“He who fears he will suffer, already suffers from his fear.” -Michel de Montaigne

I attended a powerpoint presentation recently, given by a nationally renowned psychiatrist, who provided an excellent overview of modern day psychiatry in America. It was quite disturbing to learn that the most widely prescribed psychiatric drug is Xanax. More bad news is the Center for Disease Control and Prevention (CDC) reporting a sharp increase in fatal overdoses of prescription drugs. In fact, if you look at the top fifteen most prescribed psychotropic drugs, you will find Ativan (at #3), Valium (#8) and Klonopin on the list as well. If your regular doctor is prescribing them, they can’t be all that bad, right?

The History of Benzodiazepines

Many of you reading this article may not know that all four medications are classified as “minor tranquilizers” and are from the same family of drugs, called benzodiazepines. The first “benzo” sold in America was Librium in 1960, followed quickly by Valium, which was the number one prescribed psych med for most of the 1970′s and is still high on the list. When Xanax became available in 1981, it was marketed as the best drug for panic attacks. Certainly Pfizer did a great job of marketing, making Xanax the big winner–the most popular psychiatric drug in America–but is this really the best treatment for anxiety?

Some of you who are reading this article may currently be taking one of these drugs as prescribed by your doctor. I am a psychotherapist, not a doctor, and I am not offering medical advice here. Rather, I am offering information so that you, as a consumer or interested family member, can have more facts at your disposal. Unfortunately, hugely expensive, clever commercials flash onto our screens daily, touting one promising drug or another for various psychiatric conditions. Given how debilitating anxiety can be, it is no wonder that we reach for something, anything, to fix it.

Without going deeply into the chemical composition of benzodiazepines (such information is readily available on line), they …

What do a 45-year-old professor, several well-educated parents, a retired psychotherapist, a concerned husband, and a college student all have in common? These are people suffering–or intimately connected to someone suffering–from clinical depression who didn’t know it.

How, in this day and age, with so much information available, is it possible that depression can still go undiagnosed and therefore untreated? Perhaps this is part of the reason why the blog “Depression Part Two” on Hyperbole and a Half  just went viral (besides how extraordinarily creative it is). Here are some reasons why smart people can miss the signs of depression:
1. Depression can creep up on you.
Not all depression is so severe that you can’t stop crying or get out of bed. For many people, the feelings of sadness manifest as a growing disinterest in life’s activities. What used to be fun or interesting seems unimportant or shallow. You don’t feel like going to your friend’s birthday party so you make up an excuse. You feel bored by the books or TV shows that used to appeal to you. You don’t notice how, little by little, you are pulling back from others, spending more time alone, locked in your room.
2. Depression seems to be a logical response to life’s challenges.
Since depression often worsens or can be triggered by loss or stress, you figure that you are responding appropriately to what is indeed a painful time in your life. You may have broken up with a boyfriend, had difficulties at work, done poorly on a school assignment, or moved away from a supportive environment. When you don’t snap out of it, even when your life circumstances appear to get better, you don’t realize that your negative mood state has persisted for months or even years. 
3. Some depression manifests as extraordinary irritability rather than sadness.
One of the most commonly misunderstood or overlooked manifestations of depression is hypersensitivity or irritability. People around you tell you that you are constantly cranky. You seem …

“Nature, we are starting to realize, is every bit as important as nurture. Genetic influences, brain chemistry, and neurological development contribute strongly to who we are as children and what we become as adults.” -Stanley Turecki, M.D.

Sue and Alan Richardson are like so many other distressed parents who reach out to our counseling clinic. They have three kids. Two have been launched successfully, and they have warm relationships and good communication. Sue and Alan are devastated because one of their kids, now 19, is such a problem. Samantha struggled with depression beginning in junior high, rages at them on occasion, tried to make it at college but couldn’t stand the pressure, and has bounced back home again. What went wrong? They parented all three kids similarly but Samantha was always more difficult and highly sensitive.

Stopping the Blame Game

Parents often get blamed or blame themselves for any problem that shows up in their children. We now know that every baby is born with certain innate inherited characteristics or temperament. Temperament is, by definition, the part of a child’s personality that is not caused by good or bad parenting. Built-in traits will affect each child’s style of interacting with people, places and things throughout their lifetime. The research validates what many parents knew intuitively all along. Some babies are easy, and some are more challenging. Because it is almost taboo to say something negative about one child or to compare your kids, many parents don’t get the support that they need when struggling with a more difficult child.

