What to Say to a Friend who is Ill, part 2.

This is a continuation of a blog I started last week.

I read a very good article in More Magazine, What to Say to a Friend who is Ill, by Donna Jackson Nakazawa, April, 2014.  It gives a lot of practical advice.  I decided to share some of it in my blog.

Accept that you are in uncharted territory: “…Irene Levine…author of Best Friends Forever: Surviving a Breakup., ‘Some people become less talkative when they fall sick, others more communicative.  Some go into super-coping mode, while others may catastrophize. A friend who is ill may express herself with a harshness or candor or emotionality that you’ve never seen her display before,’ says Levine.  “We have to remind ourselves that it may well be because she can’t demonstrate those raw feelings to any other friend, perhaps not even to her family.’

Cultivate honesty: “I may not be able to read you well when you’re feeling sick, so I may not know what you want.  But I want to know.  Tell me what to bring and what not to bring and when you do and don’t want company.  Several women who have had illness told me they were most moved by offers of specific, proactive assistance. ‘I am going to do something for you, and I’d rather you tell me what it should be.  If you want lamb chops or a foot rub, say the word.’ ‘…To find out what someone needs most, you often have to ask, ‘What are you most concerned about?’…It can be greatly appreciated when friends offer to combine your errands with theirs, ‘I am headed to the dry cleaners. What can I drop off for you?, or I’m going to the groomer and thought I’d pick up your dog too.'”

Know your limits: “A likely factor in how much energy you’re willing to commit is whether your friend’s condition will continue over many weeks or years….but often, the prognosis is unclear…’Be honest; says Levine’. ‘Ask yourself, Can I really do this? If you are hesitating to visit your friend, Levine suggests telling her why rather than letting her guess.  You might say, ‘Your illness stirs up memories of my mother that make it difficult for me to see you in the hospital.  So I want to find other ways to support you.”

Maintain some normalcy: “Even those facing (illness) need their circle to know they haven’t totally checked out on what’s happening around them.  When a friend is ill, you make sure to keep sharing your life, appropriately….Hey, would you like to hear the funny thing that happened to Paul yesterday when he went to the grocery store?’ Occasional distraction can be beneficial.”


More later….


5 Ways to be Sensitive to a Person who’s Ill

This is a portion of an article from More Magazine, April, 2014.

The article is What to Say to a Friend who is Ill (by Donna Jackson Nakazawa).  It is great article!  This is part of the article and future blogs will highlight other portions of it.

5 ways….

1. Pause before you enter his/her room.  On any given day, you don’t know what condition your friend will be in.  NYU’s Irene S. Levine suggests that before you visit, “given yourself transition time to think about what you may encounter and what you might say.”  What has the sick person experienced most recently?  If she’s in the hospital and just had a visit from the doctor, consider asking him about it.  “How did it go when the doctor was here?” If there is silence, pause before leaping in.

2. Touch your friend gently.  Patients often lose their sense of physical connection because they’re rarely touched except during medical procedures.  Levine suggests, “When you first see your friend, you might simply put a hand on her shoulder or hold his hand.”

3. Take the patient’s view of her disease.  “If your friend has metastatic cancer and he knows he doesn’t have a lot of time left and wants to close loose ends, respect where he is rather than trying to pretend the situation is different,” says Julie Klam, author of Friendkeeping.  Or if your friend feels certain she is going to beat her disease and wants you to support that, sign on and join her in that unwavering conviction.  “For some friends, being Sally Sunshine is appropriate; for others, it is not,” says Klam.

4. Connect digitally.  Several former patients said texting allowed them to say yes to offers of help they might otherwise have missed.  “If someone calls, I might not even answer the phone,” says Mary Wooding, whose pulmonary arterial hypertension leaves her with little energy. But if someone texts and says, ‘I am at Redbox staring at this movie you wanted to see,” it’s easy to text back, ‘Yes, thank you.'”  Texts can also be an easy way to convey affection.  “No one gets tired of hearing that they are missed,” says former breast cancer patient Catherine Guthrie.

5. Offer to make open-ended plans.  People with chronic illnesses sometimes feel guilty about canceling dates with friends at the last minute.  Chronic-illness coach Rosalind Joffe suggests offering them an out.  You could say, for instance, “We really would love it if you could be at our party, but we know you can’t predict how you’ll feel that day.  So here is the invite; come if you can.  If you can’t, we’ll understand.”


More later.

The Unfinished Business of Our Lives and Where We Finish It.

I worked with a man a few years ago who’s wife died unexpectedly and in bed with another man.  He was devastated!

