Friday, November 25, 2011

Bibliotherapy and Beyond: A Tribute to Genius

The latest business advice for psychologists encourages us to cultivate a niche of expertise.  A niche will allow your practice to stand out amidst the clutter of treatment options and help potential clients decide whether you are likely to be the psychotherapist best suited for their needs.  My practice niche is helping gifted people cope and thrive in the face of their uniquely rarified universe of talents, challenges and stressors. To further this aim, I love to read biographies of exceptional people who have achieved the outstanding kind of greatness and impact on society that can come from being driven, creative, and intellectually gifted.

Steve Jobs, who passed away October 10, is one such genius. If you would like to better understand what makes people like Steve Jobs tick, you should read Walter Isaacson’s new book “Steve Jobs”.  It can be difficult for most people to fathom the way brilliant, opinionated, persistent, irreverent, visionary people actually think.  You can enjoy a front row seat to the mystery and wonder of an amazing mind when you read this biography.  A compelling biography about the “other” Steve, at Apple, Steve Wozniak, is called “iWoz: How I Invented the Personal Computer and Had Fun Along the Way” by Patrick Lawlor.  While Jobs was moody, charismatic, grandiose and ambitious, Woz, is a sweet, shy, solitary dreamer with an admittedly high level of social awkwardness.  While I don’t diagnose people I’ve never met, he comes across as a classic presentation of high functioning Asperger’s Syndrome.  His autobiography is both touching and inspiring.  Both Apple creator biographies stand well on their own but they convey an interesting synergy when read in tandem.  They chronicle an exciting time in the history of technology and provide an answer to the age-old question, “If things are the way they are because they got that way, how DID they get that way?”…At least with regard to Apple computers, anyway!

The author who wrote “Steve Jobs” also wrote a biography of Albert Einstein (entitled Einstein: His Life and Universe) published in 2007.  Isaacson is particularly skilled at making the minute details of life lyrical and informative.  He integrates great chunks of history into his books and strives to help the reader understand the “theory of mind” of his famous subjects.  He debunks many of the popular myths about Einstein, such as the absurd idea that Einstein failed math in elementary school, which he did not.  As a psychologist, it is especially interesting to understand how visionary men like Einstein, Wozniak and Jobs integrate their exceptional giftedness with the other relatively mundane but meaningful priorities in their lives such as family, relationships, home-life, travel, values and inspirations. 

“A Madman Dreams of Turing Machines”, by Janna Levin, is about Kurt Godel and Alan Turing.  Godel was a mathematician / philosopher who gloried in the cafĂ© culture of 1930’s Vienna.  Turing was a mathematician / logician / computer scientist who is best known for mechanical decision theory and the Turing Test, which is still the standard by which the quality of artificial intelligence is gauged.  The book is an intriguing foray into the lives of two brilliant but troubled men whose lives had striking similarities and common influences, although they never actually met.  The author’s deft use of alternating chapters about each of her subjects makes for some very engrossing reading.

“End Game: Bobby Fischer’s Remarkable Rise and Fall from America’s Brightest Prodigy to the Edge Of Madness”, by Frank Brady, chronicles the troubled life of chess champion Bobby Fisher, another genius with qualities characteristic of Asperger’s syndrome.  Fischer’s IQ was measured at 181 and his odd, demanding and difficult nature was legendary.  He died in 2008, consumed by feelings of bitterness and alienation.

In my opinion, the most heart-rending biography of genius is “A Beautiful Mind” by Sylvia Nasar about the eccentric Nobel-prize winning Princeton economist John Nash.  While the eponymous movie is fascinating, the book is even better.  It explores the details of Nash’s descent into paranoia and psychosis with a gentleness and wisdom that provides thoughtful insight into the inner experience of schizophrenia.  This remarkable book is a particularly engaging read for mental health professionals wishing to develop a deeper understanding of this terrible illness. 

The poignant struggle that comes with compelling genius seems to separate a person from the rest of his world.  Ultimately, what we call genius appears to be the natural ability to comprehend universal truths and see things in a way that no one else generally does.  This can make for a very turbulent and lonely existence. The isolation, frustration and compulsive drive that characterize the subjects of these biographies shows how giftedness can be a double-edged sword.  Sadly, their greatest challenge may be growing old without becoming paranoid, alienated, delusional or embittered.  It’s always illuminating to really know the actual person behind a legend.  These biographies bring these legendary scientists and inventers alive in a way that will forever change how you perceive the costs and benefits of genius.  Hopefully, reading about their lives will make you further appreciate the price they paid to make the unique contributions that have so enriched our lives.  The insights gleaned can also compassionately inform our work with individuals on the gifted spectrum.

Until next time, happy reading!

Wednesday, October 5, 2011

Remembering Steve Jobs

“Your time is limited, so don’t waste it living someone else’s life. Don’t be trapped by dogma — which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition. They somehow already know what you truly want to become. Everything else is secondary.” -- Steve Jobs (02/24/55 -10/05/2011)

Steve Jobs died today.  He was one of my heros and there honestly aren't too many people who make this short list.  I was one of the very first users of the Apple Macintosh.  I spent a year at Stanford doing research and was able to buy my first Mac through something called the Stanford Consortium when it was first released in 1984.  I've had every version ever since.  I was also one of the first iPod and iPhone users.  I've always been an "early-adopter" when it comes to Apple's products because each one has been better than the last.  Steve Jobs has touched my life in so many ways and continues to do so multiple times per day through the delightful devices he brought to my life.  Just consider how many smiles each day he is personally responsible for!  He was an inspiration to us all and changed the way we do the simplest things, always for the better. He made it cool to be a geek, something I will always be grateful for!  He's left an amazing legacy and very big shoes to fill at Apple. It is so sad to see him taken from us so young.  The world has lost a truly great man and a genius of epic proportions today.

