Unhappy Relationships and Depression Go Hand in Hand

By Debra Manchester MacMannis, LCSW

file4801310649783“What is the opposite of two? A lonely me. A lonely you.” -Richard Wilbur

“It is not a lack of love, but a lack of friendship that makes unhappy marriages.” -Friedrich Nietzsche

The TV ads would have all of us believe that the best cure for depression is the latest and greatest medication. First it was Prozac and now it’s Pristiq and Abilify. Although medication is a life saver for many, for others the side effects are too debilitating, and the meds don’t seem to help enough anyway.

Study after study has shown that the best treatment for depression includes some form of psychotherapy. Once again, there is always the cure du jour–right now it is cognitive behavioral (CBT or DBT). Nothing wrong with that. It’s just that something is missing from the information.

Your doctor or family may have told you (if you are the depressed one) to get help. What you haven’t been told is to make sure you do some counseling with your spouse, your children, and/or your family as well. Here’s why this missing information is so important…

file1871264468042It is More Than Just Social Support

Psychotherapists have long known that social support is crucial–not only when the patient suffers from depression but with any physical or emotional illness or disability. When you visit your doctor for your annual check-up, how often are you asked about the quality of your relationships? We now know that this is even more important than we thought.

A new study by Alan Teo and his team in the Psychiatry Department of the University of Michigan conducted a ten-year follow-up of almost 5000 adults aged 25-75 to determine just how big a part relationship factors played in the risk of developing depression years later. Their conclusion: the magnitude of the impact of social relationship quality on risk for depression is as strong as the effect of biological risk factors (like obesity, smoking, high blood pressure) for cardiovascular disease.

file7281249918714Quality is More Important than Quantity

Perhaps surprising to many, social isolation was not predictive of future bouts of depression. Social isolation is measured by things such as whether or not you have regular contact with family, friends, and neighbors and whether you live alone or with someone. Apparently, some people are less social than others–and happily so.

It turns out that what is relevant is how each of us subjectively feel about the quality of our relationships. The study revealed that of the people who rate their relationships as positive and supportive, only 1 in 15 will develop a diagnosable depression in ten years time. In marked contrast, 1 in 7 who describe poor social relationships will get depressed. Now that’s a big difference.

file0001203965What Clinicians Should Be Asking

Most of the research to date has focused primarily on the positive aspects of social support. Teo and his researchers found that equally important–or perhaps even more crucial–is to look at the negative aspects in order to assess for social strain. This means asking questions like:

  • How do you feel about your marriage or about the person you are dating?
  • Do you feel that your partner cares about you and understands what you are going through?
  • Do you feel that your partner is critical of you too much of the time?
  • Do you know that you are loved by your spouse? your children? your friends? your family?
  • Can you share with your closest friends or family members when you are stressed or having problems?

Including questions about the client’s subjective assessment of both positive and negative aspects of their  relationships “should be considered evidence-based, much like inquiring about past depressive episodes” warns Teo.

It’s A Family Affair

file361245785428The research also indicated that not all relationships are created equal. Perhaps it should be obvious that the number one relationship that affects us is the relationship with our spouse or significant other. Second to that is our relationship to other family members. Friends are important but their presence or absence does not play a significant role in the later development of depression. Our loved ones do.

So the next time you notice relationship strains, think about which of you may be the most vulnerable to developing depression down the line. You? Your partner? One of your children? (Check out my blog on the warning signs of a troubled marriage). It might take years but the odds tell us that negativity in our relationships breeds resentment which can lead to more conflict or to isolation and loneliness. Doesn’t that sound depressing? Turns out, it is.

 

 



Guidelines for Choosing the Right Therapist–Does the Shoe Fit?

By Debra Manchester MacMannis, LCSW

file000635087969I will never forget a lecture that I heard in 1973 (which says a lot since there is so much that I don’t remember). The speaker was the late David Rosenhan, Professor Emeritus, in his popular undergraduate class in Abnormal Psychology at Stanford. Each year, at the end of the term, he gave a lecture about choosing the right therapist. His advice was wise and as relevant today as it was forty years ago.

“Choosing the right therapist,” Rosenhan insisted (and I quote loosely), “should be like buying a pair of shoes. You would never buy shoes without trying them on, seeing how they fit, picking the brand that meets your current needs, fits your lifestyle, and is affordable. Even then, if you make your purchase, take them home and find they pinch you in the wrong places, you would not say to yourself, ‘I need a new foot, something must be wrong with me!’ now would you? No, you would take back the shoes and seek out a new pair.”  So it should go, he sagely advised, with choosing the right therapist.

Myths and Misunderstandings About Psychotherapyfile6271273137854

As I mentioned in my last blog, far too many people fail to seek help or wait much too long before seeking professional guidance. There are numerous explanations for this reluctance, and unfortunately, many negative myths also surround the therapeutic process. In the forty years since the Rosenhan lecture, I’ve heard them all many times.

Myth #1: If you need therapy, you must really be sick or messed up. 
Myth #2: If you need therapy, it means the problems are your fault.
Myth #3: All therapy does is blame your current problems on the past. 
Myth #4: All therapists are the same and most therapy goes on for years.

Why Your Doctor May Not Suggest Counseling (even when it could help)

Myth #5: It won’t do any good, and my doctor didn’t suggest it either. Here’s why:

OLYMPUS DIGITAL CAMERAA big part of the problem is the lack of education about psychotherapy compared with constant advertising about the potential advantages of psychotropic drugs. In a world bent on instant answers and quick fixes, more and more people are choosing to pop a pill rather than seek out counseling.

Although decades of research show that psychotherapy is highly effective, money talks. Pharmaceutical companies today spend billions of dollars touting the effectiveness of designer drugs. According to Pew Research, in 2012, more than $24 billion was spent marketing drugs to physicians and over $3 billion on advertising to consumers.

