Psych Central Original articles in mental health, psychology, relationships and more, published weekly. 2016-05-01T17:17:13Z http://psychcentral.com/lib/feed/atom/ Michael Breus <![CDATA[Sleep and Memory]]> http://psychcentral.com/lib/?p=26300 2016-04-28T19:18:21Z 2016-04-30T17:45:22Z ]]> sleep and memoryA significant body of scientific research indicates that healthy sleep can have a positive, protective effect on memory.

Studies indicate that sleeping well helps protect the ability to acquire new memories. If you’ve ever tried to cram for a test while short on sleep, you’ve experienced the obstacles that sleep deprivation can have on memory acquisition. Research shows that even a brief lack of sleep can diminish the brain’s capacity to form new memories as part of everyday learning.

Sleep also is important to the ability to recall memories. Research indicates that recall of both short- and long-term memory is impaired by lack of sleep. A sleep-deprived brain is less effective at memory retrieval, while staying well rested can help protect and improve this aspect of memory function.

There is another aspect of the memory process — memory consolidation — that actually occurs during sleep itself. Memory consolidation is the process in which the brain takes new knowledge and converts it to longer-term storage, ready for future recall. Memory consolidation that takes place during sleep not only secures memory for retrieval, but also appears to prepare the brain to accept new information in the next waking day.

Sleep affects different kinds of memory, including both declarative and procedural memories. Declarative memory involves memories related to facts and knowledge, as well as details about individual experiences. Research indicates sleep is critical to the making and storing of declarative memory. Studies also show sleep deprivation and sleep disorders can negatively affect declarative memory.

According to research, the importance of sleep to declarative memory formation exists from the earliest stages of life. Scientists studying memory processing in infants found that babies 6-12 months who took naps at least 30 minutes after learning new behaviors showed better recall than infants who did not sleep.

Procedural memories are task and skill-based memories tied to motor functions and sensory learning. Much of the basic knowledge we need to function on a daily basis — from typing at a computer to driving a car to taking a run at the gym — falls within the category of procedural memory. Procedural memories are often made through repetition and practice, and are recalled without conscious thought. According to research, a routine of high-quality, plentiful sleep is important to motor skill learning and procedural memory.

When you sleep well, you’re making a long-term investment in the health of your memory as you age. Research strongly suggests that high-quality sleep during youth and middle age may help guard against age-related cognitive decline, including problems with memory, many years later. There is also a growing body of scientific evidence that suggests poor quality and insufficient sleep may increase the risks for Alzheimer’s disease and other forms of dementia. Sleep is not the only factor in age-related memory decline, but it appears to be an important one.

When you’re tempted to stay up late for the sake of being productive, keep in mind that you and your memory ultimately will be better served by getting a good night’s sleep. Well rested, you’re more likely to feel better, perform better, and to remember more.

Forgetful woman photo available from Shutterstock

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Pam German <![CDATA[Medical Care in Rural America: Don’t Be Afraid to Visit the City]]> http://psychcentral.com/lib/?p=26410 2016-04-28T19:14:21Z 2016-04-29T17:45:11Z ]]> medical care in rural americaLife in rural America is a bit different than life in the more developed areas. In many small towns, the family doctor is the only physician one ever sees. The concept of seeing a specialist is not something patients are open to. Few doctors are willing to push the issue unless the need is critical. This is the basic premise that nearly destroyed me.

I was in my early 30s when I went to the doctor. I was married with two children. I had a full-time job and was overwhelmed. My father had recently had a series of heart attacks, my son was suffering from migraine headaches and I was terrified because my mother had died of a brain aneurysm. I explained all this to the doctor and told him about the mood swings, crying fits and sleeplessness. This well-meaning general practitioner prescribed me Prozac. In a couple of weeks, I began to feel better.

About a year passed when I suffered a major back injury. The injury resulted in surgery. I lost my job because of the time it would take me to recover, and we could not afford to live on one income. Soon the pain and the depression was more than I could manage, and I went back to my G.P. He gave me pain pills and increased my Prozac. At no time did he suggest that I see a psychologist or psychiatrist for my depression.

The pain pills made me feel good, though I thought they just dulled the pain, and the Prozac was working better. I would take my Prozac daily and throughout the day my mood would be boosted by the opiates. This was my routine for the next four years. There were times when I would slip back and an adjustment of the pain meds and one more adjustment of the Prozac took care of me. In five years’ time, I went from 10 mg of Prozac to 60 mg. I was on a lot of pain medications as well.

The family doctor told me the DEA was beginning to watch the opiates, so he began to wean me back to a lower dose. Of course this brought on panic and anxiety. So he prescribed me Xanax. I was on a train that was headed for derailment but I didn’t know that.

I don’t know what caused it, but I believe it was the Xanax in high doses. I began having seizures. I had one dramatic seizure that caused me to fall into a doorframe, resulting in a head injury. That is how I ended up in the hospital. The doctors were shocked at the amount of drugs I was taking and they immediately put me in a facility to detox me and restore me to an unmedicated patient in order to properly diagnose me.

It took about two weeks to get me to a point where I could leave the facility. Yes, I left depressed. But with the help of a psychiatrist and a physical therapist, I was able to reclaim my life.

I still take Prozac in a moderate dosage. But it is used in conjunction with mental health therapy. I do not blame the general practitioner. I think he was doing what he thought was best. I am simply saying, by not seeing the proper medical professional, I nearly died. If I had it to do again, I would have traveled the hour it would have taken to see a specialist.

Sometimes we have to work for what we want. I am living proof that happiness in a bottle is short-lived.

Country doctor image available from Shutte

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Michael Breus <![CDATA[Sleep in Women]]> http://psychcentral.com/lib/?p=26294 2016-04-25T19:09:37Z 2016-04-26T17:45:41Z ]]> sleep in womenThere are many ways in which women experience sleep differently than men. Women contend with distinct sleep challenges, respond differently to sleep disorders and sleeplessness, and face particular health risks as a result of poor sleep. Research indicates that women need more sleep than men do, and face greater consequences to mental and physical health from insufficient sleep.

Scientific evidence indicates that circadian rhythms in men and women are markedly different. Women’s circadian clocks are set to an earlier time than men’s, making them more inclined to fall asleep earlier and also to wake earlier. For this reason, women tend to have stronger inclinations to be active earlier in the day than men. Overall, women’s circadian cycles are several minutes shorter than men’s.

The biological phases of a woman’s life — and the hormone shifts that accompany them — can bring about sleep problems. Hormone changes that occur during a woman’s menstrual cycle, including fluctuations of estrogen and progesterone, often make falling asleep and staying asleep more difficult.

Restless, disrupted sleep is common during pregnancy. During pregnancy, women are at significantly greater risk for sleep disorders including insomnia, restless leg syndrome, and snoring. Even women who don’t generally experience sleep problems find that during pregnancy they have difficulty falling asleep and staying asleep, as well as trouble getting enough sleep.

Poor quality, fragmented sleep is a frequent symptom of perimenopause and menopause. Sleep difficulties that occur during menopause may result from hormone fluctuations, and also as a result of other menopausal symptoms, such as hot flashes and night sweats.

