It has been estimated that about half of all depression is seasonally triggered. This is true for both regular depression (also referred to as unipolar depression) as well as bipolar depression (bipolar disorder). After a month or so of diminished sunlight (or by about mid-December), many people prone to SAD start to experience symptoms. It may start as changes in sleep, appetite, concentration, and memory, diminished libido, and a loss of interest in things. In the case of bipolar disorder, the diminished hours of daylight can trigger either depression symptoms, or manic ones (feeling of euphoria, expansive ideas, unusual creativity, diminished need for sleep, and increased energy. There may also be an increase in libido, a tendency to talk too fast, and spending a lot of money in a short period of time - unrelated to the shopping one might do for the holidays).
If you suspect that you might have SAD, see a qualified mental health practitioner. In the Chicago area, see us at www.heritageprofessional.com. Treatment can include exposure to full spectrum light, of 10,000 lumens (or lux) for at least 30 minutes per day. It may also involve the use of counseling and prescription medication.
Monday, December 15, 2008
Saturday, November 29, 2008
The Holidays.....
The Holidays perhaps more than any other time of the year are full of so many different things for people who are struggling emotionally. Mostly, folks who are hurting just wish that the calendar skipped from November 15th to January 2nd without fanfare or fuss. This is because people who are depressed, grieving, anxious, or just plain lonely often feel worse during this time of year. They know that they're supposed to be happy and others seem to be. The holidays serve as a painful reminder of what's missing in their lives. Often, these people pretend to be fine and won't tell you that they're hurting. This is because they don't want to make you feel awkward and they also worry about being misunderstood. Too often, they've heard a well-intended soul say something like "JUST...cheer up, do something, call a friend, etc." Any advice that has the word "just" in it is likely to create deaf ears in the holiday sufferer. For these folks, holidays often contain painful memories perhaps from childhood when an alcoholic parent was at his / her worst. It may be a time when financial hardship was felt the most. Children whose parents had their fair share of dysfunction simply weren't very good at making the holidays enjoyable for their kids. These kids, now grown-ups themselves have no experience or tradition to draw upon which is positive during the holidays.
If you're one of these holiday sufferers, take heart that you're far from alone in suffering through the winter holidays. It's a time to pamper yourself. Simplify your life where you can; avoid doing things soley out of obligation. Try not to stay too busy. Listen to music; read if you can focus; nudge yourself to call at least one person you can trust and say something like "I'm reaching out because I've been a bit (lonely, depressed, anxious, etc) and could use a listening ear." Get yourself moving. Go for a walk everyday. Look at the stars at night. Try to find one thing, even one small thing, for which you can be glad, maybe even grateful.
If you're trying to support and encourage someone who is struggling, mostly be an excellent listener. Giving someone the experience of feeling heard is far more important that rushing in to fix, solve, or advise. Say things like "I'm sorry it's been such a tough time for you...I'm glad that you're letting me know...I'm honored that you would trust me with your feelings...would it be okay if I called again on (name a day) to see how you are?" You can also invite this person to do something with you, but do it gently, leaving a graceful 'out' for the person if they're not up to getting together.
Regardless of who you are, may this be a season of peace, tenderness of heart, and a time when you can reach out and share the season with someone who means something to you. When you try to do these things and you just can't shake the negative effects of the holidays, get the name of a local mental health professional and go for a consultation. In the Chicago area, consider us at http://www.heritageprofessional.com/
If you're one of these holiday sufferers, take heart that you're far from alone in suffering through the winter holidays. It's a time to pamper yourself. Simplify your life where you can; avoid doing things soley out of obligation. Try not to stay too busy. Listen to music; read if you can focus; nudge yourself to call at least one person you can trust and say something like "I'm reaching out because I've been a bit (lonely, depressed, anxious, etc) and could use a listening ear." Get yourself moving. Go for a walk everyday. Look at the stars at night. Try to find one thing, even one small thing, for which you can be glad, maybe even grateful.
If you're trying to support and encourage someone who is struggling, mostly be an excellent listener. Giving someone the experience of feeling heard is far more important that rushing in to fix, solve, or advise. Say things like "I'm sorry it's been such a tough time for you...I'm glad that you're letting me know...I'm honored that you would trust me with your feelings...would it be okay if I called again on (name a day) to see how you are?" You can also invite this person to do something with you, but do it gently, leaving a graceful 'out' for the person if they're not up to getting together.
Regardless of who you are, may this be a season of peace, tenderness of heart, and a time when you can reach out and share the season with someone who means something to you. When you try to do these things and you just can't shake the negative effects of the holidays, get the name of a local mental health professional and go for a consultation. In the Chicago area, consider us at http://www.heritageprofessional.com/
Monday, November 17, 2008
Managing Stress in a Bad Financial Market
You don't need to have a Ph.D. to know that these are stressful financial times. Many investments have lost a third of their value or more. And, the markets seemed to tumble so fast. Many of us who are not certified financial planners don't know if we should ride out the storm and keep our investments or sell and run for cover. So, it's really important to have a financial planner whom you trust who can do some 'hand holding' through these difficult times.
From a psychological standpoint, try to keep the following in mind:
1. There's virtually no relationship between money and happiness.
2. The current downturn in the market has occurred many times in the past. Consider this graph of the stock market since the early 1960s.
3. This source of stress, like any other, needs to be kept in perspective. Try not to organize your life around the daily ups and downs of the market. Instead, put your emotional 'stock' into things which pay consistent 'dividends' such as: creating time for meaningful connection with others, get routine exercise, eat a reasonable diet, try to get enough sleep, play, laugh, take some time to not just be 'on' at every moment.
When you try to do these things and you just can't shake the negative effects of the stress, get the name of a local mental health professional and go for a consultation. In the Chicago area, consider us at http://www.heritageprofessional.com/
From a psychological standpoint, try to keep the following in mind:
1. There's virtually no relationship between money and happiness.
2. The current downturn in the market has occurred many times in the past. Consider this graph of the stock market since the early 1960s.
3. This source of stress, like any other, needs to be kept in perspective. Try not to organize your life around the daily ups and downs of the market. Instead, put your emotional 'stock' into things which pay consistent 'dividends' such as: creating time for meaningful connection with others, get routine exercise, eat a reasonable diet, try to get enough sleep, play, laugh, take some time to not just be 'on' at every moment.
When you try to do these things and you just can't shake the negative effects of the stress, get the name of a local mental health professional and go for a consultation. In the Chicago area, consider us at http://www.heritageprofessional.com/
Saturday, October 25, 2008
Codependency
Codependency refers to a pattern of problematic behaviors in a person who is in a significant relationship with someone who has either an addiction or other identifiable, fairly significant emotional problem. Co-dependent people are often so focused on trying to help and fix the other that they they lose track of their own needs, as well as their own areas that need growth and change.
Co-dependent people often can't tell what is their fault and what isn't, and what is their responsibility or someone else's for problems in the relationship. It involves a tendency to over-function for the other person. It is a felt sense of responsibility for the other in a manner than is too much, and ultimately, bad for them and for the other person. It involves a desire, sometimes a crusade, to fix, cure or change the other. It also involves a tendency to blame oneself for the addictions in another and to experience inapprioriate guilt for the probems in the addicted person.
In programs such as Al-Anon, the '3 Cs' are emphasized - you did not Cause the problem in the other; you cannot Cure them, and you cannot even Change them. What is important is that you do not organize your emotional life around what the other person is doing or not doing. It is really important to be in touch with your own feelings and to have healthy and appropriate outlets for their expression. Behind every well-intentioned co-dependent person is someone who is angry and resentful.
The best way to get rid of the anger and resentment is not to demand change in the other. Rather, anger and resentment go away when you do a better job of: 1) managing your emotional boundaries; 2) getting the support of others; 3) recognizing your needs and seeking healthy and appropriate means of having these needs attended to. For more assistance in this area, attend Al-anon or other comparable groups; in the Chicago area, also consider a professional consultation at http://heritageprofessional.com
Co-dependent people often can't tell what is their fault and what isn't, and what is their responsibility or someone else's for problems in the relationship. It involves a tendency to over-function for the other person. It is a felt sense of responsibility for the other in a manner than is too much, and ultimately, bad for them and for the other person. It involves a desire, sometimes a crusade, to fix, cure or change the other. It also involves a tendency to blame oneself for the addictions in another and to experience inapprioriate guilt for the probems in the addicted person.
In programs such as Al-Anon, the '3 Cs' are emphasized - you did not Cause the problem in the other; you cannot Cure them, and you cannot even Change them. What is important is that you do not organize your emotional life around what the other person is doing or not doing. It is really important to be in touch with your own feelings and to have healthy and appropriate outlets for their expression. Behind every well-intentioned co-dependent person is someone who is angry and resentful.