Although Consumer Reports concluded in 1995 that psychotherapy of various types was effective for around 80% of those surveyed, they found in a follow-up survey in 2003, that 68% of the respondents seeking help for mental health issues received drugs compared to 40% in 1994. This trend persists in spite of the fact that consumers complained of more side effects than they had bargained for–40% complaining about adverse sexual side effects and 20% about weight gain.

file3641283618643Guidelines To Find the Right Therapist

1. Do some shopping before you make your choice.

People have better outcomes when they are more active and involved in choosing a therapist. Rather than just taking a referral from your insurance company or employer, ask friends or family members for names. If you know someone who has been helped by counseling, find out who they saw and what was helpful.

Most therapists will respond to questions you have about how they work in either a preliminary phone call or in the first office visit. Find out if the therapist has experience in the kind of problem you have. Ask about average length and cost of treatment.

Make an appointment for one visit without committing to ongoing treatment. Don’t feel pressured to make a second appointment. If the therapist you see is not comfortable with the fact that you are going to interview several therapists before choosing, that should be a red flag. It is often helpful to bring a family member or friend with you to the first visit.

file16012996431132. Find out if the therapist involves family members in the treatment process–especially if you are having marriage problems or problems with one of your children.

Some therapists only treat individuals, not couples or families. If you are single and your problems do not involve any family members, that approach may work for you. On the other hand, many problems surface in the context of our intimate relationships. Those problems are generally helped more effectively and efficiently by involving the couple or the family.

Family involvement in therapy does not imply blame of anyone. We believe that although people are trying to do “what’s best”, they can get inadvertently stuck in patterns of interaction that lead to the development of symptoms in one or more family members. Our strategy is to elicit the family’s strengths and resources and to unleash hidden potentials that are somehow blocked.

The involvement of whole families in the treatment process serves to expedite change because each family member can contribute his or her unique perspective and understanding of the problem. The family often holds resources and influence essential to the treatment process of its members.

PicCollage3. Do you want a sounding board or someone to teach you skills and offer practical tools?

Therapists differ, both in their philosophy of treatment and in how active or passive they are in the treatment process. Some spend much of the time listening, providing empathy and support, and helping you discover for yourself what changes you want to make. Others are more active–offering specific skills, suggesting new behaviors, giving homework assignments, or teaching communication or conflict resolution skills.

Think about what you want from therapy and find a therapist whose model of treatment fits the bill. This difference is more important than whether the therapist is a psychiatrist, a psychologist, a social worker or a marriage and family therapist. More relevant is the therapist’s expertise and record of success.

Clients who share the same goals as the therapist and apply what they are learning in treatment to their everyday lives report more positive outcomes. Therapy involves hard work. If you want to get more physically fit, it is necessary not only to learn how to use the equipment at the gym but to actually work out three or four times per week. So it is with counseling. Change comes from practicing new behaviors, not just talking about what isn’t working. Find a therapist who holds you accountable.

file00014658050054. Find someone that you like who makes you feel safe, understood and respected.

Not every therapist is the right one for every client–remember the shoe metaphor–there has to be a good fit. And you, the consumer, are the one who knows what is best for you.

Some people only feel safe if they work with someone of a particular gender, or culture, or sexual orientation, or age or race. Honor your needs and preferences. Don’t judge yourself if you want red shoes. Since therapy will probably involve pushing past your comfort zone, you are more likely to do so if you feel connected to your therapist and believe that he or she has the experience and knowledge to help you.

5. Get help sooner rather than later.

file6351304824633The best time to seek help in therapy is before small problems become bigger ones. People often underestimate the seriousness of their situation and wait until crises occur. We don’t usually wait to get sick to go the doctor–we get annual physicals. If you have a question or discomfort about how you or someone else in your family is doing, go for a check-up with a reputable psychotherapist. It will not only shorten your treatment time but it may prevent future troubles.

Remember the wise words of Professor Rosenhan, don’t give up hope if the shoe doesn’t fit. There’s lots of therapists out there. Find the right one for you. If the shoes doesn’t fit, don’t blame your feet. Move on.



7 Warning Signs Of a Troubled Marriage

By Debra Manchester MacMannis, LCSW

100_0321aI’ve been counseling couples and families for over three decades and one thing stands out. Most people wait too long before they reach out for help…years too long. Problems that might have been solved in five to ten sessions become crises that break up perfectly good relationships.

Since only a precious few learned the necessary skills to weather the ups and downs of a long-term relationship, it is easy to slip into negative patterns of relating–either to oneself or to loved ones–or both.

What are the warning signs of problems that need to be addressed?

Sometimes the signs are glaring and obvious–domestic violence, high levels of conflict on a daily basis, serious addictions, repetitive infidelity–but far more often, problems seem to creep up on people a little bit at a time.

file0001309677526In a famous 19th Century science experiment, researchers described how if they put a frog in a pot of boiling water, it would quickly jump out, recognizing the danger instinctively. But if the frog was put in cold water that was heated to boiling very slowly, the frog had no idea of the trouble brewing. By the time the water was boiling, the frog was dead meat.

So it can be with dysfunctional families, marriages, or even organizations. It seems OK until suddenly it doesn’t.

Warning Sign #1: You are no longer warm or affectionate with your partner.

file1601299643113Happy loving couples look up from what they are doing and smile when their partner comes home from work. They touch one another with some frequency–a hug hello or goodbye, a hand on the shoulder or leg, a kiss goodnight, holding hands watching a movie, rubbing the back of the neck after a long day.

Some people try to defend their lack of physical warmth by saying it’s not how they are built but when you see them with their children, they touch and tussle, smile and cuddle. Often when affection begins to wane in a marriage, it is a symptom of unexpressed resentment that needs to be uncovered and worked through.

