All posts by James DelGenio

Individual, Family, and Couples Counselor with over forty years of experience as therapist, author, and continuing education provider.
Divorce, Marital Family Issues, Relationships

How to parent effectively after a divorce?

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

The answer is as simple as it hard!

What is in the best interest of the children?

Remember, it is not about you or your ex! It’s not about who lied, was uncivil, disrespectful or unfaithful. It’s about making this difficult time in your children’s life as easy as possibly under extremely difficult circumstances.

It goes without saying, physical  abuse, alcohol, drug abuse, neglect, endangerment or what ever the reportable event will require legal authorization for supervision, limits and boundaries. Despite the obvious, each parent must ask themselves:

Am I doing all I can do?

Act accordingly, despite the feelings involved. The following provide a point for self-reflection. What is in the best interest of the children?

1. Try to parent as a team. Co-parenting can be difficult at best after a divorce. However, I have seen many couples who still attend family functions together and make a point of going out to dinner as a family on occasion. It goes without saying that they will swap visitation dates when their schedules dictate. This is more common then you might think. Regardless of the state of your relationship, try to be more cooperative. Try to made a little easier for the children. It can be done if you really are interested in doing what is best for the children.

2. Communicate with civility and respect. Remember the walls have ears. No badmouthing your ex. No matter how angry you are; you still need to do what is in the best interest of the children.
There are several apps that help couples collaborate on their schedules and calendars. These apps give parents the ability to coordinate their schedules in order to stay on the same page. This can be very useful when there is still tension with your ex.

3. If your ex grounds a child, you should honor that decision and continue it even if it’s your weekend. I do recommend that there be parameters put on such consequences.

4. Don’t bring a new love interest around the children. Some people ask me for a time when it’s OK to bring someone around. I think it depends on the children and their age and how they are adjusting to the divorce. If I’m forced to give a time, I say one year. Parents really need to examine their own feelings and keep those emotions separate from what is in the best interest of the children.

Zoom! Now I work via Zoom  and it is still be covered by BCBS PPO Insurance. Check with your BCBS carrier for details.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Anxiety Panic Grief Depression, Bipolar Mood Disorders

How to cope with depression, panic and anxiety?

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

How to distract yourself from your depression and anxiety?

Socialization, Exercise, Hobbies, and Chores!

Socialization is an important coping skill. It is good to have fun. Have fun! People with mood disorders often become engrossed in the past, their illness, and problems. They tend to isolate and withdraw. That is just not healthy and is a common symptom of depression. You should have at least 3-4 social events each month.

Exercise (especially walking) is good for depression and anxiety and is a great distraction when one is experiencing symptoms. Research suggests that a brisk walk for 4o minutes (with your doctor’s approval) will lift your mood and reduce anxiety. Don’t wait to feel motivated. Lack of motivation is often a direct result of a mood disorder. If you wait to feel motivated, it may never happen. Walk or do cardio work at least 4 times per week. Pick your days and let the day of the week make the decision for you. This will help to avoid, “I don’t feel like it today; I’ll do it tomorrow.” Unfortunately, tomorrow never comes. Any physical activity is likely to be helpful.

Hobbies can also be an important coping skill. A hobby can serve as a distraction when you are feeling low or anxious. Go to a hobby shop and pick something. I have had a lot of people choose paint by number sets. It’s the perfect hobby. You can pick up a paint brush and distract yourself and put it down and walk away when you need to. I had one man become a very good artist after starting with just a paint by number set. So, go to the hobby shop and pick something!

Chores can also be a great distraction. Many people with depression are overwhelmed by the thought of cleaning their entire living space. Again, use the pick a day method and choose one or two chores per day. Do your chores and exercise on the days you have picked to do them. Try to have at least one social activity per week. Plan to have fun. Adding structure to your life addresses many common symptoms of a mood disorder but especially lack of motivation.

Zoom! Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jamesdelgenio.com
http://family-institute.org
http://psychologytoday.com

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Anxiety Panic Grief Depression, Bipolar Mood Disorders, Severe mental illness, Substance Dependence

Why do people resist taking medication for depression?

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

Resistance to medication?

