Category Archives: Marital Family Issues

Symptoms of Depression and other mood disorders

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

Symptoms of clinical depression & symptoms of situational depression.

If left untreated, symptoms of depression, anxiety and panic may worsen and severely disrupt one’s life. These symptoms can cause untold suffering and possibly lead to hospitalization, strained relationships, divorce or even suicide. Recognizing the symptoms of a mood disorder is often the biggest hurdle to the diagnosis and treatment. I will list commonly recognized symptoms; see how many apply to you. Typically, if you recognize more than two or three from the checklist below you should consider getting an evaluation by a licensed professional.

Symptoms of depression, panic and anxiety checklist: Note the symptoms that apply to you.
__ Lack of pleasure, loss of interest and energy
__ Lack of goal-directed behavior, lack of motivation, lethargy
__ Lack of insight into one’s own behavior
__ Inability to structure time, poor concentration
__ Anger, hostility, irritability
__ Strained relationships, marital conflict, loss of friends
__ Withdrawal, isolation, would rather be alone
__ Difficulty in getting along with people
__ Sleeping too much or too little
__ Anxiety, worry, sadness, low mood
__ False beliefs, negative thinking, rumination
__ Feeling guilty, stressed or hopeless
__ Poor self-care including hygiene and diet
__ Aches, pains, dizziness, headaches, or stomach aches
__ Unintentional weight loss or gain
__ Crisis prone, police involvement
__ Low sex drive
__ Thoughts of suicide, homicide

Zoom!
Now I can work via zoom with anyone, anywhere in the country and it may currently be covered by BCBS Insurance. Check with your BCBS carrier for details.    Call Jim at 847-733-4300 Ext 638.

http://manageyourmood.net
http://family-institute.org
http://takenotelessons.com    Highly Effective online, one on one, SAT, ACT, GRE, 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.

How to Improve Marital and Family Communication?

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

Improve marital and family communication.

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. 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 their issues and get on the same page for the meeting with the children to ensure you are parenting as a team. It’s also a great opportunity to check in with each other as a couple and plan a date night. I recommend two date nights per month to keep your connection strong. That means you each have to plan one per month.

The general topics to discuss are Compliments, News, Issues and Feedback. Here are some examples:

1. 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.”

2. 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

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.

This requires a parent pre-meeting to discuss issues and get on the same page with the message to the children. This is also an opportunity to check-in on how they are doing as a couple. This is an opportunity to plan a date night (at least twice per month) with the responsibility of planning rotating. Keep your connection strong! Plan ahead!

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!

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, 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.

Manage your Mood Disorder!

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

Mood disorders represent people experiencing mild to severe depressive disorders, bipolar disorders, panic, anxiety disorders, phobias, personality disorders and other disorders including alcohol or drug dependence.

Major research over the years has not completely explained one singular definitive cause of mood disorders. Generally, most consider a combination of bio-psycho-social factors including: family genetics, personality traits and stressful life events such as marital stress, financial issues, severe injury, chronic health issues or death of a relative or friend.

Strained relationships double the risk of triggering a mood disorder.

In the treatment of mood disorders, family conflict is present often enough that it be given symptom status.

It is estimated that up to 70% of the people who are currently diagnosed with a mood disorder also have alcohol and/or substance abuse issues. 

Casual use of alcohol or substances complicates treatment of depression/mood disorders and will likely result in a relapse to symptoms, alcohol and substance abuse and possibly hospitalization or suicide.

People with mood disorders who are long term casual alcohol users are very likely to develop alcohol dependence or addiction over the course of their lifetime. 

These two separate and distinct mood disorders (depression and addiction) complicate and exacerbate each other. For example, depressive symptoms can be a trigger for alcohol cravings.

Most patients benefit from combined psychotherapy, medication and an array of support services when dual diagnosis is present. Patients with chronic psychiatric illness are at risk for substance abuse and dependence.  Plans for comprehensive treatment of mental illness must include measures to prevent, detect, and treat substance abuse. Poor medication compliance and poor response to traditional substance abuse treatment have been associated with dual diagnosis. Substance abuse decreases compliance with treatment, compromises the efficacy of medication and thereby increases the risk of symptom exacerbation and relapse.

