Why do you feel so unhappy when you've worked so hard?

You’ve worked hard your whole life. By the world’s standards, you’re successful. You’re a leader. You’re reaching your goals.  Yet for all of the effort and successes, you feel like you should be happier. But you’re not. You lack deep relationships. Your partner is chronically unhappy with you. You should be more connected to your children and other family members. What happened? You are not alone. Many people feel a sense of disillusionment, discouragement and loss of hope despite all the efforts they have put in to have a good and meaningful life.  

But there is hope. It's actually not to pursue happiness. Happiness is too dependent on our circumstances. But, you can mostly certainly improve you well-being. Well-being is very much like contentment. It's the notion that you are okay and you will be okay. There's a science to improving your well being.  You can  learn how to discover aspects of life that bring joy, contentment, and peace. According to psychologist Martin Seligman, well being is comprised of doing exercises designed to increase the experience of positive emotions, creating a sense of engagement in the world, tending to your relationships more, creating meaning, and routinely doing actions consistent with your values. And there's ways to measure your progress along the way.

Using a combination of practical advice, wit, irreverent humor, and as I have been told, an uncommon wisdom, I can help you have a new perspective on your chronic problems. Therapy sessions include practical tips and advice. And, usually, there’s therapeutic ‘homework’ assignments. And, some time is spent as well diving a little deeper into what’s behind things. It takes hard work, courage and a willingness to become transparent. But the payoffs can be life-changing. Getting started is easy. Call (630) 325-5300 and ask to do an intake, or email me at kbaird@heritageprofessional.com to get underway. Virtual sessions are being used during the pandemic. My office is in Hinsdale, IL.

Family Bingo: Coping with the Holidays

The major holidays are often a source of stress for many. Large family gatherings, and particularly lately, the fear of political discussions and debate overtaking our celebrations, leave many feeling a bit anxious.

Years ago, a colleague and dear friend came up with the idea of "Family Bingo." Here how it's played. Either literally or mentally create a Bingo Card. Letters go across the top and numbers down the left hand margin.  Write in each square a brief word or two which describes a behavior or a comment that you ancitipate with dread coming from one of the family members.

And then, when the dreaded comment or behavior occurs, you mark that square with an 'X.' It's weird, but you actually start smiling as the squares fill in.  And when a row gets completed and you scream in your head "Bingo!", it's elation rather than frustration. It's a way of transforming frustration into playfulness. So, let the games begin!

How Do I Know what the Truth is About Anything Anymore?

It can be very troubling to figure out the truth about things. This happens when two people whom you care about are in conflict with one another and they tell you conflicting stories. Who do you believe? Or major governmental institutions, departments, government leaders point the finger back and forth and tell conflicting stories. Who are you to believe?

As if the problem of figuring out the truth isn't hard enough, add another element. And that is, our perception of things is strongly influenced by our expectations. It's maddening to me as a rational, logical, clinical psychologist for over 30 years to see my brain trick me. I wear my cellphone on my belt, set to vibrate all day long. And it does vibrate pretty often. Then I get home, I take my phone off to charge it. As I walk around in my home, I feel my phone vibrating on my belt. I reach down and remember that I'm not wearing my phone. But, my brain has delivered a signal to me that feels exactly the same as the real phone.  I mean, exactly the same and I'd bet a pile of money that my phone was vibrating on my hip. But, despite my very high level of confidence in the accuracy of my perception, it was completely wrong.

The mis-perception starts with an expectation and from conditioning. I expect phone calls, and so I perceive them. And if my brain is capable of tricking me into believing something so basic as a cell phone call, imagine how it can trick me into believing a host of other wrong perceptions as well.

If I am a Republican and I hear a negative story about a Democrat, I am conditioned to expect this. And, therefore, I am more likely to believe it as true given my expectation bias. Or, if I am a Democrat, and I hear a negative story about a Republican, I am more likely to believe it as true given my pre-conceived expectations. Add to it the natural tendency to gravitate to information that confirms my expectations and overlook data that are contrary to my expectations, and I am one sorry, biased and confused individual.

