Disasters often have a human component, including New York’s World Trade Center on 9/11 [1], the death of a teenager following misuse of alcohol [2], mass shootings [3], and, in the day before the writing of this article, the explosions at the finish line of the Boston Marathon [4]. Elsewhere, you can read about many themes that relate to dealing with a disaster, such as being prepared [5], responding to a crisis [6], dealing with the broader impact of the disaster [7], speaking to children [8], recovering from the damage [9], and living in the world after a disaster [10].

These all provide things for therapists to be on the lookout for or even to actively explore. These explorations are appropriate in different ways, regardless of whether the person was a primary victim or near-victim of the disaster, connected to such a person, or just someone who has learned of the event through media or social circles. Exploring a person’s initial reactions to a disaster can provide insight into some dimensions of his or her spirituality.

Regardless of how easy it is to immediately determine the cause of the disaster, what is the person’s first reaction? Does he or she see the blame for the disaster as being human, as being natural, or as being related to God (or some other power that is greater than human or natural means)? This blame can be seen in the statements and questions that go through the person’s head—both immediately and as a better understanding is sought. This reveals significant information about the person’s spirituality.

The cause that is “blamed” for the disaster speaks to the belief structure that the person views the world through. It determines how he or she has been viewing established meaning. It also speaks to how the person perceives community, as well as how participation in community should be and how it is influenced. As he or she tries to make sense of difficulties and seeks to resolve the current situation, does he or she look within or without for guidance? This speaks to fundamental ideas of how the world and activity within the world are ordered. While these are value judgments on the part of the individual that speak to the person’s beliefs and inform the therapist of where the person is coming from, the different choices each bring value and guide the therapist in different ways of being able to work with the individual. This guidance will apply not only in addressing this disaster but also in addressing unrelated issues with a spiritual component.

To the extent that the individual identifies with the human component of the tragedy, further information can be obtained about his or her fundamental understanding of the human state. Does the individual perceive humanity as being fundamentally good or fundamentally bad or evil? The implications of this belief reach far beyond the consideration of the tragedy. If the person focuses on the helping aspect of people around the tragedy, drawing on human goodness, then the person may be more open to help from others and more trusting in community. On the other hand, if the person sees the human contribution to the tragedy as being typical of humanity, the person may have a less favorable orientation to humanity—but this, in turn, may make the person more willing to accept his or her own flawed actions while acknowledging the need for significant effort to change how they interact.

When God is the focus of the blame, there are a number of ways this can manifest. From listening to the way the individual describes God’s role in the world and God’s relationship to human beings, significant elements of the individual’s spirituality can be discovered. Does the individual operate from a belief system in which God is active in the details of life, where God acts through individuals, or where God simply allows things to take place? Each of these has the potential of creating different experiences for individuals and for them to have different emotional connections to God and to actions in the world. Beyond this, depending on the belief structure implicit in the outlook, the individual may express different moral obligations toward things that happen in the world. As in other perspectives, the therapist should listen carefully for places where different parts of the answers are not rooted in consistent viewpoints, for these points are where there the possibility exists for future spiritual conflicts that can lead to cognitive or emotional difficulties.

In the United States, more than three-fourths of people reported believing in a personal God who answered prayers [11], so another aspect to look at is whether those who believe in God are able to question God. The spectrum for this response goes from those who see no reason to question God because God is irrelevant to the situation, to those who see no reason to question God since our questioning of God would have no effect, to those who think about questioning God but believe that doing so would be inappropriate (and thus wrong or sinful), to those who question God without necessarily expecting a response, to those who question God expecting an answer, and finally to those who feel that they can engage God in a dialogue or debate as they wrestle with the issue. Each of these positions gives the therapist insight into what the individual understands as the balance of authority between himself or herself and God. Further, the therapist can get insight into whether it will be helpful in other situations for the individual to include God as something that is addressed in the wrestling around the new situation.

While a therapist may initially focus on theodicity as the central spiritual issue when an individual faces or accounts an aftermath of a disaster or other tragedy, this situation can provide insight into many dimensions of the individual’s spirituality. Much of this can be determined by simply listening to the account (and later checking to see if what is learned applies in a new situation) rather explicitly focusing on it. While these aftermaths are often challenging for individuals, a therapist can gather important information while still helping the individual to deal with the current tragic situation.

