Creating Sustainable Change

What motivates people to change? While many people know what they need to do to be healthier and happier, the majority of people don’t act on that knowledge. There’s a disconnect between what they know and what they do. For some reason, in looking at life’s priorities, many people do not place health and happiness high enough up the list to be an active participant in making it happen.

There’s a new field of behavioral research that has produced a set of ideas called Self-Determination Theory (SDT). The focus of this research is on how people actually make positive changes in their lives – changes like quitting smoking, losing weight, and becoming physically active. It’s important for people to understand this because your state of health depends more on what you do and don’t do every day of your life, than on anything else.

What do people need to change? Psychologists have identified three things human beings need to change for the better.

  1. AUTONOMY-an individual needs to feel that s/he is making their own decisions and for their own reasons.
  2. COMPETENCE-an individual needs to feel confidence in their ability to change, and in the availability of help if they need it.
  3. RELATEDNESS-an individual is more likely to make changes when they feel a personal connection with a practitioner, friend, or family member who makes the individual feel respected, understood, and cared for.

 Research coming out of the field of SDT is showing that some reasons for change work better than others. Profound reasons for change work better than more superficial ones. For example, obese people who were motivated to lose weight by the desire to be more healthy, lost more weight and maintained their weight loss better than those who said they were motivated by the wish to look more attractive. SDT has identified intrinsic goals such as personal growth, physical health, and good relationships as being more satisfying goals than the extrinsic ones of being more attractive, acquiring wealth, or having fame.

Frequently, the process of change begins with helping someone to first identify their most heartfelt goals. By developing  an awareness of one’s intrinsic goals and achieving an alignment of one’s behavior with deeply held goals and values, motivation is successful in helping people achieve and maintain long-lasting change.

Genetics Most Important Factor in Compulsive Hoarding

Pauline Anderson

August 27, 2009 — Genetic factors contribute to at least half of all compulsive hoarding, a new study suggests.

In the first twin study to examine hoarding, investigators at the Institute of Psychiatry in London in the United Kingdom found that genetics accounted for approximately 50% of the variance in compulsive hoarding and that rates among male twins (4.1%) were double those in female twins. Severe hoarding is not just collecting stamps or coins, it is the accumulation of so many mostly worthless possessions, and being unable to discard them, that carrying out normal activities at home is difficult.

Although previous research has shown that hoarding runs in families, researchers were uncertain of the extent of its heritability, said study investigator David Mataix-Cols, PhD. “This is the first study that actually tells us that a big proportion of this condition is due to genes. But it’s clearly not only genes — you need some environmental factors as well,” he told Medscape Psychiatry.

The study was published online August 17 in the American Journal of Psychiatry.

The study included monozygotic and dizygotic twins from the TwinsUK adult twin registry. Started in 1993, the registry consists of Caucasian twins aged 16 years and older from all over the United Kingdom. Researchers sent the Hoarding Rating Scale–Self Report (HRS-SR) questionnaire to all 8313 active twins in the registry.

More Prevalent in Men

The hoarding prevalence was significantly higher among men (4.1%) than women (2.1%). This contrasts with the higher number of women seen in clinical practice, perhaps because many more women seek treatment, said Dr. Mataix-Cols. To determine genetic and environmental influences on hoarding, the researchers used a subsample of 4355 women. They determined that genetic factors accounted for at least 50% of the variance in compulsive hoarding. In addition, Dr. Mataix-Cols said, nonshared environmental factors that include such things as abuse, along with measurement error, accounted for much of the rest of the variance in compulsive hoarding.

“We know from the literature that sexual assault or a history of abuse and traumatic experiences in general are common in compulsive hoarding,” said Dr. Mataix-Cols. It is possible that traumatic experiences interact with genes to trigger compulsive hoarding, he added. In contrast, the study showed that shared environmental factors — parental practices, for example — did not contribute to individual differences in the likelihood of compulsive hoarding.

Loss and Abandonment

Some research has suggested that compulsive hoarders are trying to fill a gap in their lives. Loss and abandonment are certainly recurring themes for many patients with hoarding problems, said Dr. Mataix-Cols. “There are lots of reports of loss in these people: they talk about the death of relatives, they talk about losing their homes.”

