Have you ever thrown a casual “I miss you,” or “I wish you were here” to your partner when, in that moment, you did not miss them or wish they were with you? Spouses and partners who have been together for some time may find themselves using this form of interaction, called “deceptive affection,” in their relationships on a regular basis. Rather than hurting the other’s feelings, one partner may find it easier and more tactful to say what they think their partner wants to hear. When getting dressed up for an evening out, is it okay to tell your spouse that they look amazing when you don’t really think so? The answers are mixed.

Deceptive affection is not altogether bad, according to some experts. It can fulfill needs and placate attention-seeking. It can boost self-esteem and quell fights. But when used as a way to avoid true feelings, it can become troublesome to the relationship. Couples that engage in deceptive affection, including public displays of affection, just to keep up the appearance of being truly in love, can actually increase the emotional distance that exists between them. If lying about feelings toward one another becomes commonplace, then lying in other areas of the relationship may become accepted behavior as well.

Psychologist Mansi Hasan believes that couples would prefer deceptive affection over distance and resentment. “However,” adds Hasan, “deceptive affection cannot make a relationship last; after a while it may become difficult to mask your real feelings.” This is where the problems can arise. Hasan suggests that partners try to decrease their use of deceptive affection and foster real, genuine affection by staying in touch with their true feelings and finding ways to rekindle the romantic love that once existed between them.

Other helpful strategies include letting go of anger once a conflict has been resolved and to avoid comparing the relationship to those of friends or family members, or previous relationships. It’s okay to embellish a little. But when embellishing turns into complete fabrication, it might be time to take a closer look at what’s really going on in the relationship.

Reference:
Can Deceptive Affection Destroy Relationships? (2013). India.com (n.d.): n. pag. http://www.dnaindia.com/lifestyle/1833990/report-can-deceptive-affection-destroy-relationships

Shouting, yelling, screaming. Nearly all parents have done it; nearly all children age 10 and under have heard it. In small doses, such as in emergencies, yelling is not believed to be harmful. Yet, as common as this interaction is within families, if it happens too often it can break down positive conflict-management skills and flood a family’s emotional field with negative affect.

Why Do We Yell?

The most basic reason we yell in any situation is because, on some level, we feel we are not being heard. Whether literally—the person is in another room, for example—or figuratively, not feeling heard is an incredibly frustrating experience. When we believe we have a valid point and are being intentionally ignored, misheard, or invalidated, inside our brains we are thinking, “They must not really be hearing me. I will speak louder. That should do the trick!”

Yelling also stems from a need for control. Yelling is a form of verbal aggression; it carries the message that the yeller desires to be the loudest and most dominant person in the room. If someone is yelling, it is a good bet that the yeller is feeling out of control and is feeling the need to dominate the interaction.

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Parents often experience frustrating and even oppositional behaviors from young children. Depending on your child’s age, he or she may be focusing on developmental tasks ranging from establishing a sense of independence to experimenting with rebellion. The act of not listening to you can actually be part of your child’s necessary development.

At various times of the day or week, parents’ reserves of patience and energy can already be low. For example, a full-time parent may feel that he or she can barely make it to nap time with sanity intact. A pre-nap meltdown from their toddler hits them at their absolute lowest point of the day. A working parent’s morning can be so tightly orchestrated that just the slightest alteration in routine can cause a cascade of setbacks and tardiness. Throw in an early meeting and some traffic, and there is a perfect storm of frustration which can come lashing out toward a child. Parents can reach a saturation point at which their own coping skills are no longer carrying them through a particular interaction. At these points, parents often resort to yelling in an attempt to regain a sense of validation or control.

What’s the Case against Yelling in Families?

Yelling raises blood pressure, heart rates, and adrenaline levels. Those who yell exhibit higher levels of the stress hormone cortisol in their bloodstreams over time. These physical consequences are also seen in those who are yelled at. Like second-hand smoke, second-hand anger can take a big toll on health.

That’s a case against yelling in general, but in families with children age 10 and under, there are several other reasons that yelling isn’t healthy.

Children look to their parents to maintain the safety—physical and emotional—of the family. Babies and very young children do not yet have the ability to determine the difference between a real threat to their safety and an upsetting or frustrating circumstance. Many parents can attest to this, hurrying to the scene after having heard their toddler scream as if hurt, only to discover the source of the scream was a minor frustration such as not being able to reach a toy. The child’s cognitions in this stage are quite concrete; circumstances are either “all good” or “all bad” and there is little room for ambiguity. Children under age 5 can therefore mistake a parent’s loud tone with an alert to a true threat. This can be terrifying for a child in this developmental stage.

Fear is one of the most basic and universal emotions—every animal experiences it. Fear is centered on a primitive part of our brain called the amygdala. When fear permeates a young child’s emotional experience, such as in a household with daily episodes of yelling, the amygdala will become overly active and this will inhibit the child’s brain from working on higher-level functions such as concentration, reflection, learning, decision making, and behavior planning.

With older children who are more verbal, the words that are shouted can be even more harmful than the tone itself. Even though yelling is an attempt to gain control through aggression, the irony is that in doing so, we actually lose control of our behavior and our ability to filter and manage what we are expressing. Negative labeling, blaming, and other harsh words are especially harmful to children because children accept unconditionally that what their parents say is true. Children between approximately ages 5 and 10 have the cognitive ability to understand the words themselves, but not the adult’s emotional context. They will internalize the messages from the parent without questioning if they are accurate, and will add those messages to their budding self-concept.

[fat_widget_left]Finally, many parents who yell can relate to this scenario: “When I don’t yell, my child doesn’t listen to me. He or she only seems to respond (do what I want) when I yell.” The escalation involved in yelling can become a self-reinforcing feedback loop. Children can become desensitized over time to their parent’s escalation pattern. The child, who is interested mainly in persisting in play or attending to his or her own agenda, will naturally search for ways out of responding to a parent’s demands. We cannot fault the child for this; it is simply a piece of his or her development. The more parent-free space and time a growing child can carve out, the more he or she can explore the world around him/her and his/her own inner experience. The child learns that the parent will eventually escalate to yelling each time, and so the child learns that he or she does not need to respond until and unless yelling is used. The “pre-yelling” time becomes seen by the child as “don’t have to listen yet” time. And the parent, on the other side of this interaction, keeps needing to up the ante over time to get the same response.