Prospective memory describes the ability to remember to do something in the future, like go to a doctor’s appointment or attend a meeting. Research on attention deficit hyperactivity (ADHD) in children has shown that deficits exist in numerous areas of cognitive functioning and behavior control. In fact, behavioral and cognitive difficulties appear to be equally pervasive in children with ADHD. However, as children mature, they overcome the challenges they face with behavioral issues, but cognitive obstacles still exist. Adult ADHD is thought to affect cognitive tasks such as planning, shifting attention, and other executive functions. But the influence of ADHD on prospective memory in adults is still unknown.

Anselm B. M. Fuermaier of the Department of Clinical and Developmental Neuropsychology at the University of Groningen in the Netherlands recently led a study that looked at which prospective memory deficits were present in a sample of 45 adults with ADHD. The participants, who were not on medication for ADHD, were presented with a paradigm that required they plan for, initiate action toward and execute an act in the future. Fuermaier compared the performance of the participants with ADHD to that of 45 non-ADHD adults throughout the process and found several differences.

The biggest deficit that appeared in the ADHD participants was in the area of planning. They made less detailed plans and planned less for multiple future events than the control participants. Initiation of the plan was another area in which the two groups differed significantly. Although both groups were able to recall an impending event, the ADHD participants had difficulty initiating their action plans. “Prospective memory is crucial for everyday occupational and social functioning,” said Fuermaier.  Not only is it essential in order to complete most activities related to work, family, and social interactions, it is also critical to treatment. Clients who cannot remember to attend therapy appointments or who forget to take their medications at designated times are at risk of experiencing worsening symptoms. This can result in negative outcomes such as physical illness, job loss, and relationship conflict that can ultimately increase stress. Overall, this research shows that prospective memory deficits exist in adults with ADHD and addressing this should be part of any treatment program.

Reference:
Fuermaier, A.B.M., Tucha, L., Koerts, J., Aschenbrenner, S., Westermann, C., et al. (2013). Complex prospective memory in adults with attention deficit hyperactivity disorder. PLoS ONE 8(3): e58338. doi:10.1371/journal.pone.0058338

The process of divorce is hard enough, but when you have to co-parent with an ex who has become the bane of your existence, things can get worse. Some parents become better at being caregivers after divorce because they find their own voice and style outside the relationship. Others transform into an unrecognizable version of themselves, making parenting a horribly intolerable experience. Either way, when you can’t stand the person you are parenting with, life can become a drag, and the battle becomes exhausting.

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If you are struggling to co-parent with an ex you despise, here are five tips to help you manage the experience:

1. Reduce your ex-pectations:

Expecting your ex to be the kind of parent you need him or her to be creates frustration and disappointment. While some exes flourish as parents after divorce, others become ornery and annoying. The rule of thumb is to expect no more than the ex was doing in the marriage, and brace for less now that he or she has other priorities. Even if you think he or she should be doing a better job, remember that it’s not up to you to police your ex’s parenting.

2. Try not to be a hater:

Hate is a very strong word, but when it comes to an ex, there may not be a lot of other words (that we can use here, anyway) to describe the level of negative feelings you might have. However, to hate causes YOU stress and makes it hard to parent effectively. Get some professional help to move from hate to tolerance to see if that makes co-parenting any easier.

3. Look through your child’s eyes:

You are most likely making your children the priority when it comes to co-parenting, but sometimes the mind can become clouded with negativity. Empathy is a great stress reducer, and it can really help to shift a detrimental perspective. Try to see your ex through your children’s eyes, a view that is most likely idealized and positive. Children will do anything to maintain an attachment to a parent, even in the face of horrible behavior. You can learn from their innocence.

4. Let go of control:

Co-parenting with an ex is one big lesson in letting go. You may not approve of your ex’s parenting style or what he or she does with the kids during their time, but this is mostly out of your control. If your ex is stonewalling you and refusing to share information about your child’s well-being, you need to manage that anxiety. Your ability to relinquish your illusory power will not only reduce your frustration and stress, it will open space for you to enjoy your time alone. You cannot change your ex with your will and desire to be right. You can only model with the hope of being a positive influence.

