Saturday, December 4, 2010

Counseling Corner Extra: Holiday Stress Can Take Its Toll

With the holiday season upon us, we have parties, shopping, cooking, cleaning, decorating, wrapping and shipping to contend with, with a sprinkling of bad weather to keep things interesting..... While the holidays can be a magical, wonderful time of year, when we re-connect with family, friends and our inner child (after all, who DOESN'T like a few new toys?).... they can also be extremely stressful.   Added to this stress can be feelings of sadness or loss for friends and family we have lost.   Here are some quick tips to manage stress...and a few online resources where you can read more...

1.  Start early, don't procrastinate. 
2.  Enlist help, don't try to do it all yourself.
3.  Honor traditions to honor those who are not with us, or create some new ones!
4.  Be sure to get enough sleep.
5.  Exercise for stress and anxiety relief.
6.  Everything in moderation...while we love to Eat, Drink and Be Merry, this can take it's toll.

Remember that giving back can be a great way to increase your positive feelings, so donate your time to a good cause!  If you or someone you love is struggling this holiday season, ASK A PSYCHOLOGIST for help!

Thursday, December 2, 2010

How can I tell if my child will become violent?

Youth Violence Hits Home

Whether it’s 15 year old Samuel Hengel of Marinette, Wisconsin holding 24 hostages at gunpoint in his classroom before turning the gun on himself, or 20 year old Donte Banks of Pottstown shooting a 14 year old boy over a dispute, the news is full of stories of violence among youth. And more recently, it hits closer and closer to home.

In fact, 12 – 24 year olds face the highest risk of being a victim of a violent act, according to the American Psychological Association. 1 in 12 children in high school stated they have been threatened or harmed with a weapon each year. These are sobering statistics, the reality is that there are no clear explanations for the rise in youth violence. What is known is that there are risk factors that can contribute to one’s likelihood of engaging in a violent act. Here are some of the reasons that people become violent:

  • To express their feelings: some people become violent in order to vent their feelings of anger or frustration.
  • This is a clear problem with developing the right skills to handle uncomfortable feelings.
  •  It’s important to remember that the simple act of learning how to calm down can be critical to avoiding violent behavior.
  •         Many people believe hitting a punching bag or a pillow is a good way to vent angry feelings. NOT SO. If you hit a pillow or anything else when angry, you simply learn that when you are angry, it is ok to hit.
  • To make others do what you want
  • Violence is sometime used as a tool to manipulate and intimidate others
  • To exact revenge against others around you for a perceived slight or wrong.
As a psychologist, I am sometimes asked to predict if a child or adolescent will become aggressive or violent. There is no clear way to be 100% certain (unless you have a crystal ball!) that someone will or will not become violent. One of the best ways to predict future behavior is based on their past actions. If someone has been aggressive in the past, they may be more likely to use violence again in the future.

Here are some warning signs that someone might have the possibility of engaging in violence:
  • Frequently losing their temper
  • Getting into fights
  • Drug or alcohol use
  • Threatening to hurt others
  • Carrying a weapon
  • Hurting animals
  • Vandalism or property destruction
  • Gang membership
  • Having been the victim of bullying
  • Poor school performance
  • Not respecting the rights or feelings of others
  • Feeling rejected or alone
  • Withdrawal from friends or enjoyed activities

 Any one of these warning signs in isolation do not necessarily mean that the person will become violent, but the more warning signs, the higher the risk. Many of the warning signs can be signs of other mental health disorders (depression, learning disabilities, ADHD, etc) so consulting a psychologist is an important way to get help.  If you or someone you know needs help, ASK A PSYCHOLOGIST!


Wednesday, November 24, 2010

November is Alzheimer's Disease Awareness Month

November is Alzheimer's Disease Awareness Month. 

Many people do not truly understand the symptoms and causes of this disease. According to the Alzheimer's Association, Alzheimer's is "a brain disease that causes problems with memory, thinking and behavior".  It is a form of dementia, which is the term used for loss in memory and difficulties with one's daily life resulting from loss of intellectual abilities.  In fact, Alzheimer's is the most common form of dementia, accounting for 50 - 70% of the cases. Alzheimer's is the sixth leading cause of death in the United States.

As the "baby boomer" generation becomes older, it is important for the next generation to understand this difficult and often heartbreaking disease, so that we can provide care for our parents, grandparents and work to prevent and treat this disease as we age.

What is Alzheimer's Disease?

Alzheimer's Disease is a condition that occurs when the cells in the brain lose their ability to work properly and eventually die, causing damage and changes in the brain. There are two structures, called "plaques" and "tangles" that have a role in causing this damage.  It is normal for most people to develop some of these structures as they age, but in those with Alzheimer's Disease, they develop far more. This damage causes the memory and personality changes as well as difficulties making  decisions and carrying out daily activities.

Alzheimer's disease is scary and heartbreaking for both the older adult, as well as their family. Early intervention is an important key to slowing the progression of the disease.  There are also many erroneous belief about Alzheimer's. A few are:

1. "I forgot where I put my car keys, I must be getting Alzheimer's" - Just because someone is having memory problems, does NOT mean that have Alzheimer's. In fact, there are many different types of memory loss, and many different causes.  A doctor can help rule out other types of memory loss.

2. "My father is 78, is he going to get Alzheimer's?" - It is important to know that Alzheimer's is NOT a normal part of aging. In spite of the fact that the majority of people who suffer from Alzheimer's are over 65 (early onset Alzheimer's can develop as early as someone in their 40s or 50s), it is not inevitable. (and by the way, it's not contagious!).

3. "I want to cure my mother's Alzheimer's Disease" - At the present time, there is no cure for Alzheimer's Disease. It is a progressive disease, and symptoms generally become worse over the years. The length of survival can be between 3 to 20 years, but the average is 8 years from the time their symptoms become noticeable to others.  There are treatments that can temporarily slow the progression of symptoms, such as a medication called Aricept.

The Alzheimer's Association's website discusses 10 Warning Signs of Alzheimer's (adapted from

1. Memory problems that affect daily functioning.

2. Difficulty with problem solving skills and concentration.

3. Problems with completing simple, familiar tasks, such as driving to the store or playing a game.

4. Losing track of times and places.

5. Trouble with distance, reading or other visual problems.

6. Difficulty following a conversation or remembering a word (or calling something by the wrong name).

7. Losing items and having difficulty locating them. Sometimes, they may accuse others of taking their belongings.

8. Poor judgement or difficulty with decision making.

9. Avoiding social situations or having trouble keeping up (not remembering who won the Eagle's game, for example).

10. Mood and personality changes, as well as depression, confusion or anxiety.

If you or a loved one is suffering from memory loss, and you suspect Alzheimer's, ASK YOUR DOCTOR OR ASK A PSYCHOLOGIST. Help is available and you do not need to suffer alone.

Saturday, November 13, 2010

Social Networking for Dummies, AKA How to stay safe and protect your family in the Internet age

In my roles as both a psychologist and as a parent, I am often faced with the difficult question of "to facebook or not to facebook".  I am one of the brave ones. I have many many co-workers, colleagues and friends who are parents, who say "No way...I'm not putting MY business out there for anyone to read".  They have a point... but the Internet is a reality, and it's not going away. I am here to tell you, SO FAR SO GOOD. To date, this experiment has not blown up in my face, and you are now reading this blog because I took the risk.

As a 40-something, Generation X-er who did not grow up texting, and did not have my first 286 IBM compatible computer with Prodigy Internet (with a dial-up modem) until I was out of high school, the world of texting, Internet and, now, social networking, was initially a scary and ominous place.  Coupled with being a professional (teacher, doctor, psychologist, therapist, etc), needing to have a professional life with clear boundaries for my patients, but also having family and friends scattered across the globe, this created quite a dilemma for me.  So, I decided to plunge headfirst into the world of the "Interwebs" and the first thing to do my father taught me: arm yourself with education and knowledge.

The most important thing to remember when you turn on your computer and link to the Internet is that anything you put out there is really OUT THERE. You cannot delete things from the Internet.  Pictures, posts, video... no turning back.  If you Google yourself (go ahead, try it) you might be surprised about what you find already out there without your even trying. Imagine if you made a REAL effort to get your name out there? The possibilities are limitless. From a marketing point of view, the Web is brilliant.  Personally, it comes with a great deal of responsibility.

