Postpartum Depression

I am doing a presentation today on Postpartum Depression, and I thought it would be helpful to include some of the best links to resources here. Clinically diagnosable Postpartum Depression occurs during an estimated 10% of pregnancies and childbirths.

This is a serious disorder which can have lasting negative effects on both mother and child. The American Academy of Family Physicians reports that

Infants as young as three months of age are able to detect the affective [emotional] quality displayed by their mothers and modify their own affective displays in response to it. Cognitive skills, expressive language development, and attention have been adversely affected by maternal depression.

The AAFP lists these warning signs of the disorder:

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• Persistent feelings of sadness and crying.
• Having little desire to eat.
• Significant weight gain or loss.
• Irritability, anxiety and restlessness.
• Inability to find pleasure or interest in life.
• Feeling exhausted or having no motivation to get things done.
• Insomnia.
• Feelings of hopelessness, worthlessness or guilt.

More serious symptoms include:

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Thoughts of hurting the baby.

Thoughts of hurting yourself.

Not having any interest in the baby.

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These more serious symptoms indicate the likely presence of Postpartum Psychosis, according to The National Women's Health Information Center. Postpartum psychosis

...occurs in about 1 to 4 out of every 1,000 births. It usually begins in the first 2 weeks after childbirth. Women who have bipolar disorder or another mental health problem called schizoaffective disorder have a higher risk for postpartum psychosis. Symptoms may include:

• Seeing things that aren't there
• Feeling confused
• Having rapid mood swings
• Trying to hurt yourself or your baby.

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If you or someone you know fits this description, please seek medical help immediately. This is a medical emergency requiring URGENT care.

Also call your doctor if:

• Your baby blues don't go away after 2 weeks
• Symptoms of depression get more and more intense
• Symptoms of depression begin any time after delivery, even many months later
• It is hard for you to perform tasks at work or at home
• You cannot care for yourself or your baby

Your doctor can ask you questions to test for depression. Your doctor can also refer you to a mental health professional who specializes in treating depression.

Some women don't tell anyone about their symptoms. They feel embarrassed, ashamed, or guilty about feeling depressed when they are supposed to be happy. They worry they will be viewed as unfit parents.

Any woman may become depressed during pregnancy or after having a baby. It doesn't mean you are a bad or "not together" mom. You and your baby don't have to suffer. There is help.

Here are some other helpful tips

• Rest as much as you can. Sleep when the baby is sleeping.
• Don't try to do too much work or try to be perfect.
• Ask your partner, family, and friends for help.
• Make time to go out, visit friends, or spend time alone with your partner.
• Discuss your feelings with your partner, family, and friends.
• Talk with other mothers so you can learn from their experiences.
• Join a support group. Ask your doctor about groups in your area.
• Don't make any major life changes during pregnancy or right after giving birth. Major changes can cause unneeded stress. Sometimes big changes can't be avoided. When that happens, try to arrange support and help in your new situation ahead of time.

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Treatment for Postpartum Depression can include psychotherapy or antidepressant medication. Sometimes a combination of the two is best.

Unfortunately, major depression affects 15 to 25 percent of adults in the US each year, and women are twice as likely to experience depression as men. Here is a self-help resource for those experiencing the "Baby Blues" to begin using proven techniques for dealing with depression.

But remember, Postpartum Depression is a serious condition which most often requires professional help for recovery.

Pardon the random dots and spaces. I'm still learning how to copy quotes with bullet headings. Any suggestions?

Challenging Unhelpful Thoughts, Simplified Version

I keep trying to come up with simpler ways to use some of the well-researched techniques for countering depression and anxiety. Here is a 4-step system that may work even when you don't have your therapy notebook nearby:

1. I feel [bad, sad, angry, frustrated, discouraged, panicky, hopeless, etc.]

2. because [identify or describe the situation in a few words].

3. I've been talking to myself about it this way: [describe typical unhealthy and/or unhelpful thought patterns--note that while what you're thinking may be technically true, it just isn't helpful].