How Do We Break the Yelling ‘Addiction’?

1. Set a SMART goal around yelling: a Specific, Measurable, Attainable, Relevant, and Time-bound goal that solidifies your commitment to changing this behavior. Such a goal may sound like this: “Within the next month, I will decrease my instances of yelling on weekday mornings until I’m yelling once per week or less during that time period.” Write down your goal and put it in a place you will see it every day.

2. Find ways to increase true power, so that false control is less tempting. Yelling is false control. It feels powerful in the moment, but it undermines our internal self-control and the quality of our relationships over time. Ways to gain true power include:

• rearranging your schedule to relieve some of the pressure on certain times of the day or week that you tend to yell
• asking for help and delegating tasks to decrease your overall stress
• planning ahead for triggering moments, such as taking a distracting toy to the grocery store, or laying out your child’s school clothes the night before
• taking advantage of calm times to focus on strengthening a positive relationship with your children which will serve to buffer any episodes of yelling

3. Assume responsibility for the outcome of each interaction. You are the parent. You set the stage for the relationship between you and your child. If your child escalates, this does not mean you must escalate. If the situation escalates, this does not mean you must escalate. No matter how bad the traffic, how frustrating the missing shoe, how grating the whining, or how sassy the defiance—in the end, you always have a choice.

4. Speaking of choices, realize that yelling is only one of hundreds of things you can choose to do in a frustrating moment. Instead of yelling, you could:

• whisper
• sing
• dance a jig
• say a little prayer
• close your eyes and count to 268
• take a lap around the house
• splash your face with water
• go outside and yell at the snowman or rosebush in your yard instead

Some parents choose a grounding object, color, or mantra which they use to bring their attention away from their momentary anger and refocus it on their goal.

5. Return often to a developmental lens through which to view your children. At all times, children must be expected to behave as children. They cannot and do not think, process, or behave as you do. It is entirely predictable that children will lose things, drag their feet, misunderstand you, ignore you, and throw tantrums at inopportune times. The more you can remind yourself that this is developmentally normal, the less you will feel personally offended or annoyed by childish behavior.

6. When—not if—you do yell, be prepared to acknowledge and apologize for this to your children. Parents must be willing to role-model to children the process of owning up to poor choices and the effects they can have on others. If as parents we are not willing to do so, how can we expect the same from our children?

Breaking ingrained patterns of interaction like yelling is not an easy thing to do. Parents must take full responsibility for “being the change they want to see” in their families. Parents must make their tendencies and triggers conscious, face them honestly, and focus their attention on them if they wish to change. Keeping a written goal, a list of alternatives, and a developmental perspective will be of great help to the parent who wishes to reduce yelling. Over time, parents who make these efforts will be able to enjoy a great deal more peace in their family, a reduction in stressful feelings, and an increase in the amount of true power they are able to exert over their lives and actions.

The green-eyed monster of envy is often viewed as an emotion that leads to bad behavior. Envy can also be painful for those experiencing it. Longing for a new home or enviously watching friends post vacation photos on Facebook can slowly eat away at your self-esteem and harm your relationships with others.

Envy and jealousy may be used interchangeably, but there’s actually a meaningful distinction. While jealousy is the fear of losing something you already have – such as a spouse – envy is pain over something you don’t have – a flashy car, a perfect family, or a good marriage. Social networking can increase envy, and the media often fuels feelings of envy by parading an endless supply of things you do not, or cannot, have. You don’t have to permanently live with envy. There are several things you can do to cope with the overwhelming emotions that come with it.

[fat_widget_right]Deconstruct It
When you feel that first pang of envy, don’t ignore it, but don’t continue feeding it. Instead, try to deconstruct it. What’s really behind the envy? Envy can tell you a lot about what you want – a vacation, a successful spouse, a new job. And if you listen to your feelings of envy and interrogate them, you’re more likely to arrive at useful information about yourself. Question why you’re feeling envy, what is missing in your own life, and if any other emotions – such as anxiety or frustration – could partially account for your envious feelings.

Focus on Gratitude
You might not have a million dollar beach house, but you do have something to be grateful for; everyone does. Rather than fixating on what you don’t have, make gratitude a long-term strategy. Make a list of things you’re grateful for – no matter how small – each day. And when you feel pangs of envy, replace each envious thought with a moment of gratitude for something fabulous about your own life.

Get a Reality Check
When you’re marveling at someone’s social networking profile or alumni newsletter update, it’s easy to forget that everyone has a public and private face. We all strive to put our best face forward. That classmate or co-worker who seems to have an amazing life may be secretly struggling. Don’t believe the hype about other people. Instead, realize that everyone struggles with something and you might not know what the inside view of another person’s life is.

Decide What You Want
Rather than wallowing in envy, resolve to take steps to get your own life on track. Envy can be a positive emotion when it empowers healthy goal-setting. When you’re feeling envious, ask yourself what it is about another person’s life that you envy, then make a list of the steps you can take to reach your goals. By taking a minuscule step every day, you can get on track to have the life you want, of which you can be proud.

Help Others
While there may always be people who have things you don’t have, there are also almost certainly people who have much less than you. Helping others can offer an effective perspective adjustment. It also feels good all on its own. Try volunteering at a homeless shelter or soup kitchen, and use your volunteer experience as an opportunity to take stock of all you have instead of all that you’re lacking.

