You have to be courageous, naïve or stupid to talk about sex differences in intelligence or indeed sex differences in anything. Many people want to believe that men and women are equal not only in potential but also ability. They argue that even if there are small differences they should not be explored or explained because of the divisive effect that it has on both sexes.

To discuss, believe in, and attempt to explain difference between different groups of human beings soon becomes ideological. It inevitably appears associated with ideas of nature-nurture which is then associated with left vs right wing politics. Over the past century there have been periods where both the “difference” and “no difference” view occurred. The growth of environmentalism and feminism from the 1960’s onwards perpetuated the idea that any observable differences between the sexes were the result of socialization. Further that they were iniquitous and could and should be changed. However the pendulum from the 1990’s onward swung the other way towards a more biological and evolutionary perspective which recognised and “explained” sex difference.

There really are recognised, small but observable and replicable, sex differences at all stages at life. So in infancy we know boys are more active and spend more time awake; Girls are more physically developed and co-ordinated; Girls show R-hand preference at 5 months (not boys); Girls have better hearing and are more vocal; Girls make more eye contact and more interested in social and emotional stimuli; boys more interested in things and systems.

In the pre-school period we know boys are more interested in block-building and vehicles; girls prefer doll play, artwork and domestic activities; Boys like rough and tumble play; Girls are more sensitive and sedentary; Boys show narrow interests; girls a wider range, including boy-typical activities (asymmetrical sex-typing); Gender segregation (same-sex playgroups) appears for both boys and girls. Boys groups are larger and more concerned with dominance issues; girls play in groups of 2/3 and are more sharing – concerned with fairness.

There are noticeable differences particularly in language. Girls acquire language earlier than boys and remain more fluent throughout life; Girls develop larger vocabularies, use more complex linguistic constructions, enunciate and read better. Boys are less communicative and use language instrumentally (to get what they want); Brain localisation of language is more bilateral for females than males (MRI and lesion studies); Males suffer from bilingual development (e.g. memory deficit) while females seem unimpaired.

If you give girls and boys at primary school different tests there are clear differences. Boys can draw bicycles better than girls who in turn are more fluent with words. Boys are better at mathematical reasoning, dart throwing and mentally finds geometric forms in complex patterns and rotating objects. Girls are better at remembering displaced objects, recalling stories, precision tasks calling for good motor co-ordination.

Boys overall express more self confidence in sport and mathematics while girls do so in reading and music. Boys say any failure they experience is down to lack of effort while often girls put their own failures down to lack of ability.

Girls show more concern for feelings of others and are generally better at “mind-reading”. In a study of 6 year olds listening to recorded sound of crying baby, girls expressed more sympathy but boys twice as likely to the speaker off. Boys are more affected by bereavement, separation, maternal depression, etc; but inclined to deny loss or sorrow.

Boys overall express more self confidence in sport and mathematics while girls do so in reading and music. Boys say any failure they experience is down to lack of effort while often girls put their own failures down to lack of ability.

Girls show more concern for feelings of others and are generally better at “mind-reading”. In a study of 6 year olds listening to recorded sound of crying baby, girls expressed more sympathy but boys twice as likely to the speaker off. Boys are more affected by bereavement, separation, maternal depression, etc; but inclined to deny loss or sorrow.

But what of intelligence. Are males really brigher than females? Or is it the other way around?

Does it depend on how or when you measure intelligence?

It seems that at the moment there are essentially six positions that are taken on this issue

1. Intelligence cannot be accurately measured and therefore it is difficult to prove or disprove the existence of sex difference. This view emerges every so often usually perpetuated by educators, journalists or politicians who are ideologically opposed to testing. If you believe you can neither define nor measure intelligence accurately you have little to explain. Further, you can claim that all who make assertions based on actual scores or misguided and worse malicious.

2. There are no differences at all for one of two reasons. First, there are no good evolutionary or environmental theories or reasons to suppose there are sex differences Second, the early tests were so developed to show no difference. That is, subtests were included and excluded so that neither sex was advantaged or disadvantaged. So the way we measure intelligence shows no differences nor are there any. Any data to the contrary is flawed.

3. There are no mean or average differences between the sexes but there are differences at the extremes. Thus men tend to be over represented both at the extremes of the Bell Curve. The most brilliant are men and so as the most challenged meaning the average is the same but the distribution is wider for men. In any very large sample tested men are over-represented at the top and bottom. In short, the standard deviation for IQ is higher in men than in women.

4. There are numerous, demonstrable and replicable sex differences in a whole range of abilities that make up overall intelligence. The differences might not be very large but they are replicable and explicable in terms of evolutionary theory. So the biggest is for any measure of spatial ability, though ever that can be a little as a third of a standard deviation (5 IQ points). Those who take this position point to a very large number of (reputable) studies which have demonstrated sex differences in many groups and many cultures.

5. Sex differences that do emerge from studies are not real. They occur for three reasons. Females are taught humility and males hubris: and that this social message lead them to approach tests differently. So females under-perform not revealing their real ability. Next it is less of a social requirement (particularly in mate selection) for girls to be intelligence so they invest less in education and skill development, though this pattern may be changing. Third, it is all about personality facrors. Females are (overall) less emotionally stable than males and have greater test anxiety which is reflected in test performance. So any differences that emerge do not reflect underlying reality: they are about socialisation, attitudes and personality rather than actual ability.

6. There are real differences between the sexes with males having a 4-8 point advantage which become noticeable after the age of 15. Before adolescence females in fact have an advantage. The difference between the sexes is greatest for spatial intelligence. The difference is reflected in the brain size difference (corrected for body size) between men and women. Further this “real” difference “explains” male superiority in arts, business, education and science. It is this position that attracts most social commentary and criticism.

There are now many more researchers than before who say that sex difference in intelligence are important and real. They tend to opt for five arguments:

• Similar differences observed across time; culture and species (hence unlikely to be learned).

• Specific differences are predictable on basis of evolutionary specialisation (hunter/warrior vs gatherer/nurse/educator).

• Brain differences are established by prenatal sex hormones; later on, hormones affect ability profiles (e.g. spatial suppressed by oestrogen, HRT maintains verbal memory).

• Sex-typed activity appears before gender-role awareness. At age 2, girls talk better; boys better at construction tasks. This is not learned.

• Environmental affects (e.g. expectations, experience training) are minimal. They may exaggerate (or perhaps reduce) differences.

But there is still much argument. How big (effect size) are the differences? Should one try and do something about it? What implications does this have for education?

The arguments continue even as the pendulum swings between the biological and environmental interpretation. Perhaps the whole issue becomes so politically charged that it is virtually impossible to have a rational debate. This in turn means scholars avoid the research area which “too hot to handle”.

I bristle at rules. I usually see them as advisory. If they make sense, I follow them. If not, I tend to break them. No wonder I have a bachelor's degree in traffic school. 

Of course, some people need the limits that rules provide, but for those who might welcome a nudge to defy authority when that’s just, I offer these examples of worthy if not heroic transgressions. As a career counselor, I’ve had particular opportunity to observe where rule-breaking is likely to succeed in the workplace. So I will confine my examples therein. Of course, rules cry out to be broken in all bailiwicks, from recreation to religion. I will leave to you the pleasant task of finding opportunities therein for civil disobedience.

Work rules ripe for breaking

Accounting for your time at work.It’s the height of micromanagement to require all employees to account for their time, whether they accomplish their work or not. For example, many corporations require their sales reps to weekly list all customers they contacted, what they did, and the result. That may be appropriate for poor performers, but for most people, it’s treating them like a child. As long as an adult produces the required results, they should be allowed to allocate time as they see fit. Requiring all employees to have the same accountability is not only demeaning, it contradicts society’s #1 axiom today: celebrate diversity. We all have different ways of working. One size does not fit all.

In applying for a job, send in your resume as required.  A resume can mislead an employer: An applicant with a perfect resume crafted by a hired gun could turn out to be a disaster while a person with a Grand-Canyon-sized resume gap could be a star. So  justice is served when a job applicant submits a resume only when it validly contributes to the employer’s decisionmaking. If not, substitute one or more of the following: Work samples, a business plan describing what you’d do if hired, a human letter describing your tortuous path toward concluding that this job could be a felicitous match between the employer’s needs and where you are at this point in your life. Of course, many employers will round-file your application for not sending your resume but you don’t want to work for that person anyway. You want to work for someone who embraces your valuing substance over form.

Striving for balance.In today’s era of yoga and family-friendly workplaces, balance is deified, with long hours pathologized as workaholic. But many contented and productive people have out-of-balance lives, working long hours and with a greater sense of mission than if they spent the extra hours hanging out at home. Of course, if you hate your job and are exhausted at 40 hours, work-life balance is probably wise. But if you’d rather spend hours 40 to 60 working, shouldn’t you consider breaking the work-life balance commandment?

And if you’re the boss

If you’re in charge, ask yourself whether you’ve imposed too many or too-rigid rules or are applying them too consistently. As Emerson wrote, “A foolish consistency is the hobgoblin of little minds.”

Marty Nemko's bio is in Wikipedia.

In 1909, the psychologist Edward Titchener translated the German ‘Einfühlung’ (‘feeling into’) into English as ‘empathy’. At the time, German philosophers discussed empathy in the context of our aesthetic evaluation, but Titchener maintained that empathy also helps us to recognize one another as minded creatures.

Empathy can be defined as a person’s ability to recognize, feel, and share the emotions of another person, fictional character, or sentient being. It involves, first, seeing the other's condition or situation from her perspective; and, second, sharing her emotions, and, in some cases, also her distress. Empathy is often confused with pity, sympathy, and compassion, which are all reactions to the plight of others.

Pity is a feeling of discomfort at a people, person, or thing in distress, and often has paternalistic or condescending overtones. Implicit in the notion of pity is that the person being pitied does not deserve his plight, and is more or less unable to alleviate, reverse, or transform it. Compared to either empathy, sympathy, or compassion, pity is a more distant and superficial feeling: the mere acknowledgement of another person’s plight.

Sympathy (‘fellow feeling’, ‘community of feeling’) is a feeling of care and concern for someone, often someone close, accompanied by the wish to see him better off or happier. Compared to pity, sympathy implies a greater sense of shared similarities, and greater personal investment. However, unlike empathy, sympathy need not involve a shared perspective or shared emotions. Indeed, sympathy is often more about the person sympathizing than the person being sympathized with. Empathy and sympathy often lead to each other, but need not do so.

Compassion (‘suffering with’) is more engaged than simple empathy, and is associated with an active desire to alleviate the suffering of the other. With empathy, you mirror the other’s emotions; with compassion you not only share them but also elevate them into a universal, transcending experience. Compassion is one of the main motivators of altruism.

