Seth Grobman, Psy.D.

As my years of conducting psychotherapy accumulate, I cannot help but notice how much more time my patients take to discuss their relationships within the context of social networking.  As you know, social networking (My Space, Facebook, Twitter, etc.) has become a mode of connecting and communicating that has literally changed a human being’s way of relating to the world.  I would be so bold as to say that its impact is analogous to the invention of the telephone.  Relationships are profoundly altered: they are intensified, they are more easily severed; the network is truly the “fly’s wall!”  Access and convenience seem to be the variables that have caused this societal paradigm shift.  And it will only become easier to rely upon these tools as time goes by.  We will NEVER be able to go in reverse.

Isn’t it interesting, however, that patients will “talk” about their social networking interactions?  “Let’s discuss in a very direct way my issues about my indirect mode of communicating!”  More  often than not, however, I will find myself more interested in talking with my patients about the thoughts and feelings that come with social networking “issues.”  At times, it seems as if someone will be so compelled by their “page,” “space” or “wall,” that it is unclear as to what it is with which they are dealing.  Is it self or other?  It seems that after the layers are peeled back, the greatest allure for people is the fact that they have impact.  The power of written word (or vid or pic) is undeniably profound.  People WILL read what one  has to say, regardless of the value of the content.  And after all is said and done, one thing will never change for a person.  He needs to be heard.  My point is that the power of social networking seems to be in the need to be seen, rather than to see.  It seems obvious that people tend to be voyeuristic, but what is not as easily acknowledged is that people wish to exhibit, to be on stage, to be heard (for better or worse). 

This is not to say that  psychopathology is afoot.  It may be that the issue of degree and impact is what differentiates adaptation versus problem.  Too much of a good thing?  How does it affect one’s conduct in other aspects of life.  The media throws around the word addiction to describe the phenomenon of  “facebook” but the issue is of compulsive behavior.  To feel compelled to do something is analogous to feeling a lack of options or choice; it must happen.  This type of behavior almost always is accompanied by neglect in other sectors of one’s life.  Simply put, it is quite powerful how much time people dedicate to social networking at the expense of other forms of communication!  People would rather dedicate their time to the communication modality of social networking than to the primitive, antiquated ….. talking!  I would love to hear your thoughts about this topic and, if possible, your personal experiences with social networking.  Look, I’d love to continue this conversation, but I just got a text…someone just wrote on my wall!!!!!!!!

by American Psychological Association Public Relations Staff

October 23—With the growing financial crisis and the rising costs of gas, food, and healthcare, Americans are clearly experiencing heightened stress. The American Psychological Association’s 2008 national Stress in America survey reveals what Americans are stressed about, what they are doing to manage that stress, and how stress is affecting their health.

The Stress in America annual survey is part of APA’s public education campaign, “Mind/Body Health: For a Healthy Mind and Body, Talk to a Psychologist,” which highlights psychology’s unique role at the intersection of mental and physical health.

Among the 2008 findings:

Women are bearing the brunt of financial stress.

In September, more women than men report being more stressed about money (83 percent vs. 78 percent), the economy (84 percent vs. 75 percent), job stability (57 percent vs. 55 percent) and housing costs (66 percent vs. 58 percent).

The financial downturn is taking a toll on older women, but all are affected.

Women of the Boomer generation (aged 44 to 62) and Matures (aged 63+) are most likely to report the economy as a significant stressor, while women in general say they are more worried about money than their personal health.

Female Boomers report increases in stress associated with their job stability and health problems affecting their families. Mature women are reporting dramatic increases in stress associated with health problems affecting their families (up 17 points to 87 percent between April and September), the economy (up 18 points to 92 percent) and money (up 15 points to 77 percent).

Generation Xers (ages 30 to 43) and Millennials (ages 18 to 29) are not immune from financial worries. Generation Xers are the women most concerned about money (89 percent report money as a source of stress) and Millennials are most concerned about housing costs (75 percent report housing costs as a source of stress).

More people report physical symptoms of stress compared to 2007 survey data.