References:

1. Controlling envy. (n.d.). Dr. Phil.com. Retrieved from http://drphil.com/articles/article/340
2. Keeping envy and jealousy under control. (n.d.). University of Rochester Medical Center. Retrieved from http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1
3. Matousek, M. (2012, May 29). When friends get rich or famous (or both). Psychology Today. Retrieved from http://www.psychologytoday.com/blog/ethical-wisdom/201205/when-friends-get-rich-or-famous-or-both

This is a big topic. It may be at the core of why many divorces do not proceed well. The ability to forgive can be quite complex, depending on the events and issues under consideration. However, forgiveness may be one of the most important and perhaps most powerful experiences you may have when going through what can be a very difficult and painful event.

Some things to consider when thinking about what it might mean to forgive your ex-spouse:

1. Healthy boundaries: When we forgive, we are learning to have healthy boundaries so that we do not say or imply that what was done was OK. Holding a grudge is not the best way to make sure you are not hurt by someone again. Being clear about what you are and are not willing to do going forward is a stronger stance.
2. Ongoing experience: Forgiveness is an ongoing experience. It doesn’t happen once and then be done. It happens over time, allowing us to acknowledge our feelings and put them in perspective. Feelings such as anger and resentment take time to heal. Forgiveness is part of the healing process and important to our own health and helping to decrease stress in our lives.
3. Realistic view: When we can recognize other people for who they are and give up on the hope of changing them, this often has the impact of changing our response to them, our expectation of them, and our need to forgive them for being who they are. Having a realistic view of another person may help to minimize the things they need to be forgiven for if the expectation that they be someone other than who they are is not there.
4. Afraid history will repeat itself: We are sometimes frightened that if we forgive someone we will have to go back to being in the relationship in the same way we were before. It is important to remember we need not choose to be a victim nor allow ourselves to participate in something that is intolerable or abusive in order to forgive the actions of another.
5. Feeling powerless: We are sometimes fearful that we will feel powerless if we forgive a person who is asking for our forgiveness. We may feel powerful when we refuse to offer it to them. Forgiveness is not about power. It is about creating an internal sense of peace.
6. Continual forgiveness: We need to stay aware of choices we make that may put us in the position where we feel a continual need to forgive. This relates to being clearer about your boundaries of what you are willing to tolerate or expose yourself to.
7. Cycle of arguing and forgiving: During a divorce, disagreements and problems may arise that result in arguments and feelings of anger and resentment. We may feel an ongoing cycle of hurt, anger, argument, and forgiveness. It helps to be aware of the ways we engage that are about our expectations and disappointments that lead to anger and then a need for forgiveness.
8. It isn’t fair: One of the reasons we find it difficult to forgive is because we feel it isn’t fair that the person who has hurt us will not be punished or forced to make amends. Forgiving is not the same as thinking others should not be accountable for their actions. It is about coming to terms with what happened, allowing ourselves to find a calmer place in our hearts in understanding what happened, and letting it become part of our history rather than continually intrude in our lives.
9. Getting even: Getting even is a short-term experience. Moving on, forgiving, and living the life we want free of anger and stress is its own reward.
10. Avoid an uncomfortable situation: We can guard against forgiving someone so that an uncomfortable situation can be averted rather than because we truly feel we are ready to let go of our judgment of them. When forgiveness is given for a reason other than feeling ready to forgive, resentment will often emerge instead.
11. Not the same as forgetting: Forgiving is not the same thing as forgetting. We may have an experience which reminds us of what happened. This doesn’t mean we no longer forgive that person. It is often helpful to have these reminders as a way of remembering why we needed to forgive in the first place.
12. Forgiving yourself: It is as important to forgive ourselves as it is to forgive another. We can act in ways we regret, sometimes realizing it right after we do something. We are as capable as anyone else of transgressions and to hopefully learn from them. Sometimes, our unwillingness to forgive ourselves results in placing our anger with ourselves on someone else.
13. Private experience: Forgiveness can be a private experience with ourselves and does not need to be pronounced to the person you are forgiving. Many people have no information about the amount or nature of the ways in which they have been forgiven.
14. For your own benefit: When we forgive, it is an act for ourselves, for our own benefit, not the person we are forgiving. It is about our relationship with the self, our attitude about others, and our beliefs about what should be rather than what is.

According to the results of a recent study, not all aggression is bad. Konrad Bresin of the Psychology Department at the University of Illinois Urbana-Champaign recently conducted two separate studies examining the cathartic effect of aggression. Bresin wanted to counter the existing body of research on aggression, which suggests that for the most part, aggression is maladaptive and has only negative consequences, such as violence. Bresin based his research on the catharsis theory that implies there is a healing and anger-reducing affect that occurs through aggression. It is important that a distinction be made between aggression and violence, as the two behaviors are not mutually exclusive. Aggression, in this study, was the act of participants verbally retaliating against negative feedback. In one study, the participants were instructed to aggress toward the person who gave the feedback or a neutral individual. Measures of anger were assessed prior to and after the feedback was delivered. In the second study, Bresin wanted to see if participants who had reductions in anger in the first study would be more likely to aggress at a future time.

Overall, the results of both studies supported Bresin’s predictions and the catharsis theory. In the first study, the participants who aggressed against the source of the negative feedback had sharp decreases in anger when compared to the participants who aggressed against nonsource neutral controls. In the second study, Bresin found that these same individuals who had anger reductions were more likely to aggress in another experiment. These findings demonstrate that aggressing toward a source of frustration can have a very cathartic effect. Anger and hostility that may increase during a tense situation can be easily moderated with aggression. Although some forms of aggression are maladaptive, such as abuse, physical violence, and verbal abuse, adaptive forms of aggression appear to not only create a calming effect, but also empower participants with the tools necessary to regulate anger emotions in the future. This is especially important for people prone to violence. Because anger, aggression, and violence are quite different, being angry does not always cause someone to become violent. Bresin believes that this study shows how adaptive aggression can potentially reduce the risk of violence by decreasing feelings of anger and frustration. He added, “Future research may address the question of whether changes in anger following violence (or aggression) have similar relations to future violence.”

Reference:
Bresin, Konrad, and Kathryn H. Gordon. (2013). Aggression as affect regulation: Extending catharsis theory to evaluate aggression and experiential anger in the laboratory and daily life. Journal of Social and Clinical Psychology 32.4 (2013): 400-23. ProQuest. Web.