I admired his vision, his tenacity and his willingness to do whatever it took to make his products the best and most beautiful they could be.  He overcame daunting obstacles, even getting fired from the very company he helped found only to graciously agree to return when Apple took a nose dive in his absence.  He was able to see new ways to do things and embraced his own creativity and incredible sense of possibility.  He marched to his own drummer and never apologized for being unique.  I hope original thinkers everywhere will always be inspired by Steve and his dreams.  And I hope all of us take a moment to express our appreciation and respect the next time we reach for one of the many delightful and innovative products he brought to our lives.

Rest in Peace Steve Jobs (1955-2011).  You will be deeply missed as someone who touched the world in the best possible way!

Wednesday, July 20, 2011

My Facebook Account Has Been Disabled 2: Do Facebookers Dream of Farmville Sheep?

Tuesday morning July 5 dawned clear and bright on South Padre Island.  After a fun-filled 4th of July evening of food, fireworks, and friends, I reveled in the luxury of sleeping in.  When I finally stirred, I sauntered over to my laptop where I was delighted to receive the following cryptic message:

“Hi Jill,

I sincerely apologize for the inconvenience you have experienced. Your account was disabled in error. Your account has been reactivated and you will now be able to log in.

Thanks for contacting Facebook,

User Operations

That was it…that’s all I was told.  Thanks Hogan!   Hogan?  I’ve never met anyone with the name Hogan.  And, it was just signed, “Hogan” with no last name in evidence.  I wonder if Hogan is even a real person or just a virtual one, which would be kind of fitting for facebook if you think about it, wouldn’t it?  What a denouement!  I anxiously logged in to my account, which turned out to be just as I’d left it three days earlier when it was precipitously and mysteriously disabled.  What a relief!  I noticed the number of facebook credits listed had climbed to 5 from my customary 0.  No explanation of the 5 credits was forthcoming either.  I assume the credits were an amend for their error, perhaps so I could purchase something called an “unwither” on Farmville to rescue my virtual crops which had been neglected during my banishment.   As of this writing, it’s been two weeks and I’ve heard nothing else, so apparently, we may never know exactly what the aforementioned error was that caused me so much grief.

The errant disabling of my facebook account had given me some serious food for thought.  I’ve been a facebook user for almost 5 years.  Facebook has grown to great personal and cultural significance in that relatively short span of time.  I considered the myriad ways facebook had become an integral part of my day-to-day life to help me understand why I had taken the unexpected disabling of my account so hard.   There were so many!  I use it as an address book.  I use it to stay in touch with my family, which is spread all over the country.  It’s the primary way I share news, jokes and important information.  Facebook has become an easy way to make plans when I want to get together with my friends.  It’s my scrap book and photo album.  I’ve forged many new relationships through facebook and I missed my globally dispersed buddies when I couldn’t jump online as I was used to.  I even have some facebook penpals!  It was distressing to be unable to write to them and eagerly anticipate their replies while I was gone.  Facebook has become a way I pass the time when there are too few minutes to begin a new task but too many minutes to fill by just taking a few breaths before moving on.  The facebook games I enjoy have become an easily accessible source of simple relaxation and pleasure.  Posting on facebook has become the way I generally seek advice.  I remember asking whether I should replace or fix my broken washing machine as my status.  I had a wealth of helpful responses at my fingertips within an hour advising me to can the 10 year old machine and buy a new one, which I did.   Through facebook, I’ve reconnected with old friends from camp. high school and college who I never thought I would be close to again.  I am so delighted to see how much I enjoy their company and being a part of their lives again, even if the relationship is now (for the most part) “virtual”.  As an inveterate night owl, facebook has become a lovely way to chat with those I care about in other time zones while those who are geographically closer are blissfully snoozing away in the land of Nod.  When I couldn’t log onto my account, I worried that my friends might jump to negative conclusions, assuming that they had somehow earned my wrath, that I had un-friended or blocked them without the courtesy of an explanation.  I sent out several emails explaining what had transpired so no one would think I might do such an awful thing.   Their reassurances were a comfort to me.   In summary I realize that facebook adds a richness to my life that would cause me significant grief if it were permanently snatched away.  I hope the facebook team appreciates the honor and responsibility this bestows upon them.  