Parenthood also can pose challenges for women’s sleep. A majority of mothers — both stay-at-home moms and those working outside the home — report being sleep deprived and experiencing symptoms of insomnia, according to the National Sleep Foundation.

Women are more susceptible than men to some sleep disorders, including insomnia and restless leg syndrome (RLS). Women are also more likely to have nighttime pain that interferes with their sleep, according to the National Sleep Foundation. While men are more often diagnosed with obstructive sleep apnea than women, research suggests that women suffer from this sleep disorder in higher numbers than were once thought. Women who are overweight or obese, or who have high blood pressure, are especially at risk for obstructive sleep apnea.

Women are at greater risk for some health problems as a result of poor quality or insufficient sleep, according to research. Studies show that women are more vulnerable than men to heart disease and inflammation that is associated with poor sleep. Research indicates that women who already have heart disease are particularly at risk for unhealthful inflammation as a result of not sleeping well. Women may also be more susceptible than men to weight and metabolic problems connected to sleeplessness. Research indicates that low sleep in women is more closely linked to higher BMI. Women who report sleeping poorly are more likely than men to say they experience depression and anger.

Women may fare better then men in the short term, when faced with sleep deprivation. Research shows that when short on sleep, women report feeling less sleepy than men do, and demonstrate smaller declines in daytime performance. Women also rebound more quickly after making up for sleep loss. Scientists attribute this difference to a tendency among women to spend more time in deep sleep.

Woman sleeping photo available from Shutterstock

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Darlene Lancer, JD, MFT <![CDATA[What is Narcissistic Abuse?]]> http://psychcentral.com/lib/?p=26282 2016-04-18T22:12:46Z 2016-04-24T17:45:41Z ]]> narcissistic abuseNarcissists don’t really love themselves. Actually, they’re driven by shame. It’s the idealized image of themselves, which they convince themselves they embody, that they admire. But deep down, narcissists feel the gap between the façade they show the world and their shame-based self. They work hard to avoid feeling that shame.

This gap is true for other codependents as well, but a narcissist uses defense mechanisms that are destructive to relationships and cause pain and damage to their loved ones’ self-esteem. (Learn the traits required to diagnose a narcissistic personality disorder, “NPD.”)

Many of the narcissist’s coping mechanisms are abusive — hence the term, “narcissistic abuse.” However, someone can be abusive, but not be a narcissist. Addicts and people with other mental illnesses, such as bipolar disorder, antisocial personality disorder (sociopathy) and borderline personality disorders also are abusive. So are many codependents without a mental illness. Abuse is abuse, no matter the abuser’s diagnosis.

If you’re a victim of abuse, the main challenges for you are:

  • Clearly identifying it;
  • Building a support system; and
  • Learning how to strengthen and protect yourself.

Abuse may be emotional, mental, physical, financial, spiritual, or sexual. Here are a few examples of abuse you may not have identified:

  • Verbal abuse. 
    This includes belittling, bullying, accusing, blaming, shaming, demanding, ordering, threatening, criticizing, sarcasm, raging, opposing, undermining, interrupting, blocking, and name-calling. Note that many people occasionally make demands, use sarcasm, interrupt, oppose, criticize, blame, or block you. Consider the context, malice, and frequency of the behavior before labeling it narcissistic abuse.
  • Manipulation. 
    Generally, manipulation is indirect influence on someone to behave in a way that furthers the goals of the manipulator. Often, it expresses covert aggression. Think of a “wolf in sheep’s clothing.” On the surface, the words seem harmless, even complimentary; but underneath you feel demeaned or sense a hostile intent.

    If you experienced manipulation growing up, you may not recognize it as such. See my blog on spotting manipulation.

  • Emotional blackmail. 
    Emotional blackmail may include threats, anger, warnings, intimidation, or punishment. It’s a form of manipulation that provokes doubt in you. You feel fear, obligation, and or guilt, sometimes referred to as “FOG.”
  • Gaslighting. 
    Intentionally making you distrust your perceptions of reality or believe that you’re mentally incompetent.
  • Competition. 
    Competing and one-upping to always be on top, sometimes through unethical means, such as cheating in a game.
  • Negative contrasting. 
    Unnecessarily making comparisons to negatively contrast you with the narcissist or other people.
  • Sabotage. 
    Disruptive interference with your endeavors or relationships for the purpose of revenge or personal advantage.
  • Exploitation and objectification.
    Using or taking advantage of you for personal ends without regard for your feelings or needs.
  • Lying. 
    Persistent deception to avoid responsibility or to achieve the narcissist’s own ends.
  • Withholding. 
    Withholding such things as money, sex, communication or affection from you.
  • Neglect. 
    Ignoring the needs of a child for whom the abuser is responsible. Includes child endangerment; i.e., placing or leaving a child in a dangerous situation.
  • Privacy invasion. 
    Ignoring your boundaries by looking through your things, phone, mail; denying your physical privacy or stalking or following you; ignoring privacy you’ve requested.
  • Character assassination or slander. 
    Spreading malicious gossip or lies about you to other people.
  • Violence. Violence includes blocking your movement, pulling hair, throwing things, or destroying your property.
  • Financial abuse. 
    Financial abuse might include controlling you through economic domination or draining your finances through extortion, theft, manipulation, or gambling, or by accruing debt in your name or selling your personal property.
  • Isolation. 
    Isolating you from friends, family, or access to outside services and support through control, manipulation, verbal abuse, character assassination or other means of abuse.

Narcissism and the severity of abuse exist on a continuum. It may range from ignoring your feelings to violent aggression. Typically, narcissists don’t take responsibility for their behavior and shift the blame to you or others; however, some do and are capable of feeling guilt and self-reflection.

Someone with more narcissistic traits who behaves in a malicious, hostile manner is considered to have “malignant narcissism.” Malignant narcissists aren’t bothered by guilt. They can be sadistic and take pleasure in inflicting pain. They can be so competitive and unprincipled that they engage in antisocial behavior. Paranoia puts them in a defensive attack mode as a means of self-protection.

Malignant narcissism can resemble sociopathy. Sociopaths have malformed or damaged brains. They display narcissistic traits, but not all narcissists are sociopathic. Their motivations differ. Whereas narcissists prop up an ideal persona to be admired, sociopaths change who they are in order to achieve their self-serving agenda. They need to win at all costs and think nothing of breaking social norms and laws. They don’t attach to people as narcissists do. Narcissists don’t want to be abandoned. They’re codependent on others’ approval, but sociopaths can easily walk away from relationships that don’t serve them. Although some narcissists will occasionally plot to obtain their objectives, they’re usually more reactive than sociopaths, who coldly calculate their plans.

If you’re in a relationship with a narcissist, it’s important to get outside support to understand clearly what’s going on, to rebuild your self-esteem and confidence, and to learn to communicate effectively and set boundaries. Doing the exercises in my books and e-workbooks, particularly Dealing with a Narcissist: 8 Steps to Raise Self-Esteem and Set Boundaries with Difficult People will help you make changes. If you feel in danger, don’t believe broken promises. Get immediate help, and read The Truth about Domestic Violence and Abusive Relationships.