Here are some important things to consider when you, or your family members use social networking sites:

  • a social networking site that was originally created for college students
  • minimum age for joining Facebook is 14 without parental permission (in fact there is a law prohibiting the collection of personal information for children under 13 without parental permission!)
  • 500 million users worldwide
  • users can choose privacy options, but many have trouble finding these or setting them properly (if you have trouble with this, as someone who knows, it is critical to safeguard pictures and personal information)
  • facebook has had some difficulties with privacy practices and breaches have been reported in the news
  • Pictures, notes, and other posts can be read by anyone with access
  • 140 character "tweets" can be sent that give brief information
  • not as popular as facebook, but can give "real time" updates and let people know your whereabouts
You Tube
  • users can post video, especially risky for teens who post themselves
  • content can be removed or protected, but is still at risk for copying and exploitation
  • Social networking site used a great deal for musical groups
  • Minimum age is 14 without parental consent
  • Any one under the age of 18 is automatically set to a "private" setting, where their "friend" must know them and their email address to link with them
  • Pictures, posts and "bulletins" can be send to everyone in their network
Just remember, all of these sites can be great ways to stay in touch, but they also come with a great deal of responsibility.  I know that some parents out there will disagree with me about this, and the decision to use or not use these sites is one you must make with your family individually.  In addition, there are social networking sites that specifically target children and are kid-friendly.  If you choose to use social media, here are some tips for parents:

1.  Set the ground rules for texting, computer use, and social networking - clear guidelines and consequences for infractions will let your kids know up front what the expectations are, and what will happen if they break the rules.

2. Friend your kid - if they are on facebook, you are on facebook. Doesn't mean you have to publicly comment on everything they say, just be present and keep your eyes open. This can help detect any strangers who your child does not know personally, or can be aware of any cyberbullying that is occurring.  You can also stay on top of what pictures and information they are sharing. 

3. Be a good role model - If you have social networking accounts, use good judgement so your kids can see what it "should" look like. Do not post personal information, cursing or lewd jokes, or inappropriate pictures.

4. If you sense something is wrong, ask questions and LISTEN TO YOUR KID! - The first thing many parents do it say "That's it, no more facebook." or "I am taking your phone".  To a teenager, this feels like social isolation. The best thing to do is develop open lines of communication and use these situations as a teaching opportunity.  I am not saying that there should not be consequences - just "respond" instead of "react".

Arming yourself with knowledge and learning how these sites work is the best defense. If you have any questions, please feel free to contact me. I know that I only scratched the surface in this blog. And please remember, help is always available if you or your child is struggling. ASK A PSYCHOLOGIST!

Wednesday, November 10, 2010

How to help your kids deal with bullies...the REAL deal

When 17 year old Jesse Buchsbaum from Boyertown Area Senior High took his own life, it ignited a firestorm of debate, criticism and discussion. Could this tragedy have been prevented? Was Jesse being bullied? Who was responsible to protect him? We have been watching stories in the national headlines for months about other teens who have been teased, bullied and humiliated. This time, it hit too close to home and a young life was lost.

The truth is, despite many, many parents saying that THEIR child is also the victim of bullies, it is still a phenomenon that few truly understand, and even fewer know how to address.  In this blog, I hope to give some clear facts about bullying, and some concrete tips for both parents and kids to deal with bullies.

In short, bullying occurs when someone intentionally hurts or intimidates another person, and the person has a hard time defending his or herself.   Most of the time, bullying occurs over and over, and can include:
  • physical aggression, such as pushing, hitting or throwing things at a person
  • teasing or taunting someone
  • spreading rumors about someone
  • encouraging a group of kids to gang up on someone
  • purposely excluding a certain person from a group, just to be mean
  • spreading rumors, photos or other hurtful posting through electronic media (texting, social media such as facebook, emails, or posting video without someones permission)

So, now you know WHAT a bully does, but why do they engage in this mean and vicious behavior?  There are several reasons that kids become bullies:
  • it makes them feel better, smarter, or stronger than the person they are bullying
  • they see other kids doing it
  • they want to fit in with a certain group
  • it's easier than becoming the target of the bullies

Here are some concrete, ACTION-ORIENTED tips for how to help your child if they are the victim of bullies:

  • the first, and most important thing you can do as a parent is to LISTEN to your child with an open mind and open heart.
  • gather information about the situation, including the time, place and people involved
  • find out if there are witnesses to the incidents - other children, adults or teachers
  • contact school officials, especially if the bullying is occurring in school or on the bus.
  • expect the school to respond and to address the problem
  • do not tell your child to "just ignore it" as this may send the message that you do not take it seriously or minimize the situation
  • do not blame your child and say "what did you do to provoke it".  Bullying is never provoked, and is never acceptable
  • do not call the parents of the other child, this will often make matters worse
  • do not encourage your child to "just hit them back", as this may cause the situation to escalate, cause your child to get hurt, or cause him/her to be disciplined or expelled
  • do not react and retaliate against the bully, this will role model poor behavior for your child
Bullying is a community problem, and needs to be addressed at all levels: home, bus-stop, school, playground, and community. It takes a village to raise a child, and takes a strong, consistent message to combat bullying.  Most importantly, help is available.  If you need help, ASK A PSYCHOLOGIST!

This is a helpful website with lots of resources for parents, educators and other helpers to deal with the bullying problem including Tip Sheets and Fact Sheet that are printable resources.

Wednesday, October 20, 2010

October is Domestic Violence Awareness Month

Why doesn't she just leave him?  Why doesn't she fight back? These are common questions asked by many who do not understand the fear that a victim of domestic violence lives with on a daily basis.  Those who have not experienced this type of abusive relationship often cannot imagine and ask WHY? In this blog, I hope to both raise awareness, provide some much needed information, and help people understand that help is available to address domestic violence.

In the popular media, movies such as The Burning Bed starring Farrah Fawcett (1994), Enough with Jennifer Lopez (2002), Sleeping with the Enemy starring Julia Roberts ( 1991) and What's Love Got to Do With It (the Tina Turner Story) with Angela Bassett chronicle the stark reality of domestic violence, and in each of these films, the victim gets revenge. In the real world, domestic violence victims are often terrorized, helpless and alone, often with children who depend on them. They are isolated, often have no money or friends, and feel very alone.

Domestic violence, sometimes referred to as spousal abuse, can include actions on the part of the perpetrator that cause physical injury or pain and emotional scars that can last a lifetime. Abusers can be male or female, married or not married, and domestic abuse can even occur in teen dating relationships.  The abuser often uses their violent behavior in order to instill fear or control their victim.  Anyone can be a victim, regardless of their age, religion, race, ethnicity or sexual orientation.  Victims can be male or female, although the majority are female. In addition, children who are from families where there is domestic violence are more likely to be abused and/or neglected.  Even if they are not, they have more difficulties in school as well as behavior problems.

According to the website, examples of abuse can include: name calling or insults, stalking, intimidation, sexual assault or abuse, isolation of the victim from outside contacts (job, friends or family), withholding money or strict control of finances, and actual or threatened physical harm or injury.

Many have bad information when it comes to this topic, and I hope to dispel several of these myths.

Myth #1 Some people deserve to be hit. 
FALSE.  Nobody deserves to be the victim of abuse - no matter what they did or said.

Myth #2 Only the poor or minorities are the victim of domestic violence. 
FALSE. Domestic violence can occur in people of all cultures, socioeconomic status and age.

Myth #3 If it were that bad, she would just leave.
FALSE. There are many reasons that victims do not leave. They are often intimidated and have no support system or resources. And little hope.

Myth #4 People are only abusers because of drug abuse or mental illness.
FALSE. Domestic violence is rarely caused by drug or alcohol abuse, but is often used as an excuse.

The abusers are often people with low self-esteem and commonly blame the victim for "making them" do the things they do. They do not take responsibility for their behavior. It is not easy to recognize the abuser, they often appear to be loving and attentive in public. They choose to hit in areas where bruises are not readily visible and punish their victim for perceived slights in public. Most importantly, the abuser uses his/her actions in order to intimidate and control their victim through fear.