Compulsive hoarding is often considered a symptom of obsessive-compulsive disorder, although in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, it is only mentioned as a symptom of compulsive personality disorder. There is a push in some circles to have it included as a separate condition in the next version of the manual. “What has become quite clear now is that a large proportion of severe hoarders, probably more than half, do not meet strict criteria for obsessive-compulsive disorder,” said Dr. Dr. Mataix-Cols.

House of Clutter

Typically, patients with a compulsive hoarding problem have covered virtually all surfaces of their home with clutter. They sometimes cannot sleep in their bed, take a shower, or cook because of clutter and are often too ashamed to invite people into their homes. “One patient described it to me as C.H.A.O.S., which is an acronym for Can’t Have Anyone Over Syndrome,” said Dr. Mataix-Cols. Extreme cases can result in injury or even death. Patients have been known to be crushed when large possessions fall on them or to get burned when a fire breaks out amidst paper clutter. Newspapers, magazines, books, letters, and lists are some of the most commonly hoarded items, along with old clothing.

Asked by Medscape Psychiatry to comment on the study, Joe Bienvenu, MD, associate professor of psychiatry, Johns Hopkins University, Baltimore, Maryland, described it as “exciting.” “It tells us something that our group and other groups have suspected based on family studies — that what’s running in these families is not mediated by having a shared environment, and so it argues for some kind of genetic mechanism.” However, he said the study did not convince him that compulsive hoarding is a condition separate from obsessive-compulsive disorder. When talking about people who feel an illogical urge to hoard, “it’s hard for me to imagine what the form of this thing is, if not obsessive compulsive in nature,” he said. He is also not convinced that more men suffer compulsive hoarding. He pointed out that perhaps proportionately, “the men who filled out the questionnaire had a higher prevalence [of hoarding] than the men in the population.”

Slowing the Progress of Alzheimer’s

The memory loss and other cognitive changes of Alzheimer’s disease can’t be reversed. But there are some proven ways to delay further decline, at least over the short term.

Mental Activity

A growing body of research indicates that stimulating the brain has the power to slow the progress of Alzheimer’s, particularly in the early stages. Healthy elderly adults who are mentally active were 2.6 times less likely to develop dementia, according to the Rush Memory and Aging Project, an ongoing longitudinal study involving more than 1,200 older people.

What you can do:

Encourage your parent to participate in activities she finds pleasurable, especially those that engage the mind: reading, writing, playing the piano, working crosswords or puzzle books, playing games such as chess, or even learning a language. Present your parent with fresh materials or plenty of opportunities.

Local senior centers and adult daycare programs are more than just a way to “pass the time.” They excel at providing stimulating activities, including group storytelling, music, art, and games. Some research suggests that activities are especially protective when they involve interacting with others. Healthy people who are socially active tend to have fewer memory problems than those who are more reclusive.

Give your parent help around the home, but avoid relieving your parent of all their customary responsibilities. Participating in daily chores can be a form of mental workout, too.

The catch with mental stimulation:

It’s important that your parent find the activity pleasurable. If they find studying Spanish or learning to use a computer frustrating because of existing cognitive declines, don’t push it. Also avoid formal mental “exercises” or memory drills. They may stress your parent, causing symptoms to worsen.

Too much social activity can also be stressful. Outings are best when low-key (small dinners as opposed to, say, big parties) and last under two hours.

Daily Life Modifications

Simplifying your parent’s living environment and providing the tools to assist her existing memory can help her maintain independence longer. This has the benefit of reducing stress and slowing further decline.

What you can do:

Find ways to minimize any tasks your parent may worry about. For example, you could arrange electronic bill paying, hire a lawn service, enlist a young neighbor to handle her laundry, or cancel subscriptions to magazines they never read. Help keep the home free of piled-up newspapers, old mail, and other clutter. Look into electronic reminder systems, note-keeping systems, or commercially available tools that can help to prop up a faulty memory.

The catch with daily life modifications:

Be sure to make changes gradually. Too many abrupt changes — removing all the clutter from a messy home in one sweep, for example — can be disorienting and stressful to someone with Alzheimer’s and hasten their decline rather than slowing it.

Routine and Familiarity

The stimulation of fresh ideas can have positive effects, but too much change in your parent’s life can be confusing and disorienting. Familiarity is very important to someone with Alzheimer’s disease. The stress of having to cope with sudden or significant change can make symptoms worse. (Note: Stress doesn’t cause Alzheimer’s, but it has been shown to worsen symptoms in those already affected.)