© Darlene Lancer, 2016

Pleading man photo available from Shutterstock

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Michael Breus <![CDATA[Sleep in Children]]> http://psychcentral.com/lib/?p=26291 2016-04-18T21:58:48Z 2016-04-23T17:45:18Z ]]> sleep in childrenChildren have very different sleep needs from adults. Throughout childhood and adolescence, the need for sleep remains higher than for adults. Children spend more time in deep sleep and more time in REM sleep than adults. These two sleep stages are considered by scientists to play important roles in physical and neurological development.

The National Sleep Foundation provides guidelines for sleep for children at each phase of their development:

  • Newborns.
    Newborns sleep on and off throughout the day and night, and need somewhere in the range of 14-17 hours of sleep in a 24-hour period.
  • Infants.
    Through the remainder of their first year of life, infant children typically need 12-15 hours of sleep. This total sleep is typically spread out among nighttime rest and multiple daytime naps.
  • Toddlers.
    Children up to the age of 3 generally require between 11-14 hours of sleep. As with infants, this is usually a combination of overnight rest and daytime napping.
  • Preschoolers.
    Young children ages 3-5 need 10-13 hours of nightly sleep. Naps become less frequent but can still be used to supplement nightly rest.
  • 6-13 years.
    School-age children generally need 9-11 hours of sleep each night.
  • 14-17 years.
    Adolescents need between 8-10 hours of sleep a night.

Sleep plays a critical part in fostering biological, intellectual, emotional, and social development throughout childhood and adolescence. Sleep problems in children can interfere with cognitive and intellectual development. Research indicates insufficient sleep can have a negative effect on language development in children, as well as memory and learning.

Poor sleep, including forms of sleep-disrupted breathing, is associated in children with lower cognitive and intellectual abilities and lower academic performance. Sleep-disordered breathing includes snoring, mouth breathing, sleep apnea, and any sign of impaired breath during sleep. As many as 25 percent of children in the United States may exhibit some form of sleep-disordered breathing by the age of 6.

Sleep also has a significant impact on children’s mental and physical health. Children who sleep poorly are at greater risk for behavioral problems and psychological distress in childhood and adolescence. Research indicates that young children with sleep problems are more likely to develop psychiatric problems. The same research also shows that children with psychiatric problems are more likely to have difficulty with sleep — an indication that the relationship between sleep and mental health operates in both directions in childhood.

From infancy onward, sleep quality can affect a child’s risk of developing obesity. According to research, lack of sufficient sleep in infancy and early childhood increases the risk of being overweight in older childhood. Children who get sufficient sleep are less likely to be obese, and consume fewer calories throughout the day. Sleep patterns during childhood and adolescence can affect weight and other aspects of physical health in adulthood, according to research. Helping children develop strong sleep habits is an important investment in their short- and long-term health.

Children are vulnerable to many of the same hazards to sleep as adults are, including environmental stimuli. Moderating temperature, managing noise, protecting darkness, and minimizing sources of stimulation in kids’ bedrooms can help children fall asleep more easily, and can improve the quality and duration of their nightly rest. Keeping electronic and digital devices out of children’s bedrooms is one way to protect the quality of their sleep environment.

Among adolescents, social media has become an increasing threat to sleep. Social media use in teenagers is linked to poor sleep, and to greater risk for anxiety and depression. Engaging in social media in the evenings before bed appears to be particularly disruptive to teens’ sleep, according to research.

Girl sleeping photo available from Shutterstock

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Lynn Margolies, Ph.D. http:// <![CDATA[A Quiz on Teens: Common Misconceptions You Might Still Believe]]> http://psychcentral.com/lib/?p=26285 2016-04-25T15:42:19Z 2016-04-23T14:45:36Z ]]> Teens: Common Misconceptions You Might Still BelieveUnderstanding teens, and sorting myth from reality, is a challenge for both adults and teens themselves. So check out this quiz and update your knowledge on the latest findings.

1. Which of the following is not true:

The adolescent brain leads teens to:

  1. Explore
  2. Seek out the good in life
  3. Feel things passionately
  4. Seek novelty
  5. Process information rapidly
  6. Need their parents less and be less affected by parents’ disapproval
  7. All of the above

Though teens have gotten a bad rap, the adolescent brain has enviable features that give them unique potential for optimism, vitality, innovation, and positive change. Peers may seem to be all that matters to them and are, in fact, a key ingredient in helping teens forge their own identity. But, in spite of appearances to the contrary, adolescents still need their parents’ availability, guidance, and support, delivered in a way that respects teens’ opinions and autonomy. The challenge for parents is to tolerate, and not take it personally, when teens pull away, and refrain from withdrawing in retaliation in the guise of giving them space.

Answer: F

2. True or false: Adolescents feel more intense temptation than other ages, which makes it harder for them to say no to alluring things.

Adolescents experience overwhelming temptations and cravings for excitement. The depletion of dopamine in parts of the teen brain makes them easily bored and ready to rev up. On top of this, the reward centers in the adolescent brain are more active and easily stimulated, leading to a more intense and irresistible rush when they get excited. When things feel good in adolescence, they feel better than at any other time in life. This biochemistry is adaptive in that it pushes adolescents out of the comfort of the nest — driving them to seek out new experiences and learn the coping skills they will need as adults.

Answer: True

3. Adolescents are vulnerable to acting on their impulses:

  1. when they are being watched by peers (including via text, photos, social media)
  2. when they are with, or anticipating being with, peers
  3. when they are excited
  4. all of the above
  5. always

Under highly charged conditions for teens, the reward circuits in the teenage brain light up, and the pressure to act on temptation can be overwhelming. In these situations of high arousal, information processing is slowed, and impulse control deactivated. It is important to consider the context teens will be in when giving freedoms. For example, because anticipating being with peers, and being with peers, changes brain chemistry and disables executive functions, teens are more at risk in these situations. Under conditions of low arousal and with time to think things through, however, teens have the ability act intelligently and use good judgment and common sense.

Answer: D. All of the above

4. Which of the following is true:

  1. Adolescents are highly receptive to learning and interesting challenges.
  2. Adolescents are too self-absorbed to be able to care about learning.
  3. Adolescents have the same ability to learn as people of other ages.

The teen brain bestows a unique opportunity for kids to practice and imprint the values and skills you want them to have later in life since, like the period from birth to age 5, adolescence is a critical period of brain development. Though new skills can be learned at any age, they can be learned permanently and with less effort during these critical periods. (Exception: kids who have ADHD/executive function deficits, for whom learning is typically frustrating and extremely effortful.)

In adolescence, brain structures become specialized and develop in a “use it or lose it” manner, hardwiring new skills and templates. Unfortunately, adolescents surveyed across the country unanimously chose the adjectives: “stressed, bored, tired” to describe how they feel 75 to 80 percent of the time at school. This finding suggests that schools are failing to engage teens in learning, squandering a decisive window of opportunity.

