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.

One of my young adult patients recently noticed a Diploma in my office indicating that I was a Diplomate of the American College of Forensic Examiners and asked me why did I want to be a Forensic Psychologist?  It gave me the opportunity to talk with him about  how I ended up working at the intersection of the legal world and clinical psychology.

After going to school for seven years and completing a Doctorate in Clinical Psychology, an Internship, and then a Fellowship in Child and Adolescent Psychology, I began a full time private practice.  Since that time in 1984, I have seen literally thousands of children, adolescents, adults, and families, many of whom have been dealing with issues surrounding divorce.  In my first 10 years of practice, I found that among the most challenging and difficult situations that children and parents go through, is a divorce.  In 1998,I became eligible to apply for certification in Forensic Psychology through The American College of Forensic Examiners and have been certified since that time.  While my clinical practice is typically full, I leave one day per week for other professional activities, one of which is Forensic Psychological Evaluations.  This work primarily involves child custody issues, and the development of co-parenting and visitation plans.  Secondarily, I have also performed evaluations in regard to personal injury as well as fitness for duty assessments.  I limit my forensic work to these areas and refer to my forensic psychologist colleagues for other areas of forensic work such as evaluating persons accused of criminal offenses, competency issues, and legal definitions of insanity.

My work as a clinical psychologist has provided me with a foundation upon which to evaluate children and families within my role as a forensic psychologist.  I have been involved in child custody evaluations in Westchester, Putnam, Dutchess, and Orange Counties.  While these evaluations have been challenging, they also have been some of the most important work I have done in helping parents and children move forward.

Being a forensic psychologist in Westchester County has clearly been rewarding.  Having recently opened up an office in Ridgefield CT, I will be looking forward to developing a Forensic Psychology practice in Fairfield County as well.  My long standing commitment to careful and comprehensive evaluations along with the best interests of children, is a natural interface with the role of a Forensic Psychologist in the court system.  So often, abbreviated assessments authorized by court sanctioned agencies, who do the best job they can with the limited time they can devote to a family system, is sadly what is common in Forensic Psychological Evaluations.  

My forensic evaluations often involve up to 40 hours of interviews, telephone consultations, observations, psychological testing data, and review of important documents.  Collectively this allows me to offer attorneys and the Court an in-depth and comprehensive evaluation that provides meaningful input. I have succeeded when I help parents who are at odds with one another avoid inflicting emotional scars on their children and find common ground with a peaceful outcome.  From here, I help all the parties see an opportunity to embark upon a path free from the anger and the hurt underneath.

It has long been discussed that paying attention to one’s successes has a positive impact on an individual and that a focus on our own or other’s shortcomings and failures is not helpful and has the potential for souring any relationship. But recent neuropsychological research at MIT is showing that success has a much greater influence on the brain than does failure.

Neuroscientists and psychologists have studied how the brain learns things for some time now. Have you ever skied and made a series of bad turns, and on another run, felt like you were making one well-constructed turn after another? Or gone bowling and had a number of strikes and spares in a row? It seems that there is more than just luck to good streaks and bad streaks. Neuroscientist Earl Miller who leads a team at MIT recently published an article (Neuron, July 30, 2009) discussing how single cells in the brain learn from positive and negative experiences. In an experiment involving training monkeys to make a choice, researchers found that successful choices caused the level of the neurotransmitter, dopamine, to soar in the monkeys’ brains, and that this then caused the monkeys’ performance to soar. On the other hand, if the monkey made a mistake, even after the monkey had clearly mastered the task, the monkey subsequently did not do better than chance on the next trial. It seems the monkeys’ brains learned far more and far more effectively from positive learning experiences, than from mistakes.

If we look at how we interact with important people in our life, we might ask ourselves how often do we applaud success in the way a hockey team surrounds a teammate who scores a goal, or a bowling team applauds a teammate who makes a strike? In these instances, brain cells register that we have done good, and with that pleasurable feeling, and a flood of dopamine in the brain, our mind tells us to keep doing whatever it is that we were doing that led to that success.