What you can do:

Try to give your parent’s day a regular rhythm, with meals, sleep, outings, and bathing happening at about the same times each day. Schedule all doctors’ appointments at roughly the same time if you can, such as first thing in the morning or right after lunch. It’s not unlike the way a new parent organizes the day around a baby’s sleep-wake cycle.

The catch with routines:

A good routine is one that’s healthy to begin with. Examples of negative routines worth trying to change: If your parent is staying awake later and later and rising later, or if they have dropped all former social connections and rarely see anyone.

Vitamins and Herbs

Scientists are investigating several different dietary additions for people with dementia. Two of the most promising areas are antioxidants and gingko biloba.

Antioxidants and Gingko Biloba:

A clinical trial showed that vitamin E helps slow down mental impairment in people with Alzheimer’s. Vitamin E is an antioxidant, which helps protect cells against damage. It’s now being researched in conjunction with B vitamins. A 2005 study found that healthy people who consumed more than 400 micrograms (the recommended daily amount for adults) of folate, a B vitamin that occurs naturally in many foods, cut their risk of developing Alzheimer’s in half.

Gingko biloba is sometimes called the “memory herb,” after findings that it appears to help slow down cognitive decline for some people in the early stages of Alzheimer’s disease. To date, research studies making this claim have been criticized, however, and a randomized clinical trial sponsored in part by the National Institute on Aging and the National Center for Complementary and Alternative Medicine will be completed in late 2009.

What you can do:

Encourage your parent to inform their primary-care doctor about any supplements and herbs they have been taking, and their dosages, and do so yourself if they don’t. Bring the bottle so the doctor can see exactly what’s being taken. Too much vitamin E, for example, can cause gastrointestinal problems and other side effects, and can be fatal to people with heart disease. A recent study found that Alzheimer’s patients who most closely followed a Mediterranean-style diet (high in vegetables, legumes, cereals, fruit, fish, poultry, dairy, and monounstaturated fats — and low in saturated fats) lived an average of 1.3 years longer than those who consumed a Western diet (higher in saturated fats and meats, lower in vegetables).

Try to make sure that your parent is eating a diet low in saturated fats and rich in vitamins E, C, and B. Older people’s diets often lack fresh fruits and vegetables (such as citrus, berries, and leafy green vegetables), legumes (beans), whole-wheat or fortified bread, and nuts and seeds.

The catch with vitamins and herbs:

The one thing scientists agree on concerning memory loss and supplements is that more research is needed. No single “magic bullet” has been found to stop memory decline in its tracks, and no supplements should be taken by people with Alzheimer’s without medical supervision.


Five FDA-approved drugs are used to delay the symptoms of Alzheimer’s disease or prevent them from becoming worse for a limited time.

What you can do:

Talk to your parent’s doctor about which drugs might be appropriate. For mild to moderate Alzheimer’s, cholinesterase inhibitors — such as Aricept (donepezil), Exelon (rivastigmine), and Razadyne (galantamine), formerly called Reminyl — may be prescribed. These medications help keep the enzyme acetylcholinesterase from reducing acetylcholine, which affects mental capabilities and muscle control. The drug Cognex (tacrine hydrochloride) was prescribed in the past, but is no longer recommended.

For moderate to severe stages, the drug Namenda (memantine) is also used. This drug is an N-methyl-D-aspartate (NMDA) receptor antagonist, which regulates glutamate (a chemical messenger in the brain that’s associated with learning and memory).

The catch with medications:

Not every drug works for all patients. And each involves possible side effects and interactions with other drugs your parent may be taking. Talk to your parent’s doctor about whether any of these medications is a good fit.


Overcoming Fears

Overcoming Fears

Cognitive-Behavioral Therapy teaches clients with unusual fears and phobias that the best way to overcome their anxieties is through exposure to the situations that they fear. The original technique was to show clients relaxation techniques that they could utilize to make fearful situations more tolerable and then overcome the natural reluctance to experiencing the associated anxiety. By placing themselves in the fear producing situation often enough, the client learns that the thing they fear will not overwhelm them, the consequences they fear do not actually occur, and that their fears become more manageable or dissipate altogether.

New research is showing that there may be a more effective technique.

