Unfortunately, this is a common occurrence for those with obsessive-compulsive disorder (OCD), and often becomes a vicious cycle. OCD isolates the sufferer, and this detachment from others, where the person suffering from OCD is left alone with nothing but his or her obsessions and compulsions, can exacerbate OCD.

In Dan’s case, many of his obsessions revolved around him causing harm to those he cares about. What better way to prevent this from happening than by avoiding friends and family? And this is exactly what he did. Even though in reality he could not even hurt a fly, in his mind the “safest” thing to do was to stay away from everyone. This is just one example of how OCD steals what’s most important to you.

Another common example is those OCD sufferers who have issues with germs. Avoiding any place or person that might carry germs (so pretty much everyone and everything) is about as isolating as you can get. Or maybe they are not even worried about getting sick themselves but rather are terrified they might contaminate others.

There are many other reasons why OCD sufferers might isolate themselves. Their compulsions might be so time-consuming that there is simply no time to interact with others; OCD has taken up every second of their lives. Or perhaps it is just too exhausting to be out in public, pretending everything is okay.

Let’s also not forget the stigma that is still associated with the disorder. Many with OCD live with the fear of being “found out.” How can they best prevent that from happening? Yup — they isolate themselves.

When someone is suffering deeply, whether it is with OCD, depression, or any illness, support from friends and family is crucial. Friends who reach out to the isolated person often are ignored, and after a while, they might stop trying.

This is what happened to Dan. I have no doubt his friends genuinely cared for him, but they didn’t realize the extent of his suffering, because Dan never let on. When their efforts to connect with him were rebuffed, they, not knowing what else to do, left him alone.

In some situations — college, for example — friends are the first ones to notice another friend’s isolation. Young people need to be made aware that withdrawal from others might be a serious cause for concern, and help should be sought.

OCD sufferers can isolate themselves from family as well. When Dan’s OCD was severe, we felt separated from him, even when he was living with us. He kept to himself and would not engage in conversation. He seemed as if he was in his own world, which in many ways he was: a world dictated by OCD. As difficult as it was to connect with him, our family never stopped trying, but it was mostly a one-sided effort. It wasn’t Dan’s fault that he couldn’t communicate with us, and it wasn’t our fault that we couldn’t get through to him. This insidious disease, OCD, was to blame.

While the Internet cannot take the place of face-to-face interaction, I do believe that social media sites have the potential to lessen the feelings of isolation that OCD sufferers feel. Connecting with others on forums, or even just reading about people who are suffering as they are, can help reduce loneliness, and in the best-case scenario, prompt those with OCD to seek appropriate help.

When those with OCD, or any mental illness, cut off those who care about them, they lose their lifeline. The support, encouragement and hope that are all so important for recovery no longer exists. I find this heartbreaking, as I truly believe the more we are pushed away, the more likely it is we are needed. This is something we should all be acutely aware of, and if we find ourselves or our loved ones becoming increasingly isolated, we should seek professional help immediately.

Online opportunities for learning and for earning college degrees have become pervasive in the last 10 years. Most two- and four-year colleges now offer online options. For-profit colleges that exist solely online now offer both undergraduate and graduate degrees.

Consortiums such as Coursera, a tech company that partners with universities worldwide, offer non-degree oriented, free classes for people who simply want to learn new things. This is a sea change in education.

And yet… Only 50 percent of students who register for online classes succeed. (This is compared to an average of 70 percent of students in traditional campus classes.) It’s not because those who fail aren’t smart. It’s not because they don’t have good intentions. Research has identified factors that have more to do with a student’s psychology than intelligence. My own experience as a teacher of online classes leads me to the same conclusion.

If you are considering taking online courses and want to be in the 50 percent who make it through (and with good grades), here are at least some of the variables that make a difference:

Be realistic about what you are taking on.

There seems to be a myth among at least some students that online classes are easier than campus classes. Generally they aren’t. You are signing on to wrestle with new material, to master new skills, or to increase your own knowledge base. A good online class will be as challenging as any course you’ve taken in a brick building.

Be realistic about your reality.

Most online students are adults with adult lives. That means families, jobs, and complicated schedules. Be sure you really have the time and energy to put eight to 10 hours a week into reading, researching and responding. Often the students who have had to drop my class have found it overwhelming to fit class work into already over-stressed lives. One man who did very well for the first few weeks found to his dismay that he had underestimated the effect of a new baby in the house. The needs of the baby and his need for sleep overwhelmed his ability to focus on the class.

Whatever your good intentions and optimism, there are only so many hours in a day and you only have so much energy. Before writing the check to take a class, be sure you can fit it into your schedule.

Be realistic about your own motivation and maturity.

Online learning requires that you “show up” and show up regularly. Often you will be responsible for making submissions that other students need in order to keep a discussion going. Since there is no set time to participate in class, it’s easy to let a day or two or four go by because of other obligations. That’s a setup for failure.

More than a few of my students have fallen by the wayside due to major issues with procrastination. If you procrastinate and get behind, it becomes harder and harder to get caught up. If you are irresponsible about doing your share of group work or getting assignments done on time, you risk alienating your classmates and annoying your teacher, who doesn’t have the time or the responsibility to chase you.

Be realistic about your time management skills.

Succeeding online means logging in every day or at least 5 days a week. It means doing the reading so you can do the assessments and assignments. It means taking the time to participate in the class discussions. Students in my classes who succeed treat the online course very much like a part-time job. They set aside regular, predictable time to do the work. They keep a calendar to make sure they meet deadlines and immediately do makeup work if they had to be “absent” for a day.

Be realistic about your willingness to engage with others.

Ironically, your professor and classmates will get to know you online at least as well, and often better, than if you were sitting together in class. Campus students can be virtually invisible by not volunteering in class. Online learning requires that you be out there, visible and engaged. Success comes to those who post regularly, who show that they have thought hard about the readings, and who contribute novel and interesting ideas to discussions.

Success also comes from encouraging others, from asking good questions, and from being willing to be challenged. When people engage in discussions without attacking others and without being defensive about their own contributions, discussions can be very rich and meaningful. One of my classes only requires three posts a week. The students who do best in terms of mastering the material are often showing up 10 – 12 times, sometimes with just a word or two of encouragement for a classmate, sometimes with a new insight into the material, sometimes with an anecdote from their own life that highlights something we’re talking about. These are the students who breathe life into the class. Often they are also the students who truly master the course.

Be realistic about your skill with words.

For now, at least, online learning generally requires communicating well in writing. “Discussions” are all by posts. Group work is through written chats within the class. Your words represent you. Poor grammar, spelling mistakes, rambling prose, or confusing paragraphs will get in the way of success, no matter how good your ideas may be. Teachers and peers don’t have the energy and patience to decipher your meaning. If you aren’t confident about your ability to communicate well in writing, it would be wise to get a tutor to help you hone your skills before tackling a course online. Another option is to first take an online course in expository writing.

Be realistic about your skill on a computer.

If you aren’t a reasonably competent typist, if you don’t know your way around Word or have difficulty learning how to navigate a platform, you’ll quickly become frustrated with the whole enterprise. Frustrated people tend to get anxious and annoyed. Often they fall behind and then get so discouraged they drop out. And please: Don’t do as one of my students did and ask your mother to do your typing. He often lost points because she didn’t have time to be his typist when he had deadlines. More to the point, it made me question who was really writing the responses.

