When my kids were little and we'd be out and about doing errands, every once in a while I would say, "How about stopping for ice cream?" Imagine the shock and disappointment when the response was, "No, thanks, Mom." Honestly, I am telling you the truth. This happened more than once. It's still happening! Talk about role reversal.
My choice was to face the fact that it was me who wanted ice cream, not my kids, or go into denial and try to talk them into an Anderson's drive-by. Reality won. I didn't want to create in my kids the same reward-dependence relationship I have with food. We went home.
Because my parents unfortunately made me super self-conscious of every bite I took, I knew it was not something I wanted to do to my kids. Yet the pull is there. Until my son was ten or so he was a vegetarian, not by philosophy, he just hated the texture of meat. Until she was five or so, my daughter seemed to thrive on air. Both of them have always been of healthy weight, the pediatrician assured me all was well. So I try to focus on being as good a food relationship role model as I can.
Frank Bruni, in his article "Eat Your Peas. Or Don't. Whatever." says that's pretty much what diet and nutrition experts recommend:
They say parents can and should encourage sensible eating and vigorous physical activity by engaging in both themselves; children are likely to imitate those behaviors.
parents allow junk food or not, they should make sure healthier
alternatives are even more available — and should promote them. They
should also make time for family dinners, the nutritional content of
which they can monitor more carefully than they can a quick meal in an
by actually involving children in the shopping for, and cooking of,
meals, some parents have successfully given them a consciousness about
food — and a way to think about it — that guards against an abuse or
disregard of it. When
it comes to over-eaters who clearly thrill to that gluttony, it’s vital
for parents to try to find some replacement activity — a hobby, say —
that affords similar emotional gratification.
“Food lights some people up more than it lights other people up,” Dr. Bulik said. “We’re not born the same.”
Food lights me up like the Statue of Liberty's torch on the Fourth of July while for my kids it's more like a Roman candle. They are easily distracted away from the food that I find it way too much the focus of my existence. They made my job pretty easy, all I had to do was stay out of their way.
For many parents this food/child interface is much more complicated. Aside from addressing our own relationship with food, I recommend to parents of over-weight or food obsessed kids that they consult a qualified nutritionist. You may not ever have to bring the child in. The consultation can be just for you as parents to get a sense of what's reasonable and healthy to expect from your child. Find a nutritionist through your pediatrician, one who has the right credentials. At a minimum look for an independent Registered Dietitian (RD), one who is not affiliated with a particular product or program. You and your spouse could get some good advice, a plan of action that could put everyone at ease about food so that everyone can really enjoy it again.
Photo courtesy of Kern.Justin via Flickr
Hey, Elv- EYE – Ruh!
Like fingernails on a blackboard I have heard my beautiful name pronounced that way all my life. My first name is spelled E-L-V-I-R-A. Since before I can remember, the way American's tend to pronounce that combination of letters was my personal little hell. Beginning in kindergarten I could either have a sense of humor over my teachers' reaction when I corrected them or grind my teeth. My name is pronounced El-VEE-dah. "Well, gee, it isn't spelled that way!"
My parents gave all their kids classic Spanish names. Despite the obstacles, I love my name. It's old fashioned, like Margaret or Mary; just not as phonetically obvious to Americans (although I'm happy to say that nowadays people are more sensitive and sophisticated about getting the pronunciation right.) Back in the day, well-meaning friends and grown-ups tried to talk me into using a more simple nick name. With a tenaciousness not usually seen in a five year old, I refused. My name was a point of pride, a flag to rally around. I was not going to conform to the world. The world would conform to my name. Did the name make me stubborn? Or was I stubborn and the difficult name just made it stick?
Adversity builds character. Isn't that what people say to kids when life stinks? Well, I think my 'strange' name really did work that way for me. I learned to be assertive, patient with people and not take their ignorance or prejudices personally… Until that god-awful song came out, that is. That song! Ugh! Let's not go there. It's just too painful.
Johnny Cash's song, now that was better! I love A Boy Named Sue, about a man fighting through life with a difficult name. For me, it's cathartic, fun and true.
Can you relate to any of this? Do you have a similar story? Did you choose a nick-name that worked better for you? Change your name legally? Did you stick with the challenging moniker? Do tell.
