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The Dangers of Dehydration by Dr. Hanan Hussein

Published in the Bay Area Health & Wellness Magazine, Houston.  Visit us at txhwmagazines.com

Forced Apologies by Carol Kim, MS, LAMFT

My four-year-old daughter placed herself in the middle of our living room to play with blocks. She was so engrossed with building a wooden castle that she didn’t notice her two-year-old sister walking towards her with her right arm stretched far back to slap her older sister across the head. When that slap came, my older daughter went from happy to surprise to anger and then lots of tears. She ran towards me seeking justice. “Mommy, she hit me!” My younger daughter remained still, looking innocent. I immediately walked over to her with my older daughter in hand and said, “Hands are not for hitting. Say sorry for hitting please.”  I’m sure many parents can relate to this scenario. Teaching our children the skills for making amends is an important life skill and is not so much about saying the words “I’m sorry”.  

There is a belief amongst some parents that enforcing premature apologies on children is not effective. Their reasoning is that premature apologies teach children to lie and encourage insincerity. It also creates shame and embarrassment. Other studies show that young children have the ability to be empathetic even before they can speak; therefore, parents should encourage apologies (Smith, Chen, Harris; 2010). As I reflected on my research and my knowledge as a Marriage and Family Therapist, I recognized several things we can do as parents to create productive apologies: 

  1. Keep yourself in check: It’s frustrating to see your children fight, especially when it happens at inconvenient times. However, it’s important to remain calm and model for your children how to handle frustration.   
  2. Be immediate when possible: When you see an incident occur between your children, address it. The best time for learning and growth is when the incident is still fresh in their minds. However, when there are time constraints and the issue cannot be addressed right away, it is important to tell your children when and where it will be addressed. Be consistent when using the alternative and follow through.  
  3. Ask instead of tell: Avoid lecturing. Ask questions instead. “Tell me what happened?” “What were you feeling when you hit your sister?” Validate the expressed emotion and help them to understand that it is okay to feel frustration and sadness; however, it is not okay to hit or throw things. Help them to also make the connection between emotion and action. “Look at her face, how do you think she’s feeling right now?” Asking these types of questions enhances empathy. 
  4. Problem Solve: Ask questions about what they think they should do when they feel frustrated or sad. Help them to come up with solutions.  Ask questions about how they can make things better with their sibling/s. 
  5. Have them practice a do-over: When your child identifies the solution, have them practice it with the other sibling/s. Praise them for their efforts at the end.    

What is more important than the phrase “I’m sorry” is what children take away from the experience. We can facilitate and enhance learning opportunities by not focusing on the phrase “I’m sorry” but instead more on what can be learned from this situation and how can we improve.  

About the Author: Carol is a therapist at the American Fork Center for Couples and Families. She is a Licensed Marriage and Family Therapist who has spent the past 6 years practicing in several cities across the United States, including Boston, San Francisco, and now, American Fork. She is passionate about applying the principles of therapy to improve lives and relationships, and is committed to creating a safe, comfortable, and supportive environment. Carol specializes in individual, couples, and family therapy, and has extensive clinical experience treating depression, anxiety, ADHD, addictions, domestic violence, trauma, children/adolescents and relationship issues.

Hidden Signs of Depression by Alberto Souza, MSN, APRN, FNP-C

Studies show about 1 out of every 6 adults will have depression at some time in their life. This means that you probably know someone who is depressed or may become depressed at some point. We often think of a depressed person as someone who is sad or melancholy. However, there are other signs of depression that can be a little more difficult to detect.

 

Trouble Sleeping

If you notice a change in a loved one’s sleeping habits pay close attention as this could be a sign of depression. Oftentimes depression leads to trouble sleeping and lack of sleep can also lead to depression.

Quick to Anger
When a person is depressed even everyday challenges can seem more difficult or even impossible to manage which often leads to increased anger and irritability. This can be especially true for adolescents and children.


Losing Interest
When someone is suffering from depression you may notice a lack of interest in past times he or she typically enjoys. “People suffering from clinical depression lose interest in favorite hobbies, friends, work — even food. It’s as if the brain’s pleasure circuits shut down or short out.”