Some people come to therapy full of negativity and anger toward parents whom they hold responsible for the way they feel and the lives they live. For example, they might explain their difficulties in relationships by referring to a parent’s emotional coldness, criticalness, or divorce. Or they will fault a parent’s lack of encouragement and involvement when they were growing up for their failure to do well academically or professionally. Blaming parents for their struggles keeps these people stuck in angry, anxious, and depressed feelings, and interferes with their ability to think about what they could do to make their lives different.

“Gloria” came to her first therapy session with me and immediately began to talk. Sounding irritated, she explained, “I’m here because I can’t take it anymore. I hate my life. I’m either angry or depressed. I’m 29 years old and I haven’t been in a relationship for more than three months. I can’t seem to keep my jobs for much more than a year. For nine months, I’ve been working as an assistant in a recruiting firm where I answer phones and type résumés. I know I’m smarter than that, but I don’t know what else I want to do. I seem to go from one dead-end job to another. I’m such a loser.” Then Gloria sobbed, “I am just so stuck.”

Gloria began therapy. She typically entered my office with heaviness and depression, and talked about how miserable her life was and how hopeless she felt. She believed that nothing could change. When I asked her why, she thought she was stuck in this awful place, her lethargic demeanor changed to anger, and her voice turned strong.

“How could I change?” she said. “It’s all about my childhood. My parents separated when I was 5. My father left the house and I rarely saw him. Sometimes he would take me for a weekend, but I never believed he really wanted to. He met this woman, Fran, and all he ever talked about was her. They got married when I was 7, and then he moved to another state. I would visit them three or four times a year. She had two daughters. I could see how much he loved Fran. He never looked at me like that. He would criticize how I dressed and compare me to my stepsisters. I hated them. I could never get anything right, and they were so pretty and perfect, and I could see they were the children he wanted. When I would go home to my mother and complain, she would hardly listen. She never seemed very interested in me, either. She had a big, important job, and as I grew up, I didn’t see so much of her. She never got very involved in anything I did. She would even get nasty and critical if I told her about something good that happened. I remember when I told her that I had been asked to run for class secretary in middle school. She laughed at me and said, ‘You’ll never get elected, so you shouldn’t run. You’re just not popular enough.’ I believed everything she said about me, so I didn’t run. By middle school she had a serious boyfriend and she was always with him and never had time for me. I never thought I was good enough for much. When I think about it now, I can see my mother was really into herself and I think she was competitive with me. I don’t think she wanted me to succeed or dress well or have boyfriends. I guess she is still getting her way.”

The more I learned about Gloria’s childhood, the more I could understand why it was so difficult for her to have positive feelings about herself and to believe that if she worked at something, she could succeed. She consistently assumed people’s responses toward her would be negative personally and professionally. While her expectations were understandable in light of her childhood experiences, she was able, when pushed, to come up with memories of positive relationships, work experiences, and even good feelings about herself. Nevertheless, these exceptions to what she anticipated did not go very far in allowing her to step back and consider that she was not (in her words) “doomed to fail.”

It became clear to me that Gloria was stuck in blaming her parents for how she saw herself and how her life turned out. What made it so hard for her to move on? Was there some risk in letting go of her anger? Was there a downside to not living up to what she saw as her parents’ view of her? Was there something positive in it for her to blame her parents? These were the questions that occurred to me as I listened to Gloria, who presented herself repeatedly as a victim who would always be at the mercy of the impact of her past treatment by her parents.

I began to raise these questions to Gloria, who became curious about them. She began to consider the risks of letting go of her anger and blame. She talked about worrying that she would be letting her parents “off the hook” if she stopped blaming them or being angry. “They know how I feel and I like to think I make them feel guilty,” she said. “When I was a kid, they never seemed to expect me to amount to much. They’ve gotten what they wanted, but I do think I’ve managed to finally make an impact. I think I’ve succeeded in making them feel guilty. If my life got better, maybe they wouldn’t feel so bad or guilty. I feel bad and I want them to feel bad.”

At first, when Gloria continued to talk about her desire to hurt her parents, she smiled and said, “Now that I understand that this is what I’m doing, I have to say that revenge is sweet.” She would also get angry in our sessions and acknowledge that this new awareness created a real conflict for her. “Rationally, I get that it’s me,” she said. “I can see that I think my parents are responsible for my being a failure. They made me this way, so I’ll be the loser they created. I want to hurt them. I guess I could work on getting the life I’m always moaning that I’ve never had, and I know that would be the best thing for me. But I just don’t want to give them any good stuff.”

As we continue to talk about this conflict, which creates great anguish for Gloria, she has not been able to choose to work on giving up her anger and blame. However, she is considerably less attached to viewing her life through the lens of doom and failure caused by her parents. She has begun to take some steps to get more for herself. She has gotten a promotion to recruiter, and has made a placement that will double her income this year. She has also enrolled in a management class at a local college. We’ve even begun to talk about online dating. As Gloria continues to work in therapy, I believe she will achieve more for herself and gradually be able to see her identity in a new way and identify less and less as a victim. As she allows herself to experience the satisfactions of success, I am hopeful that the pleasure of revenge will be less gratifying.

My work with Gloria is just one illustration of the ways in which blaming your parents can keep you stuck. There is a terrible paradox in these situations: You are angry and blame your parents’ treatment of you growing up for your unhappiness and failures in your adult life. But the wish for revenge and these angry, blaming feelings keep the connection and repeat the relationship between your “bad parents” and you, the unsuccessful, unhappy child. As a result, you are stuck in the position where you cannot become the person you say you wish to be or create the life you say you desire.

As discussed in the overview of dialectical behavior therapy (DBT), the first of the four primary DBT modules is core mindfulness. Derived largely from Eastern zen philosophies and Western contemplative practices, mindfulness forms the foundation for the other three DBT modules of interpersonal effectiveness, distress tolerance, and emotion regulation.