Warning Sign #2: You don’t create enough time together doing enjoyable activities.

file00024844479If the only time that you spend with your mate is conducting the business of the marriage–doing chores, paying bills, managing child care–then the relationship ceases to have the qualities of a deep and tender friendship. As the old Michael Johnson song so aptly put it, “Love will get you through times of no sex better than sex will get you through times of no love…”

Happy loving couples make their friendship a priority. Even on weeks when they can’t afford the time or money for a date night, they participate in activities that bring playfulness and joy into the relationship. Some couples work out together, take walks when weather permits, play cards or games, entertain other friends and family, play sports, watch movies, or read books.

Warning Sign #3: You stop having sex or have it very infrequently.

file0001646047075One of the enjoyable activities that makes marriage special is the ongoing availability of a sexual connection. Contrary to myths perpetrated by the media, married people in general have more sex than their single counterparts, averaging between one to two times weekly after the honeymoon phase is over. If you begin to notice that the time between lovemaking is growing longer, this is another symptom of decreased connection.

Lots of folks–more often women in my experience–condone their behavior by saying they don’t want to have sex if they don’t feel like it but this position readily becomes a self-fulfilling prophecy. Both men and women get a boost of oxytocin–the bonding hormone–when sexual or even when cuddling, so paradoxically, if you have sex, you will then feel close (and more sexual) again. It’s a bit like priming the pump.

Warning Sign #4: One or both partners stop good self-care.

Marriage takes commitment and caring, both for oneself and for your partner. When either person begins to take the relationship for granted, resentments often build. Recent surveys have shown that both men and women are turned off when their mate puts on weight, stops dressing fashionably or grooming adequately.

Happier couples still dress up when they go on a date night as if they were courting a new relationship. Since a big part of our attraction to others is visual, it is important to want to look good for each other.

best oneWarning Sign #5: You blame your partner for your unhappiness (even if you don’t say it out loud).

Couples that don’t fight or fight very infrequently seem to have the illusion that their marriage is going well even when it isn’t. (The water is getting hotter by the minute but you and the frog are still unaware). If you feel constantly criticized or are feeling critical of your partner on a regular basis, it is a sign that issues need to be put on the table rather than shoved under the rug.

file9841279612478Warning Sign #6: You are lonely even when your partner is in the same room.

If you feel lonely in your marriage, it is time to take action. Most likely, your partner is also feeling the same thing. Loneliness is the fertile soil for affairs. Most infidelities are not due to sexual desires–although certainly sexless marriages contribute to longing–but they begin more innocently as a desire for friendship.

If you and your mate are not listening to one another’s pains and pleasures and providing support and empathy, then it is natural to look for support elsewhere. Don’t wait for the crisis and heartache of an affair. Even feeling the desire to look outside your marriage should make warning bells go off in your head.

file000905908966Warning Sign #7: Contempt has crept into your conflicts.

Be on the lookout for contempt–it is a relationship killer of massive proportions. Contempt is a form of criticism with a twist of judgment and bitterness thrown in.

It is signaled by rolling eyes and a downturned mouth indicating disgust. In John Gottman’s research, made more famous with Gladwell’s book Blink, contempt is one of the most obvious signs of an impending crisis. Simply observing couples arguing for a few minutes can help a trained observer accurately forecast the fate of a relationship.

valentine_4Get Help Before It’s Too Late!

The point of my sharing these warning signs is to light a fire in your awareness before it’s too late. If you read this and are worried because you have all seven signs a-blazing, take heed but don’t panic. With courage and commitment–and the right therapist–you can work together to create or recreate the relationship that makes you feel liked, loved and respected. Look forward to the next blog about finding the right therapist when you need one.

 

 



NEWSFLASH! Free Technique for Healing Pain Described

By Debra Manchester MacMannis, LCSW

file000912201749What if you turned on the news to the following headline…FREE new technique–with no known side effects–is found to improve the mood of 88.8% of users!!! Would you be curious or do you already know what it is?

Touted throughout history, described by Aristotle, Freud, and modern day psychotherapists of many theoretical backgrounds–the answer is allowing yourself a good cry. Weeping helps almost everyone, young and old, male and female.

Not All Tears Are the Same

Our eyes produce three kinds of tears–each of which serves a different function. Every time we blink, our eyelids produce continuous or basal tears to keep the surface of our eyes protected and moist and also necessary to help protect us from getting infections of the eyes.

file0001186408096Reflex tears, like basal tears, are 98% water. Their production is triggered when a foreign object or something irritating gets into the eye by accident, acting like a natural eye shower to keep our eyes clean.

Emotional tears are composed differently and include an endorphin and natural painkiller called enkephalin. “Emotional tears contain higher concentrations of proteins, manganese, and the hormone prolactin which is produced during stress-induced danger or arousal,” says Dr Carrie Lane of the University of Texas. This difference explains why “crocodile tears” (the type used for manipulation and trickery) are not the same as real ones.

Crying Helps Us Heal

sunday 015Dr. William Frey from the University of Minnesota is a biochemist who has been studying crying for over thirty years. He found that emotional catharsis helps shed both stress hormones and toxins. Simultaneously, crying stimulates the body to produce endorphins which not only help reduce our experience of pain but also help turn up the volume of our immune system.

Tears can make us feel better and physically stimulate healing at the same time, which is a pretty powerful combination. If you find this subject fascinating, check out Frey’s book, Crying: The Mystery of Tears. Frey is a believer in what is dubbed “the recovery theory” which hypothesizes that we literally cry things out as a way of helping the body recover from physical or psychological stressors.