The best way to get rid of the anger and resentment is not to demand change in the other. Rather, anger and resentment go away when you do a better job of: 1) managing your emotional boundaries; 2) getting the support of others; 3) recognizing your needs and seeking healthy and appropriate means of having these needs attended to. For more assistance in this area, attend Al-anon or other comparable groups; in the Chicago area, also consider a professional consultation at http://heritageprofessional.com
Wednesday, October 15, 2008
The fears of flying
To the unhappy souls so afflicted, it begins days before the anticipated event. The vivid imagination kicks into that dreaded high gear. Every feared scenario is played in the mind again and again. Heart rate goes up; breathing increases. Those cute butterflies in the stomach give way to some other species, something menacing, like a swarm of stinging hornets. Muscle tension increases, creating anything from headaches to muscle cramps. As the loathsome day approaches, there is often a loss of sleep, and with it, irritability, and lowered immunity to stress and physical illness. By the time the actual feared situation arrives, they are beyond exhausted. Their over-done imagination has wiped them out long before the real battle begins. Now once actually in the dreaded situation, the desperation rises, eyes start darting for some means of escape. When none appears, all of these symptoms of anxiety join forces into one mighty tidal wave of panic. Heart rate is now 160+. It feels like the heart is going to pound itself right through the chest wall. Normal breathing becomes hyperventilation, creating that tingling sensation in the fingers and toes, soon followed by dizziness and more nausea. The world seems to swirl sideways in a tornado of fear. Heart attack seems imminent, or worse, there’s some kind of pending psychic implosion. Now, there’s a more desperate search for escape. Anything to get out of the situation that they believe is causing this. Peer right into the eyes of someone at this moment, and you will have the image of pending death forever etched in your mind.
For those of us enchanted by flight, welcome to the other side of the world – the fear of flying. It is no coincidence that there’s little hole-in-the-wall liquor establishments doing quite well thank you, every ten gates or so at the major airports. Any cocktail mixed with some kind of prescription tranquilizer bought or borrowed will be tried if it’s likely to reduce or take away the anxiety.
There is nothing more disheartening than discovering that a loved one either won’t fly at all, or when they attempt bravely to fly anyway, are possessed by the demons of anxiety and panic. This often results in family vacations involving long car rides to avoid flying, or in trips not made at all because of a family member's fear of flying. Or when the family member decides to fly, they have worn themselves out as well as the family who has been exposed to their fear. When the fearful flier drinks or takes tranquilizers to get through the ordeal, they are worn out, passed out, or essentially hung over when they reach the destination.
For those anxious fliers who mst fly as a requirement of their job, it’s like having threatened execution as part of their daily job description. I’ll never forget the look on the face of one of my fear-of-flying patients. That morning his new boss told him that he would need to make a few trips to China each year. Or the tormented 13 year old who knew that her fear of flying held back her family from taking many wonderful vacations. Or the 63-year-old immigrant woman who was nearly homebound with anxiety. She couldn’t get herself to travel back to her homeland to see her dying mother, even by boat.
Too often, the solution comes down to avoiding flying altogether. In psychological parlance, it’s known as avoidance conditioning. And it is one of the most potent forms of conditioning that can shape behavior. Avoid the situation that triggers the fear and the outcome is universal: the fear of the dreaded situation gets worse. If you avoid something and in the process, avoid anxiety and panic, no other conclusion occurs in the mind of the anxiety sufferer. It must have been the flying that caused the anxiety and panic. So, avoid flying. While this solution may seem relatively harmless, in truth such a strategy tends to spread to other areas. Most phobic fliers have other phobias as well. Once you learn to avoid situations as a means of keeping the fears under control, the natural course of events is to avoid more and more things. Left untreated, some phobic-prone people over the course of several years end up housebound, concluding that it is safest not to venture out at all.
Instead of referring to it as the fear of flying, I find it much more helpful to refer to the fears of flying. This is because while you may have two people who both dread leaving terra firma, the basis for their fears can be quite different. And hence, the treatment varies as well. The three fears are as follows:
The Claustrophobic Fearful Fliers
By far and away, the largest proportion of people with a fear of flying are claustrophobic. They don’t like being in any room that they can’t get out of immediately. The greater the difficulty of making a quick exit, the greater the fear. So in general, crowded spaces, and especially locked spaces, all heightened the fear. Hence, such fearful fliers generally don’t like elevators, crowded buses, or crowded anything for that matter. Their credo is, get out of the situation and you get out of the anxiety and panic. If a two minute ride in an elevator is enough to inspire panic, how about being locked in an aluminum tube for four hours, in row 33 with a couple of hundred people crammed between you and that locked exit, and at 33,000 feet and 500 mph? Small aircraft don’t engender such fears on the ground. The small plane has the familiar feel of a car. Lots of windows, a door within reach, and the illusion of control. Once the plane leaves the ground, however, the panic-prone individual will begin to get very anxious, knowing that they cannot get out whenever then want.
These folks don’t fear crashing and dying. They don’t worry about mechanical problems. Their fears are greatest sometime between when the door to the airplane is locked until about mid-way through the flight. This is because during this period, they know that it is the longest stretch of time until the flight will be over and they will be able to get out. Their fears start to go down the longer they are into the flight. During descent and landing their fears really start to diminish because they are anticipating that they will be able to get out soon.
The Safety Related Fearful Fliers
In contrast, the safety related fearful fliers are not phased by the airplane door being locked. They don’t think for a minute about how to get out quickly from an aircraft that is perfectly sound mechanically and otherwise not on fire or headed into a thunderstorm. They don’t mind being stuck in the airplane on the ground for weather or mechanical delays. In fact, they prefer it any day to the possibility of encountering trouble. These fearful fliers watch the weather channel for days prior to their flight and become amateur meteorologists, figuring their odds of good treatment by the weather gods. They will get a seat near the window so that they can watch the ailerons, flaps and slats go up and down. Many have either informally read books about flying, or in some instances, have actually completed ground school for a private pilot’s license. They want every piece of information that can get that might affect the safety of a flight. They listen for every sound, smell or visual cue. They watch the faces of the flight attendants for signs that something might be amiss. Their fears are highest during any phase of flight that is most likely to result in either a mechanical or weather related problem. Put them in level cruise flight for hours in smooth air several hundred miles from the closest convective activity and their fears diminish greatly. Their fears start to rise again during descent as they anticipate the number of things that can go wrong until the aircraft decelerates and turns off the active runway. These folks don’t care much for small planes. They are well acquainted with the statistics. They know that small planes have more safety issues than big ones.
Among the safety related fearful fliers are the ones who used to fly routinely without fear. However, they went through some type of ordeal in flight scary enough to trigger symptoms of anxiety on subsequent flights. The largest subsection of this group went through bad turbulence and got shaken up. A smaller group might have been on a flight that experienced mechanical difficulties.
Temperamental Fearful Fliers
The third group are fliers who have a fear that is harder to recognize at first glance. These folks have a very high need to be in control of their lives. They don’t like to travel in cars where someone else is driving. They tend to be in leadership roles in other aspects of their lives as they don’t like others to be in a position of authority over them. They are perceived by others as ‘control freaks’ and are otherwise demanding and belittling of others. They are prone to anger when things don’t go their way, or when they are afraid. They are stubborn, opinionated, and extremely sure of themselves.
These folks don’t do very well as flying passengers. And as a flight attendant once pointed out to me, how surprised should we be that such flying passengers regress? We tell them when they can come and when they can go. We put them in their chair, belt them in and put a tray in front of them. We feed them when we decide. Seems like a toddler in a high chair scenario to me. Let’s remove every semblance of personal control over the life of someone who is fundamentally terrified not to be in control every second. Imagine adding tranquilizers and alcohol to the mix, and then put the whole kit and kiboodle into the air at a few hundred miles an hour. Guess what’s going to happen? Their (largely unconscious) fear of loss of control gets translated into being angry, ornery, demanding, and argumentative.
These temperamental fliers really have a hard time with the high chair phenomenon. This brand of fearful flier wants to be the one in control and call the shots on such factors as when the plane leaves, knowing nothing of course about such piddly little details as the weather and mechanical issues that may be delaying a flight. At the base of their anger is really a fear of being out of control of their lives and placing themselves in the hands of a relative stranger (i.e., the pilot).
The treatments…
The good news is that flying phobias can be treated very effectively, most of the time without the use of prescription drugs or home spun remedies such as alcohol. The new credo in treatment becomes: you don’t have to escape from the situation; you can learn to escape from the anxiety and panic. Very effective cognitive/ behavioral techniques provide a powerful tool to diminish these fears and in some cases, remove them completely. The use of prescription medication under the right circumstances can provide much benefit as well. See a qualified mental health care provider in your area who has experience in the treatment of specific phobias, including flying. Ask if they have backgrounds in either cognitive-behavioral therapy or evidenced-based therapy for the treatment of anxiety and phobias.
Note: I am a private pilot who treats people who have a fear of flying. For more information on how to locate us (we are in the Chicago area), see our website at http://www.heritageprofessional.com
For those of us enchanted by flight, welcome to the other side of the world – the fear of flying. It is no coincidence that there’s little hole-in-the-wall liquor establishments doing quite well thank you, every ten gates or so at the major airports. Any cocktail mixed with some kind of prescription tranquilizer bought or borrowed will be tried if it’s likely to reduce or take away the anxiety.
