The New York Times posted a blog recently that examined the ingredients for a happy marriage. As anyone married longer than 6 months can tell you, sustaining a happy marriage is not as simple as it may seem. Ask yourself, “What can I do in 5 minutes today to make my partner’s life better?” For more suggestions, see the New York Times post on “That Loving Feeling”. Meanwhile, in a recent “TED Talk,” world-renowned sex therapist Esther Perel of Belgium talks about the nearly universal experience of couples who find they have less interest in sex after years of marriage. “How can we keep wanting what we already have?” she queries, and answers in an inspiring talk, “The Secret to Desire in a Long Term Relationship.”
Teri Hardgrove, CRNP is a psychiatric nurse practitioner who has recently joined our practice. She is trained and licensed to prescribe psychiatric medications and will also be doing some psychotherapy. Her office hours are currently Mondays from 8 to 3 and Wednesdays from 8 am to 8 pm. Please call the office at 610-626-8085 to make an appointment with Ms. Hardgrove.
Nate Prentice, LCSW, CAS-PC is a therapist at Psych Choices who recently completed a Certificate of Advanced Studies in Pastoral Counseling. We invite you to read his own recent blog posting where he muses about the recent tragedy in Connecticut. Nate discusses what we can do, and how we can talk to our children about such horrific events. Says Nate, “Please vote and advocate for enhanced services for behavioral health care, especially services that enhance affordable access to care and services which reduce the stigma associated with seeking care.” http://nateprentice.wordpress.com/2012/12/14/the-newtown-ct-shooting-what-can-i-do-how-do-i-talk-to-my-kids/
For another view on talking to children about tragedy, see this article from the New York Times: http://nyti.ms/VFWju3
Many Psych Choices clients are familiar with Max, the little dog who spends all day with therapist Emily Kahn-Freedman. Although Max is loving and easygoing most of the time, he’s had his behavior problems. Our client Chris S. is an experienced dog owner who offers the following advice:
Treating Problem Behaviors in Your Dog
by Chris S.
I’ve bonded with and cared for my first dog, Bowser, for the past three and a half years. A lively mutt, he has proven to be an infectiously goofy character – like when he dragged a broken tree branch that was about three times his size into the house as a puppy. It was an odd and comical sight that evoked a laugh from everyone in the room. Like many dogs, though, Bowser has exhibited some dominant and territorial behaviors since we adopted him which suddenly escalated about three months ago. When he began “guarding” places in the house, my sister’s dog, Scarlet, couldn’t even walk into the same room as Bowser without him staring her down, and if she happened to move too close he would forcibly bark at her, sending her on her way. Upon walking him, he often barked threateningly at other dogs he apparently perceived them to be invading his “territory”. These kinds of behaviors are natural in the dog-world, although in such cases they are obviously unwanted. I’d like to impart some of the knowledge that I’ve acquired from both trial-and-error learning as well as educating myself on dog psychology and behavior for the past several years. Although this certainly requires hands-on practice and commitment, here is a general guideline.
1. First, I’d like you to pay no mind to your dog; rather, pay attention to yourself. If you feel stressed, tense, angry or virtually anything other than calmness, your efforts will most likely be in vain. Dogs listen to owners who project calm-assertiveness. To put this in perspective, leaders in any field who are frantic, worried or uptight all the time are going to receive a similar reaction from their subordinates. Likewise, your dog needs you to be as level-headed as possible. So take a few deep breathes, psyche yourself up and whatever else you can do to create a sense of positivity and motivation.
2. I couldn’t agree more with the saying “A tired dog is a happy dog”. Dogs need to walk with their “pack” and will become frustrated when they sit inside or roam in the yard all day, which tends to translate into misbehaviors of which we sometimes blame them. I began regularly jogging with Bowser a few weeks after his sudden shift in behavior and the effects I’ve seen have been undoubtedly positive. The very first time I jogged with him was only for about fifteen seconds but by the time we were finished he was visibly more relaxed and attentive to me – just fifteen seconds produced this response from him. By the end of the walk he laid down in the house, finally able to sleep peacefully.
3. Many people associate the word “Discipline” with a negative experience, however, disciplining your dog calmly and assertively will only benefit him. You should use as little force as necessary as this should be exceedingly more psychological than physical. Dogs are extremely sensitive to your emotional states; therefore, if you yell at him while he barks at the mail-man, chances are this will only intensify his behavior. If you choose to use vocal corrections, use any word or sound that will make you feel empowered. To illustrate this, if you were to say “no” but are actually feeling insecure or frustrated, he isn’t going to take you seriously. And if you were to pick any word out of a hat and use it with certainty and meaning, your chances of commanding his attention will have skyrocketed.