The problem with the original technique is that to become used to the fear producing situation, a client must experience the situation often enough, long enough, and with sufficient intensity to learn to tolerate the situation, without anxiety. A client that is relaxed may not experience enough displeasure to fully habituate to the experience. Their brain doesn’t re-learn how to tolerate the fear producing situation.

The new approach with clients is to change their basic orientation toward their fear producing situations. Instead of teaching them to avoid feeling anxious, the protocol asks them to not only try to get anxious, but to WANT to get anxious. They learn to not tolerate their discomfort, but to desire that the discomfort stay long enough for them to learn a new way of experiencing the situation. Clients are taught how to be excited when they notice they feel apprehensive and uncertain in fear producing situations. This strategy teaches them to confront their old mind set that anxiety is bad and should be avoided or stopped as soon as is possible.

Research is showing that this approach is effective in helping clients quickly learn how not to feel afraid, rather than simply learning how to tolerate and/or manage their fears.

Research links Alzheimer’s and Dementia with Being Overweight

Here is the startling bottom line: Heavy people’s brains may age faster.

If you’re overweight or obese in middle age, it can have a devastating effect on your health by causing you to age far faster than normal. According to a study from the San Francisco VA Medical Center, being overweight in your 40s and 50s causes a lower level of certain brain chemicals that signal good brain health and function. Without these chemicals, the brain’s aging process speeds up, putting you at a significantly higher risk of Alzheimer’s disease and dementia.

The study: Led by Dr. Stefan Gazdzinski, the researchers examined magnetic resonance imaging (MRI) brain scans from 50 healthy middle-aged men and women, measuring amounts of a variety of chemicals in the white and gray matter of the brain, reports Reuters. Bodies of nerve cells make up the gray matter, while connections between these cells make up the white matter. Of the 50 participants, five were obese, 15 were overweight and 30 were of normal weight.

The results: The higher a person’s body mass index (BMI), the ratio of body height to weight, the lower the concentration of N-acetyl-aspartate (NAA), a brain chemical that serves several functions and also acts as a marker for overall brain health, in the white matter of the brain’s frontal, temporal and parietal regions, reports Reuters. In addition, overweight and obese people had less NAA in their frontal gray matter, as well as smaller concentrations of choline-containing metabolite, which are substances that are key to the formation of cell membranes, in their frontal white matter.

The strongest relationship between BMI and brain chemistry was seen in the white matter of the frontal region, which is believed to be particularly vulnerable to aging-related damage, reports Reuters.

Rate of Divorce Falls to an All-time LOW

Despite the common notion that America remains plagued by a divorce epidemic, the national per capita divorce rate has declined steadily since its peak in 1981 and is now at its lowest level since 1970. Yet Americans aren’t necessarily making better choices about their long-term relationships. Even those who study marriage and work to make it more successful can’t decide whether the trend is grounds for celebration or cynicism.

Some experts say relationships are as unstable as ever – and divorces are down primarily because more couples live together without marrying. Other researchers have documented what they call “the divorce divide,” contending that divorce rates are indeed falling substantively among college-educated couples but not among less-affluent, less-educated couples. “Families with two earners with good jobs have seen an improvement in their standard of living, which leads to less tension at home and lower probability of divorce,” said Andrew Cherlin, a professor of public policy at Johns Hopkins University.

America’s divorce rate began climbing in the late 1960s and skyrocketed during the ’70s and early ’80s, as virtually every state adopted no-fault divorce laws. The rate peaked at 5.3 divorces per 1,000 people in 1981. Since then it’s dropped by one-third, to 3.6. That’s the lowest rate since 1970.

What’s fueling that decline? According to 20 scholars, marriage-promotion experts and divorce lawyers consulted by The Associated Press, a lot of things. The number of couples who live together without marrying has increased tenfold since 1960; the marriage rate has dropped by nearly 30 percent in past 25 years; and Americans are waiting about five years longer to marry than they did in 1970.

Adding such factors together, Patrick Fagan of the conservative Heritage Foundation sees a bad situation. “Cohabitation is very fragile, and when unmarried parents split, for the child it might as well be a divorce,” Fagan said. “Among those who are marrying there’s increased stability, but overall the children of the nation are getting a rawer and rawer deal from their parents.” Other experts, however, are heartened by what they view as the increased determination of many couples to make marriage work. Among them is Bill Chausee of Child and Family Services of New Hampshire, which offers marriage-strengthening programs in a state where divorces dropped more than 25 percent between 2000 and 2005. “People don’t see marriage problems as some sort of stigma any more,” said Chausee. “They’re really interested in learning how to stay married; a lot of them are realizing they need more skill.”