There is nothing more disheartening than discovering that a loved one either won’t fly at all, or when they attempt bravely to fly anyway, are possessed by the demons of anxiety and panic. This often results in family vacations involving long car rides to avoid flying, or in trips not made at all because of a family member's fear of flying. Or when the family member decides to fly, they have worn themselves out as well as the family who has been exposed to their fear. When the fearful flier drinks or takes tranquilizers to get through the ordeal, they are worn out, passed out, or essentially hung over when they reach the destination.
For those anxious fliers who mst fly as a requirement of their job, it’s like having threatened execution as part of their daily job description. I’ll never forget the look on the face of one of my fear-of-flying patients. That morning his new boss told him that he would need to make a few trips to China each year. Or the tormented 13 year old who knew that her fear of flying held back her family from taking many wonderful vacations. Or the 63-year-old immigrant woman who was nearly homebound with anxiety. She couldn’t get herself to travel back to her homeland to see her dying mother, even by boat.
Too often, the solution comes down to avoiding flying altogether. In psychological parlance, it’s known as avoidance conditioning. And it is one of the most potent forms of conditioning that can shape behavior. Avoid the situation that triggers the fear and the outcome is universal: the fear of the dreaded situation gets worse. If you avoid something and in the process, avoid anxiety and panic, no other conclusion occurs in the mind of the anxiety sufferer. It must have been the flying that caused the anxiety and panic. So, avoid flying. While this solution may seem relatively harmless, in truth such a strategy tends to spread to other areas. Most phobic fliers have other phobias as well. Once you learn to avoid situations as a means of keeping the fears under control, the natural course of events is to avoid more and more things. Left untreated, some phobic-prone people over the course of several years end up housebound, concluding that it is safest not to venture out at all.
Instead of referring to it as the fear of flying, I find it much more helpful to refer to the fears of flying. This is because while you may have two people who both dread leaving terra firma, the basis for their fears can be quite different. And hence, the treatment varies as well. The three fears are as follows:
The Claustrophobic Fearful Fliers
By far and away, the largest proportion of people with a fear of flying are claustrophobic. They don’t like being in any room that they can’t get out of immediately. The greater the difficulty of making a quick exit, the greater the fear. So in general, crowded spaces, and especially locked spaces, all heightened the fear. Hence, such fearful fliers generally don’t like elevators, crowded buses, or crowded anything for that matter. Their credo is, get out of the situation and you get out of the anxiety and panic. If a two minute ride in an elevator is enough to inspire panic, how about being locked in an aluminum tube for four hours, in row 33 with a couple of hundred people crammed between you and that locked exit, and at 33,000 feet and 500 mph? Small aircraft don’t engender such fears on the ground. The small plane has the familiar feel of a car. Lots of windows, a door within reach, and the illusion of control. Once the plane leaves the ground, however, the panic-prone individual will begin to get very anxious, knowing that they cannot get out whenever then want.
These folks don’t fear crashing and dying. They don’t worry about mechanical problems. Their fears are greatest sometime between when the door to the airplane is locked until about mid-way through the flight. This is because during this period, they know that it is the longest stretch of time until the flight will be over and they will be able to get out. Their fears start to go down the longer they are into the flight. During descent and landing their fears really start to diminish because they are anticipating that they will be able to get out soon.
The Safety Related Fearful Fliers
In contrast, the safety related fearful fliers are not phased by the airplane door being locked. They don’t think for a minute about how to get out quickly from an aircraft that is perfectly sound mechanically and otherwise not on fire or headed into a thunderstorm. They don’t mind being stuck in the airplane on the ground for weather or mechanical delays. In fact, they prefer it any day to the possibility of encountering trouble. These fearful fliers watch the weather channel for days prior to their flight and become amateur meteorologists, figuring their odds of good treatment by the weather gods. They will get a seat near the window so that they can watch the ailerons, flaps and slats go up and down. Many have either informally read books about flying, or in some instances, have actually completed ground school for a private pilot’s license. They want every piece of information that can get that might affect the safety of a flight. They listen for every sound, smell or visual cue. They watch the faces of the flight attendants for signs that something might be amiss. Their fears are highest during any phase of flight that is most likely to result in either a mechanical or weather related problem. Put them in level cruise flight for hours in smooth air several hundred miles from the closest convective activity and their fears diminish greatly. Their fears start to rise again during descent as they anticipate the number of things that can go wrong until the aircraft decelerates and turns off the active runway. These folks don’t care much for small planes. They are well acquainted with the statistics. They know that small planes have more safety issues than big ones.
Among the safety related fearful fliers are the ones who used to fly routinely without fear. However, they went through some type of ordeal in flight scary enough to trigger symptoms of anxiety on subsequent flights. The largest subsection of this group went through bad turbulence and got shaken up. A smaller group might have been on a flight that experienced mechanical difficulties.
Temperamental Fearful Fliers
The third group are fliers who have a fear that is harder to recognize at first glance. These folks have a very high need to be in control of their lives. They don’t like to travel in cars where someone else is driving. They tend to be in leadership roles in other aspects of their lives as they don’t like others to be in a position of authority over them. They are perceived by others as ‘control freaks’ and are otherwise demanding and belittling of others. They are prone to anger when things don’t go their way, or when they are afraid. They are stubborn, opinionated, and extremely sure of themselves.
These folks don’t do very well as flying passengers. And as a flight attendant once pointed out to me, how surprised should we be that such flying passengers regress? We tell them when they can come and when they can go. We put them in their chair, belt them in and put a tray in front of them. We feed them when we decide. Seems like a toddler in a high chair scenario to me. Let’s remove every semblance of personal control over the life of someone who is fundamentally terrified not to be in control every second. Imagine adding tranquilizers and alcohol to the mix, and then put the whole kit and kiboodle into the air at a few hundred miles an hour. Guess what’s going to happen? Their (largely unconscious) fear of loss of control gets translated into being angry, ornery, demanding, and argumentative.
These temperamental fliers really have a hard time with the high chair phenomenon. This brand of fearful flier wants to be the one in control and call the shots on such factors as when the plane leaves, knowing nothing of course about such piddly little details as the weather and mechanical issues that may be delaying a flight. At the base of their anger is really a fear of being out of control of their lives and placing themselves in the hands of a relative stranger (i.e., the pilot).
The treatments…
The good news is that flying phobias can be treated very effectively, most of the time without the use of prescription drugs or home spun remedies such as alcohol. The new credo in treatment becomes: you don’t have to escape from the situation; you can learn to escape from the anxiety and panic. Very effective cognitive/ behavioral techniques provide a powerful tool to diminish these fears and in some cases, remove them completely. The use of prescription medication under the right circumstances can provide much benefit as well. See a qualified mental health care provider in your area who has experience in the treatment of specific phobias, including flying. Ask if they have backgrounds in either cognitive-behavioral therapy or evidenced-based therapy for the treatment of anxiety and phobias.
Note: I am a private pilot who treats people who have a fear of flying. For more information on how to locate us (we are in the Chicago area), see our website at http://www.heritageprofessional.com
Monday, September 29, 2008
The double bind of parenting
A few years ago, I happened to have two, new individual psychotherapy patients scheduled back-to-back. They were both 20-something year old adults. After telling me her reasons for wanting to come in for therapy, I asked the first patient to tell me a little about her background. She said something to the effect of "you know what I really resented about my parents? They forced me to play the piano. I wished that they would have listened to me and let me quit when I wanted to. They made me practice and go to lessons when I didn't want to." Then, the second person came in. When it came time for him to tell me about his background, he said, "you know what I resent about my parents? They let me quit playing the piano. I wished that they would have pushed me to keep playing. I would then be able to enjoy playing piano to this day." So....welcome to parenting. All that we can do is use our best judgment to respond to our children's needs. When you're not sure about how to figure out some of the bigger quandaries that children can pose, think about getting a professional consultation. In the Chicago area, come see us at http://www.heritageprofessional.com.
Sunday, September 21, 2008
Why is ADHD diagnosed so often these days?
I am often asked why it seems as though ADHD (attention deficit hyperactivity disorder) is diagnosed more often now than it was in the past. First, a couple of points of clarification. The condition used to be called ADD and ADD-H. Now, the terminology has changed. It's all ADHD, but there are three subtypes: ADHD-inattentive, ADHD-hyperactive, and ADHD- combined type (with both inattention and hyperactivity). I know it's a bit confusing, but it's the current terminology. A second point is that ADHD encompasses much more than just problems with attention and concentration. It also includes the ability to get started on important, but tedious tasks, organization, sustained, disciplined effort, and the ability to monitor one's work for careless mistakes and legibility. Finally, an important symptom of ADHD can be a problem with working memory. Working memory is the human equivalent of RAM memory on a computer. When working memory is impaired in people, it's like a computer than doesn't have enough RAM. Certain programs run very slowly and inefficiently, if at all.
