It was back in 1998 that Jewel wrote the song “Hands”, in which she said that in the end, only kindness maters.  10 years later in 2008, Dacher Keltner, Ph.D., a neuroscientist at U.C. Berkeley, wrote in Advances in Experimental Social Psychology, that we as humans evidence a remarkable inherent tendency towards kindness.  He added that kindness is vital to our evolution.  Actually, Keltner adds some things to his discussion of the seminal components to evolution beyond kindness such as play, generosity, compassion, gratitude, and self-sacrifice.  But really, it might all boil down to kindness.

 When I talk with patients, I often feel their frustration in not being understood by their partner or spouse.  I also see how variable and how important the manner in which they present their point is.  And inevitably, it is kindness that emerges as the most salient predictor of success in their efforts to be understood by the other party. When we speak with kindness, and when we evidence kindness in our actions, it brings me back to Jewel’s lyrics that in the end, only kindness matters.  It seems this is true.  We are forgiven our mistakes, when we are kind.  We are better able to see the good in others, when we are kind.  If we can only look at the world with more awareness of the importance of kindness, we avoid so many of the pitfalls inherent in conflictual interpersonal interactions.

 David Foster Wallace, one of the truly great authors of our generation, told a story before his tragic death in 2008.  It went something like this.  “We’ve all worked a long day, come home tired and somewhat stressed, and just want to eat something, maybe unwind for a little while, and go to sleep because of course, you have to get up and do it all again the next day.  But then you remember there’s no food at home because you haven’t had the time to shop this week, and so now, after work, you have to get in your car and drive to the supermarket.  It s the end of the work day and the traffic is apt to be very bad.  So getting to the store takes way longer than it should, and when you finally get there, the supermarket is very crowded cause it’s the time of day when all the other people with jobs also try to squeeze in some grocery shopping.  You wander all over the huge, over-lit store with a grocery cart that has one crazy wheel that pulls maddeningly to the left, and go to the checkout line which is incredibly long.  You can then get in your car and drive home in the end-of-the-day traffic, being disgusted by the huge, lane-blocking SUV’s and Hummers burning the selfish, forty gallon tanks of gas, and start thinking about how our children’s children will despise us for wasting all the future’s fuel, and probably screwing up the climate, and how modern consumer society just sucks, and so forth and so on”. 

 Wallace goes on to say that there are totally different ways to think about these situations.   “Possibly the grocery clerk who wasn’t very friendly has a sick child at home.  And in this traffic, it’s not impossible that some of these people in SUV’s have been in horrible auto accidents in the past, and now find driving so terrifying that their therapist has all but ordered them to get huge, heavy, SUV so that they can feel safe enough to drive.  Or that the Hummer that just cut me off is maybe driven by a father whose little child is hurt or sick in the seat next to him, and he’s trying to get this kid to the hospital, and he’s in a bigger, more legitimate hurry than I am; it is actually I who am in HIS way”.

 It’s not easy to think this way.  We cannot expect that we will be able to do it automatically.  But we can learn to pay attention to ourselves, to be more mindful of our judgments, and to remember that we have a choice to decide how we are going to see these frustrating events in our lives.  And in so doing, possibly we can remember that in the end, only kindness matters.

The Importance of Belonging  (April 2012)

 We all value membership in groups.  Most of us can recall middle school when we felt just that, in the middle….when we thought of ourselves neither as children nor adults; when we felt an oceanic feeling of being in-between.  Recent research has shown that belonging to social groups is an important predictor of mental and physical health, even as important as diet and exercise.  There is increasing evidence that the health risk of social isolation is comparable to the risks of smoking, high blood pressure and obesity.  For example, in an article published in 2008 in Neuropsychological Rehabilitation by Holmes, et al., it was found that life satisfaction after a stroke was significantly higher for people who belonged in social groups before their stroke. 

