Why the Holidays Are Tough

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I hate to be bah-humbug about it, but the holidays suck are tough.  Every year around this time my mood fluctuates like crazy, and I can tell the people around me are feeling the same way.  I’ve written about holiday stress many times before, but this year I really tried to stop and think about WHY the holidays are so hard for so many of us.  Beyond offering tips for coping with holiday turmoil, here’s my best guess as to why this season can stink (to put it mildly):

NONE OF US CAN MEASURE UP!

Perhaps in the “good old days” the holiday season meant spending time with loved ones and enjoying the meaning of the season (whatever the meaning might have been).  But these days, it feels like it has become the season of measuring up:

  • Do you have enough money to by your sweetie the diamonds, luxury cars, and furs shown on TV ads?
  • Have you decorated your house with hand-dyed partridge feathers and spiced citrus?
  • Do have a perpetually-smiling brood of 4 or 5 who love to play Parcheesi and giggle while sipping on homemade cider?

NO??

Well, guess what? Me neither.  And I am here to tell you that no one measures up to those kinds of standards.  Not even Ms. Martha Stewart herself would come out on top with the above as goals.  So, let’s put an end to this measuring-up, and deal with ourselves, our family, our friends, and our finances for who and what they are: imperfect.  I propose that we simply do our best to get through this month with our mental health intact.  Happy Holidays!

Psychotherapy Is Not Dead

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Last weekend What Brand Is Your Therapist was published by the New York Times.  Lori Gottlieb, the author, interviewed me and a couple of other psychologists for the piece.

In her article Ms. Gottlieb writes about her journey as a new therapist setting up a practice in the congested California market.  As she struggles to find clients, she looks to other, more established clinicians for advice.  Some say find a specialty area, others tell her to focus on consultation and/or coaching work rather than traditional psychotherapy, still others (me) tell her to increase her social media presence.

With this advice in mind, Ms. Gottlieb wonders if Americans have moved past the need for psychotherapy, citing statistics indicating that fewer people have sought talk therapy in recent years.  She also wonders if our super-fast, I-want-results-now culture makes the slower paced psychotherapy process outdated.

After stewing about it for a few days, I have gathered my thoughts, and offer this response proving that psychotherapy is not dead, in fact, it is alive and well.  With this caveat: it is essential that we change (at least a little bit) with the times.  Here goes:

Having been married to an architect for nearly 15 years, I have come to know a bit about that profession.  While it may not seem that a psychologist and an architect would have much in common professionally, I have come to realize that we do – and more than it would seem.  In addition to the arduously long training process involved in both fields, many of the current dynamics and changing business models are similar.  Take a look:

Fads Come and Go.  Colonial, craftsman, beaux arts, mid-centurn modern – these are just a few of the hundreds of styles of architecture around us.  While I might like classical design, others might prefer more contemporary; the one thing we can be sure of is that styles, tastes, and fads will change.  This is a good thing in architecture – it makes our communities more interesting.  What is critical, however, is that the structure underneath is sound.  Any architect would agree that a comprehensive understanding of history, as well as a mastery of structural and construction principles is necessary before good design can emerge.

The same is true for us in the field of psychology.  There is nothing wrong with new ideas, and unique and innovative treatments – so long as there is first a fluency in psychological science.  New treatment strategies, rooted in sound science and disciplined training, can (and should!) be constantly flowing into our daily practice.  Would we accept stagnant, non-innovative care from any other field?

Gray and Green – The New Black?  Some architects have continued to design and draw only by hand, have resisted integrating technology into their firms, and have refrained from embracing environmentally sustainable design and materials clamored for by clients.  Guess what has happened to those architects in this tough economy and competitive world? They are no longer practicing – or at least not at the level to which they would like.  Successful firms have had to innovative, be responsive to the marketplace, and have had to find a way to stay productive and flexible in a time when their clients demand more, have shorter time frames, and more restricted budgets.

Psychologists are no different.  To stay relevant and helpful (that is our mission after all) we must also innovate and find new ways to give people what they want (psychological help) and need (psychological health).  A colleague of mine, June Ching, PhD, recently wrote: “I see a…theme with the ‘old ways’ juxtaposed to the newly emerged technological advances. If the mission is still the same, perhaps joining forces with the ‘grey’ and ‘green’ is a viable option.”