So, how do we get out of this hopeless mess of confusion?  First, by recognizing how all of us are vulnerable to being tricked by our own minds. We can be wrong about something even when we're very confident that we're right. Get in the habit of talking in a civil, respectful way with others whose opinions are different than your own. Strive to find at least some things they say that you can agree with. Get information from varied sources. Follow writers, journalists, news  outlets who have historically been balanced and reasoned. If you believe that none are trustworthy, consider that this is one of those things that you believe as true with great confidence like me with my cellphone. Consider how your own views on something may bias who you are likely to listen to and believe. Model for others around you a healthy respect for how we can all be vulnerable to bias.

If these challenging times feel like just too much, and you're looking for someone to talk to in the Chicago area, consider one of our mental health care providers at www.heritageprofessional.com

Managing Hardships in Life

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.

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.

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.

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.

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.

The Backwards Thinking in Healthy Relationships

I've seen many couples get tangled over certain issues and never resolve them. Like moths to the proverbial light, they become hooked into point - counterpoint; debate, argument, and the irresistible urge to prove that he / she is right about something. But pursuing these things really never promotes love, closeness or emotional intimacy. So, why do we do them? Maybe it's our cultural heritage - born on the notion that being right entitles us to something - privilege, or power or status. Maybe it's about feeling more in control in a relationship which leaves us feeling less vulnerable. But being right doesn't create or sustain love. Most couples who report having a big argument during the week, can't remember what the fight was about. But they remember how they were treated.

It's hard to let go of being right, or even the pursuit of being right. If we were to let go of this score-keeping, we become more anxious. We've lost a central mooring in the seascape of relating to others. But, William Butler Yeats invited us in his poem, Into the Twilight, to "....come clear of the nets of right and wrong." For to be in the business of judging others as right or wrong leaves us tangled in webbing that is contrary to love.

So, I coach couples on some decidedly un-American notions. Let go of fairness. It's way over-rated and doesn't promote love. It almost certainly promotes resentment. In the end, most of us are looking for love, tenderness, emotional intimacy, resting softly and safely in the arms of a lover. We simply can't there through debate, argument and amassing evidence in yet another 'courtroom' setting (which, with many couples,  doubles as a bedroom).

Just like defensiveness and argumentation encourages the same in the other person, so also is there a reciprocity around the opposite. Vulnerability invites vulnerability. Tenderness invites tenderness. Humility, kindness, putting love above being right all encourage the same behaviors on the part of the other. Strive to be your most loving, tender, vulnerable, humble self, letting go of being right and winning an argument. You'll be surprised by how over-rated being right is in the end.

If you're tangled in the did not - did do arguments (which quickly go nowhere), and are locked into the same arguments again and again, ask someone you trust for the name of a reputable counselor to help you with your relationship. In the Chicagoland area, consider one of the counselors at Heritage Professional Associates.

Forgiveness

Forgiveness is an often misunderstood concept. Most of us think of it as something we do for another person. We let them off the hook. We think that it should only happen after the other person recognizes their wrong-doing, apologizes, and then we forgive. We think that forgiveness is predicated on fairness, and should only be used when the other person makes the first (right) move.

But, forgiveness is really more for the benefit of the one doing the forgiving. When we forgive, we're released from our resentment. Forgiveness can occur even when the other person has no idea that they've hurt you (as in "forgive them Father for they know not what they do"). It is about choosing to no longer focus on the injustice. There are some pretty good quotes and sayings about forgiveness floating around in various literature and on the internet. These are not my original ones:

1. If you want to bury someone with your resentments, dig two graves.
2. I can be happy, or I can be right.
3. Resentment is you drinking the poison hoping that it will hurt the other person.
4. Don't choose forgiveness because the other person deserves it; choose forgiveness because you deserve peace.

