Editor’s note: Ashley Davis Bush, LICSW, and Daniel Arthur Bush, PhD, are co-authors of 75 Habits for a Happy Marriage. Their continuing education presentation for GoodTherapy.org, titled Helping Couples Connect When Life Is Pulling Them Apart, is scheduled for 9 a.m. PDT on September 13. The event is good for 1.5 CE credits and is available at no cost to GoodTherapy.org members. For details, or to register, please click here.

“Melissa” and “George” have been married for 19 years. Nine years ago, George’s excessive drinking had led to a separation. George admitted to his addiction and checked himself into a rehabilitation center. They reunited after six months, and George has been sober ever since.

They were in my office now because Melissa was feeling unfulfilled in their marriage. George had reluctantly agreed to come. “It’s not like I’m drinking anymore” he said, “so really, we’re fine.”

That’s when I heard the first damaging assumption: “Things are OK as long as there aren’t any BIG problems, such as addiction, adultery, or abuse.” WRONG. Certainly, those issues are significant, but marriages fall apart on far less. Bad habits such as under-appreciation, frequent exits, chronic complaining, and gradual distancing are the more frequent causes of death for a marriage. The four horsemen of John Gottman’s book, 7 Principles for Making Your Marriage Work, speak directly to this assumption.

In the course of the intake, I asked George if he loved Melissa. Melissa looked up expectantly, waiting for his answer. He replied, “Well, sure, she knows that I do. It’s not like I need to tell her every day.” Melissa sat back, deflated.

That’s when I heard the second damaging assumption: “My spouse knows that I love him/her. I don’t need to say it regularly.” WRONG. An important part of being in a romantic relationship is making sure that your partner knows, every single day, that you love him or her. Some people want to know this in words; others prefer that the message is communicated by actions or touch. Know how your partner wishes to receive your love message. This assumption is the topic of Gary Chapman’s book, The Five Love Languages.

Melissa and George had arrived at a place in their marriage where they simply didn’t understand where the other was coming from. They both felt stuck and unappreciated.

They were also holding on to the third relationship-eroding assumption: “My partner must have the same emotional needs and communication style as I do.” We all have unique neurological, biological, and social differences. And there are some dramatic differences between men and women in how they cope with stress, communicate their feelings, and get their intimacy needs met. Acknowledging and accepting the ways in which your partner is different from you is a crucial step in making your relationship work. John Gray has helped millions drop this assumption through his book, Men Are from Mars, Women Are from Venus.

It was the collapse of the fourth and fifth assumptions that finally brought this couple to counseling. But other couples need to be on guard. The fourth common damaging assumption is: “I know how my partner is feeling about our relationship.” MAYBE, but you need to find out for sure. Just because he or she isn’t complaining all the time doesn’t mean he/she is satisfied. Take up the habit of asking your partner: “Are you happy in our marriage?” “Is there anything that I can do to be a better partner?” Don’t wait until your partner drags you to marriage counseling to discover that he or she is unsatisfied. Conscious Loving, by Gay and Kathlyn Hendricks, is an example of a book dedicated to communication antidotes to this crippling assumption.

The fifth relationship-damaging assumption is: “We will never get divorced.” WRONG. A high percentage of people in divorce courts never thought they’d be getting divorced. Believing that it can’t happen to you can lead to your becoming apathetic, complacent, and lazy. You begin to take your partner for granted. Instead, knowing that time is finite (either because divorce or death might be looming), you begin to treat the relationship with TLC. George and Melissa already knew that their relationship was subject to separation.

However, once they realized that their assumptions had led to unhealthy and hurtful habits in their relationship, they began to turn things around. George, upon hearing that Melissa wasn’t feeling loved, became open to new ways of communicating to her. Melissa responded to his attention so positively that it was easy for them to embrace each other’s differences and develop new habits that eventually evolved into a whole new way of being with each other.

It is hard to be fully invested in a relationship if you’re already thinking about the messy ending. You are right about the statistics—many marriages do end. There are no guarantees. I do know that very few people go into a marriage with the intention of getting a divorce. Marriage is a leap of faith. It seems pretty clear that you are not ready to make that leap right now—and that’s OK. It’s good to know that is where you are.

What I think is interesting is that you say that you are fine with long-term commitments or even one life-long commitment. I’d be curious to know more about why that feels safer to you than marriage. The “split” rates for relationships are higher than for marriages. There are even fewer guarantees in “nonbinding” (for lack of a better term) relationships. The risks of not being able to trust, of being hurt, of friends taking sides are just as high. If you were to have children with a lifelong partner outside of marriage, custody issues would still be present; they would just look slightly different. You’d still have to figure out dividing up shared stuff (possibly even your home). There are even fewer guarantees in this kind of relationship, yet something about not being legally bound to another person seems less risky to you.