It’s a new world. I fully expect that the boundaries between campus and online learning will continue to blur as an inevitable outcome of technological advances. The best online students are those who find it exciting to be on the cutting edge of change and who engage in class with curiosity and enthusiasm. As for me, I thoroughly enjoy getting to know my online students and watching them stretch and grow through their interactions with the materials and with the class.

Me: Can you tell me a little about your learning disability and what you need from me?

Student: I have ADD.

Me: That can be really challenging. Can you tell me how it is going to affect you in my class?

Student: I can’t concentrate. Sometimes I kind of zone out and miss a lot.

Me: Yes. I understand that. Can you tell me how you have managed that in the past?

Student: Well, I always had a note taker in high school. Teachers would send me to the library to take quizzes and tests. And my mom always helped me clean up my papers. She’d ask me questions so my papers didn’t go all over the place. Oh, and my teachers would check in with me when they saw me looking blank.

Me: Did any of that help?

Student: Sure. I don’t always know what to write down so the note-taker’s notes were better. But sometimes I couldn’t do the quizzes even in the library.

Me: So, then what?

Student: Well, some teachers let me take the test orally. Like, if you read me the questions and ask about it, it can keep me focused. Some teachers didn’t want to do that, though, which is unfair since I can’t help it. My mom says she can keep helping me on papers by email.

Me: Hmmm. So how much do you know about ADD? And what have you figured out so far about how you can be independent and keep up with things in spite of it?

Student: I don’t know what you mean. I told you what teachers and my mom do to help. . .

This is a big problem. This student’s idea of managing her disability is to rely on other people. It’s long past time for her to learn strategies for helping herself. The reality is this: The further she goes in her education, the less she can expect others to take her notes, provide her with a quiet place, or clean up reports and papers. Once she gets into a profession, most employers would be dumbfounded if she said, “Well, I have ADD so I can’t do this report by myself or on time and you need to accommodate that.”

It isn’t solely the student’s fault that she’s entered college without important skills. In spite of the fact that more and more kids with learning disabilities are going on to college, the majority of high schools don’t provide good transition planning. In their desire to be supportive, well-meaning parents may have been over-involved in their kids’ school work since elementary school. Teenagers often don’t have the perspective to know how important it is to learn how to compensate for a significant learning difference.

Regardless of whose fault it is, though, if you have a learning disability and are headed for college, it now falls on you to do some preparation. Now it’s up to you to master the learning disability so it doesn’t get in the way of academic and professional goals. There are many things you can do to ensure your own success.

10 Strategies for Success for Learning-Disabled College Students

1. Research your disability. Know what you are dealing with inside your own brain. Be able to explain it clearly to your professors and to service providers. If you had an IEP (Individualized Education Plan) in high school, it may be a useful source of information.

2. Get acquainted with the services available at your college. The staff at the advising center can be good advocates for you if you need help negotiating with a particular professor. Many schools have a writing center where advanced students are available to help you organize and edit your papers. If there is a tutoring program and you generally need some one-to-one help to master material, sign up immediately. Don’t wait until you are behind. And please don’t be shy about signing on for some therapy if the school has a mental health center. College can be stressful for anyone but particularly so for those with learning differences. A therapist can help you learn more ways to cope if things get tough.

3. Whenever possible, choose classes that are more compatible with your learning needs. Consider size of the class, time of day, and whether you need a free hour before or after to organize your thinking.

4. Fill out the appropriate forms and take them to your professors on the first day of class. Most will be happy to provide those reasonable accommodations. Most are not happy to be presented with a form halfway through a semester when you are already way behind.

5. Be proactive and stay in communication with professors. Go to office hours and help sessions. Ask for clarification of an assignment if you don’t quite understand what is expected. Faculty are most supportive of those who show they are engaged in their own learning.

6. Understand what is not fair to expect of your professors. You are entitled to reasonable accommodations. You are not entitled to a one-on-one session after every class. You are not entitled to a good grade for work that doesn’t meet the goals or the standards of the course. Professors usually can’t be responsible for tapping you on the shoulder every 10 minutes to make sure you are tuned in or for reminding you of deadlines.

7. Know your strengths and work with them. If you are great at organizing material but not so great at public speaking, volunteer for the organizing part of a group project and ask someone else to take on the bulk of the presentation. If you do better taking in information by hearing it than by reading, sit up front and pay close attention to the lecture.

8. Work on time management and organizational skills. Accept that calendars, lists, and schedules are your best friends. If well-intended parents and teachers have always served as your personal calendar keepers and organizers, give it up. It’s now up to you. If you have a history of being late with assignments, forgetting details, or getting overwhelmed by expectations, face it and take charge. When given an assignment, put the due date on the calendar, map out what you need to do each day to meet it, and make lists of what materials and resource you’ll need. It’s very satisfying to check items off as you go along.

9. Develop “workarounds,” a series of strategies for working around your disability. Some students I know go to two sections of the same class in order to give themselves two opportunities to hear the same material. Some schedule classes so they always have an hour after each class — while information is fresh — to go over their notes. Others rewrite their notes right after class as a way to impress the material on their memories.

Maybe you need to record classes or take advantage of note-taking services. Maybe you need to allow twice as much time as your roommates to do assignments. Accept that you do need to make accommodations for yourself.

10. Take good care of yourself. The problems of learning disabilities are multiplied if you don’t get enough sleep, if you don’t eat right and get some exercise, or if you don’t balance your school tasks with some fun. Stress and poor habits make things much, much worse.

A learning disability is not a sentence. It is part of you, just as surely as your height, the pitch of your voice, or whether you are right- or left-handed. Ignoring your disability won’t make it go away. Relying on others to take care of it for you only limits your potential for success and makes you ever-dependent on the tolerance of others. Taking charge of it, on the other hand, means you have as much potential as everyone else.

It’s true that almost half of college students with learning disabilities don’t complete their degrees. But it’s also true that 54 percent do. It’s largely up to you which group you belong to. You are certainly smart enough to do college work. By accepting your disability and adopting supportive strategies, you can earn that diploma.

The basis of Red Flags is that some people—more than we typically assume—are sociopaths, and if we are not careful to educate ourselves about their potential dangers, we are all capable of being victims of, as Andersen calls it, love fraud.

Andersen is quick to caution that the word “sociopath” is not meant in a formal sense, as a medical professional might use it. It is instead used “as a generic description for a social predator, someone who lives his or her life by exploiting others.” Although Andersen does provide a solid amount of psychological background on sociopaths, the fact that she uses the word in a way in which it is not supposed to be used is rather curious. By painting overly broad strokes, Andersen runs the risk of oversimplifying and writing in absolute terms when doing so is inappropriate.

As Andersen writes: “Sociopaths are male, female, old, young, well-groomed, disheveled. They come in all shapes and sizes.” In this way, it is frustrating that Andersen chose to cast the term that is the basis of her thesis as something of a catchall.

This is not to devalue the merits of Andersen’s book. While her subject is not widely known, it is indeed interesting and worthy of analysis. That said, when dealing with a subject that is so psychologically complex, it is counterintuitive to make the foundation so simplistic.

There are a lot of good things in Red Flags. Often, though, general themes and ideas are restated in different ways, and the same advice and wisdom is recycled. Again, what is said is certainly interesting and noteworthy, but the constant restating diminishes the impact of the ideas and negates some of their legitimacy. It’s not so much what is said that falters, but how it is said.