In the past, it was believed that all children outgrew this condition by their mid-adolescence (15 or 16 years old). We now know that many children with ADHD (perhaps as much as 50%) continue to have the condition on into adulthood. The fact that older teens and adults are being diagnosed for the first time explains in part the increased incidence of ADHD.
Another reason that ADHD is more prevalent today is that more is expected of students at earlier ages. Witness the changes in standardized IQ tests. People are getting smarter. Students are learning more at earlier ages than was true a generation ago. With all of this increase in intelligence, kids are expected to learn more, sooner, and at a faster rate. Most of us parents can say without question that our kids are expected to learn more material, of greater difficulty, and at an earlier age than we did as kids. There are many kids who are diagnosed today with ADHD who would not have been diagnosed with this condition a generation ago when less was expected of the average student. I have also seen people who were functionally perfectly well in other countries (particularly third world countries) who come to the U.S. and all of a sudden, they have ADHD. So, some of this is cultural. We are a very fast-paced, over-scheduled society that crams too much into an average day than is probably good for us. As this has occurred more and more with each generation, there's a greater instance of people just not able to keep up with the pace. They end up having ADHD when compared to their faster paced peers who can still keep all of the proverbial plates spinning at once.
For a good, comprehensive ADHD assessment in the Chicago area, please see us at http://www.heritageprofessional.com. We also offer a wonderful training program to help improve working memory. We can train anyone on this program, regardless of location.
In the past, it was believed that all children outgrew this condition by their mid-adolescence (15 or 16 years old). We now know that many children with ADHD (perhaps as much as 50%) continue to have the condition on into adulthood. The fact that older teens and adults are being diagnosed for the first time explains in part the increased incidence of ADHD.
Another reason that ADHD is more prevalent today is that more is expected of students at earlier ages. Witness the changes in standardized IQ tests. People are getting smarter. Students are learning more at earlier ages than was true a generation ago. With all of this increase in intelligence, kids are expected to learn more, sooner, and at a faster rate. Most of us parents can say without question that our kids are expected to learn more material, of greater difficulty, and at an earlier age than we did as kids. There are many kids who are diagnosed today with ADHD who would not have been diagnosed with this condition a generation ago when less was expected of the average student. I have also seen people who were functionally perfectly well in other countries (particularly third world countries) who come to the U.S. and all of a sudden, they have ADHD. So, some of this is cultural. We are a very fast-paced, over-scheduled society that crams too much into an average day than is probably good for us. As this has occurred more and more with each generation, there's a greater instance of people just not able to keep up with the pace. They end up having ADHD when compared to their faster paced peers who can still keep all of the proverbial plates spinning at once.
For a good, comprehensive ADHD assessment in the Chicago area, please see us at http://www.heritageprofessional.com. We also offer a wonderful training program to help improve working memory. We can train anyone on this program, regardless of location.
Friday, September 12, 2008
A teen's right to privacy versus parents' need to know
Frequently I am asked by parents of teens how whey should balance their teen's right to privacy versus a parent's right to know what their teen is up to. Many parents have expressed alarm about the content of emails, text messages, and Instant Messanging that their teens are exchanging with their friends. Even 'good girls' use extremely vulgar and sexually graphic language with their friends. 'Good boys' can easily get hooked on internet pornography. Parents sigh about the decay in values. Anything from sexually suggestive to pornographic images of their teens are getting posted on Facebook. Parents wonder if it's okay to 'spy' on their teens by using available technology to track what their teens are up to. My response follows along a couple of principles.
What is your motive in wanting to know? If it's idle curiosity, trouble letting go, or you've always snooped - it's just a character trait - then these are not good reasons to monitor your teens' activities.
But, if you have become privvy to some troublesome behaviors in your teens, then first and foremost, talk to them about it. Try to stick to language that involves your concern for them rather than your judgment of them. If you suspect that the behaviors are persisting, and your child is lying about it, then I say do the greatest good and the least harm. By this I mean - consider which is the worst case scenario: a) you invade your child's privacy, they find out and they mistrust you in turn; b) you remain in the dark about your child's worrisome behaviors and something really bad happens (your daughter ends up with her nude pics on the internet; your son is up for three hours every night looking at internet porn). If you want to avoid the latter, then I say it's morally justifiable to monitor your teen's activities. Then, when you become aware of something worrisome, talk to them about it again. If they lie about it, then you may want to tell them that out of your concern, you have been monitoring their activities. At that point, counseling is the likely way to go.
Many teens get very upset when they learn that their parents have been monitoring their behaviors. I find it helpful to say something to teens like this. "You know how you can have a friend tell you 'I'm feeling suicidal but don't tell anyone. Or, I'm doing LSD but don't tell anyone.' So, you know what it's like to be in a terrible dilemma. You don't want to betray your friend by telling their parents, but you don't want something terrible to happen to them either. All you can do is strive to do the greatest good. It's the same thing with your parents wrestling with your right to privacy and their right to know what you're up to."
For further assistance in negotiating these challenging situations in the Chicago area, come see us at http://www.heritageprofessional.com/ or go to someone you trust for the name of a reputable mental health professional.
What is your motive in wanting to know? If it's idle curiosity, trouble letting go, or you've always snooped - it's just a character trait - then these are not good reasons to monitor your teens' activities.
But, if you have become privvy to some troublesome behaviors in your teens, then first and foremost, talk to them about it. Try to stick to language that involves your concern for them rather than your judgment of them. If you suspect that the behaviors are persisting, and your child is lying about it, then I say do the greatest good and the least harm. By this I mean - consider which is the worst case scenario: a) you invade your child's privacy, they find out and they mistrust you in turn; b) you remain in the dark about your child's worrisome behaviors and something really bad happens (your daughter ends up with her nude pics on the internet; your son is up for three hours every night looking at internet porn). If you want to avoid the latter, then I say it's morally justifiable to monitor your teen's activities. Then, when you become aware of something worrisome, talk to them about it again. If they lie about it, then you may want to tell them that out of your concern, you have been monitoring their activities. At that point, counseling is the likely way to go.
Many teens get very upset when they learn that their parents have been monitoring their behaviors. I find it helpful to say something to teens like this. "You know how you can have a friend tell you 'I'm feeling suicidal but don't tell anyone. Or, I'm doing LSD but don't tell anyone.' So, you know what it's like to be in a terrible dilemma. You don't want to betray your friend by telling their parents, but you don't want something terrible to happen to them either. All you can do is strive to do the greatest good. It's the same thing with your parents wrestling with your right to privacy and their right to know what you're up to."
For further assistance in negotiating these challenging situations in the Chicago area, come see us at http://www.heritageprofessional.com/ or go to someone you trust for the name of a reputable mental health professional.
Wednesday, September 3, 2008
Kids and behavioral problems
Over the years, I have seen countless children and teens presenting with a wide array of emotional and behavioral problems. In general (and of course, there are exceptions), by and large, it is not unusual for a child's presenting symptoms to be reflected in one or both parents! A child with a temper problem frequently has at least one parent with the same issue. A child who acts disrespectfully toward others is often exposed to one or both parents who can behave in the same way. The child who is socially anxious or avoidant, often has a parent who either is this way currently, or experienced many of the same symptoms as a child. This all points to the importance of parents doing their own candid inventory of their own behaviors in conjunction with getting help for their children. On many occasion, I've told parents that it will be really difficult, if not impossible, to expect their child to get better control over his temper when one or both parents routinely lose control of their own temper. It's not unusual for parents to end up getting their own counseling for their issues as one component of their child getting help as well. For futher assistance in the Chicago area, consider us at http://www.heritageprofessional.com. Outside of the Chicago area, ask someone whom you respect for the name of a competent, reputable mental health care provider.
Tuesday, September 2, 2008
After the Divorce
Many parents get divorced believing that things will get better in their lives. They will be happier, and therefore, their children will be happier. The data generally suggest that divorce is not good for kids. But, if a divorce has already occurred or appears inevitable, there are some guidelines to follow that reduce the harm to kids. A very good book on managing life after the divorce is Mom’s House, Dad’s House: Making Two Homes for Your Child by Isolini Ricci.
Here is a list of 'Dos' and 'Don'ts':
Do:
1. Set an agenda for any parenting discussion with your former spouse, share it with him or
her ahead of time and stick to it
2. Think of goals you will set for yourself to become a better parent
3. Use a business-like level of decorum when having discussions with the other parent
4. Support and encourage the other parent when you see something that they’re doing right
5. Encourage each child’s relationship with the other parent
6. Treat the other parent in the same manner that you wish to be treated
Don’t:
7. Use name calling, profanity or any other form of disrespectful language
8. Interrupt
9. Play the role of victim
10. Ask your child to report about the behavior or actions of the other parent
11. Talk to your child about perceived problems, weaknesses or negatives traits in the other
parent
I have found it helpful for any parent who feels alienated and shut out of their children's lives to keep journals to each child. Write about your concerns for your child, as well as your hopes and ambitions for him or her. Share your own feelings of anguish, of hurt or loneliness. Share your feelings about wanting to be more involved in your child's life. But DON'T write about your former spouse's flaws, mistakes or other negative behaviors. DO write about things your child has done that have made your proud. There may be a time in the future when your child approaches you and asks about what happened around the time of the divorce. Being able to present a journal that you kept just for him or her over the years will impress upon them how much they mattered to you throughout all of those difficult years.