 Many years ago I read an article written by Oliver Sachs of Columbia University. In his remarkable book, The Man Who Mistook His Wife For a Hat (1998), Sachs concluded that when determining a patients quality of life we should not look so much at the severity of the disorder but rather the person’s ability to maintain a coherent sense of self.  And so it seems from numerous psychological studies, that group life and a sense of social identity have a profound influence on our abilities to maintain a coherent sense of self as well as on our general health and well-being.  We understand ourselves fundamentally as humans who are social animals who live and have evolved to live in groups.  Human beings who live in groups and understand ourselves within a group, see that membership in a group as being an indispensable part of who we are and an important part of our leading fulfilling and satisfying lives. 

 Robert Putnam, in his book, Bowling Alone (2000), wrote that if you belong to no groups but decide to join one, you cut your risk of dying over the next year and a half, by 50%.  The 800 million users of Facebook clearly understand that social networks help us feel connected.  We now know from research that participation in group life is actually an antidote to physical and mental health problems.  All too often TV leads us down a pharmaceutical path to deal with problems.  Object relations theorists have firmly implanted in my belief system  that participating in activities that lead to feelings of belonging, of  feeling like we are members in a group, is potentially a more effective way, and likely more enjoyable way, of inoculating oneself from problems rather than treating them after they develop.  And if you struggle to easily establish membership in groups, seek out professional help for help in identifying what factors interfere with that process.

Forgiveness    (March 2012)

I have been struck by the number of patients that come to me with issues surrounding powerfully emotionally laden events in their marriages or in their relationships, that are inordinately hard for them to put behind them.  Eventually, I discuss with my patients the importance of forgiveness.  Countless numbers of pop-psychology books  have discussed the issue and talk show hosts make the most of events demanding forgiveness, allowing their guests to engage in a free-for-alls on their stage.  Sadly,  few people seem to be able to develop the skills to meaningfully forgive and move on.

 Much of the advice we most of us have been given about forgiveness surrounds the concept the deep hurt and anger are difficult to resolve, and that eventually the hurt and the angry feelings will settle down, and we will reach a place of forgiveness over time.  We might have been told that if we try to rush the process of forgiveness, it is somehow disenguine.   But what I believe is that people can forgive another person, in a true and meaningful way, when you make the decision to do so.  

There are four major components I utilize to help my patients engage in the process of forgiveness.  First, it is important to realize that by holding on to anger and resentment, you are participating in carrying on a legacy of hostility.  Forgiving is not at all telling someone or yourself that it was ok, but rather choosing not to carry on this legacy of resentment.

 A second component of effectively forgiving someone is giving up the hope of an alternate past.  Much of our resentments about long ago events are rooted in unconscious or conscious hopes that we could have had a better past history.  Part of forgiveness is relinquishing that hope for a better past.

 A third component of forgiveness is the belief that you are in control of what you’re going to do heretofore.  In essence, the adage of, “I will plant the seed that I will reap, not the seeds that you planted” is the essence of this piece of forgiveness.  One must believe that you are in complete control of your feeling states heretofore and that what happened in the past is what someone else did, in the past.

The fourth component of forgiveness is the capacity to believe that you can start anew.  Herein, the belief that we are in some fixed position and not in a dynamic process, is a crucial distinction.  Examining your life in a way that allows you to see yourself as being on a path fosters the capacity to start again, anew, void of the anger, hostility, or resentment that occupied you previously.

Mental health can be understood as a state wherein people feel integrated along a variety of dimensions.  By integrating and accepting the past and believing the future is our own to create, allows for a more integrated sense of one’s self.  This process of integration allows for a renewal of your own identity,  void of the anger that occupied your heart in the past.  That deep seated anger keeps that part of your heart from feeling love for those people whom you do love.  In that regard, forgiveness helps us at least as much as anyone else.  And so, with help, we can decide to forgive. 

The ability to trust, love, and resolve conflict with loved ones starts in childhood — way earlier than you may think. Those are the findings in a new review of the literature in Current Directions in Psychological Science, a journal published by the Association for Psychological Science.