5. Value your influence:

Having your kids half the time (or sometimes less) may invoke a feeling of powerlessness with regard to your parental influence. All parents worry about scarring their children emotionally, and divorced parents may fear that the parenting going on in the other home may damage their little ones. If you are a parent who dreads letting your kids go with your ex, or who is concerned about your lack of authority, try to remember that whatever you are doing will be enough. If there is another (or new) partner involved, stay grounded in the fact you are the primary parent and no one can replace you.

Your children love you, are attached to you, and need you to be strong and centered as the “good enough” parent that you are.

There is a growing body of research that suggests that mood influences our ability to learn. Specifically, the theory behind this research supports the idea that being in a sad mood creates a narrower focus of attention, thus providing an individual with an enhanced ability to implicitly acquire and retain information. Implicit learning is unintended and is required to function. For instance, people must learn how to disseminate various sensory cues such as smells and sights and how to identify pertinent embedded information. The latter example was the focus of a recent study designed to test this theory.

Julie Bertels of the Centre for Research in Cognition and Neurosciences at the Free University of Brussels in Belgium chose to assess how well 128 college students were able to acquire and retain information on a statistical learning (SL) task and how their mood affected this ability. SL is similar to implicit learning and involves being able to identify numbers or letters embedded in other cues. The participants were required to complete the task while they listened to a sad or neutral story. They were assessed before and after the experiment. Some were put into a delayed group and assessed 20 minutes after completion to ensure mood states had returned to baseline levels. These delayed participants, along with the other participants, were asked to consciously retrieve the information they learned during the experiment. In total, three check-in points were used to assess SL skills and mood: immediately after the experiment, 20 minutes later (for delayed group), and 20 minutes further (for same delayed group).

The results revealed that mood definitely impacted the ability to consciously retrieve information. Even though Bertels found that the neutral and sad groups both performed equally during the tasks and immediately after, the confidence they reported pertaining to their performance was quite different. In fact, the sad group reported more confidence and indeed was better able to consciously retrieve the statistical information they acquired during the experiment. Regardless of whether sad/neutral participants were also part of the delayed group, the results remained the same. These findings demonstrate that although negative mood states can impair some cognitive capacities, the narrowing of focus appears to enhance statistical and implicit learning. Bertels added, “Further studies should systematically investigate the possibility that negative words induce an analytic processing style promoting conscious processing and, consequently, higher levels of performance in recall.”

Reference:
Bertels J, Demoulin C, Franco A, Destrebecqz A. (2013). Side effects of being blue: Influence of sad mood on visual statistical learning. PLoS ONE 8(3): e59832. doi:10.1371/journal.pone.0059832

There are several unique symptoms that occur in psychosis and schizophrenia. People with these psychological problems often report being hypersensitive to sounds and scenes. Their cognitive resources become distracted and aroused by seemingly mundane background noise and they have difficulty focusing on visual cues and performing relatively easy cognitive tasks as a result. This aspect of schizophrenia has just now begun to be explored in depth. In an effort to extend the existing research, Jason Smucny of the Neuroscience Program at the University of Colorado recently conducted a study measuring the neurological processes that occur during an easy and difficult task among 21 participants with schizophrenia and 23 with no history of psychosis.

All of the participants underwent magnetic resonance imaging (MRIs) while they performed both easy and difficult tasks that required varying degrees of visual and cognitive attention. While they were completing their tasks, the participants were also exposed to what would be considered normal urban sounds, such as the sound of a train or cars on the streets. The results revealed that the participants with schizophrenia had increased neural activation in specific brain regions that impaired their ability to focus on even the easy tasks. They performed far worse on both sets of tasks than the participants without psychosis. Additionally, the schizophrenic group had slower reaction times as a direct result of the auditory distraction.

Sensory overload, such as the kind evidenced in this study, can have a significant impact on the global functioning and quality of life for people with schizophrenia. They may be unable to perform normal activities, especially in social environments, such as reading street signs, following directions, or communicating with others. These deficits can encroach on other domains required to function at optimal levels, further impairing quality of life. Smucny said, “This work is the first to demonstrate that previously reported auditory processing abnormalities may be associated with neural response changes during cross-modal, visual attention tasks in schizophrenia.” Future work should examine ways to minimize auditory distractions that occur in psychosis and schizophrenia.

