Psych Central

I Hardly Ever Wash My Hands: The Other Side of OCD

2012-05-10T12:42:14Z

A friend of mine has obsessive-compulsive disorder. His OCD doesn’t take over his life, at least not ostensibly. He has some rituals, and occasionally he does things that raise eyebrows, but overall he’s a normal guy with a few rare quirks.

Admittedly, his case is mild. But when the average person thinks of someone with OCD, my friend is the kind of person that comes to mind. Contrary to mainstream opinion, however, OCD is a much more dynamic disease. It is multifaceted, coming in all shapes and sizes, and it is nondiscriminatory: anyone can have it. And for those who do have it, their condition may not be what you think it is. Dispelling this myth is J.J. Keeler’s central mission.

In I Hardly Ever Wash My Hands: The Other Side of OCD, Keeler writes openly and often humorously about her condition. Unlike my friend, Keeler does not need to open and close a drawer a certain amount of times. Nor does she need to make sure her desk hits her wall at precisely a 90-degree angle. She’s no Jack Nicholson in As Good As It Gets. But this does not mean she lacks irrationality.

Keeler paints a perfect portrait of her condition in her opening paragraph: “I can’t tell you how many times I’ve had AIDS. I’ve probably had it more often than the average person has had a common cold or a sinus infection. I’ve had it more often than the average child has had strep throat or the average athlete has had a muscle pull. I’ve had AIDS more times than I can count.”

Keeler, by her own admission, has never actually had AIDS. Yet throughout her life, she has continually thought she has been afflicted. When she was told “dirty needles” were one cause of the disease, she took the phrase literally. And when as a child she bought a poster for her room, she thought she infected herself: “After unrolling the poster against the wall and guessing it was straight, I reached into my pocket. Almost immediately the thumbtack—a dirty needle—stuck my finger. Once again, I had AIDS.”

Keeler got AIDS in many other ways as well: nicking her hand on a tree, having a dog slobber on a cut, even just looking at a public toilet soaked in urine. “Though I decided not to use it and immediately left, I got AIDS anyway.”

Worry over AIDS is far from Keeler’s only OCD-driven fear. When she read Franz Kafka’s The Metamorphosis in high school, she “was obsessively worried about going to bed as a human and waking up as a giant bug.” And when she was given a free teddy bear at a garage sale, all hell broke loose. Keeler didn’t think there was a bomb inside the toy; she knew there was.

The inner workings of Keeler’s mind are worth devoting a few lines to:

I thought about my stethoscope from my toy doctor’s kit and listening to see if I could hear the bomb ticking, but I knew that wouldn’t do any good. Obviously, it would be ticking.

I thought about wrapping the teddy bear in a protective barrier made of aluminum foil, but I wasn’t sure if that would keep the bear secured, or just keep it fresh for tomorrow’s supper.

I thought about taking the teddy bear to some rural area and throwing it away in a field. But that was no good. Someone would find it, take it home and then their home would blow up.

I thought about shoving it down one of the slits on the sidewalk curbs that led to the sewer. This way the bomb would be underground when it exploded. But the toxins from the bomb—there had to be toxins—would get into the city’s water system and poison anyone who drank tap water.

It would be a massive understatement to say that Keeler gave this issue a lot of thought. She obsessed over the idea that her teddy bear was rigged with explosives. The notion clearly consumed her at times. She considered the idea from all different angles, trying to find the best way to deal with this highly sensitive issue.

Welcome to Keeler’s life. No, she does not fret, as she writes, about the “mouse living under [her] stove. I’m not worried. I’m not anxious. In fact, I don’t really care at all.” She is not who we consider to be the typical person with OCD. Keeler instead represents the underreported segment of people with the disease. She’s not the one obsessing about the little things. The title says it all: she hardly ever washes her hands. Such things are relatively trivial to her. It’s the big things that consume Keeler.

I Hardly Ever Wash My Hands is fascinating for many reasons. First, it is elegantly written in a confident and humorous way bereft of any filler. Everything in the book is interesting and necessary. Second, it is one of those rare books that gives the reader unfiltered access to an unusual mind at work. We can see the pain, confusion and despair dripping from each page. Third and finally, it’s just a good book. And for anyone interested in learning more about “the other side of OCD,” it’s a worthwhile book.

One thing worth noting is that Keeler does not downplay the nuisance that OCD can be for people who deal with the more mainstream version. She writes: “Don’t get me wrong. OCD is often a disease marked by a debilitating obsession of all the [typical] things, but that’s only part of the story. Sometimes it’s none of the story.”

For Keeler, common obsessions are not part of her story. Hers is unique and atypical, and news to most of us. For those who struggle with Keeler’s brand of OCD, however, it’s not news. It’s life.

I Hardly Ever Wash My Hands: The Other Side of OCD
By J.J. Keeler
Paragon House: March 1, 2012
Paperback, 170 pages
$16.95

Teens Need A PR Director

2012-05-10T13:13:42Z

The long-standing popular image of teenagers is that they are rebellious, self-centered, risk-taking, and don’t want anything to do with their parents. It is a time to search out one’s identity, travel with the pack, and reject family values. But this doesn’t fit the data from contemporary research on adolescence. No group of teens has ever been as community-oriented, worldly, knowledgeable, anxious about adult life and success, and able to debate, among themselves or with their elders, the risks of sex and drugs.

It was a pleasure to read some recent newspaper articles describing the large number of teens involved in charity work, especially the many “Walk for….” events. With the growth of gender equality in athletic funding, more teens than ever are involved in sports. Drug use in most areas has been down although alcohol use is up. Unfortunately, cigarette smoking, primarily among adolescent girls, is also up.

The vast majority of teens go to school every day, do a reasonable amount of their work, socialize with friends a lot (especially on the phone), and actually talk to their parents. There are always the music fads and clothing fads, frequently greeted with disapproval by parents. But parents of today’s teenagers are a special lot themselves, for most are products of the 1960s and have vivid memories of their own abuse of sex, drugs, and rock ‘n’ roll. For some parents, this enables them to be more understanding of their kids, especially a generation that is less rebellious than their own. Other parents, however, are ashamed of what they did, don’t want to talk about it, and crack down on their own teens out of fear.

The biggest problems for the current generation of adolescents is the breakdown of family structure. The dominance of absent parents, through divorce and dual incomes, makes communication more difficult. Teens don’t have conversation on demand. To gain insight into your 15-year-old’s thinking, you need to be around each other enough that you catch them at a moment when they want to talk. That’s become extremely difficult when parents are hardly around. Thus, one of the parenting challenges is to find opportunities for one-on-one time, even if it’s just doing some errands together or driving a child to an activity. While carpools are sometimes essential to survival and bringing another child along may be necessary, try as often as possible to make it just one parent/one teen. It’s those moments when something personal may actually come up.

A major concern is the amount of unsupervised time teens have due to not having a parent at home in the afternoons. It is important to have some agreement for touching base during the afternoons. Usually this is a telephone conversation. While some teens will resist what they interpret as distrust — “Why do you have to check up on me?” — most will appreciate the underlying care and protection of parental limits regardless of their complaints. It is also helpful if there are friends or neighbors around who can be a checkpoint for your teen. Ideally, many teens are involved in some structured activity at least a few afternoons a week or may work part-time.