I have worked with many families off and on over the course of many years during and after a divorce. The better parent-child relationship years later is the one in which the parent didn't talk negatively about the other parent. They didn't try to gain advantage by sharing the 'dirt' on the other parent with the children. They didn't play the role of victim. Instead, they faithfully looked after the child's needs and continued with their own personal growth and development. See my prior blog on coping with difficult people for more advice on how to do this.
For coaching on managing divorce in the Chicago area, see us as at http://www.heritageprofessional.com/. Outside of the Chicago area, ask someone whom you trust for names of reputable mental health care providers in your area.
Here is a list of 'Dos' and 'Don'ts':
Do:
1. Set an agenda for any parenting discussion with your former spouse, share it with him or
her ahead of time and stick to it
2. Think of goals you will set for yourself to become a better parent
3. Use a business-like level of decorum when having discussions with the other parent
4. Support and encourage the other parent when you see something that they’re doing right
5. Encourage each child’s relationship with the other parent
6. Treat the other parent in the same manner that you wish to be treated
Don’t:
7. Use name calling, profanity or any other form of disrespectful language
8. Interrupt
9. Play the role of victim
10. Ask your child to report about the behavior or actions of the other parent
11. Talk to your child about perceived problems, weaknesses or negatives traits in the other
parent
I have found it helpful for any parent who feels alienated and shut out of their children's lives to keep journals to each child. Write about your concerns for your child, as well as your hopes and ambitions for him or her. Share your own feelings of anguish, of hurt or loneliness. Share your feelings about wanting to be more involved in your child's life. But DON'T write about your former spouse's flaws, mistakes or other negative behaviors. DO write about things your child has done that have made your proud. There may be a time in the future when your child approaches you and asks about what happened around the time of the divorce. Being able to present a journal that you kept just for him or her over the years will impress upon them how much they mattered to you throughout all of those difficult years.
I have worked with many families off and on over the course of many years during and after a divorce. The better parent-child relationship years later is the one in which the parent didn't talk negatively about the other parent. They didn't try to gain advantage by sharing the 'dirt' on the other parent with the children. They didn't play the role of victim. Instead, they faithfully looked after the child's needs and continued with their own personal growth and development. See my prior blog on coping with difficult people for more advice on how to do this.
For coaching on managing divorce in the Chicago area, see us as at http://www.heritageprofessional.com/. Outside of the Chicago area, ask someone whom you trust for names of reputable mental health care providers in your area.
Thursday, August 21, 2008
Men, women, and competence
Men and women both want to feel competent. Competence feeds self esteem. When we’re feeling low, we want to do that which restores a sense of mastery and competence. When that happens, self esteem is restored. The problem is that most men and most women go about the process of feeling competent in very different ways.
Women feel competent when they create and maintain emotionally meaningful connections with others. They will feel at their best when their important relationships are going well. And they will feel at their worst when there’s been a rift in their important relationships. When feeling low or stressed, most women seek to connect emotionally with those important to them. They’ll want to talk. The point is not to fix things or solve problems. The connection is really about restoring good feelings between themselves and those around them.
Men feel competent when they feel a sense of mastery and capability in the physical world around them. This could be through solving problems, fixing things, or by being competitive at work or sports. There’s the vicarious sense of mastery that comes through channel surfing on television to watch other men pursue mastery. When feeling low or stressed, men are more likely to take on a task that will leave them with a feeling of mastery and accomplishment. Connections with other men are mostly about accomplishing a task and feeling more masterful.
The problem is that when women and men engage one another, they try to encourage the other person to do what they, themselves, want. Women want men to open up when they are feeling stressed or low. They want men to talk about their problems. This often leaves men feeling more vulnerable, ashamed, and talking doesn’t restore a man’s sense of competence. Women talk because they want connection. Men often react to women with practical solutions to fix the problems because it’s what they would want for themselves in order to restore a sense of competence. Women don’t need to feel masterful in the physical world to restore confidence. They do, however, want connection.
If you’re a woman talking to a man, recognize that when he’s trying to restore mastery through achievement, he’s working at being competent just like what you’re doing when you’re looking for connection. A man won’t ask for directions when he’s lost because he will feel less competent about himself in the process. Let him restore some competence by working on a project or by looking for competence vicariously on television. Sports or other viewing, in the right measure, is being done to restore mastery, and hence competence, and hence, self esteem.
If you’re a man talking to a woman, she wants to have her feelings validated. She wants to be heard. She doesn’t want her problems fixed or other practical solutions. Let her restore some competence merely by connecting with you. That’s all you need ‘do.’ For women, connection bring competence, which brings self esteem.
For more help in bridging the gender gap, contact a mental health professional. In the Chicgago area, consider us at http://www.heritageprofessional.com/
Women feel competent when they create and maintain emotionally meaningful connections with others. They will feel at their best when their important relationships are going well. And they will feel at their worst when there’s been a rift in their important relationships. When feeling low or stressed, most women seek to connect emotionally with those important to them. They’ll want to talk. The point is not to fix things or solve problems. The connection is really about restoring good feelings between themselves and those around them.
Men feel competent when they feel a sense of mastery and capability in the physical world around them. This could be through solving problems, fixing things, or by being competitive at work or sports. There’s the vicarious sense of mastery that comes through channel surfing on television to watch other men pursue mastery. When feeling low or stressed, men are more likely to take on a task that will leave them with a feeling of mastery and accomplishment. Connections with other men are mostly about accomplishing a task and feeling more masterful.
The problem is that when women and men engage one another, they try to encourage the other person to do what they, themselves, want. Women want men to open up when they are feeling stressed or low. They want men to talk about their problems. This often leaves men feeling more vulnerable, ashamed, and talking doesn’t restore a man’s sense of competence. Women talk because they want connection. Men often react to women with practical solutions to fix the problems because it’s what they would want for themselves in order to restore a sense of competence. Women don’t need to feel masterful in the physical world to restore confidence. They do, however, want connection.
If you’re a woman talking to a man, recognize that when he’s trying to restore mastery through achievement, he’s working at being competent just like what you’re doing when you’re looking for connection. A man won’t ask for directions when he’s lost because he will feel less competent about himself in the process. Let him restore some competence by working on a project or by looking for competence vicariously on television. Sports or other viewing, in the right measure, is being done to restore mastery, and hence competence, and hence, self esteem.
If you’re a man talking to a woman, she wants to have her feelings validated. She wants to be heard. She doesn’t want her problems fixed or other practical solutions. Let her restore some competence merely by connecting with you. That’s all you need ‘do.’ For women, connection bring competence, which brings self esteem.
For more help in bridging the gender gap, contact a mental health professional. In the Chicgago area, consider us at http://www.heritageprofessional.com/
Wednesday, August 13, 2008
Coping with difficult people
Everyone's personality, regardless of type, exists on a continuum somewhere between very healthy and very troubled. Signs of a healthy personality include: resilience, creative problem solving even under stress, flexible adaptation to change, resourcefulness, the ability to see opportunities for change and growth, a realistic assessment of one's self worth, being open to new experiences, being truthful, regulating and controlling anger and other impulses, the capacity to expect realistic entitlements, and finally, having good, mutual relationships with non-family members over many years. Signs of an impaired / unhealthy personality include many of the opposite traits: a persistent defensiveness, inflexibility under stress, failure to learn from experience, persistent lying, a tendency to collapse and have trouble coping under stress, seeing oneself as a victim, blaming others for one's misfortune, not being able to realistically assess one's self worth (i.e., either feeling chronically low in self esteem or having an inflated sense of self worth), being close-minded, not properly regulating anger and other impulses, either allowing oneself to be treated like a doormat, or treating others in this way, and not having good, mutual, long-term relationships with non-family members.
One of the best things you can do when relating to difficult people, is to embody as many traits of a healthy personality than you can. Stay flexible and adaptive; don't respond defensively; do a good job of looking after your own needs where you can so that you end up neither deprived nor as resentful. Seek feedback from those whom you trust to tell you the truth as they see it, and listen carefully to their perspectives. Remember that getting better at love is more important than being right. Set healthy boundaries and enforce them with loving detachment. Resolve that you're not going to let difficult people bring out the worst in you. When all else fails, get some help - call it interpersonal coaching, therapy, or consultation. In the Chicago area, check out http://www.heritageprofessional.com/ We can help you cultivate the healthy aspects of your personality, learn about your blind spots, and become more resilient and capable in handling difficult people.