But he said he was sorry...he bought me flowers!  This is a common response following an incident of abuse. This is referred to as "The abuse cycle".  First, there is tension where the victim feels that he/she has to walk on eggshells so the abuser does not lose their temper, however, no matter what they do, the cycle has begun and the abuse happens. Next, the abuser wants to apologize and promises it will never happen again...they are going to get help and deal with their anger.  This is often referred to as "The honeymoon phase" and can last from hours, to months. A period of calm follows. Maybe things ARE better.  Inevitably, the tension builds and the cycle starts again. And again. This is not to say people cannot change and a percentage of abusers can be rehabilitated.  If the abuser is not doing anything actively to work on the problem, chances are there is no real change taking place.

It is so important to realize that abuse is against the law. Nobody EVER has the right to physically harm another person. And help is available.

If you or someone you love is the victim of domestic violence, call the domestic violence hotline or call 911 in an emergency.

IMPORTANT: If you are in danger, please use a safe computer, or call 911, your local hotline, or the U.S. National Domestic Violence Hotline at 1-800-799-7233 and TTY 1-800-787-3224.

Thursday, October 7, 2010

Just snap out of it! The real facts about depression.

October 7, 2010 is National Depression Screening Day...Today's blog is dedicated to those suffering from this crippling disorder, and offered with hope for those affected and their loved-ones that they reach out for help.

If I had a nickel for every time I have heard "I am depressed but my __________(fill in the blank with "husband", "wife", "boyfriend", etc), says "just snap out of it!", my student loans would definitely be paid off by now.  The fact is, if you have never known someone with depression, or experienced it yourself, it IS hard to understand. Your loved-one may cry for "no apparent reason", have difficulty getting out of bed or showering, might have no desire to do things they once loved, may have difficulty sleeping or eating, and may express feelings of hopelessness or even thoughts about ending their life.

Today's blog could be filled with facts and strategies to explain to you what depression is. It is not. There is an informative booklet that can be found at the link below. Each person should click on this link to learn more. What today's edition of Counseling Corner is focused on is the simple fact that many, many people do not have a clear understanding that depression is a debilitating and potentially life-threatening disorder, and is very treatable. Depression is often the result of a chemical imbalance and/or faulty thought processes that have developed since early childhood. Most often, it is a combination of both of these factors that interact to create this often-debilitating condition.

When I talk about "Depression", it is very important to remember that this is a very general term, that can mean a lot of things to a lot of people.  Below is a link to a very informative informational booklet provided by the National Institute of Mental Health that discusses depression, the many form, as well as different treatments.  Today is National Depression Screening Day - Won't you make that call to get help today?

Tuesday, October 5, 2010

National Depression Screening Day is October 7!

Stay tuned for the next Counseling Corner about Depression. In the meantime, you can check out this informative article from the American Psychological Association to help you understand depression.  And don't forget, October 7 is National Depression Screening Day!

Friday, September 24, 2010

The Winter Blues Just Might Make You SAD.

Ever get that feeling of melancholy during the fall, and lasting into the winter months? If you do, this could be more than just the Winter could be Seasonal Affective Disorder (SAD), which is a form of depression that can sap your energy, decrease your motivation, and send you firmly into a winter funk.

As the leaves begin to change, and the chilly bite of fall is in the air, it's fitting to discuss Seasonal Affective Disorder, commonly referred to as "SAD".  SAD is a type of depression that occurs at the same time each year and can be debilitating. Most people suffering from this disorder show signs in the fall and throughout the winter months. Less frequently, you might experience this increased depression in the spring/summer months. The key to this disorder is that the increase in depressive symptoms occurs at the same time each year.  There is treatment available for SAD, and handing this problem appropriately through phototherapy (light therapy), psychotherapy and medications, can help you maintain a stable mood all year long.

According to the, there are several types of SAD that you could experience.

* Fall and Winter Seasonal Affective disorder, also known as winter depression includes symptoms such as:
      - increased feelings of sadness and hopelessness
     - decreased energy
      - isolating or withdrawing from social situations
      - lack of interested in previously enjoyed activities
      -  weight gain
      - increased sleep
      - problems with concentration and thinking clearly

*Spring and Summer Seasonal Affective Disorder, also known as summer depression, is somewhat different, ad includes symptoms such as:
     - Anxiety
     - Trouble with sleep
     - Agitation and irritation
     - Poor appetite and wight loss
     - Increased sex drive

* Reverse Seasonal Affective Disorder, which is a third type of mood disturbance, can include what is known as mania, or hypo mania. This means the mood is elevated, thoughts and speech can be racing or rapid, and agitation can be present. Other symptoms include:
     -Increased social activity
     - Hyperactivity
     - Elevated mood

You might be at elevated risk for SAD if you are female, you have a family history of SAD, and the farther away from the equator you are located. It is believed that this may be, in part, due to your chemical makeup, your age, and things such as your Melatonin and Serotonin levels (chemicals that help regulate sleep and mood), and your natural biological clock (or Circadian rhythms).  

If you have some days during the fall/winter where you feel blue, it may be perfectly normal. However, if you feel depressed for days and days and cannot snap out of it, you may need to see a doctor. If it worsens, or you have changes in your sleep habits, increases in drug or alcohol usage, or thoughts of hopelessness or suicide, you should seek help from a your doctor or a psychologist. 

Treatments for SAD include medications, most commonly antidepressants. Keep in mind that it may take several weeks for antidepressants to reach their maximum effectiveness and you should continue to take the medication until the doctor tells you to decrease or stop.  Another important component in your treatment is psychotherapy with a skilled psychologist.  This will help you learn ways to cope with your feelings of depression, identify negative thought patterns that make you more depressed, and learn strategies to improve your mood.  Finally, light therapy (also known as photo therapy) can be used. This treatment consists of sitting a few feet from a special light box so that you receive a certain level of light. This is different than a regular lamp and needs to be purchased specifically for this purpose.  Check with your physician or psychologist before purchasing a light therapy box.

SAD can be a debilitating and difficult disorder, but, as with other forms of depression, HELP IS AVAILABLE.


Friday, September 3, 2010

Stressed out? Part 2: Tips and tricks to manage your stress

Tips to Manage Your Stress

In Part 1 of this series, we examined stress: what it is, how it develops and the way our bodies respond to it.  When we are stressed, we often feel as if we are out of control of things in our lives, finances, family, work, and our environment. This sometimes leaves us feeling paralyzed and helpless to change things; when we feel helpless, we feel STRESSED OUT.  Here are some helpful tips and tricks to identify and manage your stress.

The importance of balance - When your life is "out of whack", without a balance of work/play, relationships/time alone, stress/fun, you can begin to feel that old familiar feeling of increased anxiety and stress. It is important to plan time to have a variety of activities and to be sure to allow enough time to sleep, eat well, and relax. Many people underestimate the important of sleep and diet, and it is clear that you must get enough sleep and the right nutrition, or your physical and mental health will suffer.

Know your sources of stress and frustration - It can be tricky enough to manage stressors we know about, but many people do not fully realize what their sources of stress are.  One of the keys to stress management is to take stock in your situation. This will allow you to effectively identify and label your stressors. A few key points:
       * Sources of stress are not always apparent
       * Sources of stress are not always negative
       * Sources of stress are sometimes - well, YOU.

Keeping track of times that you feel more stressed (i.e., a journal or chart can be helpful with this) can help you identify sources of stress. When you look at these events objectively, you might begin to see a pattern. Or, you might see some things that surprise you.

Identify the ways you currently cope with stress -  Learning more about your own style of stress management can help you develop healthy habits. Many of us use unhealthy coping strategies, that can help decrease stress temporarily, but will cause lasting long term problems. These include:
     *Smoking, drinking or using drugs to relax
     *Overeating or not eating when stressed
     *Spending all of your time alone
     *Sleeping too much
     *Taking your problems out on those around you.

Choose some healthier ways to manage your stress - It is important to remember that there are as many ways to handle stress as there are people, and no two are alike. You have to find the stress management strategies that best fit your personality, lifestyle and interests. For example, some people find yoga and meditation relaxing and use this an an effective tool to manage stress. For some, the thought of sitting on a mat is like torture; or may prefer to be active and use exercise to relieve stress. The best plan is to try a variety of different techniques to see which ones fit you best. Once you find your preferences, be sure to MAKE TIME FOR THEM ON A REGULAR BASIS. For example in her blog, Blogger Barbara Kosciewicz discusses how yoga practice can reduce stress.