Probably the biggest challenge for parents is trying to create a new mix in their relationships with teenage children. You need to be less authoritarian, creating a blend of parent, guide, and friend. Rules need to be open to more negotiation, yet parents must still set the outer limits firmly. I often use the analogy of moving back the fences of the corral so the young horses have enough room to run without feeling the need to jump the fence. It means both parties need to understand each other better. Don’t expect your teenager to open up to you if it’s not reciprocated. Not stories about how hard you worked at their age, but stories of your own struggles to navigate adolescence and some of the mistakes you made and still turned out okay. It also includes sharing some of your struggles in today’s world. Too often we try to protect our children from the challenges of daily life. The result is not only a distorted view of what they should expect as adults, but also a one-sided demand for openness. Share just enough that you are a real person to them as much as you want them to be a real person to you.

Of course, for some, adolescence is a painful, even dangerous, time. Depression, drug addiction, teenage pregnancies, school failure, and acting out against others occurs in many families. In these situations special help should be sought to assist in trying to solve the problems. But, for today, I just thought teens deserved some positive press. The vast majority have adapted well, despite parental fears, and credit goes to parents, schools, community organizations, and the kids themselves.

The 10 Best-Ever Anxiety Management Techniques Workbook

2012-05-10T13:06:13Z

In 2008, Margaret Wehrenberg published The 10 Best-Ever Anxiety Management Techniques: Understanding How Your Brain Makes You Anxious and What You Can Do to Change it. Now a workbook has been released to accompany the book.

While the book goes into more detail about different aspects of anxiety, the workbook includes enough background information to function by itself. Since the workbook also contains worksheets for each technique, if you were to purchase just one of the two books, you would probably find that the workbook meets your needs.

Wehrenberg says that the first step is to assess the type of disorder you suffer from. To help you do this, Wehrenberg provides checklists and assessments which she says “are based on situations I have observed over the years in my practice. As such they are not validated tests but rather represent questions I ask my clients and the circumstances they describe to me.” Some of the assessments are specifically designed for adolescents. In spite of not being validated, when I compared a few of the assessments with scientifically validated versions, they produced comparable results.

The workbook focuses on panic disorder, generalized anxiety disorder, and social anxiety disorder. It is divided into three sections: managing the anxious body, managing the anxious mind, and managing anxious behavior. In the section on managing the anxious body, chapters focus on the impact of food and drink on anxiety, and on breathing, mindfulness, and physical relaxation. Each chapter presents techniques which may be valuable for all types of anxiety, then describes how a technique can be applied to each of the anxiety disorders. The book includes a CD with guided exercises for breathing, practicing mindfulness, and physical relaxation. The CD is well-produced, with exercises read by the author, who has a pleasant voice.

Techniques vary from strategies you can use when you only have as little as two minutes to strategies for developing productive new habits. Most chapters end with a S.I.M.P.L.E plan that you create for specific problems. Each letter stands for a different element of the plan which includes “S” for describing the symptoms of your problem, “M” for the method you’re going to try, and “E” for evaluating the results.

The book includes detailed and useful information about how to perform diaphragmatic breathing, as well as teaching how to practice mindfulness and relaxation. It contains detailed and less useful information about how to stop catastrophizing and on thought stopping and replacement. Even though some of the advice may seem obvious, if you suffer from anxiety you are likely to find a strategy that could help you. One interesting idea is that when we’re anxious, we need to seek the “right reassurance.” If you ask for reassurance from others, you may feel better only temporarily. Wehrenberg says that “the right reassurance is reassurance that you are competent to handle problems.” She says that you’ll continue to worry unless “you remind yourself that even if the worst does happen, you will be able to deal with it.”

One of my quibbles with the book is that the author has an annoying habit of personifying the brain, as when she says “Your brain does not like it when you have a physical sensation without an observable reason, so it decides, ‘If I feel this bad, there must be something wrong!’” She also makes strange assertions such as “If your energy supply is not burned off through physical exertion, such as when sitting in front of a computer 12 hours a day . . . you have a release of energy that never gets used. This is a major reason people put fat on in their middles when under stress.” She implies that sedentary jobs lead to anxiety because of this “release of energy that never gets used;” and also that stress is the deciding factor in whether we get fat when we have a sedentary job, leaving out the importance of dietary intake and exercise. She also recommends questionable techniques such as the use of affirmations, even though research does not validate their use.

Strangest of all is her invention of the term “too much activity” (TMA), which she describes as though it is a scientific diagnosis. Someone with TMA suffers from a “high drive” and sufferers are unable to “hold still,” causing their feelings of anxiety to increase. Her diagnostic assessment for TMA includes statements such as “getting unexpected free time can raise my anxiety, especially if I have no warning” and “I become very impatient when something slows down my progress.” TMA also includes perfectionism, which she says some people use to control their anxiety. The strategies she describes for dealing with TMA include life/work balance, planning for free time, and learning to have fun. You may find her treatment information useful, but I question creating a new diagnosis for what might otherwise be called a “Type A” personality.

Should you purchase this workbook if you suffer from social anxiety, generalized anxiety disorder, or panic disorder? You will find a great deal of useful information, along with worksheets and tools to help you try new strategies and evaluate your progress. In spite of my reservations about a few areas that she writes about, overall, a sufferer from anxiety will probably find it and the accompanying CD useful.

The Ten Best-Ever Anxiety Management Techniques Workbook
By Margaret Wehrenberg
W. W. Norton & Company: March 19, 2012
Paperback, 240 pages
$19.95

Moving and Young Children

2012-05-10T13:10:59Z

Moving day. Such excitement! Such distress! An event nearly every family experiences a few times, if not more. The impact on children is as varied as their personalities. But a few guidelines might be helpful.

One 4-year-old boy, whose family had moved to a new state at the beginning of the summer, seemed to adjust surprisingly well. He had a great summer. His parents couldn’t believe it because he tended to have trouble dealing with change. In September, he started at his new nursery school. Suddenly he became sad, clingy, and began to soil – all the behaviors the parents had originally expected. Talking with this child gradually revealed that he had intuitively believed that living in the new home was just a summer vacation, like when the family had gone to the shore the previous year. He expected to be reunited with his friends in September. It was only then that he truly realized this was permanent and became upset. Of course his parents had explained the move, but he only heard what he wanted to believe.

In the hectic times following a move, parents often don’t have the energy to work extra hard on helping a child settle into the proper routine. A 3-year-old girl didn’t like her new home and refused to sleep in her new bedroom. It was easier to just let her fall asleep night after night in the parents’ bed. As life settled down, they became increasingly frustrated with being unable to get their daughter to sleep in her own bed.

A 6-year-old boy had no problems sleeping anywhere, until the family moved into a new home that was much larger and the boy’s bedroom was now upstairs, removed from the flow of activity. The new bedroom suddenly was inhabited with scary creatures only visible to a young boy.

Moving can be very disorienting to a young child. They are tiny creatures in a world full of giants and much confusion. They rely on predictability and attachment to caretakers to generate a sense of security. Parents often believe that using words will suffice to create an understanding of what the child is about to experience. But young children do not comprehend the meaning of words describing experiences they have yet to experience! It may seem as if they do – but don’t be fooled.

This means trying to use any strategy that can make the change as concrete and tangible as possible. Buy a new dollhouse, set it up in another part of the house, move the family and their furniture, and play out the expected activities that occur after moving. Create a book about moving, with drawings and photographs of the old house and new house. Read children’s books to them about moving. Even though it makes moving day more hectic, have the children around as the movers load the truck. Children will rely on their magical thinking and childhood logic to address the logistics of moving. They need real experiences to help guide them through the process – even if seeing their belongings carried out of the house is initially distressing.

