The daughter of the mayor-elect in New York has had alcohol/drug/depression issues and had come forward to help others. Very useful, very powerful, very hopeful message.
Observations and Reflections as the year comes to a close
Change is :
1) Change is fear
2) Change is pain
3) Change is love
4) Change is acceptance
5) Change is hope
6) Change is feeling
7) Change is action
8) Change is living life
9) Change is flexibility
10) Change is enjoying life
11) Change is dealing with inconveniences, hassles and things that aren’t fair
12) Change is grief
13) Change is sadness
14) Change is peace
Most of all change is possible
As a Marriage and Family Therapist, I have seen many couples over the years. Not surprisingly, the ones that come to my office have conflicts with their partner. The issue that needs most work is how the couple can communicate better. One of the patterns that couples repeat is reactive communication. Through our sessions, we get to figure out why one or both of the partners are reacting so strongly. Eric Berne, a psychologist, in the 1960’s, developed a type of therapy called Transactional Analysis. Berne suggests that it is the transactions between people that get them to react in communications. He hypothesized that all people had 3 internal states-Parent, Adult, Child and that these are triggered in couples communications.
Nick Davies, a psychologist in Australia, does a great job of explaining these internal states in the following video:
Let’s take a look at the following slides to see specifically how this works: [click on the slideshare button in the lower left hand corner to hear the narration]
I have been a hockey fan for most of my life. I was struck by The National Hockey League’s(NHL) speed, power, grace, and excitement. It is a sport with a regular season that goes on too long. However its claim to fame is its playoff series, a 16 win marathon that culminates in the celebration of Lord Stanley’s cup. It’s a sport played by professionals from 18-48 making it a sport played by both the youngest and oldest professional athletes.
The NHL also has a rather strategic way of policing its players who do not follow the rules. In fact, the league’s penalty system gives us a good model for parenting strategies. It disciplines its players immediately, for a specified period of time, and uses effective time outs (penalty box). It is also dishes out consequences based upon the person’s behavior.
The NHL has a very specific tier system which looks something like this:
- Minor Penalty(tripping ,holding, high sticking, inference, slashing) 2 minutes
- Major penalty(fighting) 5 minutes
- Misconduct(usually towards referee) 10 minutes
- Game Misconduct(major offense—hurting another player etc) Thrown out of game, possible suspension or fine.
When a player commits a wrong doing, it’s not only the player who is penalized, it’s his team. When a player goes to the penalty box for a two minute tripping minor, his team also plays shorthanded for those two minutes. Playing shorthanded increases the possibility that the opponents will score a goal making the penalty much more significant.
Could parents discipline their children using the NHL model? Yes! Good parenting is based upon immediacy and “making the punishment fit the crime”. The NHL has got that down perfectly. The NHL is already using a “time out” model, (penalty box), so that too is a good fit. Most penalties committed by children at home or in school are usually minor. They need some immediate consequences. A simple timeout, whether in a time out chair or sent to their room, will usually suffice as a consequence. The penalties and consequences could be adjusted according to the age of the child— a seven year old who doesn’t listen and a 15 year old who doesn’t listen could both be “minor” penalties. However the consequences of these “minors” would be different. This model also allows parents to identify appropriate consequences depending upon the infraction. A child who is bratty towards his sibling and one who steals from a store would need very different consequences. The NHL model also reinforces that yelling is counterproductive. There is only 1 reason to yell at a child, that is when they are in DANGER! I’ve never seen a referee yell at a player. He has pointed to the penalty box, asked nicely for the person to go, asked with a little more assertion, warned that the player will get a misconduct penalty if that does not go, and then gave them the 10 minute misconduct. No yelling to reinforce the consequence occurred.