Guilt hurts so many so much. In my work I often see guilt experienced as a punishment without hope of redemption. When a patient is having a hard time dealing with guilt, I ask them to replace the word 'guilt' with the word 'responsible.' Instead of saying, "I feel guilty for hurting my mother's feelings," they will say, "I am responsible for hurting my mother's feelings." Then we look at whether or not it is reasonable to feel responsible. By making that little word substitution my patients report, it is easier to detach just enough from the negative emotion to think rationally. They become empowered to do something about the guilt, not just sit with it. Being responsible makes us adults, feeling guilty often makes us feel about nine years old.
A study recently reported by John Tierney, science writer for the New York Times, suggests that guilt has its good points as long as we are allowed to make amends for whatever wrong made us feel guilty in the first place. Here's an excerpt from Guilt and Atonement on the Path to Adulthood:
“The key element is the difference between shame and guilt,” Dr. Tangney says. Shame, the feeling that you’re a bad person because of bad behavior, has repeatedly been found to be unhealthy, she says, whereas guilty feelings focused on the behavior itself can be productive. But it’s not enough, Dr. Tangney says, for parents just to follow the old admonition to criticize the sin, not the sinner. “Most young children,” Dr. Tangney said, “really don’t hear the distinction between ‘Johnny, you did a bad thing’ versus ‘Johnny, you’re a bad boy.’ They hear ‘bad kid.’ I think a more active, directive approach is needed.”
In other words, guilt can be resolved effectively if we are allowed to make the misdeed right. As Lisa Miola Furrier wrote on my Facebook page "…if you give kids the message 'you make a mess, you clean it up' they feel empowered to not 'carry the guilt' into self shame …"
Yup, that's it. And, while it might sound corny, it also makes sense for us adults who are learning to be good parental figures to our own inner-child. As long as we can judge that taking responsibility and making amends is reasonable, we can atone and heal, escaping the trap of shame. If we decide the guilt is unreasonable, we may be free to let it go.
Image by Viktor Koen
My father, a neo-Freudian psychoanalyst, once explained to me why Freud decided that for his new talking therapy he wanted to use a couch and not be face-to-face with his patients. Why? My father said it was for two reasons: 1) For the patient. The reclining position encouraged uncensored free association, necessary for analytic work. And 2) For the therapist, it helped reduce the distraction of looking at the patient’s face. Freud was actually quoted as saying he simply could not stand being gazed upon for eight hours a day. I guess, if you put it that way…
While some therapists and analysts still use the couch, today most therapy is done upright and face to face. Most recently an even newer modality is being introduced, a sort of throw back to the old faceless couch days: The telephone!
Telephone-based counseling first came to my attention years ago when a former patient of mine, who was living in California, contacted me. A crisis had thrown her off track emotionally and rather than start all over with a new therapist, she wanted to work with me long distance. I was skeptical at first, I was so mired in 20th century thinking that therapeutic boundaries needed to be confined to bricks and mortar. Was I ever wrong! Those telephone sessions worked so well, it became a regular feature of my practice.
Research is supporting my clinical experience. The Lancet, arguably the world’s oldest and most respected medical research journal, recently stated:
“Studies and actual practice have already shown that cognitive behavioral therapy (CBT) does not need to be delivered in a face-to-face setting. Telephone-based CBT programs with live therapists have been proven effective, the study’s authors noted.”
~ August 22 issue of The Lancet
The same article, ‘Therapist-delivered internet psychotherapy for depression in primary care: a randomised controlled trial,’ concluded:
“CBT seems to be effective when delivered online in real time by a therapist, with benefits maintained over 8 months. This method of delivery could broaden access to CBT.”
Which is very interesting but I’m uncomfortable with strictly email or IM based therapy due to 1) online security issues and 2) the written word is subject to much more misinterpretation than spoken words.
So the good news is you needn’t be confined to geography to find a good therapist. Consultation, life-coaching and on-going therapy can all be done effectively long-distance. And Cognitive Behavioral Therapy is particularly well suited to telephone-based counseling. Isn’t that liberating?
If telephone-based counseling is something you’d like to learn more about please feel free to contact me at email@example.com or call me at 716.308.6683.
OR… Discipline is Not a Dirty Word
There is nothing new under the sun. The bare-assed truth, when it comes to losing weight, is that we can choose to spend our money on the latest version of ‘energy in must be less than energy out’ or do it the hard way, and think. Thinking is free but it’s not easy. Take the concept of discipline, for instance.
The discussion with Frank Bruni, (a self-described recovering food addict) on NPR's Talk of the Nation last week grabbed my attention on several levels, the biggest being that he wasn’t selling a new diet gimmick and he said the “D” would out loud, several times.