I wonder if the issue may not actually be the act of marriage, but the level of trust required to risk committing yourself fully to another person. It is not unusual for children of divorce to struggle with that trust. They experienced firsthand how marriages can end. It can profoundly impact their feelings of safety and security and limit their willingness to trust in others. You say that, right now, it feels like you have to choose between a very scary “risk-it-all” approach or be doomed to a life alone. There is definitely a middle ground which can allow you meaningful relationships without such high levels of fear. I strongly encourage you to explore these feelings with a therapist in your area.

Best of luck,
Erika

How an individual perceives time affects how they plan for a particular action and what behaviors and steps they will take to complete that action. Research on time deficits and impairments in time perception has suggested that people with mental illness and psychosis may have a disrupted and distorted sense of time.

In particular, the research on schizophrenia has proposed that time processing deficits can lead to confusion, hallucinations, and delusions. The existing data on time processing and schizophrenia points to a disrupted internal clock which causes individuals to overestimate and underestimate time in certain tasks. However, to date there is little evidence linking symptom severity and time alteration in people with schizophrenia.

To add to the existing literature on time processing impairments and to further explore how symptoms severity may impact any time deficits, Jutta Peterburs of the Institute of Medical Psychology Systems Neuroscience at the University of Muenster in Germany recently led a study involving 22 individuals with schizophrenia and 22 without. The participants were instructed to estimate the time it would take for certain stimuli to reach targets. The tasks were designed to be of varying levels of cognitive demand so that Peterburs could determine if cognitive load was a factor in time processing impairment.

The results revealed that the participants with schizophrenia underestimated the time it would take for the stimuli to reach the targets. Those with more severe symptoms had the highest level of time processing impairment, especially on the most cognitively demanding tests. Peterburs believes that these findings clearly demonstrate a link between symptom severity and both predictive and anticipatory time perception in schizophrenia. This deficit is further exacerbated by symptom severity and difficulty of task.

Other factors may influence these findings, such as medication, age, gender, and length of illness. However, Peterburs did not isolate any of those factors. Future studies will have to investigate to what extent temporal processing in schizophrenia is modulated by antipsychotic medication,” added Peterburs. More specifically, future work should look at how antipsychotic medication influences the internal clock and dopaminergic dysregulation, a process that influences time perception. Until then, the findings presented here offer more support for impairment in time processing that could have a cause and effect influence on symptoms of schizophrenia.

Reference:
Peterburs, J., Nitsch, A.M., Miltner, W.H.R., Straube, T. (2013). Impaired representation of time in schizophrenia is linked to positive symptoms and cognitive demand. PLoS ONE 8(6): e67615. doi:10.1371/journal.pone.0067615

Food Selectivity vs. Picky Eating

Food selectivity is NOT just being a picky eater. Plenty of people are picky eaters. However, when push comes to shove (or when they are hungry enough), they will eat whatever food is available. When a child is a selective eater, he or she will eat only certain foods or strictly avoid foods and will not vary his/her diet without extraordinary intervention. It can get to the point that the child makes himself/herself sick. A child may not eat unless preferred foods are available. For parents of selective eaters, this can make mealtime a stressful and challenging time.

Examples

In my 15-plus years working and living with children with autism, I have seen food selectivity in action a number of times. One time, I was consulted about a young girl whose diet consisted entirely of McDonald’s chicken nuggets and fries. That was all she would willingly eat. To keep her child fed, her mother would buy four servings of each from McDonald’s at lunch time. She would reheat one serving at dinner and pack one for school in the morning. She did this seven days a week. Any attempt to try to get her child to eat anything else resulted in severe tantrums and aggression. To put food that wasn’t chicken nuggets or fries in her mouth practically required holding the child down and force-feeding her. The team I was on helped craft a behavior support plan geared toward decreasing tantrums around mealtimes and increasing acceptance of novel foods. It took a couple of years and a lot of hard work to change her palate and get her to eat a more balanced diet.

Another child I worked with was my foster child. He came to us at 6 years of age. We were told his diet consisted of the following: round cereal, chicken nuggets, fries, and grilled cheese sandwiches (we quickly learned he didn’t like grilled cheese). I remember putting a sugar snap pea on his plate with some chicken; he started screaming and threw the plate of food across the room. Basically, if we tried to feed him anything grown from the earth that wasn’t fried first, he would reject it. His diet was high fat, high starch—what I lovingly call the autism diet. Not only was his diet restricted, he had severe gastrointestinal issues due to high levels of lead in his blood (which can lead to constipation) combined with a family history of constipation issues. For him, a balanced diet rich in high-fiber vegetables was not merely a good idea but a necessity. I crafted a behavior-shaping protocol geared toward getting him to accept new foods and we worked on it for years. It was slow and frustrating, but we made progress. He is still with us today and now eats a fairly balanced diet. He has even learned to enjoy fresh fruits such as apples and oranges.

It’s Not the Result of Lazy Parenting

Some readers may be wondering if these issues are just a result of lazy parenting. The answer is a resounding no. Think about the aforementioned examples, and imagine each meal being a literal, physical fight to get food into your child. Imagine having to spend hours to get your child to eat a meal while he or she screams and yells and hits and bites you. Imagine doing this every day, several times a day. It might be a relief to find a couple of foods your child will eat. Having a quiet meal might be an incredible gift.