A favorite recommendation is to create a box of objects that provide a concrete connection to the old house. Take a shoebox and have the child fill it with leaves, rocks, and other small objects from the yard. Use a digital camera and allow the child to direct what pictures she wants. By seeing them instantly, she can let you know if you’ve captured what she wants. You may also have some of her neighborhood friends put small objects in the box as well as a picture of the friends.

Object permanency is elusive for a very young child. Out of sight often means it is gone. A few months after moving, especially if the child is expressing a dislike for the new home, make a trip back to the old home. “See, it is still there.” “See the new family and their new furniture in the house.” Yes, some children will be angry – “My house!” But that gives you a chance to help them vent the anger, working it through in play, conversation, or drawings. Then the child may be ready to complete the move.

As for the frequent night fears and sleep disruptions, keep the bedtime process in the child’s bedroom, meaning that you may need to stay in the room until the child falls asleep. Other regressions may also occur such as baby talk and loss of toilet training. This is partly a normal response to stress, partly a wish to return to the past. The child needs to be told that his being sad or mad or scared is normal. At the center of this must be the awareness that the young child’s distress increases the need to reaffirm his attachment to you, for that bond is the essence of his sense of security. Don’t lose sight of that in the midst of all your distractions caused by the move and, gradually, everyone will settle in.

Rewire Your Brain for Love: Creating Vibrant Relationships Using the Science of Mindfulness

2012-05-10T13:04:52Z

The thesis of Dr. Marsha Lucas’s new book is simple: By changing your brain, you can change your relationship. In fact, the title says it all: Rewire Your Brain for Love. The basic idea at play is one that is gaining more mainstream notice nowadays: neuroplasticity. In the introduction, Lucas highlights new research that confirms our suspicions that the brain is actually quite malleable. She goes on to capture the idea, as well as its implications for relationships, quite well:

We can, in fact, not only cause the neurons in our brains to change and to grow new connections and pathways, but we can produce new neurons, throughout our entire lives. It’s called neuroplasticity… What does this mean for you and your relationships? If you can grow new connections and new neurons, your old, getting-in-your-way wiring can be redirected and/or overridden. You can rebuild it. (Italics in text.)

This is all well and good. But how exactly does one go about doing this? Lucas’s prescription is a radical approach: “The ancient practice of mindfulness meditation, as it turns out, produces real, measurable changes in the brain in key places so that deeper connections, better love, and healthier relationships can really take hold.”

Lucas continues: This can be done “in as little as 20 minutes a day. Whaddaya think? Are your relationships worth 20 minutes a day?”

As evidenced by the style above, Lucas writes quite conversationally, which is refreshing considering how academic and formal the book could have been. Yet Lucas is able to take the complex idea of neuroscience and boil it down in a highly readable, highly engrossing way.

Rewire Your Brain for Love is divided into three sections. The first, containing just two chapters, is filled with preliminary information to give the reader a basis from which to approach the “rewiring.” The second section contains the bulk of the book. In each of its seven chapters, Lucas works with one singular idea before giving a meditative exercise to complement the words. The final section, just one chapter with a brief epilogue, provides wisdom for continuing this new practice.

Throughout the book, Lucas maintains her unique voice. Even when explaining a complex idea, Lucas is able to break it down into its simplest parts. Her casual writing style helps readers feel that complex scientific ideas are workable and capable of being successfully implemented.

A solid example of Lucas’s ability to relate with the reader comes in Chapter 6 when she discusses emotional reflexes:

We all have those d’oh moments when we realize we’ve blown it with our partners and said something we regretted. And we’ve all had the experience where, upon later reflection (sometimes days later), we finally let the authentic, meaningful response that we wish we’d had the presence of mind to come out with earlier bubble up into our awareness. By practicing mindfulness meditation, you’ll be able to give your brain more time to generate an awareness of choices.

Lucas’s casual, intimate style draws the reader in where more academic prose might have failed to do so. This is in no way to assert that Lucas does not write intelligently. She writes both with intelligence and authority. Those traits, couple with the occasional wit and of course her eminent relatability, make Rewire Your Brain for Love somewhat of a fun read.

This review has focused primarily on Lucas’s writing style and ability to present information in a readable way. But the book’s meditative component is equally important. As stated previously, each of the second section’s chapters culminates in a different meditation. It should be noted that these are not the meditations you will find an experienced Buddhist monk doing. That said, they revolve around the same basic idea: mindfulness. If you are new to meditation, or even if you have some cursory experience, then you will find what Lucas offers to be of great benefit. Each of the meditations is meant to address a different aspect of your psychological outlook. In this way, each meditation is slightly different, preventing the possibility of getting bored or frustrated by one specific exercise.

Rewire Your Brain for Love is one of those great hybrids between self-help and education. If you’re looking for a method to tackle relationship problems (or even just ‘life’ problems), you’d be hard-pressed to find a better primer.

Rewire Your Brain for Love: Creating Vibrant Relationship Using the Science of Mindfulness
By Marsha Lucas, Ph.D
Hay House Publishers: February 1, 2012
Hardcover, 201 pages
$19.95

Q&A: Disciplining a Challenging Preschool Child

2012-05-10T13:10:09Z

Q: My son is four years old and he rules the house. His first response to everything is “No!” Getting him dressed, getting him to eat breakfast, getting him off to nursery school or day care is a daily struggle. He throws tantrums whenever he isn’t getting what he wants – and sometimes even when he does. He’s very jealous of his 2-year-old sister and constantly goes after her. He wears me down. I know I’m losing it too much and screaming at him, of course, to no avail.

My husband and I try to discipline him but he won’t stay in time out – he keeps walking out of his room. And trying to get him to stay in his bed at night is another constant challenge along with attempting to have a peaceful dinner. Yet he can be a warm, affectionate child and, at times, is a delight to play with or read to. At school, they tell me he’s terrific! That makes me feel that I’m doing something wrong. I know we’re not being very consistent with our discipline. My husband and I often end up yelling at each other for not following through. Any suggestions?

A: Whenever parents are struggling with a very difficult-to-manage child, the first step is to consult with your physician, including an allergist, to make sure there is nothing medical affecting your child’s behavior. As a mental health professional, I take a careful early history to ascertain if this is primarily an issue of temperament, i.e., is there clear evidence of challenges right from the beginning? Another related avenue to explore is the more recently identified concept of sensory integration problems, often suggested by a history of not being calmed by touch, fear reactions to loud noises or frequently pulling off clothing (possibly caused by certain materials being irritating).

Whatever the cause, it is important to begin by recognizing that you cannot control your child’s behavior. It is a false expectation that contributes to a parent’s notion of being a failure or results in sometimes very harmful efforts to become even more authoritarian and angry. The only things you can control are your behavior and the consequences of your child’s behavior, which you must learn to actively and consistently manage so that your child learns to make improved choices. For many children this is an easy process because they are naturally eager to please or are very even-tempered. But some children are impulsive, moody, deficient in the ability to calm themselves and very needy of attention. These children with difficult temperaments may always struggle in that they tend to persist in a higher rate of making unacceptable choices. They present special challenges to all parents.

It’s important to realize that parenting is not a one-way process. Children influence parents as least as much as the reverse. So when you have a child who is difficult from an early age, you begin to have doubts about yourself as a parent and begin to have feelings of resentment toward this child. The latter is typically admitted with significant feelings of guilt. These doubts and negative emotions make it even more difficult to parent effectively.

It is very common for the parents of a challenging child to think of themselves as being bad parents, especially mothers, whom our society burdens with a sense of responsibility for the behavior of their children. Yet these same parents typically have one or more additional children who are doing very well but the parents don’t take any credit for that!