The NHL also rewards good behavior. There are the Player of the Week, and Player of the Month awards. At the end of the season, there are the trophies for Most Valuable Player, Best Goalie, Best Defensive Player etc. The best NHL award is The Lady Byng trophy which is given to the “player adjudged to have exhibited the best type of sportsmanship and gentlemanly conduct combined with a high standard of playing ability”. Imagine an award for sportsmanship and gentlemanly conduct in a professional sport. It is these awards and trophies that players can aspire to in order achieve bonuses in their contract. Using this incentive plan is also a way for parents to help their kids change behaviors. If you give a child a specific goal to work for (i.e. getting dressed in the morning by themselves), then they can have good reinforcement towards that goal—praise, stickers etc. Once the behavior is learned, no more struggles! Incentives also work with teenagers. Since teenagers always need something—phone, ride, clothes, money, they too can be asked to change their behaviors in order to achieve what they want.
The NHL has perhaps the finest conditioned athletes in the world, but ones who need structure, discipline, consequences, and incentives in order for them to have maximum performance. We want our kids to have their own maximum performance. To have that level of achievement, they need parents to give them incentives and consequences. Once children learn new behaviors, they feel better about themselves. Over time, they become happy and healthy kids. When they are happy and healthy, then they can win their own “Stanley Cup”.
Watch this video to learn more about the NHL:
If you missed part 1 you can read it here
Announcer “I’m here at ringside and in an unprecedented move, the fighters are returning to the ring. Disease looks confused, but is never one to turn down a fight. Mary, in a very nontraditional decision, has asked all of her handlers and doctors to go back to the dressing room. They can only watch this fight. No doctor or handler can step in. There is no referee. It’s only Mary vs. the Disease”
“The bell rings and the fight is on. Family and friends look on as Mary’s condition has weakened. She can hardly stand in the ring. She is exhausted and wobbly. The clock ticks by. Each second seems like an hour. In spite of her feeble state, Mary keeps challenging Disease to hit her. She chides Disease for being weak. She challenges Disease to take his best shot. Disease laughingly throws a few punches. The weakened Mary goes to one knee on the first punch. Mary gets up. She challenges Disease to hit harder. Disease obliges and Mary goes down again. Mary gets up. Barely able to stand, and barely able to speak, she gestures to Disease to hit her again. Disease, again, throws a punch which knocks down Mary. Remember no referee, no handlers, no doctors at ringside, no one can stop this fight. It’s a brave, last stand for this warrior who is clearly no match for a strong Disease. Mary gets up again!! Family and friends at ringside are teary. They cannot do anything to stop this. They are watching Mary fade away. Minutes later, there are no more punches, there are no more gestures, there are no more comments. The fight is over.”
Mary fought her last round. She was a gallant fighter who survived and lived against all the odds. She managed to get knocked down, get up, fight and live. She continued to do this for many years. However on July 10, 2013 she was no match against a strong disease.
All fighters who have fought their last round get memorialized with a 10 bell salute in order to remember their time in the ring.This one is for Mary:
In the sport of boxing, we cheer for our favorite fighters in each of their fights. We relish their victories, and root for their comebacks when they lose. In real life, we do the same. The major difference, however, is that when a person loses, there is no rematch, and the losses are more painful. What this tells me is that we have to rely on the basic tenet of any type of recovery; we have today.
Let’s go to ringside to our announcer for this world title fight.
“This fight is between Mary and the Disease. Now Disease is a heavy favorite to win this fight based upon its long history of defeating opponents. Mary is a game challenger with lots of desire to win this fight and claim the title.
Round 1: Disease starts off slow examining Mary’s weaknesses. Throws a short punch. Mary winces in pain. Disease throws another punch producing more pain. Disease is smiling. Mary attempts to return the punch. Disease laughs and smiles and says “is that all you got”? Mary is demoralized and feels bad. Disease goes for the knockout. Mary is rocked. The bell rings ending round one. Family and friends watching the fight at ringside are shocked and upset.
Round 2: Mary starts off strong. Throws a few punches to gain an advantage over Disease. Disease continues to smile and mock Mary. Disease throws punch after punch after punch. Mary has no response. In fact, she has no defense for the Disease. She is getting weaker, more defeated looking, and on the verge of going down. Disease throws a solid right-left combination. Mary goes down! She barely gets up as beats the bell sounds ending round 2.”