4. Dogs are obviously an entirely different species, so while it is perfectly fine to love them as we would another person it’s unwise to treat them as such when we’d like to teach them. Rewarding him is going to reinforce the way he feels at any given moment, so it’s optimal to express your love when he’s calm and attentive to you.
It’s a very satisfying feeling knowing you’ve helped your dog work through an obstacle so he or she can feel happier. Using this general formula has done wonders with helping Bowser as his territoriality is on the decline and my sister’s dog, Scarlet, feels much more comfortable in the house. We no longer feel the need to keep a constant vigil over him and our overall pet-related stress has greatly diminished.
Learning is mutual when owning a dog, and although your furry friend will teach you many invaluable lessons, I hope these basic instructions will aid you in accomplishing your goal and ultimately fulfilling your pet’s needs as well.
Psych Choices welcomes Dr. Karen Glick, who will be seeing clients on Monday and Tuesday afternoon and evening. Dr. Glick tells us, “My approach to therapy is flexible as no two people are the same…even if on the surface they share the same diagnosis! At the same time, it is important to recognize that we all share many of the same life concerns. Together, in therapy, our goal will be your ability to make the best choices possible for your own personal growth and to incorporate the values you treasure into your life.”
Dr. Glick earned her doctorate in psychology (PsyD) from Widener University in 1992. She also completed a post-doctoral certificate in neuropsychology, specializing in psychotherapy with clients who suffered from mild head injuries or strokes. She worked with hospitalized clients at Friends’ Hospital for two years as a general psychologist and also ran a partial day hospital program for older patients with depression or anxiety.
For the past 16 years, Dr. Glick has helped a wide variety of clients with many types of issues: career and education counseling, anxiety reduction, relief from depression, navigating difficult life choices, couples’ therapy, parenting issues, making changes necessary for better health, and dealing with the ultimate issues of aging, mortality, and loss.
We are pleased to welcome David Tomlinson, LCSW to our clinical staff. Dave has 30 years of experience as a therapist. He is especially skilled in working with children and teens, families, and people who have experienced traumatic events or losses.
He says of his work, ” I have learned that I do not know everything, and I certainly do not know my clients as well as they know themselves. I try to respect my clients as equal partners in finding solutions to the problems they believe are important.
I believe that everyone alive has problems of some kind, but the secret to self confidence is being very clear that we are not our problems, and our problems are not us. My approach encourages more “solution talk” in therapy, and less “problem talk.” Nevertheless, most people want to have their problems heard and understood, so the basis of the therapeutic relationship is unconditional acceptance, empathy and compassion.”
Mr. Tomlinson’s approach to therapy utilizes Cognitive Behavioral Therapy (CBT), Solution-Focused Therapy, Motivational Interviewing and mindfulness techniques.
He will be seeing clients at Psych Choices on Tuesday and Wednesday afternoons and evenings, and eventually on weekends.
Psych Choices of the Delaware Valley is pleased to welcome to our team Ms. Vanessa Walker, LSW, psychotherapist. Ms. Walker, a licensed social worker who works full time as a drug and alcohol educator, is currently completing her requirements to earn licensing as a Clinical Social Worker. She is available to see clients here at Psych Choices on Wednesday and Thursday evenings and will soon offer weekend hours as well.
We are especially pleased that she is able to offer her services at a lower, sliding-scale rate for those without insurance, or those who cannot afford their high insurance co-pays.
Ms. Walker especially loves working with teens and young adults on issues of relationship dysfunction, parenting young children, adolescent behavior problems, and life transitions, among other issues.
Ms Walker holds a master’s degree in Law and Social Policy from Bryn Mawr College (August 2011) as well as a master’s in Social Work (MSW) from Widener University (2008). Her bachelor’s degree in social work was earned at Temple University in 2005. She also holds certificates in Drug & Alcohol Counseling (Villanova University, 2009) and School-Based Crisis Response (2007). She is a member of the National Association of Black Social Workers and the Bryn Mawr College Black Student Alumni Association.
She states: “It is my belief that we cannot achieve our full potential based on self-reliance, it takes a cast of characters to bringing in fresh ideas and resources to achieve a goal. I am incredibly humbled every time I get to work with people on their life goals and aspirations by helping them identify the barriers and work towards solutions.