One of the best things you can do when relating to difficult people, is to embody as many traits of a healthy personality than you can. Stay flexible and adaptive; don't respond defensively; do a good job of looking after your own needs where you can so that you end up neither deprived nor as resentful. Seek feedback from those whom you trust to tell you the truth as they see it, and listen carefully to their perspectives. Remember that getting better at love is more important than being right. Set healthy boundaries and enforce them with loving detachment. Resolve that you're not going to let difficult people bring out the worst in you. When all else fails, get some help - call it interpersonal coaching, therapy, or consultation. In the Chicago area, check out http://www.heritageprofessional.com/ We can help you cultivate the healthy aspects of your personality, learn about your blind spots, and become more resilient and capable in handling difficult people.
Friday, August 8, 2008
Dads and discipline
Kids need to know that their parents are the authority figures in the home. They also need to know that they are loved. Usually, one parent is better at one of these and one parent is better at the other. In most homes, it is the dad who is the disciplinarian and the mom is the one who is better at the love, comfort and nurture. The ideal is for both parents to be equally good at both - that is, each parent should learn to be really good at both firmness and emotional nurture.
Dads generally need some help in 'dialing down' their anger with their kids. When I see my kids startle in response to my discipline of them (I have two boys), I realize that I have not done a good job of more seamlessly setting limits. When they escalate, I need to let them know that they are starting to travel out of bounds of my limits. So, I now try to raise my voice a little saying "Gentlemen!" This gets their attention first and foremost. I then remind them what they need to be doing. Most days this works. But, if they're more distracted than usual and I'm tired (usually a combination of the two) we move on to the next 'round.' At this point I say in a somewhat louder voice "Guys, you know that I am plenty capable of yelling. Let's get going." Almost always, they get with 'the program' and do what I am asking. When they don't startle, I realize that my escalation was not a surprise to them. I usually get something like "sorry - we're going up now (to brush teeth, get ready for bed, etc)."
Discipline works best in the context of a loving relationship with your kids. You'll never spoil them by telling them that you love them. And, you can't say those words too much. Physical affection is really important too. Don't hesitate to hug your kids - even your teenage boys (it won't turn them into sissies). Bed time routines are often an ideal time for this. So are good byes and hellos at the beginning and end of your work days. It makes your children more secure emotionally and they're more likely to respect you and follow your direction when it's time for discipline.
Studies on really well adjusted college kids have shown that a primary reason for their healthy adjustment is that their dads were present in their lives both physically and emotionally. A mother's presence is expected. And when a mother is absent, kids are really handicapped in the emotional adjustment department. But the presence of a dad physically and emotionally is the added variable that leads to a very well adjusted young adult.
If it's hard to get the right balance, don't hesitate to consult with a mental health professional. In the Chicago area, consider us at http://www.heritageprofessional.com/
Dads generally need some help in 'dialing down' their anger with their kids. When I see my kids startle in response to my discipline of them (I have two boys), I realize that I have not done a good job of more seamlessly setting limits. When they escalate, I need to let them know that they are starting to travel out of bounds of my limits. So, I now try to raise my voice a little saying "Gentlemen!" This gets their attention first and foremost. I then remind them what they need to be doing. Most days this works. But, if they're more distracted than usual and I'm tired (usually a combination of the two) we move on to the next 'round.' At this point I say in a somewhat louder voice "Guys, you know that I am plenty capable of yelling. Let's get going." Almost always, they get with 'the program' and do what I am asking. When they don't startle, I realize that my escalation was not a surprise to them. I usually get something like "sorry - we're going up now (to brush teeth, get ready for bed, etc)."
Discipline works best in the context of a loving relationship with your kids. You'll never spoil them by telling them that you love them. And, you can't say those words too much. Physical affection is really important too. Don't hesitate to hug your kids - even your teenage boys (it won't turn them into sissies). Bed time routines are often an ideal time for this. So are good byes and hellos at the beginning and end of your work days. It makes your children more secure emotionally and they're more likely to respect you and follow your direction when it's time for discipline.
Studies on really well adjusted college kids have shown that a primary reason for their healthy adjustment is that their dads were present in their lives both physically and emotionally. A mother's presence is expected. And when a mother is absent, kids are really handicapped in the emotional adjustment department. But the presence of a dad physically and emotionally is the added variable that leads to a very well adjusted young adult.
If it's hard to get the right balance, don't hesitate to consult with a mental health professional. In the Chicago area, consider us at http://www.heritageprofessional.com/
Thursday, August 7, 2008
Depression versus Grief
Depression and grief can feel identical to one another. There is sadness, loss of attention and concentration, decreased memory functioning, and changes in sleep, appetite, and sex drive. Things that used to provide enjoyment no longer do. It's hard to think about anything or anyone else in the midst of this kind of state. It hurts terribly and daily functioning can be profoundly affected.
But, there are also some key differences between depression and grief. Grief is triggered by an identifiable loss that could reasonably be expected to trigger loss and sadness in most people. The death of a loved one; the loss of a job; a job transfer and your child has to move from the only home that she/ he knew; a major financial set back; divorce - these are all significant losses that can trigger grief. But, people who are grieving have a sense that they are going to get over the loss eventually. And, usually outside of the specific loss, people who are grieiving can still appreciate other people and things in their life. I often 'prescribe' to my patients who are grieving, to take days off from the grieving to do more replinishing things. When tempted to grieve on the 'off' days, they can save the material for their next 'grieving day.' Grieving rarely lasts more than a month or two, and the worst of the grief starts to fade typically sooner than this.
Depression is a different phenomenon. It may or may not be triggered by an identifiable loss. People with clinical depression may not feel like they are ever going to get over it. As one of my depressed patients said to me: "When you are down in the dumps, it's like you're having a bad day. But when I'm depressed, I feel like I'm having a bad life." People who are depressed don't just snap out of it. There's no taking a day off from depression to focus on more replenishing things. There is a higher level of self absorption. Nothing feels good, tastes good, or is gratifying. Depression is often accompanied by suicidal thoughts; this is rarely true of grief (a grivieng person may want to be heaven with a lost loved one, but this is different than saying that they want to kill themselves to end their own suffering).
Grief goes away on its own and the worst of it goes away withing a week or two of the loss. Depression tends to linger. If the low mood is persisting, it's time to get a professional consultation to figure if it's depression or grief. Skilled and caring professionals are availble in the Chicago area at http://www.heritageprofessional.com. Otherwise, ask a trusted friend, pastor, or physician for a referral to a mental health professional for assistance.
But, there are also some key differences between depression and grief. Grief is triggered by an identifiable loss that could reasonably be expected to trigger loss and sadness in most people. The death of a loved one; the loss of a job; a job transfer and your child has to move from the only home that she/ he knew; a major financial set back; divorce - these are all significant losses that can trigger grief. But, people who are grieving have a sense that they are going to get over the loss eventually. And, usually outside of the specific loss, people who are grieiving can still appreciate other people and things in their life. I often 'prescribe' to my patients who are grieving, to take days off from the grieving to do more replinishing things. When tempted to grieve on the 'off' days, they can save the material for their next 'grieving day.' Grieving rarely lasts more than a month or two, and the worst of the grief starts to fade typically sooner than this.
Depression is a different phenomenon. It may or may not be triggered by an identifiable loss. People with clinical depression may not feel like they are ever going to get over it. As one of my depressed patients said to me: "When you are down in the dumps, it's like you're having a bad day. But when I'm depressed, I feel like I'm having a bad life." People who are depressed don't just snap out of it. There's no taking a day off from depression to focus on more replenishing things. There is a higher level of self absorption. Nothing feels good, tastes good, or is gratifying. Depression is often accompanied by suicidal thoughts; this is rarely true of grief (a grivieng person may want to be heaven with a lost loved one, but this is different than saying that they want to kill themselves to end their own suffering).
Grief goes away on its own and the worst of it goes away withing a week or two of the loss. Depression tends to linger. If the low mood is persisting, it's time to get a professional consultation to figure if it's depression or grief. Skilled and caring professionals are availble in the Chicago area at http://www.heritageprofessional.com. Otherwise, ask a trusted friend, pastor, or physician for a referral to a mental health professional for assistance.
Friday, July 25, 2008
Men and intimacy - Part II
It's called "normative male alexythymia." In ordinary language, this refers to the common occurrence in men of a difficulty recognizing and processing certain emotions - particularly the vulnerable ones (fear, hurt, shame, embarrassment, rejection, uncertainty, loneliness, etc.). It sounds worse than it is. Fortunately, a recent movement in psychology, A New Psychology of Men, spearheaded by psychologists such as Ron Levant, has introduced a treatment protocol to help men improve their capacity to recognize and communicate in a deeper and richer emotional 'language.' It starts by working on literally expanded their vocabulary of words which describe emotions. From their it moves to learning how to recognize these emotions in themselves and others, and finally, how to communicate them to others. Men embrace the protocol because it is doable.