I’ve had to learn not to be afraid of discipline. You can hear me mumbling, “Discipline is my friend,” around three o’clock every afternoon. Discipline is my good inner-parent supporting me to do what is right even when it feels oh, so hard. Working hard to get over the concept of discipline being done TO me instead of FOR me, well, I think that’s called being a grown up.
To maximize both mental and physical health, here are eight broad concepts that I’ve found the most effective for me and my patients. Discipline is involved in putting and keeping them in play. I hope you will find these ideas both familiar and encouraging:
1. Move. That can mean exercise but I’ve found for me (and apparently Frank Bruni) it’s best when the activity is hidden in something that I love (like walking or horse back riding) and if I mix it up (yoga for a while, then switch to weight training, then back) so I don’t get bored a great excuse to stop.
2. Get enough sleep. It takes a lot of discipline to go to bed at a decent hour (seven to eight hours before I need to get up the next day). Read here for more on sleep hygiene.
3. Eat well, mindfully. Choose quality over quantity. Cook from scratch or close to it when you can. Processed foods are the enemy with all that fat, sugar and salt. Meal plan. Do grocery shopping as mindfully as possible. Farmer's markets. Coops. Experiment with recipes. Read Michael Pollan’s (he write the Omnivore’s Dilema) Out of the Kitchen, Onto the Couch for inspiration.
4. Drink well. Lots of water or diluted fruit juice. I’m not a fan of flat water but I can drink it with a splash of lime juice all day long. Wine, beer and rock and roll, all in kindly, appropriately disciplined moderation.
5. Use the hunger scale. Portion control is Queen. Eat slowly, put down the fork between bites. Psych yourself out. The French are apparently masters of this art (see French Women Don’t Get Fat, by Mirielle Guiliano).
6. Stop eating two hours before bedtime. The easiest concept for me and quiet effective in avoiding an extra 100-200 calories a day. Occasionally, when I am dying for something, I will grab a sugar free Popsicle.
7. Reduce emotional eating. This concept addresses my food addiction. If I can stop and think before I go for the brownie after a hard day, it’s a major victory. Respecting food, appreciating it as a spiritual gift, helps a lot. I need to work harder to find a way to reward myself without food.
8. Live life fully because you are worth it. Keep your self-esteem well nurtured. Manage stress. Balance life, work, relationships. When we can't, our lives end up feeling like our washing machine when the spin cycle is out of whack.
Give me a call (716.308.6683) if you'd like to talk about these aspects of your life or could use some help. Your thoughts or comments are most welcome, too.
Just for the hell of it! A list of websites, some cool, some silly, I discovered this week. Totally for your viewing pleasure. Hope you enjoy browsing. And have an awesome weekend!!!
- Dining with Ex-Food Addict Frank Bruni Who was 'Born Round'
- Trash Night: What About Sex?
- Gardening While Intoxicated
- Red Bull has Competition!
- More.com Celebrating Women Over 40
- The Seven Wonders of the World!
- Rachel McAdams Giving Up the Plot to Time Traveler on The Daily Show
- Pandora Personal Radio: The Music Genome Project
- The Parable of the Hot Dogs at Woodstock
- Mad Men Season Three Premier!
The fastest growing segment of people on Facebook (FB) are those over thirty-five years old. A lot of them are parents.
It won’t be long before some very clever hacker will produce Facebook G2: ‘Where your mom can’t find you.’ Why? Because even in the Internet-cell phone- GPS age, a developing young adult wants his or her privacy. Is that so bad?
This question came to my attention when I first joined Facebook about a year ago. Being a newbie, I did everything Facebook instructed me to do, including invite everyone in my email address book to be my ‘friend’. That included my teenage son, M.
One day M. passed by me in the kitchen and we did a stop and chat. “Hey, you never accepted my invitation to be my friend on Facebook.” It isn’t often I see a deer caught in the headlights look in my son’s eyes. “Mom, no.” “What? Don’t you want to be my friend on Facebook?” The look in his eyes grew desperate, less deer and more torture victim, “Mom. Please. No.”
M. was on Facebook a year before I was. My son is a healthy typical American teenager, which is to say, his peers mean everything to him. I don’t expect to know, or approve, of every little thing he’s up to, but I do expect him to be responsible and, in the most important sense, he is. He didn’t exactly ask my permission to have a FB account but he didn’t hide it either.
