There's a Six Word Memoir project hosted by Smith Magazine. As the name implies, people write their memoirs, but you only get six words to do it. When they published the first volume of them, the title of the book was one of the favorite memoirs: "Not Quite What I Was Planning". It's hard to look at that book title and do anything but shake your head and say to yourself "boy, ain't that the truth?"
Very few of us have our lives play out like we expected, if we even had a clear sense of what we were expecting to begin with. For most of us, at some time in our life, something big doesn't go according to plan, and it's often something pretty bad. Divorce. Cancer. Addictions. Job loss. Death of a loved one. Mental illness. The list could fill a page.
Even though I'm a psychologist, I am hardly immune to life's hardships either. The biggest one that I'm facing now is that my wife of 26 years, also a psychologist, has been diagnosed with early onset Alzheimer's. The diagnosis was made a few years ago and she's pretty advanced in this disease which progresses faster when it's early onset. She rarely speaks in complete sentences, gets confused often, needs full-time care, and repeats the same questions many times over in the course of a day.
So, what are we do to do when facing the really hard things in life? I say "lean into it all." By this I mean, don't shy away from the fullness of any of it. Cry, grieve, laugh, live, embrace everything and everyone. Pretty much every day I cry with grief, but rarely does a day go by either when I don't stop to see the opportunities in the day and am grateful. And I laugh, every day, over something, usually several times each day. Alzheimer's in a loved one gives you the gift of being more in the moment - letting go of yesterday's regrets and tomorrow's anxieties. We share more sunsets and hummingbirds. There's opportunity in everything, even in the really bad stuff, if we look for it.
A faith life, a community, a support group, loving friends and family can all be magnificent ways to embrace and thrive in the midst of life's hardest challenges. We're not 'wired' to face this stuff alone. Reach out to others, let them know of your struggles, but also remember to ask how they're doing too. It's way easy to become self-absorbed in the tough stuff and we can forget that others have lives too!
So, live life to its very fullest in all ways - let every emotion, regardless of what it is, flow through you. You'll learn to become more courageous, and to be less anxious. If you're trying to do these things, but you can't get there from here, in the Chicago area consider seeing someone from Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health professional.
Sunday, November 23, 2014
Sunday, November 16, 2014
Dementia Versus Normal Memory Loss in the Middle Aged Years and Beyond....
As we age, it's normal to have some memory loss. In fact it's rather sobering to consider that we're all 'graded on a curve' after the age of 29. This is when our human RAM memory, called working memory, starts its decline and the curve slopes more downward through the remaining decades of our lives. I used to be able to remember a phone number - area code and all, after seeing or hearing it once. Not anymore. I'm much more tied to lists, electronic reminders, and I would be totally screwed if I didn't have Google calendar synched to more devices than I care to count (that's a Blog entry for another time). With normal aging, we usually remember what we've forgotten when prompted. Partner: "Did you remember to get the milk?" For those of us middle aged and beyond: "Oh, I forgot; I'll go get it." It's normal, too, in middle age to sometimes not recognize things that we've written down, or conversations that we've had with other people. It is both consoling and disconcerting to be reassured that this so-called normal memory loss that is part of the aging process.
Dementia is altogether different. Think of dementia like the generic concept of a photocopier. There are lots of brands of photocopiers just like there's lots of different kinds of dementia. Alzheimer's is by far the most common form of dementia, accounting for 60-80% of the cases of dementia, which is why it's a more recognized household word. Other kinds of dementia include vascular dementia, dementia with Lewy bodies, fronto-temporal dementia, and scores of other kinds of less-commonly occurring dementias.Contrary to popular belief, dementia is not just a problem in the elderly. It can occur in people as young as their mid 30's, and many cases of early onset dementia have been recorded and are being studied in clinical research trials.
Core symptoms of dementia can include two or more of the following: problems with memory, communication and language, ability to focus and pay attention, reasoning and judgment as well as visual perception problems. These problems were not always present, such as when the person was growing up or in young adulthood. When you're close to someone with dementia, there's usually a much bigger pit in your stomach as you witness the onset of symptoms. You are asked the same thing repeatedly within a relative short span of time. Speech can become less fluent, there's a fair amount of word finding problems (far more than the occasional word finding problem or problem remembering people's names which is normal aging). The person can be confused about what he/she was doing and they may ask you to repeat what you have just said a lot. This is because their ability to pay attention has diminished greatly.