Appetite Changes
Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in Bronx, New York cautions that a loss of appetite can be a sign of depression or even a sign of relapse back into depression. Dr. Kennedy also points out that others have trouble with overeating when they are depressed.


Low Self-Esteem

Depression often leaves people feeling down about themselves. Depression can lead to feelings of self-doubt and a negative attitude.

 

What to do
If you suspect you or someone you love may be suffering from depression talk about it, encourage him or her to get professional help and once he or she does be supportive. Remember that at times symptoms of depression need to be treated just like any other medical condition.

Sources

Healthtalk.org

helpguide.org

Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

Misconceptions Around Parental Alienation: How Professionals Can Get it Wrong By Carol Kim, MS, LMFT

Divorce is hard. It is emotionally and physically draining for all people involved, including children. When a divorce becomes high conflict, children are caught in the crossfire and are treated as “prizes” to be won. Parents start pressuring their children knowingly and/or unknowingly to choose sides. These behaviors can escalate to “alienation”. Alienation is defined as a parent teaching their children to reject the other parent using fear (Templer, 2). Due to limited research, professionals often mistake alienation for estrangement. This misdiagnosis can have devastating effects on a family.

One misconception about alienation is that the alienated parent is responsible for being rejected by their child, whereas the alienating parent is considered to have little to no part in why their child is rejecting the alienated parent. Discerning whether a parent has been alienated or estranged requires specialized skills and knowledge. Unfortunately, many professionals who are assigned to such cases often have little to no training in this area.

Misconceptions about alienation prevent families from getting the help they need and can even have legal ramifications. Here are some examples of harmful misconceptions:

It is generally believed that if a child does not want to be with their parent it means they have done something to deserve it. However, the reason could be that the alienating parent programmed the child.

It is generally believed that the child would not align with the abusive alienating parent. However, children are vulnerable to manipulation. The targeted parent often tries to enforce appropriate discipline and fill the hole left by the alienating parent. In so doing, the targeted parent is looked at harshly and viewed as not respecting their child’s wishes and feelings.

Enmeshment (blurred boundaries between two individuals) can be confused with healthy bonding. When children feel that they are not recipients of unconditional love they can be manipulated into doing what the alienating parents desires.

Professionals who have these or other misconceptions may come to the conclusion that the alienating parent is stable, whereas the targeted parent is not; this instability, real or perceived, is often the result of depression, anxiety, and anger that’s developed from the trauma of being alienated. Another example is if the targeted parent is falsely accused of abusing their child; the parent may exhibit instability due to the fear being jailed, losing their children, or financial pressure. The unfortunate reality is that even strong, emotionally stable individuals may become anxious, depressed, and angry when under the pressures of alienation.

Mental health professionals play a critical role in high conflict divorce cases and have the power to make things much worse or better. Given the high stakes, families are encouraged to carefully select a professional with the proper skills and training.

About the Author:  Carol Kim is a Licensed Marriage and Family Therapist who has spent the past 6 years practicing in several cities across the United States, including Boston, San Francisco, and now, American Fork. She is passionate about applying the principles of therapy to improve lives and relationships, and is committed to creating a safe, comfortable, and supportive environment. Carol specializes in individual, couples, and family therapy, and has extensive clinical experience treating depression, anxiety, ADHD, addictions, domestic violence, trauma, children/adolescents and relationship issues. She has also utilized her deep understanding of parenting and marriage to teach and facilitate community parenting and marital enhancement groups. Carol received her Master in Marriage and Family Therapy from Brigham Young University, where she was clinically trained and conducted extensive research in improving marital satisfaction. After graduating and before dedicating herself full-time to therapy, she was awarded the prestigious Kaiser Fellowship and worked for the San Francisco Bay Area’s most popular news station, KTVU, as a broadcast journalist focusing on mental health related issues. She is a member of the American Association of Marriage and Family Therapy and the Asian American Journalist Association.

Why Should Couples Consistently Set New Year’s Resolutions Together? By Dr. Matt Eschler, Ph.D, LMFT

I have counseled couples for twenty-five years. Panicking, anxiously pacing, wringing hands, couples have wandered into my office, hoping to find some peace in their relationships. In the counseling arena we explore some very principled foundation ingredients that, when mixed together, produce peaceful, passionate relationships.