Complicated grief….the loss of a spouse and discovery of her infidelity.

“How do I get through this?”

In American society, there is a false believe: “In life, you finish what you start”.  This is all a part of that “Manifest Destiny”, John Wayne, big ego, “be in control of everything including your future” teachings that the west is so noted for.  But what if you CAN’T finish what you start; what if something bad happens to you and you don’t know why it occurred, can’t find out why it occurred.  What do you do then?  Our modern society would say that if you can’t figure out why it occurred or can’t finish something, you are a failure or feel personal failure.

I want to introduce a new idea:

There are some chapters/stories/parts of our lives that take a long time to be finished; that are not finished before the next chapter starts; that NEVER get finished.

I have found people don’t want to think about this.  They don’t want to think about unresolved issues in their life, not having all the answers to all the problems.  What’s that phrase, “Why do bad things happen to good people?” This comes directly out of looking for an answer/reason why something has happened; the thinking being that once I understand why something occurred, I’ll be able to put it aside, move on with my life, leave it alone. But the truth is that there are a lot of things that happen in our lives that we don’t know why they happen or how our actions will turn out, down the road.  For example, I don’t know how my divorce will effect my daughters…..and I think about that daily. I’d like to think that because we (my ex-wife and myself) were civil during the marriage, divorce and thereafter, my girls will be fine…BUT I DON’T KNOW THAT!

People don’t want to acknowledge this; I think in part this is because it causes them to doubt themselves (and the American Creed is to be self confident under ALL circumstances….which is impossible).  If I don’t know why something (bad) has happened in my life, is it possible that I may have done something to contribute to the (bad) event occurring. If I don’t know how something I may do will ultimately turn out down the road;  I may do something I think is good and it turns out bad.

My point is, “Can you/I live with the unknown?” Can you live with the fact that sometimes we don’t know why a bad thing has happened?  Can you live with the uncertainty that the (“good”/”right”) things you do now, might, in the future, prove to be bad or wrong…can you live with this?

Can this widow live with the reality that she will never know for sure why he was unfaithful? Can I live with the unknown effect of my divorce on the lives of my daughters? As I get older, I see this question being put to people in my office and I see this question presenting itself to me in my life.

The answer to this lies in my ability to TOLERATE the unknown.  All I can to is make the best decision I can at the time, do the best that I can at the time and realize, down the road, you/I may discover what we thought or did not right.  That doesn’t mean what we did/thought/decided at the time wasn’t right, it just means as things unfolded, we couldn’t see everything at the time of our actions/decision and had we been able to, we may have decided/acted differently.

Getting back to the widower, can he tolerate the unknown, his unanswered questions (and not let them overshadow the rest of his life)?

He spent ALOT of time examining and re-examining his life with her and concluded that while there were parts of her that he never fully understood, he concluded this was just part of her and felt it was best if he just accepted those parts and continue their married life.  Upon the discovery of the affair, he worked through both the anger at her betrayal and the grief of loosing her….together, at the same time!  Very difficult. He further was able to accept that this will just be an unfinished part of his life.  My theology says in the next life, he will have an opportunity to ask the questions he is not able to get answers to now.  But I don’t know if that is right.  I will just have to wait and see.


More later.



Emotional Affairs

Some of the content in this blog submission were facilitated from the website: DearPeggy.com by Peggy Vaughan.  In my readings about mental health issues, I came across DearPeggy.com.  She had a number of articles on emotional affairs.

Increasingly, I see people in my office after having engaged in an emotional affair.  A few thoughts on this topic.

The key to determining whether behavior can legitimately be classified as an affair is whether or not there is secrecy regarding the relationship (outside the marriage).  So, if the outside relationship is being kept secret from your partner, even if there is no sexual involvement, it is still an affair.

It is the deception (whether sexual or emotional) that creates the most long-term damage to the trust and future of the marriage.  Most people recover from the fact that their partner had sex with someone else before they recover from the fact that they were decieved.  An affair, in the final analysis, is more about “breaking trust” than about ” having sex”.

Here are the responses to the following question from an online poll taken a few years ago:

“If your partner has had an affair, what was the most difficult to overcome?”

Women’s responses: That they had sex with someone else – 28%

That they decieved me – 72%

Men’s respnses:          That they had sex with someone else – 30%

That they decieved me – 70%

Emotional affairs are growing and affecting a large number of people, primarily due to more workplace connections and more online connections.  Since this is such a significant issue for so many people, consider the following:

It’s an emotional affair if…

I am keeping the details of my relationship secret from my spouse.