I know a lot of parents of special needs kids, and very few are lazy. They are simply dealing with problems that go far beyond what many parents have to face with neurotypical children.

Treating Eating Issues Is Autism Treatment

After my success with my son in getting him to eat better, I attended a conference about eating issues in autism. The presenter was a national expert whose practice revolved around this issue. I was pleasantly surprised to find that the methods I used with my son closely mirrored what he did. One thing he said that resonated with me was that treating eating issues was autism treatment. The act of expanding your child’s palate addresses many core autism issues such as rigidity, tolerance of change, sensory needs, and improved health and wellness.

Why They Won’t Simply Eat When They Get Hungry Enough

I can’t say why, for sure, children with autism and food selectivity don’t simply eat nonpreferred foods out of hunger. What I know from treating my son and working with many other children is that these children will make themselves ill rather than willingly eat nonpreferred foods. One child refused meals for days just because the cafeteria switched butter brands and he didn’t like the new spread. Since he primarily ate half a loaf of bread with butter as the main part of his meals, we had to get ahold of surplus packets of the old butter spread and gradually get him to adjust slowly to the new spread just to get him to eat.

My son, despite painful GI issues, would not alter his diet from foods that made him sicker. He was never able to connect his stomach pains with his diet. It took extraordinary measures (and a great deal of time) to turn things around for him. The bottom line is that while a neurotypical child will probably eat differently when there is no other choice, children on the spectrum typically will not. This leaves their parents in a quandary—do they starve and harm their child to force compliance with a healthy diet or do they simply defer to the pressures of autism and give in to their child’s desires to get him or her fed? Luckily, there is a possible solution.

Expanding the Palate Teaches Flexibility and Tolerance

One of the hallmark issues of autism is a need for structure and sameness. Children on the spectrum simply do not do well with change. By treating food selectivity and teaching a child to accept new foods, we combat this need for sameness and introduce tolerance. Learning to like new foods expands the child’s sensory world in a positive direction.

Improved Health and Well-Being Decreases Challenging Behaviors

Food selectivity often results in a poor diet. Poor diet impacts one’s overall health and well-being. When one’s health and well-being are poor, it leads to feeling lousy. When a child with autism feels lousy, he or she tends to act out. By improving the child’s diet, you improve his or her health, which leads to feeling better, which reduces challenging behaviors.

The Basic System in Five Steps

Here is the system I developed to treat my son’s food selectivity issue. I was able over the course of about a year and a half to take him from eating four foods (round cereal, red juice, chicken nuggets, and grilled cheese sandwiches) to eating a wide variety of fruits and vegetables and being willing to at least try bites of new foods. This system is based on sound principles regarding behavioral shaping.

• Introduce one food at a time: You don’t want to overwhelm the child with too much change at once. Pick a new food and work it until your child accepts it. Then introduce the next food. Usually after three new foods are successfully introduced, things accelerate quickly. In my son’s case, he suddenly started eating apples (a food we hadn’t introduced) and it became his new favorite snack.
• Small bites/alternate with preferred food: When you do feeding sessions with your child, introduce the food in small bites (microbites … no larger than a small pea). Alternate the new food with preferred foods. I find it helps to put the foods on separate plates so you can swap them out more easily.
• Ease into actually eating the food: Don’t insist on your child eating the new food at first. Start with having the child just be willing to pick up the food (let him or her look at it, sniff it, get used to it) before rewarding him or her with a bite of preferred food. Once that is accomplished, reward the child for putting the food to his or her lips, then for putting it on his/her tongue, then for putting it in his/her mouth (but not swallowing), then for taking a tiny bite, and so on until the child is able to eat a small portion of the new food. Always alternate between the new food and preferred foods. If the child starts to tantrum, use your judgement; if the tantrum is minor, wait it out. If the tantrum is major, end the eating session. Try again later when your child is calm.
• Frequent practice throughout the day—not just at meal times: Don’t practice this just at meal times. Add frequent small-snack practice sessions throughout the day where you do most of your work. In fact, it may be beneficial to do the bulk of your work during these practice sessions and present new food only during meal times with a little less pressure to eat it (so as to make sure your child is getting some nutrition at first). Just remember that the more your child is exposed to the new food, the sooner he or she will learn to accept it. Also, make note of foods your child is simply not accepting. If after a week or two your child is not showing improvement, move on to a different food. In my son’s case, he simply did not like corn. No matter how often we tried to introduce it, he would not accept it. We finally figured he was not going to like corn and focused on other foods.
• Collect data on progress: Make note of which foods are being introduced and when. Chart how many and what kinds of prompts are needed with each trial. By collecting this data, you can more easily track small progress. You can also catch things such as plateaus and reversals sooner and make crucial adjustments.

Final Thoughts

Think about how often we eat. If every meal is a fight, imagine how draining and demoralizing that might be for a parent. By utilizing this system, meal times can become less stressful and more pleasant. The act of treating food selectivity is an important part of autism treatment. It doesn’t take any fancy therapy (although working with a skilled behavior therapist can make the process go quicker and smoother) and is well within the realm of possibility for most dedicated parents. I welcome your thoughts and experiences with food selectivity and its treatment.