4. More healthy and/or helpful thoughts would be: [brainstorm a list of thoughts that are also true and which have a positive effect].

Repeat this process whenever you feel your mood deteriorating, and specifically tell yourself the thoughts you come up with in #4 several times per day. This exercise depends on the assumption that a) you are able to identify your unhealthy and/or unhelpful thoughts, and b) you can come up with positive alternatives. Some people need a therapist to even begin the process. But it's worth a try.

Bitterly Funny

While perusing the feminist blogosphere, I ran across these rules for rape prevention. I almost didn't post them for fear they could be a trigger for my clients who are rape-survivors, but the rules are so tiredly true, and yet so often overlooked, I couldn't resist:

Sexual Assault Prevention Tips Guaranteed to Work!

1. Don’t put drugs in people’s drinks in order to control their behavior.

2. When you see someone walking by themselves, leave them alone!

3. If you pull over to help someone with car problems, remember not to assault them!

4. NEVER open an unlocked door or window uninvited.

5. If you are in an elevator and someone else gets in, DON’T ASSAULT THEM!

6. Remember, people go to laundry to do their laundry, do not attempt to molest someone who is alone in a laundry room.

7. USE THE BUDDY SYSTEM! If you are not able to stop yourself from assaulting people, ask a friend to stay with you while you are in public.

8. Always be honest with people! Don’t pretend to be a caring friend in order to gain the trust of someone you want to assault. Consider telling them you plan to assault them. If you don’t communicate your intentions, the other person may take that as a sign that you do not plan to rape them.

9. Don’t forget: you can’t have sex with someone unless they are awake!

10. Carry a whistle! If you are worried you might assault someone “on accident” you can hand it to the person you are with, so they can blow it if you do.

And, ALWAYS REMEMBER: if you didn’t ask permission and then respect the answer the first time, you are commiting a crime- no matter how “into it” others appear to be.

Building Close Relationships

It is discouraging that the people we are closest to--spouse, family members, partners--are often those with whom we have the most difficulty. One reason is that these relationships matter so much. Another is that these people are with us much of the time, through good times and bad, seeing us at our worst as well as at our best. Here is information on emotional intelligence which gives ideas for developing aspects in ourselves to improve these vital relationships.

Here and here find further info on a slightly lighter note. (Remember to take internet advice with a grain of salt).

Some things to consider if you are thinking of marriage counseling. Here is a frequently updated blog about relationships and counseling.

Don't give up yet! Your relationship is likely worth working on.

Posttraumatic Stress Disorder (PTSD)

Part of the human condition is dealing with trauma. We are usually resilient enough to cope with the after-effects and move on. Some people have had to deal with exceptional trauma in their lives, however--whether it is childhood abuse, sexual or physical assault, combat situations, witnessing death or injuries, or other terrifying single or prolonged events--and they may find themselves experiencing symptoms of Posttraumatic Stress.

Here is the list of diagnostic criteria for this disorder.

Here is a good summary of the various types of treatment.

Here is a forum to talk with others with the diagnosis, get information, support, and advice from people dealing with similar issues.

As always, use your good judgment and don't take everything you find online to be the best information for you. But there are many resources out there, and the support you find may be worth sifting through others' hypotheses and testimonials. If you are not yet meeting with a therapist, or you are otherwise unhappy with your treatment situation, don't hesitate to pursue better care. Therapy is highly individualized and it may take a while to connect with the best therapist for your particular personality and situation.

Treatment of Phobias

Here is a good, general overview of treatment options for a phobia, which is defined by the American Heritage Dictionary as:

A persistent, abnormal, and irrational fear of a specific thing or situation that compels one to avoid it, despite the awareness and reassurance that it is not dangerous.

A strong fear, dislike, or aversion.