Reference:
Smucny J, Rojas DC, Eichman LC, Tregellas JR (2013). Neural effects of auditory distraction on visual attention in schizophrenia. PLoS ONE 8(4): e60606. doi:10.1371/journal.pone.0060606

Clients who have completed the mindfulness training module in dialectical behavior therapy (DBT) then move on to the second core skills module, interpersonal effectiveness. These skills are extremely important because the way we communicate with others has a significant impact on the quality of our relationships and on the outcome of our interactions. In order to communicate more effectively, DBT clients are taught skills that help them approach conversations in a more thoughtful and deliberate manner rather than acting and reacting impulsively due to stress or intense emotions. Two key components of interpersonal effectiveness are the ability to ask for things and to say no to requests, when appropriate.

In the Skills Training Manual for Treating Borderline Personality Disorder, DBT founder Marsha Linehan identifies three types of effectiveness that must be addressed in interpersonal exchanges:

1. Objective effectiveness
2. Relationship effectiveness
3. Self-respect effectiveness

For any given situation, these three factors must be considered and prioritized. The individual is likely to be more satisfied with the interaction and outcome if his or her highest priority has been addressed.

The term objective effectiveness refers to the goal or purpose of the interaction, which often is a tangible outcome. For instance, a woman might want her husband to call her when he will be working late. Relationship effectiveness represents the goal of a conflict-free relationship. In this example, the wife might rank emotional closeness and harmony as her highest priority. Alternately, self-respect effectiveness might be the top priority if this woman feels that his failure to call is disrespectful to her.

Dialectical behavior therapy utilizes acronyms to help clients remember the skills that are tied to each type of effectiveness. For objective effectiveness, the acronym is DEAR MAN, and the skills are as follows:

D – Describe: Describe the situation in concrete terms and without judgment.

E – Express: Express feelings, conveying to the other party how the situation makes you feel.

A – Assert: Assert your wishes, i.e. clearly state what you do or do not want.

R – Reinforce: Reinforce why the desired outcome is desirable, and reward people who respond positively to the request.

M – Mindful: Be mindful and present in the moment, focused on the current goal.

A – Appear: Appear confident, adopting a confident posture and tone, and maintain eye contact.

N – Negotiate: Be willing to negotiate and give in order to get, with the understanding that both parties have valid needs and feelings

Moving on to relationship effectiveness, the DBT acronym is GIVE:

G – Gentle: Approach the other party in a gentle and nonthreatening manner, avoiding attacks and judgmental statements.

 I – Interested: Act interested by listening to the other person and not interrupting.

V – Validate: Validate and acknowledge the other person’s wishes, feelings, and opinions.

E – Easy: Assume an easy manner by smiling and using a light-hearted, humorous tone.

Finally, the DBT acronym for self-respect effectiveness is FAST:

F – Fair: Be fair to yourself and to the other party, to avoid resentment on both sides.

A – Apologize: Apologize less, taking responsibility only when appropriate.

S – Stick: Stick to your values and don’t compromise your integrity to gain an outcome.

T – Truthful: Be truthful and avoid exaggerating or acting helpless to manipulate others.

The interpersonal skills taught in DBT can increase the likelihood of positive outcomes, regardless of how the client prioritizes objective, relationship, and self-respect effectiveness for that particular interaction. When used effectively, the DEAR MAN-GIVE-FAST skills help the individual convey his or her needs and wishes clearly, without the other party having to “read their mind.” It enables the person to ask for what he or she wants respectfully and with integrity, while considering the other person’s feelings and preserving the relationship.

Negative and positive affect have been studied at length with respect to depression and anxiety. Although negative affect presents similarly in people with both mood states, positive affect does not. Specifically, people with anxiety experience both positive and negative affect, and increases in positive affect do not cause decreases in negative affect. However, people with depression do see symptom improvements when they have increases in positive affect. In fact, research has suggested that high trait positive affect or increases in positive affect can act as buffers against relapse in depression. Major life events have also been considered as influential on depressive and anxious symptoms. But they have not been examined as positive or negative life events, or in relation to affect. Therefore, John H. Riskind of the Department Psychology at George Mason University in Virginia recently conducted a study to illuminate this aspect of depression.