Remember, parents: You’ve got this!

Once, I invited someone to take my workshop and she replied, “Oh, I don’t need to take your right-use-of-power workshop. I won’t cause any harm because I have good intentions.” I want to talk about how good intentions are necessary but not nearly enough for ethical use of power.

The simplest reason is the profound fact that our impact doesn’t always match our intention. In the example described in this article, the therapist’s intention was to set good and ethical boundaries with her client. The impact on the client, as you will see, was that she felt hurt, abandoned, betrayed, confused, and wrong.

Other reasons include cultural differences, impact of the power differential, projection, shame, and trauma responses. These are subjects for another article.

In the paper the other day, I found a letter in the “Dear Abby” column that was a painful example of how good intentions plus lack of skill and awareness of impact can cause more harm.

A summary of the letter: The woman wrote about seeing a therapist for issues of abandonment and trust. They became friends outside of therapy. “I trusted her completely,” the writer wrote. “During our therapy sessions, she shared her life and problems with me to the point that I feel I know as much about her as she knows about me.” The therapist, after several years of therapeutic work, “suddenly decided that ethics had been breached and that she was setting new boundaries.” The new boundaries were for no contact outside the sessions, but during their sessions, the therapist would cry and talk about how much she missed this client. Next, she abruptly decided that she could no longer be this person’s therapist. “Now, she has blocked my number and expects me to respect her demands.”

We can guess that this therapist did the technically right and ethical thing: She set appropriate boundaries, and then when she realized that she was being unethical even in the boundaried sessions, she set another appropriate boundary and stopped seeing the person entirely.

However, although her actions were correct, they certainly were not skillful or compassionate. A skillful and compassionate therapist would have recognized that the client’s issues were about abandonment and trust, which would make the separation process especially delicate. The therapist would have apologized for her behavior in participating in a dual-role relationship and made it clear that this was her big mistake and her responsibility and not the client’s fault. She would then have carefully and personally referred the person to a trustworthy new therapist. It was her responsibility to resolve and repair this misuse of her power. It seems that she thought that setting the right boundaries was all that she was required to do to be ethical.

She seemed to have imagined that because this was a mutual friendship, both she and her client would take equal responsibility for managing their grief and loss. When there is a difference in power, the responsibility is not equal. I call this the 150% principle: Both parties are 100% responsible for the health of the relationship, but the person in the up-power role (the therapist, in this case) is 150% responsible for tracking problems and resolving and repairing them.

When there has been a relationship rupture, there are five things that most people need in order to feel resolved. They may need just one or as many as all five of these things:

1. Acknowledgment: They want their experience acknowledged, understood, validated, and empathized. They want to be appreciated for their courage.
2. Understanding: They want to know what happened, or what your intention was.
3. Regret: They want a genuine apology, or an authentic expression of your sorrow or regret.
4. Learning: They want reassurance that you’ve learned or understood something about yourself or how to better care for them. (This one was a surprise to me. People are extremely generous when they feel that their pain has served some good or some learning that will prevent future problems.)
5. Repair: They want to reconnect and participate in repair of the relationship or in gaining clarity and letting go. (This one was also a surprise. It is a rare and amazing thing to hear that the person you are in conflict with actually wants to repair and be reconnected. Often just asking that question is repair.)

We all make mistakes. Had this therapist known about the difference between intention and impact, the 150% principle, and how to link power with heart, her client would not have felt so confused, hurt, and wrong; would not have had another abandonment and trust wound, and would not have written to “Dear Abby.” Doing the right thing without compassion and skill can cause more harm.

Maybe there’s some wisdom for you, too, here. Having a good intention is ALWAYS a good thing, but in human connections, your actual impact is what most needs your attention for the well-being of your relationships.

The impact of late-life parental divorce on adult children—an area of divorce that historically has received near-cursory attention but is gaining steam among researchers—is unique for each individual and varies from minimal to severe. Multifarious factors affect impact of divorce on adult children. Why does parental divorce barely throw one adult child off balance, while another adult child is powerfully impacted, perhaps altering ability to function?

This is a complex question with no single answer. One way to think about this is to look at the relationship between impact of divorce on adult children and development of ego strength. A 2012 doctoral dissertation collected data from 167 qualifying participants and found a significant relationship between two ego strengths and impact of divorce on adult children (Murphy). Using Erik Erikson’s theory of human development in eight life stages and corresponding ego strengths, data show an inverse relationship between two specific Eriksonian ego strengths: competence and love. What is ego strength and how are competence and love defined as ego strengths?