Psychiatric medication is useful in controlling symptoms of mood disorders. Mood disorders are considered bio-psycho-social disorders. They affect thinking and behavior and often create relationship issues. In most cases, medication and medication management are essential in the management of the biology or the chemistry of the disorder. I consider this to be the foundation of treatment. It is difficult, if not impossible, to treat a severe mood disorder without medication. You can’t build a solid house without a good foundation. Medication, when necessary, provides that solid foundation.

Therapy addresses the psycho-social treatment issues including identification and management of symptoms, daily living skills, coping skills, and the relationship issues and conflict which often accompany these disorders.

Refusal to take medication is a common issue. I do on occasion have clients who refuse medication. In the past, I have said, “I will work with you to see if the use of coping skills will have an impact an impact on your symptoms. If the use of coping skills does not work, I will revisit the medication issue.” If it does that’s great. If not, I will try to deal with the denial and the refusal of medication.

For instance, what if I told you that you are a diabetic and will have to be on insulin injections the rest of your life?  Of course, you wouldn’t like it, but chances are, you would take the insulin injections in order to live! Why is medication for a mood disorder any different?

Let me remind you that alcohol is a drug and if you are drinking, you are self-medicating with a depressant. This may lead to alcoholism or substance abuse and addiction. Wouldn’t it be wiser, safer, and more productive to let a doctor prescribe the correct medication to help you get on the path to recovery?

Medication and Support

Many people remain on medication their entire lives. Some people with mild depression or situational depression are able to use medication intermittently (6 to 18 months) for periods of stress that caused their depression to re-emerge. Others don’t want those periods of regression in their life, so they chose to just stay on the meds. I encourage clients to consult with their doctor for recommendations.

Therapeutic support may also be intermittent or as needed after a time. Depending on the severity of the disorder and how well a person learns to manage, many of my client’s check-in at least three or four times per year, once they are stable and consistent in management. This is especially common for couples whose disorders affect their relationship.

Unfortunately, some people with severe clinical depression or bipolar disorders  may go in and out of the hospital their entire lives if they remain in denial. This is usually a result of non-compliance with treatment and medication, combined with alcohol and/or substance abuse. Mood disorders and addiction can be global disabilities or manageable handicaps. Which one will you choose?

The number one cause of regression, recurrence of symptoms and possibly hospitalization is not taking medication as prescribed. This is not like having a headache. When you have an ordinary headache, you take two aspirin and twenty minutes later your headache is gone. In order for antidepressants or mood stabilizers to work effectively, the medication must maintain a certain level in the body. When that level is not maintained, debilitating symptoms reappear. These medications take four to six weeks to reach their peak level of effectiveness. When you miss doses of medication, drink or use drugs, you negatively affect that level.

Medication Side Effects and Allergic Reactions

All medications have side effects. Even aspirin can cause ringing in the ears if you take too much. The pharmacy must list all side effects, but that does not mean you will experience any or all of them. Most of the common psychiatric medications for depression and mood disorders have very few, if any, side effects after the first week or so. First, ask your doctor about allergic reactions and possible side effects and what to do in the event of a serious reaction. Severe allergic reactions typically include but are not limited to rash, hives, and swelling (of the tongue). Always read the medication information given to you by the pharmacist. He or she is also a good source of information on medications.

The most common and less serious side effects are typically sleepiness, nausea, diarrhea, blurred vision, insomnia, dizziness, or headache. These usually go away in the first week or two. If any side effect becomes severe or you simply have concerns, contact your doctor or go to the ER. Know the possible side effects and allergic reactions of your medications. You should always know the name of your medication, frequency, and the dosage in milligrams. Carry a card in your wallet that will tell emergency personnel exactly what you are taking. If you have questions or concerns, direct your questions to your doctor or pharmacist. Dial 911 or go to the emergency room for serious allergic reactions and side effects. Ultimately, the more you know, the safer you will be.

Mental Illness is a disease very much like diabetes. It takes insulin to manage diabetes; it takes psychiatric medication to manage severe depression and other mood disorders. Some say you just have to be tough. “You just have to pull yourself up by your bootstraps and try harder.” This is false and it won’t work. The only way to successfully manage a mood disorder is with education, medication, structure, ongoing treatment and support.

Always contact the doctor when faced with positive (active) symptoms. Do not self-medicate. A doctor never operates on himself or his own family. Don’t play doctor! Remember, the leading causes of relapse are medication non-compliance and drug and alcohol use. The doctor can’t possibly medicate you properly if he does not know honestly what the patient is or is not taking including alcohol or substances!