Other evidence of substances only found in emotional tears helps support this theory as well. Emotional tears have higher levels of certain proteins as well as manganese and potassium. Manganese is an essential nutrient that must be kept in balance for optimum health.

file000730027686It helps to maintain normal blood sugar levels, to increase the health of nerves, and to keeps bones strong (to name only a few of its many functions). Potassium is necessary for the functioning of all living cells, helping to maintain fluid and electrolyte balance.

Why Women Need to Cry More

Studies have found, that on the average, women cry around 47 times per year while men average 7 crying spells each year. Until puberty, there’s not much difference between boys and girls unless, of course, boys have been shamed or ridiculed for displaying the “weakness” sometimes associated with tears. If the parents and culture allow, both little boys and little girls cry on a regular basis–and should be allowed to–in order to stay healthy and resilient.

After puberty, hormone differences help explain why women cry more often. Women produce more prolactin, the hormone found in emotional tears. In fact, prolactin levels are highest during pregnancy and breastfeeding. They actually increase to ten times their normal level. (I’m glad there is finally something to explain my excessive tears at MacDonald’s commercials, the local news, and a sideways look from my husband during my pregnancies and postpartum).

file000445653028Crying As a Way to Resolve Painful Events

While some researchers believe that crying is cathartic simply because it releases tension that builds up during stressful events, others believe that crying is the body’s innate mechanism to work through painful events that are still unresolved. Why else would people pay good money to get scared out of their wits by frightening films? Or spend hours watching soup operas or tear-jerkers or films about deeply unsetting subjects? Perhaps we are trying to jump-start the flowing of emotions any which way we can…

I’ve written about the healing effects of laughter in other blogs, and how sometimes we laugh so hard that we cry or we laugh when the more appropriate emotional response would be tears. These examples show how grief and catharsis come in many shapes and sizes, tailored by messages passed down in our family of origin, our ethnic and religious mores and beliefs, our shaping by age and gender.

The other way that crying helps in the resolution of past trauma–especially when done with a safe, loving supportive person–is that we are allowed to express emotions that were often suppressed or forbidden at the time. Often new insights and fresh perspectives come only after the painful feelings have been acknowledged and expressed.

file9541282977224Crying As a Signal to Loved Ones

Another function of crying is that it signals the need for help, which is one reason why babies and young children need to cry more often than many adults. Tears sound an alarm that something is wrong that needs attention. Emotional crying–when effective–thus helps to strengthen our attachment to others and to elicit empathy and comforting touch from others.

This explains why crying in the company of another person is associated more often with positive mood change than crying alone or crying in a crowd. If you want to feel better, allow yourself to cry as long as you need to. Don’t stop yourself. When you cry with another person, you are really giving yourself and them a gift.

Since I know that tears are one of the most powerful tools for healing available, I feel happy and relieved when someone allows themselves to cry in front of me or in my arms. Although it is painful to see a loved one suffering from pain or loss, none of us can escape the suffering that comes with being human. What we can do is offer our calm presence, without judgment, and feel grateful for the tears that fall. Tears are precious medicine for body, mind and soul.

 



Change Your Attitude & Life Will Follow

By Debra Manchester MacMannis, LCSW

PicCollage copy 2“They must often change, who would be constant in happiness or wisdom.”  -Confucius

Each January, as the kids go back to school after winter break, after we have watched the ball drop in Times Square and rung in the new year, most of us can’t help but think about the ways we want the next year to be different–and better–than the last. What about you? Are there any bad habits you want to break or new goals that you have set for yourself?

If you are inspired to make some changes in yourself, your family or in other relationships, remember that even change for the better is stressful and discombobulating. As creatures of habit, we get used to the way things are–even when the status quo is no longer very appealing or sometimes downright awful.

Unfortunately, many people make New Year’s resolutions, fail to keep them, and then beat themselves up for failing. Sound familiar? Here’s some hints that may make you more successful in accomplishing your goals…

It All Starts with Attitudefile7181334521100

Do you remember the children’s story, The Little Engine That Could? When a red train full of cargo breaks down on the track, a little blue train takes it upon herself to attempt the difficult feat of pulling 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 models an empowering self-concept, fostering perseverance in the face of hardship.

When you are taught to believe in yourself, confronting an obstacle pushes you to try harder rather than giving up. If you think less of yourself, you will have trouble even getting started let alone persevering when the going gets tough. If you anticipate failure, why bother?

One way to change your attitude is to think about problems, setbacks, or obstacles as situations demanding attention and new strategies. When you hear yourself using the word “problem,” try substituting the word “situation”. This situation is worth facing to see what else might be done about it.

Or for an even more positive spin, you can think of the “problem” you are facing as an “opportunity” to learn some new ideas or tools or as a “compelling challenge” or as a hurdle to be jumped. The words won’t change the problem in and of themselves but they will help to open the door to possible new strategies for change and growth.

DSC_0390_Iván_Melenchón_Serrano_MorgueFileBe Realistic About Change

In one of my favorite movies ever, What About Bob?, psychiatrist Dr. Marvin (played exquisitely by Richard Dreyfuss) instructs Bob (the inimitable Bill Murray) to stop trying so hard and to take baby steps towards change, setting small reasonable goals one day at a time. Although the movie takes this idea to a hysterical level, the principle is sound. Don’t bite off more than you can chew.

Throwing in a dose of humor will also help. Watch What About Bob? if you haven’t seen it (or any other film that makes you laugh at our human foibles) or just be reminded by watching a three-minute clip here.

Another reason that most of us make numerous attempts to change, but then revert to old behaviors, is because the new behaviors don’t always get the desired results fast enough. We live in a culture that likes quick fixes–crash diets, pills for pain, instant messages, everything short and sweet. Most important changes–like confronting dysfunctional patterns of relationship, emotional baggage, or life style habits–take a long time.

