Category: Health & Medicine

We Do We

By Ginger M. Sullivan, MA, LPC, CGP, FAGPA Individual and Group Psychotherapy
www.gingersullivan.org

You Doing You

As a permission granting statement, one that lets go and grants freedom to the other, I like it. However, I wonder if, as a society, we’ve swung too far. It seems that in the last half a century, we have focused primarily on a growing individualism. Yet, we have become lonelier, internally empty and emotionally undernourished. We exist like separate islands in an immense ocean. Ones without bridges, or even boats, to pop over for a spontaneous afternoon fish fry. Each to their own. You doing you.

Are we ignoring, and worse still, contributing, to an obvious yet unnamed public health crisis?

Terrifying, really.

As a culture, we’ve learned to find our voice. Express our opinions. Beat to our own drum. Carve a separate path. Order Amazon and a week’s worth of groceries while lounging in our pajamas, without ever having to leave the walls making our home. We know how to keep our selves busy and distracted and alone – just take a look around at all the faces staring down at their phones. We have “friends” without ever meeting eyes or touching bodies. We feel shame if forced to admit we are hurting and in need of someone other than our earned and celebrated hyper independence.

Yes, personal fulfillment prevails and has superseded the value of relationship as our societal bellwether. Our highest state – that of satisfying connection – has been steamrolled. But, the cost of our individualized existence is skyrocketing.

Overdose is the number one killer of the under 50 crowd. Suicide tops 47,000 individuals per year. Marriage emphasizes personal fulfillment (am I getting my needs met?) over the design-intent of partnership and teamwork. Political divide, which dehumanizes difference as “Other,” is worsening. The ensuing intense feelings of fear and hatred are resulting in chaos, greater division and deadly violence.

Interconnection, Our Natural Birthright

We are in trouble and must turn the pendulum back to include the prize of interconnection, our natural birthright.

Most folks are familiar with studies done with lab rats, whereby when placed alone in a small cage with a lever they could press to get morphine and other drugs, the rodents would continuously self-administer the drug until they stopped eating and died. The theoretical conclusion became the brain science underlying addiction. Drugs are powerful over takers. Even rats get high until they die.

We Need Human “Rat Park” Playgrounds

However, Bruce Alexander and his colleagues at Simon Fraser University in Vancouver were skeptical of the study’s deduction. Knowing that rats are social creatures, they designed their own experiment. Called the “Rat Park,” they put together a playground fit for a large family of rats. Shavings, tin cans, running wheels and the like gave the animals a place to romp around as a group. When given access to the drug lever, they tried it but did not become addicted. They preferred to play amongst themselves.

Sounds like we need human “Rat Parks.” Places where we are reminded of the nutrition and fulfillment of in-person human contact. Live experiences where we can re-learn that togetherness has the capacity to compete with death-tempting behaviors and be victorious.

I recently watched “Dumplin’,” a coming-of-age film on Netflix. It tells the tale of an overweight high school girl who is the daughter of a former Miss Teenage Beauty Pageant Queen. The daughter, Will, struggles with her own – as well as her mother’s – body-shaming.

In a particular poignant scene, Will, gets into a fight with her thin and attractive best friend, Ellen. Ellen ruins the teen group’s rebellious plan by following adult instruction. This uncharacteristic move surprises Will and she takes it personally.

“You just did that because you are ashamed of me!” yells Will across the gym floor.

As Ellen stomps off, she retorts, “For the record, I have never seen you as fat.”

We Doing We

We need more Ellens in this world. People that reach beyond themselves to look and see the full dignity and value of the Other. Because, life is less without it. It’s when we soften our walls, not build higher ones, that the rich offering of human-to-human connection becomes possible. Less you-do-you and more we-do-we.

Sadly, our culture is bleeding out psychologically. We need each other more than ever. The external world of science, technology and electronics is exponentially outpacing that of our interior lives, the stuff of feeling, meaning and attachment. Soon, we will have a room full of toys and no joie de vie with a pack of playmates with whom to enjoy them.

Terrifying, really. How far we have gone in the wrong direction.

Relationship, a Necessity For the Constitution of a Healthy Society

Fortunately, the heart will not be ignored. She will continue to desperately call our attention, until we realize that relationship, that tie that binds, is not only a delightful beacon, but a necessity for the constitution of a healthy society.

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What To Do When Your Sibling Is Getting All The Attention

Avi Muschel, PsyD Yeshiva University Counseling Center, NYC DrMuschel@gmail.com

Wonder was a 2017 box office hit chronicling the fictional life of August Pullman (Auggie), a 10-year old boy who endured many surgeries and medical issues leaving his face with severe damage. The movie beautifully portrays the challenges he encountered in school, mainly bullying, and how he heroically overcame them.