Answer: A

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Richard Robinson <![CDATA[Early Signs of Alzheimer’s Disease]]> http://psychcentral.com/lib/?p=26273 2016-04-18T21:46:13Z 2016-04-22T17:45:38Z ]]> early signs of Alzheimer'sAlzheimer’s disease is the most common type of dementia, which mainly affects people above the age of 60. It begins with mild memory loss, which then develops progressively toward an advanced state of dementia, leaving patients unable to communicate properly with those around them and to connect with the surrounding environment.

It is a silent killer because early symptoms can be easily overlooked, leaving the patient vulnerable to the raging onset of a merciless disease. This is precisely why raising awareness about Alzheimer’s disease is crucial to helping people notice that they might be in need of medical assistance.

There are a few telltale signs which indicate that a person might be suffering from the disease. It is extremely important that people analyze themselves objectively and take action if they find that most of the following situations are all too familiar to them. If you find that more than four of these signs apply to you, consider seeing a specialist to find out whether you might be suffering from an early stage of the disease.

  1. Common memory loss that disrupts daily life.
    This is one of the most important early symptoms of Alzheimer’s, but unfortunately, it is one of the most overlooked ones as well. It is all too easy to blame habitual memory loss on stress and exhaustion, and patients usually wait too long before seeking medical assistance.

    Key signs include forgetting dates and events, asking for the same information several times or overusing memory aids, such as reminder apps, Post-its, and calendar notes. It is perfectly normal to forget things from time to time, but a healthy person is eventually able to remember them, whereas an Alzheimer’s patient cannot do so anymore.

  2. Misplacing things and difficulty in retracing steps. 
    This is one of the most revealing early-onset symptoms of Alzheimer’s. Patients find themselves unable to retrace their steps and they are unable to remember these at a later time. Experiencing difficulty in retracing steps may be caused by stress, but healthy people are able to remember this information at a later time, while dementia patients are not.
  3. Difficulty in solving problems. 
    Over the years, people develop the ability to apply problem-solving patterns to various situations. Alzheimer’s patients lose this ability and find themselves struggling with common issues that they have come across many times in the past.
  4. Difficulty with pronouncing or spelling known words.
    It is perfectly normal to forget a word from time to time and then obsess over remembering it for a while until it comes back to you. The important fact is that when it does come back, you are immediately able to connect it with various situations. When this happens to Alzheimer’s patients, they cannot remember these words and often experience difficulty in acknowledging their meaning.
  5. Difficulty following conversations. 
    It is normal to lose focus on a conversation and then not be able to retrace how the discussion got to the current point, but people with Alzheimer’s experience difficulty in following conversations even when these are their main focus.
  6. Common confusion about place. 
    Alzheimer’s patients tend to get lost easily. They may find themselves unable to remember where they are or how they got there. This is a very important symptom and it is essential that it is not overlooked. If this happens, a full medical workup is recommended.
  7. Common confusion about time. 
    Forgetting about an appointment from time to time is normal, but when it becomes excessively difficult to remember schedules without using a calendar or a reminder, it may not just be stress and exhaustion anymore.
  8. Difficulty carrying out common tasks. 
    People with Alzheimer’s are sometimes unable to carry out common tasks that they have carried out countless times before. While it is normal not to remember how to perform a task done a long time before, it is clearly a problem to forget how to use the coffee maker or write a message on your phone.
  9. Mood swings.
    People with Alzheimer’s tend to display depressive behavior. They become excessively suspicious of the people around them and they are noticeably anxious. As a consequence, they often tend to become secluded and to exclude themselves from social situations.
  10. Poor judgement. 
    Everybody makes a poor decision once in a while, but when people begin making mistakes that are not in line with their personality and their normal reactions to common situations, it may be time to ask questions. Alzheimer’s patients often become the victims of online scams, which they normally would be able to detect as being suspicious.

The early signs of Alzheimer’s disease are subtle. This is the main reason why it is commonly diagnosed when the condition has already advanced considerably. Schedule a checkup with your doctor if you, a close friend, or a relative have been experiencing the aforementioned situations.

Confused man photo available from Shutterstock

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Janet Singer <![CDATA[Evaluate Your ERP Therapy]]> http://psychcentral.com/lib/?p=26268 2016-04-18T21:59:16Z 2016-04-21T17:45:06Z ]]> evaluate your erp therapyI’ve always felt that one of the most difficult aspects of obsessive-compulsive disorder is finding the right treatment. Evidence-based exposure and response prevention (ERP) therapy, a type of cognitive-behavioral therapy (CBT), is the first-line treatment for the disorder, and it works. Yet so many people, including therapists, have never even heard of ERP. This is so unacceptable! I am doing my best, along with other advocates for OCD awareness, to help spread the word.

But knowing that ERP therapy is what you need is only half the battle. The other half is finding a good therapist who is properly trained in ERP and really knows how to utilize it correctly. Imagine thinking you are getting good ERP therapy when in actuality you’re not. You wonder why you’re not getting better; after all, ERP is supposed to work. Maybe you’re even feeling worse. You worry that your OCD is not treatable. After all, ERP is the gold standard for treating OCD. You lose hope.

So how do you find a good OCD therapist? If you live in or near a metropolitan area, check out major universities as well as centers for anxiety. Often they will have OCD specialists, or at the very least, should be able to give you some referrals.

If you don’t live near a big city or university, you can certainly ask your general practitioner. But beware! A lot of doctors don’t realize there is specialized treatment for OCD and may just recommend a local therapist. This is exactly what happened to my son Dan. He spent four months getting the wrong treatment, with disastrous results.

The International OCD Foundation website can be helpful in finding a competent therapist. It also provides a list of questions you should ask potential health care providers.

Once you are working with a therapist, how can you tell if you are getting good ERP therapy? Below are a few things to look out for:

  • If you have been seeing the same therapist for years and have not made significant strides, then it is probably a good time to reevaluate your situation. It shouldn’t take that long. In fact, if you have a great therapist and you are motivated to fight your OCD, positive results can be seen surprisingly quickly. I know of people who have had OCD for 20 to 30 years, and with proper treatment they have recovered in 12 weeks and have also acquired the tools needed to maintain their good health.
  • A good OCD therapist doesn’t tell you what to do. Rather your ERP therapy should be a collaborative effort, whether you are talking about what should be included in your hierarchy or which exposures you should be attempting. Good ERP therapy is client-driven.
  • A common mistake therapists make is to reassure the person with OCD. While this might temporarily reduce the person’s intense anxiety, it serves only to fuel the fire of obsessive-compulsive disorder. If your therapist regularly reassures you in any manner, that’s a huge red flag that he or she might not know the proper way to treat OCD.
  • It is important for a good therapist to encourage you to challenge yourself as much as possible, without actually forcing you to do anything. The higher up you can get on your hierarchy, the greater chance you have of beating OCD.
  • A good therapist assists you in becoming your own therapist, so that you will have the lifelong tools to fight your OCD.

While the above is by no means an exhaustive list, I think it’s a good start.

When Dan left his intensive residential treatment program, we connected with a therapist who told us he specialized in treating OCD with ERP therapy. Once we heard that, my husband and I didn’t ask any questions or request any specifics about his approach. I realize now how incredibly lucky we were, as this psychologist turned out to be an excellent therapist with extensive experience using ERP. Of course, not everyone is so fortunate, so we should all educate ourselves about OCD and its proper treatment as much as possible.