It took me, a typical middle-aged American, some time to understand how central Facebook is to the young people in my life. To me it’s a shiny new toy. To them it’s essential. Facebook is a prime communication tool for many young adults to keep up with real life friends. And by Real Life, I mean going-to-school-together, same age friends, the population for whom Facebook was invented in the first place.
In my dealings with teenagers I have learned, often the hard way, when it is best to not to take things personally. This appeared to be such a situation. So I asked him, as un-pathetically as I could manage, “Why won’t you be my friend on Facebook?”
He proceeded to explain. “My friends will see my Mom is my friend and that’s just not cool. Then they’ll want to be your friend and it just get’s weird after that.” The subtitles read: ‘My friends are my friends. You are my Mom. Please do not embarrass me in front of my friends.’ Got it.
This conversation opened my eyes to a conflict felt by both sides of the generational divide. There are many teens who have no problem ‘friending’ their parents and even find it fun, to everyone’s satisfaction. On the other extreme, a former client, a college student, contacted me a few months ago wanting to know my stand on parents and FB. Her mother had a history of emotionally abusive and dysfunctional behavior, issues that were central to our therapeutic work. When her mother found her on FB, my client felt pressured to allow her to become a ‘friend.’ With access to my client’s account, including photo albums, her mother could now criticize the young woman openly her wall. It took a little while before my client could act on her right to un-friend her mother.
Should a parent be their kid’s friend on FB? My opinion is… It depends.
It depends on:
Yesterday my friend who has a pool invited me over for a dip and a glass of wine. With summer finally making a reluctant appearance in the East (and not having A/C), I was very happy to accept the invitation.
After hanging up, still holding the phone, I stared blankly into space. What had I done!
Swimming=Swimsuit! Idiot! OK, don't panic, I told myself. You might be able to pull this off. First, locate the swimsuit.
There it was smushed up in the back of my work-out clothes drawer. It took a good fifteen minutes to wrestle myself into the blue one piece. It was like a live thing pushing back saying, "NO, I won't! You can't make me!"
Once I had it on, and the panting subsided, I took stock. Not too bad. No unsightly bulges, everything that needed covering was covered. Thank you God! Now I could enjoy the lightness of being in a pool. And I did.
But, boy oh boy, was this a wake up call. After goofing off in the discipline department for a couple of weeks it was time to get serious again. It's amazing to me how well denial works until it doesn't. In my defense, if I didn't pay attention to what I eat, even as intermittently as I do, I'd be as big as my horse, Annie, and she comes in at 1,100 pounds, give or take a hundred.
Of course it would be better if I could lose some weight, but I'm glad I haven't gained more than one pound in the last two weeks. Just saying. I hope to have a better report next week.
The article 7 Ways to Give an Apology and 4 Ways to Accept One got some terrific attention from readers on this blog and on PsychCentral's World of Psychology it rose to top ten most popular posts when it was published there. Thank you to everyone who wrote thoughtful and helpful responses. I learn so much from your comments. They add quality and value to the original article, continuing a conversation that is rich and instructive. You
all have certainly done that! Here are a few of my favorites from the apology article.
Steve wrote: Love the article! The only thing I would add is that when you make an apology don’t
include excuses. I think its normal because we want the other person to
know why we let them down but don’t do it. Just apologize.
All too often people say “sorry” but then they have a million
reasons why they screwed up which kinda turns into “it really wasn’t my
So for me when I have to swallow my pride and apologize I don’t
offer any excuses unless the person who was offended asks. Even then I
think its important not to try to shift blame away from yourself but it
is reasonable to explain the circumstances. However that’s only if they
That’s just my two cents.
My response: What you say is brilliant. Whatever follows, “I’m sorry, BUT…” often
effectively wipes out any good intention there was in the original
apology. Unfortunately I see this a lot in couples therapy. Thanks for
pointing out that staying with the discomfort of one simple “I’m sorry”
in its purest form is worth a king’s ransom of excuses.
Dan wrote: Whatever you do, DON’T say, “I’m sorry IF I offended you,” or, “I
apologize IF you got upset,” or, “I’m sorry to anyone I MAY have
offended.” While “I’m sorry” can be the two most disarming words in the
English language, they may not be qualified in any way or the apology
is totally insincere.
My response: Dan, You said it. This is sort of a variation on what Steve said and I
agree. Errant politicians in particular seem to think they can get away
with the qualified apology. Thank you for setting us straight.
