In the preceding blog, we considered the importance of recognizing medical illness as psychological trauma.

In this blog we report on an interview with Michele Rosenthal, author of the trauma recovery memoir, BEFORE THE WORLD INTRUDED, survivor, and host of ‘Your Life After Trauma’.  

Diagnosed with a rare disease, Stevens Johnson Syndrome, at age thirteen, Michele journeyed through two decades of undiagnosed PTSD to eventual recognition, recovery and support of many as the founder of www.healmyptsd.com.

What she offers in lessons learned is of value for parents of children who have faced illness, as well as adults who wonder how they will ever reclaim their bodies, heal their sense of self and take a new self into the future.

Michele, your journey from illness started when you were only thirteen. Parents suffer so much when they see their children suffer. How did your parents respond?

My parents were phenomenal! They were there in a very active way. Their presence next to me, their translation of what was happening to me, their role in helping the staff understand me in a certain way were all crucial to my safety and comfort.

In this era of advanced medical detection and intervention, the medical care of patients and the reduction of mortality for life threatening illness has never been greater.  Against this backdrop of success, however, what is often overlooked by professionals, family, even patients, is the experience of medical illness as psychological trauma.

• While some efforts like the emerging field of Psycho-oncology are starting to address the totality of the patient and the American Psychiatric Association now officially considers “ being diagnosed with a life –threatening illness” a potentially traumatic event, it is perhaps most important that patients and families understand why and how medical illness often brings with it- anxiety, anger, depression, panic and post-traumatic stress symptoms.
• Understanding, normalizing and validating common stress reactions can demystify and lower anxiety at a time when so much feels beyond understanding or out of control.
• Given that the experience of trauma is a function of many variables including age, nature of trauma, duration and personal meaning, people will differ in their psychological response to medical illness.
• Some may experience a few symptoms which abate within months, others will deal with a delay in the experience of depression or anxiety until well after the medical crisis, and for others the persistence of emotional distress may warrant professional help.

A recent survey reported by the American Psychological Association of 566 adults revealed that most people(93%) made a resolution to change some aspect of their behavior in 2012. Many did not succeed. The top reason most gave for failing in their efforts to lose weight, save money, exercise or make other lifestyle changes was lack of willpower.

What Accounts For This Lack Of Willpower?

Willpower is defined as the inner strength that enables us to make decisions and carry them out. What many may describe as a “lack of willpower” may actually reflect a tendency to overlook an important factor that influences our determination to make something happen – our inner dialogue.

Inner Dialogue

Our inner dialogue is actually the fabric of the story we tell ourselves about ourselves. Sometimes the inner message is very conscious; sometimes it is so automatic that we hardly know we are thinking it; and sometimes it is without conscious thought.

Often if it is negative, we may just feel down, hopeless, unmotivated, angry or anxious – the associated feelings to defeating messages sent to self.

“Outing” the Internal Dialogue

Stopping to consider your inner messages – what you tell yourself about yourself – is invaluable in harnessing willpower. It involves:

• Recognizing and understanding your inner dialogue
• Altering the negative messages
• Accessing the positive ones.

It makes the difference between heading to your goal with an inner critic or a positive internal coach.

Few people have a long range goal of dating in midlife. To the many who find themselves faced with the possibility, midlife dating can seem like a mystifying, even overwhelming, journey to find a partner.

The reality is that despite the horror stories of friends or the fictional depictions of perfect couples repelling down snowy peaks, the experience of midlife dating really depends upon your goal.

When you expand the goal of midlife dating from finding someone to finding and re-defining yourself, the experience changes. Instead of a solution to being alone – midlife dating becomes an evolution of self.

Why Midlife Dating?

Usually something has or has not occurred in the lives or personal relationships of people ages 40- 65 that makes midlife dating a consideration. Some have left a troubled or contentious marriage; some feel they have been the one left; some have never looked up from a career; some have weathered the illness and death of a partner; and some have decided they are finally ready  to settle down.” Most don’t want to be alone.

“ Why Can’ t You Just Say, Thanks?”

If this sounds familiar it is because most of us have said it or heard it.

• Most people want to feel appreciated, particularly by the person closest to them but too often the expression of gratitude gets lost in the fabric of couple’s lives.
• Recent research in the field of positive psychology informs us that feeling gratitude, the awareness and appreciation of what is valuable and meaningful to oneself, has many benefits including positive mood, enhanced physical health and optimistic outlook. Actually expressing gratitude has proven to have even greater benefits in terms of personal happiness and relationship enhancement.