As a clinical psychologist who works at a college counseling center, I was very emotionally inspired by the movie, but must admit that I found the most moving character to be not Auggie, but his sister Olivia, or Via, as she’s known. Via grew up normally, with the same wonderful parents as Auggie, but without his many physical, and resulting social challenges. Via easily makes friends, does well in school, and has a relatively calm life, outside of some relationship stress with her best friend and new boyfriend. And that’s exactly the point the movie conveys so well: everyone, even the most “normal” and “healthy,” deal with challenges in life. What makes Via’s challenges more difficult is her need to experience them alone.

A Lonesome Struggle

As Via explains in the movie, “Mom and dad would always say I was the most understanding girl in the world. I don’t know about that. I just knew my family couldn’t take one more thing.” Via’s problems are real, if milder than those of her brother, but because of the intensity of his problems, she feels she cannot utilize her parents as resources, and she’s not completely wrong. She figures out how to do her schoolwork on her own, and learns to hide her relationship struggles from her parents as well as her disappointment in their limited emotional availability. Thankfully for Via, despite her issues and general need to deal with them alone, her mother is Julia Roberts and her father is Luke Wilson, and using their Hollywood super powers, they can ultimately detect when she’s feeling neglected. When they sense something wrong, they have the luxury of taking time off to try and immediately correct the issue by spending more time with her. For many of my students and clients, it does not always work out that way. (And, to be fair, even in the movie it doesn’t always work out perfectly.)

Ilana came to the counseling center because she was starting to feel overwhelmed by stress and anxiety, but believed she could not discuss the issue with her parents because they had an older daughter, Ilana’s sister, who was dealing with severe depression. The more I got to know Ilana, the more it became apparent that her struggles had been, and continued to be, very legitimate. However, because Ilana was a very good student and had a lot of friends, she was able to, and felt compelled to hide her issues from her parents. “They just can’t handle it,” she would explain to me. “I’m their ‘easy’ daughter; I can’t give them more problems.”

Sam was struggling pretty seriously in finding a healthy relationship. He was bright, popular, and articulate, but was struggling for several years to find a steady relationship. Sam however, like Ilana, was convinced that having a developmentally disabled sister made it unfair for him to further burden his parents. “Have you spoken to your parents?” I asked innocently. “No, I can’t. They’re already dealing with my sister. They just need me to be their healthy child that can get married quickly and give them grandchildren. They can’t deal with anything else right now.”

So what are they to do?

If Ilana and Sam don’t have Hollywood parents, how do they deal with overburdened parents? There is no great answer, but here are three tips for helping deal with this difficult situation:

1. Encourage getting parents involved

Some of my sessions with Ilana and Sam, and the many others like them, were devoted to helping them let their parents into their world, helping them appreciate that parents love all of their children, and would give anything to be helpful. It is impossible for a child to understand the miracle of the endless room in his/her parents’ hearts. Sometimes the client simply needs a little push; other times he/she requires the skills to properly communicate to his/her parents that they are needed more without leaving the parents feeling blamed. But regardless of what help the client needs, after encouraging them to speak to their parents, they almost always come back feeling happy that they did. (Of course, there are exceptions, and some parents really are too overwhelmed with one child’s issues to handle issues of the others. In those exceptional cases, and they are exceptional, the other two strategies should be prioritized).

2. Connect to your “allies”

In many issues relating to parents, not just Via Syndrome, I encourage clients to try and use one of the greatest resources they may have: siblings. Author Jeffrey Kluger argues that siblings are our most important relationship and the only relationship that we can potentially experience throughout our entire lives. Obviously, not everyone is blessed with siblings and some have siblings that are more hurtful than helpful. However, one way in which siblings are so crucial is that there is no one in the world who can quite understand the experience of being a child of one’s parents like a sibling. Whether it’s an “outsider” sibling or even the “higher needs” sibling (as Auggie was to Via), siblings can be an invaluable resource in understanding and helping cope with parental issues. Often it requires taking the first step, as the sibling may not feel comfortable reaching out, but as with speaking directly to parents, this intervention often yields positive results.

3. Acknowledge the difficulty

As an ACT (Acceptance and Commitment Therapy) therapist, many of my interventions will circle back to acknowledging the difficulty of a situation as opposed to fighting/avoiding the reality. Dealing with difficult issues without parents is not an ideal solution, but sometimes a person has no choice. Certainly neither Ilana nor Sam chose to have an emotionally challenged sibling, but part of life is managing difficult situations that we cannot change. As an integral part of ACT, clients must be committed to their values, such as family and relationships, but cannot choose the specific way in which they engage their value.

For Ilana and Sam, if they indeed value their family, they should continue to pursue a relationship with their parents, even if they will never be able to fully communicate about certain topics. Additionally, as above, family and relationships are not limited to parents, as siblings and friends can be helpful resources, even if they can never replace one’s parents. Ultimately, as Via herself concludes about her fate, “It doesn’t change the fact that my mother has a great eye; I just wish that one time she would use it to look at me.” Sometimes, just acknowledging the difficulty of a situation begins to make it easier.