I also think of the various things I have done to hurt others. There are the things that I am aware of, and then there are the things I've done to others that I don't realize.  A great book on the spiritual aspect of forgiveness is Tim Keller's book, The Prodigal God. It's a compelling look at how self-righteousness can be a more problematic form of wrong-doing than the more obvious kinds of misdeeds.

I challenge myself with the notion: "getting better at love is more important than being right." Forgiveness brings us closer to others, softens us, tenderizes us, and in the end brings us peace in a way that not even the best of confrontations can accomplish.

If you're trying to forgive but are stuck in your resentments, talk to a trusted member of the clergy. Or seek out a trusted mental health professional. In the Chicago area, consider someone at Heritage Professional Associates.

Why should I do my homework if I'm learning the material?

I hear it often from bright, but unmotivated students: "what's the point of doing homework if I'm able to learn the material without it?" As a parent, you may be stumped to find a good answer to your child's question, even as you know in your 'gut' that there's something fundamentally wrong with this picture. For most students, doing homework is a way to reinforce the classroom content and textbook material. And some subjects such as math and higher level science courses, really go better when supported by regularly completed homework assignments even when the student is bright.

Beyond the benefit of better grades when homework is completed, I believe that a potentially even greater outcome is derived from regular homework completion. And that is this: every job imaginable that your child may do in the future, will contain some duties which are mundane, boring and tedious. Learning now to develop the capacity to endure and complete the mundane and tedious tasks in his/her life, will prepare your child to better manage the tedious, boring tasks involved in any future career.

Conversely, bright but unmotivated students who do the bare minimum to get by now, may be able to get decent enough grades just based upon his/her native intelligence. But they will pay the price later in the form of compromised job reviews largely because of their lack of self discipline to attend to those important little boring details which are part of any job.

If you have a bright but unmotivated student who is doing the minimum to get by, consider a consult with a reputable mental health professional. In the Chicago metropolitan area, consider one of our professional staff at Heritage Professional Associates, with offices in Hinsdale, Wheaton, and downtown Chicago.

Giving it Your Optimal Effort: A Remedy to School Stress and Overachievement

"Do your best" or "give it your best effort" are phrases most of have heard for the majority of our lives.  And, there is something to be said for applying ourselves in a sustained, disciplined way over time. As a psychologist, I have seen way too many students who are giving their best efforts toward school. And while they have phenomenal grades and get into good colleges, their maximum effort comes at a price. Signs of unhealthy levels of effort include:

• trouble falling asleep at night because your mind won't shut off
• going past your normal bedtime routinely by an hour or more in order to get school work completed
• spending way more time on schoolwork than most of your peers 
• persistent feelings of stress, anxiety, worry or depression related to school
• feeling pushed too hard by one's own or by one's parents' expectations
• engaging in little, if any, recreational time
• being unable to tone down your perfectionism

I promote the notion of "give it your optimal effort" when it comes to important activities such as school, sports, music, etc. An optimal effort means that you apply yourself in a sustained, disciplined way to accomplish things. But, the effort is not a maximum one, at least not over time. It allows for balance, moderation, and an emotionally healthy life. Signs of optimal effort include:

• feeling like your life is in balance - there's time for studying, "down time", wandering time with friends, exercise, and creativity
• you don't feel stressed on a daily basis
• you can fall asleep pretty readily at bedtime and you sleep through the night most nights
• you feel encouraged and prompted to do well, but not too pushed by either yourself or your parents 
• your natural ability and your grades seemed to be in balance (that is, there is neither under-achieving or over-achieving going on)

If you're concerned that you might be stuck in a cycle of over-achievement, chronic school stress, and a life out of balance, contact someone you trust for the name of a reputable mental health professional. In the Chicago metropolitan area, consider someone at Heritage Professional Associates, with offices in Hinsdale, Wheaton, and downtown Chicago.

How Can We Respond to Awful Things That Happen in the World?