Mindfulness is the practice of observing one’s emotions and environment, describing feelings and experiences, and fully participating in the moment. By learning and incorporating mindfulness skills, clients become more aware of their feelings, thoughts, impulses, and behaviors. This awareness empowers the individual to better regulate his or her emotions and choose more appropriate actions.

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Three States of Mind
A central concept of core mindfulness in DBT is that there are three states of mind: the logical mind, the emotional mind, and the wise mind. In Cognitive-Behavioral Treatment of Borderline Personality Disorder, DBT founder Dr. Marsha Linehan explains that mindfulness helps achieve the wise mind state, which is a balance between the logical (or “cool”) state of mind and the emotional (or “hot”) state of mind. In the wise mind, the individual considers things rationally while factoring in his or her feelings. This enables the person to acknowledge intense emotions in a nonjudgmental manner while making healthier behavioral choices.

“What” and “How” Mindfulness Skills
In DBT, the practice of core mindfulness is taught through “what” skills and “how” skills, i.e., what can we do to become mindful and how should we do it? The three “what” skills are observing, describing, and participating. The observing skill refers to observing the current environment and events, as well as the client’s own sensations, thoughts, and feelings—without describing or judging him or her. This process helps prevent impulsive reactions and the triggering of negative emotions and internal dialogues.

The second step is to describe what has been observed and experienced, being careful to express facts rather than interpretations. For example, the client might say, “I am feeling frustrated with the complexity of this project,” rather than, “I am too stupid to complete this project.”

The third “what” skill is participation, wherein the individual is fully engaged in the present moment. The focus is on the discussion one is engaged in, or the event he or she is attending, rather than allowing the mind to wander about past incidents or future possibilities—which generally increases feelings of agitation.

In practicing the “what” skills, it is critical to employ the “how” skills, which explain how to perform the “what” skills: nonjudgmentally, one-mindfully, and effectively. The nonjudgmental skill helps neutralize the common tendency to label experiences and feelings as “good” or “bad.” In applying this skill, the individual describes the key facts of the experience rather than his or her feelings and judgments about it.

The second “how” skill, one-mindfulness, refers to focusing 100% attention on the present situation rather than multitasking—in other words, participating mindfully as opposed to mindlessly. This skill is helpful in breaking the habit of dwelling on negative thought patterns, which tends to prolong and aggravate distressing emotions.

Finally, the effectiveness skill enhances the capability to select behaviors that are consistent with achieving goals rather than deliberating on what is fair or unfair, and how things “should be.” The idea is to take productive and goal-oriented actions instead of being caught up in a cycle of negative thinking and behaviors.

Mindfulness can be a challenging skill for some people to develop. Many of us have become accustomed to focusing on something that has already happened or may occur in the future, rather than what is happening right in front of us. With training and practice, however, core mindfulness enables clients to become more flexible in their thinking and avoid being controlled by their emotions. It can help reduce the tendency to react negatively based on internal triggers, allowing clients to be fully present in the moment and engage in more productive behaviors.

Children learn an enormous amount from their caregivers and parents. They learn through direct contact how to communicate, interact, and perform daily activities. They learn through exposure how to react and emotionally respond to situations. And whether parents are fully aware of this or not, a child’s behavior is in part the result of their parents’ response to it. According to a recent study led by Diana Morelen of the Department of Psychology at the University of Georgia, children and parents have a reciprocal emotional relationship. In other words, the way in which a parent responds to a child’s emotional reaction directly influences the way in which a child emotionally reacts.

The primary aim of Morelen’s study was to determine how reciprocal the child-parent emotional relationship was. Using a sample of 54 participants made up of fathers, mothers, and pre-adolescent children, Morelen examined how supportive emotional parenting (SEP) affected emotion regulation when compared to unsupportive emotional parenting (UEP). Specifically, Morelen wanted to know if SEP increased adaptive emotion regulation (AER) in children and if UEP increased maladaptive emotion regulation (MER). She then wanted to find out if these relationships were bidirectional. Morelen assessed the parents and children as they talked about four different emotions, anxiety, sadness, anger, and happiness.

She discovered that the way in which parents responded to their children’s emotions directly impacted the way in which children emotionally reacted. Morelen’s theory of reciprocity was confirmed when she found that SEP led to AER and AER led to SEP in all four of the discussion conditions. Also, MER predicted more UEP than SEP for fathers and mothers when discussing anger. However, when discussing the more vulnerable emotional states of sadness, mothers responded with SEP more than fathers when children exhibited MER. This finding could be partially explained by the male ideal of power and strength. This, in turn, may lead fathers to identify emotional vulnerability as a weakness. However, Morelen believes this is concerning because there is an abundant amount of research linking UEP to feelings of shame and inadequacy and patterns of emotional suppression, all of which can increase the risk for psychological impairment. Because of this, Morelen hopes interventions aimed at addressing family, child, and parent interactions focus on the emotional response of both mothers and fathers. “Programs could highlight the role that child behavior plays in soliciting parental behavior and coach parents on how to be mindful of the potential (positive or negative) influence of child behavior,” said Morelen.

Reference:
Morelen, Diana, and Cynthia Suveg. A real-time analysis of parent-child emotion discussions: The interaction is reciprocal. Journal of Family Psychology 26.6 (2012): 998-1003. Print.

Editor’s note: Melissa Orlov, LLC, is a marriage consultant who specializes in working with couples impacted by ADHD. She is the author of the award-winning book, The ADHD Effect on Marriage: Understand and Rebuild Your Marriage in Six Steps, and provides seminars for couples and therapists. Her continuing education presentation for GoodTherapy.org, The ADHD Effect on Couples, is scheduled for 9 a.m. PST on January 25. This event is available free with 1.5 CE credits for all GoodTherapy.org members. For details, please click here.