It is typically a relief just to help parents understand that they are not the cause of this child’s difficulties and that they cannot do anything to change the child’s core makeup. What is most likely happening by the time they reach my office is that they have been worn out by the process and are now doing things that are probably increasing the challenging behaviors.

Let’s get to some guidelines about what to do. Mornings are a challenge. It helps to remember that a central issue for this child is probably an exaggerated need for attention, a combination of problems with soothing himself and being able to stay focused on activities when alone. These children often do better in a school setting because it is typically highly structured and they are influenced to follow the rules by the rest of the children. When they do have a problem in preschool, it is usually when the program is less structured, the environment is too noisy, or their need for attention results in conflict with other children.

The extra need for structure is very important to these children. They are less able to create their own. So borrow from your preschool, which usually has the daily schedule on a big poster with pictures, and the children review it routinely. Thus, parents should create, with the child’s assistance, a large poster that outlines the morning routine. Include times, a brief statement of the task to be completed, and a picture or drawing of the task. Place a large, analog clock next to the poster. Then, throughout the morning, keep referring to the poster: “It’s 7:20 and the poster says you are supposed to have brushed your teeth already. Oh-oh, you better hurry up or you won’t be done getting dressed by 7:35.” It’s as if the poster is in charge, not the parent — you can’t argue with a poster!

If possible, build into the end of the schedule a brief playtime which, of course, can only happen if he’s done on time. That way you are getting the child to work for the very thing he wants the most — your attention.

The same process can be used at night, with the same one-on-one attention at the end if the child is ready on time.

Now, what should you do when the child throws a tantrum? Walk away, even if the child responds by intensifying the tantrum or keeping at it for a longer period of time. Wait until it run its course before attempting any discipline. If the child has really lost it, keep in mind that it is a scary experience for him and you should verbalize that probable feeling when the tantrum is over. You may also decide in those instances to offer some soothing comments in addition to a possible negative consequence.

Remember that one of the most effective discipline techniques you have as a parent is the attention you give to your children. The challenging child has learned to get most of his attention by negative behaviors. You must reverse that by withdrawing your attention at those times, with less concern about useless lectures and admonitions, and making a point of reinforcing positive behavior by giving more of your attention at those moments. It can often help to use structure here as well by listing some key positive behaviors on a chart that earn extra playtime with a parent.

Time out is still one of the most effective discipline techniques but a key to making it work, once again, is recognizing that you cannot control your child’s behavior, only the consequences. If a child refuses to go to his room or stay in there for the required amount of time (just a few minutes for preschoolers), you kneel down and look him right in the eye and say, “You’re right. I can’t make you stay in your room. But if you don’t then the next time you ask me to do something with or for you, I will just say no and remind you that you owe me a timeout.” Then walk away. Your child will soon need something from you and you remind him not until he completes his time out. You will get tested on this a few times and once the child realizes you are like an elephant that never forgets (having an elephant mask or picture handy adds some levity to this process), he will become much more compliant in accepting his punishment.

The key issues in parenting a challenging child are not to lose confidence in yourself as a parent, be persistent in creating structure and managing your attention, and finding the positive aspects of your child and focusing as much attention on that as possible.

The Art of Confession: Renewing Yourself Through the Practice of Honesty

2012-05-10T12:38:06Z

We live in an age of frequent and easy confession. People seem eager to share private information and experiences that would have been kept as closely guarded secrets in years past, perhaps guarded by shame and humiliation.

From talk shows and reality programming on television, to personal blogs on the Internet, we are flooded with people’s confessions and secrets. The politician’s confession has become so commonplace that we know the script and are only surprised when it is violated — when “the wronged wife” chooses not to attend the media event, for instance.

At the same time, the traditional context for confession, religion, is experiencing a decline in participation. What do we even mean by confession these days?

In The Art of Confession, Paul Wilkes explores the roots and branches of confession, which he conceives as an attitude more than a specific action – confession with a little c, he says. He begins the book by stating his core assumption that “deep within every human heart, there is a desire to be good.” As human beings, of course, we falter, we make inelegant choices, we betray ourselves and others, and we know it. In this context, Wilkes enlists a “Confessional Chorus” – a rabbi, a priest, a psychiatrist, and a Roman Catholic nun – to contribute sidebar commentary on the issues he explores in this small but powerful book.

The first third of the book orients the reader to the history of confession. It’s a brief but fascinating history. Starting in ancient Egypt, it travels through Native Americans; Buddha; New Guinea; Judaism; Catholicism; the Protestant Reformation; and therapy — today’s commonplace confessional context.

Confession has been secularized and in the process, as philosopher Paul Ricoeur said, “man has lost the sense of forgiveness while retaining his sense of sin.” And in the words of Swiss physician Paul Tournier, “Nothing makes us so lonely as our secrets.”

In the remaining chapters, Wilkes leads the reader forward to an understanding of confession as an attitude of realignment, to a way of minding our inner compass. Chapter Five is particularly helpful, and quite moving. It presents and describes seven very specific approaches to reflection and realignment, including:

Observe, Judge, Act – a method developed before World War II by a Catholic group who wanted to translate religious teachings into a very concrete practice
Consolations and desolations – a method developed by Ignatius Loyola to review the day, focusing on moments that produced the feeling of being alive and worthwhile, and those that produced the feeling of worthlessness
Praying backward through the day – a number of techniques designed, as Wilkes says, not to produce self-reproach or anxiety, but rather to help you see yourself more clearly
“Rummaging for God” – five steps of prayer, review, reflection, and looking ahead
A particular examen – focusing closely on a specific problem or fault
Metta Bhavana – the cultivation of lovingkindness
An adult examination of conscience – eight suggested areas for focused reflection

There are times we know we need to confess to another person. That private reflection is not the final step. In Chapter Six, Wilkes addresses this topic, exploring how, what, to whom, where, and when not to confess. Finally, in Chapter Seven, Wilkes briefly explores the next step, shaping a new way of living, which he summarizes as “doing the next right thing.”

This small book – at a trim size of 7” x 5” – reminds me of a prayer book, one I would leave on my nightstand for dipping into before sleep, one I might carry with me in my bag. The tone throughout is compassionate and real, so the reader feels welcomed and understood. Wilkes and his Confessional Chorus do not write from on high, from a position of holy judgment, but rather from the human perspective of thoughtful people who aspire to goodness and who, like us as readers, regularly miss the mark. Although the book is itself beautiful, I flagged sections, starred passages, underlined sentences, and folded pages so I could find them quickly. This is not a book I simply read and placed on the shelf; it’s a book that means to be used, that intends to place its fingers into your life, to guide you in the kindest way toward who you want to be. Although much of the history it presents and the guidance it offers is in the realm of religion, you needn’t be religious to find it useful. It takes a universal approach to the material, making room for everyone. The closing sentences make the point: It isn’t about reuniting you with a specific religious belief, it’s a wish “that you might be reunited with yourself.”

Because the book is small, and brief, I was left wishing for a bit more, especially in the final chapter about moving beyond these specific practices. That chapter felt light, even for a small book. However, the book takes an internal focus – me, inside myself – so perhaps it’s up to me to figure out those next steps for myself, anyway. This lovely little book has stayed with me in the weeks since I read it, and some of the exercises have stuck with me, if not as nightly practice at least as a regular part of my inner life. It is a welcome antidote to the excesses of our public confessional culture.

