I recently had the pleasure of attending a workshop conducted by Mr. Steve Dalton, MBA, who is a Senior Career Consultant and Associate Director at Duke University’s Fuqua School of Business. As you might expect he works with students who are seeking employment in some of the most competitive fields around: finance, investment banking, consulting, etc. Like all of us, his students are busy, and they are not enamored with spending hours and hours researching and digging up potential employers. As a result, Mr. Dalton created a “work smarter, not harder” logical and systematic process to help his students target key employers most likely to hire them. His book, The 2-Hour Job Search, which describes the system in great detail, is available from Ten Speed Press, online or at your local book store.

While it’s described as a “2-hour job search,” don’t be concerned if the process takes you a little longer. Also, because it is designed for individuals seeking mid-to-high level business positions, this process assumes a certain sophistication with spreadsheets or Word table documents. But I think it has tremendous value for almost any job seeker (including new college grads and mid-career changers) so while you might need more time to idenitfy employers and work the system, given its value, I think you’ll find it worth it.

One of the hardest parts of the job search is creating the list of possible employers you want and need to reach. Using Dalton’s approach you move quickly and systematically through a 3-step process: Prioritize, Contact, and Recruit. You start by creating a prioritized list of employers; what Dalton calls a “LAMP” list. The acronym LAMP stands for: List; Alumni; Motivation; Posting. Here's a 5-step breakdown to create your LAMP list.

1. First create an Excel spreadsheet or a Word table with the following columns: List, Alumni, Motivation, Posting. Then do a fast (40 minute) brainstorming session of potential employers. Start by identifying your chosen career field. Identify companies you already know about and would like to work at. You can use search engines like Google or Reference USA (check your library for access) to help broaden your list. In some fields you can Google a “top fifty” list to work from. (If need be, you can target this initial list by geographic region, willingness to hire H1-B, or other factors that pertain to your situation.) Enter the names of the companies you discover under the heading “List” on your spreadsheet. Dalton recommends that you list at least 40 organizations if possible.

2. Now use LinkedIn to find potential alumni or other connections. Start by going to the company employee list and search using the name of your college or university. No luck? Try entering your high school. Enter the name of your hometown. What you’re looking for is some sort of common ground and reason for that person to be willing to speak with you. Be sure you click the “3rd degree connection” button so that you will reach the largest number of individuals within that organization who have a connection to you. In the Alumni column of your your spreadsheet or table put a “Y” or “N” to indicate if you found an alumnus or close connection at the organization. (Dalton offers many more tips for finding connections in his book, including joining targeted LinkedIn groups.)

3. Decide how motivated you are about each organization on your list. Dalton encourages you to do this from a “gut” perspective rather than research. Remember, you’re trying to do this quickly and research is going to take time. In the Motivation column, rank each company from a “5” (meaning “I am psyched to work for this place”) to a “2” (“I’m not really than interested”). If you don’t know enough about the organization to make a judgment call, rank it as “1” and plan to research later.

4. Now use Indeed to see if each of your organizations has openings at the present time. The openings may be above your current skill level, but that’s all right because if they promote from within as many companies do, lower level positions may open up. The point is to ascertain if the organization is hiring. In the Posting column, score each organization as: “3” if they have a posting that’s directly relevant to you, “2” if the posting is somewhat relevant, or “1” if not hiring.

5. Now you’re ready to work the magic. Sort your table first by your Motivation column (with 5 at the top). Then, sort again by the Posting column (with 3 being the best). Finally sort by Alumni = “Y.” You now have a list of the “top ten” or so companies where you are most likely to find career opportunities which relate to your interests and field. These are the companies to start researching more thoroughly and making connections with the alumni or other potential contacts you might have. Dalton stated at the program that most people don’t need to go past their top ten before they have an offer or opportunity.

Now that you've created your LAMP list, the next part of the process involves identifying and connecting with the key people at your desired organization. Dalton presents in great detail his 5-point email for connecting with your contact. In this email he recommends that you use fewer than 100 words and do not mention the word “job” at all. He also presents a nice system for tracking all your connections so that you stay in touch on a regular basis and don’t forget to follow up to those who haven’t responded to you.

Finally, once you have identified your key organizations and contacted your identified connections, Dalton presents the third step of the process which he calls “Recruit.” Dalton dives into a deep explanation of information interviews, and encourages you to “build likability—don’t ‘sell yourself.’” He encourages you to prepare for the information interview by creating several questions to ask your contact focusing on their experience with the organization as well as what advice they might have for you.

If you've been feeling that your job search approach has been rather haphazard and you're looking for a systematic way to identify and connect with employers in your field, Dalton’s system has a lot going for it. Listening to him explain the system, I was impressed with how organized his approach is. I’m not totally convinced that it can all be done in two hours but that’s a small issue. The system is thoughtful and efficient.

©2014 Katharine S. Brooks. All rights reserved. Find me on Facebook and Twitter.

“You have a woman boss? Oh no, I feel for you. I had a woman boss once, and it was terrible.” Heard those words before? Why would someone feel that way about having a woman boss? Who would you rather work for, a man or a woman? Most men say they’d rather work for a man. And most women say the same thing. How can that be? Why wouldn’t you want to work for a woman? Is there a difference? What’s the big deal?

The Woman Boss: She’s a Keeper or Is She?

Here are some of the reasons we hear in our training classes from men and women about why someone may not want to work for a woman:

           She has no real power to make decisions.

           She’s not a problem solver.

           She doesn’t think up anything new.

           She is always hormonally driven (that time of the month, PMS, menopausal).

           She doesn’t support other women.

           She’s focused on her family (if she has one).

           She’s focused on getting a man (if she’s single).

           She plays favorites.

           She cries a lot.

           She doesn’t have the experience.

           She has no sense of humor.

           She’s not direct. It’s always a guessing game with her.

           She’s like a queen bee. There’s no room for anyone else in the game.

           She got the supervisor job because of affirmative action.

           She’s a bitch.

           She has no spine. She’s too soft.

           She can’t make decisions.

           She’s afraid to make decisions.

           She makes wrong decisions.

           She’s not connected to inside information or the powers-that-be.

           She doesn’t see the big picture.

           She’s focused on making everyone feel good instead of getting the job done.

           She’s not tough enough.

           She’s afraid to tell it like it is.

           She’s too nice.

           She’s too aggressive.

           She acts like a man.

           She cares only about herself and what you can do to make her look good.

           She’s a perfectionist.

           She sets unrealistic goals.

           She acts more like a mom than a boss. (I already have a mom.)

           You won’t get the good, challenging assignments in her group.

           No one gets promoted from her group.

           She doesn’t take a stand against management.

This list tells us that there are a lot of thoughts and assumptions out there about working for a woman. There’s not as much talk about why people don’t want to work for a man, simply because people figure they will have to work for a man; most bosses are male.

Some people tell us their best bosses were women. Some say their worst bosses were women. Just about everyone has a story, good or bad, about who they’d prefer as their boss. Let’s take the first half of this list and switch the she to a he:

           He has no real power to make decisions.

           He’s not a problem solver.

           He doesn’t think up anything new.

           He is always hormonally driven (that time of the month, PMS, menopausal).

           He doesn’t support other men.

           He’s focused on his family (if he has one).

           He’s focused on getting a woman (if he’s single).

           He plays favorites.

           He cries a lot.

           He doesn’t have the experience.

           He has no sense of humor.

           He’s not direct. It’s always a guessing game with him.

           He’s like a queen bee. There’s no room for anyone else in the game.

Some of the items don’t make sense when we use the he instead of the she:

            He is always hormonally driven (that time of the month, PMS, menopausal). Men don’t menstruate, so they don’t have a particular time of the month when they act differently (although some may say that men have hormone cycles to a much lesser degree than women and that older men go through a male menopause). If someone says to a man “It’s that time of the month,” it’s usually said with sarcasm or in a joking manner, as a putdown for his feminine-like behavior or complaints.

            He cries a lot. Nope, haven’t heard that one about a man. We have heard “He sweats a lot,” for instance, when stressed. You don’t want people to see him sweat; that could give away his position.

            He’s like a queen bee. People don’t call a man a queen bee. Instead, when acting like a woman queen bee, they might just call him a conceited jerk who hogs all the glory.

            “He got the supervisor job because of affirmative action.” Assumptions are that the supervisor is a white man, so unless he’s an ethnic minority, people wouldn’t accuse him of being an affirmative action hire which, by the way, is meant as an insult, implying lack of skills and experience to do the job.

           “He’s a bitch.” At the office people usually have plenty of names for a man they don’t like working with, but it usually isn’t “bitch.” Perhaps they’d call him a bastard.

Well, you get the idea. The ways we describe an unwanted female boss differ from how we talk about an unwanted male boss. Labels, stereotypes, and assumptions influence how we perceive the boss whether male or female and potentially our expectations of our relationship with that person. Some of the other descriptors could apply to either a male or female boss. When you close your eyes, who do you think of when you think of the best boss ever? Is it a gender thing or a personality thing? Is it about skills and knowledge? Is it charisma?

Women and men have different leadership behaviors and communication styles. This doesn’t mean that one style is necessarily better than the other or that one style is right and the other is wrong. They’re just different styles, and an excellent leader is familiar with both. It’s not only men who use a masculine leadership style or only women who use a feminine leadership style.

Code switch: Use leadership behaviors that are viewed as masculine or feminine to best meet your needs and help you make the impact you want.

Adapted from Audrey's book (co-authored), Code Switching: How to Talk so Men will Listen  (Alpha Books 2009)

My brief experience in a casino was pretty typical, I’d say.

Flashing lights. The faint smell of booze. Not much chatter among patrons. The sounds of dice rolling, machines buzzing, and coins clanking. The same butts inhabiting the same stools for hours on end. Everything you see on TV or in the movies is fairly accurate, to my untrained eye.

But one thing I didn’t notice in either the movies or real life, likely due in part to the gaudy décor, was the abundance of defibrillators lining the walls.

While nearly as common as water fountains and restrooms in public spaces like schools, malls, and airports, automated external defibrillators (AEDs) have more recently taken up residence in a place that probably needs it most of all: the casino.

In a study published last year comparing out-of-hospital cardiac events and defibrillator locations, Canadian researchers found something interesting: although schools were relatively low-risk locations for cases of cardiac arrest, nearly 75% of schools had AEDs. Conversely, while one could expect to see one cardiac arrest event per year at casinos and racetracks, there were not nearly as many of the life-saving devices at hand.