Erikson (1902-1994), a developmental theorist and ego psychologist, defined the ego as malleable rather than fixed. According to Erikson, in addition to working as a mediator between impulses (id) and moral beliefs (superego), the ego absorbs attitudes and skills as an individual develops. As individuals pass through life stages, conflicts arise. Resolution of conflicts, or crises, is again unique to every crisis and every individual, meaning that two people may experience the same event at the same time in their lives and experience very different resolutions. Unresolved crises at any stage of life potentially reactivate when a new crises emerges. A basic conflict is resolved along a continuum from positive to negative, which in turn influences outcome (Berk, 2010). Erikson’s life-stage model was built on optimism. Optimism because his theory suggests individuals can always go back to earlier crises and rework a better resolution and stronger ego strength.

Within Erikson’s framework, the ego is a mediator that absorbs individual culture, and it is malleable. For each of the eight life stages, there is a corresponding ego that develops. Stage four of psychosocial development is between approximately ages 6 and 11 years old, when a child begins to develop awareness of certain skills and knowledge. At school, a child will begin to develop capacity to cooperate and work with peers and adults. New skills are tried out. A sense of competence begins to emerge if the child feels success. Alternatively, a sense of inferiority may emerge if the child’s efforts are negatively experienced at school, home, or with peers. Again, there is a continuum from positive to negative outcome. Competence is Erikson’s ego strength that evolves at this stage. In the 2012 doctoral dissertation study of the relationship between impact of divorce on adult children and ego strength, there was a significant relationship between competence and impact of divorce. That is to say as scores on competence increased, impact of divorce decreased.

Erikson’s stage six of development is during young adulthood, ranging from about age 19 to 40 years old. This is the stage where young adults begin to establish intimate ties to others. While close relationships may have been present in adolescence, it is at this stage where selflessness develops along with mutuality and commitment. It is at this stage of young adulthood where Erikson’s ego strength love develops. This is when a mutually intimate relationship endures disappointment. Intimacy can be at risk if there are earlier disappointments in relationships. Again, in the 2012 doctoral dissertation study of impact of divorce and ego development, as scores on love increased, impact of divorce decreased. Inversely, as scores on impact of divorce increased, scores on both competence and love decreased.

So what does all of this mean? It is a first step in understanding variances in impact of divorce on adult children. No known previous studies on the relationship between impact and ego development means this is a fertile area for much more research. In the meantime, the 2012 study is a step toward understanding and validating the adult child’s experiences when his or her parents divorce. It opens the door to understanding how impact on adult children is a continuum from no meaningful impact to severe.

Demographic results from the 2012 study show that of the 167 participants, more than 83% reported their parents being married between 25 and 39 years. With a minimum age of 23 years at the time of their parents’ divorce as a requirement for study participation, 54.5% were between the ages of 35 and 59. As a testament to the significance of their parents’ divorce, 17 participants who completed the survey were between the ages of 50 and 59.

For psychotherapists, this study affords a perspective on the significance of parental divorce in adult years of the child. It can be a reminder to not fall into common assumptions about adult children and parental divorce. Looking through the prism of developmental theory, rich contextual information can be accessed and perhaps unlock a deeper understanding of how the past continues to influence the present.

References:

1. Berk, L.A. (2005). Infants and children (5^th Ed.). Boston, MA: Pearson
2. Murphy, M. (2012). Parental divorce: Relationship between ego strengths and impact of divorce on adult children from an Eriksonian perspective (Doctoral dissertation).   Retrieved from http://library.argosy.edu

People in good relationships have developed the habit of looking out for their partner’s kindnesses and considerate actions. They succeed at preventing oversights and bad moods from interfering with their affections. When this “positive perspective” is not present or insufficient, couples are more likely to have trouble managing conflict, maintaining a sense of the relationship being in their own best interests, or gaining shared meaning from their involvement.

A state of “positive sentiment override” creates an atmosphere that allows couples to handle difficulties and stress while continuing to feel they are on the same side. Couples who offer consistent support to each other experience a connection that sees them through even when they are rushed, cranky, or feeling harried.

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Negative interactions predictably breed more negativity. This positive state of sentiment override develops when couples have a strong enough friendship to overlook or shrug off moments of irritability or distraction.

For example, when one partner is facing a tough meeting at work, the other person texts afterward to ask how it went. Later at dinner, when it turns out the partner who sent the text forgot to pick up a key ingredient for the meal, the couple solves the problem together and comes up with a different menu.

However, when one person goes off to work after mentioning it will be a difficult day, and he or she never hears from the partner nor is asked about his or her day upon getting home, it becomes more difficult to be understanding when the partner said he or she would stop at the store and yet neglected to buy something important. Then the person who had the hard day at work is more likely to think, “My partner is basically a selfish person.” That thought creates emotions that lead to criticism and bickering instead of mutual support. Each person ends up feeling alone and unhappy.

Of course, this is just one mundane example. Relationship patterns are made up of many interactions repeated over time. Any couple can fall into the kind of difficult exchange described here, but couples who function well can bounce back with statements such as, “I’m sorry, I screwed up. I forgot to ask about that meeting. My day ran away with me, too! Can we catch up now? I’ll pull a snack together for us.”