The National Center for Health Statistics (2006) show about half of marriages will result in divorce.  These statistics also show that stress and arguments over money are major contributors.

Social disability is a primary source of stress; it prevents patient’s developing the supportive relationships that could provide a buffering effect; thus, it is a potent predictor of symptom exacerbation.

Social support plays a critical role and is a necessary component if treatments are to improve the patient’s overall level of functioning, quality of life and compliance with treatment.

Mood disorders rank among the top 10 causes of worldwide disabilities. About 1 in 7 people in the USA have a mental disorder. Depression affects nearly seven percent of the population of American adults. Major depressive disorder is one of the most common mental disorders in the United States. Women are 50% more likely as men to experience depression over their lifetime. Major depressive disorders account for about 20 to 35% of all death by suicide. A major risk factor for suicide is a combination of depression and alcohol or substance abuse. Clients with a mood disorder and/or dual diagnosis (mood disorder and alcohol dependence) can be taught to manage their disorders, much as people learn to manage other physical handicaps such as diabetes or epilepsy.

As one can easily see from the above literature, mood disorders including alcoholism and addiction can have a tremendous impact on our life and relationships.  Given the research it is quite possible and even likely that either you or your spouse will experience a mood disorder at some time in your life time.  Even without these disorders, sometimes life just gets in the way of our relationships.  We can easily lose our connection to our spouse due to stressors such as finances, job stress, children’s activities, parenting issues, in-laws, health issues, and death of a relative or friend. These issues, in turn, can lead to poor communication, conflict, loss of civility and respect, apathy and infidelity which creates resentment and a feeling of distance from our spouse.  Now add the complications of alcohol abuse and addiction and we are guaranteed that issues will negatively impact our relationships, creating conflict and increase the possibility of divorce.

The goal here is to give people the knowledge and skills to overcome these issues when they occur.  Chances are they will occur at some point in our relationship. There is no Cinderella story; no happily ever after.  If we are going to have a healthy, happy relationship for life then we need to recognize that relationships take work and attention.  We can’t allow life to get in the way. My goal is to make couples more aware and hopefully prevent conflict and divorce. I want to give people the tools to deal with life stressors, mood disorders, addiction and the ability to withstand whatever life hands you.

Therefore, in upcoming Blogs I will address coping with mood and relationship disorders, alcohol/drug dependence and the other common issues that tend to get in the way of our relationships and marriage.

As a therapist, I also recognize that in some relationships, couples are past the point of working on their issues themselves without a skilled therapist to intervene. I recommend a Cognitive Behavioral Approach to treatment regardless of who the therapist is.

If you have questions, please don’t hesitate to contact me at 847-733-4300 Ext 638. I can address your relationship, mental health issues and provide support for your alcohol and substance abuse issues, if any.

BCBS accepted.

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

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.

How can family help one with depression?

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

What to do when your spouse has depression?

The role of the family in treatment is simply to monitor and report. The family should observe the patient’s behavior and report anything that may be important to the stable functioning and health of the patient. The patient should not be interfered with directly unless, of course, s/he is a danger to themselves or others. The family’s role in treatment is a collaborative effort in communication. The family should think of themselves as team members. We are all on the same team! Keeping secrets from the doctor or therapist interferes with treatment and may ultimately have serious consequences. Families should call their doctor, therapist immediately or 911 if the patient has any of the following behaviors or symptoms, especially if they are new, worse, or worry you.

Report when the patient is:

1. Not taking their medication as prescribed.

  1. Abusing alcohol, substances or medications not prescribed by a doctor.
  2. Severely depressed, irritable, threatens violence or has thoughts of suicide or dying.
  3. Exhibits behavior which may result in injury or harm to the individual, family or community.
  4. Experiencing of any relapse warning signs, especially no sleep.
  5. Experiencing panic attacks, uncontrolled anxiety or restlessness.
  6. Acting on dangerous impulses.
  7. Exhibits unusual behavior that is out-of-character for this individual.