Merging The Old School (“gray”) with the New School (“green”) is the only way to continue to provide the type of help and care we all desire.

Everyone Deserves Mental Health.  Most of us can’t afford to live in a house designed by an architect.  Instead, most of us live in houses that were mass-produced by a CAD-wielding draftsman employed by a large construction company.  Yea, it’s kind of a bummer from a design perspective, but guess what?  The roof still keeps out the rain and the walls still keep us warm at night.  And the price is right.

Again, the similarities with psychotherapy are striking.  Therapy is kind of a weird thing.  Sitting in a room with a stranger spilling your guts week after week, while learning little to nothing about said stranger.  Bizarre.  Not to say we strangers don’t have a lot to offer – we do! But psychotherapy isn’t for everyone.  It’s a significant commitment in terms of time and money, and frankly not everyone is helped by talking about their problems.  Some folks prefer the self-help methods of reading books or watching Oprah to aid their mental health.  Others might find comfort at church or in a peer support group.  Still others may prefer to use pharmacological treatment.  Guess what?  That’s OK!

Psychotherapy has never been a treatment utilized by the masses, and my guess is that it never will be.  The great thing is that it gives us lots of opportunities to reach out to folks who will never sit on our couches.  Podcasts, books, blogs, talks, articles in the New York Times – these are all means by which we can get the word out about the importance of psychology and good mental health.  Realizing that the 50 minute psychotherapy hour isn’t our only means of providing solid, responsible, and useful mental health care should make us feel excited and energized to meet folks in need – wherever and whoever they are.   Because in the end, everyone deserves mental health, not just those who meet us on our own, narrow terms.

It is my opinion that psychotherapy is enjoying a particularly robust period in its history.  The stigma against treatment is down, the access to care is up (thanks to changes in the insurance industry, as well as technology) and psychology, mental health, and emotional wellness are a part of the language of everyday life.  Psychotherapy is far from dead – it is very much alive and growing.  It is up to us to determine how and when to best maximize this growth, for our clients and ourselves.

New York Times: What Brand Is Your Therapist?

This article came out in yesterday’s New York Times.  In it the author, Lori Gottlieb writes about some changes and innovations in the field of psychotherapy.  I was lucky enough to be interviewed for the article and have a quote in the middle of the article.  Check it out here.  I am still working on writing up my thoughts about the ideas presented in the article.  Hint: I’m not sure I agree with Ms. Gottlieb’s conclusions.  Stay tuned!

New York Times: 11/25/2012

Sexuality, Gender and Glee

It’s been a while since I have written about my fave TV show, Glee.  While my newish subscription to Netflix has opened up great new worlds of television programming (Downton Abbey, anyone?), I am still partial to Glee.  As I’ve written before, I love the music, the dancing, and the over the top dialogue.  But this year – perhaps even more than previous seasons – I am appreciative of Glee’s portrayal of gay teens.

Everyone loves Glease!
Photo: Glee on Fox

Glee and its actors have received awards in past years for their representation of teenage homosexuality.  These awards have been well-deserved.  But the cool thing about this season is that the fanfare seems to have died down, but the writers are still doing their thing, writing about love affairs of the straight and gay variety.  It seems to me that sexual preference  has become a bit of a non-issue over at McKinley High.  In fact, one of the newest students seems to be questioning his gender, together with his sexuality.  The sort of live-and-let-live attitude embraced by the fictional folks at McKinley High may not be representative of what is happening at all real life high schools.  But if life does in fact imitate art, sexuality and gender may one day be a sideline issue for all of us.  Something we notice in people but don’t allow to define them.  Something we allow young (and old!) people to explore and express as they may, when they may.

Adolescence can be rough on mental health.  Coping with the stressors of changing bodies, hormones, friends, academics, and the future – even the luckiest kids can struggle with bouts of depression and worry.  Add to the mix questions of sexuality and gender (and perhaps bullying by peers) and the chance of psychological distress can go up significantly.  Programs like Glee which normalize a wide range of sexual expression and gender orientation give all our kids a better chance at navigating the rough road of adolescence with a steady hand.

*Know a LGBTQ teen who is in crisis and in need of help?  Check out the Trevor Project, an organization providing crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender, and questioning youth.  Click here for their website, or call 866-488-7386 for their Life Line.