Most diagnoses of the DSM V (Diagnostic and Statistical Manual) focus on the patient suffering the symptoms. An important lesson from the fictional character of Via is to appreciate how many people are suffering from Via Syndrome, struggling but having a sibling struggle even more and gaining the majority of their parents’ attention. In these difficult situations, there are no easy answers, but trying to talk to the parents, reaching out to siblings, and acknowledging the difficulty of the situation can be helpful in overcoming this common challenge.

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Technology’s Assault On Relational Intimacy

By Ginger M. Sullivan, MA, LPC, CGP, FAGPA Individual and Group Psychotherapy
www.gingersullivan.org

More Machine, Less Human

It had been too long. A sit-down with my friend was long overdue. We picked the date and the time and of course, the usual place–a Starbucks somewhere between his office and mine.

On entering the familiar coffee shop, my heart dropped. I realized that like the Starbucks closer to home, this location was also a victim of the “Starbucks Remodeling Venture” … more machine, less human. Gone were the cushy chairs, the tight seating arrangements that facilitated conversation, and the atmospheric incentives to sit in a coffee shop and actually relax and reflect upon one’s own thoughts or those of the person sitting across from you.

Instead, products being sold were displayed, well-directed paths indicated where I should queue and rows of tables available were those best suited for what has become the modern-day conversational partner – the laptop.

I asked my friend if he had found a place to sit. He shook his head in affirmation while grimacing with frustration. The only side-by-side seats unoccupied were two hard wooden chairs at what looked like a long table for studying in a college library. All the two-top tables were occupied by single people facing a screen. So, while my friend and I shared a long overdue moment of conversation squeezed shoulder to shoulder at a table also occupied by eight strangers, rows of chairs sat eerily empty and available opposite screen-watchers. This made eavesdropping very effortless and unchallenging.

The Death of Human Interaction

What has our world turned into? Even though we have more technology than ever to help us communicate, stay in touch and cross global barriers in a flash, we are witnessing the death of human connection. Face-to-face real time contact is becoming as extinct as the dinosaurs. And while this transformation in the way we live and relate with each other is concretely displayed at a place like Starbucks, I also experience and hear it daily in my psychotherapy office.

We text, sext, email, blog, tele-work in our pajamas, shop online and Facebook our many “friends” behind the safe confines of our homes with our eyes locked on a screen. Here, we are free to present the best versions of ourselves (or made-up ones) with no mess or spontaneity. But, when it comes to actual emotional intimacy, we are even lonelier and more clueless than ever.

I certainly don’t blame Starbucks for modernizing their décor. Or even Facebook, for that matter. They are businesses adapting their environment to fit technological demand.

The Realities of Intimacy and Affection

Nevertheless, one thing I am clear about – we can do away with the conversational chairs at Starbucks but good luck ridding the human heart of its need for genuine contact. Emotional connection is to the heart as oxygen is to the lungs. The creation of intimacy requires first, that I sit with my own thoughts and feelings as a learned curiosity. Such curiosity takes an investment of time and effort to construct the space for the profundities of our inner life to surface. And then as we risk exposing our cores to another and they with us, we each expand in the knowing, tolerating and appreciating of ours and their innermost worlds. True affection then takes root and grows … giving us the opportunity to know the fullness of the human experience.

Yet, more than ever before, human beings have to be taught how to be intimate with one another. Creating and sustaining true, authentic, verbal and emotional connection is a learned skill. I see this deficit every day in my office. After partners stop the behaviors that have caused the distance between them, they both look at each other and at me, and say with lost eyes, “now what?” “Is this it?” “Are we done?” I, thus, point the way toward facing the crucial task of learning how to build a genuine, messy, loving, hating and cherishing relationship with the human being sitting on the other side of my green couch.

Usually, I get stares as though I am speaking a foreign language. I am beginning to think I really am. With the predominance of social media as our primary form of human contact, we are fostering an epidemic of relationally challenged people. We are becoming so satiated with processed cookies at four o’clock that we can comfortably skip preparing, inviting and dining over real dinner with homemade food. The overabundance of manufactured contact at our fingertips 24/7 allows us to ignore both our hunger for live human touch and the blunt realization that most of us are lousy at it.

The Scholarly Bitter Truth

Such starkness leads me to appreciate my training in psychoanalysis. My scholarly teachers, poets of pontification, deepened my experience of the world. For our purposes, I will share two of their many valued ideas.

  •    Living Unconsciousness

First, Freud was right. The unconscious is alive and well. In other words, there are parts of who we are that exist in our blind spot. The evolution of a healthy human being towards his/her potential requires that he/she seeks clarity and light around the darkened rooms within. I just need to lay on the couch and say what comes to mind, what I am thinking and feeling, out loud at the moment.