Like empathy, altruism is a modern term, coined in the 19th century by the French philosopher Auguste Comte from the French ‘autrui’, which itself derives from the Latin ‘alteri’ (‘other people’). It refers to unselfish concern for the welfare of others. The classical notion that most approaches altruism is probably almsgiving, which derives from the Greek ‘eleos’ (‘pity’), and means giving to others as an act of charity. In Christian theology, charity is, properly speaking, the love of man for God, and through God, for his fellow men.

It goes without saying that pity, sympathy, empathy, compassion, and altruism often blur and overlap.

The empathy paradox

My friend tearfully confides that, when she was a child, she was sexually abused by her father. Moved by her plight, I try to comfort her. “I know just how you feel.” To my surprise, she seems annoyed by what I just said. “No, you don’t know how I feel! You can’t!”

In claiming that I cannot know how she feels, my friend is implying that she knows how I feel—or, at least, that however I might feel, it is not how she feels. But if she is correct in asserting that I cannot know how she feels, then how can she know how I feel, and that how I feel is not how she feels?

A similar paradox is raised in the Zhuangzi, which is one of the two foundational texts of Daoism.

Zhuangzi and Hui Shi were strolling on the bridge above the Hao river. Zhuangzi said, “Out swim the minnows so free and easy, this is the happiness of fish.” Hui Shi said, “You are not a fish. Whence do you know the happiness of fish?” Zhuangzi said, “You are not me. Whence do you know I don’t know the happiness of fish?” Hui Shi said, “Granted that I am not you, I don’t know about you. Then granted that you are not a fish, the case for your not knowing the happiness of fish is complete.” Zhuangzi said, “Let’s trace back to the root of the issue. When you said, ‘Whence do you know the fish are happy?’, you asked me already knowing I knew it. I knew it from up above the Hao.

Theory of mind

Empathy rests on ‘theory of mind’, that is, the ability to understand that, being different, others see things differently from us, and perhaps also differently from reality, and that they have different beliefs, intents, desires, emotions, and so on. Theory of mind is innate (‘from up above the Hao’), first apperaring at about four years of age. It improves over time, and, for each individual and in general, can be trained in extent and accuracy. Importantly, it enables us to posit the intentions of others and to explain and predict their actions.

It has been posited that the neural basis of theory of mind resides in ‘mirror neurons’, which fire when we carry out a particular action, and also when we observe that same action in another. The neurons ‘mirror’ the actions of the other such that they become ours, or like ours. This enables us to interpret the actions and infer the beliefs, intents, desires, and emotions that motivated them. Mirror neuron abnormalities may underlie certain cognitive disorders, in particular autism.

Benefits of empathy

From an evolutionary standpoint, empathy is selected for because it promotes parental care, social attachment, and prosocial behaviour, and so the survival of the gene pool. It facilitates social interactions, group activities, and teaching and learning, to say nothing of social manipulation and deception. It enables us to forsee patterns and problems, and to respond quickly and successfully to ever-changing needs and demands. Because it is one-step removed from us, it creates the distance or detachment required to make moral and normative judgements about others, and to take into account their long term good. Finally, in most cases, empathy brings about a positive state both in the person empathizing and the person or people being empathized with.

While empathy does of course promote prosocial behaviour, it can also distort perceptions of the greater collective good, leading us to violate moral principles and to privilege the welfare of a few above that of the many. Almost by definition, empathy is tolerable to the person on its receiving end, but can be exhausting for the person on its giving end. Our abilities to empathize are limited, both in accuracy and extent. A surfeit of empathy can lead to personal distress, and excessive demands on our empathy can end in ‘compassion fatigue’ and burnout. For all the reasons, we often restrict or even suppress our empathy, not from callousness or unconcern, but to conserve ourselves and ‘help ourselves to help others’.

Altruism

Empathy leads to compassion, which is one of the main motivators of altruism. Another, less flattering motivator of altruism is fear. In this case, altruism is an ego defence, a form of sublimation in which a person copes with his problems and anxieties by stepping outside himself and helping others. By concentrating on the needs of others, people in altruistic vocations such as nursing or teaching may be able to push their own needs into the background, where they can more easily be ignored and forgotten. Conversely, people who care for a disabled or elderly person, or even for healthy children, may experience profound anxiety and distress when this role is suddenly removed from them.

Regardless of its motivator, altruism is good for our karma. In the short term, an altruistic act leaves us with an euphoric feeling, so-called 'helpers’ high'. In the longer term, altruism is associated with better mental and physical health and greater longevity. Kinder people are happier, and happier people are kinder, setting up a virtuous circle of altruism.

At a more social level, altruism acts as a signal of interactive and cooperative intentions, and also as a signal of resource availability and, by extension, of mating or partnering potential. It also opens up a debt account, encouraging others to reciprocate with resources and opportunities that are potentially of much greater value to us than those that we felt comfortable to give away. More broadly, altruism helps to maintain and preserve the social fabric that sustains and protects us, and that, for many, not only keeps us alive but also makes our life worth living.

No surprise, then, that many psychologists and philosophers argue that there can be no such thing as true altruism, and that so-called empathy and altruism are mere tools of selfishness and self-preservation. According to them, the acts that people call altruistic are self-interested, if not because they relieve anxiety, then perhaps because they lead to pleasant feelings of pride and satisfaction; the expectation of honour or reciprocation; or the greater likelihood of a place in heaven; and even if none of the above, then at least because they relieve unpleasant feelings such as the guilt or shame of not having acted at all.

This argument has been attacked on various grounds, but most gravely on the grounds of circularity: "the acts that people call altruistic are performed for selfish reasons, therefore they must be performed for selfish reasons." The bottom line, I think, is this. There can be no such thing as an ‘altruistic’ act that does not involve some element of self-interest, no such thing, for example, as an altruistic act that does not lead to some degree, no matter how small, of pride or satisfaction. Therefore, an act should not be written off as selfish or self-motivated simply because it includes some unavoidable element of self-interest. The act can still be counted as altruistic if the ‘selfish’ element is accidental; or, if not accidental, then secondary; or, if neither accidental nor secondary, then undetermining.

Only one question remains: how many so-called altruistic acts meet these criteria for true altruism?

Neel Burton is author of Hide and Seek: The Psychology of Self-Deception, The Art of Failure: The Anti Self-Help Guide, and other books.

Find Neel Burton on Twitter and Facebook 

By Ann Chanler, Ph.D.

For years my patient Jean was so preoccupied with her mother’s inability to move forward that she didn’t realize her own life was on hold. Jean’s feelings about her mother obscured other emotions Jean needed to experience to grow. Verbal therapy didn’t seem to be working so I suggested a short, guided meditation to anchor herself in her body and create an internal space of calm in which other feelings could surface. As her capacity to focus on herself increased, the irritation with her mother receded. A few months later she said, mournfully, for the first time, “My mother is crazy, but I need to take charge of my life.”

What is enmeshment?

My patient was enmeshed with her mother. Enmeshed relationships are those that lack healthy psychic boundaries. We lose a sense of where we leave off and another begins. Our sense of individuality is compromised.

If our identity is wrapped up in meeting the other person’s needs, our own life goals are thwarted. We become a stranger to our own desires and our confidence can take a hit. The following may be signs of enmeshment:

-An inability to control our emotional involvement with another person

-An exaggerated sense of empathy and responsibility for the other person’s feelings

-Guilt or anxiety when not preoccupied with the other person’s experience

-Intense fear of conflict in the relationship

-An inability to feel happy if the other person is unhappy

Enmeshment can take a physical toll on us as well. A migraine, back or neck pain, and stomach upset can all be somatic manifestations of a relationship that’s too fused. Our bodies speak a pain that our minds have yet to discover. Consider, for example, the daughter who doesn’t understand why she feels lethargic for hours after she gets off the phone with her depressed mother. In this way, the daughter is identified with the mother’s psychic pain.

Enmeshment doesn’t discriminate. We can be enmeshed with a parent, sibling, or partner. In my practice enmeshment shows up in a variety of relationships. There’s the 40-year old man who is afraid to move to another city because his father, who lives next door, might disown him. There’s the 35-year old woman who can’t find her own voice because she’s afraid of stirring up conflict with her overanxious husband. And there’s the 50-year old woman who feels responsible for her sister’s alcoholic rages.

If you can release yourself from a relationship that’s too fused, a lot can change. Personal as well as professional goals can be identified and then realized. Jean, for example, completed her college degree and started a family of her own once she began to separate from her mother.

How do you disentangle an enmeshed relationship?

One way out is to get back in. By this, I mean deepening your relationship to yourself, beginning with increasing your connection to your body. A good place to start is with the practice of mindfulness.

Mindfulness is paying attention to thoughts, feelings, and bodily sensations with acceptance and without judgment. Sit quietly for as little as 5- or 10-minutes a day, listen to and feel your breath entering and exiting your body and notice the tingling in your toes, the pulsing in your fingers.

By heightening awareness and sensitivity to our own physical experience we become more self-loving. We gain a deeper appreciation of our psychological boundaries. Our investment and preoccupation with others loosens.

As you remain still, observe your thoughts without attachment as though they were clouds passing through the sky. By decreasing reactivity, we gain control over our feelings and behavior. We have the freedom to choose what to do with how we feel. And we are more able to tolerate pain and discomfort as we get better “sitting” with our experience.

Mindfulness helps improve mental and behavioral control as we face challenging relationships. We stay grounded in our own experience, focusing on what we feel while we separate psychically from others—we can clear up the confusion that comes with fusion. We feel less afraid of conflict because we feel calmer and less invested in the other person’s experience.

The internal space provided by practicing mindfulness offers a path toward separation from those with whom we are enmeshed, as well as one toward renewed and balanced closeness to oneself and others.

Mindfulness Resources:

Gateway to Presence by Tara Brach: 10-minute guided meditation

Full Catastrophe Living by Jon Kabat-Zinn

Ann Chanler, Ph.D., is a psychoanalyst whose work blends insight, mindfulness and principles of Buddhism. She is Associate Editor for Contemporary Psychoanalysis, faculty and Supervisor of Psychotherapy at the William Alanson White Institute. She is in private practice in TriBeCa, New York City.

The blogosphere exploded this last week with the  publication of  new research showing that many men and women  anticipate a relationship's ultimate failure. The research agency OnePoll released a study showing that half of all women keep in touch with a "back up husband" in case their current marriage ends in divorce. Another study  from the University of Indiana bolstered the OnePoll findings,  determining that men and women used Facebook, as Washington Post "The Intersect" columnist Caitlin Dewey put it, to "keep in touch with back-burners—exes or platonic friends they know they could connect with romantically, should their current relationships go south."

This is not a new phenomenon . We described this very behavior in Chapter 11 of our book "The Tiiger Woods Syndrome,  comparing the life pattern of a typical relationship to the mathetmatical concept of the sine curve. Originally we observed it in women but the  latest research shows it is indeed practiced by both men and women. Let us look at the sine curve at this link.

When the sine curve begins at zero the average person begins to become interested in a potential lover. Their increased interest is depicted on the y-axis,the time in the relationship by the x-axis.