I am delighted that my account was restored so quickly.  From what I’d read of the experiences of others in similar situations I was very fortunate.  Perhaps facebook has streamlined their procedures for evaluating and restoring accounts.  If they have, I applaud this change.  If they haven’t, I hope they seriously consider that they themselves describe facebook as a social “utility.”  No other utility gets cut off without warning or remedy, even with just cause.   Personally and professionally, I see the importance of facebook in people’s lives growing more each day.   My clients share content from their pages in the course of their psychotherapy.  Relationships are not over until one’s relationship status has changed to “single” with much trepidation spent on making this proclamation.  Good news gets shared, emotional support is offered, laughter spreads because of jokes, videos or amusing anecdotes.  Information and advice fly through the ether to the benefit of all who receive them.  People from the far corners of the earth play games together and get to know one another.  Lives are cataloged through status updates, stories and photos.  Simple pleasure is constantly at our fingertips.   In this age of constant busy-ness, isolation and dissent, facebook is like the pub in the show “Cheers.”  It’s the place you can always visit where “everybody knows your name.”  What a treasure. 

I’m so glad to be back.   

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Saturday, July 2, 2011

"Your facebook account has been disabled."

I read what could arguably be the most dreaded words in the world of social networking as they flickered across my Macbook screen:

“Your facebook account has been disabled.”

After determining that this could not be explained away as a bad joke, a hack or a simple mistake, I paused and considered what despicable facebook crime I might have inadvertently committed to render me worthy of this draconian punishment from the facebook team.  I haven’t a clue.  I am a mild mannered, non-confrontational, friendly, and active facebook user.  I have a personal page, a page for my clinical psychology private practice and a page I set up and administer for the Bexar County Psychological Association as one of my responsibilities as a member of the executive committee.  My loftiest social media goal is to bring a little cheer to someone’s life because our paths crossed today.  Facebook is an ideal venue for this so I strive to be my usual pleasant, supportive, (hopefully) amusing self on my facebook pages.  I post lots of photos, quips, information and links.  I am an embarrassingly avid player of Farmville.  I think facebook should love me, not leave me!

I did some queries and discovered more than a few interesting tidbits about my predicament. 

  1. Facebook can disable your account without warning or immediate explanation.  And, without even the simple courtesy of an email alerting you to their actions.
  2. Facebook does not have a customer service phone line or live chat feature to allow you to address the problem immediately with a live person.  For a company who’s raison d’etre is connection they are surprisingly difficult to connect with when you need them.
  3. The only apparent recourse is to fill out a brief form letting them know that you think the deactivation was a mistake and then to await a reply, which generally takes at least 3 days and by some reports has dragged on for weeks.
  4. Facebook appears to have the right to with hold information about why they disabled your account if they believe you have violated their rules, rights and responsibilities agreement.  The irony is I’ve actually read this document.  However, there seems to be a pretty wide margin of error in how these rules, rights and responsibilities might be interpreted by the masters of the facebook realm.
  5. There seems to be no ultimate court of law or procedure for appeal so if you are barred they can decide the decision is final with no recourse for remedy.
  6. Other writers discoursing on the this topic advise that if you are very VERY nice, apologetic and promise never ever EVER to commit the same crime, oops I mean inadvertent violation, again it might help you get your page back.  If you get upset, argue too loudly, cause problems or make waves of any kind, it seems to reduce the likelihood they will restore you to full facebook citizenship, so I blog today with some trepidation. Could I be branded a rabble-rouser or trouble-maker unfit for the genteel confines of the facebook community? 
  7. If you don’t get your account reactivated you are not entitled to any of your page content, pictures or games because they aren’t required to give them back to you.
  8. If they don’t agree to reverse their decision they can bar you from facebook FOREVER.  If you set up a new page with a different email address, facebooks’s face recognition and data mining software can find you and disable that account too.  It is also against facebook’s rules to have two accounts or misrepresent yourself as someone you aren’t (I'm not guilty on either count).  This means that as soon as they discover your new account you were guilty before you even got out of the gate.  
  9. If that happens, you will be excommunicated from the ranks of the social media elite and forced back to the primordial slime to play your games with actual tangible objects like playing cards or jacks or tiddly winks. You will have to re-cultivate the fine art of communicating with people using that quaint device called a telephone, old fashioned paper and ink, email (that’s SO 20th century) or even (gasp, gasp) face to face.  And, of course, there’s still twitter, right?

I know many readers will consider this to be a trivial matter easily resolved.  If this might be you, click on the following link for a stark reality check

to read the poignant implorations of other frustrated deactivated facebook users.  I would like to take this opportunity to mention that backing up your facebook page is an excellent idea.  However the necessity of having to back up my facebook page had never occurred to me at all.  Aren’t we constantly being warned that anything posted on facebook is permanent and destined for perpetual storage on multiple servers to embarrass our future selves when its most inconvenient?  This represents yet another jarring example of better living through technology and the hard lessons it can teach.  Make sure all of your personal information including your friends list and their contact data, message texts and photos are stored someplace besides facebook.  Facebook may appear ubiquitous but it seems to be a privilege rather than a right so unlike Motel 6 the light will not always be left on for you.  Do a google search and you will get multiple hits for tips on how to back up your page and do it NOW.

Will my facebook privileges be restored?  Will I be released from facebook purgatory?  Only time will tell.  This unexpected hiatus will be extended by the fact that it is a three-day weekend and no serious business gets accomplished in America on holiday weekends.  Plus, I am at the beach on vacation with my lovely sister, her son, my husband and my kids.

Wait a minute!  I am at the beach with my family… who needs facebook at a time like this anyway?  The surf beckons.  The air is redolent with the fresh scent of sand and sea and sunshine.  I hear the gulls cry in the distance.  There is laughter on the beach.    I shut down my computer and I go.