Family should:

  1. Avoid placing blame or guilt.
  2. Avoid enabling. You are not responsible for the patient’s wellness. S/he is!
  3. Make regular opportunities to get away from each other. Have outside interests, hobbies and social activities.
  4. Get regular exercise (doctor permitting). Join a health club or walk at least 40 minutes on regularly scheduled days each week. In the winter if needed, use a treadmill or stationary bicycle.
  5. Learn all you can about mood disorders but do not try to be a therapist.

In most cases I have treated over the years, I have seen the client get annoyed with friends and family when they say, “You seem crabby, did you take your medication today”? The typical response is “just because I’m angry or upset doesn’t mean I’ve skipped my medications.” The way I see it, if you have a history of noncompliance, you don’t have the right to be angry when asked! Take the medication as prescribed so your family doesn’t worry about compliance or need to be intrusive in your life. They should be relatively assured that you are compliant with medication and treatment. Regardless, it is the responsibility of the family to ask because the consequences of not taking it as prescribed can lead to injury and possibly suicide.

  • Monitor and report on medication compliance.
  • Monitor and report on the use of alcohol and drugs.
  • Avoid over involvement unless the person poses a danger to himself or others.
  • Avoid trying to help motivate compliance with treatment.

Not in the Chicago Area! Now I can work via face time with anyone, anywhere in the country and it will still be covered by BCBS Insurance.

For those in the metropolitan Chicago area, I have offices in Millennium Park on Michigan Avenue, and near 22nd St and Wolf Road in Westchester. Call James E. DelGenio MS, LCPC, Senior Staff Therapist at The Family Institute at Northwestern University, 847-733-4300 Ext 638.

http://jimdelgenio.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.

The Use of Home Work in Couples Counseling

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

Homework for couples

As a cognitive behavioral therapist, I assign homework between sessions to the couples I counsel. Homework will not solve conflict, communication or resentment issues. Those issues need to be addressed in session. Home work will, however, help and typically addresses the following:

Civility and Respect
This one is a must. Civility and respect is the foundation of your relationship. When a couple loses civility and respect, their relationship is in serious trouble. They feel distant and as a result intimacy suffers. There is never a good reason to scream, swear, name call, or act out. If you have gotten into these habits you may need professional help to get it under control. It will take some time; it is a process – but if you work at it and strive for consistency you can regain civility and respect. As in any process, owning your errors is important. Don’t hesitate to acknowledge it if you say something that is not civil or respectful. Say, “I am sorry I should not have said that.” and mean it. All couples need rules of engagement for conflict. You can never allow yourself to lose control. It is the foundation of your relationship. You can’t build a house without a good foundation. Couples can’t permit yelling, screaming, swearing and name calling to undermine their relationship.

Call Time Out
When conflict becomes too intense and one or both of you are in danger of losing civility and respect, call a time out. The words time out will become a signal for both of you to settle down. Never follow your spouse when they are trying to retreat from the conflict. Standing outside the bathroom door and continuing the discussion is out of bounds. If you decide to go for a walk or to a movie, say so your spouse knows when you are coming back. It is cruel to just walk out without regard for the others feelings. The rule of time out is you must get back to the discussion within 24 hours. Far too often couples will just let the issue go unresolved, swept under the rug. This creates resentment and distance. Hopefully, after a day to reflect, you will be able to discuss the issue calmly. If not, hold the issue for the next therapy session.

Reduce Alcohol/Drug Use
Many fights occur when too much alcohol has been consumed. Alcohol reduces inhibitions making it easier to allow yourself to lose control. If you are drinking daily, you may have a problem. Denial is a huge part of alcoholism. I typically say, Can you stop drinking for a week or two month (for binge alcoholics). If you make excuses and refuse the challenge, you have an alcohol problem. There is no good reason one should be drinking on a daily basis

Date Night
A night out alone is a common suggestion among both therapists and self-help books. As I have said, couples lose their way because of all that life throws at them. Don’t forget to nurture the relationship by spending time together alone. This does not have to be a big money issue. Many people with financial stress will simply go out for coffee or ice cream. I find it a statement of the current economic times and somewhat sad that couples will go out after therapy because they can’t afford a babysitter twice in one week.

