Play Therapy

Plato once said, “You can discover more about a person in an hour of play than in a year of conversation.”

Albert Einstein called play “the highest form of research.”

There have been many theoretical frameworks since the establishment of play therapy in the early 1900s, the main theories include: psychoanalytic, Jungian, Adlerian, child-centered, filial, cognitive-behavioral, and ecosystemic.  Other important play therapy theories include Gestalt, Eriksonian, time-limited, group, structured time-limited, and numerous others. Unfortunately, since many theories have a different conceptualization of play, a universal definition is the subject of ongoing debate (O’Connor, 2000).

Psychoanalytic, Jungian, and Adlerian play therapies are all psychodynamic approaches to therapy, which focus on the unconscious motives of behavior. Child-centered or person-centered play therapy is founded on the humanistic principles of Carl Rogers and focuses on complete acceptance of the client. Cognitive-behavioral play therapy was developed based on the ideas of Aaron Beck and focuses on irrational feelings displayed by the client. Finally, ecosystems play therapy focuses on increasing the functioning of the child.

What is play therapy?

⎫The Association of Play Therapy defines play therapy as “the systematic use of a theoretical model to establish an interpersonal process wherein trained play therapists use the therapeutic powers of play to help clients prevent or resolve psychosocial difficulties and achieve optimal growth and development.”

⎫A non-directive and empowering form of play where the client usually chooses the toys, activities, and games to play.

⎫Toys and games can help a client better communicate his or her thoughts and feelings.

⎫The therapist focuses on creating a safe environment.

⎫The therapist fully attends and recognizes the client’s actions and feelings that are expressed and reflects those feelings and actions.

⎫Differs from regular play in that the therapist helps clients to address and resolve their own problems.

⎫Built upon the natural way that clients learn about themselves and their relationships with others and their environment.

⎫Helps clients express what is bothering them when they do not have the verbal ability to express their thoughts and feelings.

⎫Provides a safe psychological distance from their problems and allows expression of thoughts and feelings appropriate to their development.

⎫Allows mental health professionals who are trained in play therapy, to assess and understand children's play.

⎫May include involving the parents or caretakers directly in the treatment which is called filial play therapy or the whole family called family play therapy.

⎫The therapist uses skills such as attunement, structuring, empathetic listening, imaginary play, and limit setting.

⎫The therapist recognizes and understands play themes and interprets these themes including: content, feeling or emotion, intention, meaning, and relation of play to other sessions and daily life.

Who benefits from play therapy?
Anyone may benefit from play therapy!
Infants
Toddlers
Children
Adolescents
Adults
Families

When clients engage in play therapy, they may benefit and learn to: (Goals)

Solve problems and work through conflict

Make decisions and be heard

Express themselves

Communicate and relate with other

Recognize boundaries and test limits
Understand and develop an understanding of expressing feelings to meet needs better
Reduce maladaptive behaviors
Increase confidence
Expand self awareness and self efficacy
Stimulate imagination, creative outlooks and exploration
Practice skills and different roles
Develop cognitive skills
Resolve inner conflicts and dysfunctional thinking
Cope with difficult emotional experiences
Empathize with others and respect ones own thoughts and feelings
Show who they are, what their values are, and how they regard others.
Become more responsible for behaviors
Help a client adjust to academic settings
Better understand nature and the environment
Cooperate and engage in teamwork
Allow freedom to fail and make mistakes
Help conquer fears

Learn how to share

Play Therapy is used to treat:
Depression
Anxiety
Obsessive compulsive disorder
Perfectionistic personalities
Behavior problems
Aggression
Oppositional or conduct behavior
Trauma witnessed or endured
Abuse substance, domestic violence, neglect, physical, sexual
Divorce or separation
Encopresis and Enuresis
Power struggles
Chronic medical disorder, hospitalization, diabetes, cancer
Foster children and families
ADD and ADHD
Autism spectrum disorder
Academic and social development
Learning and Physical disabilities
Eating and feeding disorders
Natural disasters
Death, grief, loss
Relocation
Common toys found in play therapy rooms may include:
Family oriented and nurturing toys:
Dollhouse with many accessories, people, animals
Puppets
Baby doll with accessories
Dress-up clothes
A real baby bottle and diapers
Kitchen set with accessories
Container with water (1/3 filled)
Aggressive toys:
Inflatable punching bag
Dart gun with darts
Soldiers
Dinosaurs
Foam bat
Rope
Expression and construction toys:
Art supplies
Play-doh
Sand tray with accessories
Blackboard/ dry erase board
Tape
Wand
Masks

Misc. toys:
Transportation toys
Bean bag toss

Various games
Doctor kit
Playing cards
Pretend money

While therapists find it hard to agree on a definition of play, most agree that play is seen as internally rewarding, and requiring no reinforcement (O’Connor, 2000). As a result, play is “person-dominated,” meaning that the child tends to be independent and use the toys to express situations (2000). Furthermore, play is “non-instrumental,” which allows the child to play freely with no intentional goal in mind (2000).

References
Coufal, J.D. & Brock, G.W. (1983). Parent-Child Relationship Enhancement: A 10-Week
Education Program. Menomonie, WI: Coufal & Brock.
Kaduson, H.G., Cangelosi, D., & Schaefer, C. (Eds.). (1997). The Playing Cure.
Northvale, NJ: Jason Aronson Inc.
O’Connor, K.J. (2000). The play therapy primer. New York:
John Wiley & Sons, Inc.
VanFleet, R. (1994)  Filial Therapy: Strengthening Parent-Child Relationships Through
Play. Sarasota, FL: Professional Resource Press.
VanFleet, R. (1997). Child-Centered Play Therapy. Boiling Springs, PA: Play Therapy Press.

Getting Our Needs Met in Healthy Ways

You've Given to Me, But for What Reason?

"I just got Brendan to clean his room."

"Oh, how?"

"I told him he was the sloppiest kid in the neighborhood and none of his friends would want to come over and play because his room was disgusting."

What's wrong with this exchange? Didn't this mother express what she wanted her son to do?

Dr. Marshall Rosenberg writes: "Such analyses of other people are tragic expressions of our own values and needs. They are tragic because, when we express our values and needs in this form, we increase defensiveness and resistance to them among the very people whose behaviors are of concern to us."

But didn't she get her needs met? Her son cleaned his room.

Dr. Rosenberg goes on to say: "If they do agree to act in harmony with our values because they concur with our analysis of their wrongness, they will likely do so out of fear, guilt or shame. We all pay dearly when people respond to our needs, not out of a desire to give from the heart, but out of fear, guilt or shame."

Mindful Practice for the Week

Write down some recent instances when you classified someone by labeling, insulting or shaming. Think about what needs and values you wanted to have met. How else could your needs be met without using fear, guilt or shame?

"Judgments of others are alienated expressions of our own unmet needs."

- Marshall Rosenberg, Nonviolent Communication: A Language of Life

Reference: https://www.nonviolentcommunication.com/general_tips/nvctips_week07.htm

I Have Everything I’ve Ever Dreamed Of. Why Am I Not Happy?

Signs of Discontent

You don’t need a degree in psychology to know when you’re off-track, but sometimes it creeps up on you. It can seem like you wake up one day and realize that things are not right. These are a few of the signs:

•    You don’t want to get out of bed.

•    You have a hard time motivating yourself to do routine tasks.

•    You have doubts about yourself.

•    You feel mildly depressed for days at a time.

•    You sometimes overeat and/or use alcohol and drugs to feel better or escape.

•    You often feel chronically tired, deenergized, and listless.

•    You worry about how you will keep things together.

•    You feel bored or restless.

•    You wish you were somewhere else.

•    You often have headaches, stomach upset, and other body aches and pains.

•    You sleep too little or too much.

•    You have frequent bad dreams or nightmares.

•    You oversleep.

•    You complain and nag.

Feeling dissatisfied with your life is not a pleasant experience, but it can lead you in a positive direction. These feelings may be important because they are telling you that your actions are out of synch with your values, goals, or talents.