Wednesday, May 18, 2011

I'm Blogging FOR Mental Health: Bibliotherapy and Beyond May 2011

There's nothing like a good book to learn what's new in psychology and how to apply it towards improving your life.

The quality and readability of psychology books intended for a general audience has vastly improved over recent years.  These books provide a practical but comprehensive summary of recent advances in the field without having to pore over basic research findings or dense journal articles.  Many of these titles are also available as audio books, which can be downloaded to your iPod or MP3 disks you can pop into your car’s audio system so you can multitask and learn while you drive.   I particularly enjoy listening while I garden, cook or do household chores.  Here are some of my recent favorites:

Stuff: Compulsive Hoarding and the Meaning of Things by Gail Steketee PhD and Randy Frost PhD is a compassionate discussion of hoarding and recent advances in treatment of this common disorder.  Warning, while most of the book is not gratuitously sensationalistic a few of the case examples will curl your toes and make you want to go take a long hot shower and scrub yourself clean.

The Sociopath Next Door by Martha Stout, PhD: The word chilling features prominently in many of the reviews written about this book, which presents a frank discussion of everyday sociopathy and its shocking impact on us non-sociopaths who have to share their world.

On Intelligence by Jeff Hawkins and Sandra Blakeslee PhD: Jeff Hawkins is not a psychologist but he is the architect of the PalmPilot and the Treo.  Along with Dr. Blakeslee, he presents a fascinating framework integrating recent findings in cognitive neuroscience and computer design to revolutionize our understanding of intelligence and how it functions.

The Tell-Tale Brain: A Neuroscientists Quest for What Makes Us Human by V.S. Ramachandran MD:  You can never go wrong with Dr. Ramachandran.  His skill at making complex concepts interesting and approachable is matchless. 

Mindsight: The New Science of Personal Transformation by Daniel J. Siegel MD describes an innovative system of psychotherapy that integrates research in neuroanatomy, cognitive neuroscience, mindfulness practice, developmental psychology and neuroplasticity to treat psychiatric disorders like depression, anxiety and PTSD.

Sleights of Mind:  What the Neuroscience of Magic Reveals about Our Everyday Deceptions by Stephen l. Macknik, PhD, Susana Martinez-Conde, PhD and Sandra Blakeslee, PhD.: Dr. Blakeslee is highly skilled at helping psychologists with great ideas write books that are so interesting you don’t want to put them down.  Drs. Macknick and Martinez-Conde are a married couple who explore how neural adaptation, afterimages, occlusion, perspective, saccades, inattentional blindness and other neuropsychological processes contribute to our delight in magic tricks.  We also enjoy a birds eye view of their odyssey from cognitive neuroscientists to magicians auditioning at the famed Magic Castle.  This is a rare book that combines hard science, provocative inquiry, a little suspense and excellent writing in a way that is just plain fun!  How often can you say that about nonfiction?

I hope some of these suggestions pique your interest.  Stay tuned for more in my next blog post and until then, happy reading!

Thursday, March 3, 2011

Dear Dr. Jill on Bullying

Dear Dr. Jill:

It seems that teasing and ridicule have become the norm for both fourth and fifth grade students.  I don’t want my daughter to participate in hurting other students or be hurt herself.  What can I do?

Yours truly, Concerned

Dear Concerned:

I sure remember a certain amount of teasing and “picking on” that went on when I was in school, but I recall most of it started in Middle School, not Elementary!   While it seems adults of every generation  have shaken their heads and muttered, “What is wrong these kids today?”, children today live in a fast paced world with  stresses most of us couldn’t even imagine when we were young.  Children are exposed to complex adult behavior (and misbehavior) at younger ages than ever before.  Politeness, respect for authority or expertise, and good manners are not particularly encouraged in today’s culture.  Often children are permitted to be inappropriate with adults because they are considered to be equal to adults in their rights, preferences and opinions.  Unfortunately, as the teasing and ridicule demonstrates, children generally lack the judgment for this much democracy.  Children copy what they see.  When TV, movies, and video games consistantly portray sarcastic, rude, and mean interactions, children learn this as the norm.  Children generally don’t engage in unstructured play anymore.  Much of this street and playground activity provided a natural classroom for peer relations (not that it wasn’t sometimes painful…) that today’s children cannot learn from.

This insight is helpful, but it doesn’t suggest much that we can do immediately.  Solutions can include:

Talk to the principal, school counselor, and your children’s teacher about the “social environment” in the school and your child’s classroom.  While many schools provide instruction about values and interpersonal skills, they often move on to another module and never follow up or put into practice what they have taught.  Appropriate behavior is not a one shot deal, continuous attention, correction and feedback are necessary to make such behaviors routine.  Ask the teacher to to do what he can to create and atmosphere of mutual respect and kindness in your child’s classroom.If you are unhappy with the social environment encouraged or reinforced by the authority figures in the school make your displeasure known.

What kind of a role model do you want to be?  If you speak in a sarcastic or contemptuous voice, expect no different from your kids.  If you tease them, they will tease others.  If you ridicule them, ridiculing others will be natural to them.  If you are disrespectful and unkind, the apple will not fall from the tree.  If you cannot control this behavior in yourself and you are the “grown-up”, how can you expect something better from your child?  If you are out of control, individual or family psychotherapy may be necessary.

