lies in the immediacy of the reward, reinforcement or satisfaction. We feel calmer when we get a response from our partner in the moment instead of waiting to see each other. We feel especially recognized when the “likes” grow like foam and we can observe this very satisfactory phenomenon in real time. We feel more in control being able to go immediately to information that solves a question of the moment. Ultimately, the promptness of the response takes on a strong tint of reward. This of course is far from being harmless..

It is necessary to make a brief explanation of our brain mechanisms to understand how the matter in question works, and, for this, we will refer to the reward mechanism of our brain. This system is part of our "primitive brain".This implies that it bears a strong relationship with animal survival, as it “informs” about pleasant sensations.

Briefly, the reward circuit locates pleasant stimuli (eg, a good plate of food, a hug, or a drug). The consequence of "accessing" this stimulus is the release of neurotransmitters, like dopamine and serotonin, which produce in us an intense feeling of well-being. Other clear examples are when I get a hug from someone I love, when I buy something through my mobile that I have been craving for a long time, when I get an answer playing a board game -and I persist in the game after that hit-, or when I see a notification from the person I like.

Well, taking into account what has been mentioned above, it is expected that adults obtain that well-being through their mobile devices, in the same way as young people and children.

It also seems interesting to refer to the calm that parents have when they have located their son or daughter thanks to their phone. Immediacy once again plays a fundamental role.

This means that the reinforcement, namely the feeling of calm that we get from knowing where our son or daughter is, makes us go to our phone more frequently to appease unpleasant feelings. It is what we would call a negative reinforcement, whose nuance consists of the reduction of discomfort.Positive reinforcers are distinguished from the previous ones since they provide well-being. An example can be when I order something to eat through my mobile, when I listen to music that I like or I am in contact with the person I crave.

Definitely, no one easily escapes the electronic device trap. In addition, as we said previously, in the era of hyperconnectivity it is paradoxical that we find ourselves increasingly distant and isolated. We are present physically but not mentally. We meet up with our friends but we dedicate a good part of those moments to being aware of things that are not related to the specific moment. I may be having a beer with my best friend but I withdraw from the situation by talking to someone who can be found in Honolulu.

Adults also experience these situations, and it seems pertinent to make special mention of parents: the use of devices and their applications give parents an illusory sense of connection with their children. When they perceive their distancing, parents try to find other ways of communicating with them, and this is where new technologies play an essential role. It is not uncommon to see parents trying to get closer to their children by showing them what they have downloaded to their mobile or the latest joke they have been sent.

The seeking for a more genuine, more intimate and less electronically mediated contact pushes parents to find other ways of access to their sons and daughters, and they may also be caught in the excessive use of these technologies. 

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Lacan: historia y aportaciones

Lacan: historia y aportaciones

Jacques Lacan fue un psicoanalista y psiquiatra de origen francés. Nacido en París el 13 de abril de 1901, es conocido por su “retorno a Freud”, actualizando y modificando la teoría de Sigmund Freud, conocido por todos como el padre del psicoanálisis. Su evolución teórica provoca la escisión de la Sociedad Psicoanalítica de París. Dicha evolución se caracteriza especialmente por un sustancial abandono de los aspectos más puramente biológicos, confiriendo una enorme importancia al lenguaje de cara a la comprensión de los pacientes, el cual, según su concepción, estructura el inconsciente a través de sus códigos.

El objetivo del presente escrito no es tanto aportar una explicación biográfica de Lacan, si no describir de forma breve pero clara alguna de las aportaciones más curiosas que esta figura del psicoanálisis produjo en esta corriente, así como algunos datos que rindan cuenta de la particularidad de esta figura del psicoanálisis. Este no es sino un primer contacto con la teoría de Lacan. En artículos posteriores se profundizará en otros aspectos.

Escansión

Una de las características de la terapia psicoanalítica de marcado enfoque lacaniano es el conocido corte de sesión o escansión. Se dice que la utilidad de este corte es el puntuar, el hacer hincapié en una verbalización llevada a cabo por el paciente y que guarda una enorme relación con los conflictos intrapsíquicos de éste.

El objetivo fundamental de este corte de sesión es fomentar la reflexión del paciente sobre lo que dijo, abrir la puerta a un discurrir por parte del sujeto.

Partiendo de la premisa que dice que el inconsciente se estructura como un lenguaje, Lacan se negaba a plegarse a la norma de la duración de las sesiones (que debían durar 50 minutos según la IPA).

Descrito por él como un imperativo obsesivo, esta duración rígida no respetaba las puntuaciones del sujeto en su discurso (y por ende, sus contenidos inconscientes), ya que el inconsciente, según Lacan, no obedece nunca a un tiempo preestablecido. Al cortar la sesión en este punto, el analista realiza una acentuación en forma no verbal, dejándole entrever al paciente que lo que ha dicho se trata de algo significativo y que no debe ser tomado a la ligera. El analista no es en absoluto un oyente neutral. Deja muy claro que ciertos puntos, que seguramente guarden relación con la revelación de un deseo inconsciente y con un goce previamente no admitido son cruciales. El analista dirige la atención hacia ellos, recomendándole al paciente más o menos directamente que piense en ellos y los tome seriamente.

Los pacientes no tienden a hablar y puntuar espontáneamente los temas más importantes. Es más, desde el punto de vista psicoanalítico, los pacientes tienden en mayor medida a evitar aquellos aspectos. Ejemplo de ello son los temas relacionados con la sexualidad, evitando, por ejemplo, asociar sueños y fantasías con elementos que conllevan mayor carga sexual.

Muy probablemente el lector se preguntará qué se espera de uno cuando acude a un terapeuta de orientación lacaniana. Pues bien, el análisis no requiere que relatemos toda nuestra vida en detalle ni toda nuestra semana y sus pormenores. Hacerlo convierte automáticamente la terapia en un proceso infinito. Para que el analista pueda involucrar al paciente en un verdadero trabajo analítico, no debe tener miedo en dejar claro al paciente que el contar historias, los relatos detallados de lo que pasó en la semana y otras formas de discurso superficial no son el material del análisis, aunque, por supuesto, puede ponerlos al servicio del análisis. El terapeuta tenderá por tanto a cambiar de tema en lugar de intentar, de forma obstinada, a encontrar algo de significación psicológica en los detalles de la vida cotidiana del paciente.