Fresh in everyone's minds this morning is the massacre of children in Newtown, CT. As our President said yesterday, there have been too many of these tragedies. With media so accessible to us so much of the time, it's hard not to get 'disaster fatigue' when something big and bad happens. Whether it's the mass murder of innocents, or seeing the destruction on a grand scale wrought by Mother Nature, it's the feeling of helplessness in response to something so massive and tragic that creates weariness, and in some, depression.

Soon following a disaster are the many images, personal accounts of tragedy and loss, and with them an unsettling of our sense of security. If it could happen in Newtown, CT, it could happen anywhere. And it has. I still remember the images of Hurricane Sandy, or the Tsunami in Japan, or 9/11 or Chernobyl. The list keeps getting longer.  So what can we do?

Doing something in response to these tragedies is a way of reducing disaster fatigue, weariness and our vulnerability to depression and despair. In response to the Newtown massacre, I sponsored another third world child in need, in memory of the children lost yesterday. When I have lost a loved one, I re-commit to love those in my life a little more, a little better. Spreading love, charity, compassion and mercy in response to disasters, both personally and globally, are ways to react and set in motion a greater good. It's my personal statement of protest to bad things to make the world a little better.

America and Gun Violence

I think a lot about this issue. As the attached post shows (http://en.wikipedia.org/wiki/List_of_countries_by_firearm-related_death_rate), the US ranks 12th in the per capita death rate with guns. All of the other countries with higher per capita rates have much smaller populations (exceptions being Brazil, Mexico and the Philippines). Brazil's death-by-gun per capita rate is more than double that in the US, a fact that probably most people in the world would never guess. Yet Brazil's population is approaching 2/3 of the population in the US - no small number.

But the US is a country that's unique in several ways. 'She' manages to put herself and/or find herself in the world's spot light much of the time. When there's something grand going on in the US - science, technology, music, humor, the world knows about it. Probably more is known about the US abroad than is known about a lot of other countries. So, too, will the world know more about America's problems than the problems of other countries (like El Salvador having a murder-by-gun rate that is more than 5 times that of the US; but it has a population of only 6 million to the US's 312 million).

I also look at the comparison of the US to its neighbor to the north. The gun-per-capita rate comparison of the US to Canada is about 2:1. But the murder rate is way lopsided, with the US per capita murder rate exceeding Canada's by a large margin (there are about 4-5 murders in the US per 100,000 of population compared to Canada where the number is about 1 per 100,000). I think that there are some attitude differences that account for this. The average US citizen is more entitled, arrogant, territorial (we simply took a bunch of Canadian land more than a century ago when 'buying' Alaska) and has a culturally ingrained right to self defense borne out of its origins. The massacre and / or mistreatment of the native American Indian population aside, Americans have defined themselves as adversaries or opponents to oppressive governments - hence they left those mother lands for the US over the last few hundred years. And when the mother lands came to the US to take back the land or its people, the right to bear arms was engraved in its constitution. This defiant, defend my land at all costs has taken on absurd proportions. People buy hand guns to defend their 'land' even when that may be an apartment. And the fact that such self defense weapons are used against one's own loved ones more than predators by overwhelming margins, does little to change our country's engrained right to bear arms.

I'm hoping that in the US, a faction as popular and powerful as the National Rifle Association (NRA) will sprout roots and become as influential in American politics as the NRA but in the opposite direction, that of education about gun violence, and making a stance of getting rid of guns from American households. It could become a new American initiative, like Mothers Against Drunk Drivers has done to educate the country to not drink and drive.

Masculinty Redefined

What does it mean today to be a good man? Men are struggling to feel good about themselves in an increasingly complicated world. Men who were trained to work themselves to death in service of providing for their families end up feeling disillusioned. They feel unfulfilled, lonely, and have a vague sense of emptiness without knowing why. They often don't know even how to name what it is that they are feeling, other than frustrated, worn out, defeated, and maybe angry too much of the time.