Discuss and role play appropriate behaviors.  Point out example s of the right way you want things done.  For example, you might say, “Suzie was very polite when she came to borrow that egg for her Mom, don’t you think so.”  Or, “One of my customers was so nasty to me.  This is what he did … and I felt so hurt!  I would never treat anyone like that.”  Also, “Good job, you played nicely with Ethan and shared your toys.  I know he’s looking forward to having you come play at his house.” Comment on your child’s tone of voice.  Give them feedback on how you perceive them.  Children are not good at seeing themselves from another’s perspective.  They often think they are being clever and funny.  When they find out their behavior is hurtful or mean, many kids are horrified.  Talk to children about why kindness matters and how it works in the long run.  Ask them to consider the long -term consequences of mistreating others (for ex: no one will invite you to their parties).

Read books and see movies together where the characters are kind and considerate.  Be careful about the video games you buy for your kids or let them play.  Strike up conversations with your children about the characters and what’s “cool”.  Teach your children to admire characters who are smart (like Harry Potter) rather than the nasty ones, like (iforgothis namethe blomdboyfrom slytherin).  Ask them how they feel about seeing others, even if its just “virtual” “being treated badly.  Virtual violence can damage perspective as much as “real” violence.

In addition to teaching “Just say no!’ to drugs, we also need to teach “Just say no!” to nasty behavior.   Consider alternative ways for children to get others to notice and like them.  Teach them to stand straight, look teasing/ ridiculing kids in the eye, and tell them assertively that they are being mean.

The best way to make your child part of the solution rather than part of the problem is to make kindness, consideration and respect a part of their daily lives.  Children learn what they live.  Teach them well.

Dear Dr. Jill on Summer Vacation

Originally published in Oak Meadow Elementary School Hoofprints Newsletter April 2004

Dear Mommy (even if everyone else calls you Dr. Jill),

How can we have the best summer ever?

Love Greg, Bradley & Nikki
My dearest children,

First I will tell you why we have such a long summer vacation.  In the olden days, back when your great-great grandparents were children, most people lived on farms.  Farm families had LOTS of children because more children meant more help on the farm.  Everybody knew school was important, but taking care of and harvesting the crops was even more important.  They couldn’t just go down to the grocery store for their food, so if they didn’t take care of the farm, they would be hungry.  For this reason, children didn’t go to school during the summer because this was the time they were needed to work on the farm.  Not much of a vacation, was it?

Children today have lots of time off during the summer and usually there are no crops to care for.    I want to get together one night, make some popcorn, and find out what everybody in our family likes doing best.  To have the best summer ever, we need to spend lots of time doing the things we like best.  I know we will want to do lots of swimming and bike riding.  Lets plan on some lazy breakfasts where we all help make the pancakes or eggs. I think this might be a good summer for you kids to learn some cooking.  Lets take the time to learn to bake a cake and make grilled cheese sandwiches.  Yum yum!  Spending time with friends sounds great too.  Sometimes your friends can come to our house.  Remember they must follow our rules about inside voices, walking instead of running, listening, sharing and keeping hands to selves.  Other times you can go to their houses to play.  Behave well and win the good guest medal by being invited back!  I think the best times are when you go outside and you run, feel the wind, giggle, roll in the grass, get sweaty and hot, and then drink something cold or have a popsicle.  Playing with the hose or in the pool are special summer treats too.

We are planning two very special vacations this summer.  We will go to Disneyworld and to the beach at South Padre Island.  We will spend lots of good times together.  At Disneyworld  we get to go on rides, eat interesting food, ride trams and see things we’ve never seen before.  We will take an airplane and stay in a hotel so we must remember to be respectful, polite and kind.  I will pack bags with treats and activities to keep you busy.  Traveling is a great time for gameboys, coloring or reading books.  When we go to the beach, we will drive.  Lets have a nice time in the car.  We can sing and talk and listen to music or books on tape. Looking at the scenery, animals, clouds, plants, houses and train tracks can pass the time quickly.  At the beach, you have to remember to always wear sun screen and stay where an adult can see you.  Don’t go in the water without permission! We will eat in lots of restaurants on both trips.  Talk in a calm, inside voice.  Order only what you plan to eat.  Sometimes we will get dessert but not every day so please don’t complain.  Complaints are never welcome, although suggestions usually are. 

Summer vacation is a long time away from school.  It is easy to forget the things you worked so hard to learn this year.  A good way to stay smart is to read.  We will try to read at least 30 minutes every day.  You are all good readers so I bet there will be many days you will want to read even more than that.  We can go to the library or bookstore to pick out some interesting books. We can play math games in the car or at dinner.  You can go to the store with me and help me pick out what we need and figure out what we are spending.  Computer math games are a good way to stay smart too.

Remember when I told you about the farm children earlier?  Summer vacation can be a good time to learn new skills and chores.  We all enjoy living in the house together so we all must pitch in and do our part.  Lets talk about chores AND allowances.  Its nice to have pocket money to buy what you want and to learn about responsible spending.  