“As a licensed social worker, I have worked extensively in the field of drug and alcohol prevention, education, and counseling. I have also served as a caseworker with families at risk, providing crisis counseling and in-home counseling to help families stabilize.
“I currently work full time providing community based drug and alcohol education, while offering my services as a part time therapist at Psych Choices. My hours include late afternoons, evenings and weekends.
“Because I am still completing my training as a Clinical Social Worker, I receive ongoing clinical supervision from a very experienced psychotherapist who is a licensed clinical social worker. My supervisor is someone I can turn to collaborate with the most challenging cases, and my studies with him enhance my effectiveness as a therapist.
“At present, I am not able to accept health insurance. However, I do offer my services on an affordable sliding fee scale basis. Please contact the office for more information.”
At the recent conference of the American Psychiatric Association, Dr Noah Freedman attended a course on the use of melatonin in the treatment of sleep disorders. Here is a summary of what he learned.
Do you have difficulty falling asleep at night, and then difficulty getting up in the morning? Many people, especially younger people, have this problem of “delayed sleep phase.” If instead you rise much too early in the morning, and feel ready for bed hours before others do, you have “advanced sleep phase,” common especially in older people.
When your sleep schedule is off in this way, it can feel like your “body clock” just isn’t working like the clock everyone else follows. In fact, that is exactly what is happening. The body’s “circadian rhythm”, or body clock, is out of kilter. Our body temperature cools at night, when we are asleep, and rises during the day. A hormone called cortisol, produced by the adrenal glands, tends to rise early in the morning, helping us to wake up. If these changes happen at the wrong time, the rhythm of sleeping and waking will be out of sync. The circadian rhythm is triggered in part by sunlight, and in part by melatonin, a hormone produced in the pineal gland.
To re-set your body clock, you can use melatonin in tiny doses of 0.5 mg (500 micrograms). This amount will generally not cause sleepiness directly, but will help re-set your body clock. If you want to fall asleep earlier, start by taking 0.5 mg of melatonin, not at bedtime, but rather 8 hours after you wake up each day. Then, gradually move back the time you take the pill, if possible taking it about 15 minutes earlier each day. You will begin to find that you gradually get sleepy earlier in the evening.
If you find yourself waking up much too early and would like to get some more sleep, you can try taking this same small dose (0.5 mg) when you awaken (as long as it’s after 2 a.m.), and you may be able to fall back to sleep more easily.
Melatonin in larger amounts, such as the 3 mg pills typically sold over the counter, can also be used to induce sleep at bedtime, and will help some people. However, the long-term safety of this use has not been determined. To buy the smaller doses, a good source is Trader Joe’s, where they carry 500 mcg (0.5 mg) peppermint-flavored, chewable tablets of melatonin. This amount is “physiologic,” equivalent to what the body naturally produces, and is a good way to help regulate your sleep cycle if used as described above.
Melatonin is only one natural remedy for insomnia. Other natural remedies for sleep difficulties include the herbs lemon balm, chamomile, valerian, and passionflower. The links will connect you to more information about these herbal supplements on the WebMD website.
This article does not constitute medical advice, and you are encouraged to talk with your doctor or nurse practitioner about your specific sleep problems.
(reprinted from our May 2011 Newsletter)
Are you as kind to yourself as you are to your friends and family?
If not, you may be at greater risk for depression and other health problems, even including weight gain, recent research suggests. Studies show that many people who are supportive and understanding to others tend to score low on tests of “self-compassion”, and tend to beat up on themselves for things like overeating or not exercising. Then, instead of feeling inspired to change their behavior, these folks will likely feel worse, which may lead them to overeat even more.
On the other hand, people who score high on tests of self-compassion seem to suffer less depression and anxiety, and are generally happier. Self-compassion can even help people lose weight. Researcher Kristin Neff at the University of Texas, quoted in the New York Times, explains how self-compassion helps with motivation. “The reason you don’t let your children eat five big tubs of ice cream is because you care about them. With self-compassion, if you care about yourself, you do what’s healthy for you rather than what’s harmful to you.” Her book, “Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind,”was published last year. In the book she explains exercises, such as writing yourself a letter of support, meditation and “compassion breaks,” where you repeat a phrase such as “I’m going to be kind to myself in this moment.”
Dr. Neff also has a website, http://www.self-compassion.org/, where you can read more about her work or purchase her book.