If you suspect dementia in either yourself or a loved one, get a referral to a neurologist, preferably one who specializes in dementia. A good medical work up is essential. There are some dementias which are cause by vitamin deficiencies and these can be reversed and corrected. Others can be slowed down and managed better with early detection and early intervention. In addition to a medical work up, there is also neuro-psychological testing which measures memory functioning relative to one's age, thinking and reasoning skills, and a host of other mental functions.
If dementia is diagnosed, get affiliated with a good memory care clinic at a medical center near you. Social / emotional support is very important for both the person with dementia as well as for the caregiver(s) in addition to good on-going medical care.
We encourage people in the Chicagoland area to come to our practice, Heritage Professional Associates, for a brief memory screening for the following reasons: 1) if you're at risk for dementia (many people in your family have it); 2) you're wanting to know if your memory functioning is age typical or not; 3) you've noticed some recent changes; 4) or, you simply would like a baseline measure of your memory functioning to be used for comparison with future memory assessments. A brief work-up consists of an interview and some testing using screening measures. Outside of the Chicago area, ask your primary care physician or internist for the name of a reputable person who can provide such screenings.
Dementia is altogether different. Think of dementia like the generic concept of a photocopier. There are lots of brands of photocopiers just like there's lots of different kinds of dementia. Alzheimer's is by far the most common form of dementia, accounting for 60-80% of the cases of dementia, which is why it's a more recognized household word. Other kinds of dementia include vascular dementia, dementia with Lewy bodies, fronto-temporal dementia, and scores of other kinds of less-commonly occurring dementias.Contrary to popular belief, dementia is not just a problem in the elderly. It can occur in people as young as their mid 30's, and many cases of early onset dementia have been recorded and are being studied in clinical research trials.
Core symptoms of dementia can include two or more of the following: problems with memory, communication and language, ability to focus and pay attention, reasoning and judgment as well as visual perception problems. These problems were not always present, such as when the person was growing up or in young adulthood. When you're close to someone with dementia, there's usually a much bigger pit in your stomach as you witness the onset of symptoms. You are asked the same thing repeatedly within a relative short span of time. Speech can become less fluent, there's a fair amount of word finding problems (far more than the occasional word finding problem or problem remembering people's names which is normal aging). The person can be confused about what he/she was doing and they may ask you to repeat what you have just said a lot. This is because their ability to pay attention has diminished greatly.
If you suspect dementia in either yourself or a loved one, get a referral to a neurologist, preferably one who specializes in dementia. A good medical work up is essential. There are some dementias which are cause by vitamin deficiencies and these can be reversed and corrected. Others can be slowed down and managed better with early detection and early intervention. In addition to a medical work up, there is also neuro-psychological testing which measures memory functioning relative to one's age, thinking and reasoning skills, and a host of other mental functions.
If dementia is diagnosed, get affiliated with a good memory care clinic at a medical center near you. Social / emotional support is very important for both the person with dementia as well as for the caregiver(s) in addition to good on-going medical care.
We encourage people in the Chicagoland area to come to our practice, Heritage Professional Associates, for a brief memory screening for the following reasons: 1) if you're at risk for dementia (many people in your family have it); 2) you're wanting to know if your memory functioning is age typical or not; 3) you've noticed some recent changes; 4) or, you simply would like a baseline measure of your memory functioning to be used for comparison with future memory assessments. A brief work-up consists of an interview and some testing using screening measures. Outside of the Chicago area, ask your primary care physician or internist for the name of a reputable person who can provide such screenings.
Tuesday, November 11, 2014
Why is ADD/ADHD Diagnosed More Often Now Than it Was When I Was Younger?
It seems like everyone today has attention deficit disorder - officially called ADHD (attention deficit hyperactivity disorder) and it comes in three forms: ADHD inattentive (they put the 'H' in, and then modify it out), ADHD hyperactive (where the 'H' stays in ) and ADHD combined (where there's both inattention and hyperactivity). Why do so many more people seem to have ADHD now than they did a generation ago? Is this some kind of drug company conspiracy? Is it excuse-making or laziness?
Ask any parent if he or she would rather be in high school today or when they actually went through high school and odds are overwhelming - parents are glad that they went through high school when they did. I hear things like: "it's way more complicated today" or "high school today is way harder - often they're more like college classes than high school classes."