Over time their interest in a person will increase to the threshold of dating them. At this point, interest is measured as 0.7071  on the y axis or Pi/4 on the  x axis  on the chart of the sine curve. From this point onward the woman and man are a couple.

The slope of the sine curve is positive until it peaks at 1.0000 on the y axis or Pi/2 on the x axis, reflecting the upside of any dating relationship. When the sine curve reaches1.0000, there is both good news and bad news for the happy couple. 1.0000 represents the apex of the relationship. Both partners are completely satisfied with the relationship at this point in time. At 1.0000 things will never be so good again. Many a romantic looks back at his or her broken relationship and yearns for the 1.0000 moment, which in dating, can be approximated at a homecoming or prom dance, a special time together or a romantic weekender. For the married couple the peak 1.000 point will usually be the first few years, especially for those in "mirage" marriages based on the ephemeral notions of physical attraction and charm with no consideration for compatibility, shared world view or  common interests and goals.

According to the sine curve theory of human dating and mating  behavior, after the peak is reached, things slowly begin to deteriorate. Although the couple is still together, one or both begins to sense that something isn’t right. But for many, a trip to the relationship counselor is not in order. Instead,  one or both will begin to look elsewhere to meet a basic need: both men and women do not like to be alone. They like to have someone to sit across from at restaurants, tell how their day went, enjoy romantic interludes with and take on vacations. There are formal dances, holiday and family get-togethers, club, fraternity or sorority functions and Friday and Saturday nights that demand an escort. They simply need somebody to be that person, the dutiful boyfriend, girlfriend, husband or wife, and if they have decided you don’t make the cut for the part-time or permanent position, they begin to look elsewhere for suitable candidates.They may still be dating, living with or be married to you, but that loving feeling is slipping away. At this point they will begin to look for other potential partners to replace the current number one sine curve relationship, whose slope is now becoming increasingly negative.

 As time progresses, the sine curve again reaches 0.7071 on the y axis or 3 Pi/4 on the x axis, this time on the downward slope of the sine curve.  The relationship is again at the threshold of dating/not dating, which we all call “breaking up.” 

The unsuspecting partner  may not know it at the time, but when the relationship has long since peaked, then their dissatisfied mate  will break up with them. Unfortunately, many men and women in mirage relationships don’t see  the downward side of 0.7071 coming. They deny the signs something is amiss.  They aren’t able to sense the  negative feelings and pick up on the negative body language their unhappy partner  has been emitting for a while. They are the ones who feel betrayed while their ex has merrily moved  on to another boyfriend, girlfriend, husband or wife.

According to the research from OnePoll and Indiana University, many men and women will have several future "sine curves" to cultivate at work and play or on the internet even as they are dating, living with, or are married to another one. As they end one relationship at the negative end of 0.7071, they will have another potential new lover at the threshold of dating on the positive side of 0.7071 on another sine curve. Thus the man or woman can theoretically never be without an escort if they carefully end one sine curve while they simultaneously begin another.

It certainly  represents a new low in male-female relations when both can be so callous to already be planning their next relationship while the marriage or cohabitation bed is still warm. But that is love in 2014. The word for the wise is to never take your relationship for granted. Who knows who lurks in the shadows ready to take your place?

Introduction:

This concludes my autobiographical three part series concerning tomorrow’s medicine today in which I share thoughts based on my experiences in hopes this will help others to ask the right questions and get better answers. In these three October Blogs, I'm also addressing why medicine remains the fastest growing failing business in the world today! 

Patient Compliance and Rational Health Choices:

My practice and professional association with physicians made me aware of problems motivating patients to take better care of themselves and “follow doctor’s orders,” in their own behalf beginning with New Year’s Resolutions. In the context of crisis medicine (i.e., sickness-care) patients are inclined to take care of themselves. In the context of prevention (i.e., wellness- care) patients are inclined to cheat and ignore issues of weight reduction, diet, alcohol abuse, exercise, smoking, food addictions, stress, etc. It’s not uncommon patients in preventive medicine programs to throw caution and enlightened self-interest to the wind with la belle indifference.

My interest in personal motivation, self-reliance, and rational health choices focuses on making such choices and the struggle to be mindful of the risks involved. Do you suppose there is a co-dependency between society and the patient? This might be true if society caused anxiety or depression, but more likely true with individuals professing a strong sense of entitlement. However the problem may not be one of commission, but one of omission on society’s part; depending on how much of a libertarian you are, how much you believe in the virtue of self-reliance, the vice of entitlement, or how much you believe in helping fallible human beings overcome personal problems.

Individuals and society share a stake in controlling insurance and medical costs. Medical inflation hurts everyone, reduces productivity and ultimately degrades standard of living. Meanwhile opportunistic drug pricing, rather than value pricing, results in bankruptcies that sometimes destroy marriages and families.

__________

I will avoid “pathologizing” irrational health choices by looking beyond Psychology and Positive Psychology to Moral Psychology and Moral Education which I view as the ultimate Preventive Psychology to complement Preventive Medicine.

The Moral Psychology I have in mind is Axiological Psychologyand not the Moral Psychology of a hundred years ago. It is founded on a science of values. It is a psychology that encourages and supports rational health choices. It views such behavior as a scientific virtue and the failure to make such choices a scientific vice; but not a virtue or vice in any religious sense.

The revival of concepts such as virtue, vice, good, and evil works for me because I ground them in the new science of values; making possible the development of moral education to complement the learning of our ABCs and 123s. It also allows the development of societal or cultural carrots and sticks to reward rational health choices and discourage irrational health choices. By rational I mean pro-self, pro-social behavior and vice versa.

Do I have concept approval? Do you think we’re ready to move in this direction? Do you think that day will come? Do you think societal sponsorship of moral education can morph into a sort of “Third Person” (i.e., societal proxy) in the doctor-patient relationship…without shouts of “Orwellian,” “Skinnerian,” or “Brave New World?” (1)

I think we can all agree that it is desirable for patients to become more mindful of the importance of rational health choices, but is moral education, sponsored and required by society, a good way to achieve this; or is it too Orwellian, Skinnerian, and Brave New World? Do you think promoting Moral Science (i.e., Axiological Science) and moral education might even help us avoid the very Orwellian future that some see in our discussion of concepts like virtue, vice, good, and evil?

Theoretical Medicine:

Medicine is complex. It needs a theoretical medicine discipline to guide it, guide innovation, and the safe use of statistics which tend to blind doctors to the individuality of uniqueness (i.e., biochemical individuality) of patients. I want to see a Theoretical Medicine for the same reasons physics benefits from Theoretical Physics.

Preventive Psychology:

As noted, moral education is preventive psychology. But, you might ask “whose morality?” Catholic, Protestant, Islamic, Hindu, Buddhist, etc.?” None of them! I’m referring to basic moral reasoning based on the science of values (i.e., axiological science). This science derives from the convergence of philosopher Hartman’s Theory of Value and psychologist Pomeroy’s empirical validation of this theory, supported by successful business applications of this science.

This convergence of philosophy and psychology, along with their foremost applications of valuementrics and axiological psychology, gives humankind something it never had before; namely the seeds of moral education and preventive psychology. It identifies Feeler, Doer, and Thinker dimensions of moral reasoning which vary in sensitivity, balance, order of influence, and plasticity; all of which can be measured, modified, and improved as needed.

Conclusions:

I’ve offered an autobiographical discussion of medicine touching on several topics. My purpose is to address important unfinished business in the professions of medicine and psychology.

Let’s not allow the historic success of drugs treating infectious diseases to blind us to the failure of drugs to prevent and heal age related, chronic, degenerative diseases. Geriatric medicine requires integrated medicine of the sort that recent advances in molecular biology, genomic mapping, immunotherapy and stem cell therapy make possible.

My metaphorical “Third Person,” (i.e., a societal proxy) present in the Doctor-Patient Relationship represents the future of greater societal involvement. I believe that society has a role to play in motivating fallible human beings to overcome procrastination and make rational health choices that benefit themselves and society. In the end society will adopt carrots and sticks to reward virtue and discourage vice insofar as making healthy choices is concerned. This will require the surrender of some freedoms in the name of the greatest good for the greatest number; not unlike what’s happening right now in our fight against terrorism…whether we like it or not.

My call for “Tomorrow’s Medicine Today” is a way to draw attention to the importance of biochemical individuality and the goal of individualizing or tailoring medicine to address this reality rather than the statistical abstraction of the average person who doesn't exist. References to the average person appear in medical literature and it is the average person that the pharmaceutical-industrial complex, and FDA, refer to when claiming the safety and efficacy of drugs. We know how a drug will respond when poured into a test tube, but we don’t know how it will respond when poured into your body or mine because we’re not average. This is the weakness of statistics at even the level of controlled, double blind studies. . 

Arriving at a moral calculus and moral incentives to encourage and improve patient compliance in preventive medicine programs will take time and education. It may take decades depending on circumstances, but the cost of health care makes this an urgent matter now and in the long run. Today’s evolving science of values and valuations gives us a foundation for progress in this area of medicine. It will allow us to more precisely distinguish between basic moral reasoning and applied moral reasoning; which is the difference between implicit cognitive mechanisms dedicated to moral reasoning and the explicit religious, ethical, and philosophical content we’re all familiar with.

Civilization and its Discontents is the title of Sigmund Freud’s last book, and he wasn’t all that successful in diagnosing what ails both. It appears both (i.e., collective and individual) lack rules to live by of the kind provided by a scientific study of values supporting moral reasoning and moral education....enriched by the wisdom of the ages.

The concept of society playing a more direct role in motivating patients to take better care of themselves will be tested in years to come given the exploding cost of health care. This will certainly give libertarians something to fight over, and humanists something to celebrate.

(1) Note:“Orwellian” refers to George Orwell’s anti-utopian novel Nineteen Eight-Four in which he satirizes the tyranny of “Big Brother.” “Skinnerian” refers to B. F. Skinner’s radical behaviorism unfolding in the pages of Walden Two. Brave New World refers to Aldous Huxley’s negative utopia.

. © Dr. Leon Pomeroy, Ph.D.

http://www.psychologytoday.com/blog/beyond-good-and-evil

 The Doctor Patient Relationship Needs Help 

Sensory issues can be a deeply painful part of a life on the spectrum. Sadly, many of us on the spectrum, and the people who love us, have found very little published on these sometimes deeply disabling challenges. Ten years ago, occupational therapist Lindsey Biel co-authored the book Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues, which provided concrete and detailed strategies for successfully supporting children who struggle with sensory discomfort and pain.  Her latest book, Sensory Processing Challenges: Effective Clinical Work with Kids & Teens, aims to do the same for clinical professionals.   

Recently, I talked to her how she became interest in this area, and what she's learned along the way.  Here is what she had to say.  

Can you tell us a little bit about your background? 