The danger of negative sentiment override is that the couple gets into a habit of failing to make these kinds of repairs to the relationship. Instead, each person retreats to a separate corner, each feeling self-protective and neglected. It becomes an uphill climb to re-establish positive sentiments when the negative experiences are repetitive. Members of a couple that loses positive perspective no longer naturally assume the best of their partner’s intentions; instead, they ask fewer questions, talk less with each other, and attribute negative motivation to their partner.

Our minds are built to seek evidence for the way the world looks to us, and we operate with many mental filters all the time; otherwise, we would be completely over-stimulated and would never get anything done. When one or both partners begin viewing the relationship through a negative lens, it is always easy to find evidence that our parent is a flawed and imperfect human being. We are more likely to notice the coffee grounds spilled on the counter, lights left on, and to resent the inevitable accommodations we have to make in order to live with another person. Says Dr. John Gottman: “I was not able to crack the code to saving marriages until I started to analyze what went right in happy marriages.”

Wow. It sounds like you feel like you’ve really had the rug pulled out from under you. It’s certainly understandable; you’ve had daily contact for three years and it has suddenly ceased. The sense of loss you are feeling is likely compounded by how literally life-saving this communication was for you. The absence of it seems to have left you feeling very alone in dealing with a tremendous amount of anxiety. You indicated that your therapist believes that you are ready for this, so I’m wondering if the two of you have discussed the possibility of this uptick in anxiety and created a plan for handling it. If not, it might be helpful to spend some time talking about this in session. While it might very well be time to eliminate this particular source of support, it makes sense to have some strategies in place to fill this void.

The therapeutic relationship that forms between a client and a therapist is a very special and unique relationship. It is healing and powerful and not at all a fantasy. From what you have said, I feel confident that your therapist does care very much about you—daily emails for three years certainly provide supporting evidence. While you did not conjure up a fantastical relationship where none actually existed, you experienced a heightened version of this already unique relationship. The therapeutic relationship is different from any other kind of relationship, in part, because it is so one-sided. The relationship is designed for the sole purpose of helping the client. Because you were suicidal, you needed even more from your therapist than someone who was not suicidal, and you got more in the form of daily emails. Now that you have made so much progress and the suicidality has abated, your therapist has eliminated the additional support that was needed to get you to where you are today.

Finally, you mention this change in the relationship is tapping into some abandonment issues. While it certainly doesn’t feel like it now, this could be a wonderful opportunity. You see, your therapist has not abandoned you; she is still there for your weekly Monday sessions. She is still there to help you through this transition, and she is still there to help you process the issues of abandonment that this is bringing up for you. Because you have faced so much abandonment in the past, you might see it in the present where it doesn’t really exist. I wouldn’t be surprised if exploring this with your therapist and coming to terms with it is one of the final steps in healing from the abandonment in your past.

Sincerely,
Sarah

Extraordinary marriages don’t happen by accident. They’re created by partners who understand that relationships take work.

When you were young, did you dream of finding your one true love and living happily ever after? Did you think your prince (or princess) would come knocking on the door and sweep you off your feet?

I know I did. I instinctively knew my love and I were going to be the cute old couple, twinkles in our eyes, walking down the lane. What I’ve discovered since then is that extraordinary partnerships don’t magically happen; they are created!

With 25 years of experience doing marriage and relationship therapy, Bob and I have learned what couples do to create an extraordinary connection that lasts “till death do us part.” Couples in our practice who thrive and grow deeply intimate relationships have three essential keys in common. Here they are:

1. Extraordinary couples consciously and actively co-create their relationships. Most couples marry at the height of feeling emotional and erotic love for each other. Partners have a strong and deep connection, and similar dreams about their future. They are sexually active and very much enjoying their physical relationship. Having found “the one” who will make him or her happy for the rest of his or her life, they take it for granted that these loving feelings, emotional and erotic, will always be there. It’s so natural! Isn’t that how it’s supposed to be?

If that were true, we would have a lot fewer divorces. The problem is not that a lifetime of love is impossible; it’s that most people believe or expect that their connection will last without working at it. Nothing could be further from the truth. Most of the couples who see us have insidiously drifted apart because they did not know this.

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Extraordinary couples understand that they will succeed only if they consciously choose to make their relationship the highest priority, they commit to doing the work, and they actively love each other. They work on accepting and accommodating their differences. When problems arise, they turn toward each other instead of away to a friend or family member. They seek out resources and help, like counseling, when they get stuck and can’t resolve issues.

2. Extraordinary couples compassionately understand themselves and each other. Partners may come to a relationship with little or no understanding about their baggage, such as how their background and upbringing may create problems in their relationship. Whether she knows it or not, the woman who grew up abandoned by her father will undoubtedly at some point feel abandoned by her husband—like when he wants to go away with the guys for the weekend. She may experience strong anxiety about him leaving and not recognize that the strength of her fear is due to her “baggage” sneaking up on her. Not understanding how her history is being triggered, they fight about him going away without her.

Extraordinary couples are aware of the baggage they bring to their relationships. They are sensitive to their partners’ history and support each other when baggage gets in the way. They express empathy, understanding, and gratitude to each other and don’t take each other for granted. When conflict arises, they own their part of the problem, work through it as a team, and are able to apologize and forgive.