Along these lines, another criticism of Red Flags is its implicitly anti-male tone. Admittedly, Andersen does cite a statistic that men are three times more likely to be sociopaths than are women, and, as evidenced by the quotation above, she does concede that women, too, can be sociopaths. But of the numerous examples Andersen includes throughout the book, only a handful portrays a woman as the sociopath instead of a man.

Moreover, of the almost 250 pages, Andersen spends only two discussing female sociopaths. Despite the fact that men are statistically more likely to be sociopaths than are women, it would have been prudent to dedicate more text and examples to women being the predator. To not do so comes off as a something of a covert attack on men.

Despite these criticisms, it must be noted that Red Flags does provide some useful information. Through her website, Andersen has heard from and communicated with thousands of people who were, like she, victims of love fraud. And in the modern age in which we live, many of these relationships were started through online dating websites. Andersen writes:

Because of its global outreach and anonymity, the Internet is custom-tailored for social predators. It offers an endless supply of potential victims, so the hunt is simply a numbers game. Sociopaths register on multiple dating sites simultaneously. They randomly friend people on Facebook. They just keep baiting their hooks until someone bites.

Anonymity is a core characteristic of the Internet. When communicating via the web, you never really know with whom you are talking, and sociopaths use this to their advantage, pretending to be anybody they want.

Approximately one in five relationships is started through online dating. With the medium continuously gaining popularity and appeal, Andersen is right to caution against blind faith in it. While online dating is without question a useful—and for some, necessary—tool, it should be approached with a certain level of caution, especially when someone whom one is talking to fits Andersen’s bill of a sociopath.

Although Red Flags of Love Fraud is perhaps not as academic as it should be, it is nonetheless informative. It is certainly flawed, but it is also prescient: Considering how many people are victims of love fraud, not nearly enough are aware of its realities. Andersen’s book is a good first step.

Red Flags of Love Fraud — 10 Signs You’re Dating a Sociopath
By Donna Andersen
Anderly: June 11, 2012
Paperback, 246 pages
$19.95

1. Write a better story for your day. According to John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens:

For life improvement, I suggest the reader put life on pause, for at least a few moments a day, and consider what you’d like to accomplish today, and the vibe you want to carry.

Years ago, a client of mine was searching for a guidepost or mantra by which to live his life. After much soul-searching, he decided that, with every decision he makes, every day, he wanted to write the “better story.”

The better story might be getting up earlier rather than sleeping in [or] reaching out to help someone instead of passively ignoring their need… This turned out to be an enormous gift to me, as I now try to do this every day.

2. Identify what’s keeping you stuck. According to Deborah Serani, Psy.D, a clinical psychologist and author of the book Living with Depression, “This approach gets you to be both reflective and active, [which are] two steps necessary for change.”

1) Stop and see what it is that’s keeping you stuck right now. Oftentimes it’s a blind spot you can’t see, so taking time to mull things over helps you see more clearly. Is it a decision you’re afraid to make? Are certain people bringing you down? Are you in a cycle of negative thinking?
2) Look around you to how this blind spot is touching your life. Is it only at home? Or just at work [or] school? and finally
3) Listen to what your heart and mind tell you about what you need to do. Learning to reflect on your inner thoughts and feelings will help you trust putting them into action.

3. Get to bed earlier tonight. As clinical psychologist Ari Tuckman, PsyD, said, getting enough sleep is “an obvious but often overlooked” strategy.

It’s easy to steal time from sleep by staying up “just a little longer,” whether it’s to finish the laundry or finish a TV show. There’s always something that needs to be done or some fun temptation that keeps us from getting into bed on time. The problem is that the reward is had immediately — which makes it hard to resist — but the price is paid tomorrow.

It’s not uncommon to get a second wind at night, even if you were tired during the day, so that makes it even harder to stick to your bedtime. Unfortunately, even one short night’s sleep hampers our complex problem-solving, attention, and memory and makes us more irritable and short-tempered. This gets even worse when several short nights stack up.

The solution is easy to say but harder to do: Get into bed on time and you’ll feel better all the next day and hopefully get more work done, too. Of course, if you have someone that you sleep next to, then you should both get into bed even a little earlier and try to make some things happen. This will help both of you sleep better.

4. Participate in a physical activity you enjoy. Tuckman, also author of the book Understand Your Brain, Get More Done: The ADHD Executive Functions Workbook, said:

Regular exercise is an important part of not just physical health, but also mental health. It’s also one of the first things to go when we get busy. To prevent it from getting squeezed out, make it sacred and don’t let anything else intrude.

Otherwise, there will always be some other demand on your time and you’ll never get that workout in. A walk around the neighborhood is better than nothing, if that’s all you have time for, but for the most benefit you need to break a sweat.

Working out with someone else can make it more enjoyable…

5. Focus on right now. According to Alison Thayer, LCPC, CEAP, a psychotherapist at Urban Balance, LLC this can be challenging, especially in today’s world:

This is difficult for everyone, even therapists. It can be very difficult to focus on what is directly in front of you and ensure that you are fully present.

Today’s technology and expectation to be connected or available to work at all times is one of the most prominent challenges people face when trying to be present in the “here and now.”

Added Joyce Marter, LCPC, psychotherapist and owner of Urban Balance, LLC:

Honor the past, learn from it, accept it and let it go. Don’t obsess or worry about the future. Life is more manageable when you are grounded in the present. Achieve clarity through mindfulness practices such as deep breathing and meditation.

6. Set a realistic and attainable goal. Impossibly sky-high aspirations can be problematic. Thayer explained:

Setting goals is a key step in accomplishments. However, I often see clients with lofty goals that may not even be realistic. Holding ourselves to goals that we cannot reach can damage our self-esteem and inhibit our interest in trying to reach these goals again.

When setting your mind to reach a goal, ask yourself “Is this realistic and can I actually attain this goal?” If the answer is no, consider breaking the goal down into intermediate steps or modifying it altogether.

7. Reframe a situation in a positive light. Thayer shared several suggestions for taking a different and more positive stance.

There’s a reason why the saying “When life throws you lemons, make lemonade” has been around for years. When things aren’t going right, ask yourself “Could things be worse?” or “Is there anything I can take out of this that can be a benefit to me?”

More often than not, there is a positive aspect to things that happen, even those that feel negative. Try to view it in a different light and you may find your attitude turn around.

8. Be grateful, and pass it on. “If you focus on what you don’t have, you will be unhappy and attract negativity. Be grateful for what you have and you will be attract positivity, opportunity and success,” Marter said.

Emily Campbell, LCPC, CEAP, a psychotherapist at Urban Balance, LLC, suggested “Send[ing] a short note of appreciation to someone for something you appreciated about them this week.”

9. Relinquish what you can’t control. “Empower yourself to change what you can, and let go of the rest. Don’t expend your energy trying to control others. Focus on yourself,” Marter said.

10. Create an intention. According to Marter, “As in sports psychology, positive visualization increases the likelihood of success. We largely create our own realities through our thoughts and intentions, so clarify them by writing out your careers goals and objectives.”

Thayer suggested carving out time to set intentions for the following day. “Make it a ritual and part of your daily routine, like in the shower, when driving to work, or drinking your morning coffee,” she said.