“Your interpersonal experiences with your mother during the first 12 to 18 months of life predict your behavior in romantic relationships 20 years later,” say psychologists J. Simpson, W. Collins, and J. Salvatore. “Before you can remember, before you have language to describe it, and in ways you aren’t aware of, implicit attitudes get encoded into the mind,” about how you’ll be treated or how worthy you are of love and affection.  While those attitudes can change with new relationships, introspection, and therapy, in times of stress old patterns often reassert themselves. The mistreated infant becomes the defensive arguer; the baby whose mom was attentive and supportive works through problems, secure in the goodwill of the other person.

Simpson, Collins, and Salvatore have been providing that evidence, investigating the links between mother-infant relationships and later love partnerships as part of the Minnesota Longitudinal Study of Risk and Adaptation. Their subjects are 75 children whom they’ve been assessing from birth into their early 30s, including their close friends and romantic partners.  Borrowing from the classic studies on Attachment Theory, these studies divided the young children into securely and insecurely attached infants, and since then, these children, who are now adults, have returned regularly for assessments of their emotional and social development.  The authors have looked at their skills and capacity for working through conflicts with peers, teenage best friends, and finally, love partners.

Through multiple analyses, the research has yielded evidence consistent with attachment theory, but some new findings are emerging.  Historically many psychologists believed that a person’s traits and behavior were fairly stable through their life, but the authors state it was harder to “to find evidence for stable continuity than for change on many measures.”  But the good news offered by the authors is that all of us are able to change.  We can become more securely attached.  If you can figure out what those old models are and verbalize them, and if you get involved with a committed, trustworthy partner or are in psychotherapy with a skilled therapist says Simpson and his co-authors, “you may be able to revise your models and calibrate your behavior differently.” Old patterns can be overcome. A betrayed baby can become loyal.  A neglected infant can learn to be responsive and available rather than rejecting or reactive.   An unloved child can learn to love.

Throughout my years of practice, I have viewed meditation as a path to mindfulness and awareness, and through this, a subsequent entrée into mentalization leading to healthy attachments.

Over the years, I have engaged in both Qi Gong meditation exercises, Tai Chi (sometimes referred to as a moving meditation), and  a type of meditation termed Modern-Day Meditation. All of these techniques have proven useful in helping me center and ground myself.  And there are still other types of meditation that have helped countless others including Transcendental Meditation, Mindfulness Meditation, Zen Meditation, Buddhist Meditation, and Taoist Meditation.  Furthermore, there are a variety of methods of meditating ranging from sitting in a fairly fixed position to more expressive meditation wherein the body can move in any manner and let anything happen, and finally to the practice of mindful meditation wherein someone can go about their daily activities in a mindfully mediated state. Currently, I engage a method of guided meditation termed Modern-Day Meditation that I have found helpful in assisting both myself and some of my patients in getting in touch with feelings along with letting go of  feelings that can be disruptive to their life.

I understand all meditation as a process by which someone goes inside themselves blending one’s internal world into a depth of external consciousness.  A meditation that I sometimes employ in my practice is a guided meditation technique using specific songs that help to elicit a variety of feelings unique and appropriate for a particular patient.  These could be songs that have angry themes, sad themes, or painful themes; whatever songs elicit feelings that help guide my patient deeper and deeper into an emotive state that lays underneath their thinking. This is a process that requires many practice sessions in order to go deeply enough to get in touch with profound and meaningful emotive experiences. But getting in touch with these feelings is only the first step in allowing the meditative practice to help.  Once in touch with deep feelings there needs to be a period of time wherein those feelings are released and then replaced with calming, beautiful feelings of light, love, care, and compassion.  In so doing, there is a gradual therapeutic effect of letting go of painful feelings and replacing them with feelings that are comforting.