  •    The Blurry Line between   Unconsciousness and Intimacy

Second, I need to lay on that couch multiple times per week to run out of things to say. Yup! You read that correctly. I can easily fill the space of 50 minutes with a report of all life’s happenings since last week. And by the time I am done catching up my analyst, the time buzzer has expired. See you next week when we will do the same thing over again. But in psychoanalysis, I must come back tomorrow or the next day. What the hell do I talk about now? Not much has occurred since the last time I was here. So, we sit in silence. And often we sit a long time. Space has been opened and thus far, nothing is rushing in to fill it. I can’t talk about the analyst’s personal life in that this is not a social setting. And God forbid, I pick up my phone. So, I am forced to sit with myself–all the good, the bad and the ugly. And eventually, because there is this creation of space, all the rich, concealed goodies deep inside me begin to surface. We drop, or fall, into a level of intimacy where the depth of my unconscious has the luxury to make an appearance. And then we get real meat, when all the deep-seated substance eventually becomes raw material for the progression of a human towards essence and vitality.

The Time-Inefficient Fight for Intimacy

Outside of the analyst’s consulting room, there is a parallel process in real life: If I do not fight for intimacy or intentionally and consciously create the time and the space for buried thoughts and feelings to crop up, then I am settling for a life of superficiality and shallow connections. I will become a victim to life’s overabundance of distractions which will crowd my capacity to dig deeper into the shiny gold lying extensively in you and in me. Couples tell me often that they don’t have the time to do what I am suggesting in order to build and sustain real intimacy. I tell them to make the time. Relationships are an investment and they are not time-efficient. Without carving out time to reveal one’s inner thoughts and feelings to one another, we are resigning ourselves to a life of boring logistics and parallel living. Thus, it’s a wonder that Facebook becomes the go-to for empty calories and watching television has replaced the dinner table.

Passing up on the Dinner Cookies

On that cold February morning, I could have easily taken my laptop into Starbucks and engrossed myself in electronic friendship. But instead, I sat across from my dear friend in an engagement of true relationship. And he became the human inspiration that got my emotional and intellectual juices flowing.

Cookies for dinner? I’ll pass, thank you. I would rather tolerate my temporary hunger in hopes that I will feast on a gourmet meal. For, intimacy is worth the fight, even when there is no longer a cushy chair to be had.

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Take Your Relationship Deeper

Ginger M. Sullivan, MA, LPC, CGP, FAGPA

Individual and Group Psychotherapy
www.gingersullivan.org

As a child, I knew in my gut that there had to be more to relationship than the superficial. I was born with an ache for the authentic. Enough of the pretend pretty, the looking-good-on-the-outside stuff. Can someone please talk about what is really going on under the surface? I was dying a slow emotional death and finding more sustenance became mandatory. So, I started to search for depth and honesty, a journey of knowing and being known. To the heart, I descended.

I owe the beginning stages of this journey to my good friend from graduate school. The roommate lottery stuck me with Helen – the disciplined woman that went to bed at 9 p.m. and got up at 5 a.m. I went to bed at midnight and got up at 8 a.m. That left me three hours of homelessness. The ugly green couch in the student lounge became my nightly place to plop. The concerned RA took note and small talk ensued. It began with – why you are always sitting there every night at 9 p.m.? Initially, it was gossip about poor Helen. Then it became about my new friend’s dilemma – should she date the nice, boring guy or the fun, crazy one? And then it became about the recent death of my father and why I had moved back to Chicago. And so on. Our talk deepened. During the wee hours, we began to share organically. She revealed her story and I disclosed mine. Fast forward ten months and not only did we become close friends, but she had patiently taught me a thing or two about loosening my grip, melting my walls and learning through experience how to become emotionally intimate with another human being through the back and forth trading of words laced with feeling.

In this article, I offer a description of the layers of verbal and emotional communication.

Like the peeling of an onion, we go from the superficial to the profound, from outer to inner.

Let’s begin the plunge:

Layer 1:  Cocktail Party Conversation

“Hi! How are you?” “Good. And you?” “Good.” “Great. Good to see you.” “You too. Have a great day!” And on we travel through our day. No personal information is revealed. No impact has been made on either party. We have only engaged in a civil, social discourse. But, before we poo-poo its importance, it is the start to human contact. We have put words in the empty space which before divided us. We have acknowledged the other and initiated verbal engagement. After all, relationships must begin with “hello.” Furthermore, we may even feel some vibe which makes us curious and hungry for more. The fun has begun.

Layer 2:  The Outside World

Once we move past the initial hello, we have begun some kind of relationship. Our big toe goes into the water as a potential bond begins to form. Conversation at this level entails subjects outside of us, such as the weather, gossip, sports, politics or current events. Like the first layer, we are still existing primarily in our comfort zone; however, there is a little more personal information revealed. The other party gets some sense of what interests us and what our passions are. We find things we have in common, and if we are paying attention, we might pick up on an energy that is connective. One that evokes our desire to get to know someone at an even deeper level.