Prior to becoming an occupational therapist, I was a freelance writer for many years, mostly in advertising and publishing.  I enjoyed my work but it had become formulaic and I felt there was something missing which had to do with connecting with people in a deeper, more meaningful way. I considered becoming a psychotherapist or a social worker, but then came across a book while browsing the shelves at the Strand Bookstore. That book was Temple Grandin’s Thinking in Pictures. Well, that changed everything. I knew I wanted to work with people who think and feel differently and see the world from a unique and fascinating perspective.  

As I researched autism I also started reading Oliver Sack’s wonderful books which led me to recalling the pleasure I’d experienced as a volunteer doing crafts and self care activities in a nursing home in high school and then the fascination of watching the rehabilitation of a relative who’d been paralyzed in a plane crash and it all came together in one perfect intersection: occupational therapy. Fast-forward 20 years and I am proud to say one of my books, Raising a Sensory Smart Child, is referenced in the expanded edition of Temple Grandin’s Thinking in Pictures!  

You’ve published two books now on the subject of sensory processing issues, Raising a Sensory Smart Child and Sensory Processing Challenges — what drove your interest in the topic? 

While I had always intended to work with adults, I was fortunate to receive a full scholarship to New York University for a master’s degree in occupational therapy through the NYC Department of Education. This required a two-year work commitment in the city schools after graduation. 

In the schools, I worked with students with a range of disabling conditions from cerebral palsy to autism. I loved working with all of those kids and noted that almost every one of them had underlying sensory processing challenges. I, too, had been plagued by sensory issues such as discomfort with fluorescent lighting and glare in the classroom and noise in the cafeteria and on the playground. I remembered how exhausting all the light and noise was as a child and was not at all pleased to find I still had those issues working in the school environment. I was driven to learn more about sensory processing and to develop practical “sensory smart” strategies to deal with them. 

In the introduction of the updated edition of Raising a Sensory Smart Child, you mentioned how many people reached out to you after the book was first published, and what a dearth of information there is on this topic.  In your latest book, you call upon readers to educate others about sensory issues.  In your opinion, what is the most effective way to do that? Is there anything in particular that care professionals can do to help drive this, in particular? 

When I wrote the first book, Raising a Sensory Smart Child, along with the mother of a child I treated through early intervention, there was very little out there to help parents, teachers, and others understand, recognize, and help a person with sensory processing challenges. Many occupational therapists working with kids knew techniques that helped, but these techniques were generally kept within the therapy session, within the school, within the family. I wanted to reach out to so that every parent, teacher, clinician, and person with sensory problems had access to the best techniques and strategies. I also teach very practical strategy-oriented workshops to OTs, physical therapists, speech therapists, teachers, parents and others to share what helps.   

My second book, Sensory Processing Challenges: Effective Clinical Work with Kids & Teens, is directed toward professionals, i.e., psychologists, neurologists, pediatricians, social workers, physical therapists, speech therapists, OTs, and others. All too often they do not recognize sensory problems or even if they do, they still need help connecting the dots between sensory issues and behaviors they are concerned about.  

It IS so important that we all educate others about sensory issues. One of the most powerful ways to effect change in the world is to speak out. Temple Grandin spoke out in a way that directly changed my life and as a result, the lives of many thousands of people. Professionals need to listen to what people with sensory issues have to say. They need to collaborate with individuals who experience the world and their bodies differently and work together. They need to empower people with sensory problems to become more self-aware and to self-advocate. Sharing ideas, sharing perspectives, writing magazine articles both in general parenting and other general consumer publications as well as in autism and special needs specific publications, speaking to parenting groups, doing professional workshops and school staff development, and using social networks are all vital, vibrant ways to make a difference in the lives of kids, teens, and adults with sensory challenges.  

Have you seen a change in awareness of sensory issues in the years since your first book was published?  If there has been a change, what do you think has been the driving force behind that change?  How much further do you feel we need to go?  

My first book was published in 2004 with an updated, expanded edition in 2009. There certainly has been greatly increased awareness of sensory issues during this period, especially in terms of more parents and professionals recognizing sensory problems in children both on and off the autism spectrum.  

In addition to my book and others, the push toward getting Sensory Processing Disorder into the revised edition of the American Psychological Association’s Diagnostic and Statistical Manual shifted the conversation from whether sensory issues exist to whether this is actually a distinct disorder. In the end, of course, SPD did not make it into the DSM 5, but hyper- and hyporesponsivity to sensory input did make it in as a diagnostic criterion for autism. In the past few years there has been an increasing body of empirical research showing structural differences in white brain matter between people with sensory processing difficulties and those without as well as autonomic nervous system differences in children with autism and sensory issues, children with sensory issues who are not autistic, and neurotypical children. My hope is that this kind of research will earn sensory processing challenges a larger place in the next DSM. 

Meanwhile, the American Academy of Pediatricians published a report on sensory integration in Pediatrics acknowledging the benefit of sensory interventions for some children. This put the term sensory integration in front of virtually every pediatrician in the country which was a huge leap forward.  

Even ABA teachers who formerly did not “believe” in sensory issues now recognize that if a person is uncomfortable, overwhelmed, or in pain due to sensory problems, that they will not be as responsive or available for new learning. Today more classrooms are starting to incorporate movement to meet vestibular and body awareness needs. It is much easier to locate seamless socks and underwear and soft, tagless clothing for sensitive people. Noise reducing headphones are readily available.  

There is still so much research, education and awareness that needs to happen. We still ask students and workers to adjust to schools and workplaces rather than adjusting those environments to meet the needs of their users. Parents still have pediatricians who trivialize their concerns about oversensitivities to noise, or clothing fabrics, smells and so on. And they still have friends and relatives who think they’re indulging in their child when they give them movement breaks or special allowances to accommodate their sensory needs.   

In your most current book, you state that over 90% of individuals with autism have sensory issues of some kind, and some studies indicate 100% have auditory processing issues.  How has that knowledge shaped how you interact with clients on the spectrum?  

While we do have these very impressive statistics about autism and sensory issues, it is essential to recognize and honor the uniqueness of each individual. While not all people with sensory issues have autism, virtually everyone on the autism spectrum has sensory issues. Sensory issues are generally more severe and more potentially disabling in people on the spectrum.  

When working with someone on the spectrum I do make an assumption that there are sensory experiences impacting the person. The question becomes to what degree? In what situations? Is this person in pain? What sensory systems are working most comfortably? Is the person hypersensitive to some types of sensory input? Undersensitive? How much multisensory input can this person handle before it becomes problematic? When overloaded does this person tune out or act up? I try to connect the dots between daily life experiences and outward behaviors that are problematic or unpleasant for that person. Then I try to assess what variables I can adjust so the person can feel and function better. 

In your opinion, what are the most critical things a care provider needs to know about sensory issues experienced by those of us on the spectrum?  What are the most critical things a parent needs to know? 

When my first book, Raising a Sensory Smart Child, was translated into Mandarin, I had a Chinese friend take a look because I couldn’t decipher a single word. She told me the title translated as “It’s Not My Fault.” At first I was appalled at the translation and then I thought about the beauty of the new title. Every parent, teacher, and caregiver needs to know first and foremost that when a person is at the mercy of sensory issues that can be extraordinarily difficult to behave as expected. For young children on the spectrum, with all their difficulties with language and social thinking and motor skills, sensory issues make it even harder if not impossible to behave in a so-called “normal” way.  

A care provider’s best bets are to avoid harsh lighting such as fluorescents, provide soft seamless clothing, use reassuring firm touch, and speaking gently and patiently using language that is clear, concrete, and free of unnecessary words. Do not demand eye contact when you are speaking as it can be extremely hard to process sight and sound simultaneously, especially for an autistic person who may well be unable to follow what you are saying when watching your lips, eyebrows, and facial expressions change constantly. Understand that a person can’t simply stop self-stimulatory behaviors because you tell them to and that these stims are a way of coping with stressful sensations and feelings, including boredom. Finally, assume competence even if the person is unable to prove this to you yet. And start focusing on what the person can do instead of on deficits.  

Many people mistake reactions to sensory issues for purely behavioral issues. For example, mistaking a child who melts down in a store due to overload, versus a child who simply throws a tantrum because they aren’t getting what they want.  How did you learn to recognize the difference?  

A sensory meltdown represents a mismatch between the situation and sensory processing capability. Typically the sensory stimulation is uncomfortable or painful, the person cannot control impulses and reactions, and recovery happens slowly. A behavioral tantrum is a mismatch between the situation and emotions, desires, and coping skills. It tends to be goal-oriented and once the goal is met, the tantrum stops. If you know that a child does, indeed, have sensory challenges, then you can bet most unwanted behavior is due to those sensory challenges.  

If there was one thing you wish everyone knew about sensory issues, what would that be?

I think it’s important to recognize that we all have sensory issues of one kind or another to some degree or another. It’s part of who we are and how we experience ourselves in the world.  

 Lindsey Biel, M.A., OTR/L, is an occupational therapist with a private practice in New York City. She is coauthor of the bestselling book for parents,  Raising a Sensory Smart Child: The Definitive Handbook for Helping Your Child with Sensory Processing Issues. Her latest book, Sensory Processing Challenges: Effective Clinical Work with Kids & Teens. For more information please visit Lindsey Biel’s websites at: sensorysmarts.com and sensoryprocessingchallenges.com. 

Attachment Parenting is essential to raising children who can securely trust in their dependence on the support and guidance of parents. It can be counterproductive, however, when parenting adolescents who need Detachment Parenting and more freedom to grow so they can develop secure self-reliance to count upon.

Early Adolescence usually starts around ages 9 – 13. As the young person begins to separate from childhood, pushing against and pulling away from parental authority for more freedom of independence, that is usually the signal for detachment parenting to begin. 

During Attachment Parenting, the adults keep holding on to define choices that constitute Responsible Behavior. During Detachment Parenting, the adults start letting go and demanding increased accountability for choices (and dealing with consequences) to foster more Responsibility. Detachment Parenting is not for the faint of heart. After parenting a child, parenting an adolescent is usually harder to do.

Parents can sometimes get stuck in Attachment Parenting, holding on through traditional support, service, sheltering, and social control to stay as attached to their daughter or son in adolescence as they were in the young person’s childhood. When this occurs, they can risk holding back adolescent growth or at least they can make it harder for the young person to let go of them and learn to manage more self-sufficiently. For example, parents who hover over and continue to pet and play and use the same endearing terms with the adolescent as they did with the child can make acting older harder for the young person to do. “I’m not your little kid anymore, so stop treating me that way!”

The same can be true when the adolescent refuses to let go and detach from childhood dependence on parents – demanding to be given to, done for, and rescued, unwilling to detach from them. When old childhood help is forthcoming, it often protracts sense of cautiousness in the teenager instead of building confidence.

The transition from Attachment Parenting to Detachment Parenting can require a significant adult adjustment. Very roughly defined, consider what that contrast might feel like.