In the corner after round 2, the ringside doctor comes and looks at Mary. The doctor says to Mary “ you need treatment”. Mary argues at first, and reluctantly agrees.
Round 3 “ Mary starts slowly. She is still sluggish after the last round. She doesn’t know if the treatment will help. Disease jabs, and continues to jab. Mary ducks one jab, and fires back. The crowd roars. Disease again jabs continues to score with more jabs. Mary weaves past the jab and fires back a left-right combination, follows back with a jab of her own. Disease, for the first time in this fight, takes a step back. The round ends. All family and friends give Mary a standing ovation for her fight.
Round 4 Mary, with renewed confidence and strength, starts the round off strongly firing a series of jabs and straight right hands to Disease. Disease flinches a little, and fires back a solid one-two punch. Mary takes the punch rolls to the left and counters the one-two with a ferocious uppercut. Disease is wobbly. Mary fires a 3 punch combination. Disease is wobbly again. Another 3 punch combination and Disease goes down!!!! ….. Disease get up. The round ends. Mary is winning the fight!!! The crowd is electric with chants of Mary, Mary, Mary!!!”
Between rounds Mary is excited by her progress, she sees that she is beating the Disease. Her confidence is growing. She knows that she’s going to be ok.
Round 5 “ Disease slowly walks to the ring and throws out a lazy jab. Mary counters with a strong left. Mary throws a good 2 punch combination. Mary looks strong. Disease fakes a right, throws a left. The punch seems to stagger Mary. Mary comes forward throws a beautiful hook that hits Disease. Disease nods in acknowledgment. Disease comes back fakes a right again, and throws a viscous left hook, followed by a right uppercut. Mary is wobbly. An overhand right by Disease ends round 5. Mary looks shaken.
Round 6 Disease comes out strong and confident. Mary is still wobbly after the last round. Disease goes out to end this fight. Throws a 4 punch combination and then throws another 3 punch combination. Mary has no defense for these punches. Mary tries to counter. Her punches have no snap to them. Disease fires an uppercut straight up the middle. Mary goes down!!!! Her family and friends yell ‘get up’. Mary gets up barely beating the count.”
In Mary’s corner, Mary says ”I want to keep fighting this fight I can win” .The corner people aren’t sure if they should let Mary go out for another round. The doctor examines Mary and says either start treatment again or this fight is over. Mary says Ok to treatment.
Round 7 “Disease is very confident. Starts strong. Throws 3 jabs. Mary takes all 3 without responding. Mary throws a weak looking hook. Family and friends at ringside look worried. Disease smiles and throws a solid one-two. Disease misses an uppercut that would have ended the fight. Mary finds her footing. Throws 3 solid punches. Disease fires back with 3 more jabs. Mary throws a right hook followed by a jab. Mary looks exhausted. The bell sounds ending round 7.
Round 8 “This is the final round of the fight. Mary is tired. Disease looks strong. Mary starts off first and throws a powerful jab. She follows with a left hook that seems to hurt Disease. Disease throws a counter right hand that hurts Mary. Both fighters are weary after this grueling fight. Mary has a determined look in her eye. She’s aware that on the scorecards, she may be losing this fight. She gamely throws punches, one, two, three punch combination, that rocks Disease. Another solid jab that pushes Disease back. Disease comes back with with a brutal left hook that rocks Mary. Mary is wincing from that shot. Her legs are wobbly, her brain is fuzzy. She wants to win the fight, but her body is fighting her. Family and friends at ringside are cheering loudly. The bell sounds ending the fight”
Mary was a game competitor in this fight. It may be her last one. We don’t know how much damage all those punches took out of her. Disease took some punishment but we know that Disease will always be back for another fight. The decision is in the hands of the judges.
Dedicated to a special person fighting perhaps her last fight
You have been married for many years. You begin to recognize that you are not as happy as you used to be. You start examining the pros and cons of the relationship. Your partner has many pluses and a few chunky negatives. You are unsure of what to do. Follow this advice for some good ideas about your next steps.