Often, men come to therapy because someone (a loved one or an employer) tells them that they have to get help or else. But, once in the therapist's office, they really don't know what to do next. Men like this protocol because it is easy to understand, it is structured, and they will feel mastery around the tasks assigned. It's not unlike the process of going to the local hardware store referenced in my posting, Men and Intimacy - Part I. To get started with this protocol, visit us at http://www.heritageprofessional.com/ .
Often, men come to therapy because someone (a loved one or an employer) tells them that they have to get help or else. But, once in the therapist's office, they really don't know what to do next. Men like this protocol because it is easy to understand, it is structured, and they will feel mastery around the tasks assigned. It's not unlike the process of going to the local hardware store referenced in my posting, Men and Intimacy - Part I. To get started with this protocol, visit us at http://www.heritageprofessional.com/ .
Thursday, July 24, 2008
Men and intimacy - Part I
Men want (emotional) intimacy just like women do. The problem is, they don't know how to do it as well as women. Men will work really hard at something if you show them how in a non-shaming way. There's a small, local hardware store in town. Men come in droves on a Saturday morning with parts of some widget or another to meet some white haired guy named Gus of Clem. So, here they are...men in public asking for directions - for help on how to do something. And they're often doing it in front of an audience. What makes this possible? They expect that they will be enpowered to do something that they previously didn't know how to do. This is why Gus and Clem are there. So, there's no shame in showing up and asking for help. That's why people go there.
So, how do we create this same kind of environment in our homes so that men will open up, ask for help and be empowered to get better at emotional intimacy? Women, wives, girlfriends, consider this. Young boys are actually more emotionally reactive and responsive than are young girls. However, early in their childhoods, boys hear the messages "Big boys don't cry." "Don't be a mamma's boy." "Don't be a cry baby." When boys express vulnerable emotions in public, they're called "wuss" "sissy" and far worse. They soon learn not to express the vulnerable emotions. The whole process has been referred to as "normative cultural shaming." Some say that cultures throughout history have treated boys this way to prepare them emotionally to become warriors later in life. Who is the better warrior - the one in touch with his vulnerable emotions while in battle, or the one who has learned to convert his vulnerable emotions into anger and aggression?
So, how do we create this same kind of environment in our homes so that men will open up, ask for help and be empowered to get better at emotional intimacy? Women, wives, girlfriends, consider this. Young boys are actually more emotionally reactive and responsive than are young girls. However, early in their childhoods, boys hear the messages "Big boys don't cry." "Don't be a mamma's boy." "Don't be a cry baby." When boys express vulnerable emotions in public, they're called "wuss" "sissy" and far worse. They soon learn not to express the vulnerable emotions. The whole process has been referred to as "normative cultural shaming." Some say that cultures throughout history have treated boys this way to prepare them emotionally to become warriors later in life. Who is the better warrior - the one in touch with his vulnerable emotions while in battle, or the one who has learned to convert his vulnerable emotions into anger and aggression?
On rewards and punishments....
There is one and only definition of a reward. Your child does something and you respond in such a way that your child keeps doing what he or she was doing or does it more often. That's it. And, there's one and only one definition of a punishment. Your child does something and you respond in such a way that your child stops doing the behavior or does it less often. You can only tell if your parenting behavior is a reward or a punishment based upon the effect that it has on your child's behavior. Here's how it works. Your closed down, quiet adolescent son finally opens up while you're in the car together. You respond with understandable enthusiasm and start asking lots of questions. Your son shuts down. By definition, even though it was not your intention, your enthusiasm is functionally a punishment because it resulted in your son stopping a given behavior. In another example, your nine year daughter has acted out and you want to send her to her room. She wants an explanation. You end up in a lengthy debate about whether or not she deserves a punishment. You get frustrated and end up yelling at her. This goes on for some period of time. During the exchange it occurs to you that her defiance has continued. Your yelling, which you think of as a punishment or a consequence has actually functioned as a reward because your daughter's defiant behavior has persisted or maybe even increased. So, always pay attention to the effect that your parental behavior has on your child. Kids are often rewarded by your time and attention even if it's negative attention. If it becomes hard to sort out, don't hesitate to get a consult at http://www.heritageprofessional.com
Friday, July 18, 2008
Four things to do to make for better relationships
Don Miguel Ruiz wrote a book called The Four Agreements: A Practical Guide to Personal Freedom. His premise is that there are four basic agreements which, if fulfilled, lead to personal freedom. They are: 1. always tell the truth; 2. don't take things personally; 3. don't make assumptions; and 4. always do your best
It came up in one of our staff meetings at Heritage Professional Associates (http://www.heritageprofessional.com) that a modification to these four agreements may be in order as it relates to improving relationships. And these four agreements are:
1. Show up. In other words, be present. Don't get distracted by other events of the day. When interacting with others, try your best to put aside other thoughts which are competing for your attention and focus.
2. Tell the truth. As in, always tell the truth. This is one of the most basic ingredients in establishing trust.
3. Don't get defensive. Remember that the connection is more important than your pride. I'm not saying that this one is easy, but it still is an important goal to try and attain.
4. Don't worry about the outcome. We are often so outcome oriented. But, to do connection well with others, we can stay more present and connected emotionally if we're not thinking about some other desired 'end' to the connection.
It came up in one of our staff meetings at Heritage Professional Associates (http://www.heritageprofessional.com) that a modification to these four agreements may be in order as it relates to improving relationships. And these four agreements are:
1. Show up. In other words, be present. Don't get distracted by other events of the day. When interacting with others, try your best to put aside other thoughts which are competing for your attention and focus.
2. Tell the truth. As in, always tell the truth. This is one of the most basic ingredients in establishing trust.
3. Don't get defensive. Remember that the connection is more important than your pride. I'm not saying that this one is easy, but it still is an important goal to try and attain.
4. Don't worry about the outcome. We are often so outcome oriented. But, to do connection well with others, we can stay more present and connected emotionally if we're not thinking about some other desired 'end' to the connection.
Wednesday, July 2, 2008
On kids and school grades - what's their 'effort GPA'?
I hope that more than anything else, we want our kids to grow up to become happy, well-adjusted adults. They will have lives in reasonable balance with family, career, friends, hobbies and interests, etc. They will have enough self discipline to work towards meaningful, long term goals. But, they won't be so driven as to neglect relationships, leisure, and other forms of self care.
To help them accomplish this, their lives in childhood and adolescence need to reflect this same balance. I recommend that when it comes to school grades, the focus should be on the child's effort level much more than their actual, academic grades. I am less worried about the student who works hard for a 'C' than the lazy, gifted student who gets a 'B' on little or no effort. I will often ask kids what their 'effort GPA' would be if one were awarded. An 'effort GPA' of Bs in school seems to be the way to get a healthy balance in life. Kids who are are driven to put in a maximum effort at school (an effort GPA of 4.0) often do so as the cost of leisure, fun, relaxation, building relationships and caring for oneself. They usually end up with higher anxiety, stress, sleep problems, and overall happiness is diminished. And, they are setting the stage to do the same thing in adulthood.
However, kids whose 'effort GPA" drifts down to the 2.0 range and below will lack the self discipline to achieve meaningful long term goals in life. The doors of opportunity that will be left open for them will be beneath their ability level. The end result will likely be boredom, diminished self esteem, and a loss of vitality.
Granted, it is hard for any of us to achieve a healthy balance in life and keep it there. But, it helps to at least have some model in mind of what the balance should look like.
To help them accomplish this, their lives in childhood and adolescence need to reflect this same balance. I recommend that when it comes to school grades, the focus should be on the child's effort level much more than their actual, academic grades. I am less worried about the student who works hard for a 'C' than the lazy, gifted student who gets a 'B' on little or no effort. I will often ask kids what their 'effort GPA' would be if one were awarded. An 'effort GPA' of Bs in school seems to be the way to get a healthy balance in life. Kids who are are driven to put in a maximum effort at school (an effort GPA of 4.0) often do so as the cost of leisure, fun, relaxation, building relationships and caring for oneself. They usually end up with higher anxiety, stress, sleep problems, and overall happiness is diminished. And, they are setting the stage to do the same thing in adulthood.
However, kids whose 'effort GPA" drifts down to the 2.0 range and below will lack the self discipline to achieve meaningful long term goals in life. The doors of opportunity that will be left open for them will be beneath their ability level. The end result will likely be boredom, diminished self esteem, and a loss of vitality.
Granted, it is hard for any of us to achieve a healthy balance in life and keep it there. But, it helps to at least have some model in mind of what the balance should look like.
Sunday, June 29, 2008
Women and depression
Women suffer from depression at a much greater rate than men. Our culture makes it extremely difficult for women to feel as though they have gotten it 'right.' Stay home full time to raise kids and women often feel as though they have betrayed their gender's efforts to increase women's value in the workplace. Go to work full time and women often feel as though they are betraying their children who need their mother. Try to do both part-time and women often feel as though they are doing neither very well. The end result often is a sense of incompleteness, failure, futility, and eventually, depression.
As a husband and father who works full-time, I can come home, spend a little extra time with my wife and kids and society treats me like I'm some kind of hero. What an incredible double standard!