Rediscover What Is Important to You

Imagine that your life is handed back to you and you are able to do anything you want. What is important to you? What values will direct you? Consider each word on the following list individually. It is not necessary to force-rank them or compare them against each other. Assign a rating to each word:

1 = Critically important to me

2 = Important to me

3 = I can live without it

Acceptance by others

Accomplishment

Activity

Admiration

Appreciation

Authority

Beauty

Being liked

Being well-paid

Calm

Casualness

Certainty

Challenge

Choice

Comfort

Community service

Competition

Creativity

Enjoyment

Ethics

Excellence

Excitement

Fame

Financial security

Fitness

Flexibility

Fortune

Freedom

Fulfilling my potential

Fun

Growth

Harmony

Health

Helping others

Honesty

Independence

Informality

Leisure

Making a difference

Mastery

Morality

Nature

Novelty

Originality

Peace

Personal development

Pets

Pleasure

Popularity

Power

Prestige

Privacy

Prosperity

Quality

Recognition

Relaxation

Respect

Risk

Solitude

Spirituality

Stability

Status

Stimulation

Surprise

Time for friends

Time for my family

Uniqueness

Variety

Wealth

Wisdom

Now make a list that summarizes your most important values. If you think of something that isn’t listed, feel free to add it.

The final part of this process (and this is a very streamlined version of what is possible) is to compare how you are currently spending your time with your list of most important values. How well do they match each other? What clues can you find that will help you find more satisfaction in your life?

Things that don’t match:

What I can do about it:

CARING FOR THE CAREGIVER

Caring for the Caregiver

Few people are prepared for the responsibilities and tasks involved in caring for loved ones who are ill, elderly, or disabled. The success of the relationship between you and your loved one depends on several factors. One of the most important is how well you take care of yourself, empowering yourself to be there for the person you are caring for. Let's look first at what causes the stress in such a relationship, and then we will explore some ways to care for yourself as you care for another.

Sources of Stress

Caring for someone who is sick or disabled causes tremendous stress. This stress comes from several directions and each has a different effect on the caregiver. The following are the main sources of such stress:

1.    Being far away: In most families, people are spread out across the country and are not always available to help with caring for a sick or elderly person. This places extra stress on the person nearby, who often must contribute the most in terms of time and money toward the patient's care. The out-of-towners may not realize how much time and money the person close at hand is devoting to the care of their family member.
    
2.    Financial stress is inevitable when someone requires an excessive amount of care. For example:
    a. Many caregivers spend their own money to cover expenses that are not covered by insurance or Medicare.
    b. The family members who are less involved may not realize how expensive certain items are and may even resist helping to pay for them.
    c. The primary caregiver may have to work fewer hours or find less demanding work (which may pay less money). Many caregivers have to stop working completely in order to care for the patient.
    
3.    Cultural expectations: In some cultures, daughters are expected to care for parents, and in others it is not acceptable to place relatives in nursing homes.
    
4.    Relationship stress: In addition to the financial stress, all of these factors create enormous stress on the relationships among family members. This can lead to an additional layer of problems if it is not openly discussed and resolved.
    
5.    Physical stress: Caring for an ailing person can be a physical challenge. Activities like cooking, cleaning, doing laundry, and shopping can be exhausting, especially when they are added to the responsibilities of your own life.
    
6.    Home alterations: If the patient continues to live at home, you may need to make alterations such as building ramps or railings. Everyone in the home will have to adjust.
    
7.    Social stress: Providing personal care 24 hours a day can cut off the primary caregiver from family and friends. You may be too tired to have an evening out, or you may not have anyone else to take over. This can result in your feeling angry and resentful toward the person you are caring for.
    
8.    Emotional stress: As a result of these stresses, it is not unusual to feel a range of emotions, including anger, resentment, anxiety, frustration, sadness, and guilt. These negative emotions may conflict with the love you feel for your family member and the satisfaction you feel from contributing to the quality of his or her life.

With all of these kinds of stress, it is not surprising that many caregivers become overwhelmed and begin to feel burned out.

Signs That a Caregiver Needs Help

How do you know if the stress is becoming too much for you? The following is a list of signs that you need help. Take a moment to look through these and identify those that are now problems for you or may be potential problems.
1.    You don't get out much anymore.
2.    You argue with the person you care for.
3.    You have conflicts with other family members.
4.    You abuse drugs, alcohol, or medications.
5.    Your appetite has changed.
6.    You isolate yourself from others.
7.    You behave in a compulsive manner or are overly focused on minor details.
8.    You feel listless; you lack energy.
9.    You feel more angry, anxious, or worried than usual.
10.    You have a difficult time controlling your emotions.
11.    You have a hard time concentrating.
12.    You have physical symptoms of anxiety, such as an upset stomach, headaches, or a racing heart.
13.    You often forget things.
14.    You are clumsy or accident-prone.
15.    You have self-destructive or suicidal thoughts.
16.    You sleep more or less than usual.
17.    You never seem to get enough rest.
18.    You feel guilty about your situation.

Caregiver Survival Tips

1.    Find out about resources before you need them. For example, don't delay researching nursing homes until the patient needs to be placed in one.
2.    Seek all the support you can find. Be on the lookout for groups, individuals, and organizations that provide emotional, social, physical, and financial support.
3.    Ask your family and friends for help. They may be able to provide you with time, knowledge, or money.
4.    Investigate adult day care facilities. They offer therapeutic, rehabilitative, and support services such as nursing, social work services, meals, or transportation.
5.    Consider having meals delivered. Many organizations provide nutritional programs.
6.    Consider hiring a home health aide. Aides can provide personal care at home such as help with eating, dressing, oral hygiene, bathing, administering medication, and light household tasks.
7.    Find out about homemaker services. These services can assist with shopping, laundry, housecleaning, preparing meals, and taking clients to medical appointments.
8.    Look into the offerings of hospital and surgical supply services. They rent or sell medical supplies and equipment like hospital beds, canes, walkers, bath chairs, oxygen, and other equipment.
9.    Check out respite care services. They provide relief to caregivers.
10.    Look into social day care. They provide recreational activities, social work services, hot meals, transportation, and some health services.
11.    Find out about transportation services. They provide transportation to and from medical appointments or other care services.
12.    Find out about skilled nursing services. They offer professional help with specific medical problems.
13.    Maintain your interests. Keep balance in your life.
14.    Be realistic about what you can accomplish. Recognize what you can and cannot do.
15.    Maintain communication with your family and friends. When tensions and misunderstandings develop (and they will), address them quickly.
16.    Take care of yourself. Eat well, exercise, rest, and take time off.

MANAGING PERFECTIONISM

What Is Perfectionism?
This is the first of two posts that address perfectionism. In this issue, we will explore what perfectionism is and why it is destructive. In the next one, we will take a look at some strategies for both controlling the need to be perfect and living a more relaxed, satisfying life.
Perfectionists aspire to be top achievers and do not allow themselves to make even a single mistake. They are always on the alert for imperfections and weaknesses in themselves and others. They tend to be rigid thinkers who are on the lookout for deviations from the rules or the norm.
Perfectionism is not the same as striving for excellence. People who pursue excellence in a healthy way take genuine pleasure in working to meet high standards. Perfectionists are motivated by self-doubt and fears of disapproval, ridicule, and rejection. The high producer has drive, while the perfectionist is driven.
Causes and Characteristics
Fear of failure and rejection. The perfectionist believes that she will be rejected or fail if she is not always perfect, so she becomes paralyzed and unable to produce or perform at all.
Fear of success. The perfectionist believes that if he is successful in what he undertakes, he will have to keep it up. This becomes a heavy burden-who wants to operate at such a high level all of the time?
Low self-esteem. A perfectionist's needs for love and approval tend to blind her to the needs and wishes of others. This makes it difficult or impossible to have healthy relationships with others.
Black-and-white thinking. Perfectionists see most experiences as either good or bad, perfect or imperfect. There is nothing in between. The perfectionist believes that the flawless product or superb performance must be produced every time. Perfectionists believe if it can't be done perfectly, it's not worth doing.
Extreme determination. Perfectionists are determined to overcome all obstacles to achieving success. This is also true of high achievers, but the perfectionist focuses only on the result of his efforts. He is unable to enjoy the process of producing the achievement. His relentless pursuit of the goal becomes his downfall because it often results in overwhelming anxiety, sabotaging his heroic efforts.
The Costs of Being a Perfectionist
Perfectionism always costs more than the benefits it might provide. It can result in being paralyzed with fear and becoming so rigid that a person is difficult to relate to. It can produce contradictory styles, from being highly productive to being completely nonproductive. Some examples of these costs include the following:
Low self-esteem. Just as low self-esteem is a cause of perfectionist behavior, it is also a result. Because a perfectionist never feels good enough about himself or his personal performance, he usually feels like a loser or a failure.
Gloominess. Since a perfectionist is convinced that it will be next to impossible to achieve most goals, she can easily develop a negative attitude.
Depression. Perfectionists often feel discouraged and depressed because they are driven to be perfect but know that it is impossible to reach the ideal.
Guilt. Perfectionists never think they handle things well. They often feel a sense of shame and guilt as a result.
Rigidity. Since perfectionists need to have everything meet an ideal, they tend to become inflexible and lack spontaneity.
Lack of motivation. A person who expects perfection may never try new behaviors or learn new skills because she thinks that she will never be able to do it well enough. At other times, she may begin the new behavior but give up early because she fears that she will never reach her goal.
Paralysis. Since most perfectionists have an intense fear of failure, they sometimes become immobilized and stagnant. Writers who suffer from writer's block are examples of the perfectionist's paralysis.
Obsessive behavior. When a person needs a certain order or structure in his life, he may become overly focused on details and rules.
Compulsive behavior. A perfectionist who feels like a failure or loser may medicate him- or herself with alcohol, drugs, food, shopping, sex, gambling, or other high-risk behaviors.
Eating disorders. Many studies have determined that perfectionism is a central issue for people who develop eating disorders.