You need a sounding board to air out your thoughts and feelings. As you go through this process, you may also change your mind on a regular basis. A good therapist will help you with both your feelings and with your decision making process. If your partner is willing to attend counseling, then both of you can go through this change process together. If he or she is unwilling, go to counseling by yourself. It can only help.
Most people get married and stop identifying what they want. Some people become very partner driven and forget about their own needs and wants. It’s important to identify what you want and what’s most important to you. Do you want security, independence, happiness, partnership, a friend? Can you be OK by yourself?
Identify what’s a need versus what’s a preference.
Your decision making process is largely a mental and emotional event. Make sure you keep up your physical part since mental and emotional stress will drain your physical self. It’s not uncommon to lose weight or feel tired and dragging during this process. Make sure that you exercise, eat healthy, get sleep, and minimize your use of caffeine and alcohol in order to have the energy you need to make a good healthy decision.
If you are going to go through this major process, you are going to need support. Who are your support people? Consider talking to friends, relatives, etc. Find your go to people and share your thoughts and feelings with them. Ideally, find people who have stayed and those that have left. Seek out a support group. There are some amazing message boards where you can be totally anonymous and hear and learn from others’ experiences.
Find an attorney who specializes in family law. Since knowledge is power, get empowered. Find out the rules of the game. How does alimony and child support work? Learn about the business of divorce while you are sorting out your emotions. Sometimes knowing that it is possible to get a divorce opens what was thought to be a closed door. By contrast, knowing what a divorce might do to you and the family might get you closer to working on the marriage.
When people are in the decision process, they are most vulnerable. It’s easy to share pain with another person who has similar pain. The misery loves company approach seems to work to find the fix to the problem. Due to their newness, these extra relationships just seeks to cause more confusion and ultimately more pain.
When a person is unhappy in their marriage, the person they want to tell is their partner. However, how many times does the partner need to hear about the unhappiness? I’m guessing that unless that person is hearing impaired, lacking mental capacity, or suffering from neurological damages, that number is not a high one. Why add to your own frustration by being a broken record?
It’s been said many times, “If only he would stop drinking…”, “If only he would get a job…”, or “If only she wasn’t so depressed things would be so much better.” When you love someone, you want them to get better. But you can’t fix them. Encourage them to find solutions to their own problems.
When confusion, fear, sadness, and anger are the feelings that predominate, who wants to feel these? No one. The easiest way to get rid of these is to use quick fix band aids like drinking, drugging, shopping, spending, eating, sex, relationships and work. They all work, kind of, but ultimately cause other and bigger problems. Short term pleasure usually leads to long term pain.
Sometimes you see that many other people have their lives together. They are either happily married or successfully divorced. As a result, you think that you are the only one in this state of limbo. This constant stay or go makes you want to tell no one, and keep all of your pain inside. If you do this, your pain will only grow bigger and develop into a bigger problem. You really don’t need more problems, do you?
Making a decision about changing a relationship is one of the hardest things that people do. When there are kids involved, that decision making process is even harder. Give yourself the time that you need to identify your goals, identify your actions, and ultimately make yourself happy. Although there will be some tough days, you will make the right decision. Remember change is possible.
This blog is a special one. I am lucky to have a guest blogger who is a friend of mine for over 20 years and an expert in the treatment of compulsive gamblers. NJ recently passed a law legalizing on line gambling. In addition, one of the major changes in the new DSM V relates to compulsive gambling. It has gone from an “Impulse disorder” into a diagnosable addiction similar to alcohol or drug addiction. To explain all of this in more detail, is Lenny Brazer
Most research suggests that when the public has access to the availability of gambling the number of people who gamble will increase. This is not rocket science. The concern of professionals who treat problem and pathological gamblers is that with the increase in the number of people who gamble the proportion of those who will encounter problems or become pathological gamblers also will increase as well. Once again in New Jersey there is going to be a significant increase the amount of gambling that takes place. Gov. Christie recently signed legislation that will legalize online gambling. What this means is that virtually any person who has a computer or access to the Internet will be able to gamble in the comforts of their home. This will include gambling machines table games and any other type of gambling that goes on in the casino.