Helping Kids Make Smart Food Choices…Without Giving Up Cake

One of my coolest professional roles is as a Parent Advisory Board member for Produce for Kids, an organization that encourages healthy eating for kids and families.  This week I wrote an article for their website about how to help kids incorporate all types of foods into their diets.  We all know that tomatoes and fish are great for us, but I also suggest tips for how to include chocolate, cake, and nachos into a balanced diet.  After all, could any of us survive for long without cake or curly fries?  I know I couldn’t.  Check out the article for ideas on how to make healthy, balanced, and REALISTIC food choices for you and your family.

Check out the Produce for Kids website for all sorts of tips on health eating – including easy, kid-friendly recipes!

Book Review: Working Parents Thriving Families

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A few things before I start this review:

1. I typically don’t care for parenting books.  They tend to be preachy, too complicated, and make me feel like a lousy parent after reading them.  Read more about my thoughts on parenting books here.

2.  Dr. David Palmiter, the author of Working Parents, Thriving Families, is a colleague of mine so I’m not totally un-biased when it comes to this review.  With that said, one of the reasons he is a colleague is that I consider him an excellent psychologist and teacher.

3.  I have read this book a couple of times.  The first time was so I could write a quick review to go into the book.  The second time was for this blog – so I consider myself a real expert on this book! To read my review (along with a bunch of others), click here.

OK, with that stuff out of the way, here we go:

While I’m not sure if the “Working” in the title refers to parents who work outside the home, or a recognition of the fact that parenting is “work,” the title sets the tone for this down-to-earth, super accessible book that deals with a lot of real-life issues. Dr. Palmiter doesn’t focus on step-by-step techniques or discipline strategies that need a PhD to administer.  He simply talks about the basics of parenting and what needs to happen in order to raise a happy family – while acknowledging that none of us is perfect and we all get overwhelmed and frustrated with ourselves, our partners, and our kids from time to time.

A few of the things I like best about Dr. Palmiter’s book:

  • “Special Time.”  Dr. Palmiter suggests we spend an hour each week with each of our children doing nothing but watching them engage in something they enjoy, and then commenting, praising, and encouraging them in that activity.  He suggests how awesome it might feel if we (as adults) heard things like: “You prepared that dinner beautifully” or “Wow, you really managed the kids like a pro today” on a regular basis – and the same goes for our kids.  I love tips like this because they are free, aren’t hard to master, don’t have side effects, and can make a huge impact on families in a relatively short period of time.  I know, I know, I’m not sure I can really do that for what would equal 3 hours per week either (and he comments on that complaint), but it is something to work toward for sure.
  • His humor and lighthearted tone.  Parenting is a funny endeavor – but you would never know it by looking at most of the books, blogs, and websites out there.  Dr. Palmiter did a great job making me laugh. A couple examples are when he offers some comebacks to common kid complaints:

Kid: But all of my friends are allowed to do it!

Parent: Do you think their parents would consider adopting you?

Kid: But, you let (name of sibling) do that!

Parent: I love her more than you.

  • I didn’t feel like crap at the end.  As I mentioned above, lots of parenting books make me feel like a bad parent.  Either because I never have the energy or motivation to do all the things they tell me I should, or because my kids never look like their examples.  The thing about this book is that my family DOES look like Dr. Palmiter’s examples, and he even shares his own quirky family and parenting blunders with us!  He also seems to get that modern family life is crazy, hectic (his website is even hecticparents.com), and frankly ugly at times.

To learn more about Dr. David Palmiter check out his website.  To buy the book, check it out here.

 

 

Post-Election Stress Disorder

A couple of weeks ago I wrote a couple posts on Pre-Election Stress Disorder.  What started out as a sort of tongue-in-cheek post ended up as one of my most popular, and even led to a radio interview on WHYY FM in Philadelphia.  When I was contacted yesterday by a reporter for comments about POST-Election Stress, I figured I should write something about that, too!  Here goes:

There can be several reasons for feeling stressed, sad, or just plain overwhelmed after the election.  Some would argue that the protracted election brought out some of the worst of our country (nasty ads, downright lies, unproductive and sometimes ugly debates).  This alone can be reason to feel disappointment and anger at the process and the players involved.