The following links provide more tips to manage stress, include a more extensive list of suggestions you might try. If you still need help, or your unhealthy stress management habits are negatively affecting your life or those around you ASK FOR HELP.

Saturday, July 24, 2010

Stressed out? Part 1: Some myths and facts about stress

Stress seems to be a part of normal everyday life in today's society. It seems to be almost everywhere we turn, school, work, the road, dealing with fiances - and even the good things, such as receiving a promotion, buying a house, having a baby, getting married, graduation - these things all seem to pump up the pressure and we get, well, we get STRESSED OUT!

But what you may not know, is that you do not have to go through life feeling like you are always on the edge, about to explode from the stress you are under. It is important to understand is that all stress is not bad stress. A small amount of stress is what keeps us motivated and moving forward. But when you are constantly experiencing greater and greater amounts of pressure, and cannot escape it, it becomes a negative reaction to the stress.

But what is stress?  Stress is a normal physical reaction to a perceived threat. The problem is, many things causing stress are not truly threatening. Not physically, at least.  Remember my blog about Road Rage, entitled "Does counting to 10 really work?" In that blog, I outline the body's reaction to stress, in that case, conflict during rush hour. ( When you are under pressure, there is what is known as a "fight or flight" response. When facing  a deadline or financial trouble, you may experience the same physical sensations as if you were faced with a saber-toothed tiger.  Bessel A. van der Kolk (2006) explains the effect of stress from a biological perspective. He explains that brain structures, called the amygdalae, dictate our emotions, and they raise the alarm to the brain. This happens automatically, but what you experience as a result, is that old familiar feeling of anxiety (muscle tension, shallow breathing, increased heart rate, pounding heart, shaking, dizziness, perspiration). 

While day to day stressors are not nearly as serious as a real, serious threat to your life, the hormones involved (Cortisol, for example), trigger the same reaction.  For those with post-traumatic stress disorder, flashbacks can be a difficult symptom. When something reminds these individuals of the traumatic event they experienced, their body will respond the same way it did when the initial event occurred. This is why, after a person is bitten by a dog in childhood, they can become fearful anytime they encounter a dog.

So, while stress is the body's way of protecting you, and some stress can be good, excess amounts of stress can cause a multitude of problems, both emotional and physical. Long-term, repeated stress affects virtually every system in the body. Some common effects of stress can include:

* Chronic Pain
* Heart Disease
*Sleep Disorders
*Anxiety Disorders
* Gastrointestinal problems
*Infertility and Sexual Dysfunction
*Immune System problems
*Using drugs or alcohol to deal with stress

It is important to note that people respond to different stressors differently. Some are able to roll with the punches, while others fall apart at the first sign of stress.  Things that can affect your ability to handle stress are: family and social support systems and relationships, outlook on life, sense of control, and your knowledge and ability to control your emotions. Part 2 of this series, coming July 28, will outline some tips and strategies that have been shown to effectively manage stress.

This is Part 1 of a two part series entitled "Stressed Out" Part 2 will cover "Tips and Strategies for Handling Stress.

van der Kolk, B.A. (2004) Psychobiology of Posttraumatic Stress Disorder. Textbook of Biological Psychiatry. Wiley-Liss, Inc. Hoboken, New Jersey.

Friday, July 23, 2010

Helping Kids Get Healthy is a Family Affair

Stay tuned for tomorrow's brand new edition of Counseling Corner about ways to manage stress. In the meantime, enjoy this awesome article about helping your children get healthy from the American Psychological Association.

Tuesday, July 13, 2010

It's just my ADHD kicking in....

Over the last several years, there has been a great deal of attention given to Attention Deficit Hyperactivity Disorder (ADHD), formerly known as Attention Deficit Disorder, or ADD, in children. This disorder is largely considered a disorder of childhood, however, if you WERE diagnosed in childhood, it is quite possible that you still have some of the symptoms or characteristics. But what many people don't know is that you can be first diagnosed with ADHD in adulthood.

Adult ADHD is frustrating and can interfere with normal, everyday functioning. And it can be treated very effectively with behavioral strategies, therapy, and/or medication (in severe cases). In many instances, ADHD has been missed in childhood, and before it was commonly known, children might have been labeled as "bad kids", lazy, class clown, day dreamer, or slacker. The fact is, ADHD can be present, and undiagnosed, in adults for many years. They learn to compensate for their difficulties, and find careers that fit their disorganized or unfocused way of life. is a nonprofit website that provides information about ADHD and outlines several Myths about Adult ADHD and provides the facts:

MYTH: ADHD is just a lack of willpower. People with ADHD are just undisciplined and lazy.
FACT: ADHD is a real problem and is a chemical imbalance in the brain that affects planning, impulse control and focus.

MYTH: All kids have trouble with attention, and they will grow out of it when they become adults.
FACT: While many children have difficulty paying attention at all times, and some have a high level of energy, one would be diagnosed with ADHD if these symptoms interfere with their successful functioning. In addition, The symptoms of ADHD can change over time, and appear very different in adults.

MYTH: People who have ADHD don't have any other mental health disorders.
FACT: Those with ADHD are 6 times more likely to have a co-occurring disorder or learning disability.

MYTH: You have to have been diagnosed with ADHD as a child to have it as an adult.
FACT: Many adults struggle for years with symptoms of ADHD that have gone undetected, unrecognized, and untreated.

Signs and symptoms of ADHD in adulthood are:
  • Difficulty concentrating and staying on task.
  • Becoming hyperfocused and blocking out all other stimuli.
  • Lack of organization and forgetfulness.
  • Problems controlling their emotions.
  • Restlessness, agitation or hyperactivity.
Untreated, ADHD can cause problems in everyday life, such as relationship difficulties, financial and work problems, emotional and physical concerns. People with ADHD are more likely to have auto and other types of accidents. In addition, they often neglect routine checkups and do not take care of their physical health. Finally, adults with ADHD can be disorganized and fail to take care of bills and other obligations (i.e. renewing drivers license, etc).

The good news is that there is help available.  Therapy, coaching, training in organization and planning, and/or effective medications such as Concerta, Straterra, Adderral or Ritalin, can help minimize the negative effects of ADHD on both children and adults.In addition, the following article provides self-help strategies for ADHD.

Don't forget, HELP IS AVAILABLE.  Want to know more? ASK ME!

Wednesday, June 30, 2010

Counseling Corner: My country can beat your Independence Day, 9/11 and the World Cup brings us together.

USA! USA! USA!   The crowd chants, flags are flying, faces painted red, white and blue - the hope of a nation rests on the USA Soccer team....People line the street, decked out their red-white and blue, an elderly man marches proudly, a War World I Veteran, whose original Navy crackerjack blues still seem to fit after all these years.  The crowd stands in honor and applauds heartily, thanking him for his service to our nation......

In OUR town, the 4th of July parade is a local staple. Even thinking back to when I was a kid, and lived in a neighboring town, people from all around came to High Street in Pottstown, PA, to watch the parade, wave their flags, and show their pride in the USA. This annual tradition varies very little from year to year, but holds profound meaning for those who attend. The festivities are capped off with a very nice fireworks display, signifying "the rockets red glare, the bombs bursting in air". We feel pride, excitement and hope when we participate in this yearly ritual. I often shed a tear or two, especially when I see the war veterans in the parade and hear the bagpipes.  We fight the crowds, walk a mile, sometimes in the rain - uphill BOTH WAYS - but it is soooo worth it.

As my husband and I walked among the crowd this morning at the parade, I felt that familiar sense of pride, and a kinship with hundreds of people I do not know.  We are there for one reason - to celebrate our country's independence, to remind ourselves that we are a community, and to pass these traditions on to our children.  We remember that we are allowed to have such a parade because many gave their lives. we should not take this for granted. 

This morning, we took many photographs, to commemorate this day, and I have included several through this blog. The parade was fairly typical, the countless fire companies who participate (THANK YOU, FIREMEN!!), the Little League, and the giant duck, the steam calliope...the parade is predictable and provides a sense of continuity and safety. We know what to expect and we love it. It is OUR parade.