The Perfectionist versus 
The High Achiever

People produce many of their best achievements when they are striving to do their best. High achievers, like perfectionists, want to be better people and achieve great things. Unlike perfectionists, high achievers accept that making mistakes and risking failure are part of the achievement process-and part of being human.
Emotionally Healthy High Producers
You can be a high achiever without being a perfectionist. People who accomplish plenty and stay emotionally healthy tend to exhibit the following behaviors:
�    Set standards that are high but achievable.
�    Enjoy the process, not just the outcome.
�    Recover from disappointment quickly.
�    Are not disabled by anxiety and fear of failure.
�    View mistakes as opportunities for growth and learning.
�    React positively to constructive feedback.
Once you are aware of the ways by which you expect yourself to be perfect, you can start to change your behavior. In my next newsletter, I'll offer some tips to help you get started. Until then, begin the change process by thinking about which causes apply to you and writing down examples of these perfectionist behaviors as you observe them.

HOW TO BE LESS OF A PERFECTIONIST AND ENJOY LIFE MORE

This is the second of a series of two posts that explore the dynamics of perfectionism. In my last article, you learned what perfectionism is and why people develop the need to do things perfectly. In this issue, you will learn how to change your perfectionist behaviors and enable yourself to be more satisfied with yourself and your life.
You will have the greatest success if you read the first newsletter and take some time to observe your own perfectionist patterns. Once you have accomplished that, choose a few of the strategies outlined here. Keep working at it until you understand what you need to do to accept your imperfections and humanness.

Create a Support Network 
for Yourself

Seek out people who are not perfectionists. Encourage your support network to not be rigid or moralistic in their attempts to keep you on an honest course. Look for people who forgive and forget when mistakes, failures, offenses, or backsliding occur. Ask them to tell you when they think you are being rigid, unrealistic, or idealistic in your behavior. Ask them to give you positive reinforcement for any positive change, no matter how small. Seek out people who have a sincere interest in your personal growth.
Do Some Self-Exploration
Explore the following questions in your journal, make some notes here, or discuss them with a trusted friend or professional counselor:
    1.    Where do you see perfectionist behavior in your life?




    2.    How do these behaviors create problems for you?




    3.    What perfectionist beliefs do you have?




    4.    How do you think these beliefs will affect your ability to change your behavior?




    5.    What do you need to do to become less of a perfectionist and more relaxed about things?




    6.    How can you use your support system to help yourself be less of a perfectionist?




Identify Alternative Behaviors
Make a list of specific perfectionist behaviors that you want to change. For each one, think of something specific you could do instead. For example:
�    Perfectionist behavior: I expect my teenage daughter to pick up the clothes off her floor and make her bed every day.
�    Alternative behavior: I can expect my daughter to clean her room every Saturday and I will close her door every other day.
Note your own examples here:             



Perfectionist behaviors:                 



Alternative behaviors:                 



Lower Your Expectations
It is very important to understand that it is unrealistic to expect to change your behavior (or someone else's) immediately or completely.

Make a List 
of the Advantages and Disadvantages of Being Perfect

You may find that perfection is too costly. Perhaps you will discover that relationship problems, endless working, and other compulsive behaviors (eating disorders and substance abuse problems) are too high a price for the results you gain from your perfectionist way of being.

Pay Attention to Your Behavior 
and Attitudes

As you see yourself behaving in a perfectionist way, take note. In the beginning, just observe yourself. Keep a log if it helps you see your behavior more clearly. You don't have to make any changes until you have a good idea of your specific behaviors and thoughts.

Try Some New Thoughts 
and Behaviors

Begin to substitute the alternative behaviors you identified earlier. If possible, ask someone from your support network for feedback. Observe your feelings and thoughts as you try new things.
Review Your Goals and Make Sure They Are Realistic
By having achievable, realistic goals, you will gradually see that less-than-perfect results are not as disastrous as you thought they would be.

Set Strict Time Limits 
for Your Projects

When the time is up, move on to another task or take a break.
Make Friends with Criticism
Many perfectionists take criticism personally and respond defensively. If someone criticizes you when you make a mistake, the easiest thing to do is to simply admit it. Remind yourself that you are human, meaning you will sometimes make mistakes. The people who never make mistakes are no longer learning or growing.
Learn to re-frame criticism and 
see it as information you can 
learn from.
When you let go of the fantasy that humans must be perfect to have value in this world, you are less likely to feel angry or embarrassed when you make a mistake. You will see that criticism is information that you can learn from, and you will no longer need to avoid it.

WHAT CAUSES ALL THIS STRESS?

In this post, we will explore what stress is and what causes it. In the next, you will learn how to manage the stress in your life and protect yourself against it.
Stress Is a Response
Most experts define stress as a response to life situations like the following:
1.    Having too many responsibilities
2.    Vague or confusing expectations
3.    Having to do unpleasant tasks
4.    Facing too many distractions
5.    Having to do tasks for which one is unprepared
6.    Working with difficult people
7.    Being bored
8.    Being sick
9.    Experiencing too many changes
10.    Being in physical danger
11.    Living or working in a crowded space
12.    Not getting enough exercise
13.    Poor nutrition
14.    Not getting enough sleep
15.    Not enough time to relax
16.    Being dissatisfied with your physical appearance
17.    Abusing drugs or alcohol, or being close to someone who abuses them
Social and Cultural Causes of Stress
Stress has become a factor in our culture in the last 20 years because of things that were originally designed to make life less stressful. Conveniences such as ATM machines, microwave ovens, and fax machines have made life easier in many ways, but they also have woven an expectation of instant gratification into our culture. And this causes stress.
Here are a few other examples of products and services that were invented to make life more efficient and productive, but which sometimes seem instead to add to stress:
�    24-hour stores and restaurants
�    One-hour photo developing
�    Drive-thru fast food
�    10-minute oil change
�    Web sites, with their instant access to unlimited information
�    Catalog and Internet shopping
�    Personal computers
�    E-mail
�    CNN Headline News
�    30-minute pizza delivery
Stress at Work
Almost everyone complains of stress at work these days. It often results from one of the following:
1.    Having too much or too little work to do
2.    Having to do work that is very complicated and demanding
3.    Having to do work that is boring and repetitive
4.    Having unclear goals and expectations
5.    Having to follow changing or confusing procedures
6.    Being at a career dead end
7.    Working in a company with an impersonal management philosophy
Who Work Stress Affects Most
Stress affects people in every type of work setting.
People at the top of organizations suffer from stress because of excessive workloads, unrealistic expectations, and isolation. The phrase "it's lonely at the top" has some truth to it.
Middle managers often experience stress because they have responsibility for the people who report to them, but lack the control to execute what is expected. With the recent epidemic of corporate downsizing, middle managers have also been given greater and greater workloads. Managers who manage to keep their jobs often feel like they are living in the shadow of termination.
Professionals suffer from their own brand of stress caused by monotony. Doctors, lawyers, and other professionals often perform the same kind of work for many years, resulting in boredom and desperation.
Workers at the lower levels of today's organizations often feel stress caused by boredom and the frustration of dealing with the public. They also may feel less successful than their coworkers in higher-level jobs and may feel stressed by their lack of status.
Why Workplace Stress Has Increased
1.    The nature of work has changed. The fight-or-flight responses to stress are ineffective in response to the stresses of today's life.
2.    The workplace has become decentralized. In many places, people no longer work together in one place, but may be scattered around the world or work from home, connected by technology.
3.    People change with each generation. Baby Boomers differ from Generation Xers in terms of their values, work ethic, and their definitions of success. These generational differences contribute to stress at work.
How Stress Affects Women
Both genders experience stress. It affects women in some unique ways, however. Here are a few of them:
1.    Overall, women are still paid less than men for the same work.
2.    Women still face a glass ceiling as they climb the corporate ladder. A recent report stated that only 2% of the members of top management of North American corporations are women.
3.    Women who choose to have children are usually responsible for the logistics of child care.
4.    Women with children often do more housework when they get home than their husbands do.
5.    Compared with men, women with children also tend to experience more guilt feelings about leaving their children to go to work.