Of course one can also feel stressed and angered about the outcome of the election.  And let’s not forget that the position of the President wasn’t the only one for which we were voting.  Representatives at all levels were chosen last night, as were local ballot measures affecting how our communities operate.  It can be easy to forget – with all of Obama and Romney’s hoopla – that folks might be struggling with the outcomes of these “smaller” ballot questions too.  (I for one have very strong feelings about the legalization of a certain fringy-leafed plant in my state – but the reasons for that are for another post).

So how can we cope with our disappointment, stress, anger, or fear?

Keep on Keeping on.  Most of us have some pretty good stress management strategies on board already.  Whether it’s walking, talking to a trusted friend, playing cribbage, doing yoga, reading, or praying – most of us can cite at least one thing that we are already doing that helps manage stress.  Trouble is, when stress hits, we sometimes abandon these good coping tools – just when we need them most!  Today is the perfect day to carve out a few minutes to practice the stress management skills you already have.

Take a Step Back.  The cool thing about this country is that it keeps on ticking no matter who is in charge.  You may be able to point to great presidents and not so great ones, but the fact is: times marches on.  Instead of focusing on today, try taking a longer view of both our history and our future.  Putting things in perspective can be a highly effective way to manage stress in the here and now.

Do Something.  As I mentioned in my post about Pre-Election Stress Disorder, there are lots of things we can do to affect political change in our country (and what an awesome thing that is!).  These include things like: volunteering for a political campaign, donating money to a candidate or cause, or running for office yourself.  Doing something productive and worthwhile (this does NOT include posting nasty messages on Facebook, etc) can again be a super antidote to feelings of stress, anger, and anxiety.

Turn it Off.  The election is over, we know the results, they are not going to change.  The media continues to talk about it, analyze it, and second guess it because they have to – they have lots of airtime to fill.  The good news is, you don’t have to watch it!  Re-hashing the nitty gritty of the election isn’t good for anyone – especially if you are unhappy with the outcome.  So turn off your TV, radio, and political websites and get out and do something fun!

*Disclaimer: I made up Post-Election Stress Disorder – it is not a real psychiatric diagnosis.  However, the stress, worry, and anxiety that folks feel around this time every 4 years is very real.  If worry and anxiety about this (or other) issues are negatively affecting you, please contact your health care provider.

 

 

5 Questions with Sally Koslow

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Last month I posted a review of the book Slouching Toward Adulthood by Sally Koslow.  I remarked that while the book – about Generation Y’s slow pace

through life – was interesting, I found it rather sad.  Ms. Koslow, a Baby Boomer herself did a lovely job researching and writing about the history of both the Boomers and the Gen Y’ers.  I, a Gen X’er, simply found the whole topic irritating and wondered how my generation fits in between these two massive, sometimes self-centered, hugely influential generations.

Ms. Koslow was nice enough to agree to answer a few questions to help me get to the bottom of my concerns – as well as to help me (and you!) get to know her better. I am so grateful that this author, teacher, editor, wife, and mother took a moment to speak to me…Welcome, Ms. Koslow!

Dr. S: Given that Gen Y seems to be having a lot of fun traveling, teaching English all over the world, and living as long as possible without taking on adult-like commitments like mortgages and 401K’s – do you think the rest of us would benefit from adopting their worldview? Are we missing the boat by being too serious?
S.K.: I see a lot Gen X-ers and Boomers having fun. No one can accuse us of being too deep. And while sometimes the random acts of wandering you describe among Gen Y-ers allow them to hit on the magic combination to a padlock that frees up lasting contentment, for some people,–let’s be honest–this behavior is simply procrastination married to moral superiority. While researching Slouching Toward Adulthood, I met many Gen Y-ers who seemed to assume that there would always be enough time to do everything they want and that every light in front of them would always turn green. I worry that if they spend too many years in the activities you mention, they may miss out on other opportunities that they will enjoy. How many Gen Y-ers won’t evolve into cynics who wish that someone had kicked them in the butt when they were younger so they’d have already found a career path with which they can be reasonably happy and have started to build a life that makes it possible to provide a comfortable home for themselves and possibly children?