In your couples practice, you may well encounter couples in which one partner is chronically angry while the other keeps making mistakes that are hard to understand, such as regularly forgetting to do something they’ve committed to, constantly irritating their partner by being late, or never cleaning up after themselves. The angry partner tries many things to motivate his or her partner—nagging, scolding, pleading, crying—but nothing seems to work. The forgetful partner is genuinely contrite, yet continues doing the same “stupid” things.

It is possible that this couple’s relationship is being impacted by undiagnosed attention-deficit hyperactivity (ADHD).

Learning how to work with couples affected by ADHD is a relatively new and very much needed skill in couples therapy. It is only recently that we have been thinking much about ADHD in adults, and according to expert ADHD researcher Dr. Russell Barkley, as many as 90% of adults with ADHD remain undiagnosed (1). Clients often don’t know they have ADHD or that it contributes to their marital issues. Many times, neither do their therapists. Unfortunately, unrecognized ADHD can wreak havoc in a relationship—in some research studies, almost doubling rates of marital dysfunction and divorce (2).

One of the side effects of the repetitive missteps of an ADHD partner is that anger builds in the relationship. Chronic distractibility, disorganization, and difficulty remembering things are hallmark traits of adult ADHD that can severely impact one’s life. They also don’t play particularly well in a relationship or at home. A chronically distracted partner is often not particularly good at attending to his or her partner in a way that communicates love. The feelings of love are there, but the partner is simply off doing other things. It is no surprise that non-ADHD partners often report that they feel intensely lonely in their relationship (3).

As distraction, disorganization, and other ADHD symptoms continue unabated, partners of those with ADHD can lose patience and become so angry that it colors every aspect of the relationship. Minor gaffes become major blow-ups because they are symbolic of bigger issues in the relationship. For example, an ADHD partner who leaves the milk out on the counter may be reprimanded by his or her partner for “never paying attention” or being “lazy,” even though in other situations leaving milk out might be considered a “nonevent.”

With enough rebukes, an ADHD partner (who often suffers from self-esteem issues in any event) begins to avoid engaging with the non-ADHD partner. Anger that he or she is being constantly criticized builds, too. Arguments escalate more and more quickly, and the couple find themselves in a strong, negative behavioral spiral. They don’t understand their partner’s seemingly arbitrary behavior, but do understand they don’t like it.

My observation is that by the time ADHD-impacted couples make it to counseling, they are often in very significant trouble. They’ve tried everything they can think of to “fix” things, but because they don’t know about the ADHD, have not found a workable solution to their conflicts. They are suffering from great emotional pain, and are often feeling hopeless about the relationship. Many are trying to decide whether to get divorced, but are confused. They feel they ought to be able to do better and don’t understand why they can’t.

The good news for therapists is that working with these couples can literally turn their lives around. First, couples are typically greatly relieved to realize that there is a reason for their problems. Also, identifying ADHD provides a significant chance for behavioral improvement in the ADHD partner. With effort, about 70% of those with ADHD can find treatment that provides almost complete, or at least very significant, improvement in their symptoms (1).

Naming the problem not only provides renewed hope, it creates an opening for redirecting interactions between partners. Certain types of communication tactics, organizing habits, and ways to “attend” to each other simply work better than others for couples impacted by ADHD. These are often not the same tactics that couples not impacted by ADHD use (3), so therapists need new training to optimize their effectiveness.

Sometimes that training includes learning a new style of interacting with clients. I find that these couples respond well to an “activist” approach to counseling that puts the therapist in multiple roles at different points in the therapy—that of expert educator, listener, ADHD coach, sex advisor, and investigator, to name some of the most common. These couples tend not to learn through self-reflection. Rather, they need active guidance to learn a new skill set that will enable them to live together successfully and bridge their often very considerable differences.

Yes, these couples often have really significant problems. Not all of them stay together. But with the right assistance, many of them are able to turn their relationships back into something they treasure. For therapists, it can be incredibly fulfilling work.

References:

1. Barkley, R.A. (2010). Taking charge of adult ADHD. New York, NY: The Guilford Press.
2. Barkley, R. A., Murphy, K. R., Fischer, M. (2008). ADHD in adults: What the science says.New York, NY: The Guilford Press.
3. Orlov, M.C. (2010). The ADHD effect on marriage: Understand and rebuild your relationship in six steps. Plantation, FL: Specialty Press.

The new movie This is 40 has a lot of people talking. It is not only crass and funny, but also controversial. The two main characters in the movie reveal that they have secretly fantasized about killing each other. The wife admits to her husband that she has thought about poisoning him with a cupcake. The husband, on the other hand, tells his wife that he had contemplated putting her through a wood chipper. And as they share their morbid fantasies, the married lovers lie in bed looking relaxed and playful. Their fantasies, detailed in the warm light of their bedroom and the safety of a loving relationship, are as far from threatening as they could be. But what does it say about their relationship that they actually do have fantasies like this?

According to Benjamin Karney, a psychology professor at the University of California in Los Angeles, people who fantasize about killing their spouse, or about being a widow or widower, may do so because it allows them to escape taking blame for the failure of the marriage. They may think of it as an escape from a difficult marriage, but an escape without blame. It is not clear how many married couples have these types of fantasies. Rarely do you hear a spouse ask their husband or wife, “Do you ever think of killing me?”  But it doesn’t mean it never happens. Violence of any kind, including intimate partner violence, is not something to joke about. Rates of partner homicide are startlingly high. But the movie does show that communication styles can say a lot about a relationship, even when that communication is murderous.

Howard Markman, a psychology professor and co-director of the Center for Marital and Family Studies at the University of Denver, said that when the stars of the movie had their gruesome conversation, they were playful and intimate with each other. In fact, the whole topic of murder began with the wife wanting to discuss their conflicts. The husband, who was anxious and worried that another conflict would erupt, chose to use humor as a way to broach the subject. According to Markman, this type of strategy, even without the wood chipper or poison cupcake, can indicate a successful relationship.  “They still need to talk about her initial question, but this is a great model for couples,” said Markman. “It starts out negative, but then turns positive.” The movie is raising a few eyebrows; that’s for sure. But it also shows us that there is no one model for a successful marriage.