What is Cardiac Arrest?

AEDs are small, portable units that can diagnose and treat cardiac arrhythmias. Arrthymias occur when the heart is still active, but dysfunctioning in a pattern that prevents proper circulation of blood. Arrythmias can quickly grow to involve entire chambers of the heart, resulting in fibrillations, or disordered, chaotic electrical activity. Although not all arrhythmias are life-threatening, some can result in cardiac arrest, or the complete cessation of heart pump function.

After chest pad placement, the AED analyses the electrical output of the heart for a few seconds to determine whether a shock is needed. The purpose of the shock is to essentially “stun” the heart, disrupting the chaos and allowing it to return to a normal rhythm. According to the American Red Cross, the chance of survival is reduced approximately 10% for each minute that defibrillation is delayed. And with the average response time for first responders being roughly ten minutes after a 911 call, defibrillation can be a lifesaver. Every year, roughly one in 1,000 Americans will go into cardiac arrest, and only 8% who suffer away from the hospital will survive.

A Perfect Storm, Brewing for Decades

Although sudden in the moment, cardiac arrest is not as random as it seems. In fact, the risk factors for the condition are brewing in many individuals for decades: a sedentary lifestyle, combined with obesity, diabetes, or smoking. The vast majority of deaths due to sudden cardiac arrest are actually a result of underlying coronary heart disease. High cholesterol, blood triglycerides, and older age are ticking time bombs for coronary heart disease, which currently contributes to one in four deaths in America.

While people with heart disease may live out their lives and be relatively unaffected on a day-to-day basis, there’s one thing that can completely upset the already delicate balance of the body: stress. Like in gambling.

The funny thing about stress is that it can be good (winning $5,000) or bad (losing $5,000) and still exert the exact same effect on the body. When we become overwhelmed, a region of the brain involved in emotional processing, the amygdala, sends an SOS to another brain region called the hypothalamus. The hypothalamus can be thought of as the “command center” of the stress system.

When faced with a stressful situation, an axis called the sympathetic (“fight or flight”) nervous system is activated. This is caused by a signal sent from the hypothalamus to the adrenal glands, which secretes the stress hormone adrenaline. During this time, adrenaline concentrations may be up to 50 times the typical amount in the bloodstream. It’s thanks to adrenaline that we experience increased heart rate, sharper vision, and rapid breathing when faced with a stressful situation. Adrenaline is great for outrunning a predator or jumping out of a speeding car’s way.

But the hormone can do nasty things to someone who already has a damaged heart after decades of an unhealthy lifestyle. The increased heart rate and blood pressure accompanying the stress response are not friendly toward cholesterol plaques built up along the arterial wall. This can result in decreased oxygen to the heart (when the heart needs it most, no less) or formation of blood clots, which can lead to heart attack or stroke.

AEDS: Successful When Accessible

A decade ago, Columbia University researchers analysed stored data in 200 patients with implantable cardioverter-defibrillators. In the month that followed the 9/11 attacks on the World Trade Center in New York City, there was a 2.3-fold increase in risk for ventricular arrhythmias.

In a now-famous New England Journal of Medicine paper from 2000, researchers reported improved patient outcomes thanks to Las Vegas security officers trained to use AEDs. When the first defibrillation was administered within three minutes of a witnessed collapse, the survival rate was nearly 75%. According to ER doctor Bryan Bledsoe in a 2006 Wall Street Journal story on these recent changes in the Las Vegas Strip, “The safest place in America to suffer sudden cardiac arrest is a casino.”

The next time you’re in a public space, glance around and see if you can find an AED — they’re typically in white boxes mounted to the wall and include the symbol of a red heart emblazoned with a white lightning bolt. If you see someone in need, you needn’t have medical background to use an AED; instructions are given through words, images, and spoken voice.

And in the meantime, whether you’re a cardshark or prefer the slots, make sure you’ve got a healthy heart before you sit down to play. After all, if you manage to hit it big in roulette, you’ll want to enjoy those winnings for years to come.

--

Image credit: Nadavspi, Wikimedia Commons (casino); James Heilman MD, Wikimedia Commons (arrhythmia); BruceBlaus, Wikimedia Commons (sympathetic nervous sytem); David Bruce Jr., AED (Flickr)

Originally published at The Conversation.

Halloween is an eating disaster. By some estimates, the average Halloween haul contains about 7000 calories in candy. (That’s more than 13 Big Macs.) But that's the nutrition perspective. From a habits perspective, Halloween is just another day at the office.

Don’t fall for the idea that your job at Halloween is to control the candy. When we're thinking about habits, there’s only one question you need to consider:

Next Halloween, will you have to engage in the same old candy-control struggle with your kids? Or, will your kids have evolved so you are off the hook and they can moderate more of the mess themselves?

Dumping Halloween candy is a short-term solution to a long-term problem.

I'm not saying that dumping doesn't control the situation. I'm saying that dumping the candy doesn't teach your kids anything useful. That means that next year you’ll have to recycle the same set of strategies, and gear up for the same set of struggles, to get you and your kids through the celebration. Yet again.

On the other hand, if you get out of the candy-containment mindset, you can use your children’s mega-candy Halloween haul to teach them a thing or two about healthy eating habits, including how to:

• Eat without over-indulging
• Experiment with new foods and flavors
• Fit inferior “foods” into their diet in a healthy way.

And, if you need further convincing…becoming the Candy Police is high risk for teaching kids the wrong habits. Here are five unintended lessons kids learn when parents restrict Halloween candy consumption:

1) I’m going to dump it so you better eat as much as you can now. Think gorging, hoarding, hiding. Instead, limit how much candy your kids can collect by reducing the number of houses they can hit up, or make sure their Halloween bag is somewhat smaller than a suitcase.

2) Candy has power. Instead, neutralize the candy by letting your children choose when they eat their Halloween delights... until they are all gone. The only caveat is this: the candy has to be folded into your kids' sweets routine—candy or a cupcake, candy or an ice cream, candy or a cookie—not supplement it.

3) Feel guilty when you eat candy. Some advocates advise showing children pictures of decayed teeth (like showing smokers pictures of tar-filled lungs). There is no evidence that these pictures change behavior. And, they are misleading. One day (or even one week) of extreme candy eating won't make your kids' teeth fall out. Chronic candy consumption causes the damage. Instead, teach your kids the difference between plenty and greed.

4) It's best to eat candy when you're full. In theory, filling kids up on a healthy meal before they go trick-or-treating dissuades them from sampling their stash...too much. Unfortunately, it's more likely that if you fill your kids up on a healthy meal they'll still snack. It's better to give your children a small meal, thereby teaching them to save room for their Halloween haul.

5) You're not to be trusted around candy. Instead, set some limits for your kids—you can have two pieces each day—but let them regulate their own intake. Even young kids can do this.

Don’t get me wrong; I understand the concern about candy. By some reports, our kids stuff 5% of their yearly candy consumption into their Halloween candy bags.  

Flip the statistic around, and you tell another story. If 5% of all candy is consumed around Halloween, then 95% of all candy consumption happens during the rest of the year. In other words, when it comes to candy, Halloween isn’t where the action is.

Here are a few more ways to teach BIG lessons this Halloween.

Think of Halloween as a Big Buffet.

Research shows that some people browse buffets before loading up. Others load up as they go. Browsers scan the buffet as a way to make sure they fill their plates with their favorite foods before their plates are filled to capacity (or beyond). As a result, browsers tend to be thinner than loaders.¹ Teach your kids to be browsers not loaders by encouraging them to scan their stash—perhaps sorting by category first—and to eat the stuff they like best. You might also consider A Better Buy-Back.

Encourage Your Kids to Taste Test.

Every year I hear parents say, “You won’t like that candy. Choose this one.” This mindset—be cautious about trying new foods, even if those new foods are candies—ends up biting parents in the butt. Instead encourage your children to be adventurous. Conduct a taste test. Have your children sample one bite from any (or even every) candy that looks interesting. Then compare.

Teach Your Kids to Think BIG.

Proportion—eating foods in relation to their healthy benefits—is, hands down, the most important thing you can teach your kids about eating, especially in today's environment where sweets and treats (read crap) are everywhere. Rather than getting caught up in the control struggle, teach your kids to think BIG. Talk to them about proportion and how to integrate inferior foods into their diets in a way that works. It's only by talking about sweets in context of the overall diet that kids can learn to manage their eating—for life.

~Changing the conversation from nutrition to habits.~

¹ Wansink, B. and C. R. Payne. 2008. “Eating Behavior and Obesity At Chinese Buffets.” Obesity 16(8): 1957-60.

© 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). Portions of this post have appeared on Dina's blog It's Not About Nutrition.

There are some thinking errors that are so common that virtually all of us make them from time to time. Here are 7 that can put a big dent in your net worth over time. 

The Halo Effect

You do something frugal and then use that to justify other spending. For example, you bike to work and then justify buying a frappuccino on the bike ride home.

Focusing on what you’re saving rather than what you’re spending.

For example, you got ‘upsold’ when you bought an internet plan. The company offered a promotional rate on a plan that was faster than you needed. The upgrade was still more expensive than a cheaper plan but you focused on the amount you were saving and not the amount you were spending.

Another example is shopping at discount stores where the original price and the discounted price are marked. On an item that costs $100 for full retail, you focus on the fact you will save $60 rather than that you will spend $40.

The Sunk Costs Bias

For example, you buy a health insurance plan and later realize you bought something more expensive than you need. You keep paying rather than switching because you don't want to make a change until you've gotten value out of your original plan. However, this results in pumping even more money into the expensive plan.

You weigh losses more heavily than gains.

Losing a dollar feels worse than gaining a dollar. This can result in people choosing a suboptimal risk/reward ratio, or panic selling investments when staying the course would be a better option.

Even for people who don’t panic sell when the stock market goes down, you might hold off adding to your investments at just the time when the market is “on sale.”

This general principle of loss aversion also applies to the lengths people will go to pay lower taxes, since taxes are a type of loss. For example, people will sometimes give up positive overall returns because they want to avoid paying taxes on the gains.

Partial blindness to risks: You consider some types of risks but not others.

For example, you think that your money is safe in the bank and perceive that it is not losing value. You consider investment risk but not inflation risk. In effect, whenever there is inflation, you are losing money when you have it in the bank.

You don’t consider opportunity cost.

This is another example of being blind to some types of risks and costs.