Dr. S.: As a Gen X’er I am interested to hear your thoughts about how my generation fits in between the Boomers and the Gen Y’ers? Or are we too small to be relevant?
S.K.: Many Gen X’ers are now thought leaders, rising in every profession. Your impact grows by the day.  You’re had the good fortunate to have graduated from college and professional schools when there was less unemployment than there is now. Gen Y-ers have drawn the short straw.

Dr. S.: What are you reading now?
S.K.: I’m in the middle of The Odd Women by George Gissing, a British author popular in the late 1880’s. This novel is fascinating and surprisingly contemporary, though a bit one-note. It’s set in London and explores hardships faced by single women as well as inequalities in and outside marriage. Plus ça change, plus c’est la même chose—the more things change, the more they stay the same.

Dr. S.: Please tell me a bit about your new book coming out in June.
S.K.: The Widow Waltz, my fifth book, is a coming of age novel. One of the women is 50–it’s never too late to grow up—and will be published by Viking, It focuses on a recent widow as well as her daughters in their 20’s and the paths their lives take after the death of their husband/father. It’s a story of resilience built on the infrastructure of a mystery.

Dr. S.: One of the things I often write about is how to manage stress. We all know yoga is great, but I love to hear about some more creative solutions to stress management. For example, I have written that one of my go-to strategies is watching House Hunters. What do you do to manage your stress?
S.K.: Besides reading? I watch funny movies that I’ve seen so many times I can lip-synch. Topping my current rotation are Bridesmaids and As Good as It Gets. A few years ago I would have named Clueless and My Cousin Vinnie. After dipping into any of these films for a random ten minutes I feel mellow.

Thanks Ms. Koslow! To learn more about Ms. Koslow and her other books check out her website – www.SallyKoslow.com.  Click here to buy Slouching Toward Adulthood.  After reading it, let me know your thoughts!

Depression, Pregnancy, and Psychotherapy

A  study in the journal Human Reproduction recently concluded the following:

Antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer term neurobehavioral effects. There is no evidence of improved pregnancy outcomes with antidepressant use.

This is an important study for several reasons:

  • Pregnant moms who are depressed can be at risk for not taking care of themselves or their unborn baby (not eating well, not taking prenatal vitamins, not going to OB visits).
  • Moms whose depression is not well managed during pregnancy are at a greater risk of developing postpartum depression
  • Moms who are depressed risk other physical and mental health problems
  • As most families know, mom’s mental health and mood has an impact on everyone else in the family

So what do the results of this study really tell us?  Antidepressant use during pregnancy needs to be evaluated carefully.  But to me (as a psychologist, of course) the more important conclusion of this study is this statement right here:

There is some evidence that psychotherapy, including cognitive-behavioral therapy as well as physical exercise, is associated with significant decreases in depressive symptoms in the general population; research indicates that some forms of counseling are effective in treating depressive symptoms in infertile women.

In fact, psychotherapy can be highly effective for many mood disorders, including for depression before, during, after pregnancy.  This is great news because, unlike medication, psychotherapy has few (some would say zero) side effects.  An effective and safe treatment option for moms and their families – now that is an important conclusion.

Fore more information about finding and visiting a psychologist, go here.

 

 

Maintaining Mental Health in a Natural Disaster

Photo: Getty Images

By now we’ve all seen the amazing, horrifying images of the damage Hurricane Sandy inflicted on the East Coast.  And I would imagine the suffering, struggle, and emotional fallout will continue long after the media moves on to more “interesting” things in the days and weeks ahead.  My colleague, Dr. Elaine Ducharme wrote a great article about how to cope with the hurricane on the American Psychological Association’s blog, Your Mind. Your Body.  Her tips – especially the ones about getting the facts and talking to your kids – are especially helpful. Check it out here.

I also really liked the post by CNN’s The Chart about some of the nuts and bolts about living through a storm and subsequent flooding.  I didn’t realize how dangerous floods can be after the water recedes.  Check it out here.

This article on ABC about how to help hurricane victims was excellent.  I love how they reviewed several organizations, how to contact them, and how the money donated actually helps people.  Did you know over one hundred blood drives were cancelled because of the storm? Wow.  Check it out here.

For more information about managing stress and trauma after this hurricane or other natural disasters, check out the resources over at the American Psychological Association.