Today is about pride, and it is also about patriotism.  Patriotism is defined in Webster's Online Dictionary as "love or devotion for one's country". Michael J. Bader in his article "The Psychology of Patriotism" ( states that "Patriotism can be a force for good or for evil".  When I think about patriotism, I also reflect on other events as well...The World Cup, The Olympic Games, and the tragic events of 9/11.  These events bring us together as a nation, and we have a common sense of pride, belonging, and, especially in the case of 9/11, defensiveness. We have seen patriotism pull our nation together, as we did  in the days and weeks following 9/11/01. We have also seen the patriotism of other nations turn evil, as we witnessed the planes hitting the twin towers or in the case of Hitler in Nazi Germany.

But why patriotism and how does it work? Abraham Maslow defined a "hierarchy of needs", which included physiological needs, safety needs, need for belonging, esteem needs, and self-actualization.  Our safety needs and our need for belonging cause us to want to defend ourselves, our families, and ultimately, our country, and we do this in groups...parades, parties, vigils, or marches, because we need to feel a kinship with other like-minded individuals. Bader compares this patriotism to a family. We need to feel that sense of attachment and we also project our need for parental authority.  This was best seen through the Hurricane Katrina disaster, when people looked to their government for answers and assistance. Through patriotism, we have a sense of "we" that combats the isolation and loneliness that is so common in our modern society.

One aspect of Independence Day that we sometimes forget in the midst of all the parades, barbecues and fireworks, are the men and women who are serving in the armed forces around the world, those who have made the ultimate sacrifice so that we can "let freedom ring", and the families who are left behind. The American Psychological Association discusses important aspects of this on their website ( I have been a military spouse myself, and know firsthand the loneliness that can often arise on a day such as the Fourth of July.  My step-son is currently serving in Japan, and my son-in-law spent most of 2009 in Operation Iraqi Freedom.  To both of these young men in my life, and the thousands I do not know, I thank you. Because of you, I am flying my flag proudly today.

*Photos by Michael Herrigel

Friday, June 25, 2010

Counseling Corner: Friday Fun with Furry Friends

With all the talk - and heated debate- in the paper about animals: fish and fowl covered in oil in the gulf, people with too many cats, cats roaming around neighborhoods ruining flower-beds, dogs barking at all hours of the night, and finally, "Take your Dog to Work Day" on Friday June 25, I thought it would be nice to shout out to my own special four-legged friends and talk about the real mental health benefits of pet-ownership.

Take Your Dog to Work Day was first started in 1996 in the United Kingdom and June 25, 1999 in the United States. Created by Pet Sitters International, this day celebrates the great companions dogs make and encourages adoptions from local shelters, rescue groups and humane societies.

There is a growing body of research on pets and pet ownership that just confirms what any pet lover already knows: pets can enrich our lives and create a special bond. Pets become a member of the family. But what many people do not know, is that owning a pet can actually reduce stress, and decrease loneliness and help with depression. In addition, a four-legged friend can help prevent heart disease, and lower the cost of health care.

A study at the State University of New York at Buffalo showed that those who adopted a dog actually had lower blood pressure than non-pet owners.  In the elderly, pet-owners have better physical and mental health than non-pet owners.  The National Institutes of Health (NIH) reports that people with pets have fewer visits to the doctor than non-pet owners.

In addition to physical health benefits, animals can help us adjust to illness and loss, decrease anxiety, increase our sense of security,  allow us to increase social contact and become more active, and have something to care for, which has been shown to be a protective factor in suicide prevention.

As for me, I have owned pets my  entire life... cats when I was growing up, and adding a dog when I become an adult and lived on my own. I have found that having pets has helped me get through some of the most difficult times in my life, and have provided comfort and love when I was going  through a difficult divorce and was far from home living on the West coast. Pets are a wonderful addition to the family, and sometimes just what the doctor ordered!

Saturday, June 19, 2010

Celebrity Rehab, Intervention, Hoarders and Obsessed: Media brings light to mental health disorders

So, is that the way is REALLY is? This is a common question people ask when discussing these increasingly popular reality shows. Over the last several years, mental health disorders have been in the spotlight in television shows like Celebrity Rehab, Intervention, Hoarders and Obsessed. But is their portrayal of these disorders accurate?

Yes. And no. Mental illness and mental health disorders are complex, and are never that cut and dried. The facts are sobering (pun intended) and the reality is that, according to statistic from the National Institutes of Mental Health (NIMH), 26.2 percent of adults aged 18 and older suffer from a diagnosable mental health disorder in a given year. That's more than 1 in 4. 57.7 million people. Staggering. Preventable? Maybe. Treatable? Definitely.

Approximately 6 percent of those suffer from what is called a "serious mental illness". And, nearly half of those diagnosed with one mental health disorder, are diagnosed with 2 or more. Mental disorders are the number 1 cause of disability in the United States.

Some of the most common disorders are Mood Disorders (Depression, Bipolar Disorder), Anxiety Disorders (Obsessive-Compulsive Disorder, Generalized Anxiety Disorder, Social Anxiety and Phobia, and Post-Traumatic Stress Disorder), Disorders in Childhood (Autism, Aspergers), Eating Disorders (Anorexia, Bulimia, Binge Eating Disorder), as well as Schizophrenia and other psychotic disorders.

So, is the way that television portrays these disorders accurate? In a very generalized way, the individuals featured on these shows represent the extreme examples of the mental health disorders. Are there actually people who hoard items to the point that they cannot move in their homes? Sure. But more than likely, most patients have a combination of symptoms and a lesser form of hoarding.

When should you get help for a mental health disorder? If your symptoms are interfering with your normal daily routine, you are missing work, or your happiness is compromised, it is time to seek assistance. There are many very effective, research based, time limited treatments for many disorders, and finding an experienced and skilled psychologist is important in recovery. A psychologist is a professional who is most likely a doctor, and has specialized training and extensive experience in diagnosis, assessment and treatment of most common mental health disorders.

Do I need medication? Maybe, but not necessarily. Most mental health disorders respond quite well to therapy with a skilled psychologist. Some people have an imbalance in their chemical makeup, and require medication while they are developing skills to manage their symptoms. Psychologists will assess the need for referral to a psychiatrist. The fact is, that the majority of people receive anti-depressants, anti-anxiety medications, and stimulants for Attention Deficit Hyperactivity Disorder (ADHD) from their primary care physician. A psychiatrist is an important part of any medication plan and should communicate regularly with the psychologist.

Where to turn? Several sources list outpatient providers of psychological and psychiatric services. Check with the provider to see if they accept insurance or for payment structures. Clink on one of the links below to find a licensed psychologist.;jsessionid=9C5178BA07C75DFB7B7266E65D58477F.mc1

For more information about mental health disorders see the website of the National Institute of Mental Health (NIMH) ( or the website of the Pennsylvania Psychological Association (

Or, for more information ASK ME!! You don't have to suffer alone....

Sunday, June 13, 2010

Counseling Corner Toolbox: Facts and strategies for suicide prevention

1-800-273-TALK (8255)

I just got the call.  A friend of a friend died this morning. Suicide.  Senseless, tragic, sad. Memories of my own friend who committed suicide 10 years ago flood back. I am transported back to those familiar emotions I experienced when I received the call: disbelief, sorrow, confusion, anger. Many ask, what could we have done? Should we have seen the signs?

One of my duties as a psychologist is to train people in suicide prevention and intervention. It is one of the hardest training courses that I do, but also the most important, in my opinion. If arming people with knowledge can help save a life, it is well worth it.

I would never sit here an try to tell you that you can absolutely, 100%,  prevent someone from committing suicide. What I can tell you is this: becoming educated about suicide and suicide prevention can go a long way to helping prevent someone from taking their own life. Are there any guarantees? No. But there might be ways to increase the chances that that person will get, and accept, help.

There are many factors that contribute to a person's decision to end their life. Some of these are: mental illness, drug and alcohol abuse, support system, coping skills, gender, and age. There are many, many more. These interact and can sometime result in the loss of hope. A common misconception is that a someone would commit suicide simply due to a breakup or a setback. These are triggers, but the underlying risk factors are already in place.