There are three fundamental ingredients that all of us need to exercise for a shot at a sound relationship. My challenge to you is to sit with your lover and assess the following three principles, and set specific goals to learn a little more, stand a little more firm, and increase your skills in these three areas:

The first foundation principle is friendship. Friendship is unilateral. Increase your friendship with your lover every couple of hours. You do this by sharing information, being trustworthy, and being transparent—without conditions.

The second principle that relationships will not survive without is influence. You must accept your lover’s influence. Men seem to have a slightly more difficult time with this, but both partners will benefit from allowing influence. Think about a time when there was disagreement in direction of relationship or activity. Did you allow your lover to have influence? Did you argue until one of you gave in? Was their healthy negotiation until a mutually satisfying result occurred? The hope is always influence and no competition. Get a little better at this in 2018!

Finally, the third principle is generating a governing purpose for your marriage. This is the North Star that holds you both accountable to a result that is desirable and cherished. If you are seeking the same purpose, you won’t go after hostile results. For example, my wife and I want to travel the world. If I sneak out and spend our travel money on a new truck and lots of clothes, we won’t have resources available to travel. That causes issues. If I save and we put our travel fund together and watch it grow together, we will eventually accomplish our common goal.

I invite you all to accept this challenge: In 2018 be a little bit better in all three of these areas. Sit with your lover and map out a specific strategy to accomplish these three goals to improve your relationship.

 

About the Author: Matt lives in St. George, Utah where he and his wife Chris are enjoying their life with each other. Since their kids have grown and moved out perusing their dreams Matt and Chris travel the world. They want to visit 200 countries before the are done. Matt and Chris are active in their community and enjoy working out, training for marathons, and spending time participating in numerous activities with their adult children.  Matt has received his PhD in Psychology. He is focused on the arena of resolving personal conflicts and improving interpersonal relationships. In addition to his Doctorate Degree Matt has earned a Masters in Marriage and Family Therapy, studied Criminal Justice and received a category I licensure with Peace Officer Standard of Training along with a degree in the Arts of Business Management. Matt is a professor at Dixie State University and hopes to be part of the positive growth of Southern Utah.

Simple Ways to Improve Mood by Alberto Souza, MSN, APRN, FNP-C

We all have those days when it feels like we woke up on the wrong side of the bed. For whatever reason we are just in a bad mood. Often times these bad mood feelings are associated with difficult or stressful events in our lives such as trouble at work, financial problems or disappointment. Sometimes these bad mood feelings last for only a few hours, but sometimes they might linger for days at a time. There are many simple strategies to improve one’s mood in spite of what it is that might be bringing us down.

Be With People

Often times when we are feeling low just being with a trusted friend or family member and talking about our feelings can make all the difference. Having a sympathetic listener or someone that can get us laughing or looking at the bright side of things can make all the difference. We shouldn’t be embarrassed to talk about our mood or admit that we need help. In fact, many times isolating ourselves can be one of the biggest culprits in a lingering bad mood.

Get Out

Whether its a brisk walk through the neighborhood or a trip to the grocery store, getting out of the house can do wonders for improving our mood. Sometimes we just need a little sunshine or to breathe in some fresh air. The sights and sounds of everyday life can get our mind off of things and be a beautiful distraction.

Enjoy Yourself

When a bad mood strikes we might find ourselves not even wanting to do the things we normally enjoy, but doing them anyways can take our minds off of negative thoughts and often times will help us feel better overall. Think of simple pleasures like reading, exercising, cooking or baking, shopping or just watching a funny movie or show.

Talk to a Professional

Feeling sad or moody are normal human emotions that we all experience from time to time.  Depression is different from these emotions primarily because depression is a pervasive feeling of sadness that impacts our entire life and doesn’t just go away even when things in our lives are good. We should not hesitate to reach out to a professional to help us understand our feelings and deal with them appropriately.