Layer 3:  Thoughts, Values and Opinions

At this level of contact, we are sharing with more ownership. We are letting someone in on the foundational principles that define our life’s frame whether they be political, religious or cultural. Such openness means that we have moved into potentially more treacherous waters in that judgment and rejection are now possibilities. Someone might not tolerate our opinions or the values that feel essential to who we are. Someone might discount us or shame us or even, ridicule us. In other words, hurt is now a real prospect. As I get closer to the prize of intimacy, the risk goes up exponentially. Both in terms of the pain I might experience but also the reality that the relationship we are starting to invest in might not survive the additional heat. We go deeper …

Layer 4:  Facts About Me

At this level of relating, we begin to tell our story. We share the significant narratives that have come to identify who we are. Often the telling and re-telling is done from a cognitive, head-space. It is as if I am reporting a series of events outside of me. Yes, you are getting to know the facts about my life which are revealing and relating but not as connective as …

Layer 5:  Feelings About Me

Now ask me how I feel about all those central stories of my life and we got a game-changer. The emotional temperature in the person talking and in the dialogue between the party’s plummets to an emotional and relational intensity. We now have a real possibility for presence, engagement and connection. We have crossed the grand chasm from head to the sacred space of the heart. It is in this place that relationships take root and bloom. That people go from strangers to intimate friends. But sadly, we often avoid this opportunity for such a gift because we fear the risk – the risk of showing you all my best wares – the insides of who I am – and your rejecting or discarding them. Thus, in such resistance, we often miss out on entering the candy shop of life. And just as the image portrays, this is where all the good stuff is. The magical content of poets and musicians, philosophers and artists.

If we are willing to open ourselves up and share what is most raw and real, we likely draw compassion, understanding, care and warmth. We humanize ourselves which attracts other people to us – for what is most personal is also most universal. Our fears, pains, longings and aches are alike. You just couldn’t realize this when I was hiding so well.

Layer 6:  Feelings About You

At the core of human contact, the most intimate I can be with another person, is to tell him/her how I feel about them. The focus shifts from being about me, towards me and in me, to being about how I feel toward you. We stand naked, full-frontal, gazing at the eyes, heart and soul of the person across from us. Talk about risk at its height! Not only might the other not share the same feelings but he/she might not receive the feelings I have to offer. The cards are stacked to either stand tall or fall flat – something I won’t know or experience until I open my mouth and express my feelings toward the other person with my words.

So, how can this new knowledge of progressive communication assist us in our day-to-day lives? 

1. Respect yourself

You are precious. Gold. A trophy. A diva. A dame. A star.

If you really believed that, then you would learn not to reveal your inner life to just anyone. Why? Because they don’t deserve it. They don’t deserve you. You gotta make them earn it. In other words, don’t go diving into the deep end of any available swimming pool. Pace yourself. Because if you jump in and you get hurt from the undetected concrete bottom or the chilly waters or the man-eating shark that is lurking in wait, then you are the fool. You gotta test the water first. So, just put in one toe. How does that feel? Does the person seem interested, available, engaged, willing to share back? If so, stick in an ankle. See how that feels. At any point and time, if you sense danger or limitation, back it on out and take a sunbath until you muster the courage to try again – maybe with someone entirely new. In other words, respect yourself enough to reveal yourself slowly over time … not too quickly and not too slowly … and at each point, assess the other person’s capacity to receive you and reciprocate. Sometimes, you hold hands and walk together into deep waters. And sometimes, one person coaxes the other to come on in, the water is fine. And sometimes, you hit his/her cap and there is no going any further. You must stop there. Johnny might be a great bowling partner or business associate, but that is as much as there is ever going to be.

2. Respect others

No judgment, just disappointment. People bring to the table what they got for now. Accept it.

And, if you are in the mood to be generous and you sense an opening for more, be patient. Revealing one’s inner self is like a stack of cafeteria trays. You can’t get to tray #12 until you have gone through one to eleven. Sometimes, if a safe space is provided over time, people can tolerate swimming in more daring waters. That is what my graduate school friend gave to me and I am ever grateful to her for that. But she didn’t have to. She could have given up at my one-word answers and walled-off heart. And, don’t forget point #1 above – respect yourself. If you find yourself working harder on someone else’s life than they are on their own, it is time to back out. Knocking your head against a wall to try and get water from an empty well – not something I suggest. There are those that can join you in the less superficial waters. You must find them.

3. Tolerate the range

There is nothing wrong with any of the above-mentioned layers of emotional communication.

There is a time and a place for all the layers, no matter how shallow.

We need to learn how to both work a crowd at a party and how to let someone into our innermost world. Having the flexibility to stomach the range is a sign of emotional maturity. So, lighten up. Appreciate the fact that you can go as deep as there is and then back out with a good belly laugh at the silliest of things. Consider yourself one of the lucky ones who can enjoy it all.

4. Shoot for five

Heartfelt intimacy requires much time, effort and conscious intentionality. Therefore, reality precludes you from having more than a few at any given time.

The number of your Facebook friends withstanding, if you have five close, intimate relationships, you are the exception.

If you have less than five, make it a priority. Pinpoint a relationship that has potential and begin to take more risks. Stretch yourself past your comfort zone and go deeper.

So, there you have it, my friends. I’m ready for a swim. You coming in?

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Hope’s Double Edge

Ginger M. Sullivan, MA, LPC, CGP, FAGPA
Individual and Group Psychotherapy
www.gingersullivan.org

What’s there not to love about hope?