Rule of thumb: Never lie or withhold information from your doctor or therapist.

It is extremely important to learn to make healthy choices. Sometimes people do not recognize that the choices they make may not be healthy. Once stable and consistent, some people simply need to check-in with their therapist a few times per year. Others need ongoing supportive therapy every two to four weeks to remain stable. The frequency will depend on the individual and how well one manages their disorder. Together with your doctor, therapist, and ancillary supports, if necessary for dual diagnosis, you can learn to manage your symptoms and cope with the day-to-day stress of depression, mood disorder, or dual diagnosis. This is the reason that ongoing support from your doctor and therapist is essential for management.

You should call your doctor, 911 or go to the hospital if you are experiencing medication side effects or an allergic reaction. If you have thoughts of hurting yourself or someone else call your doctor and therapist immediately. If you are actively considering hurting yourself, call 911, go to the emergency room, or call the National Suicide Prevention Helpline, 1-800-SUICIDE (1-800-784-2433).

The Leading Causes of Relapse

The causes of relapse to active symptoms of a mental disorder have been well documented over the years. It’s no surprise that these reflect the relapse warning signs listed below.

They are:

  • Medication non-compliance (Not taking the medication as prescribed).
  • Alcohol and substance use and abuse.
  • Little or no sleep.
  • Lack of social support.

Non-compliance with medication and alcohol or substance abuse are by far the leading causes of relapse to symptoms. These are self-explanatory. However, little or no sleep and lack of social support may also need to be addressed.

Sleep is an important issue for most with mood disorders. People with Bipolar disorders usually report that they don’t need much sleep. They have a tendency to play with their sleep/wake cycle. They like the euphoric hypomanic feeling that lack of sleep creates. It is very much like the moth and the flame. There is an attraction to the high that one gets when they are sleep deprived. Unfortunately, you can take anyone in the world and keep them awake for two, three or four days, they will become actively psychotic or out of touch with reality. For people with a mood disorder, sleep is a mental health issue.

Social support is also very much a part of maintaining good mental health. Even if one is compliant with medication and not using or abusing alcohol and drugs, social isolation can create considerable stress and ultimately cause a relapse to symptoms. It is imperative that people with mental disorders, have an avenue to combat their tendency to isolate and withdraw from people. I encourage my clients to maintain regular social contact. This contact creates reality testing. We don’t think of socialization as reality testing, but it is. For example: You have an argument with your spouse; you call a friend and say, here is what happened. What do you think? You get feedback on your situation and behavior. That is reality testing. Lack of social support may result in an inability to test the accuracy of what one is feeling or experiencing. This is obviously a very important component of maintaining good mental health.

Relapse Warning Signs

Be aware of relapse warning signs and symptoms. When one is taking medication as prescribed by the doctor, symptoms are largely under control and the client is stable. The reappearance of certain symptoms is an indication that the medication may need to be adjusted, reevaluated or changed. These symptoms may also be an indication that the medication is no longer being taken as prescribed or alcohol and substance use is interfering with the effectiveness of the medication.

Relapse warning symptoms include:

  • Thoughts about hurting oneself or others.
  • Changes in one’s sleep/wake cycle, especially little or no sleep.
  • Inability to concentrate, rapid speech, skidding from subject to subject.
  • Rapid mood fluctuations, mania, or depression
  • Poor judgment, risky behavior, or lack of insight into one’s own behavior.

These symptoms are reflected by poor daily functioning, lack of motivation, loss of interest and conflict. These are considered to be active symptoms and usually are caused by non-compliance with medication and use of alcohol or drugs. In many instances, the medication may need to be changed or the dosage adjusted by the doctor. This may also reflect the need for family members to monitor medication compliance and alcohol/drug usage. Relapse warning signs should be reported to the doctor and therapist immediately. Don’t wait!

Zoom

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative for more information.

Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com   Highly effective online, one on one, SAT, ACT, GRE, standardized test preparation, via face time or Skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material with your doctor and therapist.

Bipolar Mood Disorders, Glossary of terms

Seasonal Affective Disorder (SAD)

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist
The Family Institute at Northwestern University

What is Seasonal Affective Disorder?