Author Daniel J. Siegel structures his book to be read in any order. He encourages readers to “flip the Pocket Guide open to any page and you will find an ‘entry point’ that guides you to explore, in your own way, the web of integrated knowledge.” The table of contents cover varied and numerous topics such as ‘Mindful Awareness,” the “Brainstem,” “Attachment,” and “Un-Health and Dis-Ease.” In his chapters, Siegel defines and expands his concepts as well as ensures that his readers pay attention to key ideas for the comprehension of the IPNB model. He also discusses the implication these specific concepts have for our lives.

Siegel illustrates some of his intricate ideas with visual representations. For example, he uses the “triangle of well-being” to explain how IPNB views the mind, brain and relationships as a single component rather than three separate entities.

Siegel describes integration as “the mind’s process of linking differentiated parts into a functional whole   . . . to be the fundamental mechanism of health.” He emphasizes how integration becomes the context for looking for dysfunction and the energy/informational flow becomes the focus for correcting the dysfunction. The premise is that integration creates harmony and that impaired integration leads to chaos and rigidity. When an individual’s brain or relationships are not integrated, they move into a dysfunctional state and the brain is unable to balance things in a flexible manner.

Siegel recognizes each individual’s inherent potential to become whole by their capacity to release the specific blockage that may be inhibiting their ability to integrate. He further stresses that the role of the mental health professional, teacher, or parent is to facilitate the potential for integration that is innate in everyone.

Siegel implements several methods to communicate interpersonal neurobiology’s concepts clearly and simply. I admire his efforts to draw from a wide range of fields — including genetics, anthropology, and evolutionary psychology — to incorporate into his INBP model. At times, however, his message becomes convoluted from trying to incorporate perspectives from so many other disciplines.

Someone unfamiliar with Siegel’s subject matter may have some difficulty following along. The Guide may be easier to follow for those who are already a fan of Siegel’s work in IPNB. Nonetheless, Siegel’s book does an amazing job reflecting his vast knowledge of how our brains and our relationships interact to shape our lives.

Pocket Guide to Interpersonal Neurobiology: An Integrative Handbook of the Mind
By Daniel J. Siegel
W. W. Norton & Company: April 2, 2012
Paperback, 560 pages
$29.95

What a shame.

Children are meant to be running free in open spaces, climbing trees, finding frogs and turtles, biking to the playground, and being hard to find at dinnertime.

Today’s child is most likely to be found sitting in front of a screen — TV, video games, computers. 8-10 year olds reportedly spend an average of 6 hours a day staring at a screen. Given an additional 6 hours spent in school plus eating, sleeping, homework and we have taken our children’s worlds and turned them into tiny, structured spaces with little physical activity and almost no free play time.

Organized sports have become the play of many children but actually only about a quarter of all children are playing an organized sport during any season of the year. So the vast majority are just sitting around, growing obese at an alarming rate and missing out on important socializing.

How did we come to such a place where the lives of our children are so restricted and isolated? Well, we can start with the lives of their parents. American adults, as chronicled in Robert Putnam’s “Bowling Alone,” have become isolated from their community. Participation in all aspects of community life has dropped dramatically over the past 30 years.

One of the interesting points in Putnam’s book is that bowling remains very popular, but bowling leagues have virtually disappeared. Adults no longer feel they have time to make commitments to be with others on a regular basis. A colleague of mine just remarked about how she wanted to start playing bridge again, found some friends with a similar desire, found a teacher, and then discovered her friends were unable to commit to a regular time for lessons.

What has happened to American adults? Changes in family structure are a major factor. With so many divorces, we have a much higher percentage of single heads of households and blended families, resulting in much more complex life schedules for parents and children. Further, dual career parents have become the norm and work has increasingly encroached on the privacy of home life with the advent of cell phones and computers. Americans work longer hours than any other industrialized nation.

In this context of reduced hands on parenting and overwhelming schedules, the current generation of parents has evolved into an anxious group who are overly concerned about the safety and the academic/intellectual development of their children. Too bad – for the parents and the children. We end up with smarter fat children who are more stressed and growing up too fast. Higher rates of anxiety and depression are no accident.

So where have all the bicycles gone? Getting that first 2-wheeler used to be one of childhood’s most exciting moments. It meant an expansion of the child’s world. The opportunity to travel beyond one’s street and meet friends at the playground, ball field, or just go to someone’s house on your own was an exciting new stage of independence. It also meant lots of exercise. But bicycle sales are plummeting — over a 20% decline in just the past 5 years. Now less than half of children ages 7-11 regularly ride a bike. This is a serious change in the culture of our children’s lives.

But it is not just the crazy schedule of parents or the increased temptation of “screens” to play with. A major role in the narrowing world of children is parental fear. Surveys indicate parents have a distorted expectation of the risk that if they allow their children to roam freely about the town, those children may be abducted by child molesters. School playgrounds are no longer deemed safe places to hang out. The woods are no longer a great place to explore. Biking across town has come to mean an increased possibility of being abducted.

Parents couldn’t be more wrong. In fact, there are only 100-130 stranger abductions a year in the U.S. This is a minuscule number. I’m not being insensitive to the pain of those parents who have had a child abducted and molested or killed but please, let’s keep some perspective here. You and your child are 3 times more likely to be hit by lightning at a soccer game than your child is likely to experience a stranger abduction!

Notice I keep emphasizing “stranger abduction.” 75% of all abductions are carried out by people the child knows, most of which are done by divorced parents who are upset about custody arrangements. Children running free – meeting at the playground or in someone’s yard – are very safe. Not only safe, but these children are learning to make creative use of their time, being physically active, and improving their social skills. And it’s free!! Now what more could you ask for.

So please, restrict access to screens, send your children out of the house, encourage them to go places on their own, and don’t just smile when your child opts to use instant messaging to talk to her friend next door. Turn off the computer and send her next door! Consider it a pleasure to yell down the street or call a friend to find your child at dinnertime instead of simply having to pry him away from his Xbox. Let’s make bicycles something special for children once again.

These are the central issues in Rosen’s new book, iDisorder: Understanding Our Obsession with Technology and Overcoming Its Hold on Us. Coauthored by fellow psychologists Nancy A. Cheever and L. Mark Carrier, iDisorder is a perceptive, thoughtful look into the world of modern technology, focusing on those that are primarily communicative.

Rosen makes it very clear at the outset that he is not by any account anti-technology: “Far from it. I have always been an early adopter, starting back in the 1970s… I have owned at least a dozen computers… I carry a smartphone and an iPad and spend hours texting my kids and friends.” This personal qualification is important, as it alleviates any fears that Rosen is on a crusade to extirpate technology from the lives of all people, young and old. Rather, Rosen understands the powers these technologies can hold over us, and, more important, he understands the possible ramifications that can result.

iDisorder certainly is a book of its time. Now more than ever, people—regardless of whether they consciously realize it—are spending far too much time using their devices. As Rosen writes: “The evidence is all around us that people are attached to their devices and oftentimes driven to use them obsessively by fear and worry. Missing out on social information, work information, and our personal pursuits can put us in a state of anxiety and even cause panic attacks, sometimes with serious consequences.”

Rosen clearly understands his field, and it is safe to say he is at its forefront. Rosen’s prose never has the slightest tinge of condescension or arrogance; the book is instead properly written from a position of authority and confidence that gives the words contained therein inherent credence and deserved attention.

iDisorder is split into twelve chapters, with each essentially focusing on one psychological disorder and then discussing how technology is contributing to or exacerbating our development of the disorder—what Rosen terms an iDisorder.