It’s one of those feel-good concepts. Dreaming about a bright light at the end of the tunnel.

In fact, we welcome hope so that we ritualize her into the fabric of our lives. We get to kiss a tired, worn day good-bye and rise to the dawn of an unchartered day … seven days a week, 365 a year. We toot horns on New Year’s Eve and blow candles out every birthday in great anticipation for all the good things we imagine ahead. We birth babies who then carry all our fantasies into their yet-to-be-lived lives. Advertisements bombard us with expectation that this product, this medicine or this opportunity will make us a better, happier, richer or healthier person. And when life kicks us in the teeth, it is often desire for that better day tomorrow that keeps us keeping on.

No question, hope is essential for the survival of the human spirit. Hope is the necessary ingredient for an optimistic future. Without it, we can move to that place of resigned despair that can accompany the darkness of depression and self-destruction. But out of context, hope can be misleading and even harmful. It can prevent us from living life on life’s terms in a present and full manner. Allow me to expound:

Hope without realistic evidence is denial.

Sometimes, the marriage cannot be saved. Sometimes, cancer wins. Sometimes, character flaws carry a poor prognosis. Hanging on to false hope grounds us in denial and stalls the process of accepting reality on reality’s terms. Learning when to keep holding on tightly with both hands clenched and when to pry back our fingers and finally let go … that is one dance we must stumble through in life. And sadly, it does not come with an instruction manual. Hope without action is passivity. It is one thing to dream but it is quite
another to put one’s feet to the fire and make it happen. Hope is not an excuse to do nothing – to sit and to wait as if we have front row tickets to a magic show. But rather, true hope demands hard work, goal-setting and perseverance through fear, risk, criticism and failure. Hope alone can prevent necessary action when it needs to be the fire that fuels it.

Hope, without an honest evaluation of our limitations, is grandiosity.

Let’s face it … I am never going to win an Olympic medal. Never gonna get him to love me again. Never gonna have another baby. Never gonna erase the mistakes of my past. There are some things, many things, that are not within my reach. I can try with all my stubborn will, but it is futile. I have only wasted my time, breath and energy hoping for the impossible rather than working toward the realistic. Without an honest, and perhaps harsh assessment of my limits, I cannot embrace the me that I am now. Humility means facing my truth and recognizing what I can and what I cannot do. Accepting my limits gives me the freedom to flow with the current of life rather than spending useless energy trying to fight against it.

Contrarily, I wonder if hope is most hopeful when it is paired with surrender. I think St. Francis got this idea. His famous serenity prayer speaks to this exact paradox “… to accept the things I cannot change, the courage to change the things I can and wisdom to know the difference.”

May compassion be your companion as life keeps you engaged in the struggle of knowing when either to hold on to hope for dear life or to find hope in the hopelessness. Because, sometimes the path to peace is letting go.

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Today’s Youth: Super Connected yet Completely Disconnected

Avi Muschel, PsyD

Yeshiva University Counseling Center, NYC                                   DrMuschel@gmail.com

Let’s start with a game: Which of the following statements about today’s youth (people born after 1995) is false?

• Today’s teenagers and young adults are starting to have sex at younger ages than teenagers and young adults of previous generations.

• Today’s teenagers and young adults engage with more sexual partners than members of previous generations did.

• Most of today’s teenagers and young adults do not want to be in emotionally connected relationships.

Think of your answer (even say it out loud to avoid cheating), and hold onto it for a moment.

Considering that I spend most of my waking hours at a college counseling center, with students born in the late 1990s and early 2000s, a book written exclusively about this age group seemed like a must-read. And so I was excited to come across “iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy and Completely Unprepared for Adulthood” by San Diego State University psychologist Jean Twenge. Twenge’s volume is fairly enlightening not only in helping understand the issues unique to this post-Millennial generation she refers to as “iGen’ers,” but in providing context for these issues. Twenge is careful to highlight that the unique characteristics of this generation are neither inherently positive nor negative; rather, they have positive and negative features.

As a general theme, she consistently finds tremendous importance given to two key components in the lives of many iGen’ers: safety and individualism. For our purposes, we will only explore and expound upon these two features as they relate to my personal area of expertise, relationships.

Twenge begins her chapter about relationships by dismissing all three of the statements I listed at the beginning of this essay as myths. As it turns out, today’s youths are less sexually active than their parents or grandparents were at their age. Similarly, although the media typically highlights the frequency and widespread nature of the casual “hookup culture,” not only is the hooking up not as pervasive as is often reported, but more importantly, despite the culture, most teens and young adults still desperately seek emotional connection. So why can’t they find it?