Here are some facts (2006 statistics):
*Suicide is the 11th leading cause of death in the United States (Homicide is ranked 15th).
*A person will take their own life every 15.8 minutes.
*11. 1 in 100,000 people have completed suicide.
*Females make a suicide attempt four times more frequently than males, however, the highest rate of completed suicide is in males.
*For every documented death from suicide, there are 25 attempts
*There are 6 survivors of every person who commits suicide (1 in every 65 Americans is estimated to be a suicide survivor - who has lost a loved on to suicide).

One of the goals of the suicide prevention course, called QPR (Question, Persuade, Refer), is to dispel certain myths about suicide. I will share these with you now:

Myth: No one can stop a suicide, it is inevitable.
Fact:  If people in a crisis get the help they need, and get through the crisis, they will probably never be suicidal again. They will most likely remember that they felt this way before and that there IS hope.

Myth: Confronting a person about suicide will only make them angry and increase the risk of suicide.
Fact:   Asking someone directly about suicidal intent lowers anxiety, opens up communication and lowers the risk of an impulsive act. We sometimes find that people actually want someone to talk to, but feel isolated and alone.

Myth:  Only trained experts can prevent suicide.
Fact:  Anybody, that means YOU, can intervene and try to prevent someone from committing suicide.

Myth:  Suicidal people keep their plans to themselves.
Fact: Most suicidal people communicate their intent sometime during the week preceding their attempt. Common signs can be giving away prized possessions, any sudden change in mood, talking about death and dying. If you see these signs, ask more questions.

Myth: Those who talk about suicide don’t do it.
Fact: People who talk about suicide may try, or even complete, an act of self-destruction (see previous Myth)

What should you do if you suspect someone considering/planning suicide? 
1. Ask the question.  Don't beat around the bush, be direct. "Are you thinking of committing suicide?" It is not an easy question to ask.  If you cannot ask, bring the person to someone who can. Another friend, a professional, a parent....someone. 
2. Next, take the person to a place where they can receive help: an emergency room, a trained professional. If they are in crisis, and refusing to get assistance, call for help immediately. Do not take this lightly.
If you or someone you know needs help, CALL 1-800-273-TALK

For more information, please contact the American Foundation for Suicide Prevention (, the QPR Institute, (, (  or contact me for more information. I perform training and education about suicide prevention and intervention.

If you or someone you know are in crisis, contact your local emergency services, by dialing 911.

Thursday, June 10, 2010

Pomp and Circumstance: The Psychology of Graduation

As Graduation season is upon us, I reflect back to my own high school graduation (SF Class of 1988!), more than 20 years ago. The world was much smaller back then. Simpler. The internet was in its infancy. Then the world exploded. Blogging, Facebook, texting, and cell phones. Back then, you still had to go to the library and use the card catalog to find books or to copy articles for that final paper. Now, the world is yours at the press of a button. (If you don't know what a card catalog is - ask your parents!)

Finishing high school is a bittersweet experience for most, the end of carefree days and summers off. Graduates face fears of the unknown as many go off to college, or the reality of the real workforce. Many view graduation as the end of something.

Commencement is so much more. The word itself, commence, means to begin. As much as the graduation is the end of high school, it is also the beginning of something, representing hope and all the future can bring. As you don your cap and gown, an age old tradition, you take part in a ritual that symbolizes a passage into adulthood.

I have had the good fortune of reconnecting with many of my friends and acquaintenaces from high school. It is amazing to see how everyone has changed and what they have accomplished. One classmate is working with the FBI, another has become a funeral director with one of the local funeral homes in our hometown, yet another has become a detective, and one classmate is in prison serving a 10 - 20 year prison sentence for manslaughter. It is almost The Breakfast Club in real life. Many have lost their lives, a stark reminder that it is not to be taken lightly. Most have children of their own now. We have one shot and need to make it count.

I guess the real lesson here is a message I try to pass to adolescents that I see for therapy - After high school, it is an entirely different world. In general, the cliques and groups dissipate, and the social hierarchy of high school seems less important. People are less mean and catty, after all, we are all freshmen again once we hit that college, University or trade school. As we move forward, commence, we take those sometimes brutally difficult lessons from high school, and try to become better humans. Without the peer pressure of high school friends, we try on new identities and allow our inner personality to shine. We gain confidence, competence and the knowledge that we need to become, well, whatever it is we want to pursue. I knew early on (Mr Aluise Psych/Soc class Junior year), that I wanted to become a psychologist. 20 years later I realized my own dream. I hope, that for the Class of 2010, they also find their own happiness. It's not as easy for them. They have new and difficult challenges to face. They have a much more complex and difficult world to take charge of...

For many facing commencement, unique challenges will be faced. First, new graduates may be leaving home for the first time. This can be anxiety producing for both the teen as well as their parents. Developing independence includes both the need to foster skills necessary to take care of oneslf (doing your own laundry, paying bills, cleaning your room without being told). I distinctly recall my father, EVERY time I saw him, saying "Did you check your oil?". In addition to the practical concerns, there are emotional adjustments to be made on both ends as well. Parents need to "let go" and the child needs to "step up". Emotionally, this can be a difficult and painful process.

When I see or speak with former classmates, many of them have changed. In fact, some are unrecognizable from the shy, awkward, skinny kids they once were. As my husband says "Life is the great equalizer". It can be ironic to realize that the most popular kids in high school may have been in their prime during that time, and many other "late bloomers" are still getting ready to shine.

One thing I know for sure: seeing the success of my own graduating class, I have hope for this generation of graduates.

Congratuations Class of 2010!!!

Spring-Ford Senior High School Class of '88 / Immaculata University Psy.D. Class of '07

Sunday, June 6, 2010

Let's Get Flyered Up! Why we need our team to win.

As I sit here at 7:30pm on Sunday evening, having just watched the Phillies lose to the Padres in the 10th, and anxiously waiting for Game 5 of the Flyers pursuit of the Stanley Cup, I am struck by the notion that I HAVE BECOME A PHILADELPHIA SPORTS FANATIC. There. I said it. I admit it.

I have always been a sports fan. After all, I WAS a high school cheerleader. (GO RAMS!). It started when I moved back to PA from California in 2001, and began to closely follow the Eagles. I bleed green. Over the last several years, the green has also been mixed with Red, and, now Orange. There have been untold Sunday afternoons, when our windows are open, that the shouts, cheers, and groans of the Eagles fans on my street can be heard. We are ONE.

Tonight, as I sit here in my living room, along with untold numbers of the other Philly faithful, waiting for the game, I begin to feel that familiar knot in my stomach, and many begin their rituals that I have been reading about, watching the game in a certain bar or pub, wearing that "lucky" shirt, heck, even the commentators were talking about wearing their orange ties. We are hungry for that Cup. We NEED that Cup.

But why is it that we care so much? After all, the Flyers winning or losing the Stanley Cup isn't a direct reflection on us. It doesn't have anything to do with our worth as a person or how we feel about ourselves. Or does it?

In psychology, there is a name for this. It is called "Basking in Reflected Glory". This was best seen in one study where researchers measured the number of people wearing their team's apparel on a Monday morning following a game. They found that 63% wore their team's "colors" the day after a win. After a loss, it fell to 44%. "By wearing a sports team uniform, attending their games, or watching them on television, the team's successes becomes the fan's successes, and as a result, wins on the field translate into bolstered self-esteem" according to Allen R. McConnell, Ph.D. In addition to wearing their team's apparel, the researchers also found that fans tend to personalize the wins and losses. You frequently hear comments such as "WE played great yesterday!", "We really need a new quarterback" (Philly gets their wish this year!), and "We'll get em next time!".

As we approach game time, let's try to keep it in perspective. Don't drink too much, make sure you take lots of deep breaths, and remember that our team wants it as much as we do. Philly is a die-hard sports town. No doubt about it. We would love nothing more than another parade. Philly fans are like no other, whether you are in the sky box or the 700 level. As you sit through what will inevitably be a nailbiter, be sure that you remember that this is one game, it IS a game (even though we REALLY need to win), and that you still need to tuck your kids in, take out the dog, and get up for work. Tomorrow is another day. But wouldn't it be a great day if we win?