Using two separate experiments, Riskind looked at whether or not positive affect provided a protective effect against negative affect in college students with depression, and also how negative and positive life events affected mood. He found that unlike symptoms of anxiety, symptoms of depression were directly impacted by positive affect. The participants with depression and low baseline positive affect had higher levels of symptomology than those with high positive affect, regardless of their level of negative affect. This supports the theory that positive affect does directly influence symptoms of depression.

When Riskind looked at life events however, he found quite a different outcome. “Individuals who had few negative events and the most positive events seemed to be at far greater (rather than lower) risk for increased depression.” This result was quite unexpected, but Riskind believes can be explained in several ways. First, individuals who experience a spike in mood due to a positive event often quickly return to their previous mood state. For the participants here, the sudden spike and then decline could exacerbate stress and increase symptoms of depression. Second, the experience of a positive event, such as getting married or taking on a new job, can also cause anxiety, tension, and psychological stress. These emotions, even though borne out of a positive event, can increase negative symptoms. Finally, positive events often mean change, which can be very unsettling to some people, further increasing the risk of depressive symptoms. The results presented in this study provide a unique look into the relationship between positive events and depression, but are limited to some degree. Future work should expand upon these findings by using a broader demographic base of participants and by assessing the influence of other psychological conditions.

Reference:
Riskind, John H., Evan M. Kleiman, and Karen E. Schafer. (2013). “Undoing” effects of positive affect: Does it buffer the effects of negative affect in predicting changes in depression? Journal of Social and Clinical Psychology 32.4 (2013): 363-80.ProQuest. Web.

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.

Many people associate a sandbox with children’s play. However, there is a special type of expressive therapy in which a tray of sand is used to create and explore imaginary worlds. This modality, called sand tray therapy, can be appropriate for people of any age. Many adult clients enjoy sand tray therapy as a way to bypass the logical and intellectual parts of themselves in order to access a deeper, creative aspect.

Sand tray therapy has been in use since the 1940s. It emerged in the form of Jungian sandplay, a type of psychoanalytic expressive therapy in which clients were asked to “create a world” in the sand. In current times, sand tray therapy has evolved to be used by therapists from a variety of backgrounds, including humanistic or transpersonal.

How It Works
The sand tray that is used in therapy with adults and adolescents is a rectangular, wooden tray, several inches deep and painted blue on the inside. Typically, the tray is placed on a wheeled table that is about regular table height. The tray is filled about two-thirds full with clean, white sand.

In the same room, there is an open shelf containing a broad variety of small toys or figurines. These usually include human figures of different types, as well as animals, plants, buildings, vehicles, and other types of things that are commonly seen in everyday experience. Any of these figurines can be placed within the sand tray to create a small, imaginary world. In addition, the sand in the tray can be shifted to make an evocative landscape. Sand can be piled up to show a hill or mountain, or it can be scraped away from the bottom of the tray to show the blue interior in order to represent water.

How It Helps
Sand tray therapy can be used with adults when success with verbal therapies is stifled, or when a therapeutic modality that allows more access to innate creativity is desired. An excellent use for the sand tray can be with grief or trauma, when words are difficult to utter or fully process. When clients touch the sand, it can be very soothing to the psyche, offering a healing beyond what we can visibly understand.

“When the beginnings of self-destruction enter the heart, it seems no bigger than a grain of sand.” —John Cheever

There are several components of sand tray therapy that make it effective for many people, including:

• The design of the sand tray environment is a safe, contained world that is fully controlled by the client, and can be manipulated or changed by adding, subtracting, or moving figurines within the scene.
• It does not require any artistic skill to have a satisfying sand tray experience—only selecting and placing objects.
• Physically moving representational objects within the sand tray container has a beneficial effect on the body, especially in people who have undergone traumatic experiences—more so than simply talking about memories or ideas.

What to Expect
In a session using sand tray therapy, the therapist will typically begin by encouraging the client to explore the sensory experience of the sand tray itself. Many clients may spend a few minutes just experiencing the cool, smooth sand on their fingers.

The client can leave the sand smooth and flat or create a landscape by shifting the sand in the tray. Then the therapist will explain how to choose figurines in order to create a world or scene in the sand tray. The therapist will instruct the client to choose several figurines that elicit a strong reaction, either positive or negative, and reassure the client that it’s OK not to “know” what each figure represents. Then the client will decide where to place each object in the sand landscape. The scene may be static, or it may evolve over the course of the session. The therapist will encourage the client to observe what has happened in the world of the sand tray and discuss the meaning that the client sees in this experience. A photograph of the scene may be taken in order to keep a record of the session.