Some states have made concerted efforts to combat divorce with publicly funded marriage education campaigns, although their effectiveness remains in question. In Oklahoma, 100,000 people have attended workshops since a marriage initiative began in 2001, but the latest divorce figures showed no drop, and the campaign’s backers no long stress their original goal of cutting divorce by one-third by 2010. The Bush administration believes such programs have merit – its Healthy Marriage initiative has disbursed more than $200 million nationwide in the past five years. Bill Coffin, the Department of Health and Human Services’ special assistant for marriage education, is convinced the programs are a factor in the declining divorce rate. “The word is getting out that marriage doesn’t have to be a crap shoot – it’s not the luck of the draw,” Coffin said. “It’s how you deal with the inevitable conflict and anger in marriage.” He subscribes to the theory that better-educated, wealthier couples have better odds of success in marriage. “What we’re doing is making sure the poor have access to some help and support,” Coffin said. “So many people never heard of marriage education before.”

One of the researchers whose studies detected the “divorce divide” is University of Maryland sociologist Steve Martin . Comparing marriages from early 1970s to those of the early ’90s, Martin found that the rate of breakups within 10 years of marriage dropped by one-third among college-educated women while remaining stable among less-educated women. “Overall, marriages will become more stable only if the lower two-thirds of the population starts behaving like the top third,” Martin said. “There’s a lot of debate – is that possible? Can marriage training or other programs give all couples the sort of relationship skills that people imagine college graduates have?” Stephanie Coontz, who teaches history and family studies at Evergreen State College in Olympia, Wash., says divorces are dropping in the college-educated sector because many spouses “are learning how to negotiate marriages based on less rigid gender roles than in the past.” “College-educated wives are more likely to work than less-educated wives, and a recent study found that unlike the past, a wife’s work now tends to stabilize marriage,” she said.

Glenn Stanton, a family policy expert with the conservative ministry Focus on the Family, suggested one factor behind the declining divorce rate was simply a societal revulsion toward the high rates of recent decades. “In the past 30 years, we’ve had more divorce than any culture has ever had,” he said. “A lot of young adults now are coming out of the family upheaval of the ’70s, and they are cohabiting out of fear. They don’t want to mess up the nice clean carpet of marriage – they saw their parents do that.”

The per capita divorce rate is different from another method of calculation – the percentage of marriages that will eventually end in divorce or separation. Many experts discount the popular notion that one of two U.S. marriages end in divorce, and suggest the breakup rate, which is hard to calculate, has stabilized in recent years at between 40 percent and 45 percent.

Gaetano Ferro of New Canaan, Conn., president of the American Academy of Matrimonial Lawyers, says overall national trends haven’t had a noticeable effect on his fellow divorce lawyers. “I’ve been active in the academy two decades plus,” Ferro said. “I’ve never heard anyone say, ‘We’re in trouble. There are fewer divorces.” But North Carolina divorce lawyer Lee Rosen, while reporting that business for his large firm is booming, says he has noticed a trend toward increased realism and civility among couples with marital strains. Many seek mediation as they split, and arrange for joint legal custody of their children. “People are coexisting more peacefully, whether they stay together or come apart,” Rosen said. “They are more contemplative and serious about their relationships, and I see people stay together who once would have allowed the marriage to unravel.”

source: Associated Press

The Rate of Divorce is Declining

When Gwyneth Paltrow and Chris Martin “consciously uncoupled” this year, ABC News said it was the latest example of the out-of-control divorce rate, “50 percent and climbing.”

When Fox News anchors were recently lamenting high poverty levels, one of them blamed the fact that “the divorce rate is going up.”

And when Bravo introduced its divorce reality show, “Untying the Knot,” this summer, an executive at the network called it “a way to look at a situation that 50 percent of married couples unfortunately end up in.”

But here is the thing: It is no longer true that the divorce rate is rising, or that half of all marriages end in divorce. It has not been for some time. Even though social scientists have tried to debunk those myths, somehow the conventional wisdom has held.