Reference:
Coe, Alexis. The truth of ‘This Is 40’: It’s actually not weird to want your spouse to die. (n.d.): n. pag. The Atlantic. 20 Dec. 2012. Web. 20 Dec. 2012. http://www.theatlantic.com/sexes/archive/2012/12/the-truth-of-this-is-40-its-actually-not-weird-to-want-your-spouse-to-die/266479/

Nicole is 16, and Ethan is 14. Their father, Jack, has battled brain cancer for the past two years. Jack was told recently that further treatment had a less than 10% chance of being successful. Jack wants to enjoy whatever time he has left feeling good and not being wiped out by chemotherapy. While no one wants to say it out loud, it’s clear that this will be Jack’s last Christmas (please substitute Hanukkah, Kwanzaa, etc., as appropriate).

How is Jack’s family supposed to come to terms with this? It can’t possibly be true. After the shock and complete denial subside, the painful reality begins to sink in. A flood of emotions comes with this realization, with profound sadness and anger often topping the list. It’s harder to face if your loved one is young and he or she has young children. The holidays speak of possibilities and are supposed to be a magical time for children; belief is suspended, and all holiday stories have happy endings.

The first step in dealing with this situation is to acknowledge that this will be someone’s last Christmas. Just saying that out loud will address the elephant in the room and help to decrease the stress that family members have been carrying internally. There will be tears, to be sure, but then the family can begin the process of grieving this sad reality together, rather than each member trying to deal with it alone. It is often the case that people don’t share their feelings with each other because they don’t want to be a burden, or want to protect the other person. In reality, family members are usually feeling at least some of the same things: fear, sadness, anger, and disbelief, to name a few.

After getting the topic out in the open, it’s time to think about how you want to celebrate this year. Don’t hold on to traditions if they don’t feel right. If you usually decorate your house to the rafters and host a cocktail party and an open house, it’s perfectly fine to do only some, or none, of those things this year. Every year, we all search for ways to make the holidays less commercialized and more significant. This year, it is especially important to ask yourself what makes the holidays meaningful for your family and your loved one. It may be as simple as sitting on the couch with a cup of eggnog and looking at the lights on the tree. Watching Christmas movies.  Listening to Christmas music. Going to a lights display. If your loved one is too ill to go out, he or she may still enjoy the experience by seeing photos of what others have done.

The person who is ill can give the gift of memories to those he or she will be leaving behind by writing letters or creating videos. If you are a parent, your children will one day be interested in what your life was like when you were young/their age. What words of wisdom do you have for them when they get their first boyfriend/girlfriend? Graduate from high school? Get their first job? Get married? Have a child? For some people, it is too daunting to consider making videos/writing letters; it puts them face to face with their own mortality too directly. In that situation, I suggest trying to think about it from your child’s point of view, not your own. The reality is that all of us will die, but not all of us will have the opportunity to choose how we spend the time we have left.

“It is not the magnitude of our actions but the amount of love that is put into them that matters.” —Mother Teresa

The uninvited house guest often stays on well beyond the point of “wearing out his or her welcome.” Likewise, for many people, chronic illness/disability is not a short-term inconvenience but rather a long-term, often permanent way of life. In the early stages of adaptation, the changes that happen in our lives and families may seem tolerable—at least while we still think there is a chance that the diagnosis is wrong or the cure is in the magic pipeline offered by big pharma.

Eventually, denial and bargaining give way to anger and depression. The uninvited guest is still ever-present, and no amount of cajoling or suggestions result in change. Bouts of anger may become a way of life for a while.

Anger
Many people flow in and out of anger and depression, rather than progressing neatly through one stage and into the next. It is often said that depression is anger turned inward, which makes expression of anger in a safe and effective way very important. Getting adequate support from formal and informal support networks is critical.

It is not unusual for tempers to flare and fuses to shorten during this period of adjustment. People who are typically long-suffering seem to be constantly on edge; those with fewer coping skills may be in a chronic state of agitation and irritability, if not outright rage. It often seems as if they are pushing away those who are closest to them at the time when they need them most.

Loved ones may unconsciously spend less time with the person who seems to find fault in their best efforts. Children are often left confused and afraid. Doctors and other providers frequently find themselves being blamed for their inability to help. This is all part of the process of adaptation.

While most people understand cognitively that their loved one is struggling and coping as well as can be expected, their own feelings of inadequacy and powerlessness may lead them to retreat on some level—if not physically, then emotionally. This often feels like abandonment to the person who is already overwhelmed by disability or illness. It is very important for caregivers and loved ones to be aware of their own feelings and find support.

Coping skills: Separate the person from the behavior. Try to remain aware of the real target for your anger—the illness or disability, not the person in your midst. Remember that we often treat those we love the most with the least respect; make amends as soon as possible if you do so. Give each other a break and extend the benefit of the doubt when possible. If your loved one treats you badly, remember that everyone is under extreme stress and doing the best they can at that moment. It is also good to remember that your caregivers and medical providers are probably not inadequate, but the resources they have to work with may be.

Caregivers and loved ones should speak up if they are being treated badly. Being sick is not an excuse to mistreat people, particularly if there is a pattern of abusive behavior developing. These behaviors need to be identified and discussed in a calm, loving way (not in the heat of the moment). This may require professional help, or perhaps the assistance of a minister or family friend who is not emotionally involved.

Most of the time, the person who lashes out or treats people badly feels guilty and needs the opportunity to make amends. For those who are unaware of how their behavior comes across, specific examples of the unacceptable behavior or hurtful/abusive language helps them develop a better awareness of their inappropriate behavior. In some cases, this is a manifestation of the illness or disability. In others, it may be the result of coping skills that are maxed out. Either way, left unattended, it usually gets worse. This is not the time to let conflicts and hurt feelings stack up. If you need help addressing these issues, ask your medical provider for a referral. Providers often have therapists or chaplains they work with who may be able to help.