Systematic desensitization is used in most treatment protocols for this disorder. Here is a more in-depth description of the procedure, for those who are interested. Systematic desensitization can be self-administered to a point, but it requires insight, carefulness, mindfulness, and precision to be successful. Here is a precaution:

Because of the potential for extreme panic reactions to occur, which can increase the phobia, this technique should only be conducted by a well-qualified, trained professional. Also, the relaxation response should be thoroughly learned before confronting the anxiety-provoking hierarchy.

It takes hard work to rid oneself of a phobia, but results can be very good.

Considering Psychotherapy?

Here is a very good site if you are thinking about psychotherapy but are not yet sure it's for you. I don't know the creator of the site personally, but his information is solid, with examples embedded in the topics. Check out the site--you won't regret it.

Sleep Problems

As you can see by the time of this post, it's nearly midnight and I'm not sleeping yet. This article (again from the American Psychological Association) offers some suggestions for dealing with sleep problems, as well as more information on sleep. There are good resources at the end of the article as well.

• Keep a regular sleep/wake schedule
• Don’t drink or eat caffeine four to six hours before bed and minimize daytime use
• Don’t smoke, especially near bedtime or if you awake in the night
• Avoid alcohol and heavy meals before sleep
• Get regular exercise
• Minimize noise, light and excessive hot and cold temperatures where you sleep
• Develop a regular bed time and go to bed at the same time each night
• Try and wake up without an alarm clock
• Attempt to go to bed earlier every night for certain period; this will ensure that you’re getting enough sleep
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APA Help Center

I like this site for brief articles and info of general interest about such issues as work and school, family and relationships, health and emotional wellness, disasters and terrorism, and managed care and health insurance.

Three Resources for Couples

I have found the following books useful tools for couples who are working on their relationships.

1) John Gottman has written several books, including The Seven Principles for Making Marriage Work. Gottman's work is based on solid research, which is more than can be said for most inspirational self-help literature.

2) The Heitler and Hirsch book The Power of Two Workbook presents simple and effective communication exercises which can be done as a couple.

3) When one or both partners have injured the relationship by infidelity or other offenses, Janis A. Spring's book How Can I Forgive You: the Courage to Forgive, the Freedom Not To can also be very helpful.

Applying for Help

I find that with the downturn in the economy, my patients and I spend more time talking about financial worries related to health- and mental health care. Some people are unemployed, others are disabled. If you suspect that you have a mental-health related disability (learning disorder, attention deficit disorder, debilitating depression or anxiety, etc.), and are unable to adequately support yourself financially or get the care you need, consider applying for state disability support.

Your local site for the Utah State Office of Rehabilitation is a good place to start. They help with job training and education. They work with Disability Determination Services in deciding who qualifies for social security income. They may refer evaluations out to someone like me, or you can have the results of a recent evaluation sent to them.* Their counselors are--in my experience--kind, competent, and knowledgeable of resources to help their clients get back on their feet. They have local offices in American Fork, Provo, and Payson (check this link for contact info for each office).

Medicaid is one of the options available for those who need health and/or mental health care but are unable to get coverage on their own or through an employer. Other health care options are described at the Division of Substance Abuse and Mental Health web site.

A growing number of people are not disabled, but are simply unable to get health insurance. Coverage for kids is available through the CHIP program. For workers who don't have insurance coverage, the UPP program helps you pay your monthly health insurance premiums through your employer's health insurance plan.

There are options out there as we wait for comprehensive health care reform to happen.

*For Utah County residents, a very good, inexpensive place for a complete evaluation is the BYU Comprehensive Clinic.

Help for College Students

A recent article in the La Crosse Tribune mentioned some of the challenges facing college students today.

Students.... show up with bipolar disorder, major depression, evidence of self-harm, officials said. "Not a day goes by in my office when one of my staff is not talking about someone with severe mental health issues," said Jon Hageseth, director of counseling and testing at the University of Wisconsin-La Crosse.

He compares his office today to an outpatient mental health clinic.