Meet and Greet
Meet and Greet is another way to address the lack of affection that many spouses feel. Touch is very important. This is not sexual touching. This is simply affection. Offer a hug and kiss when you leave and when you return. The responsibility is on both of you to find one another and do this when one of you walks in the door or leaves for work. Reaching out and holding hands when walking or just watching TV is also a way to address lack of affection.

Parent as a Team
Children learn quickly who to go to get what they want. Sometimes tension between parents is picked up on by the children and they will take sides. As I say, “the walls have ears.” Even when you don’t think they hear your arguments more than likely they do. I have had children tell me, “I listen to their arguments through the heating vent in my room.” A daughter will often side with mom. The result is when dad tells the daughter to get ready for bed, she ignores him. He gets upset and mom steps in often creating even more conflict between mom and dad. Mom needs to back dad and of course vice versa. “Do what your father says”. When mom is angry at dad anyway due to unresolved marital issues, mom unconsciously gets satisfaction from the child’s disrespect toward dad. This will continue for a while until marital issues are addressed and parents recognize how they undermine the others authority and the child sees that they are consistently parenting as a team . Parents need to support one another in family meetings to address disrespect to the other parent. This is a common issue addressed under family meetings below.

“I feel” Statements
Inability to express feeling is a major issue in many relationships. One of the hardest things for many men to do is to get in touch with feelings. I find that many men have difficulty expressing their feelings at all let alone civilly and respectfully. Yet, lack of expression of feelings is a major cause of marital discontent. Opening up is critical for a good relationship. In addition, expressing feelings out loud appropriately helps dissipate negative feelings. Women, especially it seems, need to know what their man is feeling in order to feel connected and consequently warm and fuzzy in the bedroom. Men are more R rated; they don’t like to talk. Women say about 6,000 words per day; men only 2,000. I believe that good communication is romance and that communication is needed for marital success. For most women and many men, it is that expression which makes a couple feel connected. I encourage “I feel” statements….”because.” It may at times still be a confrontational statement but much less so than when you begin statements with “you always“. First of all, never say never and always. When you have something difficult to say be nose to nose with your arms around the person. Say, “I feel” and it will more likely be perceived less defensively then things are said from across the room or behind a closed door.

No History Lessons and no skidding off current issues
Stay on the present issue. Many couples allow their conflicts to skid into the past. When this happens there is rarely a resolution to the current issue. This can create hostility and resentment. When you find yourself fighting about where you squeeze the toothpaste tube (he squeezes in the middle you squeeze on the end) obviously you are not addressing the real 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://psychologytoday.com
http://takenotelessons.com  Effective on line, one on one, SAT, ACT, GRE, 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.

How to improve communication and cooperation in the family?

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

Conduct family meetings to improve your relationship!
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 these issues and get on the same page for the meeting with the kids to ensure you are parenting as a team.  This is also an opportunity for mom and dad to discuss any issues they might be having.  It is also a great time to plan a date night.

The general topics to discuss are News, Compliments, 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 and Gratitude: Express gratitude all around the family. Search for things your child is doing well, no matter how small and acknowledge it with a compliment. 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. You did better this week but there is still room for improvement. Let’s keep this goal another week or two.”

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. Hopefully, next week you will have compliments from improvement in this weeks issues.

Tip: don’t tackle too many issues at once; no more then one or two.

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.

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://takenotelessons.com   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 and your questions about this material with your doctor and therapist.

Premarital Counseling is a really good idea!

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

Premarital counseling can help ensure that you and your partner have a strong, healthy relationship. This will give you a better chance for a stable and satisfying marriage. Premarital counseling can also help you identify weaknesses that may become larger problems during marriage. Good marriages don’t happen by accident. Many issues can be resolved prior to marriage with the help of a therapist. Common issues addressed may include: mental health issues, work, finances, drug and alcohol use, lifestyle, spending habits, credit card balances, student loans, savings, retirement planning, roles and responsibilities, children, parenting, in-laws, and leisure and fun. Marriage requires an understanding of yourself, your future spouse, and the tools and skills you need to make it work.