3. Extraordinary couples are vitally connected in head, heart, and hormones. In the beginning of relationships, most couples have a balance of the “head, heart, and hormone” connection—which is to say they are doing a lot of communicating, expressing their feelings to each other, and having sex. After marriage, when couples get busy and have less time, and especially after children, these connections may start to fade, and unless the couple nurtures them, they may slowly starve to death. The marriage unwittingly becomes last on the list, couples begin to take each other for granted, and they stop actively loving each other. We often hear presenting issues such as:

• “I feel like we are just roommates. We get along but don’t have sex.”
• “I love her, but I’m not ‘in love’ anymore.”
• “We have nothing in common but the kids.”

Extraordinary couples nurture and grow their communication, their loving feelings for each other, and their sexual connection. They make time to talk assertively and actively listen, and they embrace and manage conflict. They learn each other’s love languages and create romantic situations that stoke their sexual attraction. They create time for the relationship away from children and make sure nothing intrudes on the couple’s boundaries.

Having a lifetime relationship takes a tremendous investment of time, energy, and emotion. No one tells us this when we get married. That’s likely part of the reason about half of marriages fail. If only we were given the job description and understood what it takes, maybe we could decrease that percentage.

How does your relationship rate in the three areas above? Share this with your partner and then get to work on creating your extraordinary relationship. We are here to support you.

Researchers have determined that at least two violent video games, Grand Theft Auto and Call of Duty, seem to have relatively no negative impact on prosocial behavior. Unlike Donkey Kong and Frogger, two tried-and-true nonviolent games that have raised virtually no concern with regards to violent behavior and prosocial attitudes, the onslaught of extremely violent video games that has taken over the thumbs and minds of today’s youth have been troubling parents and social critics for years.

Grand Theft Auto and Call of Duty are two of the most commonly played and criticized. Critics of the games point to research that suggests these activities increase violent behavior in children and decrease social empathy and awareness. But according to a new series of studies conducted by Morgan J. Tear of the School of Psychology at the University of Queensland in Australia, these games have virtually no negative effect on prosocial behavior at all.

Tear performed three separate experiments on a sample of young people to determine how the type of game and the length of playing time would affect prosocial attitudes. After several tests, the participants playing the violent games had almost identical social responses as those playing nonviolent games. When Tear compared the prosocial attitudes of participant after playing classic versus nonclassic video games, the results were the same. Finally, when duration of play was assessed, there were no social attitude differences between those participants who played for short periods of time and those who played for longer durations.

Another interesting finding was that even though the participants’ social attitudes were tested against strangers, they were still deemed prosocial. This finding contradicts existing research that suggests individuals maintain higher prosocial attitudes toward familiar individuals like family members and friends when compared to strangers. Although the findings of this research do not support the theory of antisocial attitudes resulting from violent video games, Tear does not believe public concern is completely unwarranted. “Research on the effects of video game play is of significant public interest,” said Tear. “It is therefore important that speculation be rigorously tested and findings replicated.”

Reference:
Tear, M.J., Nielsen, M. (2013). Failure to demonstrate that playing violent video games diminishes prosocial behavior. PLoS ONE 8(7): e68382. doi:10.1371/journal.pone.0068382

Editor’s note: Tammy Nelson, PhD, is the author of The New Monogamy and Getting the Sex You Want. Her continuing education presentation for GoodTherapy.org, titled Couples in Recovery After Infidelity: Creating a New Monogamy, is scheduled for 9 a.m. PDT on September 6. The event is good for 1.5 CE credits and is available at no cost to GoodTherapy.org members. For details, or to register, please click here.

“Lovesickness” means you have fallen hard. Or perhaps you love someone you can’t have. Or, worse, you have lost someone you desperately want back.

Being lovesick hurts and feels awesome at the same time. It is a romantic stage of love, a feeling so familiar because we see it in seemingly every movie, hear it in seemingly every song, and read it in seemingly every poem. Lovesickness is common in every culture in the world. In almost every story ever told, in every Disney movie, and in every vampire novel, there is an undercurrent of love or loss of love. Our longing for love and the “sickness” that comes from falling in and out of it are what make up our idea of romance.

Longing—the desire for another—and the terrible and obsessive feelings it brings are what we learn from an early age to expect when we fall in love. Wanting or longing is our cultural imperative. I want what I cannot have, either because you are from the wrong side of the tracks, the wrong family, I am alive and you are dead, or some variation on the theme. In the end, we find each other somehow. Love always prevails, and we are happy, even for a moment. When love is lost, we cry and the world cries with us. The loss of love is a universal pain, as is the joy of finding it.

New love can feel like addiction. If you put someone in an MRI machine when they are newly infatuated and look at his or her brain scan, the same portions of the brain light up as those that are triggered when high on cocaine. When in romantic love, or the limerence phase, the brain is overloaded with dopamine and norepinephrine production, which creates symptoms similar to obsessive compulsion. They include sleeplessness, restlessness, and obsession. Impulsive behaviors such as driving by the lover’s house, or sleeping with the phone waiting for a call, seem illogical. Longing to be with that person all the time, regardless of other responsibilities, precludes all logical thoughts. People with lovesickness often experience intense sexual feelings for that person and can feel desperate to see the person and to touch him/her constantly.