It's a trend experts said that has been seen... nationwide -- and it has forced colleges and universities to evaluate whether they have the means to meet these more severe psychological problems.

The 2007 National Survey of Counseling Center Directors found 92 percent reported greater numbers of college students with major mental health problems.

But we have some very good counseling services on campus here in Utah Valley.

The BYU Counseling and Career Center (where I completed my predoctoral internship in psychology) offers free personal counseling for full-time students; a variety of stress management services; academic advisement including choosing a major and improving study skills; and help in pursuing a career all the way up to finding a job.

Utah Valley University has a Career and Academic Counseling Center, and also offers psychotherapy through Student Health Services. Click on the Mental Health Therapy tab for a list of specific services.

Another resource for the community (including for part-time students who may not qualify for services at the university counseling centers) is the BYU Comprehensive Clinic. As described on their web site:

Individuals or families desiring services are generally seen or evaluated by a graduate student or students under the supervision of experienced faculty. The CC provides evaluations, psychotherapy, counseling, and educational services through its Mental Health Clinic.

I also worked here for a time during my training. The level of care is superior, given the close supervision of providers, and the cost is minimal--currently $15 per session--and fees may be reduced based on financial need.

More Pictures from England

This one is from Wales, actually -- Danywenalt, near Brecon Beacons National Park (photo by our student, Marshall):This is the Durdle Door, in Dorset on the Jurassic Coast (photo by Bentley):

Here we are early one morning at Stonehenge:

This is the Tennyson Monument on the Isle of Wight (photo by Marshall):

Here is one of the Roman Baths, in Bath (photo by Bentley):

and a guard at the Tower of London (photo by Marshall):

We had a great time but we're glad to be home.

Photos of Where We've Been

...with the BYU students:

Loch Lomond - the students climbed Ben Lomond:

We visited the Ruthwell Cross, an Anglo-saxon cross about which the ancient poem "The Dream of the Rood" was written:

In the Lake District, we stayed at Wastwater, after which the students climbed over the Scafell Pass:

We visited the Castlerigg Stone Circle in Keswick:

We visited the Wordsworth houses (this is Rydal Mount):


and Brantwood, the home of John Ruskin on Coniston Water:

Brantwood gardens are lovely:

Now we are crossing the Yorkshire Dales and moors. Next stop is Haworth, home of the Brontes.

Edinburgh

We are finally here in Scotland. Here is a photo from our walk yesterday to Edinburgh Castle. It took me a few days to get my phone system figured out, but I think I can check messages fairly regularly now. I hope everyone is enjoying the spring as much as I am, but possibly getting a little more sleep!

Chicago

On our way to the UK, we are stopping to visit our daughter and her husband in Chicago. Here's a photo of the city coming in from the airport on Highway 94.

Ten Techniques for Increasing Happiness

Inspired by Dr. Martin Seligman’s Positive Psychology

1. Keep a gratitude list. Write in your journal or therapy notebook three things every day that you are grateful for, that went well, or that make you happy. For an added bonus, share the daily list with a loved one.

2. Write a letter of gratitude to an important person in your life, and share it with them in person. Do it again with another person who means a lot to you.

3. Practice secret acts of service and kindness. Be as unobtrusive but effective as possible. Begin by doing one per week and work up to once daily.

4. Reframe setbacks as challenges and opportunities rather than as defeats. This may be something to practice with your therapist.

5. Pursue a challenging hobby or avocation. Make time for the interest that you gave up long ago—it may truly improve your life.

6. When speaking with your spouse or loved ones, practice active, constructive (that is, engaged and truly listening) responding. Don’t just say “uh-huh.” Listen and comment in supportive ways. Soon you’ll find them reciprocating as the relationship improves.

7. Try writing your own legacy. How do you want to be remembered?

8. Learn to savor life as it happens. Practice being in the moment, enjoying the sensory details of the world we live in, and your own physical, mental, emotional, and spiritual response. Do brief meditation/mindfulness moments throughout your day.