Despite hand-wringing about the institution of marriage, marriages in this country are stronger today than they have been in a long time. The divorce rate peaked in the 1970s and early 1980s and has been declining for the three decades since.

About 70 percent of marriages that began in the 1990s reached their 15th anniversary (excluding those in which a spouse died), up from about 65 percent of those that began in the 1970s and 1980s. Those who married in the 2000s are so far divorcing at even lower rates. If current trends continue, nearly two-thirds of marriages will never involve a divorce, according to data from Justin Wolfers, a University of Michigan economist (who also contributes to The Upshot).

There are many reasons for the drop in divorce, including later marriages, birth control and the rise of so-called love marriages. These same forces have helped reduce the divorce rate in parts of Europe, too. Much of the trend has to do with changing gender roles — whom the feminist revolution helped and whom it left behind.

“Two-thirds of divorces are initiated by women,” said William Doherty, a marriage therapist and professor of family social science at University of Minnesota, “so when you’re talking about changes in divorce rates, in many ways you’re talking about changes in women’s expectations.”

The marriage trends aren’t entirely happy ones. They also happen to be a force behind rising economic and social inequality, because the decline in divorce is concentrated among people with college degrees. For the less educated, divorce rates are closer to those of the peak divorce years.

Of college-educated people who married in the early 2000s, only about 11 percent divorced by their seventh anniversary, the last year for which data is available. Among people without college degrees, 17 percent were divorced, according to Mr. Wolfers.

Working-class families often have more traditional notions about male breadwinners than do the college-educated — yet economic changes have left many of the men in these families struggling to find work. As a result, many wait to achieve a level of stability that never comes and thus never marry, while others split up during tough economic times.

“As the middle of our labor market has eroded, the ability of high school-educated Americans to build a firm economic foundation for a marriage has been greatly reduced,” said Andrew Cherlin, a sociologist and author of “Labor’s Love Lost: The Rise and Fall of the Working-Class Family in America.” “Better-educated Americans have found a new marriage model in which both spouses work and they build a strong economic foundation for their marriage.”

Some of the decline in divorce clearly stems from the fact that fewer people are getting married — and some of the biggest declines in marriage have come among groups at risk of divorce. But it also seems to be the case that marriages have gotten more stable, as people are marrying later.

Ultimately, a long view is likely to show that the rapid rise in divorce during the 1970s and early 1980s was an anomaly. It occurred at the same time as a new feminist movement, which caused social and economic upheaval. Today, society has adapted, and the divorce rate has declined again.

In the 1950s and 1960s, marriage was about a breadwinner husband and a homemaker wife, who both needed the other’s contributions to the household but didn’t necessarily spend much time together. In the 1970s, all that changed.

Women entered the work force, many of their chores in the home became automated and they gained reproductive rights, as the economist Betsey Stevenson and Mr. Wolfers have argued in their academic work. As a result, marriage has evolved to its modern-day form, based on love and shared passions, and often two incomes and shared housekeeping duties.

The people who married soon before the feminist movement were caught in the upheaval. They had married someone who was a good match for the postwar culture but the wrong partner after times changed. Modern marriage is more stable because people are again marrying people suitable to the world in which we live.

“It’s just love now,” Mr. Wolfers said. “We marry to find our soul mate, rather than a good homemaker or a good earner.”

The delay in marriage is part of the story, allowing people more time to understand what they want in a partner and to find one. The median age for marriage in 1890 was 26 for men and 22 for women. By the 1950s, it had dropped to 23 for men and 20 for women. In 2004, it climbed to 27 for men and 26 for women.

Perhaps surprisingly, more permissive attitudes may also play a role. The fact that most people live together before marrying means that more ill-fated relationships end in breakups instead of divorce. And the growing acceptance of single-parent families has reduced the number of shotgun marriages, which were never the most stable of unions, notes Stephanie Coontz, a professor at Evergreen State College and author of “Marriage, a History: How Love Conquered Marriage.”

Overall, the marriage trends resemble those in many other areas of American life. For people on the wealthier side of the class divide, life is better than it used to be in many ways. For people on the other side, the situation is much more complicated.

And the effects could last for decades, as the children of stable marriages grow up with both the immediate benefits and the role models for successful future relationships — while at the same time, record numbers of children grow up in one-parent households.