Over the summer, more people report fatigue (53 percent compared to 51 percent in 2007), feelings of irritability or anger (60 percent compared to 50 percent in 2007) and lying awake at night (52 percent compared to 48 percent in 2007) as a result of stress, in addition to other symptoms including lack of interest or motivation, feeling depressed or sad, headaches and muscular tension.

Women were more likely than men to report physical symptoms of stress like fatigue (57 percent compared to 49 percent), irritability (65 percent compared to 55 percent), headaches (56 percent compared to 36 percent) and feeling depressed or sad (56 percent compared to 39 percent).

Many adopt poor habits to cope with stress.

Almost half of Americans (48 percent) report overeating or eating unhealthy foods to manage stress. Women are more likely than men to report unhealthy behaviors to manage stress like eating poorly (56 versus 40 percent), shopping (25 versus 11 percent), or napping (43 versus 32 percent). Almost one-fifth of Americans report drinking alcohol to manage their stress (18 percent), and 16 percent report smoking.

Methodology

The 2008 Stress in America research was conducted online within the United States by Harris Interactive on behalf of the American Psychological Association between June 23, 2008 and August 13, 2008 among 1791 adults aged 18-plus who reside in the United States.

Additional data was collected in September; it was compared to data from April. The April data was collected online within the United States between April 7 and April 15, 2008, among 2,529 U.S. residents aged 18 or older. The September data was collected online within the United States between September 19 and September 23, 2008, among 2,507 U.S. residents 18 or older.

Data for the April and September polls were collected using an omnibus survey; the causes of stress question included a “not applicable” response. Data presented here were calculated excluding those who responded “not applicable.”

No estimates of theoretical sampling error can be calculated; a full methodology is available.

Associated Press/AP Online 2008-11-03

By CARLA K. JOHNSON

CHICAGO – Preschoolers with a parent away at war were more likely to show aggression than other young children in military families, according to the first published research on how the very young react to wartime deployment.

Hitting, biting and hyperactivity -”the behaviors parents really notice”- were more frequent when a parent was deployed, said lead author Dr. Molinda Chartrand, an active duty pediatrician in the U.S. Air Force.

The study, which was small and included fewer than 200 children, adds to previous evidence of the stress that deployment puts on families. Last year, a study of almost 1,800 Army families worldwide found that reports of child abuse and neglect were 42 percent higher during times when the soldier-parent was deployed.

This time, researchers looked at families living on a large Marine base in 2007. (The base wasn’t identified in the study.) Children, 3 to 5 years old, with a deployed parent scored an average of five points higher for behavior problems on two questionnaires widely used in child psychology than did the children whose Marine-parents weren’t deployed.

About 1 in 5 of the older preschoolers with a parent at war displayed troubling emotional or behavioral signs.

Since the war began in Afghanistan seven years ago and Iraq more than five years ago,”this is the first time any data have been published on these little kids,”said Chartrand, who conducted the study while at Boston University School of Medicine.

The researchers surveyed parents and child care providers of 169 preschool-age children. Parents, mostly mothers, answered questions on their children’s behavior and emotional state. Parents also completed questionnaires on their own stress and depression.

The age of the children made a big difference in the study, which appears in November’s Archives of Pediatrics&Adolescent Medicine.

While older preschoolers had trouble, deployment had the opposite effect on children younger than 3, yielding fewer behavior problems as rated by parents and caregivers.

The researchers speculated that, with fathers away, the younger children had more time to bond with their mothers, a benefit for that age group. But preschoolers 3 and older may be more negatively affected by their fathers’ absence.

In a few families, it was the mother who was away at war, but for most (92 percent), it was the father. The Marine-fathers had been away an average of about four months when the mothers and day care providers were surveyed.

Children with existing conditions such as autism and attention deficit disorder were excluded from the study, and the researchers took into account the at-home parent’s depression and stress.

That made the results especially notable to Michelle Kelley, a psychology professor at Old Dominion University in Norfolk, Va., who was not involved in the new study but has done similar research with older children in military families.