LETTING GO OF THE PAST

Letting Go of the Past

People have a difficult time letting go of the past because they are held back by unfinished business. They may regret choices they have made or feel guilty about past actions. As long as guilt and regret are not resolved, it is difficult to move forward.
The Regret Epidemic
Regret is an emotion that feels similar to depression or sadness. It also feels like guilt, but it isn't the same thing. Sometimes a wave of regret seems to come out of nowhere. You might become aware of it when you lose something or someone, or when you meet someone from your past. It is a common feeling in our culture for several reasons.
    1.    We have too many choices. Since we have so many options, there are many more opportunities to regret the paths we didn't take.
Example: When Linda was a senior at a major university, she interviewed with over 30 companies on campus. She was offered jobs in five different cities and had a difficult time choosing. In the end, she moved to Los Angeles and began an executive training program in a large company. A few years later, she began to wonder whether she had made the wrong choice. She thought she might have been better off in Kansas City, which had been her second choice. The regret leaves her feeling stuck and dissatisfied.
    2.    Endless possibilities. Another factor causing many of us to feel regret is that in the American culture, there is a belief that life has no limits. Our culture has an insatiable appetite for new experiences, adventure, and newness. When faced with the reality that certain things will not work out or change, we find it hard to accept.
Example: Karen has turned 45. She has never married and has no children. She has always believed that "There is always tomorrow" and "I have plenty of time to make my mark." But now, realizing that she may never be a mother and probably won't be the CEO of her company, she is feeling like life has passed her by.
    3.    No rules. Along with all of these options, our lives have become confusing because there are few guidelines for what choices we should make.
Example: Most women who have children struggle with the choices of what role employment should play in their lives, and many women feel like they made the wrong choice. Options include staying home with the children, working full-time at a demanding profession, or choosing a less demanding or part-time job.
Example: Many people feel compelled to continue on the ladder of success as long as they are being rewarded for it. When work becomes demanding and is no longer fun, it is hard to turn down promotions and pay increases in favor of less demanding, more satisfying work. People feel locked in to their career tracks and don't know how to get off the treadmill.
    4.    We value self-sufficiency. Our American culture has always valued independence. Somehow, we all get the message that it is better if we achieve our goals on our own, without the help of anyone else. The problem is that when we cannot accept support from others, we become isolated. Living a completely self-sufficient life violates the basic human need for affiliation.
Example: Matt's mother, Sarah, is 75. She is a widow and lives alone in an apartment in New York City. Matt left New York after finishing college and now lives in Florida. Sarah's friends are gradually moving to Florida, too. Matt has urged Sarah to move to a nearby condominium, and has even taken her to see a few of them. She resists, saying that she doesn't want to be a burden.
Meanwhile, Sarah is becoming increasingly isolated and depressed. She sits in her New York apartment and remembers the sunny condo she saw in Miami a few years back. She is filled with regret but won't change her mind. She feels like she has no choice but to remain independent and self-sufficient.
    5.    Instant gratification. Many people escape the pressures of daily life through drugs and alcohol. There are messages everywhere suggesting that we use alcohol and drugs to relax, escape, have fun, and be sexy. When this becomes a lifestyle, it often results in consequences that one can only regret: drunk driving, accidents, death and injury, relationship problems, poor attendance at work, or being fired.
    6.    Constant comparisons. When we compare our lives with others, it's easy to feel regret. Most of us expect ourselves to have it all together. We learn to act as if we are in control and compare ourselves with our friends, coworkers, neighbors, and the characters on television. When we don't look as good as they do, we feel like failures. We have a list of "shoulds" inside our heads-things we expect ourselves to be able 
to do.
Guilt
Guilt is usually the result of aggressive acts, wishes, and thoughts. It usually results from violating a rule-either our own or someone else's.
What to Do about Unfinished Business
If you want to move past the things in the past that are keeping you stuck-your unfinished business-you will need to acknowledge them and tell the truth about them. You don't necessarily have to take any action; sometimes just writing or talking about it is enough to lessen its impact. You can write about it in a private journal or talk about it with a trusted friend or counselor. Here are some places to look for your unfinished business:
    1.    Risks I should have taken
    2.    People I treated badly
    3.    People who treated me badly
    4.    Something I did to someone
    5.    Not doing something I should have done
    6.    Messes I need to clean up (literally and metaphorically)
    7.    Things I should throw away
    8.    Things I want to buy for my home
    9.    Things I want to buy for myself
    10.    Things I need but haven't allowed myself to have
    11.    Projects I've started but have not finished
    12.    Projects I want to start
    13.    Things I want to change
    14.    Things I want to stop doing
    15.    Things I want to be
    16.    Things I want to have
    17.    Experiences I want to have
    18.    Things I want to say
    19.    Feelings I have not expressed
    20.    Secrets I don't want to keep any longer

When Should You Consult a Mental Health Professional?

Most of us experience times when we need help to deal with problems and issues that cause us emotional distress. When you are having a problem or dilemma that is making you feel overwhelmed, you may benefit from the assistance of an experienced, trained professional. Professional counselors and therapists offer the caring, expert assistance that people need during stressful times.

There are many types of mental health providers to choose from. The most important thing is to select a professional who has the appropriate training and qualifications to help a person with your specific issues. You should also choose someone with whom you can feel comfortable enough to speak freely and openly.

Types of Problems

People seek the assistance of a mental health professional (MHP) for many different reasons. These are some of the most common:

1.    You feel unhappy most of the time.

2.    You worry all the time and are unable to find the solutions to your problems.

3.    You feel extremely sad and helpless.

4.    You feel nervous, anxious, and worried most of the time.

5.    You have panic attacks.

6.    You have a hard time concentrating.

7.    Your emotional state is affecting your daily life: your sleep, eating habits, job, and relationships.

8.    You are having a hard time functioning from day to day. Your emotional state is affecting your performance at work or school.

9.    Your behavior is harmful to yourself or to others.

10.    You are feeling impatient and angry with someone you are taking care of.

11.    You are having problems with your family members or in other important relationships.

12.    You or someone you care about has problems with substance abuse or other addictions.

13.    You are the victim of sexual abuse or domestic violence.

14.    You have an eating disorder.

15.    You are having trouble getting over the death of someone you loved.

16.    You or someone you love has a serious illness and you are having a hard time with it.

17.    You feel lonely and isolated.

18.    You are experiencing problems in a sexual relationship.

19.    Your family has a lot of conflict and tension.

20.    You are experiencing a divorce or marital separation.

21.    You are having a hard time coping with change.

22.    You often feel afraid, angry, or guilty.

23.    You have a hard time setting and reaching goals.

24.    Your child is having problems with behavior or school performance.

25.    Your family is stressed because someone is ill.

26.    You have a hard time talking with your partner, children, parents, family members, friends, or coworkers.

27.    You are having problems dealing with your own sexual orientation or the sexual orientation of someone you care about.

28.    You are planning to marry, and you have some concerns.

29.    You have gotten a divorce and your family needs help adjusting.

30.    You are part of a blended family and need help learning to live together.

When it is in the best interest of the patient or outside the scope of the MHP's license, therapists collaborate with and refer to other health professionals, such as physicians or psychiatrists in the case of prescribing medication.

Confidentiality

Each group of MHPs has strict ethical guidelines governing privacy and confidentiality. Clients of licensed MHPs can expect that discussions will be kept confidential, except as otherwise required or permitted by law. Examples of times when confidentiality must be broken are when child abuse has occurred or where the client threatens violence against another person.

When you are looking for a mental health professional to help you address your issues, it is very important to ask about a therapist's qualifications to treat your specific concerns.

Visit these web sites to learn more:

www.aamft.org (National Association of Marriage and Family Therapy)

www.apa.org (American Psychological Association)

www.naswdc.org (National Association of Social Work)

www.counseling.org (American Counseling Association)

Depression: What It Is and What to Do about It (Part 2)

Depression: What It Is and What to Do about It (Part II)

This is the second of a two-part series on depression. In this issue, I will describe how depression is treated and prevented. If you or someone close to you suffers from depression, it is important to educate yourself about it and seek treatment from qualified mental health professionals.

