Tim Sweeney, LCSW

University of Mary Washington

April 22, 2009

The Special Needs Family

1. Provide a loving and nurturing environment for your child

2. Strive for a happy and healthy marriage

3. Develop and live by a family mission statement

4. Provide each child the opportunity to develop to their potential

Family Priorities

Regardless of our family structure, the most

important thing we can do for our children is provide

secure attachment.

Priority #1 – Provide a Loving and Nurturing

Environment

Attachment is the enduring emotional tie between infant and caregiver.

John Bowlby

Attachment is a biological system of proximity seeking behavior to specific figures for protection and/or comfort.

Robert Neborsky

Attachment Theory

Attunement - Aligning the parent’s own internal states with those of the child, often accomplished by the sharing of non-verbal signals.

Balance - A child’s attainment of balance of its body, emotions and states of mind through attunement with the parent.

Coherence - The sense of integration that is acquired by the child through its relationship with its parents in which the child is able to come to feel both internally integrated and interpersonally connected to others.

Siegal and HartzellParenting from the Inside Out

The ABCs of Attachment

Secure Attachment (50-67% of us)Caregiver is responsive and

nurturingOffers a safe haven and secure

basePromotes healthy and autonomous

relationshipsCan recover from misfortune Rarely acts as victim

Types of Attachment

Insecure AttachmentAvoidant

Dismissive, aloof, disconnected

AnxiousResistant, angry, passive, needy

DisorganizedMost difficult typeAbusive caregiverCaregiver is source of terror and alarm

Types of Attachment

NeglectRejectionRole ReversalInconsistencyAbuse (Physical, Sexual, Emotional)

“Good Enough Parenting”D. W. Winnicott

Parental Behaviors that Threaten Secure

Attachment

By making sense of the impact of insecure attachment on our own lives“Be the author of our own life story.” Daniel

Siegel

Find supportive, empathic emotional relationships that encourage authenticity and nurturing, direct communication.

Breaking the Cycle of

Insecure Attachment

Be open to internal recollections that can fit into a larger picture of your life.

Have attuned communication between parent and child to share and amplify positive emotions and share and soothe negative ones.

Work on leftover issues of the parent that can block secure attachment and block accurate perception of child’s signals.

Promoting Secure Attachment

Any Marriage with a Special Needs Child or Children is a Special Marriage

You must have basics of a good marriage

before you can have a Special Marriage

Priority #2 – Strive for a Happy

And Healthy Marriage

John Gottman, PhD: two distinct periods during a marriage/relationshipWhen we disagreeWhen we get along

Influences the intensity/ depth/outcomes of disagreements

He calls it “positive sentiment override”

Fundamentals of a

Good Marriage

Accentuate the positiveDon’t eliminate the negativeHave a positive to negative

interaction ratio of at least 5 to 1Results in Positive Sentiment

OverrideMarriages of a 1 to 1.25 positive to

negative ratio spells serious trouble

Successful Relationships

69% of all divorces are caused by unresolvable differences that are not addressed!Conflict resolution tactics will not helpCouples must learn to come to an

arrangement on major problems while honoring and respecting each other

Develop tolerance

Unresolvable Differences?

“What counts in making a happy marriage is not so much how compatible you are, but how

you deal with incompatibility.”

Leo Tolstoy

Harsh Startup (starting off on wrong foot)

Gottman’s Four Horsemen of the ApocalypseCriticism – vague, broad, attacks characterContempt – sarcasm, disgust, mockery,

hostile humorDefensiveness – denial, excuses, cross-

complainingStonewalling – withdrawal, refusal to engage

Negative Interactions

Criticism – the antidote is a complaintSpecific, behavior-oriented, not

attacking characterDefensiveness – accepting

responsibility for part of the problemContempt – creating a culture of

praise and prideStonewalling – self-soothing, staying

emotionally connected

Antidotes to the Four Horsemen

50% - marriages 67% - second marriages 74% - third marriages 65-72% of marriages with special needs children

Divorce Rates

Sweden – 54.9%Australia – 46%Russia – 43.3%Germany – 39.4%Japan – 27%Singapore – 17.2%

Spain – 15.2%Albania – 10.9%Italy – 10%Turkey – 6%India 1.1%

2002 – Americans for Divorce Reform

Divorce Rates in Other Countries

Any marriage with one or more

special needs child is a special marriage.