For example, let’s say that home prices in your area are high in proportion to rents. You predict that you will still get a small return on buying a home but don’t consider whether you would get a better return through investing in other assets. You don’t consider the opportunity cost of tying up your savings in buying a primary residence.

Calculators like this one can help prompt you to look at the whole picture because of the different questions they ask you to answer. 

You don't consider the cummulative effect of small amounts of spending.

For example, check out this analysis of the cost of commuting by car, and the long term impact on your wealth.

Another example is paying what seem like small fees on your investments when lower cost options are available. Free apps like FeeX can help you hunt down these fees.

Subscribe to Dr. Alice Boyes' articles

You can get an email alert whenever Dr. Alice Boyes writes a new blog article - Subscribe.

You can read my prior articles for Psychology Today here.

Alice's Twitter @DrAliceBoyes 

Disclaimer: This post should not be construed as investment advice.

A surgeon passes out drunk in the operating room yet blames dehydration and fatigue. A commercial pilot downs more than 15 rum and Cokes at a bar just hours before flying a 727. A doctor memorizes his patients’ birthdays and addresses so he can pick up prescriptions in their names.

It’s always disturbing when drugs or alcohol take over a life but especially so when it happens to those we count on to be in control – the doctor, the pilot, the business executive, the judge, the attorney, among others. But as these anecdotes show, elite professionals are just as vulnerable to addiction as the rest of us. In fact, they may be more so, simply because of the way they are wired.

“The very nature of these execs, these Type A personalities that seek to control their environment and who use work as their affirmation, is conducive to addiction in the first place. It almost fosters the very personality that we see most commonly in addicts,” explains Matt Eggleston.

He speaks from experience. Eggleston was one of those Type As – a high-achieving, prominent attorney and special judge in Tennessee until alcohol and drug use brought his life crashing down and took him close to death more than once.

Now, several years sober, he works helping those with similar addiction issues and often speaks before groups about the professional’s ability to get in the way of his or her own recovery.

“We are the ones who fix things; we don’t get fixed,” he says. “So there is this natural resistance to doing the fundamental thing that every addict needs to do, and that’s ask for help.”

Instead, denial becomes the norm. Consider the rum-and-Coke-drinking pilot. At his trial, he insisted his many years of hard drinking meant he had been able to handle all the alcohol in his system, measured at 0.13 percent, more than three times the legal limit for pilots. The judge didn’t buy the rationalization, giving him 16 months in jail, taking away his pilot’s license and reminding him that alcoholism isn’t “a license to kill.”

Adding Up the Signs

Acknowledging a substance abuse problem can bring with it a loss of authority, reputation and income. Small wonder then that struggling professionals generally ignore their issues for as long as possible, often reinvesting themselves in the one thing they know how to control – their work. “That’s why you see so many workaholics that also have some kind of substance abuse hidden,” says Eggleston. “They’re thinking, ‘If I can take control of this environment that I know and do a really good job then it’s proof that I don’t have a problem.’”

Even when they do acknowledge problems percolating under the surface, “We try to problem-solve, we try to manage, manipulate, control, which we’re very good at, and typically it’s an utter failure.”

Eventually, even work will fail them, and the signs will be impossible for others to overlook: meetings will be missed, safety will be compromised, others in the organization will suffer and negative effects will cascade. It’s at this point that colleagues or family members commonly push the person toward help. Employee assistance programs or professional boards may also step in.

It’s what happened in Eggleston’s case. He didn’t seek help; it came to him through the Tennessee lawyers’ assistance program, which assessed his issues and directed him to treatment. He now volunteers for its board.

Most professions have assistance organizations such as these, and they can be enormously helpful in minimizing fallout to careers, assisting with licensing boards, monitoring recovery and addressing return-to-work issues. They can also help arrange for workloads to be covered – a vital consideration. Professionals often delay getting help fearing that all will crash if they leave. Most important, the organizations can help get the person to safety and to the proper resources.

Saying Yes to Help

Despite the challenges, treatment can work, especially when professionals are grouped together in programs that understand their mindset.

“Most of us enter any kind of therapeutic program with the preconceived rejection of asking for help,” Eggleston says. “It’s not necessarily conscious, but it presents unique challenges for the clinical team.”

Working with other professionals can help overcome that resistance. “I’m going to feel more comfortable, more at ease, more willing to talk about what’s going on with me because I’m going to feel a little bit safer. I’m going to see other lawyers or judges who’ve been through it and I’m going to say, ‘These guys did it. These guys were where I was, and now they are over here and I want to be over there.’”

Tailored treatment also helps professionals get past the sense of uniqueness that can come with exceptional career achievements and that can hinder recovery. They may be pilots or doctors or CEOs, but “we learn that we’re no different from the 19-year-old addict in the next room.”

The good news is that while professionals generally may be slow to seek help, once they do, their abstinence rates after treatment tend to be well above the general public. A Mayo Clinic study, for example, noted rates of around 74-90 percent for medical professionals and airline pilots. For the general population, the typical one-year abstinence rate after treatment is closer to 20-60 percent.

Recovery doesn’t always happen on the first try, however. For Eggleston, it took multiple attempts, a not uncommon scenario that speaks to the power of addiction and of the professional’s tendency to try to think their way through to a solution rather than admit they are no longer calling the shots. “It’s that moment you realize you can’t fix it and you allow others or other things or a spiritual higher power to help you, that’s when you actually get to the other side and into recovery, which is so foreign to Type A successful businessmen and women and doctors and executive and lawyers,” he says.

After treatment, support groups geared toward professionals can help them stay on track. The key is never to let down your guard, Eggleston says. “The disease is progressive, it’s terminal and it never sleeps,” he says. “And the moment that we think, ‘OK, I’ve got this’ is the moment we are in trouble.”

David Sack, MD, is board certified in psychiatry, addiction psychiatry and addiction medicine. As CEO of Elements Behavioral Health, he oversees a family of addiction treatment centers, including a rehab program for addicted professionals at Promises Malibu. 

Men today face a new challenge in Western Cultures:  How to gracefully transition from a gender-polarized society, to one that has women and men, girls and boys sharing and exchanging roles unprecedented ways. In particular, many guys struggle to define their masculinity and themselves as men in a culture that increasingly stigmatizes things like sexuality, aggressiveness, and competitiveness.

In what might be described as a type “Reaction Formation,” some have taken to re-defining masculinity into something that is decisively not.  And while men and women are free to express themselves in any way they like – something is clearly lost when we begin to blur the definition of a word simply to suit social expectation.   

Take for example an article featured on the GoodMenProject several weeks ago titled, “The Manliest Thing About Me…”  The author, Reesee Zigga Zagga, stopped a random assortment of men at a conference and asked them to complete the phrase: “The manliest thing about me is...” As I was looking through the collection of responses, I was surprised to see that most of them described attributes (stereo)typically associated with femininity, such as: “my heart,” “my ability to show emotion,” “I cry,” “my vulnerability.”  While I don’t doubt that these men were describing real aspects of their characters, I was left wondering: Are these really the manliest things about these men?  These men certainly appear to be in touch with their “feminine side,” but seem to be disregarding their “masculine side.”

Now, don’t misunderstand me.  It is fantastic that many men today are able and willing to revel in the softer aspects of their identities.  Just a few decades ago, a man’s admission of sympathy or compassion was more likely to be met with ridicule and social disapproval.  Today, many men are quite at-ease sharing parts of themselves that may have been disparaged in their fathers’ time – and that is awesome.  However, alongside this trend of men embracing their softer side seems to be an omission, dismissal, and (at times even) demonizing of traditionally masculine/male traits, e.g. protectiveness, competitiveness, aggressiveness, assertiveness, sexual appetite, deference to truth over feelings, passion, confidence, independence, and so on.  

Of course, these characteristics aren’t necessarily held by all men, nor are they necessarily absent in women.  Indeed gender expression is relatively fluid with regard to both sexes – some women are more masculine than some men and vice-versa, and nearly all individuals experience changes in their gender expression during their life or even from one situation to another. 

Nevertheless, it is also true that the traits listed above (ones typically associated with masculinity) are found in men significantly more than they are found in women – a distinction which persists across culture, history, and even species.  The majority masculine traits are directly or indirectly related to the amount of testosterone available in a person’s body.  On average, men’s testosterone levels are ten to forty-five times higher than women’s.

This is all to say, no matter how you slice it, men, as a group, embody masculine characteristics more frequently and to a greater degree than do women.  It is arguable that some degree of masculine traits are socialized into men at an early age.  However, they are nonetheless imbedded aspects of a man’s present-day character, and are resistant to change whether they were natured or nurtured into existence.  And why should we want to change them?

Whether we are talking about masculinity or femininity, there is nothing inherently good or bad, better or worse about either expression of gender. This notion is as true today as it was fifty years ago.

My concern isn’t just about the re-narrowing of acceptable masculinity within society.  What is at stake is men’s ultimate acceptance, understanding, and governance over their own natures as well as an individual and social recognition of what manhood actually entails.  When a man can’t admit that the “manliest thing” about him is his insatiable sex drive or a yearning to be better than the next guy, then he is left to feel ashamed of these parts of himself or is compelled to deny their existence altogether – only to have them abruptly emerge during times of high stress and/or vulnerability. 

In the words of Jon Kabat-Zinn: "acceptance is not surrender." That is, accepting that you are a highly competitive guy doesn’t mean you have to give-in to every felt need to outdo the people around you.  On the contrary, by accepting that competitiveness is strong motivation in your life, you can learn when and how to make use of your competitiveness and when and how to reign it in so that you can focus on more important things.  This is, of course, simply mindfulness. 

By knowing and accepting potentially problematic aspects of our masculinity, we gain insight into the truth of ourselves and our relationships with others. But a man, who is unwilling to admit that he is aggressive, sexual, protective, or competitive –at least to himself— sacrifices his capacity to oversee and make use of those parts of himself that he is too afraid or ashamed to acknowledge.

In the wake of the NFL domestic violence scandal the media has exploded with questions about what we need to do governmentally, institutionally, and politically to better manage partner abuse. Some have called the current rash of stories a “national teaching moment”—an opportunity for us to wake up to the prevalence and horror of domestic violence and take effective action against this crime.

I couldn’t agree more. A new way forward is desperately needed.

The raw statistics are staggering. One in 4 women will experience domestic violence in their lifetime. One-third of all female homicide victims are killed by intimate partners. 1.3 million women are victims of domestic violence every year.¹ These numbers actually don’t do justice to the prevalence of the problem. We know that domestic violence is grotesquely underreported. And statistics clearly can’t reveal the trauma, the horror, and the pain these women experience.