For women who feel trapped by this societal, no-win scenario, here are some practical steps:
1. Train your kids and your partner to understand that you are going to take some time each day (even 15 minutes) in which you are off duty. During this time, you will do something restoring (take a bath, read a poem, call a friend or loved one, watch the sunset, listen to some music, write in a journal).
2. Trade kid-time with neighbors. It's often easier to manage children when there are more of them in your home, especially when they include your children's friends. Trade-off time with the neighbors on a routine basis. This frees up a little more time for you during the week to decompress, if only for a short time. It is more about creating and maintaining intentionality around not always responding to the needs of everyone else all day long. It will lessen your resentment, fatigue and feelings of burn-out.
3. Forward this blog entry to your partner. Emphasize the importance of getting a few days off every six weeks. Most women never get a day off. If a male executive came to my office complaining of stress and burnout, having confessed to working seven days per week, 14 hours per day, guess what my advice would be? Stop working so much. No human being is 'built' to work such a grueling schedule. Take a few days off in a row on a regular basis for rest and restoration. So, why should it be any different for women who feel constantly pulled in so may directions by so many people virtually all of the time?
4. Learn to set reasonable limits. Teach your children that quiet time for everyone is valuable. It's a time to decrease the stimulation and do some quiet activity in the midst of the whirlwind of life.
5. Teach your children to take on responsibilities from an early age. We as parents have often made the mistake of over-indulging our children. They need to learn to not only complete chores on their own, but to even take notice when something needs attention in the way of picking up / cleaning up. Okay, you may be saying to yourself that I must be completely out of touch with how children are. But, with the proper incentives, guidance, consistency, and modeling, they can be taught (trained) to do this.
6. When efforts to implement these steps fail, it's time for some coaching / counseling to get things in better balance.
As a husband and father who works full-time, I can come home, spend a little extra time with my wife and kids and society treats me like I'm some kind of hero. What an incredible double standard!
For women who feel trapped by this societal, no-win scenario, here are some practical steps:
1. Train your kids and your partner to understand that you are going to take some time each day (even 15 minutes) in which you are off duty. During this time, you will do something restoring (take a bath, read a poem, call a friend or loved one, watch the sunset, listen to some music, write in a journal).
2. Trade kid-time with neighbors. It's often easier to manage children when there are more of them in your home, especially when they include your children's friends. Trade-off time with the neighbors on a routine basis. This frees up a little more time for you during the week to decompress, if only for a short time. It is more about creating and maintaining intentionality around not always responding to the needs of everyone else all day long. It will lessen your resentment, fatigue and feelings of burn-out.
3. Forward this blog entry to your partner. Emphasize the importance of getting a few days off every six weeks. Most women never get a day off. If a male executive came to my office complaining of stress and burnout, having confessed to working seven days per week, 14 hours per day, guess what my advice would be? Stop working so much. No human being is 'built' to work such a grueling schedule. Take a few days off in a row on a regular basis for rest and restoration. So, why should it be any different for women who feel constantly pulled in so may directions by so many people virtually all of the time?
4. Learn to set reasonable limits. Teach your children that quiet time for everyone is valuable. It's a time to decrease the stimulation and do some quiet activity in the midst of the whirlwind of life.
5. Teach your children to take on responsibilities from an early age. We as parents have often made the mistake of over-indulging our children. They need to learn to not only complete chores on their own, but to even take notice when something needs attention in the way of picking up / cleaning up. Okay, you may be saying to yourself that I must be completely out of touch with how children are. But, with the proper incentives, guidance, consistency, and modeling, they can be taught (trained) to do this.
6. When efforts to implement these steps fail, it's time for some coaching / counseling to get things in better balance.
Tuesday, June 24, 2008
On conflict resolution......
Rarely in the course of human conflict is there only one side to the story. For that matter, there are rarely only two sides. Most often, there are several 'truths' in the conflict. The fact that many of them contradict one another doesn't make any of them untrue. A biographer, writing about the Wright brothers, believed that they solved the mystery of flight in just three years because they could argue about a theory of flight, then stop, switch positions, and argue with the same passion about the opposite point of view. Neither had to be the one who was right. What if we could have the same flexibility and adaptability when arguing with a loved one? What if we could stop, take their position, and argue it with equal passion?
I encourage people in conflict to name every truth that they can. It's even better if they can name some of the truths more favorable to the other person. This 'multiple truths' approach helps people avoid the awful 'did not, did too' circular arguments that go nowhere. It also respects the complexity of most human conflicts as well as the fact that both parties have some truth that deserves to be honored and respected.
I encourage people in conflict to name every truth that they can. It's even better if they can name some of the truths more favorable to the other person. This 'multiple truths' approach helps people avoid the awful 'did not, did too' circular arguments that go nowhere. It also respects the complexity of most human conflicts as well as the fact that both parties have some truth that deserves to be honored and respected.
Wednesday, June 18, 2008
On raising kids.....
On raising children... the two most common mistakes I see parents make in raising kids are (1) over-indulgence and (2) not giving them enough of your quality time.
On overindulgence... kids need to experience optimal frustration. That is, they need to experience enough setbacks in life to learn frustration tolerance, persistence in the midst of setbacks without losing hope, and the value of sustained self-discipline to realize important, larger goals in life. Optimal frustration also teaches them that things simply won't come their way merely because they wish for them. They will also learn that even with diligent effort, sweat and toil, good outcomes are not automatically guaranteed. None of us is automatically entitled to good things merely because we wish for them.
On giving kids enough of your quality time... no other single parental action will fuel your children's healthy self-esteem more than giving them enough of your time, focused on meeting their needs rather than your own. Tuning into them and spending time with them communicates that you value them. Follow their lead, offer them the opportunity to choose among different choices (all of which you can live with).
On overindulgence... kids need to experience optimal frustration. That is, they need to experience enough setbacks in life to learn frustration tolerance, persistence in the midst of setbacks without losing hope, and the value of sustained self-discipline to realize important, larger goals in life. Optimal frustration also teaches them that things simply won't come their way merely because they wish for them. They will also learn that even with diligent effort, sweat and toil, good outcomes are not automatically guaranteed. None of us is automatically entitled to good things merely because we wish for them.
On giving kids enough of your quality time... no other single parental action will fuel your children's healthy self-esteem more than giving them enough of your time, focused on meeting their needs rather than your own. Tuning into them and spending time with them communicates that you value them. Follow their lead, offer them the opportunity to choose among different choices (all of which you can live with).
Saturday, June 14, 2008
What makes for a good life?
Is it more money? Actually, once you're out of total and complete poverty, increases in net worth have no discernable impact on happiness. That is, unless you become extremely wealthy, and then happiness starts to diminish.
Creating (and maintaining) healthy, emotionally nourishing connections with others will increase happiness.
You can increase happiness by taking even five or ten minutes per day to 'act upon the day' rather than just trying to keep up with everything coming at you. Try to develop a variety of things that can be done in short amounts of time that nourish you. Listen intentionally to some music. Play a little music yourself. Read a poem. Try writing one. Work even for brief amounts of time on a daily basis on some kind of creative project. Try to end each day with a sense of having acted upon the day rather than merely (and barely) keeping up with the demands of the day. If you try and can't manage to increase your happiness, get some help at http://www.heritageprofessional.com
Creating (and maintaining) healthy, emotionally nourishing connections with others will increase happiness.
You can increase happiness by taking even five or ten minutes per day to 'act upon the day' rather than just trying to keep up with everything coming at you. Try to develop a variety of things that can be done in short amounts of time that nourish you. Listen intentionally to some music. Play a little music yourself. Read a poem. Try writing one. Work even for brief amounts of time on a daily basis on some kind of creative project. Try to end each day with a sense of having acted upon the day rather than merely (and barely) keeping up with the demands of the day. If you try and can't manage to increase your happiness, get some help at http://www.heritageprofessional.com
Friday, June 13, 2008
Some thoughts about counseling
Psychotherapy or counseling is about entering into an important relationship for the purposes of self-exploration, looking at old problems from new perspectives, and experiencing yourself differently in a relationship than you may have in the past. It requires courage, a letting go of pride, and an openness to re-considering what you believe to be true about yourself and others. I work hard to provide an atmosphere for this to take place, as free as possible from shame or judgment. Hopefully, you can expect hefty doses of wisdom and humor in the midst of all of the hard work. Look for us at http://www.heritageprofessional.com
introduction
I am a clinical psychologist in private practice at Heritage Professional Associates in Hinsdale, Illinois (630) 325-5300. I have been in practice since 1984. For starters, here are some general adages that I have found to be as useful as they are difficult to do:
1. Getting better at love is more important than being right.
2. My definition of success: flexible adaption to change
3. Carl Roger's defintion of mental health is when your emotions match your circumstances
4. Never love principles more than people
1. Getting better at love is more important than being right.
2. My definition of success: flexible adaption to change
3. Carl Roger's defintion of mental health is when your emotions match your circumstances
4. Never love principles more than people
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