“You’re pulling out the mom’s depressive symptoms and her stress so the difference in the kids is above and independent of that,”Kelley said.”If these kids are having difficulty, it’s pretty likely that other kids are having difficulty as well.”

Col. Richard Ricciardi of Walter Reed Army Medical Center called the study important, while noting that the small number of families means no sweeping conclusions can be made. The findings are in line with unpublished military research he’s reviewed and what’s known about child development, he said.

He called for further research on preschoolers in military families.”We need to do more of this,”he said.

During the past year, the Marine Corps has increased its funding of programs to help families, said Kimberly Holmes, who directs a family program at Camp Lejeune, N.C.

The Marines are relying less on volunteers, instead hiring staff to give more support to families. Four new child care centers are planned at the base, which will provide care to an additional 1,200 preschoolers.

Deborah Gibbs of the nonprofit RTI International in Research Triangle Park, N.C., who conducted last year’s study of deployment and child abuse, has seen changes in the Army in the past year. She said Army doctors have been ordered to be more alert to problems if a parent is away at war.

Most military families are resilient, she said.

“They deal with a lot of separation and uprooting as a matter of course.”

S. Elizabeth Kortlander, Ph.D.

Over 31,000 people per year die by suicide, making it the eleventh leading cause of death (Suicide Prevention Action Network.) Yet are there interventions that might help to reduce the rate of suicide, saving not only the lives of its victims, but preventing the agonizing toll suicide takes on those who survive the victim’s death?

Among the many pathways that may lead to suicide, are deficits in cognition that maybe associated with this final, and desperate, act. Specifically, suicidal individuals demonstrate three critical characteristics in their thinking, feeling, and behavior. First they are in a tremendous amount of emotional pain, or “psychache.” Secondly, their thinking is constricted, making it difficult, if not impossible to generate solutions to their predicament. And lastly they have a strong sense that they must take action (so called “purtubation”). (See Shneidman, The Suicidal Mind, 1996, for a complete description).

Taken as a whole, these three factors may be seen as a catastrophic failure in problem solving, resulting in the suicidal individual’s “black and white” mindset that they must either endure unbearable pain or kill themselves. With this in mind, it makes sense to speculate that teaching good problem solving skills, from an early age, might be one means to help buffer the effects of pain producing stress that may result in suicidality for some vulnerable individuals. Indeed, Martin Seligman, Ph.D. (The Optimistic Child, 1995) has proposed the value of developing an “emotional vaccine” to help children learn the tools for more optimistic thinking. Essentially this includes helping them to develop the skills to persistently meet challenges, and develop the patience to solve problems.

Much has been researched and written about problem solving. Essentially there are two broad, critical components: 1) Having the motivation to attempt to solve problems—that is the belief that one’s efforts will have impact. 2) Having the specific skills associated with problem solving. While this may sound daunting, the reality is that with heightened awareness on the part of parents, educators, and others involved in the lives of children is critical. Problem solving skills can be cultivated via modeling, encouragement and education.

Children are born problem solvers and much of development is propelled through figuring out how to face and master challenges, cognitively, emotionally, and behaviorally. The trick is to raise children’s awareness of the problem, what their choices are for handling the problem, and the consequences of their choices.. Even something as simple as coping with a missing pair of shoes or discovering that a restaurant does not serve a desired food, can be identified and processed as a lesson in problem solving. While these situations may seem far removed from the desperate situations faced by suicidal individuals, a life time of tracking and practicing solving problems, big and small, might help individuals develop the habit of managing difficulties in terms of problems solving. With such a habit, this might allow for more automatic processing of stressful information in terms of problem solving. This automatic component could be critical when emotions are powerful, and can easily drain energy from the task of seeing alternatives and managing powerful impulses to take action.

Post Traumatic Stress Disorder (PTSD) and other after-effects of emotional trauma have traditionally been among the most stubborn problems that people bring to psychotherapy: at least until recently. Eye Movement Desensitization and Reprocessing (EMDR) “clears” troubling emotions and negative thinking linked to trauma and other painful past experiences. Some people have said that EMDR helped them more in one session than other therapies had in years, a statement that is being heard more commonly by patients (and their therapists) with a variety of problems.