Unfortunately the current direction of our national conversation on this issue—which has focused almost entirely on criminalizing abuse and consciousness raising — will not alone produce real results.

The scrutiny the NFL Commissioner, Roger Goodell, has come under for his handling of the Ray Rice case and his overall management of domestic violence issues within the NFL is justified. The admission by former Chicago Bears general manager Jerry Angelo that the NFL hid hundreds of domestic violence cases over his three decades in pro football shocks anyone with a beating heart and thinking mind.

But the public discourse ends where it should begin. Both pundits and the public seem to believe that strong enforcement, social sanctions, and increased public attention – suspending players for more games, increasing fines, expelling them from the league altogether, encouraging prosecutors to bring charges, insisting on jail time, speaking out forcefully against the problem, and so on – will significantly reduce partner violence.

It is not true. None of these steps are enough to do that. Not nearly.

Consciousness raising is not enough. A recent World Health Organization report² on partner violence concluded that public campaigns “can increase knowledge and awareness, influence perceptions and attitudes, and foster political will for action, [but] the link between public awareness campaigns and behaviour change is not at all well-established.”

Criminalization is not enough: That same report concluded, “There is little evidence regarding the deterrent effect of criminal justice system responses to intimate-partner violence” 

Even prevention is not enough, both because we simply do not yet know yet how to have a large impact on preventing partner violence in the first place, and because almost all of the existing programs that can be somewhat helpful are applicable in childhood. If we could muster the political will to implement them widely, which unfortunately is doubtful, the problem of partner violence will remain and any hoped for reduction of violence will be moderate and in the distant future.

In the last 30 years we have made dramatic strides in bringing public awareness to these issues, and we’re supporting victims better than we ever have before. Treatments for PTSD and that aftermath of abuse are getting stronger. Public attitudes are changing. Screening for domestic violence is increasing.

But something is missing.

Where is the perpetrator in this picture?!

Broadly speaking, the perpetrator is in the picture in only in the sense of being an object of shame and blame. Never mind that many if not most perpetrators were themselves once the victims of violence and abuse.

I worry that the public, or even the domestic violence community who should know better, thinks we have “solved” the issue as long as there are loud calls for strong action against perpetrators. We can all shout at the top of our lungs that we believe domestic violence is wrong, but until we as a society figure out how toreduce partner violence our shouts are nothing but wind. Worse in a way, we can walk very close to objectification in these conversations and if we cross that line and begin to dehumanize perpetrators, we are participating in the same process we despise. Objectification and dehumanization is psychologically abusive whenever it is applied to a human being.

The one place where perpetrators are clearly in view is in treatment. But here the news is similarly dismal. A meta-analysis of experimental studies on domestic violence reveals that, on average, men who are arrested, sanctioned, and complete current interventions programs are only about 5 percent less likely to perpetrate physical violence against a female partner in the future.³

We have to focus our minds on these shockingly poor outcomes. More of the same isn’t going to work any better. Something is wrong.

I believe that we need a new approach that puts the perpetrator back in the picture in a different way – as whole human beings.

Please save me from emails about how I want to coddle criminals. Bull. I agree that partner violence is a crime. But I want the bottom line to change, fast. Shame and blame does not do that. I want to create a more humane world for all. Shame and blame does not do that either. Let’s find something that does.

Most treatment given to perpetrators is either based on feminist theory, which views the problem as one of consciousness raising, or traditional cognitive behavior therapy, which views the problem as one of skills deficits and anger management difficulties linked to cognitive misattributions. These are the well-meaning programs that have been implemented across the country – but their objective positive benefits are still very limited.

We are only likely to make rapid strides in our battle against domestic abuse when we climb down from the self-congratulatory rigidity of righteousness and realize that both victims and perpetrators are damaged by this interaction (not equally, but both are), that both are whole human beings, and that we need to give both parties the tools they need to properly engage with their emotions, manage their behaviors, and make choices that support their real values. We’ve known for a long time that partner violence is at least in part a problem in how perpetrators relate to their own emotions. Why not treat it as such?

The good news is that one of the first large randomized controlled trial trying to do that was recently published in the Journal of Consulting and Clinical Psychology⁴—one of the world’s premier clinical psychology publications—and the results are encouraging.

A Novel Approach to Domestic Violence Intervention

The idea that perpetrators of partner violence have a hard time dealing with emotions sounds self-evident on the surface, but exactly how this occurs and how this works inside relationships is more complex. Taken together these factors tell us why shaming perpetrators will have minimal positive effects on actually reducing violence.

In the new study, Aimee Zarling and her colleagues show that partner aggression may be due to experiential avoidance and related emotional skills deficits. By digging into the existing literature on the subject, they found there was compelling evidence to support this concept for a variety of reasons:

1. Psychological disorders that are prevalent in abusive partners often contain an experiential avoidance component.
2. Abusive partners tend to be less aware of their internal states, and have greater difficulty identifying emotions.
3. People who perpetrate domestic violence tend to have a low tolerance for unpleasant, negative emotions. They also typically have deficits in emotional skills such as describing their emotions verbally, accepting emotional states, or in engaging in goal-oriented behavior when experiencing negative emotions.
4. Partners who engage in violence often have poor empathy skills.
5. Experiential avoidance has been directly linked to decreased relationship adjustment, greater use of physical aggression, and greater exposure to physical aggression.

Combine all of this with the fact that aggression tends to provide immediate, short-term relief from negative emotions and that this relief reinforces the aggressive behavior, and what you have is a pretty clear experiential avoidance model of partner abuse. Domestic violence may actually be the outcome of the perpetrators’ attempt to avoid unwanted thoughts, feelings, urges, memory, and physical sensations.

This helps explain why doling out shame is a bad idea. Shame is a combination of healthy guilt over bad actions, and an unhealthy attachment to “I’m bad” as a self-conceptualization. Directly challenging the perpetrators conceptualization of himself, as often seems to be the goal of conscious raising interventions, can easily contain the same shame-based message. Perpetrators are whole people, who are showing in relationships the cost of not being open to their own inner world, and of not having the emotional agility to adjust to what they find there.

Helping people to back out of their own self-concepts (their “ego” if you will), to open up to experience, and to focus on their values are all areas where acceptance and commitment therapy (ACT—pronounced all as one word) excels. ACT treats experiential avoidance by teaching people how to become mindfully aware of their thoughts and feelings, to distinguish themselves as whole persons from their mental chatter, and to make choices based on their deepest values while experiencing those emotions and thoughts.

Knowing this, the researchers hypothesized that ACT “…would lead to significantly greater reductions in psychologically and physically aggressive behaviors” than a control condition.

Does ACT Work for Domestic Violence?

To test this hypothesis the researchers took 100 people who had committed at least two instances of abuse in the last six months and were actively seeking treatment for their behaviors. Participants were randomly assigned to 12 weekly 2-hour group therapy sessions that included ACT exercises or one that didn’t.

The ACT group received training in topics like:

• Values
• Mindfulness
• Emotional intelligence
• Acceptance
• Defusion
• Behavior change
• Commitment

In the non-ACT group, participants received a lecture and then discussed, reflected, and expressed their feelings related to the topic at hand with the group.

Both groups were measured at intervals pretreatment, during treatment, post-treatment, and at 3- and 6-month follow up across a variety of scales that measure physical violence perpetration, psychological aggression, experiential avoidance, and emotional regulation.

The results are fascinating. By the end the of the 12-week trial perpetrators were a bit less than half as likely to commit an act of physical violence against their loved one. That’s a great start but what really matters most is that it continued to grow even after treatment stopped. Six months after treatment, perpetrators were 73% less likely to physically assault their partner and were 60% less likely to be psychologically aggressive. That is a large effect. That’s an effect that matters in the lives of perpetrators and survivors as well.

Just as important we know why this happened. ACT participants showed significantly reduced experiential avoidance and improved emotional regulation at the end of treatment. These changes mediated outcomes – that is, they were shown empirically to be at least in part responsible for the solid follow up results on physical and psychological aggression.

Yes, this is only one study, and we are going to need to replicate these results in a broader population to corroborate the data. The authors themselves admit that one of the weaknesses of the study is that the model needs to be tested on people who are not volunteering for domestic violence treatment services. Interestingly, I spoke with the lead author on the study just before this article went to print, and she is now testing this method with court adjudicated batterers and is seeing positive results. We shall see. But in a field where large effect sizes are few and far between, this study gives real hope that putting the perpetrator back into the picture as a whole person will pay dividends in reducing violence. I am aware of no other large and well-controlled study on a domestic violence treatment program with these kinds of outcomes six months after treatment has ended.

The Future of Domestic Violence Intervention

Physical aggression against a partner is a crime and should be treated as such. But even so, we need to recognize that many if not most perpetrators will not going to jail, and virtually all who do will be released soon enough. We need to look more deeply into the human problem domestic violence represents. Criminalizing domestic violence and consciousness raising are just reasonable first steps on a much longer journey. Shaming perpetrators is not helpful. In addition to legal and social action, we need to help people who commit violence to mindfully come into contact with their thoughts and feelings, learn the agility they need to choose behaviors that correlate with their true values instead of acting out as a mechanism of escape.

We can uphold our values and the law while still being concerned for the well-being of both parties involved. We can recognize partner violence as a crime while still caring about both people in the relationship.

Perpetrators are people too. We need to keep that in the conversation or this “national teaching moment” will not lead to real and rapid progress in reducing violence.

References

¹ http://www.ncadv.org/files/DomesticViolenceFactSheet(National).pdf

² http://www.who.int/violence_injury_prevention/publications/violence/IPV-SV.pdf

³ Babcock, J. C., Green, C. E., & Robie, C. (2004). Does batterers’ treatment work? A meta-analytic review of domestic violence treatment outcome research. Clinical Psychology Review, 23, 1023–1053. doi:10.1016/j.cpr.2002.07.001

⁴ Zarling, A, Lawrence E, and Marchman, J. A randomized controlled trial of acceptance and commitment therapy for aggressive behavior. Journal of Consulting and Clinical Psychology. Online First Publication, September 29, 2014. http://dx.doi.org/10.1037/a0037946

When we try to tell our stories we are often confronted by several threads which all seem as important. This is the same whether we are telling our personal story in an essay or writing up someone else’s. Where to begin? Where to end? What to leave in or take out?