For many people, this type of guided meditation is a practice that is difficult to comfortably engage.  It is very important for people to keep their eyes closed throughout this type of meditative practice in order to try to stay within oneself, shutting out visual cues that might take one out of his or her depth, and promoting the patient to focus inward.  Riveting music can serve to help a patient go deeper and deeper into those feelings that are evoked by that music, and in so doing, promote awareness of emotional states that lay underneath one’s thinking.

Meditative practices such as the one I have described cannot simply be cathartic.  Psychological research has shown that catharsis in and of itself typically produces no long term benefit.  However, getting in touch with deep feelings and then actively calming oneself in the service of letting in whatever is beautiful to the individual, i.e., whatever is filled with light and love for that individual, can be powerfully therapeutic in ridding oneself of either acute or longstanding pain and sadness.

Sometimes, my patients have lives filled with pain secondary to their sensitivity and “thin skinned” nature.   This has left them feeling the pain of others, both in their immediate environment as well as in the world in which we all live.  Such individuals in my practice have often benefited from meditation as it has enhanced their awareness of their pain, fostered mindfulness, and provided a means to replace some of that pain with feelings of light and love.  Furthermore, as an attachment-based psychotherapist, I have worked with this as a means to promote pathways to healthier attachments, a cornerstone of mental health and feelings of well being. 

In closing, I want to emphasize the power of meditation.  Meditation has been found to cause significant change in metabolic rate and blood pressure. Rate of respiration and blood pressure can also decrease as a result of meditation.  My patients have talked with me about an overall improvement in their sense of psychological well being when they experience an increased capacity to “let go” of upsetting feelings that have tormented them, sometimes for many years. In recent years, many physicians have supported the use of meditation as a meaningful component of any integrated healthcare program.  Recognizing the value of meditation both physiologically, psychologically, and spiritually has clearly been  helpful to some of my patients and I am confident that it will remain an important part of my practice.

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I brought home a Doberman puppy about 6 months ago, and its reminded me of the importance of Errorless Compliance Training.  You see, this is the third Doberman I’ve had, and anyone whose had one of these dogs knows they are the most lovable, sweetest dogs you could own, and so incredibly smart!  And so the first two I had were so ridiculously easy to train (the last one was a certified service dog for autistic children) that I forgot what its like to have to train a dog!  Well this puppy has brought me back to reality.  It does take some time.  In essence what I use is catching the dog doing it right, or forcing her to do it right, and then lavishing praise.  In essence, what I am doing is what psychologists call Errorless Compliance Training.  Its working with my 8 month old puppy, and it has been shown to be a useful approach in dealing with difficult children.  In fact, it has been shown to be effective in over 80% of children.  I recommend it to many parents who have children with oppositional behavior.

Errorless compliance training for parents is a success-based, non-coercive intervention for children with severe oppositional behavior.  It involves hierarchical introduction of more demanding parental requests at a gradual pace designed to reduce non-compliance and to prevent the need for constraining consequences (e.g., time-out).

Errorless compliance training is based on the premise that confrontational parent-child interactions in this population may (1) exacerbate the child’s  oppositional behavior, (2) increase the probability of parental violence, and (3) increase emotional problems the child may have (e.g., depression, anxiety, poor self-esteem).  An individualized set of requests needs to be developed for each child (or puppy).

Requests are categorized into a hierarchy, from requests to which child compliance is highly probable (level 1) to requests to which compliance is unlikely (level 4). In sessions conducted in the home by the parent, children are exposed to a high proportion of level 1 requests (e.g., “turn on the television”; “give me five”). These requests present frequent opportunities for parents to reinforce compliance. Requests to which compliance is less likely are gradually introduced over the next several weeks. Eventually, level 4 requests are introduced (e.g., “put away your toy”; “brush your teeth”.  Because noncompliance and oppositional behavior occur infrequently with this approach, a constraining consequence is typically unnecessary.      