There are three basic ways to treat depression: psychotherapy, self-help, and medication. Many people respond best to a combination of two or more methods.

1.    Psychotherapy: Exploring one's beliefs and ways of thinking, and learning new ways of thinking and behaving, with the guidance of a professional.
2.    Self-help: Exploring one's beliefs and ways of thinking on one's own.
3.    Medication: Altering one's brain chemistry by taking antidepressant medication.

A physician may recommend medication when four conditions exist:

1.     The patient's depression is severe.
2.     The patient has suffered at least two previous depressive episodes.
3.     There is a family history of depression.
4.     The patient asks for medication only and refuses psychotherapy.

There are four types of antidepressant medication available today:

�    Tricyclic antidepressants (TCAs)
�    Monoamine oxidase inhibitors (MAOIs)
�    Selective serotonin reuptake inhibitors (SSRIs)
�    Structurally unrelated compounds

The TCAs and MAOIs have been used for decades. The SSRIs (such as Prozac) and structurally unrelated compounds are newer and are being prescribed more and more frequently. They have fewer and less pronounced side effects than the TCAs and MAOIs.

Treatment without Medicine

One of the leading methods for treating depression is cognitive therapy. Cognitive therapists help depressed clients feel better by identifying how faulty ways of thinking are making him or her feel bad. The client analyzes his or her thoughts and beliefs, and learns to substitute more healthy ways of thinking and believing.
Many mental health professionals believe that the ideal treatment of clinical depression is medication in conjunction with psychotherapy.

Prevention of Depression

Depression can often be prevented. It is especially important to take preventive action if you are aware that you have predisposing factors such as those mentioned in the last newsletter.

1.    Identify your risk factors and be aware of where you are vulnerable. Each of us has unique risk factors, such as things we were taught in our families of origin, values we have learned, and the presence or absence of a family history of depression. Anything that has been learned can be unlearned and replaced with something healthier.
2.    Learn to manage stress. You can learn proven techniques for calming and relaxing yourself. Consider taking a stress management class or buying a set of relaxation tapes.
3.    Learn problem-solving skills. Many people who develop depression never learned problem-solving skills. They need to develop the ability to see problems from many viewpoints and to look for a variety of solutions.
4.    Build your life around things you can control. Learn to recognize what you can control and what you can't. Avoid spending much effort on situations that won't pay off for you.
5.    Learn self-acceptance. Instead of rejecting the parts of yourself you don't like, learn to manage them more productively.
6.    Become aware of selective perception. Observe how you generate ideas and opinions about people and events. Remember that these are just your views, not necessarily objective facts.
7.    Focus on the future, not the past. Depressed people tend to be focused on the past. People who set goals and focus on the future tend to be more positive about life.
8.    Develop a sense of purpose. Many depressed people lack a sense of purpose or meaning. This means they have no goals and nothing in the future drawing them forward. To prevent depression, develop your sense of purpose and meaning.
9.    Strengthen your emotional boundaries and set limits. Boundaries define your role in a social situation. They determine how you will or won't behave in a given situation. Having clear, strong boundaries is empowering, while boundary violations make you feel victimized and helpless. Setting limits means having and enforcing rules for the behaviors you expect in a relationship.
10.    Build positive and healthy relationships. Think about what you need from others in relationships. Learn to read people and trust your instincts about which people are good for you.
11.    Avoid isolation. Talk to others about what's going on with you. If you keep your thoughts to yourself, you may be unaware that your thoughts are distorted. If you share them with another person, you can become more objective.


Signs That Professional Therapy Is Needed

1.    Thinking about death or suicide. This is always dangerous and you should see a professional therapist immediately.
2.    When symptoms of depression continue for a long time, you may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.
3.    Your ability to function is impaired by your depression. Seek help before your life situation deteriorates to a serious level.
4.    You have become so isolated that you have no one with whom to test reality. Seek someone out to share your thoughts and feelings with.
5.    Depressive symptoms have become severe.
Please call for an initial free consultation. 813-240-3237 We are here to help!

Depression: What It Is and What to Do about It (Part I)

This is the first of a two-part series on depression. In this issue, I will explore what depression is and what causes it. In the next issue, I will describe how depression is treated and prevented. If you or someone close to you suffers from depression, it is important to educate yourself about it and seek treatment from qualified mental health professionals.

Depression is a serious illness, not a harmless part of life. It is a complex disorder with a variety of causes. It is never caused by just one thing. It may be the result of a mix of factors, including genetic, chemical, physical, and sociological. It is also influenced by behavior patterns learned in the family and by cognitive distortions.

Depression affects millions of people in this country. It is always troubling, and for some people it can be disabling. Depression is more than just sadness or "the blues." It can have an impact on nearly every aspect of a person's life. People who suffer from depression may experience despair and worthlessness, and this can have an enormous impact on both personal and professional relationships. In this newsletter, I will describe many of the factors that may cause depression, and I will explore strategies for preventing it.

Depression Is Pervasive

When a person suffers from depression, it can affect every part of his or her life, including one's physical body, one's behavior, thought processes, mood, ability to relate to others, and general lifestyle.

Symptoms of Depression

People who are diagnosed with clinical depression have a combination of symptoms from the following list:

·    Feelings of hopelessness, even when there is reason to be hopeful

·    Fatigue or low energy

·    Much less interest or pleasure in most regular activities

·    Low self-esteem

·    Feeling worthless

·    Excessive or inappropriate guilt

·    Lessened ability to think or concentrate

·    Indecisiveness

·    Thinking distorted thoughts; having an unrealistic view of life

·    Weight loss or gain without dieting

·    Change in appetite

·    Change in sleeping patterns

·    Recurrent thoughts of death

·    Suicidal thoughts

·    A specific plan for committing suicide

·    A suicide attempt

·    Feelings of restlessness or being slowed down

When a person is suffering from depression, these symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. This means that the person's family and social relationships, as well as work life, are impaired.

When a person is suffering from depression, symptoms such as these are not the result of a chronic psychotic disorder, substance abuse, general medical condition, or bereavement.

Grief, Sadness, and Depression

Depression may include feelings of sadness, but it is not the same as sadness. Depression lasts much longer than sadness. While depression involves a loss of self-esteem, grief, disappointment and sadness do not. People who are depressed function less productively. People who are sad or disappointed continue to function.

Depression and Socioeconomic Factors

Depression does not seem to be related to ethnicity, education, income, or marital status. It strikes slightly more women than men. Some researchers believe that depression strikes more often in women who have a history of emotional and sexual abuse, economic deprivation, or are dependent on others. There seems to be a genetic link; depression is more common among parents, children, and siblings of people who are diagnosed with depression. The average age at the onset of a depressive episode is the mid-20s. People born more recently are being diagnosed at a younger age.

Physical Causes

Many physicians believe that depression results from a chemical imbalance in the brain. They often prescribe antidepressant medication, and many people find relief as a result. However, there is no reliable test to identify such a chemical imbalance. It is unknown whether life experiences cause mood changes, which create changes in brain chemistry, or whether it works in reverse.

Depression may be associated with physical events such as other diseases, physical trauma, and hormonal changes. A person who is depressed should always have a physical examination as part of the assessment process to determine the role of physical causes.

Signs That Professional Treatment Is Needed

If you or someone you know is depressed and exhibits any of the following signs, it is extremely important to seek the assistance of a medical or mental health professional.

1.    Thinking about death or suicide. This is always dangerous and you should see a professional therapist immediately.

2.    When symptoms of depression continue for a long time, you may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.

3.    Your ability to function is impaired by your depression. Seek help before your life situation deteriorates to a serious level.

4.    You have become so isolated that you have no one with whom to check reality. Seek out someone to share your thoughts and feelings with.

5.    Depressive symptoms have become severe.

In my next newsletter, I will discuss the treatment and prevention of depression.

Dealing With Midlife Issues

I would like to help explore the challenges and opportunities that come at midlife. Let’s take the opportunity to look at issues that are specific to the Baby Boomer generation and Generation X. We also have a chance to begin the process of your own midlife assessment with a list of questions presented at the end of this article. I call this assessment the Midlife Checkup.

Benefits of the Midlife Checkup

Taking the time to assess how your life is going at this point can result in benefits such as these:

·    It can help you identify and intensify your inner strengths.

·    You can find your own voice and express it your own way.

·    You can accept your changing physical self.

·    It is an opportunity to forgive those with whom you've been angry.