ATTACHMENT PARENTING   DETACHMENT PARENTING

A CHILD                                 AN ADOLESCENT

Holding on----------------------------Letting go

Establishing dependence------------Fostering independence

Education by direction--------------Education by consequences

Commanding obedience-------------Working for consent

Managing decisions-------------------Coaching decisions

Rule-making---------------------------Responsibility giving

Keeping control-----------------------Releasing freedom

Requiring information----------------Requesting information

Judging conduct-----------------------Informing choices

Protecting from risk----------------- Exposing to risk

Being told enough---------------------Being less informed

Leading growth-------------------------Following growth

Feeling matched-----------------------Feeling mismatched

Feeling attached-----------------------Feeling connected

The trick in Detachment Parenting is managing to let go the old Attachment behaviors and still stay meaningfully Connected as the process of adolescence grows parent and teenager apart, as it is meant to do. I believe the best hope for an ongoing connection is created by continually giving the adolescent “choice points” by which I mean interactive opportunities for staying in positive contact with the parents. Maintaining this initiative requires active parenting; passive parenting won't get this connecting job done. 

When it comes to connecting, I think of five categories of choice. Parents keep Communicating (sharing and listening) with the teenager. Parents keep showing Concern (interest and empathy) with the teenager. Parents keep expressing Caring (valuing and loving) with the teenager. Parents keep offering Companionship (playing and working together) with the teenager. Parents keep expecting Cooperation (collaboration and consent) with the teenager.

The teenager’s intermittent refusal to engage with any of these initiatives is no excuse for parents to stop offering them. There needs to be this parental promise. “I will keep giving you openings to positively connect with me, whether at the moment you feel like accepting that offer or not. Should you refuse, I will not feel rejected, I will not feel hurt, I will not feel discouraged. I will not give up. I will keep reaching out to you on my side so you always have a positive opening to connect with me, even when, especially when, occasional hard times happen between us." 

If, because of too much conflict, too many problems, or too few rewards, parents break this commitment, they essentially abandon the young person. Now the teenager is at risk of reaching out for less trustworthy and reliable relationships to keep them feeling meaningfully connected and not alone.

To brave times of strain and distance with their adolescent, parents must continually offer positive choice points for engaging with them. Letting go and still remaining well connected is the challenge of Detachment Parenting.

For more about parenting your adolescent, see my book, “SURVIVING YOUR CHILD’S ADOLESCENCE,” (Wiley, 2013.) Information at: www.carlpickhardt.com

Next week’s entry: Parenting Adolescents to Independence and the Sadness of Success

What does anxiety do? 

When we’re too anxious we won’t be able to gather new information, think clearly about the problem, explore our options, give calm and clear feedback to others, and find creative solutions that consider the needs of all. And fear can run amuck, flooding our system with adrenalin and hi-jacking our neo-cortex—the thinking part of the brain.

Anxiety is a mean trickster. It signals you to pay attention, but it also turns your brain to oatmeal, narrows and rigidifies your focus, and obscures the real issues from view. Anxiety tricks you out of the “now” as you obsessively replay and regret the past and worry about the future. It tricks you into losing sight of your competence and your capacity for love, creativity and joy. It tricks you into believing that you are lesser and smaller than you really are. Anxiety interferes with self-regard and self-respect, the foundation on which all else rests.

It makes no difference whether you view your anxiety as a product of your genes, faulty brain circuitry, early trauma, current stress, world events, or the moon and stars and grace.

Whatever your perspective, one thing is certain: Anxiety can make you feel dreadful about yourself. It can impede your capacity to think. It can dig a big negative groove in your brain and make it impossible for you to hang on to a positive thought for more than five seconds. It can affect your body in ways that can feel crippling

When anxiety gets really bad, prepare to shake, hyperventilate, feel nauseous, throw up, get dizzy, sweaty, antsy, jittery, tense, irritable, agitated or otherwise hyper-aroused. You may have difficulty swallowing and feel a constant lump in your throat. In bed at night, you may grind your teeth and jerk your legs like an overcaffeinated marionette. You may breathe too rapidly, hold your breath, or feel like you might stop breathing entirely if you don’t force yourself to inhale and exhale. You may call 911 convinced that you are having a heart attack—or that you are losing control and going crazy. You may feel numb, faint, physically immobilized, exhausted, detached from your body, and, at the same time, unbearably stuck in it.

What harms you is not the dreadful way that anxiety feels in the body, whether it’s moderate agitation or a full-blown panic attack. We are all capable of managing the most anguishing physical sensations when we know what is happening to us, when we understand that what is happening is frightening but not really dangerous, when we know we won’t die from it, and when we know that eventually the feelings will subside.

As I explain in The Dance of Fear, what harms you is when you mistake anxiety for being you. You mistakenly see yourself as a weak and impaired individual, rather than as a strong, competent person who happens to have an overactive fear response.

Anxiety will always be with us. But we needn’t let it silence our authentic voices, close our hearts to the different voices of others or stop us from acting with clarity, compassion and courage. In today’s world, no challenge is more important than that.

“Without proper training on how to make wise choice…the chances are very slim anyone will make them.”                                           --Sidney Madwed           

Striving for socially defined success is the path most people pursue for seeking fulfillment.  When I interviewed, trailblazing women in fields of science, government, business, media, entertainment, and sports for my study on Women, Motivation, and Success, I knew that their achievements had given them notoriety, wealth, and power—but were they fulfilled?  In spite of their fame and recognition, the very standard by which many define success, their answers to this question often opened our conversation about what success and fulfillment mean.

One of the women who I interviewed and who became a lifelong friend was Donna Summer, a world-renowned vocalist whose success, she said, “came overnight.”  She had actually achieved “a reasonable amount success” in Germany before becoming a celebrity in the United States. Living in Germany, she travelled back to the United States learned that she was dubbed the Disco Diva.  She recalled the shock of her own celebrity status upon returning to the U.S. and shared her story for the study about how success competed with fulfillment. 

Driving down Sunset Boulevard, Summer recalled doing a double-take as she passed by her image, “larger than life,” on a billboard.  She said that overnight she had been catapulted into a foreign world, into a life of an artificial persona, describing guilt for having participated in the image making:  “They took a fundamental part of my being—my voice, which I had always believed was a gift—and through ‘the packaging of Hollywood’ elevated me to superstar status.  But was this me?”

Raised in a religious family, she expressed her embarrassment about posing as the Disco Diva:  wild, sexy, lusty, and indecent.  Caught in the whirlwind of success, with private planes whisking her from one sold-out concert after another, she was singing more often and to more people than ever before yet feeling less fulfilled than at any other time of her life.  Summer had lost her sense of self and could no longer maintain the vital relationships with family, friends, and God that had previously grounded her.  In sum, her growing celebrity status had intensified the complexity of access to her true self.

Most seek attention and recognition, but it is attention and recognition of our genuine qualities, expressed authentically, and our critical relationships, that sustain our sense of meaning and purpose—enabling us to thrive.  Donna’s voice was a genuine gift, and she had used it as an expression of her creativity and love of God.  However, when she allowed her voice to be packaged by others, she grew disconnected from herself, feeling alienated, and disingenuous. 

When I first met her Los Angeles mansion in 1980, I recall her pointing to a wall showcasing her platinum and gold records, among other awards, the symbols of success that she said “had lured” her from her sustaining relationships.  She disclosed how she began “to use drugs” and “live in the fast lane.”  However, the meteoric rise to fame brought her on a rollercoaster of emotions, contrasted by the dramatic lows she felt from within. 

On one occasion I accompanied her to a concert.  The crowd, thrilled with her performance, stood for every song, and held lighters honoring her at the event.  Though the concert ended, they kept clapping for yet another encore.  When she took her final bow, she hugged me and said nothing.  Later in her dressing room, she reflected:  “It’s hard to describe the experience of moving from overflowing applause of thousands of crowds of people who you don’t really know you to the total silence when the curtain falls.  I really feel alone.” 

Donna realized what she had lost.  She later told me that in the midst of her stardom her sister came to her home to tell that she was losing her path.  She brought a Bible over for encouragement.  Reactive to the mild, yet pointed, confrontation, Donna screamed at her, throwing her sister out of her home, and tossing the Bible at her as she exited.  Later, distraught, Donna told me that she picked up the Bible, and her eyes fell upon these words:  “My peace I give to you; not as the world gives do I give to you.  Let not your heart be troubled, neither let it be afraid.”  (John 14:27)

Donna felt as if God spoke to her directly.  She fell to the ground and cried—and, afterwards, “though not perfectly” as she said, she “worked to reclaim the path of her true self.” 

Our world offers many answers to our search for fulfillment: a high-paying job, a comfortable home, a perfect physique, a potpourri of various and conflicting “answers” and enticements.  While these may bring pleasure and give us a sense of achievement, do they leave us fulfilled?  While some seek to discover these answers within the home, others go outside, and may be distracted or cling to answers from those trained to provide guidance.  Matsuo Basho says it well:  Our task is “not to follow in the footsteps of the masters but to seek what they sought.”  We must not prepare our children or ourselves to walk in someone else’s path but to encounter the discovery.

Many studies confirm that material wealth is not the solution to our widespread or sustaining longing.  Despite unprecedented affluence, health care technologies, and advances in modern culture, few claim to be truly satisfied.  Mihaly Csikszentmihalyi (American Psychologist; October, 1999) revealed that those who have more money to spend do not report greater subjective well being.  Strikingly, children of the lowest socioeconomic stratum have been reported to have the highest degree of happiness, while upper middle-class children generally had the lowest (David G. Myers & Ed Dieson, American Psychologist, January, 2000). In fact, scientific studies increasingly lead skeptics to the conclusion that our psycho-spiritual endeavors produce greater and more sustaining results over the absence of these components (Thomas Plante & Alan Sherman, Faith and Health, 2001); and the overwhelming results of outcome studies (Harold Koenig, Handbook of Religion and Health, 2012) demonstrate hundreds of documented studies confirming the powerful results of spirituality and religion for well-being (physical, emotional, and spiritual).

From Plato’s maxim, “A healthy mind in a healthy body” and throughout the time-tested message of all the Great World Religions, we learn from very wise hearts that we become crippled when we lose touch with our soul.   Fulfillment evolves when nurturing our whole being.

                   “Here is my secret, a very simple secret;

                   It is only with the heart that one can see right;

                   What is essential is invisible to the eye.”

                                        --Antonine de Saint-Exupery

Photo credits: chicagonow.com; groundzeromedia.org; thrivechurch.com; dayspringrecoverycommunity; pamsterling.com; braeburnwellness.com.

John T. Chirban, Ph.D., Th.D. is a clinical instructor in psychology at Harvard Medical School and author of True Coming of Age:  A Dynamic Process That Leads to Emotional Stability, Spiritual Growth, and Meaningful Relationships.  For more information please visit www.drchirban.com.