Then… Why is it difficult to express gratitude to a partner?

People are complicated. Add in couple dynamics, prior history, unconscious factors, cultural context and you multiply those complications.

• Most partners don’t consider how often they thank their partner or if not-why not?
• Few are aware of the proven benefits of expressing gratitude on their personal feelings, their view of the partner, the patterns and value of the relationship.

Consider Recognizing Your Resistance and Understanding the Possible Benefits of  “Just Saying Thanks.”

Given that there are now 81 million baby boomers in this country ranging from ages 46 to 66, there are many people navigating the transitions of midlife. When you add to that the fact that 80% of the male boomers and 77% of the females are married the journey gets more complicated.

Amazon lists over 2,000 books dealing with midlife with titles as different as Awakening at Midlife, Midlife Meltdown, Thinking about Tomorrow: Re-inventing Yourself at Midlife, How to Survive Your Husband’s Midlife Crisis, Midlife Crisis For Men: Male Menopause, My Favorite Midlife Crisis etc. The message is that against the backdrop of mortality and a story half told, men and women navigate their midlife passage in different ways with different challenges and different needs. When married, the impact they have on each other is inevitable.

Last week the media reported the sad and unanticipated deaths of two men. Derek Boogaard of the Rangers died from an accidental overdose of the drug oxycodone mixed with alcohol and retired lieutenant, John A. Garcia, a 23-year veteran of FDNY who not only responded to 9/11 but responded and lost two of his men in the Deutsche Bank Fire. died by suicide.

One can’t help but wonder if the tragic deaths reflect the danger of hidden depression in men.  Increasingly we have become aware that although women are twice as likely to be diagnosed with depression, many men, beyond the 10-17% diagnosed, may also be suffering with depression.

Depression May Be More Deadly for Men

What makes depression in men so dangerous? It too often goes unrecognized and untreated because it is masked by physical complaints, substance abuse, anger and other stealth symptoms.

Despite the warnings, our basic human courtesies are not likely to be eroded by smartphones, nor will they be salvaged by quickly decided Emily Post-type rules.

Like other social norms, smartphone manners will likely evolve from the complex social group process underscored by the intellectual, physical,and psychological needs that drive us.

There was a time when it was in good taste for a gentleman to reach across the dinner table to light a lady’s cigarette. Have you seen etiquette of that kind lately?

A recent New York Times article reported on the behavior of attendees at the South by Southwest Interactive. In this arena, tech pros and professionals were reportedly on phones everywhere from the elevator to the dais. What is striking is that the appeal by one of the keynote speakers to put down the devices when interacting and give back the respect owed to each other was met with thunderous applause.

More striking is the fact that within minutes — everyone was back interacting with one eye on their phone and one thumb busy working!

For as many people as there are who dream of being with the right person, there are as many who dread breaking up with the wrong person.

Recently, there was a good deal of press about a study by social psychologists Ethan Kross and Marc Berman reporting that social rejection from an unwanted break-up was registered in the same regions of the brain activated when people experience painful sensations in their body. Clearly having someone break-up with you is not only emotionally but physically painful.

Is it equally painful to be the person who sets in motion the break-up?

While we may not yet have the MRI scans, most have personally experienced or witnessed through family and friends that breaking up is, in fact, “hard to do.” What I have found to be a commonly voiced deterrent for both men and women is the fear of being the bad one.

What Does this Reflect?

Whether the fear of “ being the bad one” is self-reflection or the expected judgment by the other partner, the fear of breaking up  is complex and is underscored by human drive, attachment needs, sense of self, dependency issues, historical and cultural expectations.

A common complaint of couples in long term relationships is a decline in sexual desire. While the cultural finding seems to be that men are often the partner complaining, research suggests that long-term relationships can have a dampening effect on either partner – for reasons that are not solely due to aging.

In my work with couples I have found that the resentment, criticism and impatience that couples show about many issues in their life often cover the rejection and shame associated with the belief that they are no longer sexually desired. When they are finally able to address it one hears comments like:

• “She never makes an advance – I don’t need someone complying out of obligation”
• “For over a year he’s just not interested. How is that supposed to make someone feel?

Whereas couple therapists have long maintained that a couple’s sexual problems are actually a reflection of problems in other areas, the reverse is also true. Many couples will fight about anything rather than face what is not happening in the bedroom.