Cuando el analista de repente concluye una sesión, puede acentuar la sorpresa de lo que el paciente ha expresado, o introducir el elemento de sorpresa a través de la escansión, dejando que el paciente se pregunte qué fue lo que el analista escuchó y que él mismo no logró escuchar. Cuando las sesiones de tiempo fijo son la norma, el paciente se acostumbra a tener una cantidad de tiempo determinado para hablar, y calcula cómo rellenar ese tiempo, cómo hacer un mejor uso de él. Los pacientes saben a menudo que el sueño que tuvieron es lo más importante que deben relatar para su análisis. Sin embargo, tratan de hablar de muchas cosas de las que quieren hablar antes de llegar al sueño, si es que llegan a él. Establecer una duración determinada de la sesión no sirve, según Lacan, sino para alimentar la neurosis del paciente: el uso que hace del tiempo previsto para él en la sesión es una parte indisociable de su estrategia neurótica, que involucra la evitación, la neutralización de otras personas y demás.

El diagnóstico lacaniano

Para los profesionales que trabajen con los sistemas diagnósticos predominantes como el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM), la sistematización llevada a cabo por Lacan resultará enormemente simplista. No obstante, ésta implica también precisiones mucho mayores respecto de lo que generalmente se considera que es un diagnóstico en buena parte del ámbito de la psicología y la psiquiatría. Los criterios diagnósticos de Lacan se basan fundamentalmente en la obra de Freud, siendo ésta ampliada en multitud de ocasiones, y en el trabajo de algunos psiquiatras franceses y alemanes como Kraepelin o Gatian de Clérembault.

En lugar de tender a multiplicar todavía más las ya numerosas categorías diagnósticas, de modo que cada nuevo síntoma o conjunto observable es considerado como un síndrome separado, el esquema diagnóstico de Lacan es enormemente simple, pues incluye solamente tres categorías principales: neurosis, psicosis y perversión.

A diferencia de las categorías diagnósticas como el DSM, los diagnósticos lacanianos proporcionan al terapeuta una aplicación inmediata, en la medida en que guían los objetivos del terapeuta e indican la posición que éste debe adoptar en la transferencia. La teoría lacaniana demuestra que ciertos objetivos y técnicas utilizados con los neuróticos son inaplicables con los psicóticos. Y esas técnicas no solo son inaplicables, sino que incluso pueden resultar peligrosas, puesto que pueden disparar un brote psicótico.

El diagnóstico no es, por tanto, una cuestión formal de papeleo, tal como requieren las instituciones sanitarias. Es fundamental para determinar el abordaje general que el terapeuta adoptará para el tratamiento de un paciente individual, para situarse correctamente en la transferencia y para realizar las intervenciones apropiadas. Lacan trata de sistematizar las categorías de Freud ampliando sus distinciones terminológicas. Lacan distingue entre categorías diagnósticas en función del mecanismo de defensa operante.

Es decir, las tres principales categorías diagnósticas adoptadas por Lacan son categorías estructurales basadas en tres mecanismos diferentes o formas diferentes de negación. Encontramos entonces que para la neurosis el mecanismo fundamental es la represión, para la perversión es la renegación y para la psicosis la forclusión. Retomando a Freud, el cual decía que mecanismo y estructura no son meras compañeras que presentan una fuerte correlación entre los pacientes. El mecanismo de negación es constitutivo de la estructura. Esto quiere decir que la represión es la causa de la neurosis, así como la forclusión es la causa de la psicosis.

Diversos estudios encuentran una relación positiva entre la impulsividad, la ira y la impaciencia. Cabe, en este contexto, mencionar la elevada de tasa de abandonos (egosintónico y suele provenir por parte de otra persona) cuando la ira es motivo de consulta. Como decíamos, la ira correlaciona con la impaciencia. Esto podría explicar que las personas que padecen este problema cuando no obtienen resultados deprisa, abandonan el tratamiento; cuando obtienen resultados deprisa, abandonan el tratamiento; cuando la pareja les deja, abandonan el tratamiento y cuando la pareja no les deja, también suelen abandonar el tratamiento.

Homosexualidad

Mientras que la corriente psicoanalítica predominante en la época de Lacan afirmaba rotundamente que los homosexuales no podían ejercer el trabajo de psicoanalistas, Lacan rompió con esta preconcepción, dando a entender que los homosexuales sí podían ejercer como tal. Roudinesco, psicoanalista de origen francés, afirma que Lacan aceptaba asimismo a pacientes homosexuales, sin el objetivo de adentrarles en lo que por entonces se consideraba la normalidad.

La Asociación Psicoanalítica Internacional (IPA) contaba en la década de 1920 con un comité encargado de gestionar esta cuestión. La rama berlinesa de dicha asociación decía así: “(la homosexualidad) es un crimen repugnante: si uno de nuestros miembros lo cometiera, nos comportaría un grave delito”, llegando incluso a considerarse como una “tara”.

En este sentido, la posición de Lacan resultó novedosa, evitando rechazar a homosexuales en su formación como analistas. Esta negación al estigma predominante, junto con su negación a establecer un tiempo determinado en las sesiones, así como su oposición al academicismo propio de la IPA conllevó su expulsión de esta institución en 1963.

A continuación, se ampliarán algunos de los aspectos descritos unas líneas más arriba, profundizando en las estructuras y en los pormenores que distinguen a dichas estructuras desde el punto de vista de Lacan.

Con anterioridad, se esbozaron de forma breve algunos de los aspectos más curiosos y característicos de Jacques Lacan. Esta no es sino una continuación de lo anterior, donde profundizaremos de forma sintética en una de las categorías diagnósticas descritas por Lacan: la neurosis. Retomando lo dicho en el anterior artículo, el abordaje lacaniano del diagnóstico puede parecer extraño y simplista para aquellos profesionales familiarizados con otras categorías diagnósticas como es el caso del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM). El propósito de este artículo no es resaltar los posibles defectos de estos instrumentos diagnósticos.