The Nature Vs. Nurture Debate

The debate about just how much of our behavior and personality is genetic vs. environmental, or nature vs. nurture, has raged on for the last hundred years. Twenty or thirty years ago, in an ongoing effort to understand why people behave in certain ways, both good and bad, researchers focused more on the nurture side, examining things like the family environment or types of parenting that were correlated with problems or resiliency in children. In the past ten …

“There exists, for everyone, a sentence – a series of words – that has the power to destroy you. Another sentence exists, another series of words, that could heal you. If you’re lucky you will get the second, but you can be certain of getting the first.”                                                                                            -Author Philip K. Dick

It will probably come as no surprise that I have been writing since I could put pen to paper–that’s my bias. That being said, I’m not sure what I would have done without it. In my teen years and early adulthood when I would never (and did never) set foot in a therapy office, I created a safe space in my journals to express everything I couldn’t talk about. Years later, when I began my journey of self-exploration and healing in early adulthood, I was able to reflect with new eyes on everything I had written. What had I learned, if anything, and what was I supposed to learn from the lessons life was giving me?

If you are not in therapy because you don’t believe in it, can’t afford it, or it’s against your religion, writing may help you. If you are in therapy, writing may help you deepen your experience and make yourself the hero of your journey. If you are a parent, and want to know how to help your child deal with the recent traumas from Boston or Newtown, here are some ideas. What is the story you tell yourself about your life and what do you want it to be?

The Health Benefits of Writing

There is now a considerable body of research showing how powerful it can be to …

Mr. and Mrs. Harrison called to request family therapy after their 13-year old son called Child Protective Services. When a social worker arrived at their home on a quiet suburban street, Mrs. H was horrified and embarrassed. What Billy called abuse was his parents’ seizing of his Xbox after they caught him playing at 1 a.m. on a school night. When he refused to hand it over voluntarily, his father grabbed the machine and threatened to throw it out the window. 

What Ever Happened to My Sweet Child?

Although power struggles between children and parents are a normal and predictable part of social and emotional development, they typically escalate when children start to grow into teenagers. The strength of some teens’ emotional reactions blow their parents away. Just as power surges occasionally knock out your home’s electricity, creating at least temporary havoc, so can these emotional outbursts bring normal life to a sudden halt.

The sudden intensity of power struggles often come as a shock to parents raising their first teenager. Sometimes the first kid glides through adolescence with very little drama but the second-born makes the challenge. Emotions escalate and often cruel words are spoken on both sides. Kids accuse parents of being mean, unfair, crazy, out of touch…parents call their kids selfish, disrespectful, lazy and disobedient. Is there any way to avoid the pain, the guilt, and the worry of this stage of development?

The Unpredictable Effects of Hormones

Unfortunately, the answer is yes and no. Some of the reason that power struggles can escalate to new levels has to do with the biology of adolescence itself. As boys (starting anywhere between 9 and 15) and girls (starting anywhere between 7 and 13) move into and through puberty, they have their own internal surges to contend with–namely the flood of hormones necessary to ensure normal development. Because of hormones, your son or daughter will have stronger emotions than ever before, feeling overly sensitive, highly anxious or becoming easily upset.

Although it can be difficult for everyone involved to deal …

If you get the Sunday newspaper, you were probably one of the 33 million subscribers who saw yesterday’s Parade Magazine cover story, “The Secrets to a Happy Family,” by the New York Times columnist, best-selling author and dad, Bruce Feiler. Feiler is perhaps best known for his book Walking the Bible, also made into a wonderful PBS series. I respect the man for many reasons–he is a great writer, an intrepid explorer of diverse cultures and religions, and a deeply committed father. But the article, and other information gleaned from interviews with Feiler, left me worried.

Already poised to be a best-selling parenting book on Amazon, since the book hasn’t quite gone to print, I haven’t gotten a copy yet. Nevertheless, as a mental health professional with more than thirty years of experience successfully helping parents and families to be more loving and effective, I was upset by the article featured so prominently in Parade. Quite a publishing coup, but at what cost to parents and families? Here are some thoughts for future readers to consider:

 What credentials make Bruce Feiler an expert on parenting or on characteristics of healthy families?

Quoted in an interview on his Amazon page, Feiler proclaims,”As for parenting books, the biggest problem is they’re out of fresh ideas.” Step aside, mental health professionals. You have nothing new to offer. Besides, the “old” information, confirmed by thousands of researchers, is, well, old. Which must mean invalid, right?

Unfortunately, this just isn’t true. A body of solid research–and books that outline the findings–are there for the picking, and new studies on healthy families are being done constantly. Important findings are available from resources such as the National Institute of Mental Health, the U.S. Dept. of Health and Human Services, the Pew Research Center, The Harvard Family Research Project (and similar projects in universities around the world). In fact, there are so many professional, competent contributors to this field that the amount of information is overwhelming. They/we are not out of fresh ideas.