The Art of Confession: Renewing Yourself through the Practice of Honesty
By Paul Wilkes
Workman Publishing Company: January 1, 2012
Hardcover, 144 pages
$18.95

Sensitive Children Who Develop Significant Anxiety

2012-05-10T12:39:04Z

In recent months I happened to work with a number of elementary-age children who had developed anxiety symptoms such as resistance to separation, excessive worrying, nightmares, restricted activity, and “meltdowns.” They were all very bright, creative children who engaged in a lot of fantasy play and were described by their parents as very sensitive. While excessive anxiety is not limited to this cohort of personality factors, I do believe that they represent a majority of the children who, in fact, get immobilized by their fears.

The good news is that those same characteristics can be used to help them change from feeling powerless and overwhelmed into children who feel capable of solving their problems. In other words, these children learn to be more resilient. When I ask parents in my workshops what qualities or strengths they most want for their children, I usually hear a list that includes happiness, health, kindness, sociability, and achievement. What I focus on, however, is resilience. This concept, expertly evolved in a series of books written by Drs. Robert Brooks and Sam Goldstein, refers to developing a sense of being able to solve the problems that life inevitably poses to all of us.

In the discussion that follows, I will describe some of the issues these children presented (details are changed to protect confidentiality) and the strategies used to empower these children to learn how to manage their fears.

Micah, an 11-year-old boy, who was described as very sensitive and caring, had developed a significant problem around separating from his parents. It had reached a point where it impacted their ability to go out without him as well as his ability to go on field trips or to stay over at a friend’s house. He had developed chronic complaints of stomachaches (nothing found by his physician). We refer to developing physical symptoms as somatization. It is very common in children (keeps school nurses very busy) but is also common in adults.

Typically one of the first stages in my work with these children is a psychoeducational piece. With Micah, I explained what happens in the body when we get anxious (nervous, worried). The brain sets off an alarm and the body, like a fire department, swings into action. This is about the “flight or fight” mechanism. The body produces adrenalin which in turn causes our heart to speed up, pumping more oxygen to give the body more energy. Our muscles tighten, ready to spring into action. Our pupils dilate, the better to spot problems. Now, this can be helpful if there is really a threat that we need to deal with. But what if there isn’t? I use one of the many ideas I’ve learned from a colleague, Dr. Susan Davidson, a behavioral psychologist, who specializes in the treatment of anxiety disorders. “Micah, does the smoke alarm ever go off in your house but there isn’t a fire?” He laughs. “Sure sometimes when mom’s cooking!” Please note the value of humor in helping children understand and deal with problems. (Actually it’s also very helpful with adults.) So we begin to use the concept of “false alarms.” Do we want those firemen racing to his house when there’s no fire to put out? Of course not.

Micah and I worked on the problem in a few ways. I taught him how to relax his body. Open your palms, hands pointed down (an inviting rather than rejecting position that is part of yoga), taking a deep breath, and then drop your belly! Kids usually laugh when I say this. But they catch on quick as I demonstrate it and can immediately feel their body relax. I explain how their body can’t be anxious and relaxed at same time. Micah started to feel he could control at least part of what was happening to him.

We also talked about how stress causes “aches” and he was able to list stomach, back, and head as common aches we all experience from stress but he had never thought of it in that way. Another helpful piece of information.

Then we began to make lists of past worries and checking off which had actually come to life. Sometimes there may be a couple. Often there are none. Either way, it is immediately clear that most of the worrying is for naught. Then we make a list of worries about what bad things might happen in the coming week. At our next appointment we review the list and rarely has any of the worries come true. I focus on the concept of the brain sending false alarms (not Micah having unnecessary worries – better to blame the brain) and that he can now begin to tell the brain when there really isn’t a fire. “Aw, it’s just mom burning dinner again!”

Given a way to understand what has been happening inside his body and a few strategies to better control what is going on, Micah quickly has a couple of positive experiences and quickly improves. I find that these bright children are able to take the ball and run to daylight almost immediately. They start to feel more confident, more resilient, and often are quickly telling me they don’t really need these appointments any more. Thank you very much, but I’d rather be playing with my friends!

Allison, an 8-year-old, brought another aspect of these issues into the office – temperament. She was described by her parents as “slow to warm up.” These children, and their close “cousins,” shy, have an exaggerated self-consciousness that makes them more prone to worry. Allison demonstrated a common aspect of worriers – “catastrophizing.” This refers to taking a small problem and turning it into a potential catastrophe. Often the child doesn’t see that she is doing this but Allison did. However, she said she couldn’t stop it and had no idea why she was doing it.

Sexuality and Marital Intimacy

2012-05-10T12:36:33Z

A good marriage is best friends with passion. Without the passion, you just have a friendship. For some, being companions is sufficient. But for most, it is not. One of the major casualties of the harried pace of modern marriage is the loss of sexual intimacy. It is too steep a price to pay. While communication is the most frequently mentioned issue in troubled marriages (see April 2005 article on “Improving Marital Intimacy”), inevitably I find a diminished sexual relationship at the center of most troubled marriages.

What follows is a brief tour through the world of marital sexuality with a focus on how to understand the issues and strategies to repair the damage.

Gender and Physiology

Men and women are different. While these differences get debated in some circles, when it comes to sex, they are real and very clear. Unfortunately many couples fail to reflect on these differences and integrate them into an understanding of how to be successful partners.

Start with arousal patterns. Men are quick to be aroused and relatively quick to achieve orgasm. The “spike” rises sharply and drops off just as sharply. Men are especially aroused visually; brain research documents this. So looking at other women, at magazines, videos, and online pornography play a much bigger role in the sexual life of men.

Women are aroused more slowly and after achieving orgasm, tend to remain at a high plateau of arousal before dropping off. These are very different physiological patterns. No wonder it is a challenge for couples to really experience mutual satisfaction. These differences must not be ignored; instead they must be incorporated into the lovemaking process.

The simplest way to do this is, regardless of who initiates the foreplay, is for men to focus on pleasuring their wives, bringing them to an initial orgasm before focus is given to bringing the male to orgasm. It is also critical for men to understand what will help their wives achieve orgasm. While clitoral stimulation is usually a key component, many women still “get off” on intercourse, especially if the angle is such that it also stimulates the clitoris or that clitoral stimulation is being done manually by either partner during intercourse.

It is also important to understand the psychological implications of the different genital anatomies. For men, sexual intercourse is an external act. This has evolutionary implications about the need for prehistoric men to “seed” many partners in order to insure survival of the species. It is part of what allows men to more easily separate sex from love. But, for a woman, to have intercourse means allowing a man to enter her body. That is a deeply personal act and men need to appreciate this. It is why women complain about the need for emotional intimacy before they can be sexually active. Combine this with the difference in arousal patterns and it becomes much easier to understand why it is so important for women to experience meaningful foreplay.

Yet there is a trap here for women that becomes a key issue for so many of the couples who come to see me. When couples are struggling, women insist on emotional safety and closeness in order to be actively sexual. That creates a prohibitive barrier to improving the marital relationship, since the lack of sex, especially for men, but a lot more for women than they recognize, is one of the central underlying problems in not resolving their issues. Women act as if sex is still a process of servicing men and often deny that they are sexual beings who need to be serviced at least as much if not more. While some female readers may be dismissing this because it is being written by a male author, this concept is a central theme in books written by some of the best known female professionals in marital work such as Betty Carter, Ellen Wachtel, and Susan Scantling.

Women need to have sex! For themselves! So it is important to overcome the excuse of emotional disconnection and have sex with your husbands as frequently as possible. It will allow BOTH partners to feel closer and create a more intimate context in which to resolve other issues. I am, of course, not suggesting that this can happen in relationships that are verbally and, especially, physically abusive.