Current beer commercials tease the man who cries, who wants to be close to his woman, or who is afraid, and tells him to "man up." Of course what this really means is to drink the right kind of alcohol like a real man and tease the men who are vulnerable. But, outside of beer commercials, these older definitions of masculinity seem to work less well today. Men who try to follow older masculine stereotypes are frustrated when these archetypes fail. The macho tough guy who prides himself in being competitive, self-reliant, aggressive, self-promoting, and restricted in the so-called vulnerable emotions is becoming archaic, out-dated, and useful in fewer and fewer circumstances in life. This older, more traditional view of manhood does not promote emotional intimacy and greatly limits the quality of marriage and of being a good dad to children.

So what is a template for today's man? It is a blend of work and commitment to family as a provider. But it also is about a greater capacity to experience and communicate about the vulnerable emotions. Fear, doubt, shame, uncertainty, loneliness, are examples of these. These are vital emotions, together with more familiar ones, love, tenderness, caring, assertiveness, which are important ingredients for emotional intimacy. When a man in angry, 99% of the time, one of the vulnerable emotions lies beneath the anger. A man is more adaptive, flexible and socially competent when he can recognize the vulnerable emotions within himself, and communicate about them directly and openly.

So, what's a man to do? There is help. Men need to learn how to first recognize, and then communicate about a wider range of emotions without the over-use of a limited number of emotions (anger, jealousy, pride, arrogance). Dr. Ron Levant has done extensive work treating what he refers to as normative male alexythymia. This refers to the inability to name a feeling. It recognizes that our culture has supported male roles that limit the emotions that are culturally acceptable for men to express. After all, what country could send an army into battle whose soldiers were trained to be in touch with their vulnerable emotions? Men are first taught to improve their vocabulary for emotion. This is because vocabulary is essential to perception. If we don't have a word for something, we are less likely to perceive it (some eskimos have 14 different words for snow. Try it - I'll bet you can't come up with that many, hence you will not perceive that many kinds of snow either). Once the vocabulary is enhanced, men are encouraged to use the newly acquired words in their communication with loved ones. The book, Masculinity Reconstructed, provides more specifics about the protocol for improving men's social competence.

Men use for coaching in business, personal trainers for fitness, so why not use one for improving social competence, and becoming better equipped to be a good husband and dad?  In the Chicago area, try one of our experienced psychotherapists at Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a qualified mental health professional.

When a spouse is impaired

The usual stock assertion in marital therapy is that spouses are more or less 50/50 responsible for the problems in the marriage. But there are also times when one spouse simply functions at a higher level most of the time than the other one. The more impaired spouse may have a problem such as an addiction, memory loss, chronic depression, or just plain and simple, he or she is constitutionally weaker from a psychological standpoint. The weaker spouse may lack self discipline, sustained follow through, and generally has a harder time making and keeping commitments.

Sometimes these differences are simply going to be there for the long haul. It's really important that if you're the stronger or healthier spouse to follow some general principles. First, don't organize your life around what your spouse is doing wrong. Compliment him/her for something done right every day.  Don't try to correct, rehabilitate or fix the other person. The impaired spouse already feels inferior and playing the role of teacher or therapist can only make this worse. Ask him or her to teach you something that they're better at than you are.

Do your best to create and sustain healthy, emotionally close relationships with friends. It's hard to expect a marriage to meet all of one's needs for closeness anyway. But this is even more the case when a spouse is impaired in some way. Support groups such as Al-Anon (when a loved is an alcoholic) or Nar-Anon (when a loved is addicted to drugs) can be invaluable to learn how to keep your sanity and even find serenity when in relationship to an addicted person.

Do your best to exercise regularly, eat right, and have a few hobbies or other pursuits to give your life more balance and enjoyment. I also try to remember such adages as "getting better at love is more important than being right." In his latest book, Flourish, Martin Seligman talks about well being using the concept of 'flourish.' To flourish is have positive emotions, flow, meaning, love, gratitude, accomplishments, growth and improved relationships with others. These can grow in us even when married to someone who is not functioning very well.

If you're trying to keep your head above water while in relationship to an impaired spouse and need assistance, in the Chicago area, contact one of the talented mental health professionals at Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health professional.