If we take Freud’s five case histories we can see that in each one he was confronted by various threads as we all are. In the Dora case there is Dora’s story with her father, with her would-be lover, Herr K. whom Freud insists she desires, and with Herr K’s wife, Frau K whom she admits she admires. There is Dora’s story with her own mother who is obsessed with her household and its cleanliness.

In “Little Hans” we have the little boy’s relationship with his father, his mother, who is both seductive and punitive, and with little Hannah, his sister whom he both loves and hates.

In the Ratman we have Ernst Lanzer’s relationship with his governesses, his father; his brother ( whom he shoots with a toy gun) and with the cruel captain who tells him of the terrible torture.

In the Wolfman we have again the father and mother, and here the sister who seduces and torments him; his nanja whom he adores.

In Schreber we have his relationship with the punitive father, his wife; his therapist and his God.

In all five cases, of course, we have most importantly the relationship with Freud himself, our narrator and guide.

How to braid all these stories together and make them into a satisfying whole? There is in each one of these cases an overarching question: what lies at the heart of the symptoms evoked here. Each one of these separate threads is gradually braided into the whole to conclude with Freud’s final diagnosis. In each one of these separate stories there is a question the reader wants answered and this answer is added to the whole and advances the initial question and discovery of what ails the patient.

Thus in my own case in a recent personal essay called “A Common Ancestor” I started with a scene where my husband announced his love for another woman: the initial question is then what will happen to this marriage, this woman, and this man. The essay then brings in the thought the wife has which is that she wishes to die, but I say in the essay, she is not the one to die young. We wonder of course who this will be. Next I bring in the middle daughter who is deaf and quite wild. Will she be the one? Or is it the reckless husband who leaves in a hurry in his green Porsche? Next the wife leaves to meet her sister in Rome.

You will have to read to the end of the essay ( to come in Subtropics) to find out what happens, but all of this is brought full circle and back to the place of the initial scene and the wayward husband and what happens to both of them.

Sheila Kohler is the author of many books including Becoming Jane Eyre and the recent Dreaming for Freud.

Becoming Jane Eyre: A Novel (Penguin Original) by Sheila Kohler Penguin Books click here

Dreaming for Freud: A Novel by Sheila Kohler Penguin Books click here

Most people fill their heads with images of death and destruction every day by following "the news." Profound anxiety results, and you may not even know it's caused by your news habit. You may think you must follow "the news" to be a good person. Consider the possibility that news-following is a habit like any other. It starts because you expect to feel good, and once it feels bad you don't know how to stop. Understanding these impulses frees you to choose whether to live in the bubble created by journalists.

I have consciously ignored "the news" for decades, but I was accidentally bombarded by it last weekend. I attended a conference with a news monitor in the elevator. The conference was on the 18th floor, the elevator was slow, and I took many breaks during the three-day event, so I ended up with a huge dose of murder and mayhem. Another dose came my way at the airport on my trip home. I was standing next to a news monitor when my flight was delayed, and I didn't move because I expected to resume boarding momentarily. Five minutes later, my head was full of global apocalypse and I felt awful. It was a reminder of how I felt before I kicked the habit, and how most people feel a lot.

You may be shocked by the thought of ignoring “the news.” (I use quotes because it’s only one slice of information rather than “the” news. Good news is left out unless it's good for some editor's agenda.) You may think you are making a contribution by immersing yourself in the pain of others.  You may think bad guys will rule the universe if you stop monitoring them on “the news.” I believed these things until I understood the brain chemicals that motivated me.

Dopamine
Your brain releases dopamine when it sees a way to meet your needs or avoid harm. The great feeling of dopamine is released when you find information that helps meet your needs. Dopamine connects neurons that wire you to expect more good feelings when you repeat the behavior. We learn to feel good by scanning for information relevant to our survival needs. Of course we have to make decisions about which information to focus on because our bandwidth is limited. The more information-processing capacity you expend on news, the less you have left to process other survival-relevant information.

So why spend a big chunk of your attention budget on "the news"? First, because this information is so easily available, and reporters keep assuring you that it is what you need. It's tempting to trust them to do your seeking and sorting instead of doing it yourself. Second, you built a dopamine pathway from past news-following, so you expect to feel good when you find out how some story turns out. It may not meet your real needs, but the pathway is real. Finally, you expect to meet social needs by following "the news." Whether it meets your social needs or not, the expectation is wired in, so you keep looking to "the news" to meet social needs.

Oxytocin
The mammal brain is always seeking safety in a world of potential threats. Oxytocin creates the safe feeling you have in the company of those you trust. Animals stimulate oxytocin by sticking with a herd, and the news stimulates it by creating a virtual herd. It's tempting to rely on a virtual herd to meet your oxytocin needs because other people often frustrate you in person.

In the animal world, herds promote survival because because there are more eyes and ears to notice predators and sound the alarm. Animals find safety in numbers by listening for the alarm calls of their herd mates. News is a steady stream of alarm calls. They may not help you navigate the threats in your individual life because they are designed to appeal to a wide audience. But they stimulate the nice oxytocin feeling that you are protected by the herd. This feeling comes at a high price. The herd you run with expects you to share their vigilance. You may lose this sense of belonging if you ignore the news. And your herd may actually shun you if you stop focusing on the perceived common threat. Your oxytocin will fall, triggering a sense of urgent survival threat that a sheep has when separated from the flock. It's tempting to go back to the fold and direct your attention in the same way as the rest of the herd. Reporters make this easy by constantly suggesting that you trust your safety to them.

Serotonin
News is a reliable serotonin stimulater because it always puts you in the one-up position. Journalists are always finding fault with the powerful, which elevates you in contrast. The mammal brain releases serotonin when you raise your social dominance. Seeing yourself as more ethical and more intelligent stimulates that nice feeling, and raising yourself above the high and mighty gives you an extra boost. "The news" will constantly do that for you.  

Journalists suggest that hostility toward leaders is a sign of your higher intelligence. Apes have the same hostility, however. Apes live with alphas who dominate their food and mating opportunity. Anger at the man is a primal impulse, not an intellectual triumph. Higher intelligence is what helps you realize that simple answers don't solve complex problems. It feels good to fantasize about having the power to do the right thing when you watch "the news." But higher intelligence helps you realize that you could not make problems vanish if you were running things. You may get a short-run feeling of significance when you follow the news. But that feeling is akin to adolescent oppositionalism, even as you tell yourself it's sophisticated policy analysis. A steady diet of news does not help you feel significant in the long run. You are more likely to feel trampled and powerless if you rely on “the news” for your sense of importance, because you cannot truly put yourself up by putting others down.

News appeals to your mind's quest for survival-relevant inforamation, but it doesn't necessarily meet that need. It squanders your attention on generalized threats signals that you can’t really act on. You are better off gathering your own information to navigate your own obstacles. You may think it’s more honorable to focus on the pain of others than on your own needs, but the opposite is true. Paralyzing yourself with anxiety does not help you contribute. You can do more when you focus on tangible obstacles in front of you instead of on abstract threats everywhere.

You can stimulate get more dopamine by finding the information you need than by absorbing the alarm calls of news packagers. You can stimulate more oxytocin by strengthening trust bonds with real people in your life. You can stimulate more serotonin by building confidence in your own ability to navigate obstacles. The news competes for your attention by making you feel good in the short run, but when you understand your happy chemicals, you can design other ways of feeling good. Then you are free to decide when "the news" is a good use of your attention.

Lots more on how to do this is in my books Meet Your Happy Chemicals and Beyond Cynical. 

With the runaway popularity of the 50 Shades of Grey trilogy of novels, and the hotly-anticipated film adaptation (due in theaters this upcoming Valentine’s Day) women and couples across the country have been inspired to experiment in the bedroom, with Lelo reporting an 82% increase in sales of vibrators and vibrating rings at the end of 2013.  

Once considered deviant or bizarre sexual behavior, role-playing, power exchange, and BDSM are becoming mainstream as more and more people experiment with this type of sexual play. There is a musical parody of Fifty Shades playing off-Broadway in New York where women and men come to laugh and get titillated by the sexually-charged scenes between Christian Grey and Anastasia Steele.  Many of my clients have experienced greater intimacy and passion after bringing an element of fantasy into the bedroom. On the heels of New York City’s recent Comic-Con (the most widely-attended event of it’s kind; this year’s surpassed the famed San Diego Comic-Con) and with Halloween approaching, the playful spirit of dress up and fantasy are in the air.

 For couples who are curious about exploring role play and fantasy in ther sex lives, now is a wonderful opportunity.  

1.  Openness About Fantasies Can Increase Intimacy

The old saying that “the brain is the biggest sex organ” still holds true. How we become aroused in a sexual scenario—either solo or with a partner—begins with fantasy and imagination. Often, my clients are shy about sharing personal fantasies out of fear of being perceived as strange, bizarre, or disgusting by their partner. Not being fully open about one’s sexual desires and needs can lead to problems down the road in the relationship. I work with couples to navigate ways in which they can share and explore their fantasies to achieve a fulfilling sex life. Role-playing is one of many options that provides a safe, non threatening way for couples to explore. 

2. Novelty Creates Excitement and Spark

The novelty of a role-playing scenario—whether it is doctor-nurse, teacher-student, or involving bondage, dominance, and submission—transforms a sexual encounter into something utterly new and exciting. Role-playing may help couples who feel they have “lost the spark” are in a “rut” or whose lovemaking has become routine and stymied. One of my clients was so amazed and enthralled when he saw his wife in a corset and stockings—he was able to see her in a new light.  Novelty can help partners increase their desire and libido in the long run. 

3. Using Fantasy in the Bedroom To Balance the Reality Outside

Role playing allows couples to enact scenes that are very different from their daily lives. Each person is able to step out of themselves and take on a new, exciting role. The harried career woman who feels powerless at work with a demanding boss can take control and power over her husband via safe and consensual bondage. In this way she is balancing her lack of control in her day-to-day existence by engaging into this kind of play. It is a way of subverting her frustrations and playing them out through sex play.  

4.  It’s All About Communication

To have a successful and stimulating role-play encounter, clear, direct, and honest communication is necessary. Especially for those exploring BDSM, knowing when to stop, and when to say “no” is extremely important. It is vital that activities remain consensual and safe, and the easiest way to do so in a BDSM scenario is to use a “safe word”. As many BDSM scenarios involve one partner overpowering another—by force, rope, or command, sometimes a submissive partner’s cries of “No!” don’t necessarily mean “stop”. It is required as part of a contract or agreement made beforehand that a neutral word  like “red” be used as a safeword. Couples should respect one another’s limits and boundaries---and clear communication is at the heart of navigating these encounters. BDSM’s main rule of Sane, Safe and Consensual is at the heart of playing with power during play.  Here’s a link for those interested in keeping sex-play with power safe. 