How then, does EMDR help people with trauma? Researchers are investigating the process using techniques from EEGs and CAT Scans. One suggestion is that EMDR mimics the action of dream (REM) sleep. Some preliminary research indicates that EMDR increases “communication” between right and left brain hemispheres, with the belief that emotional traumas are actually physically represented in various brain structures and are affected neurochemically, partly via neurotransmitters. As the amount of research on EMDR is increasing rapidly, new information continues to emerge. In the area of PTSD, there has been more EMDR research conducted over the past 10 years than on all other treatment modalities combined.

The unique part of an EMDR session is the combination of focusing on a memory and moving one’s eyes in a characteristic manner, not unlike rapid eye movement during REM sleep. As EMDR proceeds, the unpleasant feelings and negative thoughts fade and are replaced with more positive feelings and thoughts. Another unique aspect of an EMDR session is that the nature of the procedure “triggers” the brain to rapidly process information.

Traumas for which EMDR has been used quite effectively include: accidents, earthquakes, hurricanes, rape, physical and sexual abuse, sudden death of a loved one, severe and/or chronic illness/pain and combat experiences. Regarding the issue of chronic pain, it is believed that any chronic medical condition, or pronounced pain, carries with it a significant emotional trauma to the patient, particularly when there are meaningful life changes associated with the medical condition or pain, i.e., inability to work, limitations in activities of daily living, loss of employment and/or leisure activities, marital/family stresses and strains, etc.

These changes and their emotional impact are essentially no different from many of the other major traumas noted above. Due to the brain’s memory storage of similar past experiences, any past emotional traumas, both major and minor, will be “linked” to the emotional impact and physical symptoms associated with the presenting chronic medical condition and/or pain.

In addition to trauma, EMDR can be applied to phobias, addictions, anxiety, depression, chronic or excessive anger, psychological abuse or neglect, abandonment experiences, marital betrayals, difficult divorces and peak performance. New applications and refinements are constantly evolving. This exciting and effective treatment modality is but one example of remaining in the forefront of treatment of many emotional and/or physical problems.

 Elizabeth Stabinski, M.S.

Registered Mental Health Counseling Intern

Many individuals on the brink of marriage dissolution are so emotionally worn down, apathetic, injured, or angry that it is hard to picture being able to be civil with the soon-to-be ex-spouse.  If there has been infidelity, addictions, or abuse it adds an additional hurdle.  Divorce is inherently painful.  I have heard divorce likened to a death of a marriage; yet unlike death, it is ongoing.  The members of the couple will be forced to deal with each other long enough to divide assets.  If there are children involved, the couple will be involved directly or indirectly with each other for the rest of their lives.  

Of course, as a marriage counselor I am always hoping that therapy will work help improve communication and trust so that couples can begin to rebuild their relationship. And, as a therapist, I have hope for most marriages that seek therapy.   But sometimes, despite hard work by both individuals, relationships are just not going to heal.  This realization has sent many family-oriented professionals in search for something less emotionally damaging and financially costly than divorce litigation.  As an outgrowth of such searches, a new form of family law has been developing called Collaborative Family Law (CFL).

The basis of CFL is that each member of the couple has their own attorney to advise them as to their legal rights and responsibilities; but rather than only considering what would be best for the husband or wife independently, the attorneys work together every step of the way to honor the familial system. Collaboratively, they work together to create a custodial plan and divide assets. Gone is strategy and deception.  Full disclosure is not only recommended, it is expected.  Clients are encouraged to develop goals in order to work towards making the terms acceptable to both members of the couple.   In order to ensure that the attorneys are truly working towards settlement, CFL contractually obligates the attorneys to resign from the case if it becomes apparent that litigation is inevitable.

                Within Collaborative Family Law there are a few different modalities.  The team model utilizes two collaborative lawyers, a financial planner and a mental health professional all trained in the collaborative process.  While the attorneys are advocates for their clients, the team is an advocate for the family.  Everyone works together to create a divorce that will best suit not one member of the dyad, but the entire family unit.  Meetings as a group are organized, goal-oriented, and client centered.