I am saying and doing things with the other person I wouldn’t do if my spouse were present.

I am sharing things with the other person that I don’t share with my spouse.

I am making an effort to arrange to spend time with the other person.

Most people who get involved in an “emotional affair”…

weren’t looking for an affair.

didn’t intend to have an affair.

didn’t think they were vulnerable to an affair.

Most people, especially men, do not realize there is an everpresent trap around people who are in a relationship.  The trap is the attraction that can occur when one shares intimate (not necessarily sexual ) thoughts, feelings, hopes, etc. with someone besides their partner.

If there is ongoing interaction with someone with whom you have been very honest in sharing your deepest thoughts and feelings, this can generate a feeling of closeness that stimulates even more sharing…and more closeness…and more sharing…and more closeness, etc.  Eventually, this relationship can become extremely close and an emotional attachment develops, causing serious damage to the marriage….whether it becomes sexual or not.

Statistics (from DearPeggy.com) suggest about half of emotional affairs escalate…become sexual.

The first step in healing is to severe all contact with the other person…all contact.

The second step (for the adulterer) is to demonstrate their trustworthiness to their partner.

In general, the third step in healing is for the couple to create a new relationship.


More later…



What we learn from our parents’ marriages

“What we lean from our parents’ marriages” is the name of an article in June 2009 edition of Redbook magazine.  It is essentially about that…what couples, through interview with Dr. Scott Haltzman, author of The Secrets of Happy Families, have learned from studying their parents’ marriages.  Yeah, I know…Redbook is not The American Journal of Family and Marriage but it is one of the magazines in my waiting room and the article has good principles in it.  I thought it was so good, I copied it and had it available in my waiting room as a handout for anyone interested.

Anyway, below are the principles the 9 couples and Dr. Haltzman outlined in the article.

1. “Marriage takes alot of work.”  I hear this over and over in my practice.  It is really not the work of living together that is so bad…the laundry, the toilets, the running.  But rather, what is so hard and time-consuming is the communication required in a good marriage.  Both people must: talk (About what, you ask….typically everything.); you must be patient while listening to your partner; be able to control your impulses to interrupt; be able to tolerate your feelings (from what your partners say)/thoughts (going on in your own head in response to what your partner is sayiing) while you are listening; ask for clarification for terms and phrases used that you are not 100% sure about; respond using a tone that is not provocative or (passive)aggressive; AND you must then negotiate a solution to what ever is being discussed….anything from how far the clothes-hamper is from the wall to how often we have sex!  Marriage is alot of work!!!

2. “Your parent’s marriage is not your marriage.” It is the FEAR of being like your parents (in their not-so-great ways) that is the real culprit here.  It is fear that keeps us from looking at issues.  My experience in my office is that the fear you have in looking at the issue is not nearly as bad as what you thought or… feared.

3. “Speak kindly to each other.” It is critical that, no matter what, you talk with each other with respect.  I didn’t know that when I was first married.  I’m not proud to say that it took me time to learn that but I did learn it.  It is something I address with couples on a daily basis.

4. “Speak intimately to each other.” What we are talking about here is being vulnerable with your partner in conversation.  If you are vulnerable with them, they will be with you.

5. “Show your children your love.” This is the greatest gift you can give your kids.  Aside from it giving your children a solid base to grow from, it also shows) them how powerful love and affection is(…as a force through the tough times, what adult love looks like, that adults show their loved one their affectionate, sensitive and vulnerable side.  It gives them a model they can use when they are in their own relationships.

6. “Show your children your independence.” So often I see couples that either do EVERYTHING together or, more often, do NOTHING together.  It is critically important you have your own interests and time (by yourself) in a relationship.  It helps you remember who you are in a relationship, separate from your lover (A real problem for most women.) and again, it models for your kids what a healthy relationship looks like.  It also shows them one more way you respect your partner and his/her needs.

7. “Keep playing/laughing”. There is just SO much serious stuff couples have to deal with in a relationship….See #1 above.

8. “Share the work” Guys……Guys….Guys, do you know what she complains about so often in my office when you are not there…?

9. “Put your marriage BEFORE your kids and put your partner on a pedestal…occasionally.” I like both of these.  You know, on airlines, in the preflight instructions when they talk about…..”parents put your oxygen mask on before you put it on your child”…well, the same applies here.  If mom and dad don’t stay connected, everyone goes down, everyone is effected.  Secondly, yeah, I believe it is good to occasionally put your partner first…occasionally ladies…only occasionally.  Guys…an observation…we, as a group in American society, are socialized to put ourself first…seriously.  So, if you can’t recall the last time you truely put her first, did something for her that she truely loved and that you were not expecting anything in return (spelled S.E.X.), then you are not doing that enough.  Put her first…more often.