Surprisingly, Feiler chose to ignore the usual psychologists and family experts, and instead, as stated in his interview, …

“In order to succeed, people need a sense of self-efficacy, to struggle together with resilience to meet the inevitable obstacles and inequities of life.” -Psychologist Albert Bandura

Given that change, with accompanying losses and hardships, is an inevitable part of life, it is crucial to learn how we can increase our capacity to rebound or spring back after painful life events, a capacity called resilience. Although we know that some aspects of resilience are inborn (related to temperament as explained in another blog), others aspects can be learned and practiced. Just as children are vaccinated to avoid physical disease, parents can help by inoculating them for the challenges they will face throughout their lives.

This can be done by teaching kids to have a resilient mindset or a positive lens through which they see themselves and the world. An example of this is teaching young children that mistakes are an inevitable part of learning new skills and are actually helpful rather than something bad to be avoided. An essential building block of resilience is a high level of self-efficacy. Although I have a pet peeve against fancy words when simple ones can do just as well, I think that it is important that parents, teachers, and therapists learn about self-efficacy: what it is, why it is important, and how to build it in ourselves and others.

Self-efficacy is defined as a person’s belief (whether true or not) in his or her ability to succeed or manage in specific situations or tasks. It is what helps nurture effort, perseverance, resilience, serenity, and optimism in the face of adversity. Do you remember the children’s story, The Little Engine That Could? When the little blue train has to pull a load of toys over the mountain, she succeeds only when she tells herself, “I think I can, I think I can, and then delights in her success by saying to herself, “I thought I could, I thought I could!” The little engine is a model of high self-efficacy.

Albert Bandura, …

“Humor is mankind’s greatest blessing.”     -Mark Twain

Every year, at this time of year, tensions mount. The arrival of the gift-giving holidays like Christmas and Hanukkah (“What should I get my mother-in-law?”) accompanied by impending vacations from school (“What will we do with the kids all cooped up in the bad weather?”) collide with the week-long visits of friends and relatives (“Will my divorced parents fight in front of the kids? What will we do with everyone? How can we feed a group with two vegetarians, a die-hard carnivore, and six fussy kids?”). These questions and others like them threaten to put most of us over the proverbial edge.

What can you do to prevent the slippery slope of irritability and overwhelm? How do healthy families manage? Although the complete answer to these questions could fill an entire book, the swiftest solution is to find the humor wherever possible. As William James, the father of modern psychology, so aptly said over a hundred years ago: ”We don’t laugh because we’re happy, we are happy because we laugh.”

What Kids Can Teach Grown-ups     

Did you know that the average kindergartner laughs 300 times a day–in vivid contrast to adults who average only 17 laughs a day? They also indulge in generous amounts of spontaneous play. Now that is something to stop and think about. I don’t know about you, but I’m going to start counting my giggles and see if I can get back into the hundreds. Clearly, most of us grown-ups are taking life far too seriously for our own good. The more stresses that build up, the more essential that we find something, anything, to laugh about.

Laughter Cures What Ails Us

Not only will our laughter make the holidays go more merrily, but we will be less likely to catch the latest virus. Although we have known instinctively for millennia that laughter, like crying, can be a powerful antidote to pain and suffering, the scientific world is catching up. According to the American Association for Therapeutic Humor, laughter may …

Did you know that more than half of kids aged six to nine now use some kind of children’s social network? Or that 47 percent talk to their friends on the Internet? And that 14 percent are on Facebook in spite of the fact that they are underage? To top off these startling revelations of a new study is the distressing news that 58 percent of parents admit they are in the dark about what their kids are up to in our brave new world.

Our kids have been born into this world. They are “digital natives” and many parents and teachers are “digital immigrants,” trying to learn a new foreign language and enter a mysterious culture that is both unfamiliar and overwhelming. Some parents I talk to have stuck their heads in the sand, hoping it will all just go away. Not likely.

Our children are spending more and more time online—and this trend is only going to continue to soar as smart phones are in kids’ hands at younger and younger ages. It is imperative that parents educate themselves about how to protect their children in the new technological universe.

“Isn’t it kind of silly to think that tearing someone else down builds you up?”  -Sean Covey, The 7 Habits of Highly Effective Teens

Just a few days ago, I was meeting with two teenage girls and their mom and dad. The parents wanted counseling to help them lessen the conflict and emotional volatility of their communications. The younger daughter, soon to go into eight grade, suddenly announced that she wanted to change schools in the fall to escape a group of horrendously mean girls at her junior high.

As the parents were alternately upset, speechless and defensive, the older sister chimed in with enormous empathy, having been the recipient of similar attacks a few years prior. Although I was sad to see the suffering of this close family, I was relieved that both girls were openly sharing their painful experiences, enlisting the support of their parents in the process.