There are many caveats as well as benefits that go along with this new legislation. On the positive side the legislation will enact for the first time a significant source of funding for the treatment of problem/pathological in the state of New Jersey. Casinos in order to be licensed will have to pay an annual fee of $150,000 and it is anticipated that eight casinos will apply for the license. Portions of that money will be divided between treatment and prevention/education via the Council on compulsive gambling of New Jersey Incorporated. One anticipated difficulty in spite of some sophisticated language and controls will be monitoring whether underage (people 18 years of age and younger)will be able to access a site and gamble illegally.
The American Medical Association recently published its Fifth edition of the Diagnostic and Statistical Manual of mental disorders(DSM V). An important departure from previous diagnostic manuals is that the substance related disorders chapter has been expanded to include Gambling Disorder this change reflects the increasing and consistent evidence that some behaviors such as gambling activate the brain’s reward system with similar effects to those of drugs of abuse and the fact that gambling disorder symptoms resemble substance use disorders to a certain extent.
In order to diagnose gambling disorder one must have a persistent and recurrent problematic gambling behavior leading to clinically significant impairment or distress as indicated by the individual exhibiting four or more of the following in a 12 month period.
1) Needs to gamble with increasing amounts of money in order to achieve the desired excitement
2) Is restless or bored when attempting to cut down or stop gambling
3) Has made repeated unsuccessful efforts to control cutback or stop gambling
4) Is often preoccupied with gambling e.g. having persistent thoughts of re-living past gambling experiences, handicapping or planning the next gambling venture, thinking of ways to get money with which to gamble.
5) Often gambles when feeling distressed e.g. helpless guilty anxious depressed.
6) After losing money gambling, often returns another day to get even “chasing” one’s losses.
7) Lies to conceal the extent of one’s involvement with gambling.
8) Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
9) Relies on others to provide money to relieve desperate financial situations caused by gambling (bailout).
Gambling behavior is not explained by a manic episode.
When making the diagnosis one can differentiate between
Episodic:meeting diagnostic criterion at more than the one time point with symptoms subsiding between episodes of gambling disorder for at least several months.
Persistent: experiencing continuous symptoms to meet diagnostic criteria for multiple years.
It can also be classified as in Early Remission:
after full criterion for gambling disorder were previously met none of the criteria for gambling disorder have been met for at least three months but for less than 12 months.
Sustained Remission would suggest that after full criterion for gambling disorder were previously met none of the criteria for gambling disorder have been met during a period of 12 months or longer.
Severity can also be monitored now, ie mild 4 to 5 criteria met; moderate 6 to 7 criteria met; severe 8 to 9 criteria met.
Discussions during the development of these new criteria suggested that the reclassification of pathological gambling from being an impulse control disorder to a behavioral addiction will help those who have been suffering from this disorder gain access to treatment. It was also suggested that more insurers would recognize gambling disorders as treatable and third party reimbursement for treatment would increase. That is yet to be seen. Given the potential proliferation of gambling that will be happening in New Jersey, this therapist certainly hopes for the aforementioned to become realities.
Leonard Brazer Ed.S. CCGC
300 West Main Street
Rockaway,New Jersey 07866
Leonard Brazer, Ed.S., M.A., CCGC is a New Jersey Licensed Marriage and Family Therapist. He is also a certified New Jersey School Psychologist and a Certified Compulsive Gambling Counselor. He completed a one year internship in Clinical Psychology at Monmouth Medical Center. His professional degrees are from Seton Hall University. Mr. Brazer worked for two years in a Mental Health Center prior o entering the field of addictions in 1980. He has developed comprehensive Chemical Dependency Rehabilitation Programs for adults and adolescents. Mr. Brazer also founded and supervised the Pathological Gambling and Money Disorder Programs at Saint Clare’s Hospital, and at Hackettstown Hospital.