El objetivo es describir una alternativa en un contexto donde la psicología ha tendido en gran medida a aproximarse a la medicina -y por ende, a la psiquiatría-, intentando operativizar y cuantificar aspectos que, al fin y al cabo, resultan intangibles. El diagnóstico lacaniano, en lugar de multiplicar las categorías diagnósticas, incluye tres categorías principales: neurosis, psicosis y perversión.

A diferencia de otras categorías diagnósticas, proporcionan una aplicacióninmediata al terapeuta, guiándole en sus objetivos e indicando la posición que éste debe asumir en la transferencia. Un aspecto interesante de este abordaje es que las personas que son habitualmente consideradas “normales” (Cabría preguntarse qué es normalidad y qué no lo es) no tienen una estructura especial propia. Por lo general, son neuróticas en términos clínicos. Esto quiere decir que el mecanismo de defensa básico es la represión. Freud sostenía lo siguiente: “Si adoptamos un punto de vista teórico y desatendemos el aspecto de la cantidad, podemos afirmar que todos estamos enfermos, o sea, que todos somos neuróticos, ya que las precondiciones para la formación de síntomas, a saber, la represión, también pueden observarse en personas normales”.

A diferencia de otras estructuras como la psicosis, la neurosis se caracteriza por la instauración de la llamada Función paterna, la asimilación de la estructura esencial del lenguaje, la primacía de la duda sobre la certeza, un considerable grado de inhibición de las pulsiones que se opone a su puesta en acto libre de inhibiciones, la tendencia a encontrar más placer en el fantasma que en el contacto sexual directo, el ya mencionado mecanismo de la represión, el retorno de lo reprimido en forma de lapsus, actos fallidos y síntomas, etc.

A diferencia de la perversión, la neurosis implica el predominio de la zona genital frente a otras zonas erógenas, cierto grado de incertidumbre respecto de lo que excita y lo que no o una importante dificultad para lograr la satisfacción aún sabiendo lo que excita. La represión: “Lo esencial en la represión no es que el afecto esté suprimido, sino que está desplazado y es irreconocible” Lacan, Seminario XVIII, p.168.

Como decíamos anteriormente, el mecanismo fundamental que define la neurosis es la represión. Este mecanismo es el responsable de que, mientras que,en la psicosis, tal y como veremos en el siguiente artículo, el paciente es capaz de revelar toda su “ropa sucia” sin aparente dificultad, el neurótico mantiene esas cosas ocultas para los demás y para sí mismo. A diferencia de la neurosis, en la psicosis no hay inconsciente, ya que éste es resultado de la represión. La represión puede ser descrita como la expulsión de la psique de pensamientos o deseos que no son aceptables para nuestra visión de nosotros mismos o para nuestros principios morales. Además, ésta puede explicarse como una atracción ejercida por el núcleo del material reprimido “original” sobre elementos relacionados con él. La represión no implica la absoluta y completa eliminación de ese pensamiento, al contrario que en la psicosis, como veremos que sí ocurre. En la neurosis, la realidad y sus elementos son afirmadas en un sentido muy básico pero desalojados de la conciencia. El afecto y el pensamiento están conectados, tal y como defienden también terapias de corte cognitivo como la Terapia Racional Emotiva de Albert Ellis. La represión ejerce una separación, “un divorcio” entre el afecto y el pensamiento, siendo éste excluido de la conciencia. Este es el motivo por el cual los analistas a menudo se encuentran con personas en consulta que dicen sentirse vacíos, tristes, ansiosos o culpables sin saber por qué. O bien las razones que esgrimen no parecen corresponderse en modo alguno con la magnitud del afecto que los acompaña. La carga afectiva perdura cuando el pensamiento ha sido reprimido, llevando a la persona a buscar explicaciones a ese sentimiento. Esto, es decir, la ausencia del pensamiento pero la presencia de un afecto arrollador son muy comunes en la neurosis histérica. En la neurosis obsesiva, el pensamiento puede estar presente pero no suscitar afecto alguno. Tenemos por ejemplo pacientes que relatan haber sufrido acontecimientos gravísimos pero éstos no suscitan absolutamente ninguna reacción afectiva. Aquí, el analista trata de traer esos afectos disociados al aquí y ahora del análisis. El retorno de lo reprimido:

Cuando un pensamiento se reprime, queda latente, no desaparece. Trata de expresarse allá donde pueda, conectándose con otros pensamientos relacionados. Estas expresiones adoptan la forma de lapsus, sueños, actos fallidos y síntomas. En este sentido, Lacan afirmaba que “lo reprimido y el retorno de lo reprimido son uno y el mismo”. Aquello que ha sido apartado de la conciencia aparece aparece de forma maquillada a través del olvido de un nombre, la rotura “accidental” de un regalo, o el rechazo hacia el cariño de una madre que desvela la represión del niño de su deseo por la madre. Otro ejemplo de esto son las interrupciones o irrupciones.

Existen multitud de ejemplos para exponer el retorno de lo reprimido. En cualquiera de estos casos, algún deseo está siendo sofocado. Para Lacan, el síntoma neurótico cumple el papel de la lengua que permite expresar la represión (Seminario III, p.72). Se trata de un mensaje dirigido al Otro. La insatisfacción del deseo y el deseo imposible o neurosis histérica y neurosis obsesiva : El neurótico obsesivo se caracteriza por su deseo imposible. El obsesivo puede, por ejemplo, anular o negar al Otro. Por ejemplo, mientras hace el amor, el neurótico obsesivo puede fantasear que está con otra persona, negando de esta manera la importancia de la persona con la que está. El deseo en la neurosis obsesiva es imposible: cuanto más próximo a su satisfacción se encuentra el obsesivo lo sabotea.