Depression
Depression often occurs during the adaptation process, and may happen at other times or continue. Clinical depression can be very difficult to manage. It is more than sadness or disappointment; depression is a collection of symptoms that exist most days for two weeks or longer and create some level of impairment in daily functioning. The symptoms may include many of the following:

• sadness/tearfulness
• low energy or agitation/irritability
• loss of interest in things previously enjoyed
• problems with concentration/foggy thinking or trouble making decisions
• changes in sleep or eating patterns
• feelings of guilt or worthlessness
• thoughts of death or suicide/not wanting to live
• rumination/negative thinking
• others (physical pain, changes in motor skills, etc.)

If you or someone you know have four or more of these symptoms that are present for more days than not over a two-week period, talk to your medical provider about getting help.

There is also a type of depression called situational depression that is a normal reaction to a loss or change. Almost all people with chronic illness or disabilities and their loved ones experience this. The same symptoms are involved, but the symptoms may not be present most of the time, or may not be severe enough to impair your ability to function (relationships, work, taking care of your kids, etc.).

Situational depression can linger or become more serious after a while, becoming clinical depression. If the symptoms begin to impair functioning or last longer than a few weeks, it is wise to speak with a medical provider or therapist. People with situational depression are often able to experience periods of happiness when receiving good news, or other momentary reprieves from the darkness of depression. Those with clinical depression may be unable to experience even brief moments of relief when the situation calls for it.

The best treatment for depression is believed to be a combination of talk therapy, exercise (I know—it is very hard to exercise when you are depressed), a good diet, and medication, if deemed medically necessary. The right intervention for depression depends on which type of depression you are experiencing. For those with a few symptoms that are not present all the time, self-help may be sufficient. People with four or more symptoms that are present most of the time probably need to see a therapist and possibly a psychiatrist.

Anyone who is suicidal should seek professional help immediately. This national hotline is for people struggling with depression. The crisis line is staffed 24 hours a day by trained volunteers: 1-800-273-TALK.

Coping skills: I recommend that people talk with a therapist when dealing with situational depression and try to get as much activity in as possible. This may mean simply walking outside to get the mail, sitting on the porch for 20 minutes to have a cup of coffee or juice, watering the plants, or walking the dog. Sunshine is another natural remedy that increases vitamin D, which is often deficient in people who are depressed and those who do not go outside often. Eating properly is also critical, and there are natural supplements available at your local health store that may help with situational depression. Talk to your medical provider or therapist about these options.

Support groups and self-help groups can be very helpful. Groups provide a great resource for people living with chronic illness and disabilities and their loved ones. You can find online and local resources, and most are free. Many are affiliated with local hospitals or nonprofit agencies that serve people with chronic illness or disabilities.

If depression is serious enough to impair functioning, or you/your loved one has thoughts of suicide or not wanting to live, it is important to get professional help immediately. Start with your medical provider or therapist unless the person with depression has a plan to cause self-injury or death.

In situations where someone’s safety is at risk, call 911 or the local emergency number for your area, or take the suicidal person to the closest emergency room. Your role in the situation is not to intervene, but to get professionals involved as soon as possible. If the suicidal person is unwilling to go to the ER (or medical provider’s office during business hours) or you believe it may be unsafe to transport them, simply call for the emergency medical providers to come to you.

Don’t worry about the person who is suicidal being upset by your actions—when people are in crisis, they are usually not thinking clearly, so it becomes crucial for you to make good decisions on their behalf. The medical professionals who are trained to help in these situations will make the decisions once they arrive. This will likely mean that the person who is suicidal will be transported to the hospital for an evaluation, and may need to stay there for a few days until stabilized.

Again, it is not up to you to make that decision, only to make sure the person is safe until medical professionals can take over. It is a lot of responsibility and instills fear in most of us, but in the end, when your loved one is thinking rationally again, he or she will likely be grateful. If not, you will know that you have done what you needed to during the crisis.

Ongoing thoughts of suicide or not wanting to live need to be addressed with mental health and/or medical professionals regularly. Some states (Washington, Oregon, and Montana) permit medical professionals to participate in a well-thought-out, documented plan to end life (known as rational suicide), but most do not. Discussion of a patient’s end-of-life wishes should also be considered carefully and documented in a legal document for your specific state. Legal resources such as a living will specifically identify a person’s end-of-life wishes.

It is a good idea to talk about signing a consent form that allows you to discuss your loved one’s mental health (and physical) treatment with medical providers and therapists. This will enable you to enlist their help if depression becomes unmanageable or a crisis occurs. The consent can be relinquished at any time if the patient is considered to be of sound mind, and could be a great resource. Fortunately, resources are available to assist you in being prepared for a suicidal crisis should you need them.

There are many issues to be discussed regarding suicide, including family members’ thoughts and feelings about it. It is important to remember that euthanasia is against the law in all U.S. states, and assisted suicide with the help of a physician who prescribes a lethal cocktail after careful planning and documentation is legal only in Oregon, Washington and Montana. Legal professionals should be consulted if “rational suicide” is something you or a loved one is considering.

Adaptation
Using the analogy of the uninvited house guest, this is the period when people have settled into their routines and learned to live together with whatever adjustments are necessary. The initial period of adjustment after a disability or illness almost always requires going through each of the stages in the process outlined here. It can take a long time for some to arrive at adaptation, and not everyone in a family gets there at the same time. With some luck, a lot of support, good communication, and teamwork, the process will likely resolve in time for most people.

Unfortunately, surviving the initial period of adjustment does not ensure there will not be others. As mentioned earlier, people tend to get emotionally triggered when there are relapses or new symptoms/stages of the illness or disability occur. Triggering means that some reminder of the initial trauma (usually diagnosis or the actual accident or illness) sets off the same cascade of emotions experienced at the time of the original event.

Living in fear of a relapse or a change in physical status creates a certain amount of anxiety for everyone. The unpredictability of living with a chronic illness or disability will be the focus of our next article.

In the meantime, please share below how you have effectively coped with anger and depression.