9. Be socially active. Seek out the company of others regularly. Even if it’s hard at first, it will give a boost to your mood.

10. At this web site: http://www.authentichappiness.sas.upenn.edu/Default.aspx try the VIA Signature Strengths Questionnaire (scroll down to the middle of the page). You have to register, but you can make up a name and email address if you’d rather not leave your own.

The "As-If" Exercise

Imagine that one morning you wake up OK. The struggle has been successful, the battles won, the changes made, there is nothing more to feel guilty about or to berate yourself for. You truly deserve love, satisfaction, success, respect, and all the good things in life. This may take some time to fully imagine. Don't be in a hurry. Feel it all the way inside. How would things be different if you were just fine right now?

My emotional state:

My view of myself:

My personal habits:

My relationships and the way I behave with others:

My plans for the future:

What I would do just because I wanted to:

Why I can't act and feel this way now, what's stopping me:

At least one thing that I can do right now:

At least one positive way that I can feel or believe about myself:

Types of Relaxation Exercises

JACOBSONIAN RELAXATION (tense/relax):

The most basic type of relaxation, this exercise is based on the fact that the resting state of muscles after contraction is less tense than before contraction:

Separate muscle groups are tensed and relaxed in turn, in conjunction with breathing. The muscle groups are chosen systematically (i.e., from head to foot or vice versa), and the same routine is followed each time. Although they may be modified, general procedures are as follows:
1. Begin by being aware of breathing. Take several deep breaths (slowly, so as not to hyperventilate).
2. On a deep inhalation, hold the breath and tense the muscle group for a slow count of five. Upon exhalation, release the tension.
3. Take another slow deep breath (without holding), and release residual tension.
4. Breath in a normal, less deep manner for at least two breaths before tensing again.
5. Repeat at least once for the same muscle group.

The muscle groups should be as small as possible--shoulders, upper arms, lower arms, and hands, for example, rather than just "arms". Right and left sides should be done separately. Some muscle groups should be tensed in more than one way. The mouth can be opened wide or tightly shut; the hands can be balled into fists or splayed open; the stomach can be sucked against the backbone or tensed (as if a bowling ball were going to fall on it); the feet can be flexed or extended. Thoroughly done, this exercise can take several hours. Shortcuts are ok, of course.

DEEP MUSCLE RELAXATION

This exercise is very similar to the Jacobsonian technique, except there is no deliberate tensing of muscles. The breath is not held, but the person relaxes separate muscle groups on exhalation, again moving in a systematic manner throughout the body. Be sure to repeat the relaxation at least 2x per muscle group.

AUTOGENIC TRAINING

This exercise involves self-suggestion and the autonomic nervous system. At one time believed not to be under voluntary control, studies have found that para- and sympathetic functioning is actually quite amenable to conscious intervention.
1. Find a comfortable reclining position.
2. Scan the body for tense or uncomfortable areas, and adjust position or consciously relax that area.
3. Internally repeat the following phrases, allowing at least ten seconds between repetitions and at least ten repetitions per phrase:
My breathing is smooth and rhythmic.
My heartbeat is slow and regular.
My stomach is calm and relaxed.
Warmth is flowing into my right arm and hand.
My right arm and hand are heavy and warm.

Repeat the last two phrases for left arm and hand, right leg and foot, left leg and foot. Then repeat the entire procedure. People can increase the temperature of their extremities by several degrees because of the increased blood flow to the arms and legs. They can actually lower heartrate, muscle tension, and blood pressure when using this exercise.

VISUAL IMAGERY

This exercise allows the most variability and specificity in dealing with tension and anxiety. The person should first do a short version of whichever of the above exercises is most effective, in order to achieve a state of physical and mental relaxation before beginning visual imagery.