Human beings have RAM memory, called working memory. And there's simply no denying it. Students need LOTS more of it today than they would have needed a generation ago. Students are expected to learn more and learn it faster as the boomer parents have worked to ensure that school curricula kept getting more advanced and more competitive. Expectations keep rising, and it's not unusual for the country's best high students to graduate with a year's worth of college credit. So, kids need lots more RAM or working memory but the problem is that the human brain evolves over a very long period of time. Many kids diagnosed with ADHD today simply would not have been diagnosed with this condition a generation ago. For many kids, it's like they're the equivalent of a computer built in 1995. Their brains would have handled formal education just fine 20 years ago. But, the same brain simply doesn't have enough RAM memory to work very well today in modern times with higher demands from today's school curricula. Learning, storing and retrieving information is slow, sluggish, and very frustrating.
So what's the solution? Certainly parents need to adjust their expectations of their kids, and along with them, school boards and curricula planning committees. At the same time, human RAM memory or working memory can be improved with training. Our clinical practice has seen very promising results from the Cogmed Working Memory Training Program. Training over five weeks, five times per week for about 45 minutes per day, significantly improves the working memory in about 80% of the people who complete the training. Moreover, the benefits appear to be long lasting.
Another alternative is the use of prescription medication, which like the Cogmed training, has been shown in double blind controlled studies to produce significant improvement in working memory as well as planning and organization.
If you're in the Chicagoland area, check out Heritage Professional Associates. We offer both Cogmed training as well as psychiatric services to treat working memory problems and other symptoms of ADHD. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health professional.
Ask any parent if he or she would rather be in high school today or when they actually went through high school and odds are overwhelming - parents are glad that they went through high school when they did. I hear things like: "it's way more complicated today" or "high school today is way harder - often they're more like college classes than high school classes."
Human beings have RAM memory, called working memory. And there's simply no denying it. Students need LOTS more of it today than they would have needed a generation ago. Students are expected to learn more and learn it faster as the boomer parents have worked to ensure that school curricula kept getting more advanced and more competitive. Expectations keep rising, and it's not unusual for the country's best high students to graduate with a year's worth of college credit. So, kids need lots more RAM or working memory but the problem is that the human brain evolves over a very long period of time. Many kids diagnosed with ADHD today simply would not have been diagnosed with this condition a generation ago. For many kids, it's like they're the equivalent of a computer built in 1995. Their brains would have handled formal education just fine 20 years ago. But, the same brain simply doesn't have enough RAM memory to work very well today in modern times with higher demands from today's school curricula. Learning, storing and retrieving information is slow, sluggish, and very frustrating.
So what's the solution? Certainly parents need to adjust their expectations of their kids, and along with them, school boards and curricula planning committees. At the same time, human RAM memory or working memory can be improved with training. Our clinical practice has seen very promising results from the Cogmed Working Memory Training Program. Training over five weeks, five times per week for about 45 minutes per day, significantly improves the working memory in about 80% of the people who complete the training. Moreover, the benefits appear to be long lasting.
Another alternative is the use of prescription medication, which like the Cogmed training, has been shown in double blind controlled studies to produce significant improvement in working memory as well as planning and organization.
If you're in the Chicagoland area, check out Heritage Professional Associates. We offer both Cogmed training as well as psychiatric services to treat working memory problems and other symptoms of ADHD. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health professional.
Sunday, November 9, 2014
When Good People Appear to Lack Empathy
There is a general belief that all good human traits seem to 'wire together'. So, someone who is kind, is also generous. That person also shows compassion and it is presumed, that with all of these wonderful traits they should also have an abundance of empathy. Neighbors routinely comment on how this person is so nice, generous, and must be wonderful to have in the family. And yet, despite the real presence of all of these wonderful traits, you are baffled by what seems like the repeated and consistent absence of empathy from someone who love. You tell them in clear language those reasonable things that you would like, things that you need, or what is important to you. And yet these things are routinely ignored no matter your manner of delivery. Whether you say it kindly, with tears, or anger, none of it seems to matter. This lovely person seems utterly incapable of putting themselves in your emotional 'shoes' to understand how you feel. As a result, he or she cannot adapt their behavior accordingly.