Source: Psychology Today

About the Author:  Alberto has worked in healthcare for over 10 years. He began as a CNA and then worked as a registered nurse until completing his Master’s Degree in Nursing.  Alberto has been been working as a Nurse Practitioner since April of 2013.  In addition to his work as a Nurse Practitioner, he also teaches online classes for the Dixie State University Nursing Program.  He is currently working at the St. George Center For Couples & Families.

For Busy Parents: Increasing Quality Time With Your Kids by Carol Kim, LAMFT

tradition 3Life can get super busy. There are so many things we have to do in a day… make breakfast, feed the kids, change diapers, clean, make lunch, feed the kids, clean, work, clean, go shopping, put toys away. And we do it all over again the next day and the day after that. When we get into this kind of routine, it feels like there is no room to make time to connect with our children. We often feel stuck or too exhausted to problem solve. We don’t have to make drastic changes in our routine. The secret is that little moments every day add up. Here are several simple things you can do to better connect with your children.

1) Let your children help out. This can be challenging. For example, I’ve found that involving my toddler in the kitchen makes tasks longer and often creates a big mess. However, I know that she loves helping me mix things and measure ingredients. I also know that I feel happy when we spend this time together. In addition, helping can also teach kids things such as math and motor skills.

2) Talk with your children while driving. Engage them in conversation. Talk to them about how their day is going. Sing songs with them or sing to them if they are too young. They will enjoy it.

3) Watch TV with your kids. I sometimes find myself needing a break and put the TV on for the kids. This break time can be a great time to connect with your kids through cuddling or talking with them about what they are watching.

singer 34) Take 10-15 minutes out of your day to have one on one time with your child. This can be challenging, especially for mothers with many children or who work. Be disciplined in scheduling 10-15 minutes a day for the purpose of connecting with your child. If 10-15 minutes isn’t feasible, try 5 minutes, or if circumstances demand it spend time with one child a day . The important thing is consistency. During this time, play with them and give them your undivided attention.

5) Bedtime. Make it meaningful and a time you look forward to. Chat, tell each other stories, read books, sing, pray, or any other calming activity that allows you to connect..

As parents, sometimes we feel like we are in survival mode. Life gets busy but it is important to mindful of being present with our children. If we practice being in the here and now, our children will take notice and we will have a stronger relationship.

CarolAbout the Author: Carol Kim is a Licensed Associate Marriage and Family Therapist who has spent the past 6 years practicing in several cities across the United States, including Boston, San Francisco, and now, American Fork. She is passionate about applying the principles of therapy to improve lives and relationships, and is committed to creating a safe, comfortable, and supportive environment.

The Power of Meditation by Kenneth Jeppesen, LAMFT

Lone Tree in SnowMost people I meet don’t meditate, though many have tried it once or twice. What we know about meditation usually comes from TV shows and movies, where wizened gurus tell us to think of nothing, or to clear our minds. But anyone who has ever tried to think of nothing knows how impossible that is. How do you visualize and think about something that doesn’t exist?! I’m not sure you can. The irony is, we think of “nothing” by thinking with intense focus on something.

There’s more than one way to meditate, but in general, the important part is that we concentrate on something in our present reality. For most, that means concentrating on our breathing, how do we do that? It’s helpful to pick one aspect of our breathing like the way the air feels in our nostrils, or the sound the air makes as it goes in and out. Focusing on our breathing anchors our awareness to the present moment, and that is the essence of mindfulness. We become more aware of our existence. We get out of our head and start to concentrate on being. We notice the signals coming from our body, we become more connected to ourselves, more in touch with what we are experiencing in the moment. As we become focused on just being, existing without having to do or think about anything, we find a stillness that begins to settle on us. It is an amazing feeling and one that you just don’t experience unless you’ve practiced calming your mind. Some people like being out in nature because it helps them find this clarity and calmness. But we don’t need to plan an expedition so that we can feel peace. The brain can’t really tell the difference between being in the woods and imagining being in the woods.

balanceVisualizing being in a beautiful place where nothing is required of you, where you are your perfect self is an incredibly powerful way to let go of the sorrows and worries we usually carry around. For the time we are meditating, it’s like we’re a different person who doesn’t feel stress. Really though, this is our true self, this is the person we are when the baggage of the world is stripped away. We can access this blissful, stable, and happy self of ours whenever we pause to meditate. With practice, we strengthen the neural pathways of peace in our brains. Where once there was an overgrown and hard to find path to peace, with frequent use, we can pave it to create a wide freeway leading to serenity. It took me about a year of consistent practice to get to that point. It was well worth it, because now at any time, I can concentrate and return to stillness without actually having to meditate. Frequent meditators enjoy more happiness, deeper sleep, better immune systems, and less fear. It is a skill worth practicing, that I hope someday will come to rightly be seen as important as eating our vegetables.