Es por ello, por ejemplo, que en la neurosis obsesiva sea frecuente encontrar narrativas de una persona (el obsesivo) que se enamora de alguien inalcanzable o establecer requisitos extremadamente estrictos a sus parejas y allegados. En la neurosis histérica, el sujeto adopta la posición de objeto de deseo del Otro. Asimismo, el sujeto puede identificarse con un par y desearlo como si fuese él. Es decir, desea como si estuviese en su posición. A menudo podemos encontrarnos con parejas donde uno aprecia ciertas cosas y el/la contrario/a acaba deseándolas. En la histeria, se detecta en el Otro un deseo, un consecuente posicionarse como objeto de satisfacción de ese deseo pero luego negar dicha satisfacción para seguir manteniéndolo vivo (el deseo). La neurosis obsesiva y la neurosis histérica en el análisis: Dado que el obsesivo intenta neutralizar al Otro, cuanto más obsesivo sea, menores serán las posibilidades de que se analice. El obsesivo puede, intelectualmente, llegar a aceptar la existencia del inconsciente, pero no la idea de que éste es inaccesible sin la ayuda de otra persona. Refiere dificultades, pero se limita a hacer un “autoanálisis” que toma la forma de llevar un diario, escribir sus sueños o preocupaciones de la semana. Comúnmente, el obsesivo vive su vida en rebelión contra uno o todos los deseos de sus padres, pero niega cualquier relación entre lo que hace y lo que sus padres quisieron que hiciera.

La primera maniobra que ha de efectuar el analista es asegurarse de que el obsesivo entienda que el Otro no puede ser anulado o pasado por alto. Es decir, tratará de impedir los intentos del obsesivo de repetir eso con el analista. Los analistas que trabajan con obsesivos están familiarizados con la tendencia de estos pacientes a hablar y hablar, interpretarse a sí mismos o asociar, sin prestar atención a las puntuaciones del analista. Éste muchas veces ha de hacer un auténtico esfuerzo para evitar que el obsesivo arrase con sus intervenciones, ya que suele tener la sensación de que el paciente se interpone en el camino de lo que quería decir. Podemos pensar, teniendo en cuenta lo anterior, que en la neurosis histérica el paciente será un paciente ideal, ya que éste está atento al deseo del Otro. Asimismo, el paciente quiere saber en estos casos. Es por esto que en la histeria es fácil pedir la ayuda del analista, pero también es difícil para ella trabajar una vez está en el proceso analítico. En el caso de que el analista acceda a darle al paciente lo que busca, es probable que éste lo cuestione, lo desarme y encuentre la falla en el saber del analista: esto la convierte en la prueba de que puede complementar el saber del analista. A menudo pueden resultar un desafío para los terapeutas, dado que pueden hacerles sentir que no están a la altura de la comprensión de la situación. Se convierten así en amos del saber del analista, ya que le empujan a saber y prontamente. En la histeria es frecuente que el sujeto traiga un nuevo síntoma cuando el anterior se resuelve.

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Reseña de Libro: Controle su ira antes de que ella le controle a usted

Reseña de Libro: Controle su ira antes de que ella le controle a usted

Reseña de Libro: Controle su ira antes de que ella le controle a usted

El propósito de las siguientes líneas es esbozar de forma breve aquellos aspectos más importantes del libro de Albert Ellis y Raymond Chip Tafrate “Controle su ira antes de que ella le controle a usted”. En un primer lugar, se expondrán los motivos por los cuales se considera pertinente hablar de esta temática en términos generales y en términos más actuales. El Trastorno Explosivo Intermitente (TEI) consta de una prevalencia entre el 1,4% y del 7%. Por otro lado, a la época actual de confinamiento tan longevo se suma la sombra de la violencia intrafamiliar. De ahí se desprende, a juicio del autor, la necesidad de abordar este tema, apoyándose en el libro que motiva esta reseña.

La época que estamos viviendo demanda de nosotros recursos que hasta hace poco teníamos olvidados o a los que habíamos tenido que acudir en momentos muy puntuales o por períodos breves de tiempo.

Se puede hablar en estos casos de aspectos como la resiliencia, la paciencia o la perseverancia entre otros. Esta situación y sus características pueden producir en nosotros reacciones de irritabilidad y enfado.

Muy probablemente el lector haya sentido, al salir a la calle, las miradas de desconfianza de otros ciudadanos, o cierta irritabilidad referida a la mera presencia de otras personas en el supermercado o el transporte público. Además, la preocupación por la salud se ve acompañada de una preocupación de corte económico que no facilita alcanzar estados de ánimo especialmente positivos. Si a esto le sumamos un confinamiento extendido en el tiempo, con la sombra de la violencia intrafamiliar flotando sobre nuestra sociedad, obtenemos una mezcla de lo más explosiva y necesaria de aplacar. Con todo esto, es más que probable que se den reacciones de enfado o ira. He aquí la utilidad de este libro tanto para el momento presente como para otros momentos no exclusivamente relacionados con el confinamiento y las consecuencias de éste.

El interés de este libro reside en varios pilares. Por un lado, la manera en la que está escrito lo hace enormemente asumible para pacientes y profesionales de la salud mental. Su lenguaje ameno y explicativo le proporcionan una notable utilidad. Por otro lado, el libro aúna varios aspectos enormemente importantes y que se podrían enmarcar en las terapias de tipo cognitivo-conductual: aborda el poderosísimo componente cognitivo de la ira, así como técnicas más procedimentales y comportamentales para amansar reacciones propias del enfado. El libro, asimismo, no edulcora el tema que le compete: la ira presenta unos efectos devastadores para el individuo y su entorno. Mi experiencia en el campo de la clínica con personas que sufren este tipo de problemática me reafirma en el acierto de comentar este último aspecto y en la enorme necesidad de darle su cabida a lo largo del proceso terapéutico: estas consecuencias devastadoras no son en absoluto eludibles.

Este libro es además una extraordinaria oportunidad para adentrarse y comprender la principal aportación de Albert Ellis, que podría resumirse de la siguiente manera: uno no se siente de determinada manera por el acontecimiento o hecho en sí, sino por el significado o la interpretación de ese mismo hecho. Esto significa que el resultado emocional no dependerá del evento, sino de lo que pensemos al respecto. Si me molesto porque mi familia no me presta ayuda, no es solamente por ese hecho, es por lo que significa para mí (“Yo siempre les ayudo y ellos no me ayudan nunca”). Aquí reside la importancia del libro objeto de este análisis. La ira, o el resultado emocional, no es debida al acontecimiento o a “lo que ha pasado”: es debido a qué significa para la persona lo que acaba de pasar.