Getting the right help for obsessive-compulsive disorder is not always easy, but what worthwhile endeavor is? And just think how huge the payoff is — a life not dictated by OCD.

Magnifying glass photo available from Shutterstock

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Jan Stone <![CDATA[Book Review: My Confection: Odyssey of a Sugar Addict]]> http://psychcentral.com/lib/?p=25493 2016-04-19T17:39:25Z 2016-04-21T14:45:37Z My Confection: Odyssey of a Sugar Addict is both a funny and dramatic memoir recounting Lisa Kotin’s journey to free herself from a fierce eating disorder after leaving home for college. […]]]>

My Confection: Odyssey of a Sugar Addict is both a funny and dramatic memoir recounting Lisa Kotin’s journey to free herself from a fierce eating disorder after leaving home for college. Her clear, frank writing and acerbic wit match the ironies she immediately reveals.

Kotin is the youngest of a family of four: three sisters and a brother who becomes a physician. Her dad, a dentist, and her mom raised their family in an upscale northern California community where the siblings attended private schools. But a privileged neighborhood couldn’t extinguish her parents’ childhood ghosts.

Her Brooklyn father’s “response to his poverty-stricken, Depression-era upbringing was to hold back. Don’t spend a dime.” Her mother’s family was “so poor her father only allowed the lights to be on in one room at a time.” Thus, Kotin says of her parents: “she was on a life-long quest to soothe her inner poverty… Nothing was enough for her. Everything was too much for him.”

It is this environment that fuels her struggles to to become everything her mother knew she could be, a particularly vague notion given Kotin’s young talent as a mime. And it is this tension that triggers her epic battle with sugar, a substance that science shows is more powerful than cocaine and is linked to heart disease, hypertension and many forms of cancer.

In her late teens and early twenties, Kotin is tortured with conscious and unconscious anxiety over who she will become, and her addiction memoir is not lessened by the fact that sugar is her numbing drug of choice. As with most dependencies, Kotin runs the gamut of emotions. She suffers relentless guilt, soaring sugar highs and seemingly bottomless sugar blues, while she struggles to define herself through her relationships with her siblings, her parents and their families.

Because she’s smart and talented, she applies and gets accepted into some of the nation’s most prestigious workshops and university programs. She works with therapists and attempts Overeater’s Anonymous. Still, she ricochets from schools, troupes and roommates, looking for love and jobs, all the while trying to fill that donut hole of sugar addiction. But nothing, including several dangerous and traumatic liaisons, seems to quell her sugar hunger.

That is until she finds solace in writing, an interesting shift given her mime background. So she transfers from NYU’s Experimental Theatre program to its Dramatic Writing Program and moves into her own apartment. From here on out, with the help of a Jungian therapist and finally meeting her soul mate, Kotin’s angst-ridden years of sweets, sex and school rotations begin to come to a close. At 27 years old, she graduates from NYU’s School of the Arts and is at last able to corral her toxic addiction.

My Confection is well written—fast-paced like a sugar high, sometimes laugh-out-loud funny and sometimes heart-breaking, but always intoxicatingly frank.

My Confection: Odyssey of a Sugar Addict
Beacon Press, January 5, 2016
Paperback, 248 pages
$15.95

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Michael Breus <![CDATA[Sleep and Mental Health Disorders]]> http://psychcentral.com/lib/?p=26288 2016-04-18T21:47:12Z 2016-04-20T17:45:13Z ]]> sleep and mental health disordersSleep is essential to the maintenance of mental health. Sleep helps to regulate mood and process emotional information and experiences into memory. Insufficient sleep is associated with increased emotional reactivity and emotional disturbance. Research indicates that REM sleep may play an especially significant role in maintaining emotional well-being and psychological balance.

Sleep problems occur substantially more frequently in people with psychiatric conditions than in the general population. Often, sleep and mental health disorders exist in bi-directional relationship to each other, with each condition influencing the other. Poor sleep can contribute to the onset and severity of mental health disorders, and mental health problems can create and exacerbate sleep issues. Treating sleep problems may deliver therapeutic help for mental health conditions, just as sleep may improve as mental health disorders are treated.

Sleep problems may affect the following conditions:

Attention deficit hyperactivity disorder (ADHD)

Sleep problems are associated with ADHD in both children and adults. Children with ADHD are more likely to suffer from daytime tiredness, as well as sleep-disordered breathing. In children, symptoms of sleep deprivation may appear similar to symptoms associated with ADHD.

In adults, symptoms of ADHD may appear similar to symptoms of certain sleep disorders, including narcolepsy and hypersomnia.

Anxiety

Anxiety disorders and sleep problems are frequently present together. Sleep problems occur often in people with panic disorders, generalized anxiety disorder, and post-traumatic stress disorder, among others.

Anxiety contributes to disrupted sleep, often in the forms of insomnia and nightmares. Sleep deprivation elevates the risk for anxiety disorders. One mechanism by which sleep induces anxiety, according to research, is by increasing activity in the centers of the brain responsible for emotional regulation. This same research suggests people who are naturally prone to worry are especially vulnerable to the anxiety-producing effects of poor sleep.

Bipolar Disorder

Sleep problems are a symptom of bipolar disorder. During manic episodes, people often sleep very little, and feel a diminished need for sleep. In depressive episodes, people with bipolar disorder may experience insomnia as well as hypersomnia — excessive tiredness during waking hours, which may be accompanied by prolonged periods of sleep.

Research indicates that bipolar disorder is accompanied by changes to the structure of sleep, known as sleep architecture. In particular, bipolar disorder is associated with alterations to the timing and duration of rapid eye movement (REM) sleep.

Depression

Sleep and depression have a complex relationship, with sleep disruption contributing to depressive symptoms and depression interfering with sleep. Roughly 75 percent of people with depression also experience symptoms of insomnia. Hypersomnia also is common among people with depression. Antidepressant medications also may interfere with sleep.

Insomnia is not only a symptom of depression, but also is a contributor to the mood disorder. People suffering chronic insomnia are five times more likely to develop depression, according to research.

Psychosis

Psychosis is frequently accompanied by disrupted sleep. People who experience psychosis may sleep excessively or very little. They may sleep inconsistently, without a regular schedule. Changes to sleep patterns can be an early signal of psychosis among people with schizophrenia.

People who experience psychosis are at higher risk for certain sleep disorders, including obstructive sleep apnea. Lack of sleep can increase the risk of psychosis and of paranoia. Sleep deprivation can generate symptoms of psychosis even in healthy adults. Research indicates that a 24-hour period of sleep deprivation results in signs of psychosis that resemble the symptoms of schizophrenia.

Understanding the interplay between mental health disorders and sleep problems can aid in correct diagnoses and improved treatments for both conditions.