The Special Marriage

“The National Survey of Children with Special

Health Care Needs 2005-2006”

Study done by the Department of Health and Human Services – Health Resources and Services

Administration

http://mchb.hrsa.gov/cshcn05/

Special Needs Defined

Special Needs DefinedChildren with Special Health Care Needs are

“...those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.”

McPherson, M, et.al., Pediatrics, 102(1):137–140, 1998

13.9% of children in U.S. or 10.2 million children are special needs (16.1% boys, 11.6% girls)

3.5% of special needs children are uninsured

1/3 of families say insurance coverage is insufficient

23.8% of parents cut back/stop working

Survey Results

Gender differences can be more pronouncedConflicts about the disability can interfere

with relationshipOne parent (usually the mother) gets

enmeshed in the disabilityOne parent (usually the father) gets distant

and develops more outside interests (work)

Challenges of the Special Marriage

Denial of disability – The “He/she will be fine” school of thoughtOther spouse has to become the total resource

coordinatorLoss of idealized child – griefDisagreement on level/style of interventionMarriage gets neglected

Child’s disability becomes the central issue of the marriage

Common Pitfalls

Recognize/discuss differences in your feelings about the child(ren).

Develop helpful support structuresAssociationsGroupsOther parents

Divide and conquer e.g., mothers do appointments and fathers

advocate with insurance company

Keeping the Marriage Special

Honor the relationshipHave a life outside of the disabilityAs possible, do things as a coupleAs possible, do things for yourself

Mothers often prefer being with friends

Fathers often prefer doing thingsWork on issues within the marriage

Special Marriages

Women:Recognize the intensity of emotions is

overwhelming for menMen often react by working harder and can

feel unappreciated for doing soMen need education about the disabilityMen can take longer to process the situationAre solution-oriented and may try to “fix” the

child

Address Gender Differences

Men:Women often feel they are carrying too much

of the burdenProvide more help than is customarySpend time with the child (floor time)

Good for the childLet’s mother have time for other things

Women have needs to convey their feelings more than menNeed listening and compassion

Address Gender Differences

Be aware of the emotional peaks and valleys in having a child with special needs

Guilt and blame damage intimacy and ruin the marriage

Avoid criticizing your spouse concerning his/her approach to treating the disability. Let your spouse learn from mistakes.

Both parents being very involved with parenting increase chances of successful special marriages

Special Marriages

Identity is driven by equal input from parents and children

Make the family the priorityCreate “Family Time” and be faithful

to itDevelop a family mission statement

Priority #3 – Develop and Live by a Family Mission

Statement

1. Be proactive2. Begin with the end in mind3. Put first things first4. Think “win-win”5. Seek first to understand…then to be

understood6. Synergize7. Sharpen the saw

Covey’s 7 Habits of Highly Effective Families

1. Explore what your family is all about

2. Write your family mission statement

3. Use it to stay on track

Develop a Family Mission Statement

Our family mission:To love each otherTo help each other

To believe in each otherTo wisely use our time, talents, and

resources to bless othersTo worship together

Forever

Sample Family Mission Statement

Our family mission:To always be kind, respectful, and supportive

of each other,To encourage each of us to reach our

potential,To keep a spiritual feeling in the home,

To love each other unconditionally,To be responsible to live a happy, healthy

and fulfilling life,To make this house a place we want to come

home to.

Sample Family Mission Statement

Parent all children the same wayRecognize and respect sibling needsProvide for all aspects of your child’s or

children’s needsTreatment for the special needsAllow for development in other areas

Give each child one-on-one timeLet them be kids

Priority #4 – Provide Each Child the Opportunity to Develop to

his/her Potential

Have higher rate of childhood depressionMay feel they have to overachieve to make

up for their brother/sisterMay bury their feelings/problems Can be embarrassed by their siblingsTeased/bullied at school Resentful of limited/infrequent family

outingsMay worry about their long-term futureMay worry that condition is contagious

Special Siblings

Have open family discussions and encourage the expression of honest feelings

Explain the disability to them in terms they can understand

Give them privacyBe a positive role model on how to handle

challenges

Tips for Parenting Special Siblings

Family Priorities1. Provide a loving and nurturing environment

for your child2. Strive for a happy and healthy marriage3. Develop and live by a family mission

statement4. Provide each child the opportunity to

develop to their potential

Summary

Tim Sweeney, LCSW11244 Waples Mill Road, Suite K

Fairfax, VA 22030703-359-4848

www.timothysweeney.com

Thank You!