SAD as it is known by many, is a type of depression related to the dark gloom of fall and winter with shorter days and less sunlight. SAD is exacerbated by a decrease in activity level that is generally created in the cold winter months. The symptoms are largely the same but not as severe as for other depressive disorders including poor sleep and fatigue, crying spells, irritability, poor concentration, weight gain and loss of sex drive. In some severe cases, seasonal affective disorder can also be associated with thoughts of suicide.

Though symptoms usually improve in the summer, many people have found relief from the use of full spectrum lighting in their homes. These lights come in a variety of shapes and sizes and can be easily found on the internet. Probably the least expensive of these is the 27-watt full spectrum CFL bulb which can be placed strategically in fixtures and lamps throughout one’s residence. These are effective when used on a daily basis. Sometimes, however, these lights are simply not enough. In these cases, many of my clients have found relief by taking an antidepressant for a period of time and by increasing the level of physical exercise especially cardio work.

Zoom!

Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative for more information. Call 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com   Highly effective SAT, ACT, GRE, standardized test preparation and much more.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Couples, Marital Family Issues, Relationships

How to nurture your relationship!

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

Nurture your relationship if you want to make it last.

It is a hectic world we live in. Everything seems to take precedence over our relationships. Health issues, kids’ activities, work issues all take precedence. The next thing you know when you look back is that you haven’t had time for just the two of you in months!

All-in-all life just gets in the way so it’s easy to lose your connection to your significant other. The way to deal with this is to plan your quality time. Trade who gets to pick what you will do.

Gentlemen, don’t let her do all the planning; it takes the joy away for her. When you do get out that is not the time to talk about the kids or your issues with one another. It’s time to be a couple and have fun together.  I recommend that you each pick 3 date night activities and you should rotate so you have at least two date nights per month.  You each get one veto in terms of your spouses selection.  In other words, if my wife chooses the Lyric opera, I would definitely veto that one.  When you are done with all 6, just start over. Date night twice per month will keep your relationship strong.

Some couples even plan for intimacy which I have also seen work. The goal here is to reconnect but if it’s going to happen planning will be necessary. Put it on the calendar and have fun. It’s good to have fun. Have fun together! I’ll bet your level intimacy will improve also.

Zoom! Now I can work via Zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative for more information.    Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com   Highly effective on line, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Marital Family Issues, Relationships

Weekly Family Meetings address many common child behavioral issues.

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James E. DelGenio LCPC Senior Therapist at The Family Institute at Northwestern University

Address common child behavior issues and improve your relationship at the same time!
Once upon a time, families ate dinner together. There was no eating in front of the TV; no texting or answering the phone and no internet. This was a time when families discussed what was going on in the household i.e. news, upcoming events, behavior issues and general discussions. Dinner used to be the natural time for families to discuss their lives, upcoming events and issues of importance.
Today, I find that families rarely eat together, missing the opportunity for family discussion. Child activities including little league, football, soccer, music lessons, dance lessons, and all kinds of after school activities have come to interfere in this essential family event. Families have become ships in the night passing one another as they head out the door. The idea of after school activity is potentially a good one: keep the kids busy and you will keep them out of trouble. However, what has been lost is the sense of family and the opportunity for good communication.
When I was a child, dinner time was always between 5 and 5:30pm. I had a lot of freedom but I also knew what was expected of me. In this case, it was “be home by 5pm” for dinner.
We would hear stories, news and discuss family issues. Today parents have become dependent on dual incomes in order to maintain the lifestyle they want to give their family. Now that the world economy has become more difficult and we have high unemployment and home foreclosures are rampant, parents are working two jobs just to make ends meet. They work late or have different schedules and their relationship suffers. They too, are ships passing in the night. Many couples today report they feel disconnected, their communication has suffered and, in turn, so has the level of intimacy they share. This will ultimately lead to bickering, conflict, infidelity and possibly divorce. How sad that an important family event has disappeared without realizing the major negative impact on the family. Even when couples do realize the problem, there is little that can be done since they are trying to stay afloat financially.
One way to reclaim some of that lost family communication time are family meetings, though some of my clients prefer to call them team meetings. I encourage families to gather at least once per week to discuss four areas. Ideally, this should be done at the same day and time each week. There should also be a pre-family meeting for mom and dad to discuss there issues and get on the same page for the meeting with the kids to ensure you are parenting as a team.
The general topics to discuss are Compliments, News, Issues and Feedback. Here are some examples:

  1. News: This is a chance to keep everyone up to date of all the family events coming up. The more informed everyone is, the more opportunities to share the scheduled load and the less stress for last minute- must do projects. “We are going to grandma’s house next weekend or Joey has a science project due and he will need craft paper”
  2. Compliments: Search for things your child is doing well, no matter how small and acknowledge it. It will increase their sense of confidence and self-esteem. Show that you are excited and proud of them. “You did a nice job getting ready for school on time.”
  3. Issues: We live in an increasingly complex world that challenges us every day with a wide range of disturbing issues. By initiating conversations with your children you will create an open environment and be able to address the tougher topics i.e. homework, curfew issues, chaotic morning or bedtime routine, alcohol and drug abuse.
  4. Feedback: Listen to your children and allow them the chance to express their concerns, complaints and express their feelings. You will learn more about your child if you open your ears and close your mouth.
    I have found that both parents and children love this opportunity. The only concern is that as much as everyone in the house likes this, parents themselves have a difficult time being consistent. They often report that they were consistent initially but the process hasn’t been repeated in weeks. Be consistent! Family meetings are just one way to address the potentially poor communication within the family.
  5. Planning is key
    It is a hectic world we live in. Everything seems to take precedence over our relationships. Health issues, kids’ activities after school, work issues all take precedence. The next thing you know when you look back is we haven’t had time for just the two of us in months! All-in-all life just gets in the way so it’s easy to lose your connection to your significant other. The way to deal with this is to plan your quality time. Trade who gets to pick what you will do. Gentlemen don’t let her do all the planning; it takes the joy away for her. When you do get out that is not the time to talk about the kids or your issues with one another. Some couples even plan for intimacy which I have seen work also. The goal here is to reconnect but if it’s going to happen planning is the key. Put it on the calendar and have fun. It’s good to have fun. Have fun together! I’ll bet your level intimacy will improve also.

Zoom! Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative. Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jamesdelgenio.com
http://family-institute.org
http://psychologytoday.com
http://takenotelessons.com   Effective on line, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.


Alcohol Dependence, Anxiety Panic Grief Depression, Bipolar Mood Disorders, Coping skills, Couples, Divorce, Glossary of terms, Marital Family Issues, Premarital Issues, Relationships, Substance Dependence

The Family Institute at Northwestern University

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James DelGenio LCPC is a senior staff therapist who offers remote teletherapy and accepts BCBS PPO Insurance.  Teletherapy is HIPPA approved via Zoom.com 

His services include: Individual and family counseling, marital and premarital counseling, and treatment of mood disorders and substance use and dependence.

Offering Teletherapy anywhere in IL via zoom.  HIPPA approved and accepted by BCBS PPO Insurance.

TFI is a unique not-for-profit organization that is leading the way in all facets to strengthen and heal families from all walks of life through clinical service, education and research. No other institution brings together such a concentration of knowledge, expertise and academic credentials to help improve the lives of people in the Chicago area and around the globe.

As a practicing Psychotherapist for over 40 years, I employ a variety of clinical approaches including Cognitive Behavioral Therapy (CBT) in the treatment of couples, families and individuals.

Individual Practice: Assessment and treatment of anxiety, stress, panic, trauma, anger, grief, depression, mood disorders, mental illness and alcohol/substance abuse.

Marriage and Family Practice: Lack of intimacy, infidelity, poor communication, conflict over finances, lack of trust, parenting and behavior issues, premarital and divorce issues.

Specialization: Treatment of couples, depression and its impact on relationships and the family.

Zoom! Now I can work via Zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative for more information. Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com   Highly effective on line one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

music and voice lessons, Standardized test preparation

Highly effective ACT, SAT, & GRE preparation via Zoom!

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Is your child preparing for a standardized test? Let Take Note’s test preparation experts help. At Take Note, we believe in giving students a set of tools that will help them find success not only on their upcoming test, but will also help them excel in their future academic pursuits. Our unique mix of conventional and unconventional teaching methods are proven to help raise your child’s scores and, even more importantly, to increase his or her overall confidence. Though Take Note Lessons is based in New York, our instructors can work with anyone, anywhere in the country via Skype. Get highly effective online instruction while never having to leave your home.