Por ejemplo, un hombre puede sentirse molesto cuando su mujer le dice que no presta suficiente atención a sus hijos. A ese evento puede, muy probablemente,  seguir un pensamiento como “Estoy harto de me vea como un mal padre”. Su mujer no ha dicho que él sea un mal padre, ha dicho que no presta suficiente atención a sus hijos. Hemos ahí el poder de las interpretaciones que nosotros hagamos en relación a lo que nos ocurre. Ese hombre se siente mal por pensar que su mujer le vea como un mal padre, no por lo que ella dijo.

Diversos estudios encuentran una relación positiva entre la impulsividad, la ira y la impaciencia. Cabe, en este contexto, mencionar la elevada de tasa de abandonos (egosintónico y suele provenir por parte de otra persona) cuando la ira es motivo de consulta. Como decíamos, la ira correlaciona con la impaciencia. Esto podría explicar que las personas que padecen este problema cuando no obtienen resultados deprisa, abandonan el tratamiento; cuando obtienen resultados deprisa, abandonan el tratamiento; cuando la pareja les deja, abandonan el tratamiento y cuando la pareja no les deja, también suelen abandonar el tratamiento.

Esto es una llamada a la responsabilidad y el compromiso por parte de aquellas personas que se sientan identificadas con lo que se ha descrito a lo largo de estas líneas. Lejos de culpabilizar, el propósito es también hacer visible el sufrimiento de la propia persona, no solamente de su entorno. A pesar de ser la familia, los amigos, los compañeros de trabajo el termómetro más fiable, la cara visible de las consecuencias, el sufrimiento que padece la persona está lejos de ser un villancico.

Quien “tiene” arranques de ira, explosiones de enfado y actitudes enormemente hostiles a ojos de los demás, también “tiene” una arrolladora sensación de culpa, disgusto e inadecuación, que, sostenidos en el tiempo, facilitarán a su vez un nuevo episodio de enfado.

Este libro puede ser de enorme utilidad también para ellos: hablar de nuestros aspectos más lesivos y “repugnantes” con un desconocido puede no ser plato de buen gusto para todos. El uso de un libro como el que se está comentando puede servir de hoja de ruta, de material a modo de refugio al que acudir. Además, este libro no es indiferente a esto que comentamos: lejos de aplastar cualquier tipo de enfado futuro, también se hace referencia a la función de un enfado adaptado a la situación, como el establecimiento de límites, el hacer partícipes a los demás de aquello que hacen y nos disgusta, etc. Es decir, el enfado forma parte de la vida y cuenta con una función necesaria, siempre y cuando exista una pertinencia y proporcionalidad. 

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Literacy development and identifying bilingual children with difficulties

Literacy development and identifying bilingual children with difficulties

Each person has a particular rate of growth and development. The area of literacy (the process of learning to read and write) does not escape this determination. Each child has their own learning speed and this can vary even more in bilingual children.

Detecting the difficulties that an individual may present in this area early and effectively through an early evaluation can represent a significant improvement for the well-being of the person. For these reasons, diagnosis, evaluation and treatment can be decisive in the development of children.

Although we live in an increasingly digital world, reading and writing continue to be an essential tool in most people’s lives and it seems it will continue to be so at least in the near future.

In general, as adults we have forgotten how we learnt to read and write when we were children and simply carry out the process automatically, but it is in fact a complex and lengthy learning task for children, which requires effort and continuous practice. In order to start reading, it is necessary to understand that oral language is divided into isolated sounds, each with its matching graphic representation, which are the letters of the alphabet. As children learn the different sounds for each letter, they can join them to form words and in time will create mental representations of whole words that they can then recognise visually, helping them to read at a faster rate. Therefore, reading has a visual component, identifying letters and words, as well as a linguistic component providing access to the meaning of words, sentences and texts, enabling comprehension of written information.

Children tend to develop these abilities at a different pace, often based on the amount of stimulation received. In general, at 5 years-old they begin to recognise the sounds of certain letters and to identify some words commonly found in children’s books. Around 6-7 years of age, children are considered to have enough tools to start formal literacy learning and progressively begin to decode words and sentences. At the same time they will also start writing some words. In the following years, the process continues to be gradually perfected, achieving independent reading and a progressively improved access to meaning. It is important to highlight that learning to read and write can be done simultaneously from the start in more than one language and that bilingual children learn these skills in the same way as monolingual children do.

Although there are many different definitions of the term bilingualism, in a broad sense it can be understood as the common use of two languages by an individual or a group of individuals inside a community of speakers. However, people who use more than one language do not often belong to a homogeneous group with many differences regarding the moment of language acquisition, the frequency of usage and the level of competence in each language, amongst other aspects. In the past, bilingualism was believed to be potentially harmful and have a negative influence on children’s linguistic abilities. In fact, today there is enough evidence to disprove that this is the case. Therefore, it can be concluded that bilingualism in itself does not cause oral language, literacy or learning difficulties, or any other cognitive or emotional issues whatsoever.

However, bilingual children can have difficulties when learning to read and write, just like children who only speak one language. As there are several factors that need to be taken into account, it is essential to analyse the reasons why the child is experiencing difficulties in each individual case. The following are some red flags that can arise at different stages: early difficulties in recognising or remembering letter-sounds, later slow reading and letter or syllable substitution, addition or omission errors, letter inversions, persistent spelling mistakes, difficulties organising ideas on paper, etc.

In any case, if there are signs of a possible difficulty, it is vital to carry out an early and individualised assessment, using specific tests in order to determine in which areas the child needs help, as well as providing specific recommendations and steps to follow, and establishing the right support at school as soon as possible.

On one hand, some children might show a mild delay, due to developmental delays or lack of stimulation and with the right help they are able to reach the level of their peers in a relatively short period of time.

On the other hand, other children show significant and persistent difficulties, presenting considerable differences compared to the expected level for their age with no apparent reason. In these cases a specific learning difficulty for reading and/or writing must be considered as a possibility. It is estimated that dyslexia, a specific learning disorder of neurobiological origin is present in approximately 5-10% of the population, whether or not there exists a bilingual situation. Bilingual children will show difficulties in both languages, and in all cases dyslexia requieres an early evaluation in order to avoid a possible scenario of school failure in the future.