Individuality vs Relationships

The importance of individualism is a prominent part of growing up today, for better and for worse. Politically, for example, this emphasis on individual autonomy has manifested through unprecedented activism in support of tolerance toward any and every kind of minority in America and across the world. One clear downside of this individuality, which directly impacts relationships, is the resulting belief that relationships negatively impact one’s individuality. More and more iGen’ers report avoiding relationships out of the fear that it will ruin their ability to grow individually. While many members of the previous generation either ignored their own individuality for the sake of a relationship, or considered their relationships as a part of their identity, kids growing up today consider relationships a “distraction,” which “hold you back from your true potential.”

At the counseling center, I have heard many students describe their lack of time for relationships. Students have insisted to me that they need to “work on themselves” or “find themselves” first before they are ready for a relationship. Jack, a 23-year-old college student, told me that he “hit it off” with a girl he met at a recent event, but decided not to pursue the relationship in order to take time away from relationships and figure out his own life path first.

What I’m also seeing concurrently is the feeling of guilt or confusion students experience over their feeling bad about a breakup. Rachel, a 25-year-old graduate student, had broken up with her boyfriend of four years, and was struggling to move on, often catching glimpses of his Facebook page to see pictures of his newest girlfriend. “I consider myself a feminist and it doesn’t make sense that I need a man to be happy, but then why do I care about him so much?” she asked me. “I don’t know. Maybe because you’re a person, and you went out with him for years and you really loved each other,” was my empathic reply, a not-so-subtle attempt to help her appreciate her humanness in seeking, and missing, a romantic relationship.

She, like many others her age, struggle to appreciate that it is appropriate in life, even as a feminist, to rely on others for emotional support. Several decades ago, John Bowlby made famous what we now all intuitively believe: a child needs love and emotional support, what he called “attachment,” to thrive in life. Sue Johnson, the world-renowned marriage therapist and developer of Emotionally Focused Therapy, simply extended Bowlby’s discoveries about children and applied them to adults. As it turns out, people don’t grow out of their innate need for others. iGen’ers’ desire for individual autonomy is praiseworthy; their belief that emotional relationships hijack this autonomy is perilous.

Pursuit of Safety

The second prominent feature of today’s youth is their emphasis on safety. Aside from physical safety, which has fortunately led to reduced rates of teen pregnancies and STDs, iGen’ers also fear emotional pain, an unfortunate but natural byproduct of life and development. This fear is understandable–no one wants to experience pain–however, like their attempts at achieving individuality, iGen’ers pursuit of safety is not without cost.

Stress Therapy

The easiest way to understand the fallacy in avoiding emotional pain is through a basic comparison to physical pain. Nobody wants to have the flu, but to increase the likelihood of avoiding the actual flu, most healthy people receive an injection of a small amount of the flu in a vaccine, to help protect the body against stronger versions of the flu in the future. This idea is as true in mental health as it is in physical health. In fact, certain psychology techniques, such as stress inoculation therapy and attitude inoculation, demonstrate the notion that exposing a person to small doses of something negative can be helpful in the long-term. The same is true with emotional pain. Experiencing rejection or other frustrations in emotional relationships can feel devastating, but completely avoiding those feelings hurts a person even more in the long-term. Pain is inevitable, but experiencing some pain throughout life helps develop the very “immune system” that helps cure the pain a person will continually face.

This, too, is a challenge that presents all too often at our counseling center. One student I worked with for a long time, Nancy, told me about how she would always have “emergency exits” in her relationships to protect herself from any form of rejection. If a boy she dated would show any sign of not being interested in her, even for a minute, she would immediately “escape” the relationship and avoid feeling rejected. As she explained so elegantly, before he can dump her, she would dump him.

Another student, Brian, related to me that relationships are challenging because of the inherent requirement to make himself vulnerable. He realized that he even struggled to make eye contact with the girls he dated, as well as with me, his therapist, lest he become too vulnerable and allow someone to see into his eyes and into his soul.

As Twenge explains, iGen’ers believe ‘tis better to never have loved at all, than to have loved and lost. Like with their pursuit of individuality, iGen’ers understandably seek to avoid pain, and often make good choices as a result, but their firm insistence on avoidance of any pain paradoxically hurts them more than it helps.

Contrary to the way they are portrayed in popular television shows, kids, teens, and young adults of the current generation are not stupid, lazy, or bad. They are, like every generation, endowed with their own unique strengths and weaknesses that are a product of parenting styles and the culture around them. The best way to help them thrive in life is to understand their unique traits, namely their focus on individuality and safety, and help foster positive growth as a result.

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Mindful Eating

Michael J. Muschel, MD FACC MS

Open the newspaper, turn on the radio or television, or read the magazine covers in the checkout line at the supermarket and you’ll be bombarded with tips and tricks for weight loss. Eat for your blood type, or only raw produce, or no carbs, or protein shakes, or powerhouse smoothies. Our country has a mind-boggling obsession with WHAT to eat for weight loss but precious little focus on HOW to eat.

This point was driven home powerfully during my recent trip to Southern France. On the final day of the trip, members of our tour group sat and reminisced about the week we had spent together and discussed what each of us found the most interesting. What did I find particularly interesting? A quizzical look on our tour guide’s face one afternoon.