Gratitude this Thanksgiving

As Thanksgiving approaches, different emotions arise for different people. For those struggling with depression, loneliness, or strained family relations, Thanksgiving can be a painful holiday. There is little to feel thankful for. Many such people wish that the holidays could pass as quickly as possibly. Some have even said that they wished they could hibernate through them and wake up on January 2nd so they could avoid them altogether.

So, why be grateful? Research has shown that whatever we focus on seems to become more prominent in our lives. Research subjects randomly assigned to track what they're grateful for ended up feeling happier than other people randomly assigned to track either neutral or negative events in their lives. Even if you have to start pretty small and simple, be grateful for the air that you breathe and for lungs to breathe it. Be grateful for a blue sky or a sunset or a sunrise. It's hard to be critical of a sunset. If you make it your resolution, you can probably find something redeeming about even the most difficult of relatives. Focus on one small thing that even an ornery relative has done in a given day. If you make that your focus, your day is likely to end up differently than if you focus on that person's more identifiable faults and weaknesses.

Small gratitudes usually lead to bigger ones. So start creating a new habit of seeing things you can be grateful for. It's a gift to give yourself this Thanksgiving. If you try and you just can't get 'there' from 'here' ask for some assistance. In the Chicago area, consider someone from Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health professional.

Kids and the video game, Call of Duty

Maybe your child (using your credit card) was one of the 20 million or so customers who pre-ordered Call of Duty - 6, Modern Warfare 2, and then waited anxiously for its release on a Tuesday night (aka a school night) last November. There are few of us parents who don't feel at least a little ambivalent about allowing our kids to play a first person shooter game, especially one that has blood (as in, lots of it), and victory can be claimed by detonating a nuclear bomb, which ironically enough, appears to explode within a mile or so of the 'winning' team. Then, there's Call of Duty 'Live' for X-Box 360 in which your child is talking live with God knows who, from who knows where while shooting people and trying to 'nuke' the other team. Have we all gone mad?

So, as a clinical psychologist whose sons play this game on far more than a casual basis, let me offer some musings on the pros and cons of this game as I understand it.

The positives of this game:

1. It really is more about mastery, competence and teamwork than it is about killing and maiming. As a child of the 1960s and 1970s myself, the concern then was about watching too much television. Most of us had seen well more than 100,000 people getting killed over the course of our TV watching 'careers' prior to the age of 18. Parents were sure that we would become mass murderers or at the very least, grind the world to a stop because we had turned our brains to mush in front of the 'boob tube.' Playing Call of Duty is not going to cause people to turn into serial killers or else we would have had a catastrophic rise in the number of them over the last few years.

2. Call of Duty is about strategy, learning from one's mistakes, communicating with other people, and getting better at something through sustained focus and repetition.

3. Then there's the fascinating element to the game called 'Prestige.' This comes when you voluntarily give back all you have accomplished and basically say, "it wasn't good enough. I want to start all over again." This is something like telling your child to re-do their major paper because it wasn't good enough. Kids choose prestige, sometimes multiple times. Of course there's certain badges of recognition for doing this, but it requires a lot of persistence, humility and determination. These are not bad aspects of a game for use in real life.

4. There's the teamwork involved in playing the game 'live.' Listening to my kids' animated chat with other people on the game is way more activity than when I sat on the couch as a child watching Tom and Jerry hit each other with sledge hammers and steel anvils, always without injury.

When the game becomes unhealthy:

There are certainly times when the game is not healthy for kids. Here are some telltale signs:

1. They won't get off of the game when you tell them to. Kids then stay up too late, and avoid other more important activities such as homework, general studying, exercise, or getting together with friends face-to-face and doing something besides, well, Call of Duty.

2. Siblings argue and / or get into physical altercations about whose turn it is to play the game. Time, I say, to give the video game a time out.

3. Meeting someone on line and then agreeing to meet them in person without telling you about it. Obviously, this is a problem and time to disable the internet connection to the game.