Speaking honestly and openly about all that is important to you or your partner is a critical ingredient of any heathy relationship.  But speaking the truth with kindness and compassion, is the part of being open and honest that can be difficult.  Speaking openly and honestly, always trying to speak with kindness and compassion.  has been a core element of my work with many of my patients over the years.  In reviewing a recent book by Dachur Keltner, Ph.D., Born to be Good, I was struck by the author’s research that supports the position that we as human beings are genetically and neurophysiologically programmed with tendencies towards kindness, generosity and self-sacrifice.

Keltner and other researchers at U.C. Berkeley, focusing on the vagus nerve, a bundle of nerves that originate at the top of the spinal cord, have found that the vagus nerve plays a central role in humans’ tendencies towards kindness and compassion.  The vagus nerve activates many of the central organs of our body such as the heart, lungs, liver, and digestive organs. The vagus nerve can also reduce heart rate. Recent research has shown that it is also likely to produce a feeling of “warmth” when we are moved by something like another person’s generosity or goodness. The vagus nerve is also thought to stimulate various speech centers in the brain that enable communication. And the most recent scientific findings have suggested that the vagus nerve might be closely connected to receptor networks for oxytocin, a neurotransmitter involved in trust, compassion, and maternal bonding.  Researchers at Berkeley have found that people who have high vagus nerve activation in a resting state are prone to feeling altruistic, compassionate, more loving, and happier.  Other researchers at Arizona State University (Isenberg) found that children with high baseline vagus nerve activities were more cooperative in their play and more likely to share.

So many current theorists emphasize the fact that if we can be more conscience of the importance of kindness and compassion in our lives, the more we will be able to derive happiness in our day to day existence.  A “science of happiness” has been emerging in psychological literature that attempts to examine quality of life issues in much the same way that medical science examines life expectancy.  Green movements are increasing our awareness of and reverence for the beauty of nature.  We are becoming more consciousness about garbage, pollution, and waste and their impact on the environment.  Furthermore, we are seeing increasing use of meditation as a means of focusing inward upon our internal experiences of happiness in an effort to highlight the importance of these qualities in our day to day life. Talking about the things for which we are grateful in our classrooms, at our dinner table, and even with ourselves promotes well being and health. Moving away from materialistic desires and towards devoting our resources to others in the service of promoting relationships often brings about lasting feelings of well being.  We are seeing Doctoral Programs in Clinical Psychology emphasizing the importance of compassionate and empathic listening as an important component in promoting healthier outcomes for patients.  And so, what we are seeing is that psychological research is validating that which many of us have known:  kindness, compassion, appreciation for others, and gratitude are at the core of creating and promoting quality in our lives.

December 2011

I’ve been working with an increasing number of blended families in recent years and wanted to offer some advice to those persons who may be in the midst of recent efforts to blend their families, or are considering the same.  I offer this advice both from my own experiences as well as the recent experiences of my patients who have remarried and are attempting to blend their families.

First, be patient.  The process takes time and it doesn’t happen because you want it to happen.  Try to provide events that allow the children from each family to participate in something that most will enjoy.  And don’t force anything.  The blending into a single cohesive family will occur as it can, not how you want it to.   You have made the decision to enter into a partnership, but the children have not made the same commitment to each other.   Allow those relationships to evolve over time. 

Second, have weekly family meetings that allow each person to say one thing that is working for them in regard to the blended family, and one thing that is not.  Just giving everyone an opportunity to speak can form bonds that otherwise might not.  Have rules that when one person is talking, they cannot be interrupted, regardless of how inaccurate you feel their perspective is.  Everyone’s task around the table is to listen to the speaker, and just listen to whatever their issues are. 

Third, expect difficulties.  There are going to be different ways in which each of you and your families did things, and tolerance is the key here.  There is no right way to do things.  Only what works for each person, and often its different for each of you and your children.  Allow for everyone to develop a system over time. 

Fourth, don’t be passive.  The children will need guidance.  Explicit discussions first between the two of you, about house rules, expectations, how things work in the house, is essential.  After the two of you come to a mutual understanding, its time to open it up to the kids. 