Let me explain. We were returning from shopping and browsing in a small village market. As we boarded the tour bus, our guide – a genteel and elegant French woman – stared at something in the hands of one of the members of our tour. “Where did you get that?” she asked, incredulous. “That’s very unusual since most stores wouldn’t sell that here.”

The item in question? A cup of coffee in a paper to-go cup. “Look out the window at the people on the street,” the guide continued. “Do you see anyone holding a coffee to-go? Certainly not!” And she proceed to explain that in Provence, a person who wants coffee sits down in a cafe, often in the company of another, and is served coffee. Seated. At a table. The coffee is served in a china or ceramic mug. That’s the way the French people drink – with more attention to HOW than to WHAT. And that’s the way they eat.

What a great lesson. It brought to mind the cardiologist’s “French paradox”– the famous observation that the French do not have much heart disease, especially considering the croissants, butter, creamy dressings, and desserts that are staples of their cuisine.

Could the regular intake of red wine, with its heart-protective antioxidant compounds, explain this? Maybe. But an equally compelling explanation is the French way of eating, which contrasts dramatically with the eating habits in the US and other Western countries. This not a new observation, nor even my own. Mireille Guiliano, wrote her best-selling book, “French Women Don’t Get Fat,” based on this idea. For me, seeing the idea live, looking at that busy pedestrian-packed street with nary coffee cup to be found, eating rich dinners French-style for an entire week in a French chateau, and taking mental notes was uniquely instructive.

What are some of the characteristics of French eating? They are eating-related practices that reflect mindful eating that is never distracted or absent-minded, hurried, or multitasked.

The phrase “mindful eating” refers to being actively engaged and fully present in our culinary experiences. In contrast, mindless eating implies the very opposite, eating when distracted and without full awareness, a practice that can cause you to eat too much.

I have a new commitment to eat more like the French, and be slimmer and healthier for it. I encourage you to give it a try.

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For Heart-healthy Eating, Try Mediterranean

Michael J. Muschel, MD FACC MS

In early 2013, The New York Times reported on a scientific study that adds another bit of support to the link between a Mediterranean-style diet and heart disease prevention. Since the 1950s, we have known that people living in countries and regions bordering the Mediterranean Sea — Southern Italy, Greece, Spain — have less heart disease than people living in other westernized countries.

Epidemiologists and scientists have long suspected that the “Mediterranean diet” common to these populations, one that is high in fruits and vegetables, whole grains, legumes, nuts, and olive oil and includes red wine, while restricting red meats and dairy products, is responsible for this health benefit.

Observational studies over the years have indeed confirmed that population groups whose diet closely adheres to these Mediterranean dietary principles have a lower risk of heart disease. But these early reports on large groups of people needed to be confirmed by clinical trials that track and compare the health of subjects who are randomly assigned to different diets.

Dietary Modifications Save Lives

The first of such randomized clinical trials, the Lyon Heart Study, began in 2001. In this French study, patients who had suffered a heart attack (myocardial infarction, or MI) were randomized to follow either a carefully supervised Mediterranean diet or a standard low-fat, low-cholesterol diet. The Mediterranean diet group had dramatically lower incidence of recurrent heart attacks, supporting the idea that dietary modifications could indeed save the lives of heart disease patients.

So what makes this study so exciting?

It was the gold standard, a large, randomized clinical trial that looked at whether heart disease might be outright prevented by following a specific diet. This means that the results can be applied to the general population at large rather than just to those with heart disease or a history of heart attacks

30% Lower Occurrence of Heart Attacks

The 7,500 individuals enrolled in this new study, conducted in Spain, had heart disease risk factors, e.g., smoking, high blood pressure, family history of heart disease, and/or high blood cholesterol but were healthy otherwise. About one-third were instructed and regularly coached in the details of a traditional heart-healthy, low-fat diet. Another third were instructed in the specifics of a Mediterranean diet and were closely monitored. This group also received large quantities of olive oil for daily use. The remaining one-third also regularly received guidance and provided feedback on Mediterranean eating, but was supplied with large quantities of nuts. After about five years, the number of new heart attacks, strokes and cardiac deaths was 30 % lower in each of the Mediterranean diet groups as compared with the low- fat group. This study supports the potential role of the Mediterranean diet in preventing cardiovascular disease.

Start Eating Mediterranean Now

Can this good news motivate those of us at risk for heart disease to eat in a more heart-healthy way? Some of my patients despairingly tell me that it is too late for them since their blood vessels and heart are too far gone. That’s not true. The average age of subjects in this most recent study was over 60 years!! Even participants with years of heart-unhealthy eating lowered their risk after switching to a Mediterranean diet. I also hear from patients that diet won’t make a difference because they already are taking Lipitor, Crestor or another cholesterol-lowering drug. They’re wrong. Many of the patients in the Spanish study were in fact taking these very medications and still benefited. This shows that diet and medication work together for even greater effects – each is good and both are better.

So start today by making one or two small changes to bring more Mediterranean foods into your diet. Your heart, and your taste buds, will thank you!

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