Things Can Get Worse Initiallyfile000557708328

John Steinbeck once queried, “I wonder why progress looks so much like destruction.” This favorite quote of mine can serve as  a touchstone during times of rapid and radical change. Given how easy it is, in the face of change, to feel that everything around you is being destroyed, we all need something to bolster our courage to hang in there.

I remind others (and myself) that whenever we embark on a new path, things usually get worse before they get better. When parents decide it is finally time to begin to set limits, kids often act out even more than before. When partners decide to be more assertive with one another about areas of disagreement, bigger conflicts are usually the first sign of change.

Many couples report how when they finally get away alone together–sometimes after years because of having babies and young children–all they do is fight. Does this mean they are no longer in love? Usually the opposite is true. The renewed closeness can bring up old stored-up resentments, fears of abandonment, and the longing for more intimacy. As any change begins, old habits must die first–which is why progress often looks a bit like destruction.

file000443155139Become An Expert Observer

Almost all bad habits start with a cue (or stimulus) that leads to the behavior that has some reward attached to it. If you can follow this sequence of events and make a tiny change to disrupt the pattern, voila!–change can begin, one tiny step at a time.(Watch this three minute clip from The Power of Habit to get the quick version.)

It helps to substitute a new behavior when trying to eliminate an old destructive pattern. Once you have examined thoroughly the habit loop you are trying to break, change the time, the place, or alter the sequence that leads to the undesired behavior.

Imitate the behavior of someone you admire and ask them how they maintain their positive routine. Give yourself lots of pats on the back or gold stars for every little step you take. This is why AA gives people chips as they accumulate weeks, months, or years of sobriety.

Track your progress on your calendar or with an app on your cell phone. If your goals were not realistic, go back and set new intermediate steps that you can more easily accomplish. And always remember that the road to success is always paved with failures. You are not alone.

 

 



Helping Yourself by Serving Others

By Debra Manchester MacMannis, LCSW

file9021344553210“The best way to find yourself is to lose yourself in the service of others.”  -Mahatma Gandhi

“Let us make one point, that we meet each other with a smile, when it is difficult to smile. Smile at each other, make time for each other in your family.” ― Mother Teresa

This is the time, beginning with Thanksgiving and lasting through the arrival of the new year, that most people think not only about themselves but also about how to help others less fortunate. It is impossible to turn on the news without seeing the needs of others in your community or elsewhere in the world.

Given the difficult parts of the holiday season–extra things to do, children out of school wanting to be entertained, increased financial burdens, bigger crowds, more traffic, and what often feels like exponentially increased pressure from all directions–the attention turned to serving others can be one of the best parts of the season. It can also help you to pause and reflect on what you can be grateful for.

file9031300633696Acts of Service Can Be Great or Small

Everyone has something to give. A smile or kind words to a stranger, shoveling snow for your neighbor, soup for a shut-in. No money is required–only willingness to think of someone else. The most precious things we can give are our time, our attention, our touch, or simply our presence.

Even if you are depressed or lonely–or perhaps especially when life is difficult–doing something kind for someone else can take your attention away from yourself and your pain, if only for a moment. Seeing the suffering of others can also make you realize that you are not alone. Every family faces losses–the death of loved ones, the dissolving of relationships, the trials of aging.

From the time our children were toddlers, we went together as a family to sing at convalescent hospitals for the elderly. We always went on Christmas day because the people left were alone, without loved ones to visit.

Some were silent and looked like they were dead, while others cried and clung to us when we approached their beds. Some spoke gibberish, and many didn’t smell very good. Our children were at times very afraid and hid behind us or begged not to go, and at different ages were more curious, comfortable, and open-hearted.

They learned first by watching, singing from a distance as we held people’s hands, stroked their hair, and wiped their tears. Every year our family shared the miracle of watching perfect strangers, fellow human beings, come alive and smile or weep at the touch of a hand, the sight of a child, or the ring of a familiar song. This has become one of our most treasured rituals of the holiday.

The Essence of All Religious and Spiritual TeachingsChristmas Carolers

“I slept and I dreamed that life is all joy. I woke and I saw that life is all service. I served and I saw that service is joy.” ― Kahlil Gibran

“Kindness in words creates confidence. Kindness in thinking creates profoundness. Kindness in giving creates love.” ― Lao Tzu

All of the world’s major religions teach that charity and service are essential values to practice and to teach to our children, with the explicit message that helping others is a kind and loving thing to do, which it is. But another, equally important reason to find ways to be of service, not only now but all through the year, is because of what it teaches the giver.

Ralph Waldo Emerson, the great American poet and philosopher, believed that “it is one of the great compensations in life that no one can help another without helping themselves.” Besides the joy and satisfaction that we can get from knowing that we have helped someone, acts of service can teach us and our children many important lessons. What better way to learn empathy for others, gratitude for what we receive, and familiarity with people who are different from us.file9921250747866

Changing Consciousness from Me to We

As family and as community, we can face together the reality of old age, illness and death. We can share stories of our grandparents and how they lived and died. We can hear the stories of people who fled oppression and of those who are oppressed still. We can hear stories of hope and of perseverance against all odds. It only takes the time to listen deeply without judgement.

Serving meals at a homeless shelter, taking packages to needy children, visiting shut-ins, or singing in hospital wards can be difficult but, then again, so is life. Serving can break your heart…open.



Where Does the Time Go? 5 Tips to Conscious Connection

By Debra Manchester MacMannis, LCSW

file0001853328862“What greater thing is there for human souls than to feel that they are joined for life—to be with each other in silent unspeakable memories.”  –George Eliot

The wish to seek and have a deep sense of family connection and commitment is universal. Ask people what is most important to them and their first answer is always the same–their family. In healthy families, there is a sense of cohesion or family togetherness. Without it, we feel more like strangers than kin.