Mr. Brazer has appeared as a guest on the Sally Jessie Raphael, Joan Rivers, Good Day New York, News Talk New York, Channel 12 News, The O’Reilly Report and Caveat Venditor, and on various radio talk shows as an expert, offering information on gambling and money disorders. He has written articles for several major New Jersey newspapers, and authored a chapter for a text “I Shop, Therefore I Am, Compulsive Buying and the Search for Self”. He has consulted with 48 Hours and the Oprah Winfrey shows on feature stories regarding gambling and spending. As well, he has lectured at most major statewide conferences and East Stroudsburg University, Montclair State University, and New Jersey City University.
Mr. Brazer has been a private practitioner and consultant since 1983.
This article is reprinted from:
How many times have you said things like: If only I could lose these five pounds, I’d feel so much better. I would love to stop smoking, these things are so expensive. I want to go to the gym. I want to get in good shape for the summer.
If you’re like most people, you’ve had conversations like this about many things. Unfortunately, you haven’t figured out how to take that huge first step. Some of you have plunged ahead only to have the next step be the one that brings your change momentum to a screeching stop. Here are some ideas that will help you to start the change process.
People inevitably think about change in large chunks. This viewpoint is a setup for failure because if your goals are too big, it’s easy to become frustrated. Think about making your changes small – lose 1 pound this week, go to gym once. If you succeed with this goal, your can take on a bigger goal next time.
Sometimes when people make the decision to change, they feel overwhelmed. They don’t know where to start. Should I stop drinking, eat better, lose weight, work on my relationship? Sometimes it’s just good to do some part of the change. If I want to stop drinking, maybe I should: read about not drinking, read about celebrities who have stopped drinking, or remove all the alcohol from the house. These are all examples doing part of the change process.
This is called the opposite theory. Let’s say that your goal is to meet the woman of your dreams. You continue to go to places to meet this woman and strike out every time. Opposite theory would suggest that you stop looking. Do activities that enhance your well being. Mister or miss right will show up when you are not looking for him or her.
Treat your change process like a good research experiment. Write down your starting weight and other measurements like BMI, etc. and do regular weigh-ins. Log in your data weekly so that you can see the change. Your perception of the change may be different than the facts. Stay with the data, not how you feel.
Not everyone is sold on the idea of change. In fact, most people are not. There is usually the healthy part of the person that wants to change. There is also the safe and comfortable part of the person who does not. This is normal. There is no reason to beat yourself up about things that you should want to do but don’t, like “I should want to lose 25 pounds”. You will find your way when you are ready.
Change is hard. No one is perfect. No one changes perfectly. Change is always 3 steps up and 2 steps back. People learn more about change from their setbacks than from their success. Be gentle on yourself, accept that these setbacks are part of the change process.
It’s easy to fail when you have set up way too big a step of change, “I will lose 10 pounds in 2 weeks” for example, or “I will be divorced by the end of the month.” Be realistic, the old adage “slow and steady wins the race” is applicable here.
Ambivalence is the battle between the healthy part and safe part of yourself. Sometimes when people are succeeding in their battle to change, they set themselves up their failure – the all you can eat buffet when on a diet, the bachelor party when stopping drinking, etc. Identify the risk factors that could lead to a setback and don’t put yourself in harms way.
Most people have several attempts at failed change before they get it right. All of these failures are actually success, because they give good information about the triggers that set up failure. They also highlight when change will be tough. When you are ready, you will succeed.
It’s easy to get the “f*ck- its” about the change process and go backwards. Have patience with yourself and recognize that change is hard work. Allow yourself to have setbacks. You are human right? Remember the best hitter in baseball fails 7 out of 10 times. Have some stick-to-itiveness in the process.
It’s easy to do the same old same old over and over. It’s familiar, predictable and safe. You can have so much more but you have to take that first BIG step. Be aware that you may have pitfalls, but recognize that they are opportunities for learning. No one fails at change, they just get better at it. You can be safe and miserable or take the risk and be happy. You know which one works best. Hopefully you’ll pick the change side. Always remember that change is possible.