And certainly, there are notable personality problems including personality disorders in which empathy is glaringly absent. These include narcissistic personality disorder as well as antisocial personality disorder (formerly known as a sociopath). People with these personality disorders routinely violate the rights, liberties and feelings of others. They are seemingly incapable of understanding how another person feels. They are only looking out for themselves, and are fundamentally incapable of considering that another person has needs, feelings, drives and wishes of their own.They are highly manipulative and you usually get feedback from others that they are not very well-liked. This is when, if blinded to such personality disorders, you think of marrying this kind of person, relatives come out of the woodwork to tell you that it is not a good idea.
But this problem of lacking empathy can occur in a far more subtle way with people who otherwise appear kind-hearted, compassionate, and possessing an abundance of what looks like rather good values and priorities. Over time as you know them well, you come to understand that they really don't seem to know how you feel. You can tell them over and over how something hurts you, how much it would mean for you if they could honor a wish or request, but repeatedly, these kind-hearted and good people sidestep your requests and you end of feeling angry, resentful, and utterly bewildered by their lack of consideration for what you have asked for repeatedly. You can feel crazy in your frustration, not understanding how an otherwise lovely and compassionate person can routinely violate your wishes, needs and feelings despite the fact that you have articulated them several times in every way that you know how.
So, what seems to be the problem? Sometimes these otherwise lovely people are raised in families where it was hurtful when they were children to try to understand how another person felt. A parent may have placed impossible demands on a child, and was somewhat inconsistent and unpredictable when a child tuned into the parent's needs and wishes. That child (your loved one now), learned over time that having empathy for another person 'cost' them. Or they were indulged and catered to so much that they didn't need to tune into others' needs. Either way, they grew up by following general principles of value-based living. Strive to do good, be kind and considerate to others, and live a purposeful and noble life. But such good traits are carried out in the absence of being able to tune into the needs and feelings of other people. They become utterly bewildered when given the feedback that they are self-centered, thinking only of themselves, and seemingly incapable of responding to the needs and feelings of others.
Unfortunately, sometimes the best way to get through to one of these loved ones is to treat them the same way that you are being treated. They may have to experience feeling what it is like to have someone ignore their emotional needs and requests, for them to understand that this is a very unloving and hurtful way to behave. They may be able to change their pattern of behavior not really because they have now developed empathy, but because they are able to modify some principles about how to live based on the particular lesson you have just given them.
It is not easy to deal with these very painful and difficult dynamics because they are often so subtle and couched within the personality of a person who otherwise has so many wonderful traits. If you are struggling with this dynamic and live in the Chicagoland area, consider seeing one of our psychotherapists from Heritage Professional Associates. If you live outside the Chicagoland area, look to someone whom you trust for the name of a reputable mental health professional.
And certainly, there are notable personality problems including personality disorders in which empathy is glaringly absent. These include narcissistic personality disorder as well as antisocial personality disorder (formerly known as a sociopath). People with these personality disorders routinely violate the rights, liberties and feelings of others. They are seemingly incapable of understanding how another person feels. They are only looking out for themselves, and are fundamentally incapable of considering that another person has needs, feelings, drives and wishes of their own.They are highly manipulative and you usually get feedback from others that they are not very well-liked. This is when, if blinded to such personality disorders, you think of marrying this kind of person, relatives come out of the woodwork to tell you that it is not a good idea.
But this problem of lacking empathy can occur in a far more subtle way with people who otherwise appear kind-hearted, compassionate, and possessing an abundance of what looks like rather good values and priorities. Over time as you know them well, you come to understand that they really don't seem to know how you feel. You can tell them over and over how something hurts you, how much it would mean for you if they could honor a wish or request, but repeatedly, these kind-hearted and good people sidestep your requests and you end of feeling angry, resentful, and utterly bewildered by their lack of consideration for what you have asked for repeatedly. You can feel crazy in your frustration, not understanding how an otherwise lovely and compassionate person can routinely violate your wishes, needs and feelings despite the fact that you have articulated them several times in every way that you know how.