What gives families a strong sense of connection?

The answer is very simple although often a challenge. We must spend quality time together, just hanging out, or if separated by geography, spend time talking and listening to one another. We need to know that we can count on each other for the relationship to be close. In research on happy loving families, sharing time together is made a priority to build trust and intimacy.

One of my favorite times to talk to my mother is when I am chopping vegetables for dinner with my headset on. We take those minutes to share details of our day, and my mom always asks me what’s for dinner. My husband has long weekly talks with his mom who lives out of town when he goes on hikes to get his exercise.It often helps to schedule talking and listening time in whatever schedule “book” you use, committing yourself to family time instead of slipping into the habit of watching TV, computer surfing, video gaming or answering one more email.

What are the benefits of spending quality time with loved ones?

Only by making the time to share the details of our daily lives as well as our successes, hardships, dreams and disappointments can we reap the rewards of our intimate bonds. Researchers at Brigham Young University analyzed results from 148 studies from the last century and found that social support not only makes us happier to be alive but also literally adds to our longevity, increasing our survival by 50 percent.file50e9dcb10fdd0

Another important ritual for spending regular time together is the family dinner. There is a growing body of research that reveals just how significant this time is for the physical and emotional health of the kids. Routines and rituals such as this provide consistency and structure which not only help families to feel more connected but also help to buffer the negative effects of stress.

Unfortunately, twenty-first century families are more isolated than ever before. With both parents working more hours than ever and with the demands of work infiltrating family time via computers and cell phones, most everyone we talk to complains about the same thing. There’s just not enough time!

file00018101157725 Tips for Creating Family Time

TIP #1: Remind yourself in the following week to take the time each day–even if only minutes– to connect with your family members.

TIP #2: Remember to use the precious times you already have to talk and listen rather than remain plugged into cell phones or iPods.

TIP #3: Catch the moments in between–like driving in the car, eating a snack, walking the dog–to share thoughts and feelings with your loved ones.

TIP #4: Create a daily ritual of checking in. Any habit practiced for thirty days becomes the new normal.

TIP #5: Schedule talking and listening time in whatever calendar system you use, committing yourself to family time instead of slipping into the habit of watching TV, computer surfing, video gaming or answering one more email.

If you have discovered other creative ways to connect with family, please let us know so we can share them with other families like yours.



The ABC’s of Mental Health and Happiness

By Debra Manchester MacMannis, LCSW

file0001244043169How well do you know your ABC’s of mental health and happiness? Let’s start at the very beginning–although you will see that the alphabet of skills below is really a circle that starts and ends wherever you are…

Awareness…because the first step in happiness is to become aware of what you are thinking, feeling, doing and projecting in the world. Awareness leads to authenticity–striving to be yourself, unique and precious, unlike anyone else on the planet.

Believe…not only in yourself and your capacity to grow but believe in something greater than yourself–whether that is God, ultimate enlightenment, the unity of nature, the laws of science, or the power of Love to transform people.

Communicate…with courage and compassion. Humans were given the gift of language and the capacity to invent alphabets in order to communicate our thoughts, feelings and desires.

Determination…is a necessary strength that can be cultivated. Mental well-being emerges from consistent effort and the daily practice of empowering attitudes and decisions.

Exercise and Eat well…since our bodies and minds are not separate from one another.

Family and Friendships... provide the social support that we need to combat despair and loneliness. Take time to develop and nurture relationships that bring you comfort and joy.

Gratitude…helps us change our attitude. Instead of feeling victimized by others and focusing on pain and suffering, when we remember to notice small things each day that to be grateful for, it gives our lives new perspective.

file3371253285836 Hobbies…help us cultivate broader interests, meet others, lose track of time and get in the flow of creativity.

Intention...sets the stage for our actions. Envision the kind of person you want to be, and make it your clear and firm intention to practice whatever skills and attitudes will help get you there.

Joy...helps every journey, however long and perilous. Like gratitude, it can be found in the smile of a stranger, the smell of fresh coffee, the color of the sunrise.

Kindness...to others can heal broken hearts and will come back to you sometimes when you least expect it. Give to others what you would like to receive.

Learning…lifelong learning…is what it takes to become a kinder, happier, more loving person. Life gives each of us many lessons along the way. Cultivate the mindset of a child with the openness to learn something new each and every day.

Mindfulness and Meditation…help teach us how to quiet our monkey minds (the incessant chatter in our heads–often negative), how to remember to breathe through pain, and how to stop ourselves before saying something cruel or unnecessary.

Nature…is Herself a great Teacher and healer for children and adults alike, teaching us to be observant, to play, to be alone, to be more imaginative, and to be in our bodies.

Optimism…is an outlook on life that fosters hope. It helps us to live longer, get along better with others, and persevere in spite of suffering. Is the glass half full or half empty?

Practice and Persistence…are crucial to the success of any venture–including happiness. As Thomas Edison said, “Genius is 1 % inspiration and 99% perspiration.”

Question…yourself and your current state of mind with curiosity and the willingness to change. Don’t get stuck in believing that you are right when it brings you little joy or connection. Don’t take things that others do so personally. Instead, cultivate curiosity and remember that everyone else is trying to learn things too.

file000809379634Rituals and Routines…are the best ways to ensure that new skills and attitudes get incorporated into daily life. Just as we learn to brush our teeth at night before bed, if we practice gratitude or meditation or any life-enhancing skill at the same time each day, it will become second nature.

Sleep..and enough of it, is necessary for not only our physical health but our emotional stability as well. Without it, it is easy to fall prey to pessimism, irritability, and depression.

Talk…to others about your troubles. Therapy is not for the weak or the sick but for those with the courage and determination to make their lives–and that of their children and loved ones–better. Talking to others (anyone!) also builds trust, opens us to new ways of thinking and allows us to test new behaviors.