I reviewed 3,000 famous artworks to select 14 paintings and one sculpture that, for me at least, feel the most psychologically moving. I reproduce them here plus, in the caption for each, writing a feeling it evokes in me. I hope you find the experience as rewarding.

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Marty Nemko's bio is in Wikipedia.

They say all is fair in love and war, though certainly for different reasons. War is hell, and all sorts of morals are ignored when things escalate to its atrocious state.

And anyway all isn’t really fair in war, as the Geneva accords and international court will tell you. Perhaps more accurately more unfairness is tolerated in war, not that it should be.

Love’s a different story. Love at least today is largely recreational. We’re increasingly tolerant of people getting together and breaking up and with whom they please.

And all is not fair in love really either. It’s fair for you to break up if you decide that’s best for you. But it’s not fair to pretend that you’re available for relationships when you aren’t. For example, it’s not fair to claim love you don’t feel just so you can get into someone’s pants or wallet. It’s not fair to pretend your unmarried or single when you aren’t.

We don’t owe each other romantic commitment, but we do owe each other clear signals.

We don’t always have clear signals to share. Maybe that’s what’s meant by all’s fair in love. In love you place your bets you take your chances. Your bet may be uncertain: “If this continues to work as well as it has so far, I’ll want to stay in it,” or “I don’t know yet, but I’d like to go on another date.”

Your bet is bound to be uncertain at first. You can’t commit tell you’ve given it a full test; you can’t give it a full test until you’ve voiced willingness to commit. How can you tell for sure that you want to sleep with someone until you’ve slept with him or her?

It’s an unfair misinterpretation of love’s gamble if you cry foul when you chose to sleep with someone and they decide not to sleep with you again. You can’t honestly say, “But you said you wanted to sleep with me!” Love starts with testing the waters. It is inherently risky.

But that shouldn’t let us off the hook on clear signaling. When you begin to doubt your commitment, you should start to feel fairness’s requirement that you let your partner know.  Don’t hide behind “It would hurt them.” In the short run, yes, but in the long run they’ll be better off if they knew where you stood.

Of course choosing when to signal is hard. You don’t want or need to signal reduced interest with every dip in your enthusiasm. One of the challenges of partnership is that neither partner wants to be in deeper than the other. When you signal ambivalence it’s likely to make your partner back off too. It’s hard to even give love a try when two people are both hair-trigger and signaling their every ambivalence. So it’s a tough judgment call as to when you should signal a change in personal direction. But out of basic respect for fairness and for the people we date, we should feel the burden to signal, not to bite our tongues, out of supposed respect for them or more callously to keep our options open.

And out of basic respect for fairness and our dates, we should make room for such signaling. Don’t shame your partner into silence about his or her intentions. Don’t turn commitment into a moral issue. It isn’t one. No one owes us partnership. Face the fact that partnership is a delicate dance, a bid for something extremely intimate and risky.

Any of us who value our lives are going to want to enter it gingerly, carefully, cautiously, and to back out if it looks like it’s going to derail us from our values and priorities. To that extent, enter courtship aware that all is fair in love, including that our partners get to vote with their feet. 

When I was growing up in the 1950's and 60's, my friends and I all lived in what we now refer to as an intact family.  Sure, my parents, and those of my friends and relatives as well, all had their share of struggles and sorrows.  Yet whatever their marriage problems, couples mostly kept rowing together, sharing one boat, to the end of life.  As one song of that era put it, they "traveled along, singing their song, side by side." No one I knew at that time had parents who had divorced.  Now, by contrast, there's an epidemic of singledom.

During my junior high school years a popular Frank Sinatra song, to which I and probably most of my classmates knew all the words, began "Love and marriage, love and marriage, go together like a horse and carriage...This I tell ya, brother, you can't have one without the other." 

"Try, try, try to separate them, it's an illusion.
Try, try, try and you only come to this conclusion:

Love and marriage, love and marriage,
Go together like a horse and carriage.
Dad was told by mother ...
You can't have one without the other."

Who would have dreamed then that the idea that marriage was an inevitability once couples fell in love would potentiallly become, within half a century, nearly as antiquated as horse and buggies!

The problem is not that boys and girls do not want love to lead to marriage.

According to recent studies, most high school kids still aspire to the love and marriage duo. A 2013 Gallup poll for instance found that a whopping 84.5 percent of high school senior girls and 77 percent of high school senior boys still believe marriage to be "extremely important." 

That's good news, at least to those of us who believe that emotionally healthy marriages and families  form the foundations of a civilized society. Happy families generally raise happy kids, who in turn become happy grownups capable of being the strong workers of a viable economy and the informed citizens that democracies depend upon.  

Single parent families, double-domicide kids who shuttle between their divorced parents' homes, and step-families pose tough challenges.  Though for sure they sometimes do succeed for both the kids and the grownups in them, the odds of difficulties are significantly higher.

Research suggests that families in which the parents do not know how to act in the manner of a grown-up loving couple and instead fight, drink or use drugs addictively, bicker incessantly, or ignore each other or their children can pose even worse challenges for the mental health of their members.  Still, a couple who are good enough with each other, and good enough as parents, offer well-documented benefits to each other and their kids: more physical health, emotional well-being, satisfying sexual lives, successful children and even more financial success, in general, than their unmarried peers. 

To what extend are love and marriage no longer necessarily attached to each other?

What percentage of Americans currently are living the love-and-marriage dream?  

People do still fall in love, and people do form close, lasting attachments.  Interestingly, the Pew Research center has found that about the same number of people are in on-going relationships now as in 1960.  But while this just-over-70% is the same percentage, a significant chunk of these loving couples now are not living in marriage relationships. Even more startling, Pew researchers found that whereas in 1960 only 9% of single folks over age 25 would never marry, now that number is up around 20%, that is, one in five!

Sadly, on the whole well-being levels are markedly lower for unmarried relationship partners than for relationship partners who are married, which suggests that not marrying may be a less-than-optimal solution for many of these folks.

What's causing this breakdown of the love and marriage, forever-together option?

Having been the beneficiary of a bountiful married life for over forty years myself, I'm a huge marriage fan. At the same time, as a marriage therapist I have seen many reasons why so many folks either do not marry or marry and then divorce.   

1. The times

There may be a watershed phenomenon.  All of my 23 neices and nephews for instance who are older than 32 have married, and most of them either have children or are currently pregnant.  The five who are younger than 32 though, by contrast, all still are single.  Not exactly a random sample, but suggestive nonetheless of trends that match the statistics I relayed above.

Does this small sample suggest that many young adults wait until later than their twenties to marry?  That with the economy slowed down, marriage rates have slowed as well because marriage feels to many like an economic leap appropriate just for couples with good enough jobs to support each other?  Or maybe that marriage has gone out of fashion? 

Certainly in Europe non-married partners have become the norm.  Has that trend crossed the big pond to become contagious here in the US?

2.  External barriers

One young man has lived for multiple years with a girlfriend who is still an undergraduate.  In their California university, she would lose her financial aid if she was married. How's that for an institutionalized disincentive!

In this regard I recall many years ago when my elderly grandfather began living with an equally elderly grand dame.  As my parents explained to me then, by the time people have already lived most of their lives, their kids are grown up, and they don't want to share their money or confuse the lines of inheritance, it then may be more sensible for them to share a living arrangement without exchanging wedding rings.

3.   Wanting to be on the right side of the 50% statistic.  

Especially if your own parents divorced, and all the more so if you do not understand what went wrong, caution makes sense.

As one young adult friend of mine said, "My parents divorced.  I want to wait to marry until I'm sure which side of the 50% divorce statistic I'll end up on." 

The good news here was that my friend met a woman who felt totally right.  Together he and his new girlfriend took a marriage communication course that taught them the skills they would need to feel "professional" at the art of living as two.  They now have been married for over a decade and they and their eventual children as well have been flourishing.

4.   Marriage breakup is too painful.

Many singles would want to put themselves again, or their potential children, through the sadness and upheaval they experienced when their parents untied their knot, or when they themselves ended a prior marriage.  Call it commitment phobia, call it understandable caution.  What ever you call it, this concern blocks many young adults from wanting to tie the knot.

5.    No one else is marrying.

Societal norms, right or wrong, have enormous impacts.  Everyone is doing it leads to everyone doing it.  Few people doing it leads to even fewer doing it.

6.   Education

School takes so long, and you're not really a grownup while you are still a student.  Medical school, law school, many kinds of grad school can keep young adults infantalized as financial dependents up into their late twenties. 

Some students, and especially students who work part-time and therefore are older or who are in graduate school, do defy the norm and marry.  In my graduate school program, only two of the twenty of us were married.  Yet the two of us were the only two who finished the five-year PhD program in just five years, the rest took six, seven and more to complete their doctorates. 

A son of one of my close friends dropped out of college. His parents were quite concerned, until Bob met the love of his life, married, and returned to school...successfully not only completing college but going on from there to earn a spot in a prestigious law school, a clerkship with an important judge, and then a job at one of the city's best law practices.  Bob is certain of the secret to his transformation from uninspired student to hard-working star....MARRIAGE.

7.    No career so not yet marriage material.

Establishing a career path may take longer than ever. In this economy especially, young adults feel fortunate to get any full time job, or at least to cobble together a pastiche of work situations.  Those who actually land on a viable career path within the first few years after high school or college graduation are becoming the exceptions rather than the rule.

While a full career may not be necessary for marriage, women these days do seem to want to know if the man they are choosing for lifetime partnership has potential to become a serious bread-winner. 

8.    The pill.  

If love used to mean sex which then invited pregnancy, you had to have a marriage to take care of the children.  Now love means sex with only minimal likelihood of pregnancy.  Who needs marriage?  

The Sinatra song insisted, "Love and marriage...Dad was told by mother, you can't have one without the other."  Now you can.

9.    Marriage takes skills.

Many young aduts, and older ones as well, have not learned the skills they would need for marriage happiness.  Living a life yoked together on the same life path, spouses need skills for talking over differences without fighting.  Emotional IQ alone is not enough; couple communication skills also are essential if you want to experience the joys with very little of the struggles of marital partnership.

It used to be that if your parents dealt with conflict by either fighting or avoiding each other, you were likely as an adult to "speak the language" of conflict that you learned in your family of origin. Fortunately now there's courses anyone can take that teach these skills.  The SmartMarriages website lists many that can teach you how to:

    a) handle anger so they don't hurt others with needless emotional escalation

    b) talk collaboratively instead of getting adversarial, becoming blaming, or listening dismissively

    c) resolve differences with win-win action plans and

    d) convey positivity, that is, affection, appreciation and love.

10.    Divorce has become easier and more socially acceptable.

Have we become a society in which relationships are like paper plates?  Throw it away once it has been used or looks sullied.  It's easy enough to find another the next time you feel hungry for connection.

11.  Been there done that.

Adults who have been married and then divorced may feel that the pain was not worth the gain.  "Never again" may become their motto, even if a second marriage, if based on both better marriage communication skills and a better choice of mate, could bring a vastly different outcome than the first. 