5..  Enhancing Trust

Engaging in roleplay and/or BDSM is something that can enhance trust between partners. Roleplay and BDSM put individuals into vulnerable positions. One might feel silly and absurd acting out a teacher-student scenario, not be able to control their giggles, or feel worried about what their partner will think if they reveal their curiosity about being tied up. To expose one’s fantasies—and then explore them—is an act of putting tremendous trust in one’s partner. It not only takes trust to engage in these activities in the first place, but couples might find a newfound sense of trust after engaging in roleplay. This type of sexual activity pushes one’s boundaries and comfort zones, and doing so with someone you love or feel strong affection for can strengthen the bonds of trust and the erotic connection with one another.  One has to realize that the play created in role play is just that: play.  It is not necessarily the way a couple relate to one another outside the bedroom.  

6.   Boosting Confidence in the Bedroom Can Increase Confidence Outside the Bedroom

Naming your fantasy and figuring out how to enact it in your sex life can be an empowering experience sexually and help you gain power in other areas of your life. Mustering up the courage to act out a fantasy with your partner might just give you the courage to ask for that raise, promotion, or more vacation time. 

Herb Geller is 92 years old and still going strong. Born in the South Bronx in 1921, he came of age at the start of World War II and enlisted after Pearl Harbor in 1942. Later, when he returned home, he became a journalist, got married, and had three kids. Since his retirement in 1988, he and his wife have traveled all over the world and have continued to live life to the fullest. We chatted about an older era, singing, and the key to staying youthful no matter your age.

KP: Herb, you grew up in the roaring twenties in New York. What are your earliest memories of that time?

HG: I remember my first football game when I was 7. It was between NYU and Fordham.

KP: Ha, NYU doesn’t even have a football team anymore. What was it like growing up in that era?

HG: My father was a prosperous real estate broker. I went to private and public school, then worked as a delivery boy. It was 1940 and I got paid a salary of 50 cents a week.

KP: Was that a lot of money to you at the time?

HG: It didn’t compare to when I got home from the war. I went to college on the GI bill and got $75 a month. That was a fortune to me. Believe it or not, I could take a gal to a Broadway show and have a drink for $12. 

KP: That’s incredible. 

HG: I graduated college at 28 and the most money I had owned at that time was $102. Then I moved to Westchester and became editor of the local paper, a feature writer, and a produced playwright. I retired when the newspaper was sold. 

KP: What has been the biggest highlight of the last 90 plus years?

HG: My daughters and seven grandchildren. And I try to keep active. Right now, I’m co-chairman of the North-Salem Democratic Committee. I’m still active in politics.

KP: Have you also kept physically active?

HG: Now I go to physical therapy twice a week. I also used to swim at the YMCA and at the retirement place in Florida where we go. But I had a big operation a year ago, an aortic valve bypass. So I use a cane now.

KP: What do you like to do for fun these days?

HG: At the retirement community, I conducted classes in history. I try to keep myself busy. I think older people should do that. A lot of them, you can’t really talk to them or they’re so depressed that nothing interests them. I can sing songs, I know all the words to the old songs.

KP: Which is your favorite?

HG: (laughs) There’s a song from World War I. (sings) Beautiful Katie, you’re the only beautiful girl I adore, when the moon shines over the snow sheds, I’ll be waiting over the kitchen door. My mother taught it to me.

KP: Wonderful. What advice do you have for others who want to stay as youthful as you into their older age?

HG: Try to enjoy life. It can be hard to do that. You are friends with people who die. You try to keep yourself going, have a family, keep up with your family. 

KP: What about interacting with your family members—any lessons to be learned from your long experience with human relationships? 

HG: You can’t get mad at people. I get angry at times, but if you get angry, just yell at them for five minutes and forget about it.

KP: (laughs) In other words, don’t hold a grudge.

HG: No, I get angry at my kids but I don’t hold a grudge. I love my kids. And my wife and I have always been very close. We used to argue a lot but not about anything important.

KP: Any regrets? 

HG: No I’m good with my life. Sometimes I wish I could’ve made more money. But I enjoyed being a journalist. I got prizes from the New York State Press Association for one of my features series and I was almost nominated for Pulitzer prize once.

KP: What is the meaning of life in a few words?

HG: You have to live. Did you ever see Auntie Mame with Rosalind Russell? Live, live. Some people don’t know the meaning of the word. Watch the movie.

Today I went to my daughter's preschool Halloween parade. During the parade I saw about 30 Elsas, many superheros, and a ton of doctors. But one little boy's costume stood out in my mind. He was dressed as Princess Anna and sporting a mega watt smile. I've never seen a kid so proud to show off his costume or one so joyous and carefree. I don't know this little boy at all--I don't even know his name. But I was struck by his bravery in being who he was no matter what other people thought.

I wondered what his parents thought when he picked that out at the store. Did they question whether they should get it for him? Did they wonder if other kids would tease him for his choice? Or did they embrace it because it was his choice and his happiness is what matters the most?

I have friends who have made similar choices; parents who have raised their boys wearing pink boas and My Little Pony costumes. These friends love their kid completely, including loving the bravery it takes to be who they are despite it defying social norms. I wish that we all had that bravery and embraced our choices and our personality the way that little boy dressed as Anna did.

But too often, we get stuck in gender roles and can't find a way to get out of them. Stores have separate boys' and girls' sections, even from infancy, and no matter how hard you try, it's difficult to find clothes that are gender neutral so too often you end up smothering your daughter in pink and purple ruffles and bows and your boy in sports-themed blue clothing. Movies and tv shows teach kids what their roles are--boys are meant to be princes who save damsels in distress, girls are meant to wear gowns and wait patiently to be saved. And although there is a trend in recently produced tv shows and movies to feature girls as pirates, superheroes, and doctors and to demonstrate that princesses can be brave and even save a prince sometimes, there still aren't many models for boys teaching them that they can be who they want to be. There still aren't many shows teaching kids to embrace one another's differences and be who they are.

So this Halloween, and for every day from here on, I will think about the bravery of this little boy and his happiness in being himself and feel inspired by parents who love their child and stand by him just for being him.

Copyright Amy Przeworski.  This post and all portions of this post may NOT be duplicated or posted elsewhere (including on other websites) without permission of the author.  However, a link to this post may be posted on your website without the need to request permission.

Follow me on Twitter @AmyPrzeworski https://twitter.com/AmyPrzeworski

Like my Facebook page: https://www.facebook.com/DrAmyP

Follow me on Pinterest: http://pinterest.com/amyp100/

Alcohol and substance use is widespread among adolescents with recent figures finding that 71% of students have tried alcohol and 54% have reported being drunk at least once by the time they leave high school. Similarly, 36% of teens have reported drinking and 16% have reported at least one drunk episode by the end of middle school (Johnston et al., 2011).

In and of itself, these statistics may not be that alarming, but when you think about the risk factors associated with early initiation, particularly drinking prior to the age of 15, the issue becomes more pertinent. Teenagers who report early drinking episodes are twice as likely to have alcohol-related problems later in life (Fergusson et al., 1994). The question then becomes what can we do to prevent early drinking?

There are many factors that relate to the onset of substance use and future problems, including peer substance use, family history of substance use, parental attachment, parental conflict in home, early conduct problems, as well as a host of other factors too vast to discuss in one post. Conduct problems, in particular, are important to consider. Young adult alcohol problems can be predicted from a number of adolescent antisocial behaviors, such as fighting and getting into trouble with law (Clapper et al., 1995). 

One theory proposed could be that adolescents are simply bored. Reseach is still developing, but I can tell you what I’ve heard many times in my clinical work, “There just isn’t anything better to do.” One way researchers have tested this is by asking teens about their engagement in a variety of activities, such as sports, school clubs, shopping, organizations, dating, and dozens of other options, and whether they derive pleasure from these activities. Adult literature suggests that those with increased depression tend to engage in a decreased number of pleasurable activities, which is associated with increased smoking (Audrain-McGovern et al., 2011). 

This research does not necessarily suggest a direct cause-effect link where more boredom leads to increased smoking. Instead, it suggests that those who are depressed tend to withdraw from pleasant activities and do not engage in reinforcing environments. This withdrawal and lack of engagement in pleasurable activities is associated with greater levels of smoking.

There is still more work to be done to prevent substance use problems and initiation in early adolescence. We need to create healthy alternative behaviors that can be reinforcing for teens to engage in. Not everyone will enjoy the same things, but perhaps schools can provide more options both on campus and around the community that may help mitigate later substance use problems. These options may vary by class and across different cohorts, but making prevention a focus may help prevent the economic impact substance use problems has on society. Those with substance use problems and another disorder, such as Major Depressive Disorder or Conduct Disorder, incur higher treatment costs and report more behavioral problems (King et al., 2000).

It is undeniable the impact early substance use can have on an adolescent and we have to be mindful of the confluence of factors associated with early substance use. Yes, it’s partially genetic predisposition, but it’s also environmental circumstances, such as the ones described above. We cannot fix the genetics for which children came into this world, but we can create different conditions for them once they are out.

What conditions do we want to create?  What are the environments we’ve made available for adolescents?  How can we foster enjoyment and pleasure in activities? Let us model the type of person we want our teenagers to be. When we find pleasure and solitude in our glass of wine every night and lack joy everywhere else, what does this tell the children? Now there is absolutely nothing wrong with having a glass of wine at night, but if that is your only source of joy, then what do you think your child sees and learns? 

Leave a comment below on how you and those around you can begin to create different conditions for teens to grow up in. What's worked for you and your family? 

Rubin Khoddam is a PhD student in Clinical Psychology at the University of Southern California whose research and clinical work focuses on substance use issues. He founded a website, Psych Connection, with the goal of connecting ideas, people, research, and self-help to better connect you to yourself and those around you.

Seeing Around the Corner…

Twenty-eight years ago I began my first experiment in Conversational Intelligence. I was hired by Union Carbide to work with 17 high-powered sales executives in danger of losing a bid for a key contract. My job was to figure out how they could raise their game and beat the other seven competitors.