While it is simple to offer a blanket solution to the book’s central thesis—“just stop using your devices so frequently”—it is by no means appropriate. Rosen takes the stance that, for many of us, our obsession with technology is firmly psychological; telling someone to stop using his iPhone as frequently as he does is akin to telling a confirmed drug addict to limit his habit to just once a day. It’s not workable. Thus, throughout the process of discussing and dissecting iDisorders, Rosen offers suggestions.

At the end of each chapter, Rosen, in one form or another, gives some sort of game plan for tackling each specific iDisorder. In Chapter 5, “The Ups (and Downs) of Leading a Cyberlife,” Rosen closes with a lengthy section titled “Combatting a Depression or Mania Disorder.” Contained therein is a questionnaire with a scoring system to determine the severity of one’s iDisorder.

In this way, the book is part story of interest, part self-help. Rosen’s final chapter, “It’s All in Your Mind,” offers an even more detailed method of tackling our iDisorders. And with that comes a message of hope:

…many of us are on the verge of an iDisorder as our daily interactions with media technologies may be imbuing us with signs and symptoms of one of many psychological disorders, including narcissism, obsessive-compulsive disorder, addiction, attention-deficit disorder, social phobia, antisocial personality disorder, hypochondriasis, body dysmorphic disorder, schizo-disorders, and voyeurism… Luckily for us, our brains are constantly changing. Neuroscientists call this ‘neuroplasticity,’ which is basically a constant process of strengthening and weakening neural (nerve cell) connections in the brain as a function of our experiences…. Given that our brains are inundated with stimuli all day long and that the digital content currently available in our world is the equivalent to everyone in the world tweeting or blogging constantly for a century, neuroplasticity is a brain-saver.

Yes, our brains can change, and with that we can learn not to overuse our technology. Rosen boils it down well: “It’s all about being aware of and monitoring your behavior around all of these marvelous technological inventions.” Like anything pertaining to obsession, moderation is key.

iDisorder is written from a position of such eminent authority that it is difficult for a layman to critique the actual content. As well, the book is written in a way that both informs and aids. Rosen’s goal is to alert us to our possible conditions before it is too late. If it is in fact too late, though, Rosen believes that, like with any disorder, there is room for improvement, if not absolute correction.

As might be assumed, there is little in iDisorder over which to argue. The content is solid, the studies referenced are germane and compelling, and the tone in which Rosen writes is well-suited to the task at hand. Rarely does Rosen overstate his argument, as all conclusions are backed up with empirical data. With little conjecture and an abundance of wisdom, iDisorder is a book worth reading for both its prescience and its timeliness. Rosen has dedicated his career to understanding how we use technology, and for that, as well as this book, he should be praised.

iDisorder: Understanding Our Obsession with Technology and Overcoming its Hold on Us
By Larry D. Rosen, PhD
Palgrave MacMillan: March 27, 2012
Hardcover, 256 pages
$25

By definition, this adult obsessive pattern of thoughts and behaviors will continue despite:

• Attempts made to self-correct problematic sexual behavior
• Promises made to self and others toward sexual behavior change
• Significant, directly related negative life consequences in life and relationship stability, emotional and physical health concerns, or career and legal problems.

Sexual addiction can be considered a process addiction (as opposed to substance addictions such as drugs and alcohol), similar to gambling, binge eating or compulsive spending. As such, sexual addicts typically spend a much greater amount of time engaged in the pursuit of sex and romance (the process) than in the sexual act itself. They are addicted to the neurochemical and dissociative high produced by their intense sexual fantasy life and ritualistic behavior. This is their addiction.

What Sexual Addiction Is Not

The diagnosis of sexual addiction is not necessarily made if an individual engages in fetishistic or paraphillic sexual arousal patterns (e.g., BDSM, cross-dressing), even if these behaviors lead the individual to keep sexual secrets or feel shame, distress or “out of control.” Unwanted homosexual or bisexual arousal patterns also are not considered sex addiction per se. Sexual addiction is not defined by what or who the individual finds arousing, but rather by self- and other-objectified, repetitive patterns of sexual behavior utilized to stabilize distress and to manage emotional triggers.

In simple terms, most people don’t consistently utilize sexual arousal as a means of “feeling better” when having a bad day. Healthy people reach out to friends and intimate others for support when upset and also demonstrate a greater ability to self-soothe and tolerate emotional stressors than do sexual addicts.

Differential Diagnosis and Comorbidity

Sexual addiction can be viewed as an adaptive attempt to regulate mood and tolerate stressors through the abuse of intensely stimulating sexual fantasy and behavior. It is believed that sexual addiction is a dysfunctional adult response to innate personality, character or emotional regulatory deficits, as well as a reaction to early attachment disorders, abuse and trauma.

In order for the diagnosis of sex addiction to be made, professionals must first rule out concurrent drug abuse, as well as those major mental health disorders that also include hypersexuality as a symptom. Examples of these include bipolar disorder, obsessive-compulsive disorder and adult attention deficit disorder, all of which have hypersexual or impulsive sexual behavior as a potential symptom. Some individuals may have both a major mental disorder and sexual addiction, both of which need to be addressed, much as one might be both alcoholic and bipolar.

Why Seek Treatment?

Many sex addicts seek treatment for sexual addiction only after suffering significant consequences to their health, career, finances and relationships. Most men report initially seeking sexual addiction treatment to find relief and help with related negative life consequences such as pending relationship, legal or interpersonal crises, or threats of divorce or abandonment by a spouse or partner. Overt negative consequences related to sexual behavior, such as job loss and arrest, also drive individuals to seek treatment.

A Diagnosis?

While not yet fully acknowledged as a legitimate mental health disorder in the clinical literature (reportedly due to a lack of research study), sexual addiction and hypersexuality nevertheless is becoming identified in the public consciousness as a legitimate neuropsychobiological disorder. This slow shift in consciousness regarding this disorder is largely due to the escalation of technology-driven sexual problems, the growth of international sexual recovery 12-step groups, evolving research study data, as well as the term “sex addiction” being consistently referenced in relationship to the highly publicized problem sexual behaviors of certain major U.S. political, entertainment and sports figures.

We got off easy. The teens in question only got scared, not hurt. Bumpers can be fixed. A little hair dye will cover my gray. But we and the teens may not all be so lucky next time. Sadly, there probably will be a next time unless texting and driving is made illegal and the law is rigidly enforced.

Lest you think it’s no big deal, consider this: The National Highway Traffic Safety Administration reported in 2008 that driver distraction was the cause of 16 percent of all fatal crashes — 5,800 people killed — and 21 percent of crashes resulting in an injury — 515,000 people wounded. That was now four years ago! More teens than ever have cell phones. Chances are more teens than ever are finding it impossible to resist the urge to read or respond to texts while behind the wheel. According to the American Automobile Association, nearly 50 percent of teens admit to texting while driving. Not good. Scary.

So why, oh why, do teens persist in testing while barreling down the road at 50 miles an hour (or more), despite warnings, admonitions, and threats by parents and other concerned adults? Why don’t those “X the Text” public service announcements make an impression? What’s so compelling about the latest tidbit of teen connection that it is worth risking a wreck?