When dyslexia is suspected, a multidisciplinary assessment and diagnosis should be carried out by a speech and language therapist and an educational psychologist. However, in Spain, speech and language therapists are the main professionals in charge of the detection, evaluation, diagnosis, and specific intervention, which needs to be individualised, explicit, systematic and designed with a mid-long term period in mind. This is different from English speaking countries like the UK or the USA, where the professionals are usually specialised teachers or tutors. In Spain, speech and language therapists specialise in reading and writing issues, as these are considered to be equally related to language, even though the communication channel is written instead of oral. Intervention consists of a specific approach to treatment focused on the rehabilitation of the reading routes and any other aspect detected during the evaluation, together with a series of recommendations regarding school adaptations.

In other cases it may also be useful to work with an academic tutor, whose job is mainly focused on supporting children with school-work and training them in study techniques. This is principally to help children with mild difficulties or those who have already received therapy. This type of support will be of great help to improve time-planning, organisation and self-monitoring skills, etc.

It should also be mentioned that oral language difficulties can affect reading and writing development, either because of specific issues in this area, or due to lack of development in the first language or in the language of instruction (vocabulary, sounds, etc.)

In every situation, oral and written language stimulation at home and at school will be essential with the aim of encouraging curiosity and a life-long love of reading. By making it as fun as possible, a reading habit can be established for life, and not just for studying or working purposes. If children are motivated, improvement will be consistent and observed on an academic and also a personal level, helping in their general well-being.

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Why Do Therapy Online?

Why Do Therapy Online?

We are living in digital times. We send a Whatsapp message when we want to let someone know how our day has gone, after a long day we flop and the sofa and play Candy Crush on an iPad, we stay in touch using video chat to talk to far away friends and family, we write our to-do list on our phone and we google “how to (fill in the blank)”.

Despite technology being a part of our everyday, when we think of online therapy it can seem a little strange or unusual. Having been a Clinical Psychologist for a number of years now and being accustomed to seeing patients in-person, I also had my own doubts initially: Is online therapy useful? Does it work? Is it as effective as in-person therapy? Science has this to say:

A study published in 2018 in the Journal of Anxiety Disorders stated that online Cognitive Behavioural Therapy (iCBT) is “effective, acceptable and practical”.

The study found that online Cognitive Behavioural Therapy is as effective as in-person therapy for disorders related to depression and anxiety (panic disorder, social anxiety, general anxiety etc)

In 2104, another study published in Behaviour Research and Therapy found that online Cognitive Behavioural Therapy (iCBT) is effective and less costly for anxiety disorders. The effects were shown to be long-lasting, with benefits evident a year after therapy had been concluded. Link

Also in 2014, a study published in the Journal of Affective Disorders compared the efficacy of online and in-person therapy and found that online therapy is just as beneficial as in-person therapy. Link

Armed with this information, I decided to begin seeing patients online and have since had the opportunity to treat a large number of clients who, for one reason or another, were unable to, or preferred not to, undertake in-person therapy. These patients included students, travellers, expats, migrants and their children, people who were unable to leave their houses due to physical or psychological limitations, or those who, after a long day would like to have some “me-time” in the comfort of their own home.

Online therapy allowed these people to access the psychological support that would have been otherwise unavailable to them. Their experiences allowed me to identify and witness firsthand the benefits of online therapy:

  • Location independent: It allows for freedom of movement. Sometimes, due to work, travel or other commitments, it can be difficult to attend in-person therapy.
  • No travel required: It eliminates the time and cost of travelling to and from therapy.
  • Continuity: As we can participate in a therapy session from anywhere, there is no need to stop or postpone my mental health care when I travel or move house.
  • Flexibility: It allows me to choose from a wider timeframe when making appointments, making it easier to find a time that suits me and my therapist.
  • Comfort: It allows me to participate in therapy from the comfort of my own home, or the place where I feel most relaxed and safe.
  • Secure: Online therapy is facilitated by secure, encrypted platforms that guarantee that the information shared remains private and confidential.
  • Immediacy: I can access the documentation shared with me by my therapist immediately.

Online therapy has understandably been growing in popularity over the last few years. With ever-increasing frequency we use the tools provided by technology and science to serve the most human of needs; connection.

Online therapy provides us with the opportunity to attend to our mental health, with the warmth and humanity of our therapist, from the comfort of our own home.

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Interview with a Specialist in Family Therapy

Interview with a Specialist in Family Therapy

How long have you been seeing families at Sinews?

I have been seeing families in therapy at Sinews since I joined the team in 2017. This is an element of my practice that I really enjoy as, unlike working one-on-one, working with the whole family paints a fuller picture of the some of the problems or history that has been faced. It allows the psychologist to “zoom out”, see the wider picture and access an abundance of information which is harder to get at through individual therapy.

What sort of problems are addressed in family therapy?

Family therapy can help address any number of issues, but it’s main focus is on difficulties in the dynamics between the family members. Family therapy can be most helpful when poor or little communication between family members results in conflict within the family, something which can cause much distress. Family therapy can be a great tool in helping to manage situations involving mental health diagnoses, substance abuse or addictions, behavioural problems or academic difficulties in children, a death or illness in the family, caring for a family member with special needs or an impending divorce or separation, especially when there are children involved.

Who needs to attend a family therapy session?

This depends on what is to be worked on in that session. In some cases, the whole family is invited to attend, but in others it might be preferable to see a specific subsystem within the family, like the parents, or just the mother and daughter. Before attending your first family therapy session, it might be a good idea to give the therapist, or centre you’ll be attending, a general idea of what difficulties your family is facing, and they can help inform your decision. Once in treatment, your therapist may have sessions will all or some of the family members as needed.

What if a family member doesn’t want to attend?

While family therapy can certainly benefit any family that wants to improve their dynamics or get support while going through a difficult time, this is only true if all family members who attend are able and willing. If one of the family members doesn’t want to come, it’s best not to pressure them. The family members who do come can learn skills that will benefit them, which in turn could have a positive impact on the family member who is not attending.

What does family therapy look like? How does it work?

Family therapy is a space that encourages and promotes healthy communication, which aims to create empathy, trust, and ultimately, a stronger bond within the family. It is meant to be a safe space for conflict resolution, forgiveness and stress-reduction. Sometimes this might be through dialogue, through play, or by learning new skills and applying them, inside and outside of therapy. The idea is for every member of the family to be able to express themselves openly, all the while reconstructing their story as a family unit.