For two weeks I had them role-play potential conversations with "customers" and charted what they said. The patterns were clear: The executives used "telling statements" 85 percent of the time, leaving a paltry 15 percent for questions. And, almost all the questions they asked were actually statements in disguise. They were talking and talking, trying to bring their counterparts around to their point of view, all the time thinking that they were still conducting good, productive conversations.

Having observed thousands of executives in similar situations—from prospecting to performance reviews, business development to innovation—I know that this is a common problem. People often think they're talking to each other when they're really talking past each other. They carry on monologues, not dialogues.

There is a biological explanation for this: When we express ourselves, our bodies release a higher level of reward hormones, and we feel great. The more we talk, the better we feel. Our bodies start to crave that high, and we become blind to the conversational dynamics. While we're being rewarded, the people we're talking to might consciously or subconsciously feel cut off, invisible, unimportant, minimized and rejected, which releases the same neurochemicals as physical pain.

Feeling rejection sends them into a "fight, flight" response, releasing cortisol, which floods the system and shuts down the prefrontal cortex, or executive brain, letting the amygdala, or lower brain, take over. To compound conversational challenges, the brain disconnects every 12 to 18 seconds to evaluate and process, meaning we're often paying as much attention to our own thoughts as we are to other people's words.

In business, we must learn to master these natural impulses because clear two-way, empathetic, non-judgmental communication is critical for high functioning. It's how deals get done, projects get run, and profits get earned. That's why I now teach more executives, like those at Union Carbide, how to become more intelligent in conversations.

Recognize your blind spots:

STOP underestimating your own propensity to have conversational blind spots. We all have them – it’s part of being human. Identify which blind spots are yours!

• Blind Spot #1 The first blind spot involves an assumption that others see what we see, feel what we feel, and think what we think.
  
  
• Blind Spot #2 Thefailure to realize that fear, trust, and distrust change how we see and interpret reality, and therefore how we talk about it.
  
  
• Blind Spot #3 An inability to stand in each other’s shoes when we are fearful or upset.
  
  
• Blind Spot #4 Theassumption that we remember what others say, when we actually remember what we think about what others say.
  
  
• Blind Spot #5 The assumption that meaning resides in the speaker, when in fact it resides in the listener.

START ….

• Paying attention to and minimizing the time you "own" the conversational space.When you open the space for othrs to contribute you allow them the time to process new insights that can have a dramatic impact on 'what comes next' in the conersation.
  
  
• Sharing that space by asking open-ended discovery questions, to which you don't know the answers, so you stay curious. (i.e., What influenced your thinking? What ideas might be valuable for us to discuss? How might we address this challenge together?)
  
  
• Listening to connect not judge or reject.When we listen to connect we connect through our heart, and prefrontal cortex - which also activates our centers of empathy, openness and receptivity to others points of view. When we listen to judge, we are listening to see when we fit our ideas into the conversation, we look for what is missing in the other person's perspective and we often 'trump them' which creates resistance and 'lock down.'
  
  
• Double-clicking on what others say to facilitate sharing and discovering and opening the space for deeper connection and relationship building.Too often we listen to confirm what we know or defend what we know. Double-clicking on what others are saying keeps us in the higher brain, expands our connectivity, and builds a stronger partnership with others.

Conversational Intelligence & Reality Gaps

Our blind spots spring from reality gaps. Your reality and mine are not the same. You and I have different experiences, we know different people, we came from different parts of the world, and we use different language to label our world. Even those of us who are in the same room at the same time will take away different impressions of our time together. That is why culture is so important. It creates the conversational rituals and practices that harmonize our experiences, create a shared language, and help us bridge and connect with others more fully—it creates a shared reality.

Too often we fail to recognize or acknowledge that our reality is not the same as the reality of the person we are speaking with. Through coaching, the Union Carbide sales team learned to use the term “reality gaps,” and learned to make their invisible blind spots visible. They began to notice when they were making assumptions, interpreting incorrectly, and jumping to conclusions.

Through coaching, the Union Carbide sales team began to notice when they were making assumptions, interpreting reality incorrectly, and jumping to conclusions. They started asking discovery questions and paying close attention to their customers' answers, which expanded their frame of reference and gave them new insights into needs and opportunities. In so doing, the executives presented themselves as conversationally intelligent partners, not sales people. And, they won the contract!

Judith E. Glaser is CEO of Benchmark Communications, Inc. and Chairman of The Creating WE Institute. She is an Organizational Anthropologist, and consults to Fortune 500 Companies. Judith is the author of 4 best selling business books, including her newest, Conversational Intelligence: How Great Leaders Build Trust and Get Extraordinary Results (Bibliomotion, 2013)

Visit www.conversationalingelligence.com;www.creatingwe.com;jeglaser@creatingwe.com or call 212-307-4386.

Follow Judith E. Glaser on Twitter: www.twitter.com/CreatingWE

Four years ago, Andrés Correa clicked on a radio and listened to a woman speak about her experience with depression, suicide attempts and recovery. That first coincidence set in motion a cascade of events that led to the publication of Decidí Vivir, celebrated this week in Dallas. The woman described how depression felt, the illogical logic of a brain turned against itself. This woman was not like his mother in many ways, from a different country, raised with a different language, with friends and experiences no one would pair. Yet their experience of depression matched. Andrés picked up the phone and called his father Jorge, who downloaded the woman’s book. Jorge translated this book, page by page into his wife's native Spanish to make it easier for her to understand in her depressed state.

The voice on the radio was mine.

Jorge Correa’s work that transformed Struck by Living into Decidí Vivir is detailed in “A Translator and a Life Saver.” We celebrated the publication of Decidí Vivir this week with good food, a little wine, old friends, new friends and complete strangers. Our panel, all North Texas residents, hailed from everywhere except Texas: Dr. Ahmad Raza, (born in Pakistan, the psychiatrist that heads the inpatient unit at Zale Lipshy, UT Southwestern where both Jorge’s wife and I were treated), Dr. Abel Tomatis (born in Venezuela, a bilingual psychologist specializing in adolescent care), Jorge Correa (born in Chile, Director of Community Service and a Spanish teacher from St. Mark’s School of Texas) and me (born in the United States, but in Rhode Island, another country when compared to the Lone Star State). Ana Cristiana Reymundo (born in Mexico, Editor of Nexos Magazine, award-winning journalist, speaker of seven languages, merger of culture extraordinaire) moderated the panel.

Dr. Madhukar Trivedi  from UTSW (born in India), a world-renowned expert on depression, closed the Q&A from the audience with an astute observation. His message distilled: Even though a person with depression has the chance at an exceptional quality of life with the right treatment, many people fear depression more than diseases like cancer or diabetes.

Fear causes people to ignore symptoms and delay getting help, leaving most mental illness treated in a critical care state. Everyone knows it’s easier to treat a cold than pneumonia, but we have not accepted that approach with our brains. Life transitions, trauma, lack of sleep/exercise/social support, poor nutrition and the cumulative impact on an overstimulated, overpacked life, can run down a brain just like these experiences can deteriorate a heart or immune system. As Dr. Raza said: “Depression does not come from one place.”

Mental health does not come from one place either, but boring bits of self-care that meld into a whole. This responsibility can seem overwhelming, but the critical point is to try. Occasionally, those efforts are rewarded with something unexpected: a new friend at the track, an light beam of insight offered by a psychologist, a medication prescribed or procedure that removes the shackles of a negative mind. The possibility of health awaits, but requires a series of small steps that at times appear to lead nowhere before moving forward. There is no single-pill solution or fail-safe guarantee.

Sometimes, however, our steps bestow gifts we never envisioned. Imagine if four years ago, when I exited the radio interview, you asked me, “Do you realize that interview will lead to a Spanish translation of your book?” I would have looked over my shoulder, certain you were speaking to someone else. That one step, done blindly in the hope that it might help someone, has enlightened my life. I’ve met new friends, laughed, deepened my friendships with old friends, and learned a new word to define the experience. Milagros. Miracles. There are lots of them. Sometimes I just have to open my eyes to see.

For the curious, here is that interview with KERA's Krys Boyd on Think! that Andrés Correa heard rebroadcast on the radio. More information is available on the Decidí Vivirand Struck by Livingwebsites.

Personal memory involves recalling an event that we remember actually living through. The primary subjective experiences are the perceptual quality of the memory and the sense of reliving the event when remembering it, including emotional and physiological responses. What does it mean to say that such a memory is inaccurate?

A wealth of literature demonstrates the fallibility of memory for events we have directly experienced. Expectations prior to the events and questions afterwards can alter our memories. We also forget a lot.  But juxtaposed with these repeated demonstrations of memory’s malleability is the contradictory finding that some memories (for example, joyous or traumatic memories) can remain virtually unchanged and verifiably accurate for decades. In fact, oral testimony about well-documented events has been used to correct inaccuracies in the historical record.  How can we reconcile this contradiction between memory’s unreliability and its remarkable ability to retain our experiences? 

One way to answer that question is to specify exactly how memory is wrong, developing a taxonomy of memory’s mistakes. In one study of mine, participants were required to 1) describe a personal memory they knew was inaccurate in some way, 2) specify what was not accurate, and 3) provide evidence to support the assertion of inaccuracy. My orientation was that of a human naturalist, in the words of Marcel Proust, trying to identify the different aspects of memory inaccuracy.

Most of the memories described in this study were of ordinary events. With a few exceptions, the events were not profoundly traumatic or deeply intimate or overtly life-changing. Many events were consequential but within the realm of normal life: athletic injuries, the death of an aging grandparent, the birth of a sibling, moving to a new house, visiting one’s mother in a hospital. Some events were seemingly inconsequential: playing with cousins, fishing with an uncle, shopping with a friend, a family vacation.

Participants verified the inaccuracy of the memories primarily in two ways: with documented facts (medical records, journal entries, actual physical measurements, photographs, and artifacts) and with validation from parents or other older witnesses (parents, relatives, and neighbors).  Another method for verification was the implausibility of the recalled events (for example, playing baseball in Cleveland in January). 

What kinds of mistakes were made? Most of the committed mistakes were composite images. Specific images from different time periods were overlaid on one another, as in superimposed imagery. People could be inserted into scenes in which they were not present. The people were remembered accurately and the locations were remembered accurately, but the people were not placed in the correct locations. Ordinarily, this may not be a serious mistake, but in a legal setting, it can be.