·    It can help you find ways to reduce stress.

·    You can learn to simplify your life.

·    You can reenergize yourself in preparation for the second half of your life.

Generation X or Gen X 

Generation X is the demographic cohort following the baby boomers and preceding the Millennials. There are no precise dates for when Generation X starts or ends. Demographers and researchers typically use birth years ranging from the early-to-mid 1960s to the early 1980s.

Members of Generation X were children during a time of shifting societal values and as children were sometimes called the "latchkey generation", due to reduced adult supervision as children compared to previous generations, a result of increasing divorce rates and increased maternal participation in the workforce, prior to widespread availability of childcare options outside the home. As adolescents and young adults, they were dubbed the "MTV Generation" (a reference to the music video channel of the same name). In the 1990s they were sometimes characterized as slackers, cynical and disaffected. Some of the cultural influences on Gen X youth were the musical genres of punk music, heavy metal music, grunge and hip hop music, and indie films. In midlife, research describes them as active, happy, and achieving a work–life balance. The cohort has been credited with entrepreneurial tendencies.

As young adults

In the 1990s, media pundits and advertisers struggled to define the cohort, typically portraying them as "unfocused twentysomethings". A MetLife report noted: "media would portray them as the Friends generation: rather self-involved and perhaps aimless...but fun." In France, Gen Xers were sometimes referred to as 'Génération Bof' because of their tendency to use the word 'bof', which translated into English means 'whatever". Gen Xers were often portrayed as apathetic or as "slackers", a stereotype which was initially tied to Richard Linklater's comedic and essentially plotless 1991 film Slacker. After the film was released, "journalists and critics thought they put a finger on what was different about these young adults in that 'they were reluctant to grow up' and 'disdainful of earnest action'."

Stereotypes of Gen X young adults also included that they were "bleak, cynical, and disaffected". Such stereotypes prompted sociological research at Stanford University to study the accuracy of the characterization of Gen X young adults as cynical and disaffected. Using the national General Social Survey, the researchers compared answers to identical survey questions asked of 18–29-year-olds in three different time periods. Additionally, they compared how older adults answered the same survey questions over time. The surveys showed 18–29-year-old Gen Xers did exhibit higher levels of cynicism and disaffection than previous cohorts of 18–29-year-olds surveyed; however, they also found that cynicism and disaffection had increased among all age groups surveyed over time, not just young adults, making this a period effect, not a cohort effect. In other words, adults of all ages were more cynical and disaffected in the 1990s, not just Generation X.

In 1990, Time magazine published an article titled "Living: Proceeding with Caution", which described those in their 20s as aimless and unfocused; however, in 1997, they published an article titled "Generation X Reconsidered", which retracted the previously reported negative stereotypes and reported positive accomplishments, citing Gen Xers' tendency to found technology start-ups and small businesses as well as Gen Xers' ambition, which research showed was higher among Gen X young adults than older generations. As the 1990s and 2000s progressed, Gen X gained a reputation for entrepreneurship. In 1999, The New York Times dubbed them "Generation 1099", describing them as the "once pitied but now envied group of self-employed workers whose income is reported to the Internal Revenue Service not on a W-2 form, but on Form 1099". In 2002, Time magazine published an article titled Gen Xers Aren't Slackers After All, reporting four out of five new businesses were the work of Gen Xers.

In 2001, sociologist Mike Males reported confidence and optimism common among the cohort saying "surveys consistently find 80% to 90% of Gen Xers self-confident and optimistic. In August 2001, Males wrote "these young Americans should finally get the recognition they deserve", praising the cohort and stating that "the permissively raised, universally deplored Generation X is the true 'great generation,' for it has braved a hostile social climate to reverse abysmal trends", describing them as the hardest-working group since the World War II generation, which was dubbed by Tom Brokaw as "The Greatest Generation". He reported Gen Xers' entrepreneurial tendencies helped create the high-tech industry that fueled the 1990s economic recovery.

In the US, Gen Xers were described as the major heroes of the September 11 terrorist attacks by demographer William Strauss. The firefighters and police responding to the attacks were predominantly Generation Xers. Additionally, the leaders of the passenger revolt on United Airlines Flight 93 were predominantly Gen Xers. Demographer Neil Howe reported survey data showed Gen Xers were cohabitating and getting married in increasing numbers following the terrorists attacks, with Gen X survey respondents reporting they no longer wanted to live alone. In October 2001, Seattle Post-Intelligencer wrote of Generation Xers: "now they could be facing the most formative events of their lives and their generation". The Greensboro News & Record reported Gen Xers "felt a surge of patriotism since terrorists struck" reporting many were responding to the crisis of the terrorist attacks by giving blood, working for charities, donating to charities, and by joining the military to fight The War on Terror. The Jury Expert, a publication of The American Society of Trial Consultants, reported: "Gen X members responded to the terrorist attacks with bursts of patriotism and national fervor that surprised even themselves".

In midlife

Google co-founder Sergey Brin, speaking at a Web 2.0conference

Guides regarding managing multiple generations in the workforce describe Gen Xers as: independent, resourceful, self-managing, adaptable, cynical, pragmatic, skeptical of authority, and as seeking a work life balance. In a 2007 article published in the Harvard Business Review, demographers Strauss & Howe wrote of Generation X; "They are already the greatest entrepreneurial generation in U.S. history; their high-tech savvy and marketplace resilience have helped America prosper in the era of globalization.” In the 2008 book, X Saves the World: How Generation X Got the Shaft but Can Still Keep Everything from Sucking, author Jeff Gordinier describes Generation X as a "dark horse demographic" which "doesn't seek the limelight". Gordiner cited examples of Gen Xers' contributions to society such as: Google, Wikipedia, Amazon.com and YouTube, arguing if Boomers had created them, "we'd never hear the end of it". In the book, Gordinier contrasts Gen Xers to Baby Boomers, saying Boomers tend to trumpet their accomplishments more than Gen Xers do, creating what he describes as "elaborate mythologies" around their achievements. Gordiner cites Steve Jobs as an example, while Gen Xers, he argues, are more likely to "just quietly do their thing".

In 2011, survey analysis from the Longitudinal Study of American Youth found Gen Xers to be "balanced, active, and happy" in midlife (between ages of 30 and 50) and as achieving a work-life balance. The Longitudinal Study of Youth is an NIH-NIA funded study by the University of Michigan which has been studying Generation X since 1987. The study asked questions such as "Thinking about all aspects of your life, how happy are you? If zero means that you are very unhappy and 10 means that you are very happy, please rate your happiness." LSA reported that "mean level of happiness was 7.5 and the median (middle score) was 8. Only four percent of Generation X adults indicated a great deal of unhappiness (a score of three or lower). Twenty-nine percent of Generation X adults were very happy with a score of 9 or 10 on the scale."

The Baby Boomers

The Baby Boomer generation is passing midlife (Give or take a few years) right now. This generation includes almost 78 million Americans born between 1946 and 1964.

The Boomers are the largest generation in U.S. history. They have had a major impact on American society as they have passed through every life stage. They are passing through midlife in their own unique way, differently from their parents and differently from Generation X, the group born in the years after 1964.

The first Boomer turned 50 at the beginning of 1996, and the remaining 78 million will observe this anniversary sometime between now and 2014.

Typical Feelings

According to Rocking the Ages authors J. Walker Smith and Ann Clurman (researchers at Yankelovich Partners) and authors like Gail Sheehy, people passing through middle age typically experience the following kinds of feelings.

Great expectations: Most Boomers are beginning to recognize their own limitations. Growing up in the comfortable 1950's, the Boomers learned to expect unlimited growth and endless possibilities. They believed their good luck would never end. Now that they are turning 50, many are shocked to discover that there are limits to life's possibilities.

Regret: As people reach midlife, they must face up to the loss of some of their dreams and regret the mistakes they have made. It is not easy for anyone to face the person one will never be.

Loss: At midlife, everyone has to face the loss of youth, valued by our society. In her book New Passages, author Gail Sheehy calls this experience "The Body Blues" or "The Vanity Crisis."

Meaning: According to Sheehy, the "universal preoccupation" of the middle years is "the search for meaning in whatever we do." As they face the fact that time is limited, the Baby Boomers typically become even more intent on this need to analyze and search for significance.

Change: The midlife years can be a time of radical change for many people. This is the result of endless questioning and evaluation of how one has lived life thus far. Many midlife crises become mid-life meltdowns, says Sheehy, because some people react to feelings of emptiness or disillusionment by destroying everything they have built.