Kenneth-Jeppesen-Headshot-e14380277335081About the Author Kenneth Jeppesen is a Licensed Associate Marriage and Family Therapist and a member of the American Association for Marriage and Family Therapy. He earned a bachelor’s degree in Child and Family Studies from Weber State University, and a master’s degree in Marriage and Family Therapy from Converse College in Spartanburg, South Carolina. Kenneth is a therapist at the Provo Center for Couples & Families.

Pornography Addiction: An Epidemic By Dr Matt Brown and Dr. Mike Olson

Pornography is a big business. Americans spent 97 billion dollars on pornography over the past five years. The monetary cost of this epidemic is only a part of the real cost of this problem in our country. Over the past decade, increasing attention has been given to the damaging effects of pornography on the brain and, by extension, the lives of individuals and families. The accessibility of pornographic material and the multitude of technologic means by which it comes into our lives has brought this issue increasingly into the spotlight. In fact, you may be reading this because pornography has impacted you, personally, or someone you love.

There has been controversy in the psychiatric literature about whether those who struggle with pornography are “addicted.” Whether or not it is formally designated in the professional literature as an addictive disorder, it certainly has been shown to affect the brain and the lives of its users in ways consistent with other addictive disorders. As with any addiction, an understanding of the process is key. Let’s start with how the brain responds to pornography. Our brains are designed to catalog our experiences with the end goal of preserving life and eliminating threats to our safety. Essentially, our brains are effective at remembering what feels good and what doesn’t. While this process is complex, a basic understanding of a few key brain chemicals is critical.

stress 1The brain responds to pornography by releasing a powerful chemical called dopamine. Dopamine is released whenever we have pleasurable experiences. The release of dopamine and another powerful chemical called epinephrine (adrenaline) floods the brain in connection with pornography. With repeated exposure, a neural pathway in the brain is created that links arousal and associated neuro-chemicals dopamine and adrenaline with pornography use. As pornography exposure and dopamine release increases, dopamine receptors are eliminated. This “flooding” of the brain creates habituation or tolerance, resulting in the need for even greater stimulus (more explicit and “hard-core” pornography, novelty and intensity) to achieve the same effect.

Dr. Donald L. Hilton, Jr. MD, a neurosurgeon at the University of Texas, has written extensively about the effects of pornography on the brain. His research and other reviews conclude that the effects of pornography on the brain are comparable to potent drugs, such as cocaine. He also explains that when the body orgasms, the brain produces a particular neurotransmitter called “oxytocin” which creates bonding. Oxytocin is also secreted in the brains of babies and moms during breastfeeding. So we are literally bonding to pornography (a digital image) when we reach climax. In an article published in the Harvard Crimson, Dr. Hilton states that “pornography emasculates men—they depend on porn to get sexually excited and can no longer get off by having sex with their women alone. What happens when you are addicted to porn is that you crave it. Real sex even becomes a poor substitute for porn, and you lose interest.” ¹

A final neurophysiologic effect of pornography is the damage created to the impulse control center of the brain, the pre-frontal cortex. With constant flooding of the brain with dopamine and epinephrine, there is a reduction in size and control of this area. Essentially, the ability to self-regulate and exercise impulse control is reduced until, ultimately, the addiction drives appetites, desires, and behaviors. As individuals fall into the grip of this addiction, they often experience other effects, such as isolation, depression, anxiety, sexual dysfunction, and relationship distress, among others – all of which spiral the individual away from resources that can lift and help them toward recovery and healing.