The imagery can be as simple as the memory of a favorite relaxing place, or as complex as a detailed journey through a fantasyland, with encounters with multiple characters. It can be as short as 5 minutes or as long as an hour--20-40 minutes is optimal, in my experience. It can deal directly with real-life problems by behavior rehearsal, or speak symbolically to deep personality structures. This type of relaxation exercise is perhaps best approached with a therapist.

Comments:
The first three types of exercise can be done by individuals at home. They may find it helpful to tape record their own or their therapist's voice and then listen to the tape when relaxing, in order to achieve the passive, receptive state that best promotes relaxation. Deep relaxation can be similar to a trance state. Therapists and patients should be somewhat cautious of the statements made in any of these exercises if the person is susceptible to suggestion. Feedback from the person is very important.

Brief Relaxation Technique

suggested by “The Relaxation Response” by Herbert Benson, MD

1. Sit quietly in a comfortable position and close your eyes.

2. Become aware of your breathing. Breathe through your nose if possible. As you breathe out, silently say the word “one” to yourself. Or you may choose another word with a relaxing connotation, such as “peace,” “calm,” “serene,” etc.

3. Deeply relax all your muscles, beginning with your feet and progressing up to your face and head (or the other way around). Exhale tension with each breath.

4. Continue for 5-10 minutes. As an addition or variation, or if you have more time, you may add the visualization of a relaxing place, real or imaginary, where you can be completely comfortable, safe, and calm. Be as detailed as possible in constructing the visualization, using all five sensory modalities.

5. When you finish, sit quietly for a short time, and recall yourself to the present. Do not worry about whether you are successful in achieving a deep level of relaxation. Maintain a passive attitude and permit relaxation to occur at its own pace. When distracting thoughts occur, let them float through your consciousness and away (like clouds through the sky) without paying attention to them. Return to repeating your relaxing word.

Basic Cognitive Behavior Therapy

For this exercise you will need a therapy notebook and some time for self-reflection. Next time you notice yourself feeling bad, sit down with a pen and your notebook, and follow these directions:
1. Describe the situation which led to feeling bad:
2. What is your specific feeling? Sad, resentful, worried, etc.? On a scale of 1-10, how strong is the feeling? Use the SUDS Scale [see adjacent post].
3. Write down the negative self-talk that occurs as the situation unfolds:
4. Identify the twisted thinking (see David Burns' "Ten Forms of Twisted Thinking”) that is present in the self-talk:
5. Write rational responses (see Burns' “How to Untwist Your Thinking” from The Feeling Good Handbook) to the negative self-talk:
6. What is your feeling now? On a scale of 1-10, how strong is it?
Repeat as needed, any time you notice that you’re feeling bad.

Measuring the Bad Feelings: Creating Your Own 'SUDS' Scale

The SUDS scale is one way to communicate to yourself or others how much distress you are experiencing. SUDS stands for Subjective Units of Distress Scale. The scale runs from 0 to 10, least to most distress. It is important that you assign your own measures to this scale. Sometimes, it may seem as if your distress is beyond a 10. This scale is adapted from the work of Smyth (1999).

The following is a SUDS using the negative feeling of anxiety, but the scale can be applied to any negative emotion.

0 I am completely relaxed, with no distress. I may be deep in sleep.

1 I am very relaxed. I may be awake but dozing off.

2 I am awake but feel no tension.

3 I feel a little bit of tension; it keeps my attention from wandering.

4 I am feeling some mild distress, apprehension, fear, or anxiety, and body tension.

5 My distress is somewhat unpleasant but I can still tolerate it. (I am looking at a spiderweb with a huge spider in it, but it is several feet away and the spider can't jump that distance.)

6 I am feeling moderate distress and unpleasant feelings. I have some worry and apprehension.

7 My body tension now is substantial and unpleasant, though I can still tolerate it and can think clearly.

8 I am feeling a great deal of distress with high levels of fear, anxiety, worry. I can't tolerate this level of distress for very long.

