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PsychNotes January 2014
by Monica A. Frank, Ph.D.
Clinical and Sport Psychologist

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January 30, 2014

Rule 2: To Be Considered, Be Considerate

To Be Considered, Be Considerate My husband lives his life by this rule. I don't have the research evidence to provide for this rule. I have only what I have observed in the last 35 years with him. What I have seen is that people are very responsive to him and willing to go out of their way to assist him. However, this response from others is not because he demands it but because they want to. Their positive reaction to him is due to how he treats others. By treating others with interest and respect, he more often than not receives the same back.

I have seen this same reaction from others in my own personal experience. For instance, when I worked in hospitals I took the time to talk to the office staff, ask about their families, and generally take an interest in them. What I noticed (although it was not my purpose for taking time with them) was they responded to my requests much more quickly than requests from other doctors who just treated them like office help and not as people.

There are several aspects to this rule that are important:

1) The responsibility is yours, not others'. Too often I have seen people demand that they be respected or that others should treat them better. Frequently I hear couples say “If only she...” or “If he would...” indicating that they would behave better if the other person did first. Many people place the responsibility for change on someone else instead of taking responsibility themselves.

However, we don't have control over other people's behavior. We only have control over our own actions. Therefore, if we want to change how others respond to us, we need to change how we act towards them. By being aware of and managing your own behavior, you have greater control over how others react towards you. Read more...

January 28, 2014

Rule 1: The Moment is More Important Than Capturing the Moment

The Moment is More Important Than Capturing the Moment At the very time we are gaining evidence about the benefit of mindfulness to psychological and physical well-being, people are becoming less and less mindful. Everywhere people are focused on their mobile devices: playing games, texting, taking pictures, and more. In situations where people used to interact with one another or participate in the events around them they are now recording the events or interacting with their devices.

What is the impact of technology upon the psychological health of people?

Certainly, there are positive uses of technology, but when it becomes excessive, when it interferes with the normal experience of the world, how does it impact us?

One important impact may be upon the development of episodic memory which is the memory involved with recalling past events. The quality of this memory has been found to be associated with higher levels of depression. In particular, people who create more general memories of the past rather than specific memories have a greater tendency to develop depression (Hamlet, et al., 2013). For instance, specific memories of birthdays would involve different events that occurred in different years whereas a general memory would be a vague notion of having celebrated birthdays. Read more...

January 27, 2014
The next 5 cognitive-behavioral therapy (CBT) tools, Exposure Methods, are discussed in the sixth installment of this article: read about the methods of gradual desensitization, acting "as if", expressing yourself assertively, tolerating the anxiety, and structured worry time.

This article will be updated over the next couple weeks to include 50 CBT tools for panic and anxiety which are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment.

January 15, 2014


Question:I am the mother of a 36-year-old daughter. Our relationship is very strained. She repeatedly speaks to me with sarcastic intonations in spite of my numerous requests for her to "try to talk nice." She rolls her eyes and smirks at me openly. Then when I get upset/hurt, she says I'm making a big deal about nothing and tells me I drive her crazy. When I try to put some time/distance between us so that things can cool down and I can focus on the things I need to do to take care of myself, she calls me, always due to the latest crisis with which she desperately needs my help (usually requires monetary assistance--something I have in short supply myself). I end up helping her and my son-in-law mostly in the interest of helping my grandchildren. No thank you, no sign of appreciation, and if I say anything that indicates even remotely that a little appreciation would be nice, then the sarcasm starts up, or screaming, or I get cursed out. I realize I'm a huge part of this equation, but I feel like I'm on a merry-go-round, and I don't know how to get off. I see that I am repeating/reliving my relationship with my mother (deceased) with my daughter, and it makes me sick. I feel like my heart is broken. Please help!


January 14, 2014


EVENT: My adult daughter repeatedly speaks to me with sarcastic intonations in spite of my numerous requests for her to "try to talk nice." She rolls her eyes and smirks at me openly, then when I get upset/hurt, she says I'm making a big deal about nothing, and tells me I drive her crazy.