                Collaborative Family Law has been used successfully for years in states such as California and Texas.  While it is newer to Florida, there are many lawyers in the area who have been using CFL successfully.  These attorneys have found that CSL is a cost-effective, efficient means of marriage dissolution. In addition, the team schedules the agenda, location and times of each meeting.  This offers greater flexibility than litigation where meetings are dictated by the court.   Like anything, Collaborative Law has its limitations and  is not for every marriage, but it definitely adds another option for couples who want to end their marriage without litigation. 

                As with any major, life-altering decision, divorce should not be the first course of action.  That being said, if it is the right decision for your family, there are new options to litigation.  Take the time to research and call respected family attorneys in the area; ask them to explain Collaborative Family Law, its strength and weakness.   Hopefully you did not rush into marriage without consideration; take the time to give your divorce the same type of attention.

For most of us, Labor Day exists primarily to mark the end of summer and beginning of school, schedules, and structure.  As a parent, I love the easy, long days of summer that are unblemished by a myriad of activities. I find that what we dislike most about the onset of school is the homework.  Homework is not fun!  But problems arise when we allow the assignments our children bring home to become our work and responsibility.  Many of my family sessions revolve around the topic of homework and of the unfortunate dynamic that it creates.
My first suggestion is to remember that homework is your child’s responsibility.  Most good educators believe that the intent of homework is to reinforce skill sets that were introduced in the classroom.  Simply stated, your son or daughter should already understand the concepts of any assignment brought home and should be able to complete the activity independently. Undoubtedly, there will be times that a concept is difficult and need explanation; but explaining is not the same as doing the work with them or for them.  In the early elementary years, depending on the maturity of your child, you might need to sit next to them to model appropriate academic behavior.  Try, however, to get them use to do their work independently.   To ease yourself into this new habit, you might try having your own “assignment” to do.  If your student needs you to be in close proximity, read a newspaper or book.  You are close by to offer assistance and are also modeling wonderful, life-long learner behaviors.  Slowly try to move further away by doing activities that allow for you to check-in frequently.  Many have found success by preparing dinner while their child sits at the kitchen table.  The goal is to be able to act as a coach and not a teammate. A coach teaches the skills before the game and then players are on their own.  You should be on the sidelines cheering and encouraging, not in the middle of the action!
Secondly, allow for breaks and fun.  Your child has been in school for a minimum of six hours and many have been in a structured setting even longer due to aftercare and enrichment activities.  I always recommend experimenting with your child to find out what works best.  Some kids can easily sit down and finish an assignment knowing that they will have time for play once they are finished.  Others will need breaks either before they begin or in the middle of the assignment.   As an active observer, you will find the rhythm that works best for your student.  (Remember that sugary after-school snacks might cause excitability followed by exhaustion. You might want to save the sugar until after homework is complete.)
My third and most important suggestion is to allow for mistakes.  Typically, before your child is in high school, nothing is “transcriptable.”  This means that not doing your homework in third grade one night will not prevent your son or daughter from going to the Ivy Leagues.  If your child refuses to do their homework, let them go and face the natural consequences of their actions.  It is important to try not to alter the family schedule to compensate for poor choices.  If homework is not completed before bedtime and remorse has already set in, encourage your child to think a solution.  This solution should not be to stay up late or to miss school the next day.  Thanks to technology, you could covertly let the teacher know of your struggles and perhaps collaborate to help motivate.  Most kids will not enjoy having to go into school without their assignment.  Mistakes are often the best teachers.
Not all families or students are created equal. If your child struggles, talk to a professional.  Your first line of defense should be their teacher.  A simple phone call or email should educate you about the teacher’s philosophies of homework and about the time it should be taking to complete the assignments.  If it is taking longer than expected on a daily basis, ask for a conference so that he or she might be able to help you to understand your child’s issues.  Evaluate the situation together.  If it is a behavioral issue, you might want to discuss suggestions with a guidance counselor or family therapist about ways to positively reinforce your student.  You are not alone in this struggle and counselors have some “tried and true” techniques that will assist you.  If the homework is causing stress because of academic deficiencies than these same struggles are evident in the classroom.  All schools have a built in system, often called Child Study or Collaborative Problem Solving, to address behavioral and academic issues.  These meetings consist of a panel of specialized educators who will work to help address concerns that are specific to your child.  Interventions will be created for both school and home to help address these hurdles.  If these interventions are not effective, the school will make recommendations for further evaluation.
Finally, try to understand your child’s needs, capabilities, and limits as well as your own.  You graduated from school already; now it is your child’s turn. One of the hardest things as a parent is to let our children fail.  But, if they never fail then they will be robbed of the elation of success.  You are the most influential teacher that your child will ever have.  If you can teach independence, organization, and problem solving, you are well on your way to creating a self-sufficient, successful adult.