Friday, May 28, 2010

Part 1: Media, models and self-esteem: the impossible dream

Take just a moment to watch this video, it will surprise you. Then read on:

This video, courtesy of Dove, provides a stark glimpse into the unseen world of media advertising and the way the newest technologies can edit and tweak these images in a scarily distored way. In turn, this will distort and create unrealistic expectations of what we "should" look like, and this can have a dramatic impact on the development of self-esteem. Children,and many adults, believe that these models look this way naturally, and feel quite inferior that they do not measure up to this ideal.

A child's self-esteem is made up of their system of beliefs and feelings about themselves. It includes their overall evaluation or appraisal of their own worth. These patterns begin very early in life, based on successes, failures and messages from those closest to the child. Parents, siblings, teachers and, yes, television and the media. As children grow, and experience the succeses and failure of life, their self-esteem can fluctuate and change. This is a very normal part of development. Children with healthy self esteem enjoy social interaction, work through challenging situations, and have an optimistic outlook. When children are constantly negative, saying "I'm dumb", "I'm ugly", "I'm fat", or, most heartbreakingly, "I can't", this can signal a larger problem.

Low self-esteem can lead to greater difficutlies: social problems, lack of achievement, distorted body image, anxiety and depression.

A recent study estimates that an average child will spend 900 hours per year in school. That same child will average 1500 hours in that same year watching television. Is it any surprise that our children are developing their image of what they "should" look like from the media? This same study estimates that parents will spend just 3.5 minutes per week engaged in meaningful conversation with their children. These statistic are shocking. And also give clues to the origin of the low self-esteem epidemic.

Based on the video above, do you think that your child is gaining a realistic expectation of what a woman should look like? I think not.

Here are some signs that your child may have low-self esteem:

1. She/he may not want to try new things, and may give up easily when frustrated. "I can't do this!" might be something you hear. They may be overly critical and pessimistic.

2. She/he may put him/herself down, and speak negatively, sayting things like "I'm stupid" or "I am a failure".

3. He/she may avoid social situations or new settings, where he/she feels that others might judge her.

4. She/he may catastrophize small setbacks, saying "I will NEVER be able to do this!" or "Nobody likes me!"

Mark Tyrell outlines signs of low self-esteem in his "Top Ten Facts about Low Self Esteem" (

These include:
"Social withdrawal
Anxiety and emotional turmoil
Lack of social skills and self confidence.
Depression and/or bouts of sadness
Less social conformity
Eating disorders
Inability to accept compliments
An Inability to see yourself 'squarely' - to be fair to yourself
Accentuating the negative
Exaggerated concern over what they imagine other people think
Self neglect
Treating yourself badly but NOT other people
Worrying whether you have treated others badly
Reluctance to take on challenges
Reluctance to trust your own opinion
Expect little out of life for yourself "

What can you do to help your child develop healthy self-esteem? Here are some helpful tips:
1. Watch what you say to your child.
2. Set a positive role model.
3. Set realistic expectation and provide realistic feedback.
4. Praise your child's successes and encourage them when they struggle.
5. Encourage your child to get involved.
6. Balance television and media exposure with conversation and quality time.
7. Expose children to realistic role models and avoid over-exposure to models and extremely thin role models.

Part 2 of this series will focus on self-esteem and it's relationship to body image. It will also discuss dieting, disordered eating and how parents can encourage healthy nutrition and exercise and help their children accept themselves as they are.

Thursday, May 20, 2010

Pottstown teen driving tragedies move HB 67 legislation forward

It's every parents' nightmare. The unthinkable. Losing a child is probably the single worst thing that can happen in a parent's life. And it is happening - all too often.

The series that appeared in The Pottstown Mercury "Teens and Cars: Tragedy in Numbers"  (, provided a wealth of information regarding teen driving and highlighted the tragedies that several area families endured when they lost their children to automobile accidents.

Among other new requirements, proposed legislation, HB 67, would limit the number of non-family passengers in the car. This will serve to decrease the level of distraction in the car and assist young drivers in making better choices while they are behind the wheel.

But these tragedies underscore one fact: Adolescent brains process information differently than adults. Research by neuropsychologist Deborah Yurgelun-Todd, Ph.D., at Harvard University, uses neuroimaging to examine the developing brain. What this research found can help explain adolescent qualities, such as impulsive behavior, increased social anxiety and poor judgement.  According to Yurgelun-Todd, teens do not have the brain structures in place to think things through in the same way as adults. The teen's developing brain, in particular, something called the prefrontal cortex, is responsible for decision-making, insight, and judgement. While the researchers acknowledge that these real differences in the brain do not fully account for the reasons that kids make poor judgements, but it does lend some important clues.

What we can take away from this research, and apply in everyday life, is that while teens can seem mature, intelligent and responsible, their developing brains are not fully equipped to respond to the complex situations they confront when they are behind the wheel of a car, with several of their friends, with radio playing, texting and cell phones in use. They can become more anxious, more distracted, and respond in more impulsive ways. This can further be compounded by peer pressure, drug/alcohol use, bad weather and road conditions, sun glare, and other factors.

The website provides information for parents and here you can find a Driving Contract. that you can use with your teens.

Their "Parents Section" provides useful information for parents who are teaching their teens to drive. They stress several important points:

* Know the rules - As a teacher, and mentor, it is crucial that parents know the rules of the road in their state.  Do your reasearch and be prepared for questions from kids when you are teaching them to drive. is a website that provides links to driving sites in the United States and Canada.
* Be a role model - As a driver, following the rules of the road applies to everyone, and sending that clear message to teens is important. Just as our children learn to walk, talk and tie their shoes from parents, they also learn their driving style and habits.
* Set the rules for driving, and enforce them - Just as you do with anything else, there must be rules about driving and you must be willing to enforce these rules. Getting their driver's license is a great thrill, a rite of passage, and also a great responsibility.  Set rules for curfew, number of passengers, approved destinations, etc., and follow up to ensure the rules are followed.
*Talk to your kids about safe driving - Most teens will not approach their parents with questions. No matter how close you think you are to your kids, you MUST start the discussion. Be sure to cover important topics, such as distracted driving (texting, phone calls, radio, makeup, eating), drug/alcohol use, procedures for emergencies, etc).
*Before your teen goes solo, be sure they have the training they need - Driver safety classes and experience on the road, with an adult, cannot be overstated.  As with any other skill:

Practice, Practice, Practice!!!

If you are having trouble with your teen, ASK FOR HELP!

Information regarding Pennsylvania's House Bill 67 can be found at the following:

Wednesday, May 19, 2010

Crash victim's father urges: Sign this petition - The Mercury News: Pottstown, PA and The Tri County areas of Montgomery, Berks and Chester Counties (

Stay tuned for this week's blog, which will focus on important reseach about teens and the biological clues to their "quirky" behavior. This has important implications for House Bill 67 that would restrict the number of passengers in cars driven by teens.

Crash victim's father urges: Sign this petition - The Mercury News: Pottstown, PA and The Tri County areas of Montgomery, Berks and Chester Counties (

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Wednesday, May 12, 2010

It's 9:15, do you know where YOUR kid is?

Of course I do, she's sitting right here. On her laptop, Facebooking.  But you may not know as much as you think.  Read on...

In January, 15 year old Phoebe Prince of South Hadley, Massachusetts, entered the national spotlight when she committed suicide, it raised a multitude of questions about bullying. How can this happen? Where were the adults? Why didn't anybody DO something?   Others took the another view; come one, it's just kids! Kids will be kids...hey, I was bullied and I never tried to kill myself! Phoebe's story was a sad one. A teenager who suffered for months of constant bullying. On May 3, 2010, anti-bullying laws were passed in Massachusetts. But not soon enough to help Phoebe.

The reality is, there are many factors that contribute to a person making the forever decision to end their life. Phoebe's death was surely tragic and unnecessary.  But this blog is not about suicide prevention. That will be a topic for another day.  What reading this story really made me think long and hard about, is bullying. And the new and horrible ways kids are using technology to bully each other. 

Teens are sometimes the most difficult group to engage in psychotherapy, especially if they didn't ask for help.  I often acknowledge to them that I would not go back to being in high school for "a million bucks" and that they have it so much harder than my generation did when I was in school. Yes, bullying was around when I went to Spring-Ford High School in the 80s.  To be honest, I encountered bullying first hand when I was in 10th grade, when a group of older girls bullied me for - well, I am still not sure why.  I am one of the lucky ones. With the help of my parents and the school, I was able to work things out and it didn't last.  I can't imagine having this day in- day out and having to cope with that type of rejection. And I can't imagine the pain that Phoebe Prince was feeling the day she ended her life.