My Experience
Having sand trays in therapy rooms can provoke a client’s curiosity. I recall a non-sand tray client in the sand tray room stroking the sand as he was talking to me. I called his attention to this and he remarked, “It’s soothing.” Just having the sand tray nearby to touch supported his ability to relax in the room. Another example is when I was working with a couple. After a turbulent session with his wife, the man took the opportunity before he left the therapy room to put a shark head down in the sand—a visual and nonverbal communication about his feelings.

As I allow each and every client to have his or her own experience, I find the benefits of sand tray therapy useful. It allows clients to have experiences they may not if they were to use only language.

Reference:

The Columbia World of Quotations (1996), Columbia University Press. Retrieved April 11, 2013, from http://quotes.dictionary.com/search/sand_?page=3

Family burden is a term that encompasses all of the challenges that may exist for an individual who lives with someone who has experienced a significant illness, particularly a long-term illness. Even if the illness does not require that the family member provide care for their loved one, the emotional toll that the illness can have on the family is part of the overall burden. Additionally, any caregiving responsibilities and financial, relational, and personal effects are considered part of family burden. Because family caregiving is becoming increasingly popular and more individuals are living for longer periods with physical and mental illnesses, it is imperative to understand how family burden affects the caregivers and even significant others who do not have to provide care. Therefore, Edel Ennis of the School of Psychology at the University of Ulster in the UK recently conducted a study that explored the relationship between family health, family burden, and participant psychological well-being.

Ennis considered the type of illness, noting that some illnesses such as bipolar, dementia, and Alzheimer’s are particularly emotionally taxing on family members, the relationship between the participant and ill family member, marital status, income, and gender. After examining over 3,000 participants, Ennis found a direct and distinct relationship between family burden and individual mental health. Specifically, the higher the perceived family burden was; the worse the psychological well-being of the participant. For women, high family burden was related to increased risk for depression. For men and women, low income, and singlehood were risk factors for increased stress and poor mood. Ennis believes that limited finances and lack of other people in the home to provide support could explain this finding.

One result that was unexpected was that the participant’s relationship to the ill family member did not affect overall psychological well-being. Previous research has suggested that caring for a spouse is often more emotionally depleting than caring for a parent or child. However, in this study, that was not the case. But, Ennis did find that younger caregivers were more vulnerable to negative psychological outcomes. For all the participants, higher family burden was reported for family member mental health problems versus physical health problems. In conclusion, this study shows that individuals living with an ill family member, even those who do not directly provide care, are at risk for psychological problems and should be targeted for interventions. Ennis added, “This is essential given the increasing numbers of individuals requiring additional support, and the increasing reliance on the family to provide this support.”

Reference:
Ennis E., Bunting, B.P. (2013). Family burden, family health and personal mental health. BMC Public Health 13: 255. Published online 2013 March 21. doi: 10.1186/1471-2458-13-255

Very few people in Western cultures enforce or even endorse arranged marriages. The thought of having your spouse picked out by your parents can be repulsive to many young adults. They often view the opportunity to sow their own oats and experience the rush of first love as a fundamental rite of passage into adulthood. It is a process that is born of free will, choice and many believe, should be the sole privilege and right of the individual seeking a partner. But for Eastern societies, arranged marriages are not only encouraged, they are required. It is when Eastern and Western cultures clash that the problems arise.

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A recent article describes some of the benefits and pitfalls to arranged unions. First, parents who favor arranged marriages believe that they are more experienced and objective than their children. They will be able to make better, less impulsive choices regarding a compatible, and often financially supportive mate than their child will. In many cultures, disobeying the arrangement can lead to disownment and exile from the family. But for the children, arranged marriages can cause fear and resentment. Many young people long for the chance to find their perfect soul mate, the one who makes their heart flutter and their palms sweat. They want to experience intimacy on many levels with that person before they make the commitment to spend the rest of their lives with them.