4. You are using the game as a convenient babysitter so you can get things done, but in the process, spend less time with your kids.

Most of the problems surrounding this game can be negotiated with your kids by regular dialogue. The best ways to have obedient kids include spending time with them, consistency of discipline and rules in general, and taking time out of the general busyness of life for more focused time with your kids. If you're having trouble accomplishing these, and your child is seeming to get more and more hooked on 'screens' then contact a reputable mental health professional. In the Chicagoland areas, consider one of the mental health providers at Heritage Professional Associates.

Couples and money

Money holds a unique place in long term committed relationships. It's the number one thing that people lie about in a relationship, and is one of the most common causes of arguments. Money, together with time, sex, and food (meal preparation), is a powerful 'currency' which symbolizes the giving and receiving of love. Are you giving out more than you're getting back?

Money is a focus in a relationship for a number of reasons. It's tangible. You can see in black and white terms what a bank balance is, how much is owed on a credit card, and whether payments are late. It's far harder to get one's 'arms' around more murky, but more important issues like the amount of kindness and tenderness there is in a relationship. How about compassion, understanding, and empathy? These, too, are crucial, but they're harder to define, measure, and therefore, talk about.

Money looms very large in our culture as the standard of success and security. And of course, money is important. But we shouldn't let it loom larger than kindness, tenderness, understanding, empathy, moral decency and living a meaningful life. Research has shown that once we're out of total poverty, subsequent increases in wealth don't really impact our overall happiness very much.

So, keep money in perspective. If you're going to have a money talk with your partner, keep in mind what you love and respect about the other person and tell this to him/her. Say aloud what values and virtues you cherish in the other, and then have a candid talk about money. Look at your financial realities square in the 'face' and come up with a solid plan to live your life within your means and make sustainable financial goals for your life now and for the future. But, as you do this, keep it all in perspective. Money really doesn't buy happiness. But, emotionally intimate, emotionally secure relationships do.

If you've lost perspective on this and need some guidance, in the Chicago area, consider a mental health professional at Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health professional.

What is ADHD / ADD?

The letters ADHD / ADD can be confusing. The current diagnostic term is ADHD for all forms of ADD. ADHD stands for attention deficit hyperactivity disorder and it comes in three types: the inattentive type, the hyperactive type, and the combined type in which both inattention and hyperactivity are present.

Attention deficit hyperactivity disorder is not a very good way to label the syndrome. ADHD inattentive type is actually a compilation of several executive function symptoms. These can include: getting started on important (but boring) tasks, planning, organization, sustained mental effort (again on something that is important but not terribly interesting), attention, concentration, freedom from distractibility, being able to check one's work for legibility and careless mistakes, and finally, working memory.

Working memory is the human equivalent of RAM memory on a computer. It is the ability to take in multiple pieces of information, hold onto them, and plan a series of responses to each one without losing track of the other ones. It is central to being able to follow a set of instructions, to multi-task, to remember a phone number briefly, and to compute math problems in one's head. Having low working memory is like a computer that has limited RAM memory. Applications are processed in a more sluggish and inefficient manner.

The hyperactive side of ADHD can include fidgety behaviors, restlessness, impulsivity, and feeling like one is being driven by a motor.

A good work-up for ADHD includes interviews, taking a thorough family history (ADHD appears to be inherited), using current and valid rating forms to compare the person to others of the same gender and age, and using performance measures of ADHD to measure directly such things as attention, concentration, and working memory. It is also important to check for things which can mimic ADHD such as anxiety problems, depression, motivational problems, learning disabilities or other processing problems, and even underlying psychotic conditions. Finally, very bright children (especially boys) can be mis-diagnosed with ADHD. Hence the need for a comprehensive evaluation.

For a good ADHD evaluation in the Chicago area, see one of our diagnosticians at Heritage Professional Associates. Outside of the Chicago area, ask someone whom you trust for the name of a reputable mental health care professional who is equipped to do these kind of evaluations.