Is there anything families should know beforehand?

Family therapy, just like any other type of therapy, is a process that takes time. There is no magic solution, especially considering that a family is made up of so many fluid and relational interactions. Each member should take the time to think about how and what they are willing to change and to take responsibility for and commit to it.

If you think your family, or a family you know, could benefit from family therapy, feel free to get in touch with the Sinews team for a consultation.

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

What Exactly does the School Counsellor do? Can my Child Receive Therapy at School?

What Exactly does the School Counsellor do? Can my Child Receive Therapy at School?

What Exactly does the School Counsellor do? Can my Child Receive Therapy at School? In the school context, there can be a wide variety of difficulties and challenges. Schools are, by nature, a very dynamic and complex environment. Students at the same school can have a wide variety of very differing needs, and it is of the upmost importance to provide them with the specific support they require.

There are many terms to describe the process of helping an individual overcome challenges and maximise growth, such as counselling, coaching or psychotherapy. The professional who is best placed to provide these services, such as counsellor, coach or psychotherapist, varies depending on the goals to be achieved, the approach or model used or the context in which they work.

Counsellor and Psychologist are the terms that are most often used broadly and interchangeably, and although both provide support and encourage healthy development and mental health, they take different approaches to achieving these goals. It's important to make this distinction to provide clarity and recognise the differences in the roles.

The main objective of the School Counsellor is to identify and address the social, emotional and behavioural needs of the school community (students, families, teachers etc) and provide the necessary emotional support, allowing everyone to have an optimal experience at school. The School Counsellor employs a consultation approach.

In the case of a School Psychologist, they work with an intervention approach, with a focus on understanding and intervening in the emotional and behavioural context, as well as with academic issues. This is done in a more exhaustive and specific way, analysing the problem through testing and assessing.

En otras palabras, los psicólogos escolares son los profesionales de la salud mental que están capacitados para evaluar y hacer un diagnóstico oficialmente, mientras que los school counsellors pueden sugerir que existe esa problemática y derivar a un psicólogo escolar para pruebas adicionales.

As we can see, the difference between these two roles is that generally school counsellors work at the level of the entire school community (students, families, teachers etc), while school psychologists tend to focus on working with individual students with more specific issues. In other words, school psychologists are the mental health professionals that are trained to test for and officially make a diagnose, whereas counsellors can only suggest those conditions exist, and make referrals to a school psychologist for additional testing. These two school-based professionals typically provide counselling rather than psychotherapy (Hess, Magnuson and Beeler, 2012). There are similarities between counselling and psychotherapy, such as the provision of a confidential space in which to explore personal difficulties or the effectiveness of the intervention depending, to a large extent, on the quality of the relationship. However, there are also important differences.

In general, we can say that counselling is a short-term service delivered to individuals or groups to increase their adaptive functioning. In the case of school counselling, the adaptive functioning is relative to the school setting. An illustration of a counselling intervention is when a student who is struggling in her peer relationships finds, with the help of the school counsellor, solutions to reduce the conflict.

Conversely, psychotherapy provided by a psychologist tends to be a longer-term practice, representing a deeper, more fundamental level of work, over a longer period. Also, the issues or concerns that an individual presents can be more serious and may reflect a pathology (e.g., depression, suicidal ideation, eating disorder (Hughes and Theodore, 2009).

However, this distinction does not mean that School Counsellors never work with students who have a diagnosable disorder. It just means that their focus is one of support rather than treatment. For example, a student may have a serious disorder (e.g. generalised anxiety disorder) but still be seen by a school-based professional who works with the student on strategies to manage the anxiety while he or she is at school in order to achieve academic goals. Ideally, the student is also working with an external therapist to manage the anxiety disorder.

Here, School Counsellors can play an important role by providing the family with a referral to a local therapist, by staying in close contact with this therapist, by reinforcing the student’s use of newly learned coping strategies, and by consulting with the student’s teachers as appropriate.

It is important to emphasise once again that the complexity of the issue to be treated in the individual student, and the goals to be achieved will require the intervention of one professional or another. As we have seen, school is not the right context in which to carry out a therapeutic intervention and similarly, the school counsellor is not the professional best placed to carry out such work. The School Counsellor does carry out interventions throughout the school community, which can complement therapeutic interventions. Many times the work carried out by the School Counsellor is preventive, increasing exponentially the welfare and health of the entire school community.

 

 

Bibliography:

Feltham, C. (1995). What is counselling?: The Promise and Problem of the Talking Therapies. Sage Publications Ltd

Henry, A (2012). How Do I Select a Therapist or Counsellor? Recuperado de https://lifehacker.com/how-do-i-select-a-therapist-or-counselor-5874359

Hess, R.S., Magnuson, S. and Beeler, L. (2012). Counselling children and adolescents in the school. Thousand Oaks, CA: Sage.

Wake Forest University (s.f.). What’s the Difference: School Counselor vs. School Psychologist? Recuperado de https://counseling.online.wfu.edu/blog/whats-difference-school-counselor-vs-school-psychologist/

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Depression After a Cardiac Event

Depression After a Cardiac Event

Interviewer: How can we improve the quality of life in these patients?

The most important thing would be to treat depression, as it has been established that depression more accurately predicts quality of life than other factors, such as lifestyle or other comorbidities.

However, treatments that reduce depressive symptoms do not necessarily result in improved quality of life. Psychotherapy might be more effective as it directly targets general well-being.

A recent meta-analysis by Hofmann et al concluded that both psycho-pharmacological treatment and cognitive behavioural treatment improved quality of life in depressed patients. Specific interventions should include enhancing socialisation (as isolation is a risk factor), treatment adherence and self-care.

Interviewer: You mentioned before that there are specific measures to combat depression in patients who have suffered a cardiac event?

Fortunately, most hospitals now have cardiac rehabilitation programs, which are a crucial element in the recovery of these patients. They form an essential component of the comprehensive management of cardiac patients, largely to reduce the detrimental emotional, psycho-social, and physical consequences of cardiac events.

Interviewer: How should these patients be treated then?

These patients should be attended by a multidisciplinary team of coordinated professionals that include: a cardiologist, a rehabilitation specialist, nursing staff, a psychologist and a psychiatrist.

