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Tuesday
May152018

Anti-Bullying Programs: Are They Effective?

I was recently reading an article that discussed Melania Trump’s recent speech regarding her “Be Best” platform.  One of the three main facets of this program included today’s hot button topic of bullying.  Anti-bullying programs seem to be popping up in every school in the last decade as more and more attention is being drawn to the increasing problem of social media’s impact on bullying.  While there is no denying the negative impact social media has had on the bullying epidemic, I often have to wonder about the efficacy of some of the programs that have been designed to “defeat” bullying in schools.

One such program is Christian Buck’s Buddy Bench, to which Mrs. Trump gave a nod in her speech.  For those of you that don’t know, a Buddy Bench is simply a bench placed strategically on the playground.  The idea behind it is that kids who are lonely at recess can sit on it and other children will ask them to participate in games and activities with their group of friends.  I can certainly see how this bench could be a valuable tool for kids that are new to the school and have not had the opportunity to make friends, which is why it came to Christian’s attention in the first place.  However, it seems highly unlikely to me that students who are predisposed to shyness are going to put themselves out there to be rejected just because a bench exists for that purpose.  And even if they did, how is this teaching them the skills they will need later in life to make friends and assert themselves when there isn’t a Buddy Bench to assist?  As adults it seems unlikely that the water cooler clique will be looking around to see who is sitting alone and inviting them to join the office lottery pool. 

The even bigger issue with the Buddy Bench, in practice, is whether the use of the bench negatively impacts the peers of the children who are more likely to sit on the Buddy Bench.  Let me explain.  If, as discussed above, the shy children are less likely to put themselves in the spotlight by sitting on the bench, who is comfortable doing so?  Often, the answer is children that might have previously exhibited aggressive and bullying behavior, which behavior has alienated their classmates.  When this is coupled with the fact that the kids encouraged to engage with children sitting on the Buddy Bench are often those children predisposed to be sensitive and kind to others, the use of the bench can perpetuate, rather than alleviate, bullying by pairing sensitive children back up with their bullies.   What is the take away message for these children?  It doesn’t matter how someone treats you, you still have to be nice to them.  Worse yet, the take away message for the aggressive child is that it doesn’t matter how you treat others, they still have to play with you.  I am not really sure those are messages I would like to be reinforcing.

While I am obviously not a huge fan of the Buddy Bench, I do really like the programs that work to create kindness by exposing children to service projects that connect them to other populations within their community.  Exposing these children to the reality that we are all people, and helping them learn more about philanthropy and cultural groups to which they wouldn’t normally be exposed, will be much more likely to develop kinder and more thoughtful individuals.  I also love the education programs going into teaching kids ways to be “upstanders”.  It is never a bad idea to teach kids how to assert themselves and stand up for what is right. The message that a group can be just as powerful toward the positive end of bullying as it can be in perpetuating the bullying is a message I want my own kids to hear loud and clear. 

What I would really like to see is parent education about helping your child be more assertive and building self-esteem.  Staff education for teachers about how to identify kids who are being bullied and how to handle potential bullying situations would also be nice.  However, nothing will beat having more qualified mental health providers in the school assessing for potential victims and working with them to build up their assertiveness and confidence.  The truth is that kids are cruel and they are likely to continue being so.  Technology removes the discomfort of seeing the effects of the pain you inflict, which is emboldening kids who otherwise might never bully.  Programs must be aimed at helping victims become less likely to be victimized and educating parents to become more involved and aware.  Finally, the adults of our society could do a lot of work modeling common courtesy.  I have been dismayed to see that as our efforts to create kinder children have increased, we have also become a far less courteous society overall.  What message is that sending to the watchful eyes of our children, I wonder?

 

 

Monday
Apr302018

Are You Suffering From Insomnia?

In the past, I have talked about matters of sleep hygiene or ways that you can create the best possible chance of getting quality sleep.  However, none of this is particularly helpful in curing true insomnia and the number of sufferers is increasing.  So how can you tell if you might have insomnia?  The first step is always to rule out any underlying medical issues.  Fatigue may be a symptom of many medical problems and should always be addressed with your medical doctor. 

Additionally, there are diagnosable sleep disorders that can wreak havoc on your daily life.  Normally the way to determine whether you have insomnia or a sleep disorder is to consider two factors: your risk factors and the type of symptoms that are occurring.  Risk factors include a tendency to snore, high blood pressure, aged over 50, male gender, body mass index over 35, neck circumference larger than 17 inches (16 inches for women), and whether anyone has observed you stop breathing while sleeping before.  Symptomology is trickier to determine.  The main difference between insomnia and a sleep disorder is that those with insomnia express feeling tired and fatigued while those with a sleep disorder actually doze or fall asleep during the day.  If you suspect a sleep disorder you should seek professional assistance as soon as possible. 