More later.

His Diary/Her Diary and the different way men and women think.

Her Diary:

Tonight, I thought my husband was acting weird.  We had made plans to meet at a nice restaurant for dinner.  I was shopping with my friends all day long, so I thought he was upset at the fact that I was a bit late but he made no comment on it.  Conversation wasn’t flowing so I suggested that we go somewhere quiet so we could talk.  He agreed but he didn’t say much.  I asked him what was wrong. He said “Nothing”.  I asked him if it was my fault that he was upset. He said he wasn’t upset, that it had nothing to do with me and not to worry about it.  One the way home, I told him that I loved him.  He smiled slightly and kept driving.  I can’t explain his behavior.  I don’t know why he didn’t say “I love you too”.  When we got home, I felt as if I had lost him completely, as if he wanted nothing to do with me anymore.  He just sat there quietly and watched TV.  He continued to seem distant and absent.  Finally, with silence all around us, I decided to go to bed.  About 15 minutes later, he came to bed.  But I still felt that he was distracted and his thoughts were somewhere else.  He fell asleep.  I cried.   I don’t know what to do.  I’m almost sure that his thoughts are with someone else.  My life is a disaster.

His Diary:

Motorcycle won’t start…can’t figure out why.


Ok…first, this is great! LOL. But aside from that (and yes, it is a bit extreme), there is an important point to learn from this…Men and Women Think Differently and if you want a satisfying relationship, both need to understand this, both need to understand how the other tends to think (Personal life experiences will shape how your interpret and react to events occuring in your life.) and both need to be willing to talk about what they (themselves) are thinking and what the other is thinking.

Men…don’t roll your eyes at this.  Need I have to remind you that women bring SO much to our lives.  Men need to talk more about what they are thinking and feeling to their women.

Women…monitor or check the degree of emotionality in your thinking.  If you listen to communication experts, they suggest women need to stop making assumptions about what is going on with their men, ask suscient questions, accept that, as a whole, we are quieter than women and can become obsessed about things that have absolutely nothing to do with you (our women) or our relationship with you and which makes no sense to you at all…the fact that our motorcycle doesn’t start…it started last summer….

Obviously, this is not a solution to all relationship problems but I do see the principles of this cartoon get played out in my office enough for me to keep this cartoon on hand for couples to read and discuss.

More later…

Men to Avoid: 11 Characteristics

1.  He takes no responsibility for anything.  He blames others/things/circumstances for his behavior.

2.  He treats you rough at times…twisting your arm, pulling your hair, shoving you.

3.  He is nice to others but treats you badly.

4. He steals; he uses people, cheats them out of money, always borrowing to spend on himself and then doesn’t pay back the loan.

5. He professes to be “religious” but attacks your religious beliefs.

6.  He gives gifts but demands favors in return.

7.  He puts down women in front of you.  He’ll ridicule you if you get upset.

8.  He encourages pity from others.   He tells stories about how he was victimized all his life…that no one really ever loved him.

9.  He constantly cuts down your friends and family and tries to keep you isolated from them.  When you do get together with them, he wants you to tell him everything that was said and makes you account for all the time you were away.

10.  He is very impatient and when he gets angry, he will destroy (your) property.

11.  He is overly sensitive and sulks when he does not get his way.

Valentine’s Day – Tough Love

Ok…you don’t have a sweetie…what do you do on Valentine’s Day…..YOU   DECIDE   to    treat   yourself.  That is what you do.

First, consider “YOU” in the statement above.  Our society is still so hung up on the romantic idea of love!  We are still waiting/looking for/wanting to be that knight in shining armor…meaning we wait for it (love) to happen to us…and when it doesn’t, we are quick to make all kinds of assumptions, most of which are very skewed negatively.  When love doesn’t come knocking, with respect, get up and go do something!  YOU are the only one who can make a change in your world, in the areas that can be changed and in light of the fact that you can’t make someone fall in love with you, you could do something to distract yourself from the loneliness you feel.  This is not meant to minimize the loneliness you are feeling. Rather, this is to challenge you on your assumption that you can do nothing about feeling lonely.

“But the loneliness will be right there when the movie is over… when I finish my book… when my show is over…what do I do then?”

You either accept the loneliness or you do something else.

“But that sounds like alot of work.”