Organize Your Mind, Organize Your Life

2012-05-10T13:07:41Z

A wonderfully executed book which sets out with the lofty objective of organizing and taming our society’s fast-paced lifestyle, Organize Your Mind, Organize Your Life is a true prize in its class of literature. It’s extremely thoughtful in its prose, giving the reader countless images and examples to better understand the relevance of the scientific information presented.

The authors — an assistant professor of psychiatry at Harvard’s Medical School and assistant psychiatrist at Massachusetts General Hospital’s Department of Psychiatry and “Coach Meg,” the founder and CEO of a leading corporation which focuses on building international standards for professional health and wellness coaches — offer a very holistic approach to decreasing the frenzy that so many of us encounter in our daily lives. They complement each other wonderfully. Dr. Hammerness (the professor) usually approaches the reader head-on, lobbing out new tidbits of scientific research and trying to get the reader up to speed on the ever-evolving field of neuroscience. Coach Meg, on the other hand, greets us at the end of each chapter in a more “nitty-gritty” manner, giving us practical steps to take on our journey toward less chaos.

Each chapter walks the reader through a clear and concise look at one “Rule of Order,” as the authors term these guidelines to gaining control and order in our every day. They typically illustrate where so many of us go wrong and help us pinpoint the moment or moments that lead to disarray. Many of the cases highlight individuals who have made it into adulthood with varying levels of ADD or ADHD, often through acquisition of coping skills that unfortunately have their limits. When these people or those coping skills have met their limits, Dr. Hammerness conveys to the reader, he often sees them in his office, eager for their first appointment.

As a younger professional in the sciences who has been diagnosed with ADHD, I can easily empathize and readily understand these individuals. Throughout the book, we see myriad cases in which people struggle to keep their heads afloat in a world that seems to never stop picking up the pace around them. The authors relay tales of mothers who allow themselves to obsessively get roped into cleaning a garage, while the rest of the world spins out of control, and contractors who forget pertinent details needed to keep business booming in a subpar economy.

Within this book we gradually move with the authors through the all of the Rules of Order: “Taming the Frenzy;” “Sustaining Attention;” “Applying the Brakes;” “Molding Information;” “Shift Setting” and “Connecting the Dots” (where we learn to put together each one of these valuable tenets to form a practical design with which to newly approach our lives). If ever, during the course of the narrative, we doubt the real need for adjusting our turbulent lifestyles, the authors rein us back in with new understandings in neuroscience and another example of someone burning the proverbial candle at both ends.

At one point the authors even lure us into a few examples of people “multi-tasking,” goading us into momentarily believing that those people who seem adept in this supposedly coveted ability to handle more than one task at a time are superior. But quickly we see that multitasking is akin to seeing a snapshot of a juggler with a dozen balls in the air. We don’t see the juggler drop all of the balls in the next snapshot, so don’t truly have an accurate depiction of the ability or limitations of the juggler.

Similarly, when we see the person in the office next door texting, typing and listening in on a conference call, we should understand that each of those tasks will be of poor quality and many likely will not be completed at all. There are, Dr. Hammerness assures us, limitations with any human brain.

For anyone who has sought this title out in a bookstore, there will likely be no disappointment with the content. Organize Your Mind, Organize Your Life is an extremely well-constructed and astutely interesting mix of science and recipe book, arming the modern-day person with countless tasks consistently scheduled, a more productive and less stressful manner with which to approach life. By the end of the last chapter the authors seem like two dear friends with whom we have learned invaluable skills, like stepping back from each situation and assessing before acting. With them we learn to welcome an interruption and flex with the changing nature of the world around us. Surely if we follow these two recommendations alone, we can thank both authors for a few added years!

As the book claimed from the beginning, Coach Meg and Dr. Hammerness offer us tools with which “to tap into our embedded organizational skills, improve focus and attention and better structure our life.” As someone who has at times struggled with the challenges of ADHD, I practice mindfulness meditation, engage in regular physical activity (which the authors strongly urge) and attempt to eat well. This book is a priceless addition to my library in terms of very tangible life skills that will certainly improve my ability to organize and manage my hectic schedule.

In addition, I look forward to pursuing some of the websites and citations found within this gem. For these two gifted authors to utilize them, it will certainly be worth my time and effort to follow up on all extraneous information offered. I cannot recommend Organize Your Mind, Organize Your Life enough, as it truly does just what it sets out to do: educates and empowers the reader to “train your brain to get more done in less time.” It would hard to begin to put a cost on that.

Organize Your Mind, Organize Your Life: Train Your Brain to Get More Done in Less Time
By Paul Hammerness, MD and Margaret Moore
Harlequin: December 27, 2011
Paperback, 272 pages
$16.95

Ideology, Psychology, and Law

2012-05-10T13:15:05Z

Ideology, Psychology, and Law is a wonderful collection of essays edited by Jon Hanson, the Alfred Smart Professor of Law and Director of The Project on Law and Mind Sciences at Harvard Law School. This is the first book edited by Hanson, whose work has appeared in six other books and many periodicals. Hanson also cofounded The Situationist blog in 2005, and in 2011 it won the Media Prize from the Society for Personality and Social Psychology.

Spanning 21 essays, the first of which Hanson wrote (as well as four others which he cowrote), Ideology, Psychology, and Law is an academic book that belongs either on a classroom desk or a library shelf. It’s not really the kind of book you bring to the beach for light reading. That said, for students and academics looking to examine the intersection of the three titular areas, Hanson’s new contribution is nothing short of a marvel.

Each of its essays is distinct, coherently argued, well written and worthy of reading. Hanson starts the book with his own essay, “Ideology, Psychology, and Law.” In it, he lays the groundwork for the remaining essays and gives some background on and context to the meaning of the three terms under discussion. He does not aim to define them, leaving that task to the essays that follow. Rather, Hanson provides the reasoning behind the book’s composition:

It should not be obvious what a volume titled Ideology, Psychology, and Law is actually about. After all, each category—ideology, psychology, and law—has numerous definitions and covers a vast domain. Furthermore, the concepts are not commonly understood as closely linked. One goal of this volume, however, is to help delineate the sizable overlap between the categories of ideology, psychology, and law and to show that the links between them are tighter and stronger than conventionally perceived.

Hanson’s other goal is to, in a sense, create a new field of study—or rather, to look at preexisting fields in new ways. He writes:

In bringing together some of the world’s most illustrious scholars in law, political science, political psychology, and social psychology, my aspiration for this book has been not only to illuminate the intersections among those disciplines but also to expand the ties between those fields in the hope of encouraging more interdisciplinary collaboration, research, and insight in the future.

Hanson is almost calling for some quasi-revolution in how we study these three fields. Human behavior is not only dynamic, but also largely misunderstood. In this way, the implications contained in Hanson’s book can result in profoundly new ways of conceiving of these disciplines. And by attempting to reorient the reader’s world and renegotiate his perception of reality, Hanson is implicitly catalyzing the evolution of our studies. Are there arguments in Ideology, Psychology, and Law that will be contested? Of course. But they are rooted in such substantive theory and testimony that it is not easy simply to dismiss them.

Moreover, Ideology, Psychology, and Law does not have one single or even several themes that abstractly bind the book together. Instead, Hanson gave his contributors free rein to write and argue as they pleased. In this way, readers will surely agree with certain arguments and disagree with others, and they will surely favor certain essays over others.