But do parents know best? Parents often arrange marriages for their children because doing so will ensure that their child stays vigilant in their religious beliefs. People from different cultures often see freedom of religion as a threat and are afraid of the varying views in Western societies. “The human mind finds security in habit so adjusting is hard and change is frightening,” says psychologist Jade Caton. That is why, according to Caton, many parents insist on arranged marriages. And maybe they are on to something. According to some research conducted in India, couples in arranged marriages have more extended periods of being in love than partners who choose their own mates. And arranged marriages end in divorce about 10 times less often than nonarranged marriages. But for young adults who cannot see past the pursuit and passion that come from falling in love, these statistics are often merely academic.

Reference:
Han, Mayzin. (2013). First comes marriage, then comes love. Spark Magazine (n.d.): n. pag. Web. http://www.sparksunderland.com/featured/2013/04/first-comes-marriage-then-comes-love/

Picture someone with attention-deficit hyperactivity. Odds are good you’re envisioning a child who can’t sit still zooming around his or her classroom, struggling with grades, and driving parents crazy. But ADHD isn’t just for children. Some kids grow out of this diagnosis or develop coping skills, but others continue to struggle as adults—some of whom were never diagnosed as children.

Children have the benefit of existing under the watchful eye of adults who can advocate for their interests. Adults, however, may struggle for years before they realize that their procrastination, difficulty concentrating, and trouble completing tasks are the result of ADHD, not a personal failing.

What Is Adult ADHD?
Adult ADHD is the same issue that children experience, but it can manifest in different forms. Children may struggle with school or making friends, but life-altering consequences from the condition in childhood are rare. In adulthood, however, failing to turn in a presentation, skipping a semester of college, or being unable to listen to a spouse can end in catastrophe. Consequently, adults who have ADHD—particularly if they’re not getting appropriate treatment—may have more dramatic difficulties than children, and often get much less sympathy.

Recognizing Symptoms
Symptoms of adult ADHD may include:

• Difficulty listening to others, trouble responding appropriately in conversation, or focusing on side details rather than the main point of a discussion.
• Procrastination and difficulty planning.
• Extreme disorganization that interferes with functioning; for example, forgetting to deposit checks or failing to bill clients.
• Trouble remaining focused on a task, even an important or fun one.
• Making careless mistakes.
• Zoning out in conversations.
• Anger.
• Restlessness and feeling unable to sit still.
• Impatience.
• Inability to tolerate boredom.
• Frequent fidgeting.
• Alternating between being excessively focused on a task—for example, reading for 12 hours—and being unable to focus on anything.

Adult ADHD and Other Mental Health Conditions
Some people with adult ADHD initially seek help for a different condition, such as depression or anxiety. The frustration ADHD can cause frequently leads to other symptoms. An adult with the issue might have trouble in his or her relationships, struggle to keep a job, have a hard time managing finances, frequently lose his or her temper, or experience low self-esteem. If the symptoms are caused by ADHD, treating depression or anxiety sometimes won’t help, which can add to the frustration.

In other cases, ADHD can co-occur with other mental health issues, and people with ADHD are more likely to be depressed than those without. If you’re experiencing symptoms of two different conditions, it’s often helpful to treat the one that’s causing you the most discomfort first. If your inability to focus is making you depressed, focus on that. But if your procrastination is a small problem and constant feelings of sadness are leaving you hopeless, it may be better to treat depression first.

Getting Help
Medication—including stimulants such as Adderall and Ritalin—and therapy can help people with ADHD, but this doesn’t mean you’ll have to be in treatment for the rest of your life. Simple lifestyle remedies such as staying meticulously organized, planning ahead, meditating, and adopting strategies for focusing can make a big difference. Seek treatment providers who specialize in ADHD. They’re more likely to understand the effects these issues can have on adults, and can recommend successful coping strategies.

References:

1. Adult ADD. (n.d.). Dr Hallowell RSS. Retrieved from http://www.drhallowell.com/add-adhd/adult-add/
2. Adults with ADHD. (n.d.). CHADD. Retrieved from http://www.chadd.org/Understanding-ADHD/Adults-with-ADHD.aspx
3. McGillivray, J., & Baker, K. (2008). Effects of Comorbid ADHD with Learning Disabilities on Anxiety, Depression, and Aggression in Adults. Journal of Attention Disorders,12(6), 525-531. doi: 10.1177/1087054708320438