The most important way to have the best summer ever is to enjoy time as a family and time by your self.  We have the most fun when we are kind and considerate and generous with each other.  We are happiest when we take turns and practice patience.  At night, we can sit outside and watch the stars and moon.  Maybe we will see constellations or planets.  Sometimes we can catch fireflies but we must always let them free before we go inside.  I also like to watch our pets playing.  It is so relaxing!  Our dog does funny things that make us laugh.  Our cats are so cute together and love to be petted gently.  We should spend time outside watching the clouds, blowing bubbles, playing games and walking in the woods.  Maybe we can go through some old photos together and talk about your grandparents and what life was like when Mommy and Daddy were your age. Quiet time spent thinking about our love for each other, what we are grateful for and how to be the best we can be is a good way to spend hot afternoons.  Its so easy to forget how nice it can be to do nothing.

Sounds like a good plan for the best summer ever doesn’t it?  I can’t wait!  

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Dear Dr. Jill on Work/Family Balance

Dear Dr. Jill:

My husband and I both work and sometimes it feels like our children are raising themselves!  We need both of our jobs to meet our budget.  We also enjoy our work and find it to be very meaningful.  What can we do to be more involved and connected with our kids?

Welcome to family life in the new millennium!  Balancing work and family has always taken love, creativity and stamina.  Throughout history, parents have worked and had to do their parenting AROUND their work.  Dad didn’t delay harvesting the wheat because Junior had a spelling test the next day.  Mom baked today’s bread even when she had a sick child to tend.  Traditionally, the ability to devote one’s self full time to parenting has been a luxury most parents couldn’t afford.  The great mid-century post-war prosperity allowed many (but not most) families this luxury.  Today, many working parents experience considerable guilt because their children are deprived of the idealized family life of the 1950’s.   The good news is that you can be involved and connected with your kids by combining both “quality” time and “quantity” time as your situation permits.  Here are some ideas:

1.    Make family a priority. Schedule consistent weekend time as a family. Family vacations and regular family activities will enhance family connection.  Reconsider your volunteer work and civic contributions.  Would it be best to spend more time with your kids now and more time on these other important pursuits later?  Plan time with extended family.  Keep family pictures around where kids can see them. 
2.    Focus less on individual activities and more on family activities. Minimize separate after school sports, clubs and activities.  Have everyone take an art class this summer and try basketball together next fall.
3.    Talk to your kids about your work.  Make sure they know what you do.  Share what is meaningful about your career with your family.  Take your children to your office.  Have them sit in your chair. Show them their pictures on your desk or their artwork on you bulletin board. 
4.    Enjoy meals together.  Plan at least 3 leisurely meals together per week.  TURN OFF THE TV!  Make conversation and listen to each other.
5.    Watch movies, read books (aloud!) and play games that celebrate family and encourage interaction.
6.    Develop family rituals and traditions.
7.    Become the family your children’s friends want to hang out with.
8.    Involve your children in caring for their own home and family.  Give them chores that can be done along with other family members (such as weeding, washing dishes, cooking) rather than solitary activities like taking out the trash.. In the past, shared chores were an important part of parent-child interaction, as well as the only way to get things done before modern conveniences.
9.    Promote a family friendly workplace.  If you are in a management position, allow your employees the flexibility to attend school functions, prepare for important holidays, vacation during school breaks, and work at home when necessary. Remind each other that you work to live, not live to work.  No one uses their last breath to wish they had worked more.  Vote for politicians who promote life balance and family rights.
10. Involve yourself in what’s important to your child, especially school and school projects.  Include your child in activities that are important to you.

Dear Dr. Jill on Homework

Dear Dr. Jill:

My eight-year-old son is now in third grade.  He is getting a lot more homework this year than ever before.  Getting his homework done is a real problem.  He makes up all kinds of excuses, “forgets” that he has homework or waits until it is bedtime to even start his assignments.  We never had this problem with his older brother and we are at our wit’s end.  Please help!

Harried Homework Mom

Dear Harried Homework Mom:

As I am sure you already know, all children are different.  Therefore something that comes easily to your first child will not necessarily come easily to your second one.  First of all I have some great news.  Your child’s homework is his assignment, not yours!  This is good news because it frees you from homework-related anxiety and guilt.  Unless you plan to go to college with your son, he MUST learn to do his own homework.  Of course, this doesn’t mean you ignore his needs, it simply means that clarifying what is YOUR job and what is HIS job, can bring your homework-related stress level way down.  HIS job is to actually get the homework done.  HIS job is to learn the material the homework was assigned to teach or reinforce.  It is not YOUR job to do the homework for him (I once thought I was working on a diorama WITH one of my sons.  After it was done, I realized that I had somehow done all of the work while my son looked on admiringly.  What a clever boy!  His teacher sent home a note to let me know that the project was very well done and that “I” had received an “A”.  I never did another one of his assignments all by myself again.) 

It is not YOUR job to make sure his homework is the best in the class.  It is not YOUR job to show everyone how smart you are through his homework.  It is not YOUR job to demonstrate how cutting edge your computer equipment is or how amazing your artistic abilities are.  It is definitely not YOUR job to allow getting homework done to be a battleground that ruins your evenings and interferes with the quality of your relationship with your son.