Sleepless woman photo available from Shutterstock

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Samantha Munoz <![CDATA[Book Review: Goodbye Anorexia, Hello Life]]> http://psychcentral.com/lib/?p=25491 2016-04-19T17:37:15Z 2016-04-20T14:45:51Z There is something uplifting about stories of overcoming personal obstacles and the self-published Goodbye Anorexia, Hello Life! How God Helped Me Finally Find Myself and Embrace Living Loved, Healthy, and Whole […]]]>

There is something uplifting about stories of overcoming personal obstacles and the self-published Goodbye Anorexia, Hello Life! How God Helped Me Finally Find Myself and Embrace Living Loved, Healthy, and Whole is no exception. Readers follow Allison Bryant’s journey through the darkness of her struggle with anorexia through to her recovery many years later. Bryant’s ability to draw the reader in with her story keeps the reader involved and hoping for her full recovery.

The book opens with Bryant’s explanation of how anorexia had been in control of her life for 25 years, affecting her starting when she was only 11 years old. While I found this to be shocking, as I continued reading the book, I began to understand why. Bryant’s relationship with this disorder rocked her life so much that she labels Anorexia as a character in her book who displays herself primarily as a negative voice inside Bryant’s head. We dive into Bryant’s early life and follow her through adulthood, from various jobs and degrees to a bad relationship and multiple inpatient treatment periods of her life. With every piece of history that Bryant reveals to us, we are better equipped at understanding how Anorexia has affected her life, drawing her into a deep depression and tempting her to restrict her food intake for the sake of her well-being.

Bryant first describes the family dynamic and events during her adolescence. Her relationship with her parents and her schizophrenic brother led her to feel isolated from her family and unable to relate because of the attention given to her brother. Anorexia gradually began taking a hold over her life; she was first tempted to reduce her calories, then exercise by walking excessively after school. Bryant’s relationship with Anorexia also affected her intimate relationship with her boyfriend. It even convinced her to follow him to the same university out of her fear of being alone. It was because of Anorexia that Bryant pushed to stay with someone who emotionally abused her.

After her years at the university, Bryant struggled with both seeking treatment and finding a job that fulfilled her passions. Anorexia’s hold on her was so deep that she was even unable to completely finish her first of many trips to inpatient treatment centers. After her breakup with her boyfriend, Bryant continued to find it difficult to secure a job or enjoy her job once she got one. She went back to school numerous times until she decided to settle for jobs in customer service. Bryant’s turning point was her relationship with God, which pushed her to finally love her body and herself. She went back to more treatment centers to break off her relationship with Anorexia for good and repair her personal relationships with her parents. While she is no longer under Anorexia’s control, she considers herself still in recovery but finally free and in a loving relationship with God.

Before I even opened the book, I knew that a lot of the recovery process for the author would involve God, as the subtitle read How God Helped Me Finally Find Myself and Embrace Living Loved, Healthy, and Whole. While I wasn’t sure how much the book was going to be about religion, it wasn’t until I started reading that I realized how much it played a part in her journey to recovery. Her relationship with God helped her find love for herself and the inner strength to be free from Anorexia’s clutches. The book goes into great detail not only her physical journey, but also her spiritual one, which is something a reader must keep in mind. Bryant has a great ability of weaving together her relationship with God and her journey however, sometimes her explanations would run a little long at more than a couple of paragraphs.

But I liked how Bryant portrayed Anorexia, not just as a disorder but as a character in itself. Bryant’s struggle with this disorder seems more real and raw as she describes Anorexia’s hold on her and her struggle with over exercise and starvation. Anorexia didn’t just force her not to eat, it encouraged her to pursue unhealthy relationships and cut off healthy ones. It is almost as if Anorexia was holding a knife to Bryant’s throat, forcing her to do her will and whispering lies into her ears. It is with this imagery that readers can sympathize with the turmoil Bryant went through, root for her as we read about her treatment, and celebrate even more at her recovery.

I will admit that reading this book was a journey in itself. Bryant emotionally pours herself into this book and I can’t even begin to imagine what it took for her to write it. This book is not just a memoir, it is a great reminder of what kind of havoc disorders can wreak in people’s lives and how we can find resilience in ourselves and sometimes in higher powers. Going through Bryant’s journey with her was uplifting and can remind anyone that we can overcome whatever obstacles come our way.

Goodbye Anorexia, Hello Life! How God Helped Me Finally Find Myself and Embrace Living Loved, Healthy, and Whole
CreateSpace Independent Publishing Platform, November 27, 2014
Paperback, 264 pages
$13.99

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Bethany Duarte <![CDATA[Book Review: The Smart but Scattered Guide to Success]]> http://psychcentral.com/lib/?p=25484 2016-04-14T18:56:50Z 2016-04-19T18:54:56Z True story: I started writing this review about five times. Each time, a distraction presented itself right as I began to write and took my attention away from this task […]]]>

True story: I started writing this review about five times. Each time, a distraction presented itself right as I began to write and took my attention away from this task for a while. When I came back to it, it was harder each time to get started again. As an entrepreneur who answers to herself and to clients, staying on task is 100% my responsibility, and in most cases, there is no one to hold me accountable. I have found that the pain/pleasure principle comes into play as I prioritize my work schedule, determining whether or not I will see the pleasure of a job done at a reasonable pace or the pain of a looming deadline. From that perspective, The Smart but Scattered Guide to Success, written by two masters of executive skills and learning/attention disorders, was both a challenge to step up and an answer to a desperate plea for help.

The Smart but Scattered Guide to Success is a practical work written by Peg Dawson, EdD, and Richard Guare, PhD, that is truly deserving of the descriptor “guide.” Its focus on the development of executive skills — defined as the core brain-based abilities needed to maintain focus, meet deadlines and stay cool under pressure — is not age or industry specific, and reads as if targeted instead to the desperate, disorganized and dysfunctional thinker.

The authors set out to take the reader on a journey, beginning first by helping the reader identify both his or her strengths and weaknesses as they relate to executive skills, before walking through the step-by-step, action-oriented process of skill development. While it is scientifically-based with many plentiful case studies and resources for practical application, Drs. Dawson and Guare have successfully encapsulated a course on living with excellence into a 294-page book.

This book fits into my library next to others that focus on strengths and skill-building such as Strengths Finder 2.0 and other personality-based metrics. While I enjoyed those and certainly gained from the coach-like tone of those works, The Smart but Scattered Guide to Success takes a different approach. Going back to my initial example, it was not difficult for me to find my weakness in the area of Task Initiation, listed as one of the Essential 12 executive skills discussed in the book. It was defined (a type of procrastination), explained in accessible language, and then pulled apart, one piece at a time into manageable bits.

One factor that I found particularly unique and increased my regard for this book and the insight of the authors was the emphasis on task and environment modification. In my case, the book prescribed ways to modify both the space and environment around me to strengthen this core area, as well as ways to modify the task itself to empower me to succeed instead of procrastinate. I found this approach to be both effective and innovative, and most importantly, easily replicated.

While this one example targeted only one of 12 Essential executive skills discussed in the book (response inhibition, working memory, emotional control, task initiation, sustained attention, planning/prioritizing, organization, time management, flexibility, metacognition, goal-directed persistence, and stress tolerance), the other sections give breakdowns of the skills listed and explain how both a strength and a weakness in that area can hinder and limit professional and personal growth. Where the book really shines is in the plentiful resources available, including quizzes, charts, organizational tools, action plan templates and more, all designed to not only help you strengthen these executive skills, but also to stay on track to do so. This book also excels at not degrading any one weakness, but demonstrating how each individual is a combination of strengths and weaknesses and that growth is a constant, ever-changing process.