My personal favorites are the first section of Hanson’s introduction from which I quoted above, “Ideology, Psychology, and Law;” “Bias Perception and the Spiral of Conflict” by Kathleen A. Kennedy and Emily Pronin; “Backlash: The Reaction to Mind Sciences in Legal Academia” by Adam Benforado and Hanson,;and “Crowding Out Morality: How the Ideology of Self-Interest Can Be Self-Fulfilling” by Barry Schwartz.

The second section of Hanson’s introduction provides brief synopses of each essay to come. He succinctly describes the scholars’ arguments in readable, concise language. To Schwartz’s essay above—perhaps my favorite—Hanson writes:

Contrary to popular opinion and to legal theory, that is, people are not inherently self-interested. Schwartz shows that the ideological presumption that people are self-interested in law and in other institutions creates powerful, self-fulfilling expectations and situations. Schwartz further describes the problems with allowing market ideologies to govern social interactions and he examines the impact of economic thinking on legal justice.

I quote Hanson’s summary for two reasons: one, because I enjoy Schwartz’s essay and I think it is worthwhile, but two, and more important, I believe it shows the level of commitment to and investment in this book that Hanson professes. Ideology, Psychology, and Law took a long time to assemble, and though he himself did not write everything contained therein, Hanson did write a substantial amount and he did edit everything that did not bear his name. Given its timeliness, thought-provoking nature and ability to elucidate key and heavy ideas, Ideology, Psychology, and Law should without question be studied by those interested in its subjects. As well, Hanson should be commended for his staggering efforts.

Ideology, Psychology, and Law (Series in Political Psychology)
Jon Hanson, Editor; John Jost, Series Editor
Oxford University Press, USA: January 11, 2012
Hardcover, 816 pages
$110

White Elephants

2012-05-10T13:08:26Z

As I cried, I wanted to believe it was the alcohol that induced Mom’s words. I had to believe it was the alcohol. I don’t want them. The words rang in my ears. That’s the night my heart first broke.

White Elephants is the story of Chynna Laird’s childhood with an alcoholic, bipolar mother. Not for the faint of heart, this memoir is a gripping tale that Laird colorfully paints for those unfamiliar with what it is like to grow up in this situation.

This review’s opening paragraph comes from a story in the first chapter. Laird overhears a phone call between her grandmother and her mother. Her mom is drunk and on one of her many “vacations” and Laird’s grandparents are taking care of Laird and her brother, Cam. Five-year-old Tami (the name Laird went by for most of her life) hears her mother say on the phone, “I don’t want them.” This scene sets the stage for the drama that plays through the rest of the book.

No one seemed to understand the manic behavior and profound depression of Tami’s mother, Janet. Janet’s siblings and parents were constantly at their wit’s end. Laird describes several points when her mother was clearly actively suicidal.

Living in a chaotic home filled with binge drinking, verbal and physical abuse will leave its mark on a child. Tami was molested and raped in her own home. She and her brother started drinking at a young age and were both involved in drugs at various points. They both struggled with anger. Cam raged on the exterior, punching walls and sometimes turning on their mother, whereas Tami unleashed her anger on herself. She was known among other high school students for crying when she was drunk. By the age of 15, she had begun cutting and even attempted suicide one night. As she grew older, Tami struggled with her self-esteem and developed bulimia.

In hindsight, Laird is able to recognize the “angels” who played a role in her life. She and Cam were close to their grandparents, who practically raised them. They were the only real parents that Tami had ever known and their influence was prevalent through most of her life.

Her stepfather, Pat, rescued her many times from herself and from her mother. At 15, Tami was drunk at a party and had to call Pat to pick her up. When they got home, he hugged her and told her he was not going to ask what happened. “I just wanted you to know I’m glad you’re both home safe…You’re better than this, Tam. You’re better than she is.”

However, when Tami finally realized that she needed help, she turned to her godmother, “Auntie Lois.” Tami moved in with Lois and her family and began a daily ritual of having tea with her aunt. Over tea, Lois would patiently listen while Tami spoke about the trauma, the alcohol, and all of the other dark secrets that she had been carrying for so long. This was the turning point for Tami:

In that moment, as I felt Auntie Lois hug me – a person who really believed me, a person so close to God she could be considered an angel – the flood gates opened and I cried. I cried for the little girl I never was. I cried for all the times I hurt but couldn’t react. I cried for not having a mother who loved me the way she wanted to.

White Elephants touched me much more than I expected. Laird says that she wrote the book in hopes that it would help someone who has been in a similar situation. Because she could not help her mom, she hopes that someone can find some help in her story. Although I have not been through the trials that she has, her strength and determination to not allow her mother’s abuse to determine her future is admirable and inspiring. The moment I began reading her book I could not put it down. Moreover, after finishing it 24 hours after I started it, I was ready to read it again. There are not enough adjectives to adequately describe White Elephants: inspiring, tragic, heroic, admirable, honest, and deeply moving. There were points when I found myself crying along with Tami and others when I was cheering for her on the sidelines during her recovery.

I think that Laird accomplished her goal through her story. Not everyone will be able to relate to the events, but I believe most people will be able to relate to the struggle of pulling yourself out of depression and finding your own feet to stand on. In this way, Laird has most assuredly accomplished her goal for this beautiful book.

White Elephants – A Memoir
By Chynna T. Laird
Eagle Wings Press: February 1, 2011
Paperback, 280 pages
$14

Two Plus Two: Couples and Their Couple Friendships

2012-05-10T12:24:40Z

What if I told you that one secret to making a long-term relationship more fulfilling is to have another committed couple with whom you and your beloved could spend time? The very premise of Two Plus Two is that it is important for couples to have couple friends. Drs. Greif and Deal (a duo whose names brought a smile to this depressed writer) crafted Two Plus Two in such a way that anyone could understand it. They avoid academic jargon and cast aside the pompousness of most other self-help writers. The book explains the methodology, expectations, results, and lessons for scholars, but especially focuses on the lessons for the reader. It was a pleasure to read, and I definitely learned a few things.

Every couple has experience with friends. In some cases, the couple’s mutual friends introduced them. In other cases, the couple met another couple and became friends. In all cases, there are friends that one partner likes and the other does not. Two Plus Two examines these couple relationships in depth. Drs. Greif and Deal note that it is important for the individual to have friends, but that it is also important for a couple to have friends. Just as friends enrich our individual lives, friendships with other couples may enrich the lives of the two halves of the partnership.

Two Plus Two examines several real-life heterosexual couples ages 21 and up who have been committed for at least a year. The study also included 58 people who had divorced. The study found that people can be classified on a spectrum of how likely that person is to seek and make friends. There are people who actively seek friendships and have many friends. There are also people who have very few friends and are still happy. Of course, there are also people everywhere in between.

In the context of a couple relationship (that is, two couples being friends), there will inevitably be the male half of one couple interacting with the female half of the other. One would think that this often raises suspicions between the couples. The opposite, however, is true. Two Plus Two found that each member of a couple is completely trusting of the other member with the members of their couple friends. There was very little, if any, sexual tension among the people involved.

I enjoyed reading Two Plus Two. As I mentioned earlier, the authors made it easy for anyone to understand. Also, even though the study focused on heterosexual couples, I can testify that the same rules and principles presented in the book apply to homosexual couples. Overall, Two Plus Two is a refreshing look into what makes people tick. Friendships help us to grow as individuals so that we may be good partners. Couple relationships help our partnerships grow so they may become lifelong fulfillments of our deepest desires.

Without a doubt, I would recommend Two Plus Two to anyone looking to better understand themselves, their partner, or their relationships with other people. It certainly helped me resolve some issues in my love life and aided me in concluding that my partner and I were simply incompatible on the most fundamental of levels—he wanted to actively seek out new friends, and I am perfectly happy having a few close friends. Two Plus Two is absolutely a book that will teach you more about yourself and your partner than you probably cared to know.