The Boomers developed a value system that is based on a sense of entitlement and which values individuality. Because they hold these values, Boomers respond differently to each life stage than do other generations. You can see these values reflected in scenes like those from television shows from the 1950s and early 60s.

According to Smith and Clurman, four important characteristics of the Baby Boomer value system are:

Self-absorption: The Boomers (once called the "Me" Generation) have the reputation of being more narcissistic than other generations. Because of the times they grew up in, they have always been fascinated with themselves. The indulgence they experienced at home in the 1950s and the world's seemingly limitless possibilities created a fascination with self and a feeling of specialness.

Sense of entitlement: As a generation, the Boomers see themselves as superior to others. They have always assumed that they could have life their way and that the rules were meant for others, but not for them. They feel entitled to rewards and view themselves as winners. They expect success and cannot accept failure.

Need for control: The Boomers need to feel certain and to sense that they are in control of life. They have a difficult time dealing with uncertainty.

Reflection: Baby Boomers have always valued introspection and take pleasure in asking questions.

For most people, life at age 45 or 50 doesn't match the dreams they had at age 20 or 30. When people reach age 45 or 50 and are even slightly disappointed by their achievements and experiences, their feelings are likely to be compounded by these factors of self-absorption, sense of entitlement, and a need for control. But there is also a positive side to this. The tendency to reflect and explore can help one look for new possibilities instead of being stuck with feelings of disappointment.

Keep all of this in mind as you complete the Midlife Checkup. It is a list of 29 unfinished sentences that will help you assess your life to date. The items on this list provide a framework for conducting your own assessment. Please add your own ideas that you think will help you reflect on your life's direction.

The Midlife Checkup

    1.    My most important accomplishments are...

    2.    I am disappointed about...

    3.    I would describe the person I turned out to be as...

    4.    I want to change the following things about my self and my life...

    5.    Things I want to do before I die...

    6.    If I knew I couldn't fail, I would...

    7.    Things I have mastered...

    8.    Things I want to keep...

    9.    I want to keep these relationships...

    10.    I want to let go of these relationships...

    11.    I want to keep these possessions...

    12.    I want to let go of these possessions...

    13.    I want to have these experiences...

    14.    I want to clean up these messes...

    15.    I want to celebrate...

    16.    I don't ever again want to...

    17.    My body is...

    18.    My children are...

    19.    My parents are...

    20.    My spouse is...

    21.    I want to remember...

    22.    I want to forget...

    23.    I must apologize to...

    24.    I must seek an apology from...

    25.    I am most proud of...

    26.    I wish I could forget about...

    27.    I wish I could do over...

    28.    I wish I had never...

    29.    I wish I had...

    30.    Add your own items:

Non Violent Communication

1. Nonviolent Communication®

Nonviolent Communication® was developed in the sixties of the twentieth century by Dr. Marshall Rosenberg – a student of Carl Rogers. Rosenberg, born in 1934 in the USA and of Jewish religion, grew up in an inner-city Detroit neighborhood where he was confronted with various forms of violence, including race riots with deaths. This triggered his desire to explore what exactly happens when people behave violently, and conversely, what allows some people to stay compassionate and human under even the most trying circumstances (Rosenberg 2000, pp. xi-3). He chose to study clinical psychology and received his Ph.D. in Clinical Psychology from the University of Wisconsin in 1961.

While studying the factors that affect our ability to stay compassionate, I was struck by the crucial role of language and our use of words’ (Rosenberg 2000, p. 2).

In the wake of these findings he developed an approach to communicating that enables people to connect with themselves and with others in a way that allows their natural compassion to flourish. He called his approach Nonviolent Communication®.

Nonviolent Communication® is based on the vision of a world in which everybody’s needs are taken into consideration and people give and take with joy. The primary goal of NVC® is to help people connect with themselves and others.

Nonviolent Communication® (shortened NVC®) is based on the assumption that…

• Needs are the ‘motor’ of all human behavior, i.e. that all activities of people are attempts to meet needs.

• All people have the same needs, e.g. autonomy, reliability, freedom, peace.

• Violence (including verbal violence) is an expression of unmet needs.

• Our feelings are signals whether needs are met or not.

• All people have the potential (but in many cases not the knowledge and skills) to empathize with themselves and others.

(Richter-Kaupp, course notes, International Intensive Training with Marshall Rosenberg, August 2002, Switzerland)

For many people the NVC® communication model is easy to understand but difficult to put into action. It requires the following three core skills:

1. Self-empathy: The ability to empathize with oneself.

2. Sincerity: The ability to sincerely express oneself in a way that increases the willingness of the other person to listen and respond to what is said.

3. Empathy: The ability to be present and empathize with the other person.

In order to facilitate these skills, the NVC® model suggests the following steps:

Needs are universal and enable people to connect with each other. They therefore play a central role in the NVC® model. Each and every person on earth – no matter what age, gender or cultural origin – at least at times wants to be heard, accepted, trusted, respected, to name just a few. Feelings act as a signaler, because they point us to those needs which are currently being met or unmet.

Learn more by watching this 12 Min. Video: Be CLEAR About What You WANT | Marshall Rosenberg

https://www.youtube.com/watch?v=xxiO4HnoiVQ

Why Am I So Anxious?

Why Am I So Anxious?

Fact: You Cannot Be Anxious and Relaxed At The Same Time! Therefore, the antidote to anxiety = relaxation...

Every human feels anxiety on occasion; it is a part of life. All of us know what it is like to feel worry, nervousness, fear, and concern. We feel nervous when we have to give a speech, go for a job interview, or walk into our boss's office for the annual performance appraisal. We know it's normal to feel a surge of fear when we unexpectedly see a photo of a snake or look down from the top of a tall building. Most of us manage these kinds of anxious feelings fairly well and are able to carry on with our lives without much difficulty. These feelings don't disrupt our lives.

But millions of people (an estimated 15% of the population) suffer from devastating and constant anxiety that severely affects their lives, sometimes resulting in living in highly restricted ways. These people experience panic attacks, phobias, extreme shyness, obsessive thoughts, and compulsive behaviors. The feeling of anxiety is a constant and dominating force that disrupts their lives. Some become prisoners in their own homes, unable to leave to work, drive, or visit the grocery store. For these people, anxiety is much more than just an occasional wave of apprehension.

Types of Anxiety Disorders

An anxiety disorder affects a person's behavior, thoughts, feelings, and physical sensations. The most common anxiety disorders include the following:

Social anxiety or social phobia is a fear of being around other people. People who suffer from this disorder always feel self-conscious around others. They have the feeling that everyone is watching them and staring at them, being critical in some way. Because the anxiety is so painful, they learn to stay away from social situations and avoid other people. Some eventually need to be alone at all times, in a room with the door closed. The feeling is pervasive and constant and even happens with people they know.

People who have social anxiety know that their thoughts and fears are not rational. They are aware that others are not actually judging or evaluating them at every moment. But this knowledge does not make the feelings disappear.

Panic disorder is a condition where a person has panic attacks without warning. According to the National Institutes of Mental Health, about 5% of the adult American population suffers from panic attacks. Some experts say that this number is actually higher, since many people experience panic attacks but never receive treatment.

Common symptoms of panic include:

·    Racing or pounding heart

·    Trembling

·    Sweaty palms

·    Feelings of terror

·    Chest pains or heaviness in the chest

·    Dizziness and lightheadedness

·    Fear of dying

·    Fear of going crazy

·    Fear of losing control

·    Feeling unable to catch one's breath

·    Tingling in the hands, feet, legs, or arms

A panic attack typically lasts several minutes and is extremely upsetting and frightening. In some cases, panic attacks last longer than a few minutes or strike several times in a short time period.

A panic attack is often followed by feelings of depression and helplessness. Most people who have experienced panic say that the greatest fear is that the panic attack will happen again.

Many times, the person who has a panic attack doesn't know what caused it. It seems to have come "out of the blue." At other times, people report that they were feeling extreme stress or had encountered difficult times and weren't surprised that they had a panic attack.

Generalized anxiety disorder is quite common, affecting an estimated 3 to 4% of the population. This disorder fills a person's life with worry, anxiety, and fear. People who have this disorder are always thinking and dwelling on the "what ifs" of every situation. It feels like there is no way out of the vicious cycle of anxiety and worry. The person often becomes depressed about life and their inability to stop worrying.