Elizabeth Stabinski is an experienced therapist who has a passion for counseling children, adolescents and adults with extremely challenging social and emotional issues. She received her Bachelor’s Degree from the University of Michigan, College of Literature, Science, and the Arts and her Master’s Degree in Mental Health, Marriage & Family, and Guidance Counseling from Barry University.

There is a significant difference between acute versus chronic pain. Acute pain is typically characterized by a temporary decrease in activities, reliance on medication and seeking the appropriate medical intervention, with the entire acute phase lasting no more than several weeks. In persistent, or chronic pain, alterations in patterns of behavior begin to emerge, including decreased activity levels and continued reliance on medications, patients may attempt to continue working as a coping strategy, with an increased focus on their symptoms because they are beginning to realize that they are “not getting better.” Not uncommonly, anxiety begins to appear, as well as possible depressive symptoms, all of which can exacerbate the underlying perception and intensity of pain. Simultaneously, patients with chronic pain continue seeking medical care. While such patients hope for an ultimate cure, the treating physician(s) begin to speculate about the patient not improving to the expected degree, given the structural diagnosis. Accordingly, the medications continue, as well as other clinical interventions, e.g., physical therapies, nerve blocks, or other diagnostic procedures, etc. By this time, very little new information is forthcoming as to why the patient is not improving as expected. Simultaneously, the patient frequently continues to deteriorate physically, as well as emotionally. By this time, the treating physician and patient likely do not know why progress is not being made, leading to a situation that is essentially “out of control.” Since the treating physicians do not understand why the patient is not progressing, the natural tendency is to continue prescribing the same or similar treatments, all to no avail.

It must be understood that the presence of chronic pain is not limited to the structural or physical abnormality. Chronic pain includes the structural portion, as well as the cognitive (what you think about your pain), emotional component (how you feel about your pain), and cellular memory (prior events that are stored in memory that may be impacting your present condition). In other words, chronic pain involves all four components. Traditional medical practice, however, is typically limited to focusing on the structural (physical) component. Traditional medical practice is the treatment of “body parts” rather than people.

The passage of time contributes to the development of chronic pain in some people due to the potentially negative influences of what we think, how we feel, and our history of prior events which may play an important role in the creation and maintenance of a chronic problem. As a result, time is of the essence. It is well known in the medical field that the earlier the intervention, the better the outcome. If an acute medical problem becomes chronic when not expected or anticipated, then other factors are likely operating to create and maintain the chronic problem. When faced with such a situation, the individual would be best served by seeking out the services of a psychologist, or other mental health specialist, experienced in the evaluation and treatment of such situations.

The author, Albert Zbik, Psy.D., is a Clinical Psychologist specializing in the treatment of chronic medical conditions, with a goal of minimizing pain and maximizing life. He can be reached at Weston PsychCare, P.A. by calling 954-385-8385.

da ek-sistence is a magazine devoted to celebrating the importance of Psychology to the arts, creativity, and meaningful living.  The staff and contributors to the magazine aspire to enrich the lives of its readers through the inclusion of articles that explore books, plays, film, and dance relevant to Existential and Dynamic themes.  Additionally, scholars and creative individuals will be contributing their viewpoints on issues that affect the purpose and Being of our lives.

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