Facts About Suicide

  • Suicide is the 8th leading cause of death in the USA, accounting for 1.3% of all deaths

  • Suicide is the 3rd leading cause of death among 15-24 year olds

  • There are four male suicides for every one female; however twice as many women as men attempt suicide

  • Suicide rates are relatively constant for men, age 25-64, but go up significantly after age 65

  • Over 60% of all people who die by suicide suffer from Major Depression. If you include alcoholics who are depressed, the figure rises to over 75%.

  • Death by firearms is the fastest growing method of suicide. Firearms are now used in more suicides than homicides.

  • 25-50% of people suffering from Bi-Polar Disorder will attempt suicide at least once.

  • White males, over the age of 85 have the highest likelihood of being suicidal.

Danger Signals to Watch For

  • People who kill themselves have usually attempted suicide before.

  • People who end up taking their own lives have often talked about it directly or indirectly.

  • Suicidal individuals often arrange to put their affairs in order, pay off debts, and give away keepsakes and heirlooms prior to attempting suicide.

  • Suicidal individuals may start collecting prescription medications with which to overdose themselves.

source: American Foundation for Suicide Prevention

Curbing Road Rage

10 Suggestions for Controlling Yourself While Driving

Recently, a roadside billboard showed an infuriated driver screaming at the car ahead of her while her toddler observed from the backseat. The tag line said, “She learns by watching you.”

The National Highway Traffic Safety Administration (NHTSA) states that road rage “involves a criminal act of violence, whereas aggressive driving can range from tailgating to speeding to running red lights.” The number of deaths related to road rage is difficult to track, but NHTSA estimates that aggressive driving accounts for about one-third of all crashes and about two-thirds of the resulting fatalities.

Increasingly congested roadways are a growing source of driver frustration, but studies suggest the real root of aggressive driving lies within each of us. Drivers can cope by taking an honest look at their driving behavior and attempting to reduce their stress level behind the wheel.

1. Get your Zs. A national epidemic of sleepiness is a contributing factor to road rage, according to the National Sleep Foundation. We all know how cranky we get without enough sleep. It makes us prone to feelings of annoyance, resentment and even anger. Eight hours is still the recommended daily dose of sleep for adults.

2. Plan ahead. Do you regularly whiz through your morning routine in a whirlwind of chaos, trying to make up time while on the road? Do you allow just enough time to drive to an appointment? Then you’re probably also more prone to a lead foot and a lost temper. If you add 10 minutes to your expected travel time, you’ll have time to stop for gas, safely navigate those snowy roads or detour around road construction. Also, try preparing clothing, briefcases, children’s school bags and lunches the night before to minimize your morning rush. Extra time equals calmer driving.

3. Your car is not a therapist. Many of us love and identify with our cars, but sometimes you can take the “car as extension of self” idea too seriously. If your boss or your spouse left you steaming, take care not to use driving as a way to blow off steam. Competitive types (you know who you are) shouldn’t try to prove themselves on heavily traveled thoroughfares — save that enthusiasm for weekend romps on your favorite back roads. No matter how much power you’ve got under the hood, your vehicle is first and foremost a mode of transportation, not a weapon.

4. Turn down the bass. Without getting into the argument over “aggressive music makes people aggressive,” it makes sense that listening to relaxing music — or even a comedy channel  — will make you less pumped up for action than a driving bass line. Try tuning in to classical or jazz to reduce stress. Or listen to an audiobook. Either way will also help drown out stressful traffic noise.

5. Loosen up, then breathe: If you notice yourself clenching the steering wheel in a death grip, try flexing your fingers and loosening your hold — you’ll find that you can control the car just as well. If your right foot is cramped, set the cruise control if traffic allows. If you’re on a prolonged road trip, try not to exceed three hours of travel time without a break where you get out and stretch. Struggling to see through a dirty windshield is also an unnecessary stress factor, so fill up with washer fluid before you go. Periodically roll down the window and breathe deeply and slowly.

6. It’s not about you. Perhaps another driver cut you off. Or the car in front of you is braking erratically. Before you assume the driver is getting off on your rising anger levels, realize that you, as an individual, are not the target. Perhaps the driver simply made a mistake or was just being oblivious. Maybe there’s a screaming baby, a loose pet or a crazed bee in the car. Maybe he was on a cell phone. The point is, don’t take things so personally.