We may feel intense grief, frustration, and sadness when we can’t be with the person. When we get scared and worry we are losing our love interest, we might actually become physically ill. Depression can increase, and cravings for things such as ice cream or chocolate are common due to the serotonin levels changing in the brain. When our brain chemicals are disrupted, if our love object breaks up with us or if we are separated during this falling-in-love phase, we might become more obsessive and do things we never dreamed of, including parking in their neighborhood or outside their homes. At this point, those who are more unstable might even turn dangerous, breaking into homes, stealing belongings, or checking computers and phones. Jealousy, intense suspicion, and even violence can increase in people who have these tendencies.

If the relationship continues in a normal, happy way and real love kicks in, the relationship moves into the attachment phase. Dopamine levels in the brain begin to level off. Both people start to relax as levels of oxytocin and vasopressin increase. These chemicals make us want to bond, to cuddle, and to stay home. We stop wanting to see friends or even leave the house. Sex wins out over socializing, and if we’re not careful, we might get married and begin procreating.

Being lovesick can cause great surges of creativity. Some of the greatest songs in history are written at times like these. Creative urges are strong at times of real lovesickness; poets, writers, and artists have known this for ages. Sublimation means turning intense emotions into something else. If you are lovesick, now is the time to write, sculpt, sing, or even start a new workout routine. This will help you take all of the intense energy in your heart (and brain) and channel it into something that will benefit you. Start a journal and write about your feelings. Two years from now, you might read it and think, “Ugh … what was I thinking?” Or you may find you have a wonderful new romantic novel or beautiful new love song.

Does menopause or a hysterectomy quash or quicken your sex life? This question applies not only to those of us who might face these, but also to the romantic partners who love and live with many of us. Since our most important sexual organ is between our ears and not our legs, I believe our interest in sex (libido) is largely dependent on our beliefs about sex and what we can and should expect.

In my practice, I work with many older women who have read about increasing their estrogen levels in order to improve their sexual experiences and increase their sexual desire. Some swear by bioidentical hormones, while some declare that testosterone (T) is their favorite “hormone of desire.” (Susan Rako’s popular book bearing this title swears by T, but she backs her theory with personal anecdotes and no scientific data whatsoever.)

In 1985, researcher Barbara Sherwin wondered if lack of testosterone caused problems with libido. She discovered that administering T to women who had undergone hysterectomies enhanced the intensity of their sexual desire and increased frequency of sexual fantasies. But there was no evidence the hormone had affected their physiological response, so its effect was more motivational than physical.

There have been few well-designed studies of sexual interest in healthy people. Most studies of sexual problems have come from women who consulted their physician because of some health concern and thus had issues of some kind already. When well-known sexologist Alfred Kinsey and his colleagues spoke to women throughout their life cycles, they found that as age increased there was a distinct decline in the frequency of intercourse. But there was no decline in solitary self-pleasuring until well after age 60.

Among people I’ve talked to about sex, I’ve found over the years that men report a greater loss of sexual interest between 45 and 55 than women do; perhaps that’s why some of these women are masturbating! Many women over the course of menopause do report some decrease in intercourse and vaginal lubrication, but not in solitary sexual enjoyment when utilizing one of the many intimate lubricants available. Hooray for the slippery stuff!

A high percentage of our feelings about sex are determined by the culture that surrounds us. I once read about a study of aging women in a small village in Thailand. Some of them experienced a decline in libido, but they celebrated this, perceiving it as a welcome release from having to worry about sex. So while uterine changes may cause some lessening of sexual desire, not everyone experiences it and not everyone who does experience it considers it a problem.

I once worked with a young, single woman who underwent surgical menopause when she was in her late twenties. (I don’t recall whether her ovaries were removed.) She initially lost interest in sex, but when she regained her libido she began to lament that men were no longer interested in dating her. She would sit in my office and weep: “I’ve lost my mojo!” I scoured professional journals and spoke to colleagues about how the surgery might have affected her level of sexual attractiveness or desirability, and finally read about a study of monkeys that showed that males were no longer attracted to females who had hysterectomies. But when vaginal secretions containing pheromones from “intact” females were rubbed on the ones who had hysterectomies, males regained interest.

Pheromone secretion aromas are sexually stimulating, and after hysterectomy they are no longer produced in females. We do, of course, need to be careful about drawing conclusions about human sexuality from animal studies such as this, since so much of our sexuality is psychological and sociological. But popular magazines have recently published findings that seem to show that men “rate” women they’re watching on video who are ovulating as “more attractive” than women of a similar age and appearance who are in other stages of their menstrual cycle.

However, it isn’t as simple as no womb, no pheromones, no sex. Many older women are seen as sexy and are enjoying as much sex as they want. I guess we’re more complicated than monkeys!