EMOTIONS: frustration, sadness

DISTRESS RATING: 8—high level of distress

THOUGHTS: “I am heart-broken because my daughter doesn't care about my feelings. She treats me disrespectfully and only calls me when she needs my help. I help her because I worry about the grandchildren but she shows no appreciation.”
CAN YOU IDENTIFY THE IRRATIONAL THINKING IN THIS EXAMPLE? There are at least 3 irrational beliefs.

HOW CAN YOU CHANGE THE THINKING? What is another way of thinking about the situation that won't cause the feelings of frustration and sadness?


January 13, 2014

PsychNote: Is it More Important for Your Children to Love You or Trust You?

I recently saw a sign quoting author George MacDonald “To be trusted is a greater compliment than being loved.” This statement reminds me of the problem many of today's parents have with their children. For these parents it has become more important to be loved than to be trusted. When you first read this statement you might disagree “No, that's not true! I want to be trusted as well.”

However, behavior tells us whether love or trust is important. When a person NEEDS to be loved by their child they are often more permissive and don't set consistent limits. Boundaries and consequences are necessary for trust. Limits teach children appropriate behavior. They show a child that the parent cares enough and is willing to deal with discomfort for the sake of the child. It is not fun for a parent to say “no” and to experience a child's anger but a good parent does so because it is in the best interests of the child. Always giving in and saying “yes” is for the convenience and self-interest of the parent.

Unfortunately, the permissiveness of parents who have a NEED to be loved by their child comes at a price. The parent still has expectations of the child not the least of which is “you SHOULD love me and treat me with love and respect.” However, because boundaries were never set the child was not taught how to behave with love and respect. As the child grows older and becomes an adult, the parent is resentful and critical of the child because he or she treats the parent poorly. However, the adult child is acting according to how they were taught.

If a parent sets a limit such as “you can't go out and play until your homework is done” to a young child or “if you don't help around the house you will have to move out” to an adult child, but doesn't follow through, the child learns that the parent can't be trusted. If the parent can't be trusted in this way, how does the child know the parent can be trusted in other ways?

Children need to feel safe. They need to trust that their parents will love and support them no matter what. However, that does not mean they are allowed to do whatever they want. Children need to trust that their parent will do what is best for them even if it is unpleasant and difficult. To feel safe in this world children need boundaries. I will always remember sadly a statement made by a teenager I worked with: “I wish my parents would say 'no' instead of letting me do whatever I want because then I would know they care.”

The interesting thing in all this is that when a parent acts in ways that garners a child's trust, they are more likely to be loved. When they are permissive in an attempt to obtain love, they often lose both trust and love.

This PsychNote is partially in response to a question I had from a reader on my website regarding a passive-aggressive relationship with her adult daughter.. To show the process of cognitive-behavioral therapy (CBT) I have decided to divide my response into 3 components: education (this PsychNote), cognitive diary training to challenge irrational thoughts, and how to manage passive-aggressive behavior. CBT involves understanding the problem, changing the irrational thinking, and changing the behavior. Over the next couple of days I will post other parts to my response.

January 10, 2014 The next 7 cognitive-behavioral therapy (CBT) tools, Advanced Cognitive Training, are discussed in the fifth installment of this article: read about identifying probability, challenging catastrophic "what ifs", thought-stopping techniques, exaggerating the fear, identifying triggers, learning to live with anxiety, and creating an experiment.

This article will be updated over the next couple weeks to include 50 CBT tools for panic and anxiety which are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment.

January 5, 2014

PsychNote: Wisdom Doesn't Come in Sound Bytes

I found an inspirational Google community +Wisdom that shares positive quotes and images. Although the site can help influence positive emotions, it made me reflect on something else. As with everything these days, people seem to want wisdom fast and easy. But wisdom is earned, not ingested in quick bites.

happiness cat image How can you earn wisdom? Certainly, life experience is one way. However, you can also use these type of quotes in a way that help create wisdom. For instance, starting around the age of 15 I would find quotes I liked and I would meditate upon them. What I found was that most statements hid a deeper meaning.