7. Hostility is toxic. And risky. People most prone to anger are almost three times more likely to have a heart attack than those with low anger, according to the American Psychological Association. Other health risks seen in those who display hostility include obesity, depression and stroke. Wow, who knew? Safe driving promotes healthy hearts!

Not only will giving into anger not resolve an irritating situation, it can increase the risk of retaliation. Think to yourself, “Is making my point worth endangering my life?” If all else fails, do a mental 180 and try to laugh it off.

8. Use restaurant etiquette. While it’s upsetting when a stranger is rude or cuts in line in a restaurant or store, most folks wouldn’t lose their cool and become abusive as a result. It isn’t only because they have good manners. Driving a car makes people feel more isolated and protected, allowing them to act in ways they would normally find embarrassing. So when another driver acts like a jerk, respond as though you’re in a restaurant.

9. Take the self-test. Classes designed to help curb aggressive driving often have participants tape-record themselves while driving. Hearing themselves swear or rant on tape is enough of a wake-up call for them to recognize and reduce dangerous behavior. So try analyzing your driving. Do any of the following statements sound like you?

· I regularly exceed the speed limit in order to get to work on time.
· I tailgate other drivers, especially those who sit in the left lane.
· I flash my lights and honk my horn to let drivers know when they annoy me.
· I verbally abuse other drivers whether they can hear me or not.
· I frequently weave in and out of traffic to get ahead.
· I feel the need to set bad drivers straight.

If you answered “yes” to any of these questions, your driving may qualify as aggressive. The American Institute for Public Safety (AIPS) has a more detailed RoadRageous Test that determines if your driving habits fall under the “aggressive zone,” “hostile zone” or — worse yet — “war zone.”

10. Practice kindness. Dr. Leon James, aka “Dr. Driving” and author of Road Rage and Aggressive Driving, says that remembering simple courtesies, like allowing someone to merge or apologizing when we make a mistake, can go a long way in making the driving experience positive for ourselves and others. His basic motto is the old “do unto others” rule: Treat fellow drivers how you would like to be treated.

As additional incentive, reducing your aggressiveness on the road can also keep you out of serious trouble: Several states have created special law enforcement teams to seek out and cite aggressive drivers. Depending on the frequency of offenses, violators may be fined, lose their license temporarily or even face jail time. Often, they are required to take a behavior-modification class as well.

We’re all bound to lose our cool at some point, but by planning ahead and keeping things in perspective, we can prevent our emotions from getting the best of us. Putting aggressive driving in park will help to ensure your own safety, as well as the safety of everyone around you.

Repairing Your Marriage After an Affair

Probably the greatest threat to a marriage is when one of the partners engages in an emotional or sexual relationship with someone else. The behavior is a betrayal of the marital vows we make and triggers deep feelings of mistrust and hurt.

Psychiatrist M.Goulston describes the response to infidelity as, “the four H’s – you will feel Hurt, Hate, Hesitation (to trust) and Holding (onto resentments).”

Counseling to repair a marriage after an affair involves teaching the, “the four R’s – Remorse, Restitution, Rehabilitation, and Request for forgiveness.”

To help your partner resolve their feelings about your infidelity, your partner needs to know that you feel genuine REMORSE – and it must be reflected in the way you act and what you say. It likely means apologizing repeatedly over time. This will only be helpful if you can sincerely apologize. You need to know, and be able to express that you know how painful it was for your partner to find out you were cheating and lying.

Part of the healing process is your partner seeking RESTITUTION. Frequently your partner’s hurt feelings require that they express their anger. The best restitution can be your allowing your partner to verbally vent every bit of revulsion, disgust, disappointment, anger, and/or hurt that you caused, without your defending yourself – just listen! This outpouring of emotions can satisfy your partner’s need for revenge by making you feel as bad as they feel.

Because the trust in the marriage has been lost, your partner will need to see you actively REHABILITATING yourself and learning how to better cope with the marital relationship. You will both need to learn better communication skills and learn how to better meet your partner’s needs.

As your partner may likely being holding onto resentments, you will need to REQUEST forgiveness. This should follow a track record of remorse, restitution, and rehabilitation lasting at least six months. You don’t get forgiven because you ask to be. Forgiveness has to be earned.