12. Not a pair-bonder

Some animals pair-bond for life.  Others go from sexual partner to sexual partner.  Still others mate for one season, and then find new partners for the next.  People may be similar.  While most seem to want to pair-bond, some may be genetically from a different breed.

In my practice I find this pattern of discomfort with the idea of picking one partner to stick with for the rest of their living days mostly associated with narcissism.  When "it's all about me," a person in a sense has already pair-bonded for life--with him/herself. 

Similarly, people with Aspergers and others on the autistic spectrum may find the constant togetherness of marriage and the associated need to consider always another person's concerns, preferences, feelings etc. emotionally overwhelming.  The idea of being married may sound appealing to them.  At the same time the realities of living in tandem with someone else may not work for them.

13. Cultural stereotypes

The Frank Sinatra song continued with the words "Love and marriage...it's an institute you can't disparage." Yet too much of today's movies, songs and other media do disparage marriage.  Too often they seem to assume that marriages are either a) non-existent or b) for ending.

What do today's media depictions of marriage portray?  Not a pretty picture, for the most part.

What could make a difference to stimulate the re-linking of love and marriage?  

Two strategies seem especially potentially high impact for changing both societal and individuals' views of marriage as an appropriate sequel to love. 

1) Teach/learn the skills for marriage success.

Our society needs to teach skills for collaborative dialogue and problem solving, including how to keep anger at bay, from the early grades onward.  That trend has begun.  Many schools, at the preschool level and all the way up through high school, include a curriculum on conflict resolution without fighting.  We just have a long ways to go. 

Meanwhile, unmarried individuals who decide that marriage partnership sounds appealing to them need to sign up to learn the skills.  Would you expect to become a doctor without medical training?  The good news is that training to be a mate is far easier.  At the same time, trying to be a mate without the requisite skills just doesn't work.

2)Look to the media: movies, TV, songs, etc.

Our society needs many more positive media depictions of marriage.  Change a culture's images of marriage and maybe the whole deal will swing around.

Take a look for instance at this video by Denver singer-songwriter Julie Geller.  If the video is not showing, please click here.  Note, by the way, that the people in the video who portray her husband and children are her actual hubby and kids.  

Will love and marriage again reconnect?

Can you imagine how attitudes toward marriage might shift if a) most people learned how to sustain love in marriage and b) the positive take on marriage that Julie Geller so lovingly portrays in this music video were to pervade our tv shows, movies and songs?

May that day come soon!

------------------------------------

Denver clinical psychologist Susan Heitler, Ph.D, a graduate of Harvard and NYU, has authored From Conflict to Resolution for therapists, plus the Power of Two book, workbook, and website that teach the couple communication skills for successful relationships.  

Click here for a free Power of Two relationship quiz. 

Click here to learn the skills for strong and loving relationships.

Dear Mark Bittman, 

I am a fan. I’ve read so much of your work that I’m practically a stalker. So, Mark, forgive me when I say that the advice you gave parents on how to raise a good eater in this past Sunday’s New York Times was useless.  

"Parents should purge their cabinets and shopping lists of junk, and they should set and enforce rules on what their children are allowed to eat. I can be even more specific: Teach your kids to snack on carrots and celery and fruit and hummus and guacamole — things made from fruits and vegetables and beans and grains. Offer these things all the time. Make sure breakfast and lunch are made up of items you would eat when you’re feeling good about your diet. Make a real dinner from scratch as often as you can. Worry less about labels like “G.M.O.” and “organic” and “local” and more about whether the food you’re giving your children is real."

I know you meant well. And here’s the strange part, your advice is actually right. It’s useless, though, because you gave the part of the advice that everyone already knows. 

(You must have missed my post I Understand Why Parents Feed their Children Unhealthy Foods. Parents don’t feed their kids junk because they don’t know better. They do it because feeding kids unhealthy food works for them.)

Here’s the problem: only parents who are just starting out in the feeding game and who have willing, complaint, and relatively adventurous eaters can benefit from your advice.

Advice like yours, Mark, makes successful parents feel superior. It sends the message that it’s easy. “Just don’t keep chips in the house.” “Serve carrots frequently.”

Unfortunately, advice like yours also makes struggling parents feel incompetent and defeated. These parents end up thinking that picky eaters can’t be changed. And so they end up catering to their kids’ eating preferences. These parents fail to set good boundaries and to teach good lessons. Eventually, Mark, these parents give up, and their kids’ eating problems become entrenched.

Like Bettina Ellias Siegel, the brilliant mind behind the blog, The Lunch Tray, I ask: What would have happened if you had had a third child? Bettina says, “Maybe that child, too, would have tucked into salt-grilled mackerel with gusto-or maybe he or she would have made [you and your] wife nuts by refusing to eat anything but bananas and buttered pasta.” Read the rest of Bettina's post.

It’s time for the experts to stop telling parents what their children ought to eat, and to start telling parents how to get kids to eat the food that is served.

And we have to go beyond the well-meaning, but relatively ineffective advice that so often gets passed around:

• Model healthy eating habits!
• Cook with your kids!
• Shop with your kids!
• Grow a garden with your kids!
• Offer fruits and vegetables all the time!

As Bettina points out, every child is different. But here’s where Bettina and I part ways. Just because your child isn’t born an adventurous eater, it doesn't mean you have to just wait it out.

All children can be taught to eat right. The problem is twofold. First, techniques like, “model healthy eating habits,” are too passive. Second, every drop of positive change produced by cooking together on Sunday night, for instance, is easily overwhelmed by the bucket of negative consequences that come from:

• Serving kids a steady stream of child-friendly foods
• Begging, bartering, cajoling kids to eat two more bites
• Using dessert to “win” the veggie war

Three habits translate nutrition into behavior:

• Proportion--eating healthy food the most frequently
• Variety--eating different foods from meal-to-meal and from day-to-day, even if those aren’t always (or ever) new foods
• Moderation--eating when you’re hungry, not when you’re full, and certainly not because you’re bored, sad or lonely

These three habits lead to good nutrition, to becoming an adventurous eater, and to the right lifelong eating habits. Moreover, they help parents figure out what to do when kids won’t play along:

• Teaching proportion doesn’t mean ditching all the junk food and having a showdown with a reluctant eater over the broccoli you’re serving for dinner. It means thinking about how taste preferences are formed, how to move kids towards healthier foods, and teaching them how to manage the junk they’ll be facing for the rest of their lives.
• Teaching variety means thinking about how to “grow a good taster.” This starts by creating a safe, pressure-free environment where kids can explore the sensory properties of food (taste, texture, aroma, appearance, temperature and sound) well before they’re expected to eat anything new.
• Teaching moderation means being painfully aware that many of the most common parents tactics like “Eat two more bites” disconnects children from their own hunger and satiety. It means letting children learn to gauge how much they need to eat, knowing they’ll sometimes get it wrong. And it means finding ways to keep eating free from emotional baggage (or at least as much as possible).

None of these lessons lends itself to a good sound byte so it makes sense that experts whittle their advice down to what can be said simply. But really, if we want to help parents, it's time to give them the kind of advice they truly need.

~Changing the conversation from nutrition to habits.~

© 2014 Dina Rose, PhD, is the author of the book, It’s Not About the Broccoli: Three Habits to Teach Your Kids for a Lifetime of Healthy Eating (Perigee Books). She also writes the blog It's Not About Nutrition.

"Okay, you've convinced me not to punish. But my two year old still bites, has tantrums, throws his food and scribbles on the furniture...." - Rebecca

Unfortunately, a two year old's frontal cortex is still developing the ability to control his emotions and behavior. That means they throw food, break things, have meltdowns, bite when they're mad, and scribble on the furniture. In other words, they act like two year olds.

But since the brain is still developing through the teen years, kids of all ages sometimes lack the rational control to behave as we'd like. Sometimes even 15 year olds act like 2 year olds!

So what can you do when your child acts out, whether he's a toddler or a teen? Here are the five best strategies for preventing misbehavior, for all age kids.

1. Connect. Stay connected by seeing his point of view, so he's motivated to develop self-control. When humans lash out -- biting his sisters, breaking things, defiance -- it's because they feel afraid or hurt. That upset disconnects your child from you, even if you're usually close. But his motivation to "behave" comes from his connection with you, so you have to re-establish the connection before you can influence his behavior. As soon as you see your child getting upset and pushing on the limits of acceptable behavior, move in close and re-connect: "Sweetie, I think we all need a hug...come here." Sometimes that's enough to turn things around, especially if you can then move into....

2. Play. Children process emotion through play, so you can often prevent "misbehavior" by helping your child channel her big feelings into giggles. Toddlers need regular throwing games where they can satisfy those throwing impulses. Try beanbag tossing into a bucket, or balls outside, or tossing stuffed animals down the stairs. Watch, compete (badly), admire his throwing, and be silly to get your child giggling. All young children need lots of wrestling, and games where they get to feel powerful:"You're just too fast for me! How come you always win?!" The more laughter, the less misbehavior.

So when your child is beginning to push the limits, you might grab her up in your arms and run around the house with her, chanting something that gets her giggling, like "We're growly, growly puppies... anyone who comes close gets a big puppy lick!" Compete with each other to see who can growl most fiercely until you're both giggling and the whole mood changes. (Adapt this for older kids. I find pillow fights essential to life with tweens and teens.)

Unless, sometimes, things have gone too far and your child just needs to express all those tears and fears, and play won't shift the mood. Then you....

3. Help him with emotions so they don't drive "misbehavior."

When your child is cranky or defiant and play doesn't shift the mood, he's asking for your help with his big feelings. All young children carry a figurative "emotional backpack" where they stuff the emotions they don't feel safe enough to experience at the moment. When those feelings are pushing to come up and be expressed, kids feel disconnected from us. They show it by refusing to cooperate. When we ignore these signals, we can be sure our child will soon escalate and lash out.

Instead, prevent "misbehavior" by proactively helping your child surface and express his upset. How? Create safety. Muster as much compassion as you can. Move in close and look him in the eye. If necessary, put your hand on his arm to stop him from throwing, or on his belly to stop him from moving toward his sister. Set your limit as kindly as you can: "Sweetie, I won't let you do that."

Hopefully, he'll melt into tears. More likely, he'll first turn his anger toward you. If you stay compassionate (and if you've been maintaining a close connection with lots of play and special time), he'll feel safe enough to show you the tears and fears behind the anger. Welcome these emotions. Sometimes fear looks like a tantrum, whether two or ten, but he needs the "holding environment" of your warm presence to experience these feelings he's been stuffing.

The good news about emotions is, once we feel them, they evaporate. After his meltdown, your child will feel more relaxed, ready to happily reconnect and cooperate.

The younger the child when you start "allowing" emotions, the better he'll control them as he grows and the fewer meltdowns you'll see. But even older kids will sense the safety you're creating and "show" you what's upsetting them. Keep breathing and don't take their anger personally.