Understanding…how our body, mind and spirit are connected helps motivate a healthier lifestyle. There are many curricula available through books, lectures, and classes about cultivating mental health and well-being. Increasing your knowledge will increase your motivation and persistence.

Volunteering…helps build more positive relationships. As we see the suffering of others, we realize we are not alone, building greater empathy and compassion. We also feel better about ourselves which in turn promotes more self-care and self-compassion.

Work…is an important way to put all of the above into practice. It is relatively easy to be happy when you are doing things that are fun. Some people are blessed to do work that fulfills them, but many spend countless hours doing things that are tedious or boring. Learning to see one’s work in a positive light–it puts food on the table, it builds discipline–is truly walking the walk.

Xpression of feelings…in a balanced way–not too much and not too little–helps us stay attuned to ourselves and others. Crying can help us heal from the pain of loss or betrayal. Learning to express our anger in non-violent ways helps us move to compassion.

file6331286648519Yoga…is a physical, mental and spiritual practice from ancient India that was designed to bring peace of mind to the practitioner. Think of the difficult moments of life–whether in your job, your relationships, or your physical health–as your yoga. Many of the most important lessons learned in life come from transforming our mistakes into opportunities for growth and learning.

Zeal and Zest…are the end product of putting the ABC’s into practice. They also make the journey more enjoyable along the way. Laughter is one of the best medicines–and certainly cheap enough for everyone with no known side effects other than increased optimism and well-being.

Which brings us back to the beginning. They all go together. Start anywhere you like. Or just start with A….one ACTION towards health and happiness.



Create an Attitude of Gratitude

By Debra Manchester MacMannis, LCSW

file5991298749300“At times our own light goes out and is rekindled by a spark from another person. Each of us has cause to think with deep gratitude of those who have lighted the flame within us.” – Albert Schweitzer

Schweitzer’s quote seemed especially timely given the arrival of the Thanksgiving holidays and this year’s rare convergence of Thanksgiving and the first day of Hanukkah, the Jewish festival of lights.

Both holidays are celebrations of religious freedom and of survival against all odds. Both remind us to be grateful to be alive and to have food on our table, since not everyone on our planet is so lucky. That being said, expressing thanks is both a universal urge and a crucial strength that can be cultivated, not just at Thanksgiving but on any day.

The world’s religious teachers, ancient philosophers, and indigenous people have spoken about the importance of gratitude for over a thousand years, seeing it as an important virtue to be cultivated and practiced. In religious traditions, the saying of grace before each meal is a way of thanking God for the food on your table.

file000458839787Most parents teach their children the “magic words” of saying “please” and “thank you”. We have always known intuitively that grateful people seem to be happier with their lives and also more able to confront life’s challenges.

The More the Better

Scientists were latecomers to this awareness. Only in the past ten years have researchers started to take a hard look at exactly how and why gratitude leads to increased health and happiness. Now, a growing body of research is emerging that verifies not only this but much more.

Psychologist Robert Emmons from the University of California at Davis is one of the prominent researchers on gratitude, now conducting highly focused, cutting-edge studies on the nature of gratitude, its causes, and its consequences. Many other researchers are following suit.

They have found that gratitude helps boost the immune system and is in itself a form of stress reduction. We are also learning that adversity can, paradoxically, bring an increase in thankfulness. People who have faced losses early in life often have higher levels of optimism, suggesting that adversity can add to personal growth over time.

file5171267885752Teach Your Children Well

Research on happy, healthy families has found that the parents in these families emphasize the positive, yearning to bring out the best in one another in spite of individual differences in temperament, talents or interests. They teach core values such as honesty, fairness, kindness and responsibility, and typically foster a spiritual or philosophical perspective that includes serving something greater than just ourselves.

Rather than focusing on complaints or how the glass is half full, we want to teach children–and remind ourselves–how to learn from mistakes, apologize for wrongdoings, and have gratitude for what we already possess. When we cultivate our positive feelings of joy, empathy, gratitude and love, we are opening our hearts and activating pathways in our brain that lead to more helpful thoughts and actions.

If you did not come from such a family, you may need some help to be able to change your thinking towards a more optimistic, positive point of view. Negative thinking and complaining can be habit forming. And to break any habit takes conscious effort and deliberate practice. Make it a goal to be more positive but don’t be hard on yourself if you slip into doom and gloom.

Self-Help Books on Positive Thinkingfile0001727698973

A great place to start is with one of the books of psychologist Martin Seligman, the father of positive psychology. Seligman is a professor at the University of Pennsylvania and the current Director of their Positive Psychology Center. Author of many classics in this rapidly rising field, check out his book Learned Optimism: How to Change Your Mind and Your Life, published in 2006.

Not only does this book give the reader an overview of the theory and research on both optimism and pessimism, it includes tests for both parent and child to determine levels of positive and negative thinking. The final third of the book provides the most hands-on learning with worksheets for both parents and their children.

file0001362503108Films and Music That Inspire

If you would prefer to be inspired through film rather than through a book, depending on the age of your children you could watch The Lion King and discuss the virtues illustrated in this film classic. Two other favorite movies of mine to help jumpstart more positive thinking are Pay It Forward and The Pursuit of Happyness. Watching a movie together at home, taking the time to talk about what you each have learned, can be a fun way to cultivate more positive outlooks and behaviors in yourself and your kids.

Music is yet another universal way to be inspired and uplifted. What are the songs that build you up rather than bringing you down? I love “Climb Every Mountain” from the Sound of Music and “Anthem” by Leonard Cohen. For songs and activities that bring positive messages to young children, check out the album on Happiness and Attitude at KidsEPs.com.