General knowledge about people could also create mistakes within a specific memory by intruding into that memory.  Suppose we usually go hiking with a cousin, but one time we went with a neighbor. When recalling the day we went hiking with our neighbor, the accumulated memories of hiking with our cousin might intrude into that single instance, and we might remember hiking with our cousin instead.

Other errors involved exaggeration of some sort. Events were remembered as taking longer than they actually did. People, objects, and rooms were remembered as larger than they actually were. Some mis-memories of events were also created by photographs or retold family stories. In a couple of cases, people remembered dreams as actually occurring.

One resonant conclusion from this research on mistaken memories is that very few personal memories are simply made up – or fabricated. Mistakes of commission usually result from blending memories whose components accurately represent original experience. Even mistaken memories represent much of the original experience accurately.

(One side lesson I also learned was that most people do not think about memory nearly as much as cognitive psychologists do. But if asked, these people show a high level of metamemory and insight.) 

Computer code that is 99.3% accurate is wrong. But should human memory be held to that same standard?  The next time we hear about inaccurate or fabricated memories, we need to ask: In what ways were the memories wrong? Chances are, there is a lot more accuracy than inaccuracy. And the inaccuracies can probably be specified and explained.

All images are in the public domain and provided by en.wikipedia.org.

For more information about the author, see http://professorkraft.com/

You’ve been putting so much energy into this. It might be a relationship, an arduous task, or the pursuit of a far-away goal—one that you aren’t sure you can actually reach. You’ve expended great effort but have seen little progress. Still, despite the frustrations, you’ve chosen to press on.  Persistence is good, right? So you push...and you push...and you push some more.

Then, at some point, you start to experience an internal shift. Even as you continue to forge ahead, a voice seems to well up from within:  

“ENOUGH!”

“NO MORE!”

“THIS HAS TO STOP!”

Whoa. You weren’t expecting this. You’ve been so committed to this pursuit.

But still, here it is: Although it might range from a whisper to an outright scream, something is telling you to put on the brakes.

So...now what are you supposed to do?

Should you “honor that inner voice” and stop what you’ve been doing? Or is it better to press past that dissenting, distracting message and stay focused on your goals?

This would be a good time to engage in a process of discernment. Think it through: If you follow this impulse, where is it likely to lead? Will it take you toward greater life, love, and freedom, or will it take you farther away from these things? You might work through this discernment process on your own, but it can also be helpful to talk it through with someone you trust. This person could be a spiritual director, a therapist, a member of the clergy, or a trusted friend or relative---but ideally it will be someone who doesn’t already have a stake in a particular outcome. 

Taking the time for discernment can be vitally important, because that inner voice that is telling you, “ENOUGH!” could come from some very different sources. Here are three important sources to consider: 

Plain old fatigue and depletion. This explanation isn't very glamorous, but it often fits. After pushing for so long, you’re exhausted. Your self-control muscle has been pushed to the limit. This is a natural, everyday reaction when you’ve been working hard. And when you’re wiped out, it’s natural to have some desire to throw up your hands and say, “I QUIT!” In most cases, this is not the best mental or emotional state to be in when making a major life decision. But yet that strong sense of “ENOUGH” may still be the voice of wisdom, at least in the short term: Perhaps this is enough effort for the moment—or for today. It might be time to end this particular conversation or work session. What to do: If possible, wait. Rest. Take a break to renew your energy. Respond to your immediate physical and emotional needs. Then revisit major decisions later, when you are in a more fresh state of mind. See if this sense of “ENOUGH!” persists or if it was just a fleeting reflection of your fatigued state.

Dark voices of self-destruction. Where did we get the idea that those “inner voices” are always giving us words of wisdom? Sometimes those voices sound so seductive--but they are more like a devil in disguise, pulling us in dangerous directions. Overwhelmed with stress and emotion, we may be tempted to give up and walk away from important relationships or commitments—not just for a few hours, but for good. And here we’ve really got to watch it. Seriously. Because in its most sinister forms, this is the same kind of thinking that can push people onto window ledges and over bridge railings. In moments of temptation and reckless thinking, those impulses to escape seem so sweet. They tantalize us with false promises, seeming to offer immediate chances at freedom or power or control. But they are really like a dark undertow, pulling us right into harm’s way. What to do: Stand firm! Resist the lure of those dark voices. Look past them and grab on to any source of hope that you can find. Do whatever it takes to hold on to life, to love, to what really matters. 

A genuine call toward change. Despite the cautions raised here, the exciting news is that you might really be hearing a call to make a positive change in your life. You might interpret it as the voice of wisdom, God, or your true, deeper self. But regardless of how you identify the source, it’s clearly a pull toward something brighter. When you trace it out into the future, you see good things. Setting aside this commitment or project will open up space for something better: more life, more love, more joy. Thoughts of this change bring refreshment, hope, and peace. Deep down, it feels right. Maybe it really is time to lay that burden down. What to do: Usually there’s no need to rush, especially when changing direction could have major effects on your own life or the lives of others. Unless an immediate decision is required, you might wait a while (hours, days, months...) to see if this new idea persists. But once you feel certain and steady, try not to stall or procrastinate: Start to move in the direction of change.

Discernment does take more time and energy than simply following our impulses. But that effort can yield big payoffs over the long term, especially for major decisions. By taking the time for discernment, we can pursue the path of wisdom rather than setting ourselves up for regret.

Sometimes there’s nothing like an AICR press release to make you feel good about your lunch.

You see, just before perusing the latest press release from the American Institute of Cancer Research, I had enjoyed a steaming bowl of chicken curry comprising various vegetables (carrots, onions, mushrooms, leeks, peas and Brussels sprouts), herbs and spices (fresh ginger, garlic, turmeric, chili, curry powder and fresh cilantro) and healthy fats (olive oil); no rice.

My mouth still aglow from my spicy lunch, I turned to my emails and – lo and behold – read in said press communication that pretty much every food I had eaten was a crucial tool in fighting inflammation and cancer. Not to boast, but I was just a little bit pleased with myself.

Chronic inflammation has long been known to be one of the key factors driving various types of cancer, as well as other disorders, such as cardiovascular disease and metabolic syndrome. It’s also been well known that certain foods – mostly, refined western fare – can increase inflammation, while others – whole, mostly plant-based foods – can calm it.

New inflammation index

Now scientists have a tool to evaluate the inflammatory potential of people’s diets. In new research presented today at the AICR’s Annual Research Conference, researchers showed that diets high in fiber, spices, healthy fats and carotenoids all contribute to an anti-inflammatory effect that reduces the risk of colorectal cancer.

"We know inflammation is important in carcinogenesis because experimental data support this mechanism and the use of anti-inflammatory drugs is protective," said Susan E. Steck, University of South Carolina (USC) Associate Professor, in an AICR press release. "Now we're starting to see that diet influences inflammation and that the inflammatory potential of the diet is associated with colorectal cancer."

Today's research builds on an inflammatory index of food and food components developed by USC researchers. The dietary inflammatory index includes 45 foods, nutrients and plant chemicals. It was first developed five years ago using a global literature review of studies investigating the role of foods on one or more of six inflammatory markers, including C-reactive protein (CRP). At that time, the index based its inflammatory ranking on almost 1,000 studies.

Last year researchers updated and strengthened the inflammatory index by including 1,943 studies published through December 2010. Saturated fat and trans fat rank among the top nutrients on the pro-inflammatory list; fiber, carotenoids, turmeric, ginger and flavonoids at the bottom.

The recent study scored the inflammatory potential of 34,703 women's diets who were part of the Iowa Women's Health Study. Women were ages 55 to 69 and cancer free when they reported their dietary intake. By the end of 2010, 1,636 of the women were diagnosed with colorectal cancers, including 1,329 colon and 325 rectal cancers.

The study found that women who consumed the most pro-inflammatory diets were at 20% increased risk of colorectal cancer compared with women who consumed more anti-inflammatory diets. Green leafy vegetables, fish, fruit, nuts and whole grains were among the top foods more commonly consumed among the anti-inflammatory diet group.

Another study published last month by the USC team found that a group of police officers eating the most pro-inflammatory diet were more likely to have risk factors associated with risk of heart disease and poor metabolic health compared to those consuming an anti-inflammatory diet.

Liberating: Index evaluates whole diet, not individual foods

What’s liberating about the inflammation index is that it will encompass diets as a whole, rather than focusing on the inflammatory potential of individual foods. Taking food out of context – as is often done in research studies – bears the risk of unfairly demonizing individual foods, such as meat.

“If someone regularly consumes red meat but also a lot of fruits and vegetables, they might balance each other out in terms of pro- and anti-inflammatory factors," Steck explains. “Now, we know that consuming more fruits and vegetables, which are high in flavonoids and carotenoids, and moving toward a more plant-based diet will improve your dietary inflammatory index score and translate into anti-inflammatory effects."

Broken-record alert: The Mediterranean diet is the perfect antidote to inflammation. It corresponds exactly to the criteria listed above, brimming with anti-inflammatory compounds from vegetables and fruits, herbs and spices, legumes and whole grains, nuts and seeds, and healthy fats from olives, nuts and oily fish. Pro-inflammatory foods, such as red meat, refined grains, butter and alcohol, are consumed sparingly.

Studies have repeatedly shown the Mediterranean diet to be associated with lower levels of inflammation (e.g., here, here, here and here). The Western-type diet, on the other hand, which is high in red meat, high-fat dairy products, refined grains, and simple carbohydrates, has been associated with higher levels of inflammatory markers CRP and IL-6.

These findings don’t mean we all have to become vegetarians or vegans to lower inflammation and ward off cancer. It does mean, however, that we should include highly nutritious plant foods in every meal we eat – whether it’s berries for breakfast, or vegetables and salads, and legumes, nuts and seeds -- at every other meal.

My books, Zest for Life and Modern Mediterranean: Christmas and New Year, show how easy it is to eat an anti-inflammatory and delicious diet. More anti-inflammatory recipes are available for free on my website, www.modernmediterranean.com. And if you want easy prompts for ways to eat anti-inflammatory foods, then follow me on Instagram, where I show you what I eat.

(c) Conner Middelmann-Whitney. Conner is a nutrition coach and cookbook writer specializing in the Mediterranean diet. She is the author of Zest for Life: The Mediterranean Anti-Cancer Diet and Modern Mediterranean: Christmas and New Year. She offers Mediterranean weight-loss coaching and Mediterranean diet coaching (online and in-person) to people who want to get fit and healthy without resorting to fad diets. For more information about her work, please visit her website, www.modernmediterranean.com.