Being a kid today is tough. Plain and simple. 

The latest generation of kids has found ways to use the latest technology to engage in bullying. This relatively new phenomenon is called, aptly, "cyberbullying".  If you think it's not a problem, think again.

Here's how it happens:  According to the National Organization for Victim's Assistance (NOVA) reports that "kids will commonly send hurtful text messages to others or spread rumors using cell phones or computers. Kids have also created web pages or profile pages on social networking sites making fun of others. With cell phones, adolescents have taken pictures in a bedroom, a bathroom, or other locations where privacy is expected, and posted or distributed them online. More recently, some have recorded unauthorized videos of other kids (or adults) and uploaded them for the world to see, rate, tag, and discuss." Cyberbullying can take a heavy toll on kids. Research has shown that it can affect self-esteem, and can cause kids to feel sad, angry and afraid and embarrassed. Here are some things to consider:

According to NOVA, a child or teenager may be a victim if he or she:
  • unexpectedly stops using the computer;
  • appears nervous or jumpy when an instant message or email appears;
  • appears uneasy about going to school or outside in general;
  • appears to be angry, depressed, or frustrated after using the computer;
  • avoids discussions about what they are doing on the computer;
  • or becomes abnormally withdrawn from usual friends and family members.
A child or teenager may be a cyberbully if he or she:
  • quickly switches screens or closes programs when you walk by;
  • gets unusually upset if computer privileges are reduced;
  • avoids discussions about what they are doing on the computer;
  • or appears to be using multiple online accounts (or an account that is not their own).
In general, if your child acts in ways that are inconsistent with their usual behavior when using the computer, it's very important to ask questions and find out WHY.

In order to prevent cyberbullying:
  • If your kids are using the Internet, you must educate them about appropriate online behaviors (and kids must follow the rules)
  • Monitor their activities while online. If your kid is on Facebook, you'd better be one of their Facebook friends! (or have a close family member do it) in order to monitor their activity.
  • In addition, you can use an "Internet Use Contract" and/or a "Cell Phone Use Contract"  (I have posted the links below) to lay out the rules and expectations. 
  • Kids need to learn that inappropriate online actions will not be tolerated. If they break the rules, follow though on the consequences
  • If you discover that your child is cyberbullying others (yes, it could happen), be sure to let your child know how their behavior affects others whether it is the "real world" or in "cyberspace". The anonymity of the Internet often allows people to do/say things they would not say in a face to face interaction. 
  • Firmly enforce consequences; structure is how kids learn the boundaries!
  • If an incident was particularly serious, you may want to install tracking or filtering software as a consequence.
  • Moving forward, it is essential to pay even greater attention to the Internet and cell phone activities of your kids to make sure that they have internalized the lesson and are acting in responsible ways.
Don't be afraid to ask for help!

To visit the National Organization for Victims' Assistance (NOVA) website rergarding Cyberbullying, use the link:

To download the cell phone use contract and the Internet use contract, use the links below:

Friday, May 7, 2010

Putting Mother's Day - and Motherhood - into perspective.

As a psychologist, and psychotherapist, part of my job is to help my patients "put things into perspective". Often, during this process, revelations applying to my own life often come as a huge surprise and smack me right between the eyes. This week was no exception. I had planned to write a blog merely extolling the virtues of gratutide and appreciating mothers; what follows is how it developed.....

When Anna Jarvis, from Grafton, West Virginia, created a day to celebrate mothers, with the help of wealthy Philadelphian John Wannamaker in 1908, it was the realization of a dream her own mother had for many years. In 1914, President Woodrow Wilson made it offical: the second Sunday of May would be that day. Little did Anna Jarvis know at that time, within just nine short years, her mother's dream would become a commercialized phenomenon that it became known as "The Hallmark Holiday". Mother's Day is now THE most lucrative holiday for florists, greeting cards, and restaurants around the nation. I am sometimes ashamed to admit this, however, my own family is BIG, and I mean HUGE, on the greeting card front. In fact, we should have bought STOCK in the Hallmark Company (and, according to my Dad, the electric company). The ultimate goal on holidays is to find THE best card, and make the recipient cry. To this day my husband and I still play this game. The objection many had to the commercialized version of the holiday is that it takes away people's need to actually write down their feelings, and we let someone else do it for us. For some who lack the gift of writing, it's the only option. Either way, it's a very impersonal way to get personal.

Despite all of the hard work Anna Jarvis invested into making Mother’s Day a reality, it was not long before she came to loath the vey thing she had created. Long before the present, this day to honor the woman who carried and guided you into the world became SO commercialized that Anna Jarvis later denounced the holiday and spent her remaining years, and every last penny, protesting and fighting against the very day she created, obviously with no success. What many people do not realize, Mother's Day is celebrated around the world, from the Arab nations to Europe, Africa to Canada...and is also observed on different dates throughout the year.

So why do we need a special day to celebrate this beloved woman who gave you life?

For many, Mother's Day is a wonderful day to remember and celebrate all the special things your own mother has done for you; after all, you would not be where you are today, if not for Mom. Giving thanks to her on this day is not only the right thing to go, it's good for your mental health! In fact, Martin Seligman, Ph.D., Director of the Positive Psychology Center at the University of Penn, states that of the five factors he found to be most important in having a happy life, gratutide is the most important. (check out for more info on Positive Psychology).

Over the years, I have often wrestled with the meaning of this holiday in particular, primarily due to the fact that I lost my own mother when I was still a teenager, some 22 years ago. This left me with several options. My first solution was, I could honor my father on both Mother's and Father's days...since he was "both". So, I trudged to the Hallmark store for those first several years and purchased Mother's Day cards "to my father". After a time, I came to realize that this was not a real solution because it didn't really ring true. After all, as much as I love my Dad, he is still "Dad". The next “solution” involved simply honoring the other "Mothers" in my life. My grandmother, my sister, and my stepmother. Nice, and it is great to honor the "mother's" in our lives, but it's still not the same. Some years, I went to the cemetary, some years not....I even wondered at some points if I could simply ignore the holiday. After all, no Mother - no Mother's Day. Great idea THAT was – all that accomplished was to leave me bitter and angry that there was a Mother's Day at all and that I was not able to participate and honor MY mother like everyone around me. NOT FAIR!!!

Fast forward to 2000. I met, and fell in love with, my wonderful husband, Mike, AND his 5 children; every single one of them. I am especially close with Nicole, who moved to be near us and lives just across the street with her husband. She is 24. I think that our special relationship lies in the fact that I have never tried to be her mother. She HAS a mother. In fact, I have never even tried to be a step-mother. As a psychologist, I realize that going down that road will lead to sure disaster. So I tried very hard NOT to be a mother. None-the-less, as the years have gone by, Nicole and I have developed a very special bond. However, I never thought of it as a “Mother – Daughter” type relationship.

Yesterday, I received a Blackberry message from Nicole. She wanted to know what we are doing on Sunday. I replied "I don't think we have plans, why?". She replied that she wants to make dinner or take us out. Wow. That is nice (wonder what she wants - haha). I called Mike to let him know. "I don't know what is up" I said. He replies "She wants to take you out for Mother's Day". Wow. Blown away doesn’t BEGIN to describe what I was feeling after hearing those words! Even when I was planning this blog and KNEW Mother's Day was Sunday, I never made the connection! Without even trying, I had become "a mother" to someone. In fact, once I thought about it, on my recent birthday, I received three text messages that said "Happy Birthday Mommy!". It seems that in spite of the fact that these wonderful human beings have TOLD me that they think of me as a "mother", I needed it to smack me between the eyes to "get it".

I can honestly say that, in spite of many very important women in my life, there has never been anyone to replace my own mother. I miss her every day, and this Mother's Day, I will reflect, and honor her memory. She obviously taught me something profound about being “a Mother” in someone's life, even if I don’t realize that I am filling that void. I am proud and thankful that these “step-children” chose me. Thank you Nicole, you have given me one of the most important lessons of my life: Anyone can have kids. But being a Mother is something else entirely.

Like this blog? Check out some of my others...


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