So then, what is YOUR job?  Your job is to create an appropriate opportunity for homework to be done and to offer your son the guidance necessary to understand and complete the work.  The goal is for your child to learn how to bring home his assignment, figure out what must be done and do it according to his own skill level before bedtime.  An important puzzle piece we often forget is that it is also HIS job to develop good study habits as early in his academic career as possible. 

Your first step can be having a heart-to-heart talk with your son.  When you are both in a reasonably good mood, find someplace quiet where the two of you can talk.  Perhaps, you can take him out for ice cream, just the two of you. Tell him you don’t like the way the homework problem is affecting your relationship with him.  Ask him to share how he sees the problem.  You will likely be surprised how your perceptions and his differ.  Explain what YOUR job is and what HIS job is as described above.  Ask him for ideas about how you can get your job done and he can get his job done.  It is thrilling to discover how often children know exactly what they need when you ask them.  Gently offer your concerns, feedback and suggestions. The next day, put the plan into action.  Let him know that this is a work in progress and that you will revisit the issue in the next week or two.  From that point on, only assume responsibility for the part of the job that is YOURS.  If his plan doesn’t work, ALLOW natural consequences to take their toll.  If he “forgets” his homework, let him get a zero (a few zeros on third grade will not reduce his chances of getting into Harvard in ten years).  If he asks to stay up late because he didn’t start his homework at the agreed upon time, don’t let him stay up.  Be flexible if your own time constraints or family activities interfere with getting the homework done according to plan.  Inform the teacher, but don’t write notes explaining why his homework is incomplete or undone.  Do not nag or hassle him. If the homework is still not getting done properly in a week or two, THEN feel free to offer some new ideas. 

The good thing about being the parent is that you can set rules and expect them to be followed.  However, bear in mind what you can and can’t control before setting any rules.  You cannot MAKE him do his homework.  You can offer a quiet place to do so and you can insure that the TV is off (I know one Mom who had to physically remove the TV to keep her son from turning it back on).  You can tell him he must sit at his desk quietly for 30 minutes so he has the opportunity to do his homework but you cannot actually make him apply himself to the homework.  Tell him you are happy to help him understand the assignment or the concept but you will not do the whole assignment for him.  It is OK, however, to talk him through a problem or two if he needs some help him figuring out what needs to be done. 

If you are still having difficulty, you can try a star chart or reward system to encourage completion of homework.  Only use small rewards, such as more desert or an extra 15 minutes before lights out. Do not offer money.  If you offer big rewards for completing 30 minutes of homework in third grade, what will you need to offer when he is in 10th?  Limiting video games or TV until after homework is done usually works very well too.  Remember, your goal is to encourage intrinsic motivation to do his homework and develop good study skills.

When he is doing his homework regularly and independently, make sure to congratulate him.  You might consider taking him out for ice cream again, but this time it will be just for fun.  

Jill Squyres, Ph.D. is a clinical psychologist in private practice.  

My Turn 2007

My Turn
And Who Should Bear the Cost?
Jill Squyres, PhD

As a teenager growing up in the post Viet Nam era, I have to admit my opinion of veterans was less than flattering.  When I was offered a research job at a prestigious VA Hospital when I was 22, I was excited by the research opportunity but chagrined that I would be working at a VA Hospital.  However, I was favorably impressed by my experience.  I grew to have a deep respect for what veterans had done for my freedom and the way of life I valued.   I went on to do my clinical psychology internship at another VA hospital several years later and discovered I really enjoyed working with vets.  In 1991, I was hired as a staff psychologist at the VA Hospital in San Antonio Texas.   I resigned in frustration in 2002 and I am now in private practice.  I take many different insurance plans in my practice, but I am proud to continue serving veterans and their families as a Tricare provider.  I was shocked and dismayed to receive a letter two weeks ago informing me that my Tricare reimbursement rate, already one of the lowest among all managed care plans, was being reduced.  How could they be offering to pay me less to treat veterans and their families when the need for psychological services was going up?  It didn’t make sense.

I have been watching the recent news about veteran’s services with interest and frustration.  When I started out at the VAMC in San Antonio, I was proud of the excellent care we provided to our patients.  We were appropriately staffed with caring employees and well-credentialed professionals.  Then the budget cuts began.  The number of veterans needing services increased.  Our documentation requirements were raised.  Standards of care became more rigorous.  In most settings, the logical response would have been to hire more staff to meet increased demand.  Instead, my job was put on a list to be RIF-ed.  The RIF  (Reduction in Force) list was based solely on longevity as a civil service employee.  I was explicitly told that the quality of my work, my credentials, and my expertise in my job were irrelevant.  Eventually the RIF list was quietly withdrawn.  The budget was balanced by instituting a hiring freeze accompanied by natural employee attrition.  Unfortunately, this increased the pressure to do more with less and spread fear among us that one of our coworkers might choose to retire and leave us with twice as much work to do with 100% less help.

General dissatisfaction and complaints escalated.  Wait times increased dramatically.  Staff members quit and were not replaced.  Some patients started hiring their own caregivers to stay with them at the hospital because the nursing staff was overworked and did not respond to their calls.  The Spinal Cord Injury unit where I worked allowed family members to spend more and more time with their loved ones, otherwise paralyzed patients might not have anyone to help them eat or provide basic personal care.