James Delgenio, academic director of take note lessons, has been teaching standardized tests and helping students in math and writing full-time for over 10 years. His students have seen huge improvements in their test scores and grades. He is an expert in standardized test preparation. On the SAT, he has helped students improve their overall scores more than 400 points. On the ACT, one of his recent students raised her score from a 27 to a 33. Most of his students are accepted to their top choice school. Some of these schools include Harvard, Yale, Columbia, Cornell, Dartmouth, University of Pennsylvania, University of Chicago, Vanderbilt, University of Michigan, NYU, USC, and many others.

James holds a Master of Fine Arts in writing from the American Film Institute. He received his Bachelor of Arts from the University of Michigan in Ann Arbor. He had perfect scores on the ACT math and science sections and the SAT II math II subject test. James brings this wealth of knowledge and experience to Take Note as a teacher and director of our academic programs.

Contact http://takenotelessons.com for quality academic tutoring, test preparation and guidance on writing the college application essay.

Marital Family Issues

Don’t let a lack of civility and respect destroy your relationship!

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University      

No relationship will last if there is a lack of civility and respect. 

All couples need rules of engagement for conflict. When a couple loses civility and respect their relationship is in serious trouble. They feel distant, disconnected and as a result, bickering occurs.

Case Scenario – Tony and Julie
Tony and Julie have been married almost two years. Tony is thirty-two; Julie is thirty. They have one child who is one and a half years old. Tony’s parents divorced when he was 6 and Julie’s parents are still married but have never had a good relationship. Tony and Julie dated for almost three years before marriage, but they never learned how to resolve conflict. Both are determined to win the argument. When this happens, no one wins. The baby has not helped the situation because he has colic. The resentment is building because of unresolved issues which are now affecting their level of intimacy. Arguments turn into history lessons in which the conflict is never resolved and never focuses on the issues at hand. They recognize their marriage is in trouble. Tony and Julie want to find their joy again and address issues before they end up divorced.

After getting the necessary preliminary information, I acknowledge the stress that they are experiencing and try to reestablish civility and respect when in conflict. No couple can withstand loss of respect. I point out that it will take some time to change their communication habits. When one or the other fails at respect, I encourage them to immediately say “I’m sorry; I should not have said that” as a step in the right direction of not having lost respect in the first place. Time out is the signal that this conflict is going nowhere but the rule of time out is that you have to get back to the issue within twenty-four hours. Hopefully, with a day to reflect on the discussion, it will be more productive. If that fails then they are instructed to save the discussion for our next appointment. I also look at how long it has been since the baby was born that they have had a night out together. In most instances, they have had no time out together because they have no babysitter that they trust. I encourage taking the time to find a babysitter; bring in the sitter and let them get to know one another under the parents’ supervision. Their goals also include a date night at least twice a month if possible. It may take three or four sessions to begin to see some changes but more often than not they will start to see better communication and less conflict.

Poor Communication
Many marital problems are rooted in poor communication. As seen above, effective communication between partners can be learned and developed.

When communication is poor and feelings go unsaid or unaddressed, the couple feels disconnected. Over time, this leaves them feeling distant, even resentful. Resentment creates a further distance which in turn creates a lack of civility and respect and a lack of intimacy.

Good communication is often oversimplified as just being romantic. It is not. Good communication involves the sharing of ideas and feelings. Good communication is made possible by means of trust, confidence, and mutual understanding.

Try to convey to your spouse the importance of expressing their feelings, even though they may think it’s silly. Explain how important it is to you and how it makes you feel. Explain to them how never knowing how they feel about this or that, confuses you and makes it more difficult for you to feel connected.

I encourage both men and women to use “I feel” statements. This allows the couple to say things that have in the past created conflict when sentences are started with: “You always” or “You never”. Never say never or always. This is known as skidding into other issues or a history lesson into the past and therefore a minor conflict is never resolved and may even be magnified.

Zoom!
Now I can work via secure zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative for more information.  Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

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Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.

Couples, Premarital Issues, Relationships

How to address common relationship issues?

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By: James E. DelGenio MS, LCPC
Senior Staff Therapist,
The Family Institute at Northwestern University

Common relationship issues
For a vast majority of the individuals, families and couples there are common conflict themes. These include mood disorders, lack of civility and respect, resentment, poor communication, lack of intimacy, infidelity, alcohol and substance abuse, financial and parenting issues to name a few. One thing is certain, there is no guarantee of “happily ever after” especially in this day and age when so many things can get in the way of your relationship. Relationships take work and attention to ensure a good marriage. Life has a way of interfering in our relationships. Couples can get lost in the day-to-day grind of life. We have to make time for one another to keep our connection strong; planning is key. Many of the common issues listed here are addressed in the following case studies.