Our teens are generally good kids. But even good kids can behave thoughtlessly and badly when it comes to texting while driving. Reasons are usually some combination of these:

• Denial. Teens are great at denial. They think they are invincible. They have a puffed-up sense of their own importance, competence, and invincibility. Adolescence is a time of increasing independence and an increasing belief that grownups and their opinions – even their opinions about safety – aren’t relevant.
• Underdeveloped impulse control. You’ve probably heard about it. The frontal lobe, the part of the brain that governs judgment and decision-making, doesn’t fully develop until the late teens and early 20s. That’s why teens are particularly likely to do crazy, risky things. They don’t stop to think because the part of their brain that puts on the brakes isn’t reliable. Our teens don’t like it but they need us to provide the brakes until theirs are fully operational.
• Myth of being a multi-tasking master.Our kids are growing up in a multi-tracked, multi-tasking world. They are often listening to music, texting their friends, and doing their homework while watching TV – all at the same time. They have an inflated idea of their competence at keeping track of everything at once. The trouble is that every task takes on equal importance.This is fine when they’re watching a rerun of “South Park” while texting friends. It’s not at all fine when texts are as important, or even more important, than what’s going on with the traffic. In the moment a text comes in, the urge to read it is as strong as the need to keep their eyes on the road. This is an accident waiting to happen.
• Overconfidence as a driver. When my kids were new drivers, I actually wished they would get into an accident serious enough to scare them but not so serious that they’d get seriously hurt. I knew parental lectures weren’t getting through.Be careful what you wish for. Three of my four kids totaled cars. Fortunately they, and the people in the other cars, walked away from those crashes unhurt. In two of the three cases, the kids were not at fault. That didn’t matter. They got the message and sobered up about the reality that accidents happen even to people who are doing what they should.

  I dearly wish there had been another way to get their attention. But like most teens, they were sure they would never get into an accident; that they were so good at driving that a fender-bender was the most they’d ever have to deal with.

• Risk-taking high.Taking risks is an adrenalin rush. Taking risks and escaping by a hair’s breadth makes the blood run and impresses friends. Teens can get enamored of risky business because squeaking by feels great! (It’s the same reason people ride roller coasters even when they’re scared to death.)Teens go skiing down trails that are beyond their skill level. They ride bikes pell-mell down rocky hills with no bike helmet. They are suckers for a dare. Unfortunately, they also sometimes like the high of speeding down the highway at 80 or playing chicken. Remember that impulse control issue? That plus the surge of adrenalin that comes from being scared is a recipe for stupid behavior.

What’s a Parent to Do?

First and most important, we need to model good driving behavior. If your cell phone rings, ignore it or pull over. There are few calls that are so important that they can’t be responded to a few minutes later.

If you need to make a call, pull over or ask that teen who is sitting next to you to make the call for you. A picture really is worth millions of words. Show your kids that your mind, eyes, and hands need to be on the wheel, not on the phone. You’ll have no credibility at all with the kids if you demand they treat their phones differently than you do.

We need to talk to our kids. We need to talk to them often. We need to be willing to risk teen anger and take away their phones if they can’t just get it that texting while driving is driving blind. They’ll have lots of reasons why it’s okay: “It only takes a second.” “It’s no different than talking to someone else in the car.” “Hey. I’m great at multi-tasking.” “It’s the other guy who’s going to cause an accident, not me.” And then there’s the age-old, “Everyone else is doing it.”

The answers to that list are: “A second is all it takes to get in a wreck.” “Talking doesn’t take your eyes off the road, texting does.” “Multi-tasking skills are irrelevant when you’re driving a two-ton automobile at 60 miles an hour.” “It’s especially important to be alert when there are ‘other guys’ who aren’t paying attention.” “Everyone else doesn’t concern me. You do.”

Teens may not have good judgment or impulse control, but we do. If they can’t show they are able to exercise self-control, they need parents to be clear that they’ll provide it. There is no rule that our kids are entitled to drive our cars. If they need the car to get to a job or to school or to a game, it will be even more impressive if they have to do without it for a week or so if they break the rules. Make it clear that one infraction, just one piece of evidence that they couldn’t resist the call of the cell phone, will mean the loss of both for a good long time. Then stick to it. Your teen’s life may depend on it.

The mom and I started to chat about the symptoms the sick girls were exhibiting. But the mother was either distracted by the clicking or felt the girls were being rude, and she soon made the two sick teens turn their phones off.

The pair grudgingly obeyed, sticking the devices in their purses, but not before whining, “Why doesn’t she have to stop?” “Because she’s not the one with the doctor’s visit,” Mom replied. “But she’s the one who’s texting us!” the girls protested in unison.

I was speechless. Here were three sisters in a room together communicating with their thumbs. That encounter really hammered home to me just how plugged in we have all become. We are suffused daily in a multitude of digital communication options.

According to a recent Pew research study, one in three teens sends or receives over 100 text messages a day. It’s not that texting is inherently bad. Like many other forms of communication, it has the potential to keep us connected. But Sherry Turkle, MIT professor and author of Alone Together: Why We Expect More From Technology and Less From Each Other suggests that while constant texting may give the appearance of increased connectedness, these technologies may actually be keeping us isolated from each other. She argues that “Facebooking” is not socializing. “Thumbs up or thumbs down on a web site is not a conversation.”

Texting can also be dangerous. Texting while driving can be so deadly that it is banned in many states. When I’m at the gym, I cringe watching folks text while walking down stairs or running on treadmills. They look like accidents waiting to happen, like that poor woman whose YouTube video went viral when she fell into a fountain texting while she walked at a mall.

Children should be taught to turn off their cell phone when engaged in any activity that requires their full attention: school, homework, babysitting. Children also need to understand that some forms of texting—like sexting (sending nude or inappropriate photos in a text message) or cyber-bullying (sending mean, taunting or embarrassing text messages)—can have disciplinary consequences at school and even legal ramifications.

Another new issue being raised about texting is its effect on teens’ sleep. We are learning more and more about teens who bring their cell phones into their bedrooms and text long into the night.

Technology is developing at a rate that may be faster than our ability to monitor it and ensure its safe use. Parents should have frank conversations with their children about the dangers of texting and driving and the negative emotional and sometimes legal consequences of sexting and cyberbullying. Parents should review their children’s text logs to see who is texting them, when and how often. Limits can be placed on the number of texts sent and received as well as the hours texting is allowed. And parents can certainly confiscate phones after a reasonable hour, if necessary.

We need to be good role models for our children as well. While many parents take their kids’ cell phones away from them during our office visits so we can have face-to-face conversations, I have just as many parents who themselves text during our visits. We have to be careful what kind of example we set. My heart breaks whenever I see a mom or dad texting in the bleachers of their kid’s big game instead of watching their child play. If we are disengaged from our children, can it be long before they’ll disengage from us?

Kids texting photo available from Shutterstock

According to the author, the rise of information technology was important in creating a “new economy.”  It is no longer business as usual for “we will not get far trying to solve twenty-first-century problems with twentieth-century (and older) thinking.”  Critical to success are the recognition of four key elements in this new economy:  a complex global playing field, new consumers, unpredictability, and sustainability.  Rather than a hierarchical business model you are likely accustomed to, “relationships are intertwined and all parts are interdependent” in Cholle’s model and the focus is on using intuition and instinct to facilitate those connections.

Like a directional compass used to navigate your way in the outdoors, the Intuitive Compass can help businesses navigate their way successfully in the new economy.  Unlike a directional compass, however, the Intuitive Compass assigns a “fundamental dynamic of human performance” to each principal point on the compass:

• Reason resides in the north
• Instinct in the south
• Results in the east
• Play in the west.