Yet, if you have insomnia, there are many things you can do to work on the problem on your own.  There are two biological factors that work in tandem to help you have quality sleep.  One of those is sleep drive.  The more you are awake and active, the more sleep drive you build up throughout the day.  If you are waking up frequently, or too early in the morning, perhaps you are not accruing enough sleep drive throughout the day.  The answer may be as simple and easy as increasing the amount of hours you are awake or the amount of time you are spending active during the day. 

The other biological system at play is circadian rhythm.  This is the system in your body that notices when light starts to ebb and makes you sleepy.  It is easy for a body’s circadian rhythms to get out of sync when sleep and wake times aren’t consistent throughout the week.  Keeping a sleep diary can be a huge help to determine whether or not you have insomnia and what the underlying causes might be.  While there are many available templates for a sleep diary, the information should at least include what time you get into bed, what time you try to fall asleep, what time you actually fall asleep, how many times you were up and for how long total, what time you wake up for the day, what time you get out of bed, and how you would rate the quality of your sleep.  In order for this information to be useful, it is important to keep track of it for a period of at least a week.  Sleep diaries often help you determine bad habits that may be affecting your sleep and what is the best thing for you to change to improve the quality of your sleep. 

You may notice that you spend a lot of time in bed, but very little of it is time that you are sleeping.  A lot of people have the mistaken idea that every adult requires eight hours of sleep.  This is not always the case.  You may be waking up or not sleeping as well because you are spending too much time in bed.  In that case, you could try restricting the amount of time you are in your bed.  For instance, if you are noticing that you are only sleeping five hours a night, you would wait until you are sleepy to go to bed and allow yourself five and a half hours in bed before your desired wake up time.  Then as you start to see yourself sleeping the full time you are in bed you can increase the amount of hours you are in bed by a half an hour every few weeks until you begin to feel rested.  Note, however, that it is never safe to restrict your time in bed to lower than five and a half hours even if you are actually sleeping less than that.

Another problem you may encounter is that your sleep and wake up times may differ depending on the day.  In that case, you may have to work to try and pick a middle ground sleep and wake up time that would work for the full week.  Once you implement this it is important that you try not to go more than half an hour off of the times you have set for yourself if you truly want to see improvement. 

A final problem that is often encountered is that you may have developed worry about sleep that has caused your body to develop a negative association with your bed.  This may occur in people who have a tendency to be anxious and find themselves stressing while lying awake at night in bed.  A good indicator that this is your problem is that you may be falling asleep on your sofa watching TV but as soon as you are in bed you are wide awake.  The best way to deal with this is to create a “nest”.  The idea is to remove your mind’s negative association with your bed.  So when you cannot sleep, don’t just lay there tossing and turning.  Get up and go to a quiet and calming place.  Engage in a restful activity such as meditation, reading, knitting or even watching non-stimulating TV.  Once you feel sleepy, head back to bed.  Initially this may require you to go to your nest often, sometimes even more than once a night.  However, soon the nest becomes the place that you associate with wakefulness and worry instead of your bed and you will find yourself reclaiming quality sleep.

A combination of the techniques I have suggested may be necessary to solve your insomnia issues.  Also, the problem often feels worse before it gets better.  The first few weeks of change are the hardest, but if you stick with it the results of quality sleep will be well worth the time.  If you want more information about any of these ideas I highly suggest purchasing the book Quiet Your Mind and Get to Sleep by Colleen Carney and Rachel Manber.  Finally, if you notice your insomnia getting worse or have concerns about your ability to stick to any of these techniques, consult a professional and get the help you need.

Wednesday
Mar142018

How Can You Maintain A Relationship When You Are Starting a Family?

A lot of couples find that their relationship undergoes a drastic change immediately following the birth of a child.  There is often a misconception that having a child will bring a couple closer together.  However, the opposite is more likely.  While having a joint love and interest can allow you to see wonderful qualities in your significant other shine, it can also create new hurdles that previously didn’t exist or just seemed like minor annoyances.

The first facet of the relationship that is likely to be affected is sexual intimacy.  A lot of women remark that changes in their bodies make them self-conscious even before the baby has arrived.  Then, post baby, there is a period of time where healing takes precedence.  A lot of men tend to take cues from their significant other regarding the availability of intimacy so there is a tendency for a long period of time to elapse before normal physical intimacy patterns are restored.  While all of this is normal and transpires in most relationships, for some it is hard to get back to sexual desire once so much time has gone by.  Sleepless nights and physical exhaustion exacerbate the problem. 