Two Plus Two: Couples and Their Couple Friendships
By Geoffrey L. Greif and Kathleen Holtz Deal
Routledge: January 10, 2012
Paperback, 231 pages
$23.95

Overcoming the Fear of Making Mistakes

2012-05-10T12:29:58Z

“Perfectionism is the voice of the oppressor, the enemy of the people.” This is a famous quote from Anne Lamott in her book Bird by Bird: Some Instructions on Writing and Life. Intuitively, we know that perfectionism is unrealistic and restrictive, a tyrant that steals success. In fact, there are many sayings and experts that stress the importance of making mistakes for creating and achieving great things.

But still there are many people who fear making mistakes. According to Martin Antony, Ph.D, professor of psychology at Ryerson University and co-author of When Perfect Isn’t Good Enough, “Generally, fears are influenced by both our biological and genetic makeup, as well as our experiences.”

We model what we see, Antony said. He gave the example of parents expressing their fears over making mistakes, which a child, like a sponge, soaks up.

The messages we receive from others, including friends, employers and the media, also play a role. “The constant pressure to improve performance can have the effect of triggering fears of underperforming and of making mistakes,” Antony said. He added that constant criticism has a similar impact.

Having some fear of mistakes can be a good thing, Antony said — it can help to improve your performance. But excessive fear causes problems. For instance, you might start avoiding fear-provoking situations. “[People] may avoid social situations (meetings, dating, presentations), for fear of making some sort of blunder, and they may procrastinate for fear of not being able to complete a task perfectly,” Antony said.

Or you might engage in “safety behaviors” to prevent making mistakes. Antony defined safety behaviors as “small behaviors to protect oneself from perceived dangers.” So you might spend hours pouring over your work to make sure it’s mistake-free.

Overcoming the Fear of Making Mistakes

“Overcoming any fear involves confronting the feared stimulus directly,” Antony said. For instance, he and other perfectionism experts recommend people practice making small mistakes with mild consequences – and stop engaging in safety behaviors.

Changing perfectionistic thinking also is important since it’s our thoughts, our interpretations of what’s occurring around us, that perpetuate perfectionism. As Antony and co-author Richard Swinson, M.D., write in When Perfect Isn’t Good Enough, we actually don’t fear making mistakes. We fear what we believe about making mistakes. That’s what’s upsetting or anxiety-producing for us.

“Perhaps you assume that making mistakes will lead to some terrible consequence that can’t be corrected or undone (such as being fired or ridiculed by others). Or you may believe that making mistakes is a sign of weakness or incompetence,” they write.

Perfectionists tend to take such distorted thoughts as gospel. In their book, Antony and Swinson explain how readers can alter their perfectionistic thinking with these four steps:

identify the perfectionistic thought;
list alternative thoughts;
think about the pros and cons of both your thoughts and the alternative thoughts; and
pick a more realistic or helpful way to view the situation.

They give the example of a man who feels embarrassed and anxious after making a joke that others didn’t seem to find funny. Initially, he thinks that others see him as awkward and boring, and won’t like him if he’s not entertaining.

His alternative thoughts are that people won’t judge him based on one measly uncomfortable situation; and they find him interesting, anyway. When evaluating these thoughts, he realizes that his friends know him well, and even though they make bad jokes, he still enjoys their company. Plus, people invite him to functions, so they must find him entertaining.

In the end, he picks this more realistic and helpful perspective: “Perhaps I need to give myself permission to make mistakes when I am talking to other people. I don’t judge other people when they say something unusual or awkward. Perhaps they are not judging me when I make mistakes.”

Instead of assuming your thoughts are facts, Antony also asks people to test their beliefs with small experiments. “For example, if someone is convinced that mispronouncing a word would be a disaster, we might encourage him or her to mispronounce a word and see what happens.”

Examining the evidence for your perfectionistic assumptions is another way to alter distorted thoughts. For instance, let’s say you believe that getting less than an A on your research paper is terrible and unacceptable. According to Antony and Swinson, “you could try to recall what happened in the past when you received a lower grade on a paper or exam. Did you survive the experience? What happens when other people receive grades that are lower than an A? Do terrible things occur as a result?”

While it might feel like your fear of mistakes is unshakeable, fortunately, there are many effective, practical strategies to overcome perfectionism. If your fear seems excessive and impairs your functioning, don’t hesitate to see a mental health professional.

Easy Steps to Reconnect: A Guide for Emotionally Avoidant Dads

2012-05-10T12:50:10Z

It was torture for Jason when his 13-year-old son, Dylan, gave him the “cold shoulder” and wouldn’t speak to him. Jason felt his angry reactions were justified because he believed Dylan was at fault. Jason defended his position, often lecturing Dylan. Alternatively, he would give Dylan the silent treatment right back. This would go on endlessly, creating tension for everyone in the house. Neither Jason nor Dylan wanted to be the one to break the impasse. It usually ended one of two ways: Naturally, over time, or when Dylan wanted something.

When Jason finally saw that he was actually hurting his son, he became motivated to improve their relationship and end this destructive cycle. He decided that when his son behaved this way toward him, he would make things better by ignoring how Dylan was acting, be nice and pretend everything was okay. However, even this seemed to backfire, making Dylan pull away more.

In therapy, Jason said one of Dylan’s complaints was that his dad was always too busy working and that he seemed to care more about “things” than about his son. When Dylan was excited and wanted his dad to watch him do an athletic trick in the house, Jason often was preoccupied with getting him to be cautious and warning him not to break anything. Jason failed to notice that Dylan wanted him to join him in his excitement and be proud of him.

In talking about the problem with his son, Jason remembered a grudge against his own dad: Jason’s father had not paid attention to him or talked with him, and failed to connect or show affection. As he talked about this, Jason spontaneously remembered that he too as a child gave his dad the silent treatment. He would keep it going as long as he could, hoping his dad would feel something and preparing what he would say when his dad would ask him what was wrong. But he never did.

As Jason thought about this, it suddenly occurred to him why ignoring Dylan made things escalate. He realized that maybe his son wasn’t just trying to punish him, though it felt that way, as it had when Jason’s dad had ignored him. Dylan needed Jason to feel something and show that he cared. Jason had needed the same from his dad. Dylan’s behavior was a desperate effort to communicate something that wasn’t getting through otherwise. By trying to make his dad feel rejected, Dylan wanted him to understand how Jason made him feel. Dylan hoped his dad would “get it” and respond by coming back to him.

Jason was uncomfortable being identified with his dad, and quickly pointed out that he spent more time with Dylan than his father did with him. Still, he saw that Dylan seemed to share some of the same feelings that Jason had toward his dad. Further, Jason could see that, similar to his own father, he too was unable to recognize and effectively respond to his son’s feelings, and easily retreated emotionally or became reactive.

Even when Jason recognized that he was reenacting what his dad did to him and hurting his son, he was at a loss for how to understand or respond in a helpful way when Dylan was upset. He never learned how to read and respond to his son’s feelings. Because of his own parents’ psychological limitations, the emotional capacities which form the basis of these skills were never developed during Jason’s childhood.

Empathic ability, or “mind reading,” is an aspect of brain development that occurs as parents are able to read their children’s reactions and respond emotionally in a way that helps kids regulate their emotional states. This process also involves the parent helping the child understand what is happening interpersonally and emotionally. The child digests and internalizes such experiences, building the capacity to make sense of themselves and relationships, and to manage emotions in interpersonal situations.