If you want to be inspired but don’t have time for a whole movie, take ten minutes when you can stop, breathe, and open your heart to the exquisite beauty of nature. Louie Schwartzberg has been doing time-lapse photography of flowers for thirty years. In a Ted talk, Nature, Beauty, Gratitude, his stunning images are accompanied by powerful words from Benedictine monk David Steindl-Rast on being grateful for every day.

-2Loving What Is

The German mystical theologian, Meister Eackhart, teaches that “If the only prayer you said in your whole life was, ‘thank you,’ that would suffice.” This quote made me think about how most people generally pray for something. And we generally pray for somebody, ourselves or our loved ones. We might ask for good health for ourselves or our family members, for food and shelter, for love, for an end to suffering, for miracles, for a job, or simply for strength or wisdom.

Today, and this Thanksgiving, my prayer is simply this: to be grateful for what is. All of it. The blessings and the suffering, for they both are teachers, and they walk hand in hand. Or as Leonard Cohen reminds us, “There is a crack in everything–that’s how the light gets in.”

 

 

 

 



Why Do Fools Fall in Love? Our Brains Have Some Answers.

By Debra Manchester MacMannis, LCSW

file000960252474There are probably more books written, more movies made, and more opinions offered about love and relationships than just about anything else. From poets to scientists, everyone chimes in with an opinion. “Love is blind,” proclaims Chaucer, the poet, and Albert Einstein adds the warning, “You can’t blame gravity for falling in love”.

“Why, tell me why, do we fall in lo-ove?” goes the song, Do Fools Fall in Love?, first sung in 1956 by Frankie Lymon and the Teenagers (quite appropriate for the subject matter), further popularized by the Beach Boys in 1964, sung by Diana Ross in 1981, Missy Elliott in 1998, and The Overtones in 2010. That tells you something right there, doesn’t it? And the answer to the question posed by the song: a resounding yes, fools indeed fall in love.

No wonder we are obsessed with the subject. Fortunately, we are learning more about exactly what happens in the brain to explain our desire to meet, mate, and marry. One angle that explores the source of our obsession comes from anthropologist, Helen Fisher, who has been studying romantic love for thirty-five years and has most recently been a consultant for Match.com.

The Brain in Lovefile0001052648856

If you are interested in examining love from the point of view of both brain science and cultural anthropology, then you may be intrigued by the book, Why We Love: The Nature and Chemistry of Romantic Love. The book’s authorHelen Fisher is a research professor in the Department of Anthropology at Rutgers University, and her work has examined marriage and divorce in 58 societies, adultery in 42 cultures, patterns of monogamy and desertion in birds and mammals, and gender differences in the brain and behavior.

At the core of her theory is the scientific study of three very different operating systems in the brain. Fisher’s work explores the chemical basis of love. from research conducted on subjects whose brains were scanned using functional MRI’s. The scans pinpointed the different effects of specific chemicals like dopamine, norepinephrine, and serotonin, proving that much of our romantic behavior is hard-wired. (Check out her great TED talk on “The Brain in Love” to get a closer look).

file000930862865Lust

The first “operating system” affecting our relationships rules and causes our sex drive. This drive is mostly controlled by testosterone, in both males and females, and evolved in order to ensure the survival and reproductive success of our species. The intense craving for this hungry love is strongest during the childbearing years, diminishing as levels of testosterone gradually lower with age.

As most of us know, you can feel lust towards unavailable partners and inappropriate choices. This drive is very impersonal and very physical. When testosterone is high, it can be as uncomfortable or painful as deep hunger.

Romantic Love

The second system, which drives our need for romantic love, is caused by an increase in dopamine, stimulating the pleasure centers in the brain. Although people often think of love as an emotion, when dopamine goes up, it feels more like an addiction, stimulating the same reaction as a rush of cocaine. People in love describe thinking about their beloved 24/7 and constant craving to be with that person.

But did you know that when people are in this early phase of increasing interest and infatuation, they have a decrease in serotonin? No wonder this stage is so intense and perhaps why we call file000846429979it falling in love. It is well known that increased levels of serotonin are correlated with a sense of serenity, good moods, and an ability to inhibit behavior. So even though you might think that falling in love would make us happy (and raise serotonin), this is not what happens in the brain.

During this stage of falling for someone, our moods are highly unstable–like someone suffering from an anxiety disorder. We are happy when things are going well and unhappy when they are not. We might even feel a bit bipolar. The drop in serotonin also helps explain our wild inability to control our thoughts during this intensely emotional stage. (Serotonin is also low in people who suffer from obsessive compulsive disorder). It is both confirming and almost a relief to know why love can so easily mimic an addiction.

Why, you might ask, was the brain wired to make falling in love so much like an addiction? Evolutionary biologists suggest that this operating system helped humans to stop lusting for all nearby two-leggeds in order to narrow the focus of attention to one potential mate. Because human babies need care and protection for much longer than most animals, the bond of the parents needs to be intense.

file000582850807Deep Attachment

This leads us to the third operating system in the brain which fosters attachment or bonding, modulated mostly by the increase in two hormones, vasopressin and oxytocin. These neurotransmitters are responsible for creating pleasurable sensations, specifically the feelings of calm and security, and help us develop deep and lasting bonds with our loved ones. 

After the pain, the craving, and the turbulence of the first two stages has subsided–assuming you are still with the person you fell in love with–the brain helps us form attachments with our beloved. Just as parents feels empathy, compassion and a sense of protectiveness towards their children (even their adult children), so too this same kind of bond evolves with our mates. This is why people often describe even partners they have divorced as “family” and why many happily married adults describe their partner as their best friend.

Mother Nature designed our brains with intricate design. The mystery of it all is still unfolding.

 



 
How's Your Family Really Doing?
Don MacMannis, Ph.D. & Debra Machester MacMannis, MSW are the author of How's Your Family Really Doing?.

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