As awareness of this issue increases, so do resources aimed at educating and assisting those affected by pornography addiction. A relatively new campaign called “Fight The New Drug” (www.fightthenewdrug.org) is an excellent resource for those seeking more information regarding the impact of pornography. There are also many religious/spiritually-based programs available², many of which are based on the twelve-step program utilized by Alcoholics Anonymous (AA).

¹ http://www.thecrimson.com/article/2011/4/7/porn-men-addiction-pornography/

² https://addictionrecovery.lds.org/family-and-friends/help?lang=eng

mattAbout the Author: Dr. Matt Brown is a licensed Marriage and Family Therapist. He holds a doctorate degree from Texas Tech University and a master’s degree from Brigham Young University. He is currently Assistant Professor and Program Director in the Marriage and Family Therapy program at the University of Houston-Clear Lake and a therapist at the South Shore Center for Couples and Families.

Compassion by Dr. Victor S. Sierpina, MD

?????????????????Compassion, a universal cure to what ails us as individuals, societies, and nations, is the response to the suffering of others that creates a desire to help. This attribute, essential to the optimal practice of medicine and healing, gives the healer an understanding and appreciation of the effects of suffering and sickness on the attitudes and behaviors of others. More than mere tolerance, it creates a feeling similar to love, in the universal sense of that word.

While browsing my library recently, I noticed a paperback by the Dalai Lama called Beyond Religion, Ethics for a Whole World. A skilled, heartfilled local meditation teacher, Terry Conrad, uses it when he teaches at the Osher Lifelong Learning Institute (OLLI) and it found its way to our library through my wife’s work there.

The Dalai Lama, a Buddhist by tradition, pointed out that the compassion lived and espoused by the founders of all major spiritual traditions is often lost amongst their followers. In the name of religion and the defense of various ideologies and creeds, people across time have often violently departed from the teachings of their revered scriptures and teachers. They visit upon others what they would not want done to themselves. Compassion has often been abandoned, leaving the world a worse place.

The philosophically practical Dalai Lama points out that we all share a common humanity. We are not necessarily born into a religion or belief system, but are all driven by a desire to be happy and to avoid suffering. Acknowledging that all other humans share that same basic drive is the basis of compassion. This means seeing others as more like us than different from us, seeing their suffering as our own. Compassion is a necessity to the survival of humanity. Without it, we turn on each other like wild and undisciplined animals.

How do we develop compassion? It is an intrinsic human trait universally encouraged by all major spiritual traditions. Meditating on compassion for others and ourselves helps us bring it into our daily lives and consciousness.

I wrote awhile ago about the “Loving kindness Meditation” which I have found helpful in bridging the compassion gap between me and those I see as different from me. While there are many versions, here is one to consider. I keep it taped onto my dashboard and my phone.

May you be happy.
May you be well.
May you be safe.
May you be peaceful and at ease.
May you be filled with loving kindness to yourself and all others.

balanceConsider this kind of compassion building meditation/prayer exercise daily with a focus first on compassion for yourself. As you continue, channel it mentally toward someone you greatly respect and honor such as a spiritual teacher; then to a dearly beloved person such as a spouse or family member; then to a person whom you know but feel neutral toward; and finally direct your loving kindness meditation toward someone who you consider hostile or even hateful.

Do your part in building a more compassionate you and a more compassionate world.

The hope of a secure and livable world lies with disciplined nonconformists, who are dedicated to justice, peace, and brotherhood. The trailblazers in human, academic, scientific, and religious freedom have always been nonconformists. In any cause that concerns the progress of mankind, put your faith in the nonconformist! -Martin Luther King, Jr.

*Previously published in Galveston county daily news.

Sierpina_Victor_5x7About the Author: Dr. Victor Sierpina is currently the director of the Medical Student Education Program at UTMB, Galveston. He is a WD and Laura Nell Nicholson Family Professor of Integrative Medicine, and also a Professor in Family Medicine. He is a University of Texas Distinguished Teaching Professor. His clinical interests have long included holistic practices, wellness, lifestyle medicine, mind-body therapies, acupuncture, integrative oncology, nutrition, and non-pharmacological approaches to pain.