We were strongly encouraged to reduce visit length and raise the number of patients seen each week.  While enhanced efficiency is both responsible and desirable, increasing “numbers” at the expense of effectiveness is not.  We were required to do our work with little to no administrative support.  I would type my own forms and run any copies I needed, while still being expected to see more patients every day.  There was no one to delegate administrative tasks to since much of that staff had already been downsized.  I became very proficient at fixing the copy machine, an absurd task for a psychologist but a necessary one when I had a psychotherapy group waiting for handouts and no copies to give them.

My salary and benefits were good.  I was doing meaningful work for patients who deserved the best medical care available.  I was part of a great team of caring professionals.  However, all the fat in the system was trimmed and we were well into the lean muscle.  Without appropriate funding, even the most caring and capable professionals cannot provide quality services.  Administrators can’t allocate money they don’t have in their budgets.  Is it prudent for those in charge to dissemble when the truth is discouraged?  My decision to resign was difficult but also prudent.

Private practice is not easy.  Managed care can be frustrating.  I can no longer treat patients without concern for their ability to pay.  I miss that flexibility but it is a business reality.  We can blame whomever we want for the troubles at Walter Reed and the VA but we, the public, need to hold up a mirror and reconsider our priorities.  We cannot afford peace at any price.  Our veterans should not continue to bear the cost of our freedom with frustration and substandard care.   If we can find money for bombs, why can’t we find money to care for our vets after they come home?  The cost of a war includes bearing the cost of care to veterans and their families.  In 1865, Abraham Lincoln promised that our country would “care for him who shall have borne the battle and his widow and his orphan”.   It is my fervent hope that we decide this still holds true

Bibliotherapy and Beyond 06/2008: Memoirs

The summer reading season is upon us!  How delightful it is to lounge on a warm Sunday afternoon sipping a cold glass of iced tea while savoring a good book.  I always try to save my best reads for the summer because somehow summer reading is the best of all.  Most of us are so chronically busy these days that relaxing with a good book on Sunday afternoon may seem like too much of a frivolous luxury to indulge in.  After all, there are so many other more constructive things we should be doing, right?  Wrong!  First of all, we must practice what we preach.  If we preach balance to our clients, we must practice balance ourselves.  So a little indulgence becomes self-care, which is professionally responsible.  Second, if you read the books I recommend in this column you get to enjoy yourself, relax AND get some work done.  That’s a win-win all around.

This month, I am focusing on memoirs.  Memoirs are huge assets in our work as psychotherapists.  They can be as engrossing as novels but they have much more credibility.  After all, what better way to learn than to hear about it from someone who has actually been there and prevailed in a way that is interesting enough to publish?  Its far more efficient and enjoyable than actually having to go through the experiences ourselves!  There are so many great memoirs out there so it was hard to winnow down my list but upon reflection, these are my top three:

I Know Why the Caged Bird Sings by Maya Angelou (1969)
Maya Angelou is an amazing person and she seems even more amazing after you read her memoir.  Ms. Angelou is an African American poet who has inspired many women, including Oprah, to rise above oppression.  Considering all she’s been through, we would completely understand it if she spent the rest of her life curled up in the corner in a fetal position in a Seroquel haze instead of writing prize winning poetry.  The book is beautifully written.  Although some of her experiences are truly horrifying, the lovely prose keeps you reading.  She writes about victimization and helplessness with journalistic precision paired with compassion and hard-earned wisdom.  Reading this book is an enjoyable, engrossing and inspiring experience.

The Glass Castle by Jeanette Wells (2005)
This New York Times bestseller is one of the starkest dysfunctional family dramas I’ve ever read (and I’ve read a LOT of them).  Both of the author’s parents drag their four kids through the horrors of their mental illnesses. Depending on their parents’ folie de jour the children alternate between feeling neglected or abused and believing they are the luckiest, most special, cherished children on earth.   Their father is a master spinner of tales paired with misguided genius and unrequited dreams.  He is never formally diagnosed but symptoms of narcissism, antisocial personality, paranoid delusions, psychosis, bipolar disorder and alcoholism are evident.  Their mother is depressed, dependent, histrionic and ineffectual (borderline comes to mind).  One sister ends up schizophrenic but the other three children demonstrate a resilience that is remarkable to behold.  This book demonstrates that all children from dysfunctional households do not have to end up dysfunctional themselves.  The author’s compassionate but unflinching consideration of her complex, chaotic and heartbreaking childhood raises fascinating questions about the varying roles of adversity, resilience, love and redemption in personality development.          

Divided Minds by Pamela Spiro Wagner and Carolyn S. Spiro, M.D. (2005)
What is it really like to be schizophrenic?  How can we even begin to imagine the chaos in the mind of someone who is psychotic?  If you want to know, read this book.  Divided Minds chronicles the lives of a pair of identical twins raised in an upper middle class family in Connecticut from their earliest memories (in the 1950’s) to the present.  One twin, Pam has chronic paranoid schizophrenia and the other twin, Carolyn, is a psychiatrist (I know, I know, hold the jokes please!).  The twins, who are now in their 50s, wrote the book together, primarily during the psychotic twin’s more lucid (aka well-medicated) moments.  For the researchers among us, please note that this pair of twins represents one of the most fascinating natural experiments in the etiology of schizophrenia to date. This illuminating and compellingly readable book will forever change your understanding of psychosis.