And being in a real, mature, growing relationship is also alot of work too.

It is so easy to think only of the fun, romantic, easy things about love on this day.  In truth, there are benefits to both stations in life. The question is, can you/are you willing look for them.

Second, your brain is constructed such that feelings CAN/WILL override your thoughts(hence we have affairs, make poor investment decisions, etc….).  But, you can override the override.

We humans are inherently social beings…we are made to be with other humans.  When we are not with others, in an intimate way, we feel something inside us…something uncomfortable…loneliness.  We are made to feel this under these conditions.  It is our body’s way of alerting us to a “danger” in our environment.  The internal (brain) structures that precieve your aloneness and produce the feeling of loneliness do this as a protective/survivalistic reaction (Why? Because early man lived longer when they lived in groups versus alone…More people to hunt for food and more people to have and protect childen.).

But just as we calm a child frightened at Halloween, we too can calm and reassure ourselves when we are scared of being alone.  And just as we may need to repeatedly reassure the child, we will need to constantly reassure ourselves when we are alone.

“But I don’t want to have to constantly reassure myself today/when I am lonely.”

And I bet you don’t want to get grey hair either…but you do and you make decisions what to do about it.

“Well, that is not the way the fairytale goes.”

No, it is not…but this is not a fairytale…this is life and sometimes, it is hard.


More later…

Before You Divorce…..

In early 2013, I will be starting a group for individuals and couples contemplating divorce.  It will be an education and therapy group, for 1 1/2 hours, once a week.  The purpose of the group is to give an individual or couple time to RATIONALLY consider divorce BEFORE/AS they (decide to) divorce.  At present, I envision that the first 1/2 hour, I will present information/education on divorce; the remaining hour will be devoted to therapy…providing an opportunity for an individual/couple to discuss aspects of divorce they are questioning/struggling with.  The group will be “open-ended”, in that individuals/couples can attend as long as they wish, up to the time they decide to divorce and/or until their divorce is legally finalized.

Some of the topics I an preparing to discuss/present on include the following:  How to tell the difference between normal fighting  and fighting that suggests divorce, How divorce relates to the motivation for marrying and who is picked to marry in the first place, Should I divorce (or “stick it out”), Signs within a relationship that divorce is on the horizon, How will we tell the kids (“One is 3 and the oldest is 17…”), How will this effect them, Feelings to expect during/after the process (of deciding), What to do if you want to divorce but you are afraid of financial issues, visitation issues, etc., etc.

So often, I see couples who have fought, threatened, suggested, hinted at, avoided, wished for, begged for, asked for….a divorce.  But…they never discussed it…rationally.  Or, they divorced and THEN talked about it or wished they had. This group is intended to fill that gap.

More (details) later.

Couples Therapy…some thoughts

Identifying what to do and how to do it is often easy to identify.  The bigger challenge is why you don’t do it.

How to think differently about a problem is often more effective than just trying to figure out what action to take.

Your partner is limited in his/her ability to respond to you.  You are limited in your ability to respond to your partner.  Accepting this is a huge step.

The definite possibility exists that you have some flawed assumptions about your partner and your partner has some flawed assumptions about you.  The problem is we don’t want to believe our assumptions are flawed.

Couples therapy works best if you have more goals for yourself than for your partner.

It is human nature to try and change one’s partner instead of adjusting our expectations.  The aspect of human nature is what keeps therapist in business.

The hardest part of couple’s therapy is accepting that you will need to improve your response to a problem.  Very few people want to focus on improving their response.  It is more common to build a strong case for why the other person should do the improving.

You cannot change your partner.  Your partner cannot change you.  You can influence each other, but that does not mean that you can change each other.  Becoming a more effective partner is the most efficient way to change a relationship.

It is easy to be considerate and loving when vistas are magnificent, the sun is shining and breezes are gentle.  But when you are cold, hungry and tired and your partner is whining and sniveling about how you got them into this mess, that is when you are tested.  That is when you can either blame your partner or try to be the person you want to be or that the relationship needs you to be.

The more that you believe that your partner should be different, the less initiative you will take to change the patterns between you.

You create trust by doing what you say that you will do.

It is impossible to be in a highly inter-dependent relationship without ever being judgmental or being judged.

If you strive to always feel emotionally safe in your relationship, you, your partner and the relationship will become dull.

Most of the ineffective things that we do in relationships fall into just a few categories: blame, withdraw, compliance, resentfulness, whining or denying.  These are normal emotional reactions to feeling threat or high stress.  Improving your relationship means better management of these reactions.

More later…