Finally, create some new rituals that reflect the new blended family system.  Maybe pick a new vacation spot that becomes a regular yearly event. Or a new restaurant that no one has been to.  Something new that reflects the blended family, distinct from either of the families that everyone was once in.

A recent blog in Psychology Today, offered recommendations for “Top Bananas” and my thought was that not only Chief Executive Officers, Chief Operating Officers, and Managing Directors can use some of this advice.  I thought that Domestic Engineers, i.e., moms or even dads who are managing the home, might also benefit from some of these recommendations and so I offer them below as discussion points for those of you that might want to talk about them with your spouse.   

Be Real.  “It is important to be straight forward, honest, and open with others. Tell people exactly what you are doing and why. Authenticity leads to trust, and trust is critical for effective leadership.”

Be a Visionary.  “Be creative because the best leaders keep the vision of an organization in mind, but are flexible how it is achieved.”

Remember the Buddy System.  “As a leader, a boss learns to command respect without ever having to demand it.  Therefore, an effective boss is not a dictator but a partner; he is always part of the solution and never intentionally part of the problem.”

Know Your Limits. “In every organizations culture, there are some aspects that are changeable, and some that are not.  A strong leader is realistic about what’s within his or her control and what isn’t, and makes thoughtful choices about which path to take based on this knowledge.”

Go Long.  “Don’t give instructions, rather give goals.  If I am given the freedom to figure out my own path to the top of the mountain, I’m more likely to give my all to get there.

Social Smarts.  “Leadership is not about process, it’s about relationships.  It’s at least as important for a manager to understand people as it is for the manager to understand the structure of the organization.”

Most of us realize the demands on mothers to be managers and effective leaders. These business tips above, written for business leaders by Industrial & Organizational Psychologists, provide useful tips not to CEO’s and the like, but also to managing directors of families.

I recently read an article in the Journal of Personality and Social Psychology, June 2011, in which MIT researchers examined how quickly men and women respectively say “I love you”.  The vast majority of the persons studied believed that women normally say “I love you” first, and predicted that in an ongoing relationship, these women would utter these few special words near the two month mark. 

To the surprise of the researchers and to many of you, in more than 62% of relationships, the man said “I love you” first.  Men in the study stated that they first began thinking about professing their love about three months into the relationship.  Women in the study first started thinking about saying those three word at the five month mark.  Researchers stated that from an evolutionary standpoint, women have more to lose from committing to a potential mate too soon, so they hold back instead of prematurely “getting serious”.

One interesting finding from the MIT study was that on average men reported being happier if they received confessions of love by women before their relationship turned sexual.  In contrast, women reported being happier if the first declarations of love came after sexual intimacy in the relationship.  The researchers concluded that whether it is conscious or unconscious, males take a “pre-sex I love you” to mean I am ready to have sex with you, while women worry it might be a ploy on the part of men to get them into bed.

The men in the study were significantly more interested in long term relationships with persons with whom they are having sex, as compared with female subjects.  These male subjects who were interested in long term relationships preferred to hear “I love you” after sex when it wasn’t a rash declaration. The researchers concluded that the stereotype of men saying I love you in order to procure sex needs to be examined more closely. 

Who said “I love you” first, and when and where it happened, is often something remembered in long term relationships. While research may shed some light on who actually says it first and how it’s received, I am always struck by how hesitant people are to express a statement of love, when they feel it.  So often, love is thought to be something so different when we talk about love for a sexual partner in contrast to the love we might have for our children, our parents, our siblings, or our pets.  My understanding of love is that is more akin to the poet who said, “Love is love is love”  The love that we have for all the different persons in our lives, whether it be spouses, siblings, parents, children, pets, or our friends, is the same love, taking different forms.   The love exists differently by virtue of the  manner in which those relationships exist.  But love, while taking its many different forms in each of these different relationships, is the same.  Love is love is love.