Does this mean you accept verbal abuse? No. You say "Ouch! You must be so upset to speak to me that way. What's wrong, Sweetie?" Then you listen, and keep breathing! Later, your child will probably offer a spontaneous apology. If not, you can certainly comment on respectful language being one of your house rules. 

4. Set limits with empathy. Of course, none of this stops you from setting limits. It's our responsibility to guide our kids. But all humans resist being controlled. Kids of all ages are more likely to follow our guidance when we understand their perspective. (It's also easier for humans to redirect an impulse than to stop it completely.)

"Food is not for throwing! Are you showing me that you're done eating? Say 'Done, Mommy' and I will help you get down....Since you want to throw, should we get your beanbags??"

"I know, it's hard to stop playing and get ready for bed. I bet when you're a grown-up, you'll never sleep...You'll just play all night long every night, won't you? Right now, though, it's time to get ready for bed."

5. Regulate your own emotions. Kids will always act like kids. When we react by throwing a tantrum ourselves, it always makes things worse. If you can regulate your own emotions, you can always calm the storm. That's what teaches kids to manage their own emotions. Which is what allows them to manage their behavior. 

These 5 tools -- Connect, Play, Help with emotions, Set limits with empathy, and Regulate your own emotions-- will give your child the support he needs to be his best self most of the time. Of course, if your child is a toddler, you'll also want to practice prevention: keep pens out of reach, don't have markers in the house that aren't washable, and develop really fast reflexes to catch his bowl when he's done eating

This week, a stomach-turning therapy (seriously—no pun intended) has been gracing our social media feeds with unexpected zeal. The idea: That fecal transplants, delivered via tiny little capsules, can cure one of the most difficult bacterial infections that exist. In the U.S., Clostridium difficile causes a quarter million hospitalizations and kills 14,000 people a year. Fecal transplants delivering beneficial bacteria have been previously found to be about 90 percent successful, but they typically require invasive and uncomfortable colonoscopies or, even worse, tubes up the nose.

In the most recent study, which was to ascertain whether treatment could be administered via less invasive methods (ie, pills), Elizabeth Hohmann of MassGeneral Hospital, together with Ilan Youngster from Boston Children’s Hospital and colleagues, enrolled 20 patients, ages 11 to 89, who’ve had at least two to three episodes of C. difficile infection. The overall success rate for the frozen capsules was 90 percent, making them just as safe and effective as traditional transplant techniques.

As the New York Times noted in their coverage of the story, stool can contain thousands of types of bacteria, and scientists do not yet know exactly which ones have the curative powers. So for now, samples must be used pretty much intact. Hence, the undeniable cringe factor. But, here's where it gets interesting.

As the microbiome, the community of microorganisms that we play host to with a population outnumbering our own cells by a multiple of 10, takes center stage as a key player in our health, the potential for more selective bacterial interventions on a whole host of conditions becomes incredibly enticing.

An article in the journal Current Gastroenterology Reports from last year noted other disease states are closely linked to the GI microbiota, namely, obesity, metabolic syndrome, diabetes, and even autism spectrum disorder. Patients with any one of these disorders may, theoretically, see an improvement with microbiome tinkering. Even more fascinating, and hinting at a bright future for microbiota therapy, are the isolated case reports of fecal transplantation responses with multiple sclerosis, Parkinson’s disease, and chronic fatigue syndrome. The power of the microbiome even calls into question free will, as behavior itself can be modified just by altering it. Again, this is a new frontier with massive implications, and these therapies will see accelerating evolution in the coming years in no small part due to the success of these recent trials.

The brain-gut axis is so burgeoning an interest that just recently, a new peer-reviewed journal specifically to explore this scientific border town was announced, called Brain and Gut, edited by neurologist and best selling author Dr. David Perlmutter. It will be dedicated to exploring a vast array of physical interrelationships, including those between the gut bacteria, the microbiome, and various neurological processes.

Imagine being able to take a pill packed with microorganisms, isolated and grown in a lab (no poop required), which could then cross-talk with your own microbiome for positive health outcomes. We would no longer have to treat ourselves, but the universe of bacteria living within us, which, when taken as a whole, is vastly more complex than we are: for every gene in your genome, there are 100 bacterial ones. The implications for our health are just astounding.

Follow Max Lugavere on Twitter for more: www.twitter.com/maxlugavere

“We have not even to risk the adventure alone for the heroes of all time have gone before us. The labyrinth is thoroughly known. We have only to follow the thread of the hero-path.” And where we had though to travel outward, we shall come to the center of our own existence. And where we had thought to be alone we shall be with all the world.”

                                                                                               ~Joseph Campbell

Metamorphosis refers to the process of transformation, whether it’s the changing of an immature insect into an adult insect, or the changes that occur in each of us throughout our life span. Metamorphosis was the theme of the Eurotas Conference I attended in Crete last week with my fellow transpersonal psychologists. The workshop topics were poignant and powerful; including everything from whether we need crisis to evolve, Kabbalistic psychology, mythology, metaphor and healing, transpersonal research, Mother Kundalini, astrology, awakening, and the art of dying, just to name a few. Yet whatever the topic, the overarching theme was the quest for transformation.

The idea of transformation and metamorphosis reminds me of my mother’s comment whenever someone says that they are aging. Without hesitation, she stops and says, “You start aging from the day you are born.” I take those words of wisdom one step further to say; we start transforming even before birth and if you believe in the afterlife, transformation continues even after our physical body dies.

As Crete is rich in mythological stories, the discussion of the hero’s journey brings a close connection to the idea of metamorphosis, reminding us of Joseph Campbell’s classic book, The Hero with a Thousand Faces. Campbell shares the structure of the “monolith,” otherwise known as the hero’s journey, with the premise that whatever your life’s journey or path, various forms of metamorphosis are inevitable along the way. In the same vein, he claims that during our lives, we all experience similar yearnings, fears, joys, trials and tribulations. Along the way, the connections we make and the encounters we have, in some way increase our awareness and/or growth. This ultimately leads to a better understanding of our inner landscape which in turn helps us on our path to transformation and empowerment. According to Campbell, the hero ventures from a common life into a supernatural world where there are challenges and victories. Then the hero returns from this mystical adventure, more powerful and aware of the self and others.

In essence, life is an adventure into the unknown and mysterious. When we are born, we follow a particular path, but as time goes on, we expand our quest, perhaps undertake an adventure or try something new and different; it is about stepping out of the box to discover something outside our comfort zone, and welcoming some sort of metamorphosis or change. We might respond to a particular calling, some pull in a different direction, and we are compelled to face the challenges offered on that path.

Along the way we meet guides, mentors or role models who help us and are available with love and support. While on the path of metamorphosis, we realize that there is no turning back, we are submerged in an adventure, one where new opportunities present themselves. Mythologically, a warrior or dragon might be awaiting us, guarding the entrance to new destination. This is what might be considered the crossroad of decision, the place where we have the chance to incorporate what we learned from our guides. Unfortunately, sometimes this comes with great consequences or risks. In the mythology of the hero’s journey, the hero reaches the Mysterium, a supernatural world with unknown rules. Here, the hero continues to learn and discover new things about him or herself and the surrounding world, growing and transforming and metamorphosing in the process.

In the final stage of the hero’s journey, there is the confrontation with death, sometimes called our primal or original fear. This is an opportunity to abandon all that we have carried that no longer serves us, thus offering the opportunity to begin a new life. In other words, this is the resurrection into a completely new life. During this time, the hero conquers the grail or treasure, which symbolizes what, was lacking in the former life. The hero is then given the choice whether to return to the former or ordinary life or stay on the new path (The Mysterium), enjoying its magic. When the hero is back to daily life, he or she realizes that he or she has attained a new sense of awareness about the self and openness to others. This results in the ability to live more happily and freely.

Note: While Campbell used the term “hero” instead of “heroine,” I would like to change this to “The Human Journey.” The fact that the Minoans paid a great deal of homage to women and the power of women, is indicative of the fact that equality of power between the sexes is an idea that goes way back.

For more on this, please read the blog of my friend and colleague, Steve Taylor, also in Crete, who offers a wonderful perspective on the feminine.

http://www.psychologytoday.com/blog/out-the-darkness/201410/if-women-ruled-the-world-0

I am outraged. I do not understand sentencing a juvenile for life imprisonment without parole, ever. Developmentally, youth are not adults and therefore, do not have the same decision-making capabilities. They should not be tried as adults. When youth commit crimes we have to look at the full spectrum of their lives and the shaping of their worldviews before determining the appropriate ways of addressing their crimes. We are products of our environments and when we are surrounded by violence, we learn to use violence as means of resolution.

In 2012, The Sentencing Project conducted research and found there were more than 1500 youth serving life sentences without parole for crimes committed as a juvenile. One man, 67 years old in 2012, has served 49 years in prison. He was 18 when convicted, and committed his crime as a juvenile. 49 years in prison for a crime he committed when he was technically a minor! In this study of the youth serving life sentences without parole, a high percentage showed high socioeconomic disadvantage, racial disparity in their sentencing, limited judicial discretion and correctional policies and practices that block rehabilitation. How can we allow thee young people to be committed to prison for life, while they are still children?

Another outrageous statistic is how we are treating juveniles who commit crimes, who are not sentenced for life, and instead are committed to correctional facilities. A 2011 report by the Annie E. Casey Foundation shows that of youth who are committed to correctional facilities, 40% are placed in locked long-term juvenile detention centers that resemble prisons more than homes. These detention centers usually house 200-300 youth. Their learning in these detention centers is that people cannot be trusted, the world is a dangerous place, you have to take what you need because no one else is looking out for you, and they might as well take their chances continuing down this path because they have no better alternatives. How do we expect them to behave when they are released back into their neighborhoods? I do not need to state here how high the recidivism rates are for addressing youth crime in this manner.

This is a depressing state of affairs and a social world within which I do not want to live. I am advocating that while these young people have to be held accountable for their actions and the choices they make, there should be learning opportunities toward building a constructive future. There are many systemic issues that need to be addressed, such as better education, less violence in homes and in communities, and more employment and economic opportunities. This takes collective and persistent effort until there is enough momentum built that there will be no turning back and no settling for less, from our politicians and each other. We need more chances to express ourselves through the arts as a means of communication, bonding and healing.

At the same time, individually, we need to improve the way we communicate with and treat one another. When people are treated respectfully as human beings, we are more likely to reciprocate that behavior. We need local role models who demonstrate on a daily basis what it means to wake up everyday optimistic and proactive, ready to build a successful life, step by step. There are organizations and individuals in our communities making these efforts: those that practice conflict resolution, peacebuilding and social justice. We need to tell the stories of these organizations and people as one by one they improve their lives, the lives of others and their communities.

References

The Sentencing Project - http://www.sentencingproject.org/template/index.cfm

Annie e. Casey Foundation - http://www.aecf.org