When further divided into quadrants (NW, NE, SW, SE), “a personality or approach to life or business” is defined.  A short questionnaire in the book’s introduction assesses your place on the Intuitive Compass and primes the pump, so to speak, for the rest of the book.

“Intuition empowers us to operate in the zone of ambiguity and change, the exact place where imagination and genius occur.”  A set of skills that invites you to think holistically, think paradoxically, notice the unusual, and lead by influence serves to create synergy between the four quadrants.  This skill set is termed Intuitive Intelligence and it supports the creation of new and better business innovations necessary to remain competitive in our new economy.  Cholle relates examples of each of these by using stories about business operating decisions made by companies including Hermès Paris, Google, and Virgin America.  Even President Obama’s election campaign is analyzed as an example of leading by influence, which Cholle says is probably the most essential aspect of Intuitive Intelligence.

Stories about other big names in business are peppered throughout the book to provide additional examples of decisions that were made, reasons why they came to their conclusions, and the outcomes.  As the author states: “You have to show people that change will be beneficial to them; you have to make it both nonthreatening and inspiring.”  From Cirque du Soleil to Evian and from Maytag to Ralph Lauren and many others, these stories about a specific point in time for their businesses make for fascinating reading all on their own. 

Something I found to be successful in getting my attention further were the five ways Cholle offered up to tap into your intuition.  Now if you are like many people, you are of the opinion that intuition is something you just know, not something you can learn.  However, when reading the “ideas to ponder and exercises to do” I was left with the idea that, yes, these tools can help to increase your capacity for intuition.  The author invites you to revisit your perspective and perceptions; get comfortable with the part of life that is not logical; accept that you are not in control; relax and practice noticing; and sharpen your ability to notice through careful listening.  I was struck with the thought that approaching any decision by utilizing these five ideas might seem either foolish or well worth the effort to someone, depending on their willingness to think outside the box.  Whether it is a business decision or a personal decision, your ability to recognize how well your current method of problem-solving and decision-making has served you in the past may be just the motivation you need to put these ideas into practice.

“The Intuitive Compass is a tool that helps us innovate, solve problems, and move forward creatively in a highly unpredictable environment where old practices no longer deliver what we need to succeed and achieve sustainable progress.”  One of the quadrants is vital to getting the most out of the Intuitive Compass and it requires “a type of management that many of us are unfamiliar with.”  Are you curious which quadrant that could be?  Read The Intuitive Compass to find out.  If you are not already operating from this quadrant – and it is my assumption that the vast majority of businesses are not – you will begin to rethink the old school “we’ve always done it this way” method of doing business.  For those who are just starting out in the business world, applying the principles from The Intuitive Compass is a golden opportunity to put your company in a prime position for success earlier rather than later.

The Intuitive Compass:  Why the Best Decisions Balance Reason and Instinct
Jossey-Bass: October 18, 2011
Hardcover, 288 pages
$27.95

A total of 141 students completed anonymous questionnaires on their self-esteem, well-being and stress levels, and their Facebook use. This showed that students who interacted more on Facebook in their first semester reported being happier and less stressed and had higher self-esteem. However, a greater number of Facebook friends did not appear to be beneficial.

The second part of the study involved 169 students completing the same questionnaire halfway through their first year. At this point, the frequency of their Facebook use was not linked to stress, self-esteem or well-being, but having more Facebook friends was linked to higher self-esteem and well-being.

In the first semester, students who have a tight support network surrounding them are likely to feel more confident and appreciated, say the researchers. By the second half of the year, those with more friends on Facebook are likely to be the ones who have been happier, interacted more, and have therefore made more new friends.

Dr. Stiff presented his findings last September at the British Psychological Society annual conference in Cambridge, UK. He believes that receiving frequent messages on Facebook could help students who are about to begin college and are feeling in need of support.

“When teenagers come to university for the first time, they may find this significant life transition extremely stressful. Moreover, as the new student’s local support network is no longer available due to their geographical displacement, stress and associated maladies may be exacerbated.

“Facebook is not just a tool for superficial social networking,” he said, “it is also a highly effective conduit for social support during students’ first few dizzying months at university.”

However, more recent research suggests that people who spend more time on Facebook have a relatively worse self-image. Dr. Hui-Tzu Chou of Utah Valley University and colleagues explain that Facebook “provides a platform for people to manage others’ impressions of them.” Because people tend to present themselves in a favorable way on their Facebook profile, reading these profiles may have an impact on others’ perceptions of their own lives.

In the journal Cyberpsychology, Behavior and Social Networking, the team reports on their study of 425 undergraduates at a state university in Utah. The students were given questionnaires on the duration of their Facebook use, time spent on Facebook each week, number of Facebook friends, and perceptions about others’ lives.

Those who had used Facebook longer and who spent more time on Facebook believed that others were happier, and were less likely to believe that life is fair. Having more people who they did not personally know as Facebook “friends” was also linked to believing that others had better lives.

Dr. Chou states that Facebook users “tend to attribute the positive content presented on Facebook to others’ personality, rather than situational factors, especially for those they do not know personally.”

It seems that the impact of Facebook on self-esteem is a mixed bag. A 2011 Kent State University study concluded that having a greater number of Facebook friends is positively linked to well-being.

The 391 college students in the survey described their “self-presentation strategies” as either positive or honest. Analysis showed that positive self-presentation had a direct effect on well-being. But honest self-presentation had an indirect effect on well-being via perceived social support from Facebook friends. The researchers say that self-disclosure plays an important role in signaling one’s need for social support.

Finally, a team from Assumption College, Worcester, Massachusetts looked at how Facebook relates to self-esteem and adjustment to college among 70 students. Their survey implied that the number of Facebook friends “potentially hinders academic adjustment, and spending a lot of time on Facebook is related to low self-esteem.”

Number of Facebook friends was negatively linked to emotional and academic adjustment among first-year students. However, the relationship became positive later in college life, “when students use Facebook effectively to connect socially with their peers.”

These researchers, led by Dr. Maria Kalpidou, write that their findings point to “the value of studying further the notion of Facebook friends.”

References

Facebook as a Means of Managing Stress Associated with Life Transitions. Can Social Networking Help New University Students? Presented by Dr Chris Stiff of Keele University at the British Psychological Society Social Psychology Section annual conference in Cambridge, UK, from September 6-8, 2011.

http://www.bps.org.uk/events/social-psychology-section-annual-conference-2011

“They Are Happier and Having Better Lives than I Am:” The Impact of Using Facebook on Perceptions of Others’ Lives. Chou, H. T. and Edge, N. Cyberpsychology, Behavior and Social Networking, published online December 14, 2011.

The Facebook Paths to Happiness: Effects of the Number of Facebook Friends and Self-Presentation on Subjective Well-Being. Kim, J. and Lee, J. E. Cyberpsychology, Behavior and Social Networking, published online November 30, 2011.

The Relationship between Facebook and the Well-Being of Undergraduate College Students. Kalpidou, M., Costin, D. and Morris, J. Cyberpsychology, Behavior and Social Networking, published online December 30, 2010.

Now it seems things have gone one step further. A recent pilot study of the effectiveness of ICBT (Internet-Based Cognitive-Behavioral Therapy) shows promising results.

Twenty-three patients underwent a 15-week ICBT program “with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression.”