Case Scenario- Depression – Dan and Wendy
Dan and Wendy have been married for 14 years. They dated for three years prior to marriage. They have three children ages 6, 9 and 12. Dan’s mother has a history of mood disorder though it was never formally diagnosed. She lives in the past having never gotten over the infidelity of her husband, their subsequent divorce and his marriage to the other women. His Dad is a recovering alcoholic. Dad has been sober for ten years but he is difficult to get along with as his second marriage is also an unhappy one.
Dan is currently unemployed because he can’t get along with co-workers. He has no friends; all have abandoned him because of his temper. Dan tends to hold grudges and he writes people off if he perceives that they have wronged him. He has few interests and spends his time surfing the internet or playing video games. Dan lacks motivation and drive and his concentration is poor. He stays up until four or five in the morning. Wendy is scared because he is unmotivated to look for work and they are now in financial trouble. They bicker over his alcohol use and his inability to share his feelings.

My assessment indicates that Dan has many of the classic signs for clinical depression, his symptoms include lack of motivation and no friends. He isolates himself and his sleep wake cycle is reversed. He is up most of the night and sleeps most of the day which is a way of avoiding people and responsibility. He has been drinking more than usual. Wendy made the appointment and Dan was reluctant to join her but he did. I asked that Wendy come in even if Dan says that he won’t come. Invariably the husband will ask about the appointment. I suggest when asked, “If you want to know you’ll come with me next time.”

I gave Dan the list of depressive symptoms and asked him to put a check next to those that applied to him. He checked 8 of the symptoms listed. I encouraged him to have a psychiatric evaluation for medication to address his depression and use of alcohol to self-medicate. The doctor put him on the appropriate medication. I worked closely with the doctor to ensure a unified treatment approach. Goals were set for him and for them as a couple.

First part of his education was learning about his depression. I pointed out that it was not his fault. More than likely he inherited this from either one of his parents. To start him on his path to recovery, I encouraged him to have more structure in his day. That meant getting up at 8pm and going to bed no later than eleven thirty. He was also to take a walk at least 4 times per week for forty minutes since they could not afford a gym membership at this time. Part of creating his plan was to pick the days that he was to walk each week. He was also encouraged to reconnect with his friends and to avoid the use of alcohol. After a few weeks on the medication, he began to feel better. In the meantime, I continued to educate both he and Wendy about his depression. Once Dan was feeling better, we began to address the marital issues created by his depression. He was encouraged to make “I feel statements”. These types of statements help address emotional withdrawal by allowing the partner to understand what their loved one is thinking and feeling, ultimately helping them feel more connected. Saying “I feel,” is also a signal to alert Wendy that Dan is trying to communicate effectively. Hopefully this signal will help both Dan and Wendy to be less defensive in their communication.

I also encouraged a date night at least twice per month and advised that these dates do not have to cost a lot of money. Just getting out together, walking or going for coffee or ice cream was fine. The idea is to spend some quality one-on-one time.

Mood disorders are a chemical imbalance in the brain but also include environmental issues and personality traits. About one in seven individuals will at some point in a marriage experience it. Situational depression is created by marital conflict, job loss, grief and ongoing health issues. These will surely affect your relationship.

Many disconnects in a relationship begin when with mood disorder, alcohol or substance abuse and situational depression. If these issues are not addressed, it is unlikely that progress will be made in couples counseling.
Many studies show that there is usually a history of mood disorder or alcoholism on one or both sides of the family. It is imperative that the therapist be direct with their clients about the assessment and encourage a psychiatric evaluation to determine if medication is appropriate. Once this is addressed, it is very possible to resolve many of the couple issues.

Zoom!
Now I can work via zoom with anyone, anywhere in the country and it may still be covered by BCBS Insurance. Check with your BCBS representative for more information.  Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com    Effective online, one on one, SAT, ACT, GRE, standardized test preparation, via face time or skype and much more.

Disclaimer: This material is meant to be used in conjunction with psychiatric treatment, medication, if necessary, and supportive therapy. Always share this material and your questions about this material with your doctor and therapist.