By meditating on these quotes I discovered these meanings. And at different points in my life I might find even additional meaning in the same quotes. “When the student is ready, the teacher will appear.” Many people have said the same thing about my assistance audios such as the Rational Thinking audio. Even though they have listened to it many times, they hear something different when they are ready.

Once you have meditated upon a quote, the next step is to implement what you discovered through your meditation. Make your discovery part of your everyday life. Live what you have learned.

In this way, inspirational quotes can become true inspiration creating wisdom and not just a “warm and fuzzy” statement you read and forget.

January 4, 2014

PsychNote: Medication and ADHD: What's Wrong with these Numbers?

Studies have shown that when accurately evaluated and diagnosed about 5% of North American children have Attention-deficit Hyperactivity Disorder (ADHD; Polanczyk, 2007), yet the Centers for Disease Control statistics indicate that 6-8% of teenage children in the U.S. are receiving medication for ADHD with 11% being diagnosed with it (Visser et al., 2013).

Not only that, but a review of the worldwide research (Polanczyk, 2007) examining over a 100 studies with 170,000 subjects indicated that if impairment was included in the criteria less than 2% of children would be diagnosed with ADHD. Impairment means that the child's grades, friendships, other activities or quality of life are being affected negatively.

Questions to be considered:
1) Why are twice as many children being diagnosed with ADHD than actually have the disorder?

2) Why are children being diagnosed with ADHD when there is no impairment?

3) Why are children given medication when there is no impairment?

4) Why are nearly 8% of teenage children medicated for ADHD when only 2% are impaired by it?

These questions are of particular concern for two reasons:
1) The primary medications that are prescribed are amphetamines--highly addictive controlled substances. The research reviewing the safety of medication and ADHD primarily uses children who have been appropriately diagnosed with ADHD so early use of medication is likely to reduce substance abuse disorders in a group who have a higher likelihood of developing these problems (Kollins, 2008). But what about the other 75% who are given medication but don't need it? It is more difficult to find research indicating what happens to these children. However, there are indicators that using these stimulant medications can alter the brain and lead to increased risk of addiction (Steiner and Van Waes, 2012).

2) Many children who do have ADHD, especially milder forms, can be helped with behavioral modification and parental training. Certainly, some children may require medication. I have personally seen cases where medication was warranted. However, we need to be careful and not overly prescribe amphetamines to children due to the risk of substance abuse later in life.

Interesting read: The Selling of Attention Deficit Disorder

Kollins, S.H. (2008). A Qualitative Review of Issues Arising in the Use of Psycho-stimulant Medications in Patients with ADHD and Co-mormid Substance Use Disorders. Current Medical Research and Opinion, 24, 1345-57, doi: 10.1185/030079908X280707.

Polanczyk, G., Silva de Lima, M., Horta, B.L., Biederman, J. and Rohde, L.A. (2007). The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis. American Journal of Psychiatry, 164, 942-948.

Steiner, H. and Van Waes, V. (2012). Addiction-Related Gene Regulation: Risks of Exposure to Cognitive Enhancers vs. Other Psychostimulants. Progress in Neurobiology, doi: 10.1016/j.pneurobio.2012.10.001.

Visser, S.N., Danielson, M.L, Bitsko, R.H., Holbrook, J.R., Kogan, M.D., Ghandour, R.M., Perou, R. and Blumberh, S.J. (2013). Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-deficit/Hyperactivity Disorder, 2003-2011. Journal of the American Academy of Child and Adolescent Psychiatry, in press.

January 3, 2014 The next 6 cognitive-behavioral therapy (CBT) tools, Advanced Mindfulness, are discussed in the fourth installment of this article: read about practicing mindfully letting go of worries, body awareness, letting yourself grieve, using mindful grounding technique, mindful acceptance of yourself, and practicing mindfulness with discomfort.

This article will be updated over the next couple weeks to include 50 CBT tools for panic and anxiety which are divided into several categories: general skills, initial relaxation training, initial cognitive restructuring, advanced mindfulness training, advanced cognitive restructuring, and exposure treatment.

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