And Tanya wrote: Dr.
Aletta, I'd like to know what has happened to the social apology. When
I was young it was considered common courtesy to apologize when bumping
into someone. It did not matter if it was your fault, theirs or no
ones. It was, bump, and then an 'I'm sorry' or 'excuse me.' Now you get
nothing. These small lapses isolate us even more from the masses around
us. This detachment from our fellow Earthlings is as another blow to
our humanity and another step toward a narcissistic society.
My Response: It is sad that fewer people are taught the small courtesies that are important aspects of a civilized society, the social apology, as you describe it, being one. I try to focus on my own small, but I hope significant part in behaving well myself, saying sorry if I bump into someone, keeping the door open for strangers, etc. and teach my children to do the same. At least I can do that.
From Rebecca: I
agree with much of the article, but not everything (for example, in my
opinion and experience, groveling is never appropriate, healing, or
In my private practice, I use a 5-part model (though every part is
not always necessary): Find the truth in the other’s position,
Acknowledge the other’s feelings/thoughts/values, Share your feelings,
Express appreciation for the other, Inquiry to deepen understanding and
For some couples I see, using the Five Apology types that Chapman talks about is a helpful framework.
I wrote: By
groveling I meant, set aside false pride and apologize from a position
of humility. As a couples counselor I’m sure you have seen people
struggle over this concept. I wasn’t familiar with Gary Chapman, so I
googled him and found terrific guidance for couples. http://www.fivelovelanguages.com/learn_apology.html
Last week in an article about apologizing, I confessed to stealing a friend’s hair brush when I was six. That brush burned a hole in the back of my closet until the unbearable guilt ratted me out to my Mom. She marched me over to my friend’s house and stood at a supervisory distance while I did the death walk of the condemned up to the door. The brush was returned together with a shaky, sincere apology. I never felt so bad, before or since. Thus ended my career in petty crime.
When I read Perri Klass’s article in the New York Times Health section, Stealing in Childhood Does Not a Criminal Make, it rang so true. Dr. Klass is a pediatrician/writer whose career I’ve followed since my graduate school, her residency days back in the '80s. Like me, she is now a seasoned professional with kids of her own.
When she caught her seven-year-old with a stash of bills lifted from her wallet she worried, “How do we handle this? What does it mean? Does this tell us something we didn’t know about our child’s character? About ourselves? Is something really wrong?”
Dr. Klass consulted child development experts. Here is a summary of what she learned: Most children will take something that’s not theirs at some time.
2-4 year olds will take something, probably because they are struggling with the concept of mine vs. yours and sharing in general. A two year old is not a thief.
5-8 year olds know the rules of ownership. If they take something that’s not theirs they will hide it, even deny they took it if confronted. “This turns out to be extremely common,” wrote Dr. Klass.
“This phase is a testing phase,” said Dr. Barbara Howard, an assistant professor of pediatrics at Johns Hopkins School of Medicine, consulted by Dr. Klass. “Kids are trying to find out what happens if you get caught…” Dr. Martin Stein, a professor of pediatrics at UC San Diego, said, “It’s really a teachable moment.”
Most young children who steal fall into this category, they simply admire what they don’t have and they take it. Parents need to be concerned but not overly worried that this is a fixed behavior.
8 years old and older. Truly troubling are children who don’t stop taking things after being corrected or who are angry or anxious and are stealing as a form of acting out.
“If a middle school child is stealing money, you have to worry, already, about drugs and alcohol and the other influences in that child’s life.” Dr. Klass goes on, “ …a pattern of stealing without any remorse can mark a serious problem – and that child needs help right away.” If you are worried about a child like this, talk to his or her pediatrician to discuss the matter and to get a referral to the appropriate behavioral health professional.
Most parents, like my mother, can take a little childish thievery in stride as part of growing up and an opportunity in child rearing. Dr. Howard advises parents, once you know of the theft, “They [the children] need to be stopped, they need to pay it back, and they need to apologize, but they shouldn’t be taken to the county jail as if they’re bound to be criminals forever.”
Whew! My Mom dealt with my six-year-old crime spree exactly right, thus sparing the world another Bonnie Parker.
Has your child ever stolen something? How did you handle it? Did you when you were a kid? How did your parents handle it?
To read Dr. Klass's article in it's entirety click here.
Illustration by Lars Leetaru for the NYT