In our day to day lives, there are countless opportunities for us to focus upon ourselves, our achievements, and our successes, and in so doing, not only decrease neediness and feelings of needing to be applauded by others, but also increase the chances for our success to continue. Looking at our successes, no matter how irrelevant to others, can help us to work toward a larger goal. Moment to moment successes at work in the gym, or elsewhere, can segue into larger and broader feelings of self-worth. In the absence of positive feedback, we are vulnerable to negative thinking and more generalized negativity. This can lead to depression as well as have a souring effect on our relationships. Much the way we might tell a child who loses the playoffs to look at the friendships that he or she created throughout the season, we must find in ourselves and in those we love, the positive, the win, the place where some success resides.

In marriages, when needs are not being met, partners are often disappointing one another, and separation is growing amongst a husband and a wife, it becomes clear that little opportunity is present from which either husband or wife can gain the neurochemical momentum to promote the behaviors and affective expression that will allow pleasurable and desirable behaviors to continue. At such times, parties need to take a step back and actively seek out successes. We need to be open to the idea of promoting and applauding our spouse as the sine qua non of happy and successful relationships. It is important to remain mindful of trying to bring out the best in our partner. Meeting the needs of our partner can give both them and ourselves powerful feelings of satisfaction and that can then spiral in a positive direction that allows the relationship to blossom and flourish.

In our children, we need to find islands of competence in which we can applaud their successes. False applause is shallow and has little meaning to a child or teen who tends to pay little attention to what he or she experiences as false praise. But fostering an ability in a child, and then paying attention to those abilities, is a clear path to promoting our children and their self-image. In addition, Miller’s work at MIT sheds light on the neural mechanisms linking environmental feedback to neural plasticity, the brain’s ability to change in response to experience. As such, our attention to success has implications for understanding how we learn, and how we understand and treat children with learning disorders.

March 2010

In my clinical work with many different patients, I have been consistently impressed by the extent to which belonging in social groups and social networks, with its consequent feelings of attachment and belonging is such a powerful predictor of people’s ability to deal with life’s problems and feel satisfied with life in general.

Many studies have shown that sociable people who report feeling like they belong to more than one social group do remarkably better after a significant negative life event. A study done at Columbia University in 2005 looked at over 600 stroke patients and found that patients who were socially isolated where nearly twice as likely to have another stroke within five years as compared with those who had meaningful social relationships!

It seems that victims of a stroke who were cut off from others were the most likely group to suffer another stroke. This increased risk was far more robust that what most people think to be the traditional factors that would produce a secondary stroke such as having coronary artery disease, or being physically inactive, both of which increased the likelihood of a subsequent stroke within the next five years, but by only 30 percent. In addition, a study of 16,000 elderly people by the Harvard School of Public Health found that there is significantly less memory loss in seniors who are more socially integrated and more socially active as compared with less socially active seniors.

Clearly, there is compelling evidence that the psychological factor of isolation is as powerful a predictor of poor health as is the more common negative correlates such as smoking, obesity or high blood pressure. But we do not see the same emphasis on the psychological factor of feelings of belonging as we do heavily publicized medical evidence.

Some might ask if it is important to belong to more than one social group. The danger to belonging to one and only one group is that we put ourselves in a much more vulnerable position, very much along the adage of avoiding having all your eggs in one basket. We can readily see this in a person who is over-involved in his work, and who neglects his family and friends, and then suffers dramatically with the loss of his job; or a jogger who has no other involvements and then injures her knees and can no longer jog. She too would be more vulnerable to these negative consequences than if she had belonged to multiple groups.

Many years ago Oliver Sachs, the Neurologist at Columbia University, wrote “The Man Who Mistook his Wife for a Hat (1998)”. Sachs noted that patients who suffered with severe neurological impairment were not necessarily worse off as a correlation of how severe the impairment was, but rather the extent to which the person maintained a coherent sense of themselves and connections to others. Herein, we see the seminal importance of attachments in protecting ourselves from the inevitable stressors in life. Clearly, having a sense of ourselves and social identity has a very important influence on our general health and well being. We are social beings and for humans, membership in groups seems to be a critically important part of who we are and what we need in order to feel like we are leading satisfying and fulfilling lives. Not only can group life inoculate us against threats to physical or mental difficulties, it can improve our overall feelings of well being with far fewer side effects than pharmaceutical options. Belonging seems to be vitally important. And developing these connections is worthy of the time and energy we must devote to establishing and maintaining our involvement.

February 2010