Even though having a child is a wonderful experience, it is also a stressful one.  Like any major life transition, it requires a lot of adaptation, which can be very difficult for some.  Add in the demands of a baby and sleep deprivation and it is often a recipe for a lot of irritation, argument, and resentment.  Additionally, there is the whole new world of parenting decision making that may cause a couple to butt heads.  Communication patterns that may have been healthy previously may devolve and bad habits may develop that will be hard to break when things settle into a routine.

Furthermore, it is easy for a child to become the center of your focus.  This is especially true because each new experience causes a shared excitement.  The problem is that a child can become the only thing you talk to your significant other about, leaving no room for focus on other aspects of your relationship together.  Once you begin to disagree about parenting decisions, it becomes hard to see your significant other as more than an adversary when parenting is your biggest or only current connection.

Therefore, the question becomes, what are some easy things that you can do to keep your relationship healthy and strong during this period in your life and going forward?  First, I suggest a “Babymoon”.  Before the baby arrives take some time to be together.  For some people that involves a trip but it can also just involve a staycation where you are unplugged from everything but each other.  Talk openly about fears, concerns, and things that are important to you with regards to parenting.  Try to maintain some physical intimacy even if sex is out of the question and definitely keep a conversation about it going.  Make eye contact and touch each other lovingly a lot.  Foot massages and other forms of loving physical contact help maintain your connectivity.

 

Once the baby arrives, you may have your hands full, but make standing dates where you spend quality time together and don’t talk about the baby.  A candlelight dinner while the baby sleeps or a picnic lunch in front of the fireplace can be great ways to show each other that you are making your relationship a priority even if you don’t have reliable trusted childcare or money for outings.  While occasionally the baby may make keeping your appointments with each other impossible, it is important that nothing else short of a serious emergency get in the way of this time.  Remember, this is also a time where both of you will be sensitive to criticism and unsure of your abilities to be good parents, so praise each other often. 

It is easy to take for granted that your strong relationship with your significant other will still be strong when you adjust to this new journey on which you are embarking.  However, resentment is likely to build when your significant other feels that they are being taken for granted.  Keep communication flowing and find little ways to let your partner know that they are still a priority in your life. This small time investment now will pay off in a big way in the future when you are sharing the triumphs of parenting together as a team.

Monday
Mar052018

Should You Let Go of a Difficult Relationship?

I am often asked why I believe the divorce rate has become so high in this country.  Although I don’t presume to have all the answers to this question, I do notice a trend in the couples that seek out therapy and yet end in divorce.  While I still treat plenty of couples that have grown resentful and cannot even sit next to each other in my office by the time they come to seek my help, I also seem to be seeing a lot of couples that have positive feelings towards their significant other, but are nonetheless miserable in the relationship.  Unfortunately, the latter couples are more likely to end up divorced and my belief is that this is due to the relationship being flawed from its inception. 

The trend in our society has been for couples to seek out marriages later in life than previous generations.  There are many benefits to this lifestyle choice, including more career satisfaction and more maturity when entering the relationship.  However, it also seems to lead to fear of ending up alone and rushed decisions to marry, at least for many women, based on the fear of an inability to have families.  So when you meet someone who is mature, well rounded, has built a nice life for themselves and is an all-around good person why would you not want to spend the rest of your lives with them?  The problem becomes that sometimes two wonderful people have had life experiences that don’t allow them to meet each other’s needs. Of course, there is little worse than a spouse who is unable to meet your deepest needs.

When someone comes to my office in these circumstances I often hear statements about how they have shared their desires for changes with each other and their partner is receptive.  Sometimes there is even an initial push to make those changes in order to save what is basically a good and loving relationship.  However, over time those changes fade and the old behavior patterns emerge and both parties are left frustrated all over again.  They are eager to uncover why this keeps happening and how to solve the problem.  

The reason is often easy to determine: people grow and adapt based on experiences with their families of origin and other relationships.  For instance, they may learn through a difficult childhood to be extremely self-sufficient, thus making inclusion of their significant other difficult when it comes to emotions, major decisions or milestones.  It may not occur to such a person to share big news or skip an important work meeting for a birthday.  None of these decisions makes this individual a bad person, but it may make them a bad partner for someone who watched their parents be a connected team and place value on being present for celebrations of each other.