Interviewer: How is treatment organised?

Treatment can be divided into different areas, such as cardiac monitoring, physical exercise and mental-health treatment. Even though I will focus on the latter, let me just give some pointers about physical rehab. Exercise training is useful for these patients, not only because of the effects on the heart but also because it has an impact on mood.

It is known that supervised physical exercise reduces the rates of depression in patients recovering from a cardiac event and could even reduce the dose of antidepressant medication.

Psychological treatment is necessary for most of these patients for several reasons, the principal one being that it can be difficult to come to terms with a life-threatening experience and patients benefit from the guidance of a trained professional.

Interviewer: How are patients treated psychologically then?

Patients usually receive cognitive behaviour therapy (CBT) which, according to Beck and Dozois, aims to counteract psychological disorders or problems that arise from dysfunctional thoughts, feelings, and behaviours that develop early in life and can become activated in response to stress. Patients are trained to modify negative and distorted thoughts, change maladaptive behaviours, and develop new coping mechanisms and skills. CBT has been proven to be useful for depression after a cardiac event.

Interviewer: What about antidepressant medication? Is it safe?

Antidepressant medication is only used for those cases identified and diagnosed with major depressive disorder; they have proven to be an effective treatment for depression. When considering antidepressants, one has to bear in mind several aspects that include safety, tolerability and efficacy. There is evidence that while some medications have better efficacy, others have shown more tolerability.

Antidepressants are generally considered safe in cardiac populations, but different classes have been associated with different risks.

Almost all selective serotonin receptor reuptake inhibitors (SSRI) are safe as they have little effect on the electrical activity of the heart, except for escitalopram. In the benefit/risk assessment, it is clear that the benefits of treating depression with antidepressants in a patient recovering from a cardiac event is much higher than the risk of any side effects that could undermine their well-being. Overall, SSRIs have good efficacy in treating depression and, for reasons of safety, are the antidepressants of choice. All this said the importance of potential interactions between antidepressants and cardiovascular medications should be considered when treating depression in cardiac patients.

Interviewer: How would you sum up everything we have spoken about?

The key points would be:

• Depression frequently appears after a cardiac event and it has been linked with increased morbidity and mortality.

• Depression is an independent risk factor for cardiovascular-related death and all-cause mortality.

• Depression is often under-diagnosed and under-treated in patients with cardiovascular disease.

• To date, there is no specific test to assess depression in patients with cardiovascular disease.

• Compared with men, women have higher rates of depression and higher mortality rates after myocardial infarction.

• Antidepressants are generally safe, effective and well-tolerated.

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment

Quality Time with Kids at Christmas

Quality Time with Kids at Christmas

With the arrival of the Christmas Holidays, our family routine changes, both in content and in rhythm. We have a short break from set routines, never-ending school hours, homework, extracurricular activities and everything that we associate with school-time fades into the background. Giving way to a period of rest (both physical and mental), to relaxation and enjoyment and to the opportunity to spend some quality time together. Our job as parents does not come to a halt during the holidays but with this change in activities and in pace, new opportunities arise to educate our children. The holidays provide us with the opportunity to partake in fun activities with our children that during the rest of the year we are otherwise unable to enjoy.

These moments are necessary and something we should give more weight to as they strengthen the bond we have with our children and can help them in their personal development. In short, they can serve to satisfy some of the most basic needs that children have; to feel loved, protected and valued. These fun activities also provide an opportunity to continue educating our children in values, beliefs and codes of conduct that, once internalised, they will continue to use throughout their lives.

One example of these kinds of activities, which as well as being fun can also be educational, is to watch a movie together. There is a wide variety of movies to choose from and the one we ultimately choose depends on the message/s that we wish to transmit. One movie that I recommend is Wonder, based on the book by R.J Palacio that tells the story of Auggie Pullman, a 10 year old boy that was born with congenital facial deformities. The first 10 years of his life were spent between hospitals and staying within the confines of his house. The 27 operations that he undergoes allow him to see, talk and hear like everyone, but his face looks unlike that of any other 10 year old child. He has never been able to go to school, with his mother always home-schooling him.

Auggie has his parents and his older sister who love and protect him, but he is fully aware of his appearance and suffers when other people reject him. When his mother believes that the time has come for him to face the world and attend school for the first time, he is petrified, but at the same time holds out hope that he will be accepted and be able to live the life a normal child. The movie focuses on Auggie’s first year at school and narrates his experiences as well as the experiences of those around him. The environment and the situations that are described in the movie are real and relatable, allowing the audience to easily empathise with the different characters.

The movie touches on some very important issues such as bullying, friendship, the need to feel accepted, tolerance, respect, kindness, empathy, humour, strength in the face of adversity, the need to confront difficulties in order to overcome them and many other life lessons. The way in which the film is narrated by different characters permits us to appreciate the different interpretations of the same event and the impact that these events have on each person. In fact, although the central focus is on Auggie, the secondary characters also face difficulties and learn different life lessons over the course of the movie.

Wonder is a moving and touching film portrayed with sensitivity that will appeal to both children and adults. The story is so relatable that it encourages us to think about our own lives, it invites us to be more conscious of what is happening around us and, I believe, it even pushes us to try to be better people. In the movie, there is a quote by Wayne Dyer, a well-known American psychologist, made by one of Auggie’s teachers that sums up part of the message of this movie:

“When given the choice between being right and being kind, choose kind."

This movie can be used to discuss and to highlight some very important values. After watching it, we can start a conversation and ask questions which will help our children reflect on what they would do in these situations. For example: What would you do if someone new or different came to your class? How would you react? Would you think how difficult it must be for someone to experience something like that? Would you try to help them? How?

In fact, the movie can also help parents to be more attentive to the needs of all our children and not only to those that are in obvious need of attention and support.

While the Christmas holidays can provide many opportunities for fun and overindulgence, we can also ask ourselves where the opportunities for connecting and teaching lie. Watching a movie like Wonder together with our children is a magnificent opportunity to spend some quality time with them while at the same time transmitting fundamental values that will ultimately help them to become better people.

Sinews MTI
Multilingual Therapy Institute
Psychology, Psychiatry and Speech Therapy
Clinic Appointment