9 The distress is so great that it is impacting my thinking. I just can't think straight.

10 I am in extreme distress. I am totally filled with panic and I have extreme tension throughout my body. This is the worst possible fear and anxiety I could ever imagine. It is so great that I just can't think at all.

You may use this SUDS scale at any point in time as you work on overcoming your anxiety. You may decide on which SUDS rating means you should take a break from the work and return to relaxation. You may also decide that getting stuck at a certain SUDS level means that you need to stop doing the work for a period of time and consult with your therapist.

Off to the UK Again

My husband and I are taking a group of university students to Scotland and England from 22 April to 23 June this year for BYU Study Abroad. I will have suggestions and ideas for clients at this site to work on if you wish while I'm gone. I will update the blog regularly with links to resources and exercises, and I'll post a few photos of the trip as well. If you are a client, you have my contact info--leave a message at one of my phone numbers and I will call you back.

Have a great spring!

Positive Psychology

The BYU Counseling Center sponsored their annual workshop last week, on the hot topic of Positive Psychology. It was a fun and inspirational presentation by Dr. Chris Peterson, a research associate of Dr. Martin Seligman. Here is their website, which I have only just begun to explore. Dr. Peterson said that taking their evaluations requires registering, but suggested that we use a fake email address if we're uncomfortable using our real one. More later!

More Resources for Anxiety Disorders

Here are a few more places to look for information on anxiety:

SAMHSA's National Mental Health Information Center

ADAA, the Anxiety Disorders Association of America

The American Psychiatric Association

and of course, the American Psychological Association.

Anxiety

These are stressful times all the way around, and even though there is reason for hope and optimism, I find that a large proportion of my new clients suffer from anxiety. Here is a good resource for information about anxiety.

Anxiety is a normal reaction to stress. It helps one deal with a tense situation in the office, study harder for an exam, keep focused on an important speech. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder.

The NIHM site is a trustworthy place to look for info on mental health issues.

Surviving Financial Stress

The January APA Monitor has an interesting article on dealing with economic bad times. The take-home info for family survival is:

Conger and colleagues observed that children in families whose parents put family first and continued to communicate despite the hardship fared much better in the short and long term than those who allowed the crisis to fracture them.

Youngsters "weren't terribly bothered by not having a lot of stuff," Conger says. "What bothered them was when their parents became angry and irritable and withdrawn."

Similarly, children whose parents maintained strong community ties did much better over time than those who were not as embedded in their communities, says Elder, Conger's research colleague.

"Kids whose parents were connected to church, school and civic organizations lived their lives the same way," he says. "Those involvements really predicted what they were going to do in their lives and how successful they would be."

Sometimes psychological research yields "well duh!" results. But it's nice that science matches up in this case with common sense. Go read the whole thing here.

Why I Love My Job

I attended a UPA Ethics workshop yesterday at the SLC Library (presented by Steve Behnke, director of the APA Ethics Office). As usual in these workshops, we discuss vignettes which involve conflicting principles or values--confidentiality vs. the duty to report child abuse, for example. One vignette Dr. Behnke presented was that of a Jewish female psych intern whose prospective patient is a neo-Nazi. Is the intern obligated to disclose that she is Jewish? Will she be able to work with a neo-Nazi? What if he finds out later in therapy that she is Jewish? Will it damage the therapeutic relationship? What is her ethical obligation in this instance?

One of the other attendees raised her hand and said, in gently accented English, that she was a Holocaust survivor as a child, and her very first patient as an intern during graduate school was the Utah head of Aryan Nations. "But he was not a big scary SS officer," she said, "and I was no longer a little child. He was a victim of child abuse himself, sad and trying to build himself up. The roles were different, and because I saw him that way, we were able to work together."

The presenter asked her what had happened if or when she informed the client that she was Jewish. "I asked him about it later," she said. "He figured it out in our first interview. He said when he told me what he was I didn't even flinch, and he knew that I would be able to handle his issues."

I love my colleagues. Every time I talk to them or listen to them they inspire me and remind me of why I do what I do.