Finances: Current debt, student loans, savings goals, retirement, pension, pool money or keep separate?
Family: Family relationships and issues, do you get along with in-laws, how often will you see them?
Religion: What are your religious views, what religion will you use to raise the children, will you attend services regularly?
Children: Do you want children, how many, thoughts on education, do you have similar values, parenting styles? What if you can’t have children?
Leisure and fun: What do you like to do in your spare time, common interests, vacation styles?
Spending: What is discretionary spending, how much is ok without consulting the other. Do you gamble?
Work and school: Will you be going to school? Will you both work; would you be willing to relocate for your spouses job? Are your work schedules compatible?
Roles: Parenting, paying bills, chores, traditional roles: women as homemaker, man as bread winner?
Lifestyles: What lifestyle are you aiming for? Where do you want to live?
Alcohol & drug use: Are there issues now that need to be addressed? Are you willing to seek help?
Holidays: What is your respective family traditions around the holidays? Will there be conflicting family expectations? How will you handle it? Will you really want the children to open gifts and then rush to get in the car to go visit family? It might help to think of you and your spouse as your own family unit, most especially, once you have children. Definitely worth the conversation especially if it has not come up already.

Zoom! Now I can work via face time 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://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.

How to parent effectively after a divorce?

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.

How to improve communication in the family?

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

Family meetings for better communication

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 imparting values and 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. Both parents feel the need but also the desire to work to maintain a certain lifestyle. However, they often have to work late and have conflicting schedules. This creates a disaster for the their relationship. 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.

Family Meetings: One way to reclaim some of that lost family communication and emotional connection are family meetings. Some families prefer to call them team meetings. Regardless, 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:

1. Issues and connection to one another, such as, affection, gratitude, compliments, and non sexual touch. “Meet and Greet” as it is often referred to, is a hug and kiss when one enters or leaves the home. It is on both to find each other not just the one coming home. This will frequently turn into a family hug, even the dog will want in. This goes a long way in helping maintain emotional connections. In addition, discuss issues with disproportionate work time, me time, family time, and couple time. These will never be proportionate but each should be part of your discussion each week/month.

2. Discuss finances such as bills, budgets, disposable income, spending limits and use of credit cards Assets, savings and retirement should also be discussed periodically.

3. Each plan a date night. Each person plans one date night per month with approval of the other in the pre-family meeting. As far as couples are concerned, I always suggest selecting date nights and putting them on the calendar. You both are expected to plan one date night per month. You select the activity, get it approved by the other and you get the tickets and babysitter. By the way, you each get one veto. In other words, my wife is never going to Chicago Bear game. She hates to be cold; she is just not interested. That’s ok because I’m never going to the opera. Planning is key and date night can’t always fall on the wife to take care of all the details. That takes all the enjoyment away for her.

4. Plan a vacation.

5. Get on the same page for the meeting with the children to ensure parenting as a team.

When the children are included you, of course, want to be a unified front. So, get on the same page with your relationship, parenting, and rules and consequences for the children. How will you handle the morning routine issues in the future. What will consequences be for being uncooperative or breaking the rules.

The general family topics are: News, Compliments, 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 much better getting ready for school on time this week. Let’s keep it up.”

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. For example, discuss “the morning routine with Joey outside of the moment because in the moment never works. In the family meeting we say, ‘we all want a more cooperative, peaceful morning to start the day. Let’s try and make that happen.’ This creates a built in reward system even if their is only slight improvement. So you continue that goal until you feel it is consistent enough to move on to something else.

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. Try to have some one on one time periodically with each child. Go to McDonalds, and shut your mouth, and open your ears. You will be surprised what a difference it makes in so many ways. It creates a good emotional connection.

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 poor communication and help nurture relationships within 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

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.

What are the most common relationship issues and conflicts?

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

How to deal with conflict in your relationship?

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. 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. Many of the common issues listed here are addressed in the following case studies.

Case Scenario – Depression
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 their life 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.

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://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 with your doctor and therapist.