People who have generalized anxiety usually do not avoid situations, and they don't generally have panic attacks. They can become incapacitated by an inability to shut the mind off, and are overcome with feelings of worry, dread, fatigue, and a loss of interest in life. The person usually realizes these feelings are irrational, but the feelings are also very real. The person's mood can change from day to day, or even hour to hour. Feelings of anxiety and mood swings become a pattern that severely disrupts the quality of life.

People with generalized anxiety disorder often have physical symptoms including headaches, irritability, frustration, trembling, inability to concentrate, and sleep disturbances. They may also have symptoms of social phobia and panic disorder.

Other types of anxiety disorders include:

Phobia, fearing a specific object or situation.

Obsessive-compulsive disorder (OCD), a system of ritualized behaviors or obsessions that are driven by anxious thoughts.

Post-traumatic stress disorder (PTSD), severe anxiety that is triggered by memories of a past traumatic experience.

Agoraphobia, disabling fear that prevents one from leaving home or another safe place.

Treatment Options

Most people who suffer from anxiety disorders begin to feel better when they receive the proper treatment. It can be difficult to identify the correct treatment, however, because each person's anxiety is caused by a unique set of factors. It can be frustrating for the client when treatment is not immediately successful or takes longer than hoped for. Some clients feel better after a few weeks or months of treatment, while others may need a year or more. If a person has an anxiety disorder in combination with another disorder (such as alcoholism and depression), treatment is more complicated and takes longer.

While a treatment plan must be specifically designed for each individual, there are a number of standard approaches. Mental health professionals who specialize in treating anxiety most often use a combination of the following treatments. There is no single correct approach.

Cognitive Therapy

The client learns how to identify and change unproductive thought patterns by observing his or her feelings and learning to separate realistic from unrealistic thoughts.

Behavior Therapy

This treatment helps the client alter and control unwanted behavior. Systematic desensitization, a type of behavior therapy, is often used to help people with phobias and OCD. The client is exposed to anxiety-producing stimuli one small step at a time, gradually increasing his or her tolerance to situations that have produced disabling anxiety.

Relaxation Training

Many people with anxiety disorders benefit from self-hypnosis, guided visualization, and biofeedback. Relaxation training is often part of psychotherapy.

Medication

Antidepressant and antianxiety medications can help restore chemical imbalances that cause symptoms of anxiety. This is an effective treatment for many people, especially in combination with psychotherapy.

The treatment for an anxiety disorder depends on the severity and length of the problem. The client's willingness to actively participate in treatment is also an important factor. When a person with panic is motivated to try new behaviors and practice new skills and techniques, he or she can learn to change the way the brain responds to familiar thoughts and feelings that have previously caused anxiety.

How Psychotherapy Retrains the Brain to Expect (and Feel) Better

People enter psychotherapy with the desire to feel better, but they are often unsure how therapy will help them accomplish this goal. A common refrain from people hesitant to enter therapy is, “How is talkinggoing to help?” People are used to talking to other people to get practical solutions to problems, and while problem-solving does have a place in therapy, change also occurs on a much deeper and unconscious level. This process has to do with the way the human brain is programmed and cannot easily be mimicked outside of a relationship with a psychotherapist.

Our brains are always evolving unconsciously through our relationships. People who experienced painful relationships growing up have been trained to expect hurtful experiences with others. It takes a new type of relationship—in particular, a therapeutic relationship—to retrain the brain to expect more positive experiences, which is a big part of ultimately feeling better. 

WHY CAN’T A THERAPIST JUST TELL ME WHAT TO DO?

To understand why the therapeutic relationship can be so valuable and cannot be mimicked by, for example, advice in a self-help book, it is instructive to look at how the human brain has evolved. Broadly, there are three parts of the human brain that represent different phases of evolution: There is the reptilian brain, which evolved first and is responsible for the automatic control of vital bodily functions such as breathing; the limbic brain, which evolved second and is responsible for the regulation of emotion and behavior; and the neocortex, which evolved last and is responsible for higher-order functions such as symbolic thought, language, and reasoning.

When a person asks their therapist or a friend what they should do about something, they are essentially asking for a neocorticol solution—something that is rational and can be consciously implemented. Often, however, their problems are a result of hurtful experiences in their earlier relationships that have caused changes in their limbic brain, and only a new type of relationship can alter their limbic brain to produce fewer negativeemotionsand more positive ones.

BRAIN WIRING IN OUR YOUTH: HOW EMOTIONAL ISSUES BEGIN

Our emotions are meant to help us survive in a world in which we need the help of others. Over time, our limbic brains evolved to automatically create emotions, such as anger and sadness, that are meant to help us navigate the social world. When someone mistreats us, evolution has programmed us to become angry to try and change their behavior. When someone rejects us, we feel sad so we can mourn the loss of what we wanted with them and move forward with our lives.

However, when we are young and particularly dependent on others for survival, whether our emotions actually help us navigate the world has a lot to do with how other people—our parents in particular—respond to them. A child who responds to unfair or disappointing experiences with anger and is further punished for doing so may, over time, come to unconsciously pair the expression of anger with pain. As this occurs, rather than directly experiencing anger at times of unfair treatment or disappointment, they may instead experience anxiety about having anger because their brain has been trained by their social environment to expect that anger will hurt rather than help. Their limbic system is in effect attempting to prevent further emotional pain in the form of being punished, but the cost is another type of emotional pain in the form of persistent anxiety. This can be particularly problematic when people enter into new relationships (friendships, romantic relationships) where there would not be the same costs associated with the open expression of an emotion like anger, but earlier experiences still create anxiety and inhibit its expression.

RETRAINING THE BRAIN WITH PSYCHOTHERAPY

A psychotherapy relationship allows a person to essentially retrain their limbic system to no longer expect negative reactions to the expression of certain emotional experiences, and in doing so can alleviate the anxiety and unconscious emotional suppression their earlier experiences programmed into them. The therapeutic relationship does this in part because the parameters of psychotherapy recreate the type of relationship in which a person was first forced to suppress their emotions: one where they are dependent on another person to meet their needs.

A successful course of therapy helps restore a person’s emotional flexibility and empowerment so they can have greater agency in their relationships.

Just as a parent has a daunting task in meeting all of a child’s needs, so too does a psychotherapist, especially since many people arrive to therapy wanting a conscious, rational solution to their problems when such a solution often does not exist. Therapy presents a unique opportunity to heal and feel better by the way the therapist solicits and responds to feelings such as disappointment, anger, and sadness that emerge over the course of treatment. Rather than punishing a person for having these emotional experiences in the same way that may have occurred when they were younger, a therapist can actively solicit, explore, and normalize their feelings. This helps to retrain a person’s limbic system to no longer pair the expression of those emotions with punishment. As this de-coupling unconsciously occurs, the person becomes more easily able to tolerate the experience and expression of emotions.

THRIVING IN ADULTHOOD

This shift in tolerance for emotions naturally causes a person’s anxiety level to diminish because their mind is no longer fighting to ward off their innate emotional impulses. In addition to symptom relief, the beautiful part of this process is it restores a person’s ability to constructively access their emotions for their original purpose—as a way of helping to navigate the social world. It is hard to thrive in relationships when we have been programmed to believe we must accept the mistreatment of others or that we cannot show others when we are hurting and in need of care. As adults, this is often no longer the case, but our early experiences may make such underlying beliefs unconsciously feel true.

A successful course of therapy helps restore a person’s emotional flexibility and empowerment so they can have greater agency in their relationships. The result can be genuinely transformative, and studies suggest people who have been through therapy show less activity in the areas of the brain responsible for creating negative emotions. Talking, it turns out, can help quite a bit when the person you are talking to is a skilled and compassionate therapist.

If you’re struggling, reach out to a therapist in your area for help.

References:

1. Bowlby, J. (2005). A secure base: Clinical applications of attachment theory (Vol. 393). UK: Taylor & Francis.
2. Cozolino, L. (2010). The neuroscience of psychotherapy: Healing the social brain. New York, NY: W.W. Norton & Company.
3. Damasio, A. R. (2006). Descartes’ error. New York, NY: Random House.
4. Grecucci, A., Theuninck, A., Frederickson, J., & Job, R. (2015). Mechanisms of social emotion regulation: From neuroscience to psychotherapy. In Emotion regulation: Processes, cognitive effects and social consequences, pp.57-84.
5. Karlsson, H. (2011). How psychotherapy changes the brain: Understanding the mechanisms. Psychiatric Times, 21.
6. Lewis, T., Amini, F., & Lannon, R. (2007). A general theory of love. New York, NY: Vintage.
7. MacLean, P. D. (1990). The triune brain in evolution: Role in paleocerebral functions. Berlin: Springer Science & Business Media.