There was considerable information focused on the aging process and the importance of developing these skills as we age, which was both useful and out-of-place. The section was more a prescription of preventative medicine for a future of diminishing executive skills, as is common with general aging. Tucked away at the end, it seemed more as an afterthought than a strong component of an otherwise substantial work on the topic.

From the standpoint of someone invested in building on strengths and lessening weaknesses in the area of executive skills, The Smart but Scattered Guide to Success hits the target with accuracy, precision and an accessible style that will make it a regular fixture in my professional development library for many years to come.

Book Review: The Smart but Scattered Guide to Success: How to Use Your Brain’s Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home
The Guilford Press, January 16, 2016
Paperback, 294 pages
$16.95

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Tamara Hill, MS <![CDATA[Book Review: Beyond Schizophrenia: Living & Working with a Serious Mental Illness]]> http://psychcentral.com/lib/?p=25482 2016-04-14T18:54:14Z 2016-04-18T18:53:13Z Schizophrenia is an earth-shattering disease that not only complicates the life of the sufferer, but the lives of those around the sufferer. Despite a history of working with early onset […]]]>

Schizophrenia is an earth-shattering disease that not only complicates the life of the sufferer, but the lives of those around the sufferer. Despite a history of working with early onset psychosis in children, I can only imagine just how much pain schizophrenia inflicts on families. My empathy is not enough to compensate for the occupational, psychological, emotional, physical, and social challenges that sufferers and families must cope with. For many families, the act of writing a book, speaking out, or volunteering becomes a passionate endeavor to open the heart and minds of society to a serious mental illness (SMI) that remains a highly stigmatized disorder.

That’s why Marjorie Baldwin wrote the book Beyond Schizophrenia: Living and Working with a Serious Mental Illness, to highlight her experience as an educator and labor economist who conducts research on work discrimination, as well as a mother of a son with schizophrenia. She explains the difficulty her son had pursuing a college education and employment with schizophrenia. For example, in chapter three, she explores the social stigma that her son experienced once released from a psychiatric hospital to return to college at the University of North Carolina.

Baldwin explains that her son became increasingly more withdrawn, isolated, and unmotivated following his release from the hospital and leading up to his re-enrollment in college. Her son is described as often feeling discouraged by his illness and social stigma. She reports “an aura of sadness surrounded him. One afternoon I found him lying on his bed, staring at the ceiling, with tears running down his face. When I asked what was wrong he said ‘my mind’s playing tricks on me again, mom.’”

As with any parent observing the stress of schizophrenia in their child’s life, Baldwin must have felt helpless, hopeless, and afraid. She does a good job in explaining the disorder, highlighting economic statistics, and drawing attention to the educational and occupational challenges that often occur in lives of those suffering with SMI. Sadly, it is apparent that Baldwin may have been biased in her perception and interpretation of the University of North Carolina’s actions.

While it is important to be mindful of how we perceive individuals with SMI, we also need to be mindful of how we ensure that our society (workplaces, schools, campuses, etc.) is safe. We must also be mindful of how to support and re-integrate into our society those who are struggling with SMI. Baldwin explains that the University of North Carolina held a meeting, consisting of faculty and administrators, to convene with the family on whether it was the right time for her son to re-enroll in classes and continue his college education. Most schools typically hold such meetings when a school has reason to question whether a student can safely be reintegrated back into the college culture. For many parents, this procedure is well-respected and appreciated, especially if the parent’s child is the one being protected by college administrators and faculty who have concerns around safety. But for Baldwin, this procedure seemed to emphasize stigma and make she and her son feel ostracized.

Thankfully there are colleges and organizations (e.g., Active Minds) across the nation that are dedicated to supporting those with SMI. Unfortunately, Baldwin may have neglected to look at the fact that it wasn’t just the college that had concerns about her son’s stability. Baldwin reports that she, too, had concerns about her son’s health and safety. She reports:

“I made excuses to travel to the Triangle area (Raleigh-Durham-Chapel Hill) on a frequent basis, so I could visit David without saying I was “checking up” on him. I frequently stayed overnight, cleaned the apartment, and stocked the refrigerator with food. That fall he successfully completed two classes. After he completed four more in the spring, we began to think that he might graduate only one semester behind schedule. We did not realize that he had stopped taking his medication.”

It is apparent that Baldwin is a loving, caring and frustrated mother who strives to stand up for the rights of her son. But we must be careful, as passionate advocates, not to minimize a situation to make a point about social ostracism, politics, and stigma. Research suggests that individuals with SMI often forget or refuse to maintain appropriate medication management. Sufferers of SMI are sometimes incapable of protecting themselves, pursuing mental health or crisis services, living safely within the community, and providing for themselves, even when they want to. 

As a result, college campuses, work sites, and other social places have the right to discuss the concerns around safety and SMI. In addition, it appears the book becomes less and less personal as Baldwin delves into discussing work-related discrimination and the need for various accommodations to support those wanting to return to the workforce or educational system. While facts related to these real issues are extraordinarily important, some readers may become disengaged as the exploration of economic disparity can be researched by Googling information as needed. Each chapter is structured to review pieces of the author’s own story and the educational and occupational letdowns and challenges of her son.

Even more, some readers may question the difference between this book and other books on schizophrenia and SMI. With so many books on the shelves of similar content, it can be difficult for writers to find their niche on a broad topic such as SMI, draw and maintain an audience of interested readers, and provide fresh information. Sadly, Baldwin is not the only mother who has written a book to share personal details and highlight barriers to equality. This book may fade into the background for readers who have already read thousands of similar books.

However, for a reader looking for a book (written by a passionate mother) that explains the occupational and social pressures inherent in the lives of those with SMI, this book is for them. For readers who are looking for real tools on how to overcome the social and occupational stressors of those living and working with SMI, this book might disappoint. Overall, Baldwin does a decent job of highlighting the accommodations that should be considered in the public and by businesses to help support those with SMI. Because it can be difficult for society to identify the occupational, educational, and social needs of those with SMI, we have writers like Baldwin who can impact society by bringing these issues to light.

Beyond Schizophrenia: Living and Working with a Serious Mental Illness
Rowman & Littlefield Publishers, April 16, 2016
Hardcover, 256 pages
$36.00

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Claire Nana <![CDATA[Book Review: Parenting for a Happier Home]]> http://psychcentral.com/lib/?p=25480 2016-04-14T18:50:34Z 2016-04-17T18:47:36Z When most people think of parenting, they probably think of setting rules, implementing discipline strategies, and curbing disruptive behavior. However, in Stuart Passmore’s new book, Parenting for a Happier Home: […]]]>

When most people think of parenting, they probably think of setting rules, implementing discipline strategies, and curbing disruptive behavior. However, in Stuart Passmore’s new book, Parenting for a Happier Home: The Step-By-Step Guide To Keeping Your Kids On Track, we are reminded that parenting starts by building a healthy relationship with our kids.