So, what seems to be the problem? Sometimes these otherwise lovely people are raised in families where it was hurtful when they were children to try to understand how another person felt. A parent may have placed impossible demands on a child, and was somewhat inconsistent and unpredictable when a child tuned into the parent's needs and wishes. That child (your loved one now), learned over time that having empathy for another person 'cost' them. Or they were indulged and catered to so much that they didn't need to tune into others' needs. Either way, they grew up by following general principles of value-based living. Strive to do good, be kind and considerate to others, and live a purposeful and noble life. But such good traits are carried out in the absence of being able to tune into the needs and feelings of other people. They become utterly bewildered when given the feedback that they are self-centered, thinking only of themselves, and seemingly incapable of responding to the needs and feelings of others.
Unfortunately, sometimes the best way to get through to one of these loved ones is to treat them the same way that you are being treated. They may have to experience feeling what it is like to have someone ignore their emotional needs and requests, for them to understand that this is a very unloving and hurtful way to behave. They may be able to change their pattern of behavior not really because they have now developed empathy, but because they are able to modify some principles about how to live based on the particular lesson you have just given them.
It is not easy to deal with these very painful and difficult dynamics because they are often so subtle and couched within the personality of a person who otherwise has so many wonderful traits. If you are struggling with this dynamic and live in the Chicagoland area, consider seeing one of our psychotherapists from Heritage Professional Associates. If you live outside the Chicagoland area, look to someone whom you trust for the name of a reputable mental health professional.
When Your Son or Daughter Wants to Get a Tattoo.....
And so the dreaded moment arrives when your son or daughter approaches you to tell you that they want to get a tattoo. It's not exactly like they're asking for permission. It's more like they're telling you something to find out how drastic your reaction is going to be before they proceed with putting permanent ink on their body.
For many of us parents from that 'older generation,' tattoos were reserved for servicemen returning from battle, or other demographic groups that we'd rather that our children not become affiliated with. But undeniably, tattoos mean something else today. They are obtained by people from all walks of life, and they're placed on all parts of the body, with a variety of art and accompanying messages. The dilemma as a parent is that if you fight the tattoo idea, your son or daughter is likely going to get the tattoo anyway, and you will be perceived as out of touch with modern times. And yet to just give consent seems to betray a nagging sense of something just not being right with someone at the age of 19 or 20 deciding to put something on their body which is permanent.
In my work with parents and their children of age who want to have tattoos, I make the following comments. First, I mention the generational tension in the previous paragraph. Then I point out that a sizable percentage of people who get tattoos later regret it and wish to have them removed. In fact there's a term for this, 'tatoo regret,' and it's estimated that about one third of tattoo wearers regret having gotten one.
And so what I propose is this. Parents pay for their son or daughter to get a temporary tattoo of the design and placement of their choosing. Parents pay to have the temporary tattoo redone for up to one year. If after a year, the son or daughter still wants to have the permanent tattoo, then parents give their consent.
Managing dilemmas is difficult. If you're in one and are struggling to find a solution, and you live in the Chicagoland area, consider seeing one of our fine mental health specialists at Heritage Professional Associates. If you're not in the Chicagoland area, ask someone you trust such as a friend, family doctor or clergy-person for the name of a reputable person.
For many of us parents from that 'older generation,' tattoos were reserved for servicemen returning from battle, or other demographic groups that we'd rather that our children not become affiliated with. But undeniably, tattoos mean something else today. They are obtained by people from all walks of life, and they're placed on all parts of the body, with a variety of art and accompanying messages. The dilemma as a parent is that if you fight the tattoo idea, your son or daughter is likely going to get the tattoo anyway, and you will be perceived as out of touch with modern times. And yet to just give consent seems to betray a nagging sense of something just not being right with someone at the age of 19 or 20 deciding to put something on their body which is permanent.
In my work with parents and their children of age who want to have tattoos, I make the following comments. First, I mention the generational tension in the previous paragraph. Then I point out that a sizable percentage of people who get tattoos later regret it and wish to have them removed. In fact there's a term for this, 'tatoo regret,' and it's estimated that about one third of tattoo wearers regret having gotten one.
And so what I propose is this. Parents pay for their son or daughter to get a temporary tattoo of the design and placement of their choosing. Parents pay to have the temporary tattoo redone for up to one year. If after a year, the son or daughter still wants to have the permanent tattoo, then parents give their consent.
Managing dilemmas is difficult. If you're in one and are struggling to find a solution, and you live in the Chicagoland area, consider seeing one of our fine mental health specialists at Heritage Professional Associates. If you're not in the Chicagoland area, ask someone you trust such as a friend, family doctor or clergy-person for the name of a reputable person.
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