Solving these problems is a much bigger task and ultimately sometimes an impossible challenge.  The couple mentioned above can learn how to navigate these differences once they understand they are present and implement systems for making these decisions.  The question is whether they are both invested in changing and that investment comes when they recognize their behavior as a problem for their relationship.  Unfortunately, if their behavior is not something that they can recognize as a problem, it is not likely to change.

My advice would be to consider letting go of relationships where your needs are not being met, even if it means that you are letting go of a wonderful person.  Just because someone is a good person does not mean they are the right person for you.  Often understanding that someone is loving you in the best way they know how, but it is not the way you need, helps you to let go.  Think about whether the relationship you are in meets your needs.  What things do you truly need to make you feel valued and understood?  Everyone deserves to be with someone who can meet their needs, whatever those needs may be, and while nobody will likely be a perfect match to everything you want you should never stay in a relationship where you are thinking that someone will change for you over time.  I ask each couple that comes to see me before they get married one question and it is a good question to ask yourself about your relationship: if your significant other never changes would you still want to be with them?

If you are already in a relationship that you think may fall into this category, do not despair.  I always advise meeting with a therapeutic professional who may be able to help both parties gain the self-awareness necessary to make compromise possible.   Either way, open communication and an awareness of the real underlying problems within the couple’s dynamic will be incredibly helpful to improve any relationship.  While it is never easy to make a decision about whether or not to end a long term relationship, I hope being armed with some information about why it may not be working will help you come to the best possible decision for you.

Thursday
Jan182018

Can Men and Women be Friends Without More?

Yesterday I was listening to a great new radio program called “The Happy Hour” on TODAY Show Radio (SiriusXM channel 108).  The show included lively discussion about relationships, and more specifically, the question of whether or not men and women can be friends without more.  Not surprisingly there were differing views regarding whether or not this was possible.  The thoughtful comments and insights on the show made me think about the patients I have seen over the years and how small steps across boundaries can lead to extramarital affairs.  There are definitely patterns in the seemingly minor problems that lead to major boundary crossing.  Awareness of these patterns can help prevent you from putting yourself in situations that are potentially damaging to your romantic relationship. 

It is my opinion that men and women can be friends in certain circumstances.  Of course, the key to sustaining a healthy friendship with anyone is creating and maintaining appropriate boundaries.  I think this is especially true of male/female friendships.  If you are behaving towards your friend in a way that would upset you if the same were true of your significant other, that may be a good benchmark to use for your boundaries.  It may also become important for you to ask your partner about where they feel the boundaries should be in order to avoid trouble in your primary romantic relationship. 

One factor that can influence whether a relationship can successfully be maintained on a friendship level is the circumstances under which you meet the individual in question.  For example, men and women who meet in professional settings are more likely to develop friendships that are healthy and appropriate than those that meet out socially.  The professional capacity of the relationship sets implied boundaries that facilitate the friendship’s harmless nature.  Regardless of what boundaries are introduced at the beginning of the relationship, however, it always remains important to respect and maintain those firm boundaries as the friendship moves forward. 

I’ve also noticed that men and women seem to view this issue through very different prisms.  For many women it is important that they do not share too much of themselves and develop a strong emotional connection with their male friends.  These emotional connections often cause boundaries to become blurred and potential affairs to take root.  For men, the impetus to cross boundaries often seems to be much more related to flirtations and physical proximity.  These differing motivations can also result in the two friends having drastically different perceptions of the relationship. 

One should also be mindful of the priority he/she is placing on their romantic relationship compared to other relationships.  It is typically symptomatic of a problem if you are investing more time and energy into a relationship with a friend than with your significant other, especially if that friend is the opposite sex.  Have the self-awareness necessary to recognize when you are at risk of losing the proper balance between these relationships. 

I believe that maintaining fidelity to your relationship with your significant other has to come from an awareness of, and faithfulness to, appropriate boundaries.  It also helps to invest a lot of time and energy into your relationship with your significant other and not to share emotional experiences with your friend that you wouldn’t share with your significant other. Additionally, don’t badmouth your significant other to the friend.  This may lead to comparisons such as my friend listens to me more than my partner.   Avoidance of comparison is extremely important.  Someone that you share responsibilities with cannot possibly be fun or energetic all the time whereas you might primarily be seeing your friend in their best environment.  When you compare people in this way, you might as well be comparing apples and oranges.  Maintaining healthy relationships with opposite sex friends may seem like a minefield, but if you respect boundaries you stand a better chance of maintaining the appropriate balance in your relationships.