Passmore, a psychologist who specializes in kids who are often labeled difficult or disruptive, draws upon his many years’ experience to first teach parents how to build a sense of belonging in the home, use active and reflective listening to better understand and communicate with their kids, understand and accept their children’s emotions and behavior, and help their children develop empathy and moral behavior — the core skills of his RANE parenting program. With these skills firmly in place, Passmore then shows how to use discipline in an effective way.

Passmore begins by encouraging parents to walk a mile in their child’s shoes, with the idea of learning to practice responding to them with the respect and empathy they might expect from others. From this, parents can learn to create a constancy of pleasing interactions that demonstrate an enduring and persistent care and concern for well-being, which, Passmore says will help children to develop a secure attachment.

While the attachment theory focuses primarily on the role of the mother, Passmore emphasizes the role of the father, writing, “It has been my experience that the way in which a man defines himself as a father often influences his parenting behavior.” The reason attachment matters, according to the author, is because insecure attachment corresponds with poor mental health and behavioral problems.

But parents must also know their parenting style. While they can be authoritarian, permissive, uninvolved, or authoritative, what is most important is that parents be aligned in their parenting efforts and present a unified front. Without this, Passmore tells us, not does the child’s behavior suffer, but the marriage might as well. However, when parents do work on building a strong marital relationship, the child’s behavior often gets much better. Passmore writes, “I often find that as the couple works through marriage counseling and begins rebuilding their relationship, I also begin to hear more and more about how the child’s difficult behavior is decreasing.”

The next step for parents is communication, and Passmore suggests active and reflective listening as a cornerstone of developing an open and honest communication with children. To do this, the author offers many helpful tips, such as using “I” statements, asking clarifying questions, making eye contact, really listening (as opposed to preparing an answer) and getting down on the child’s level. When parents can communicate authentically with their children, they can also develop an emotional attachment with them, which Passmore tells us, “means sharing an interest in their life, in their thoughts and feelings, and their joys and disappointments.”

And there is an important connection between a strong emotional connection and how parents discipline their kids. Because emotional involvement expresses an attitude of unconditional love, acceptance, approval, and forgiveness, and is expressed both verbally and physically, it also means that parents will behave the same with their children when they succeed and when they push them to their outermost limits.

And parents must also be aware of what they are modeling for their children, which they can do by asking themselves questions such as: “What behaviors do I want to teach my child?” and, “What behaviors am I actually teaching my child?” Some characteristics parents should model include: being warm and responsive, displaying parental competence, maintaining consistency between assertions and behavior, and inhibiting unfavorable acts. Perhaps of utmost importance is that parents help their children develop empathy. Passmore writes, “Empathy predicts selfless behavior and promotes prosocial behavior in the classroom.” However, to do this, parents must know not just what blocks empathy—factors such as neglect, using threats, withdrawing emotion, inconsistent reactions and bribing—but also what promotes it—being responsive, talking openly, encouraging taking others’ perspectives and modeling empathic behavior.

On the topic of discipline, Passmore writes, “Discipline has at its foundation absolute respect for the child with an understanding that while it may indeed incorporate negative consequences for a child’s misbehavior, such consequences only play a small role in modifying a child’s misbehavior overall.” So just how do parents go about the sensitive issue of discipline? Passmore suggests first listing five behaviors parents would like their children to change. Next, parents should list five potential consequences for misbehaviors. Parents should then develop a contingency plan where privileges can be removed should the child misbehave even after being given a consequence. Lastly, parents should have family meetings to help children understand clearly what is expected of them, and how they will be held accountable. Of most importance, Passmore reminds parents, is that once the consequences have been applied, that is the end of the discipline.

For any parent looking for a quick fix, Passmore’s book is probably not the right pick. Passmore devotes the majority of his writing to teaching parents how to improve themselves, because he believes a child’s good behavior starts with a parent’s good behavior. And that should be reassuring for any parent. Just as we hope to bring out the best in our children, we should also hope that they bring out the best in us.

Parenting for a Happier Home: The Step-By-Step Guide To Keeping Your Kids On Track
Exisle Publishing, April 19, 2016
Paperback, 207 Pages
$21.95

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Elaina J. Martin <![CDATA[Book Review: The i’Mpossible Project: Reengaging With Life, Creating a New You]]> http://psychcentral.com/lib/?p=25282 2016-04-14T18:47:30Z 2016-04-16T18:46:40Z We all have a story to tell, a story that needs to be shared so that others don’t feel so alone and different. It needn’t be long or exaggerated, just […]]]>

We all have a story to tell, a story that needs to be shared so that others don’t feel so alone and different. It needn’t be long or exaggerated, just a few pages of a book, perhaps. In telling our stories, we encourage others to tell theirs and to have hope that they will get through whatever hardship they are dealing with.

This is exactly what Josh Rivedal shares in his The i’Mpossible Project: Reengaging With Life, Creating a New You. He has collected the stories of 50 authors, all in different stages of their lives, who relate their experiences in 1,000 words or less. It isn’t easy to open up your heart and share what is inside in such a short piece, but these talented writers do so with eloquence and grace.

What is truly great about this book is that it uplifts the spirit. No matter how dark the subject matter — suicide, a son’s homicide, living with MS — each and every story ends on a high note. Every story offers the hope that you can, and will, get through your own experience.  Coming into the book, it might be hard to imagine that an essay in which a mother talks about burying three of her four children could teach the reader about joy, but it does, as do the stories of rape and physical illnesses such as breast cancer and Parkinson’s.

The stories are split into seven applicable chapters, and Josh Rivedal was quite smart in selecting the categories for each chapter’s group of stories. The chapters include: i’Mpossible Families, i’Mpossible Physical Health, i’Mpossible Trauma, i’Mpossible Mental Health, i’Mpossible Lived Experiences With Suicide, i’Mpossible LGBT, i’Mpossible Second Acts and Second Chances.

Looking over the chapter titles it is easy to see how this is a great book for those of us with mental health issues and for those who do not understand them. For example, in Jennifer Haussler Garing’s “You Can Come Back,” from the i’Mpossible Lived Experiences With Suicide chapter, the reader can understand how Garing felt and why she would want to commit suicide.

“Depression is a life wrecker,” she writes. “It swings in and topples your life and leaves you buried in collateral damage — in no condition to clean up the mess. As you lie there you see nothing but darkness with no memories of past happiness, love, hope, or sunlight.”

But her story doesn’t end on that dark note. It ends with the following paragraph, “The one thing I will always be sure of is that the only constant in life is change. No matter how bad things get, they will always get better, even if they have to get worse first. I cling to that.”

I think The i’Mpossible Project does exactly what Rivedal set out to do – allows readers to “reengage with life (and) create a new you.” Every story teaches the reader something, even if it is simply “That’s exactly how I feel!” Covering such a wide scope of topics means there is something for everyone. I highly recommend this book.

The i’Mpossible Project: Reengaging With Life, Creating a New You
Skookum Hill Publishing, January 16, 2016
Paperback, 258 pages
$14.95

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