OCFighter, based in the United Kingdom, is a CCBT (computer-aided CBT) program that has been used widely for over six years. While it began as a phone-interactive voice response program that included a workbook, it is now in the process of being adapted to the Internet. Shown to be quite successful in multiple studies, OCFighter has been used in the United Kingdom, United States, and Canada.

The benefits of these ICBT programs are many. In the United Kingdom, where there is a one- to two-year wait to receive cognitive-behavioral therapy, OCFighter has the potential to help OCD sufferers who otherwise might just languish on a waiting list. For those who live in rural areas, have limited financial resources, or want complete privacy, this form of therapy could be a good option. Because ICBT is home-based with 24/7 access, the flexibility it affords decreases the need to deal with scheduling conflicts, babysitters, and travel time. And for those with OCD so severe they cannot leave their homes, ICBT could be a lifesaver.

As is often the case with the Internet, one site begets another. There are now apps that you can download to your iPhone to help you beat OCD. One such app is OCD Manager and is touted as “Cognitive Therapy in the Palm of Your Hand.” Another is iCounselor: OCD which will help you “learn skills to resist obsessions and compulsions.” My guess is there are more out there as well.

Both of these apps profess that they are not a substitute for professional help; they are tools to assist the OCD sufferer with Exposure Response Prevention Therapy, the cognitive-behavioral therapy commonly used in treating OCD. Of course, once ICBT becomes more well-known and widespread, it is likely that there will be many more sites popping up all over the Internet. As you would do before seeking any kind of treatment, it is of the utmost importance to check out the credentials of the sites or therapists you will be dealing with. The IOCDF is always a good place to start.

I do believe these various types of ICBT have their place in the treatment of OCD. But I have concerns as well. I know when my son Dan was battling severe OCD, he would not have had success with any ICBT programs. In fact, he was often not even able to use his computer or cell phone. I hate the thought of someone with OCD downloading an app, struggling with the program, and then writing off therapy altogether.

While OCFighter does involve a 30-minute screening interview with a therapist (either by phone or face to face) before beginning treatment, and there are ways to seek help from an on-call therapist, the OCD sufferers are, for the most part, on their own. And that, for me, is the biggest negative of ICBT. There are no therapists meeting regularly with clients, nobody actually looking the OCD sufferers in the eye, reading their faces or body language. There is nobody to regularly screen for coexisting conditions, or to talk with, listen to, or support those with OCD.

And so while there is no question there are positive aspects to ICBT, many professionals feel it should only be pursued if face to face therapy is not a realistic option. Because as effective as these ICBT programs may be, the bottom line is that they are not human. They cannot empathize, understand, or care about a person, and when someone is suffering, isn’t that what they need the most?

Productivity Strategies

1. They single-task.

Multitasking can crush concentration and even creativity. That’s why blogger and author Caitlin Boyle prefers to single-task. “Now I realize that it’s a much better use of my time to focus on one thing at a time and finish it,” said Boyle, who blogs at HealthyTippingPoint.com and OperationBeautiful.com and wrote the book Operation Beautiful: Transforming the Way You See Yourself One Post-It Note at a Time. “For example, I don’t try to keep up with emails while writing — I just write, and then I go through emails.”

2. They focus on what they’re great at.

Many of us think that in order to be successful we have to do everything. We must be able to work through a project from start to finish on our own, along with tackling all the other responsibilities that pop up. But a smarter strategy is to identify your strengths, and delegate everything else.

“[I figure out] what I can give to someone else, so I can concentrate on the stuff that only I can do,” said Michael Bungay Stanier, author, coach and founder and senior partner of Box of Crayons, which helps organizations do Great Work.

3. They manage their energy levels.

You can have all the time in the world, but if your energy levels are low, you probably won’t get much accomplished. Stanier said that boosting his energy levels also boosts his productivity. He referred to Tony Schwartz’s work on performance and energy.

According to Schwartz on his website, “Time is finite, but energy — the capacity to do work — can be expanded and regularly renewed. The better we meet our energy needs, the more value we’re capable of creating.” In his most recent book, Schwartz lists various ways readers can lift their energy levels.

4. They accomplish one important task each day.

No matter how erratic his days, Stanier spends several minutes “at the start of each day figuring out what the most critical thing is I want to accomplish.” He makes sure to follow through on this one goal. Similarly, he encouraged readers to think about their one thing. He said:

I like the idea of picking a ‘Great Work Project’ — the one thing you’re really going to focus your time and energy on to make a difference and get excited by. What’s the thing you want to boast about when someone asks, “What are you up to?”

5. They know their time-wasters and avoid them.

“The web is a huge time suck for me,” said Linda Formichelli, a wellness coach, personal trainer and freelance health writer. She recognized the websites that regularly pilfered her productivity, and blocked them.

She also uses a program called Freedom, which turns off your Internet connection for as long as you need. This prevents you from mindlessly cruising online at the expense of your work.

6. They start early.

Formichelli prefers to get up at 6 a.m. because she’s super productive during the quiet hours of the morning. By 10:30, she’s already answered email, developed workouts for clients, written interview questions, enjoyed a run, showered, studied for her wellness coaching certification course and had breakfast with her family! Waking up early also means that she’s able to stop working at 5:30 and spend the rest of the evening with her husband and son.

7. They take care of themselves.

Being a harried entrepreneur isn’t just harmful to your health, it’s also unproductive. No one can work round the clock, especially when they’re continually stressed. Self-care is productive.

Formichelli makes time to exercise regularly, take baths and meditate — all vital activities that keep her “at an even keel.” This is especially “important since, as someone with an anxiety disorder, I’m easily stressed and overwhelmed,” she said. Boyle, who works from 9 a.m. to 7 or 8 p.m. usually “take[s] an hour and a half or so for lunch and a workout.”

Overcoming Productivity Pitfalls

Entrepreneurs have to contend with many challenges. Below are just a few of these obstacles along with insight on overcoming them.

Unruly e-mail. “My habit is to check all day long and to answer e-mails as they come in (and I get a LOT), which really scatters my attention and makes it hard to get anything done,” Formichelli said. Recently, she’s started answering email twice a day, which has actually cut down on her correspondence. “I answer e-mails when I get up until 8, and then later in the afternoon. I find that when I do that, I actually get less e-mail because I’m not creating a back-and-forth with people all day long,” she said.

She also noticed that many of her emails were just social media alerts. (You know the kind: This person is now following you or that person just retweeted your tweet.) As Formichelli said, “That’s where the boundaries come in. I don’t want to be rude to people, but I need to make my own agenda and my own family the priority.”

Shiny Object Syndrome. Whenever anyone starts a project, they get wholeheartedly excited. But completing it can become another story. “I like starting things, and I’m less good at finishing them,” Stanier said, who calls this the “Shiny Object Syndrome.” “So I do what I can to self-manage around that, including checking in with my business partner about what I’ve got on my plate.”

Overscheduling. Overscheduling is “a huge challenge and a big stress” for Formichelli. For instance, her goal is to complete 50 practice wellness coaching sessions by the end of October. Formichelli’s fix? To do the best she can with her sessions, and use this as a lesson in creating a better schedule in the future.

Time management. Boyle finds it especially tough to manage her time effectively. “Either I spend too much time on a task or get easily distracted by Facebook and Twitter.” So she uses Online Stopwatch “to set time goals for myself. When the buzzer goes off, I move to something else.”

Knowing how others are able to stay so productive can be eye-opening and instructive. And experimenting with a variety of strategies helps. Just remember that the real key to productivity and success is what works for you.