Sunday, December 27, 2009

A Vacation With Old Friends

A Vacation With old Friends

Today is my last post until my wife and I return from a vacation with two of our dear friends and their wonderful wives. The guys are two old friends that I first met in Cub Scouts.

Life-long friends are wonderful. If you have them, or redicover them, they can be a very special link to your past and warm pleasure in your present. They can be the most comfortable company. Some of what you may have forgotten, they will remember and visa versa: This can be a hoot! Reunions with old friends can be the best times of great enjoyment.

We will board a cruise and voyage through the Panama Canal. God willing, I will be posting here again on January 11, 2010.

God Bless,

Dr. Tom

P.S. Look for good behavior in your loved ones and others and let them know how much you appreciate what they are doing!

Thursday, December 24, 2009

Mom's Christmas Trees

Mom’s Christmas Trees

When I was a small boy and when it was time, like always before, I looked out my little second story window. Out through the cold jack-frost figures, through the darkness and to the blowing swirling clouds of snow across the busy street–to that great and wonderful circle of radiant white light. They were there again!
The christmas trees had returned to red’s gas station.
And my own christmas tree was in the front room, in front of the big window. It was almost up to the ceiling and it was so very green and it smelled so sweet and special, just like I remembered.
It was a mountain of colored lights, brightly reflecting balls and other pretty things; and it was covered with wisps of shimmering-shining silver tinsel. The tinsel hung like hundreds of tiny ice- cicles on my giant tree.
Mother had the soul of an artist and her Christmas trees were simply magnificent. I wish I could remember the very first Christmas tree of Mom’s that I ever saw; but I cannot. I can only feel a wistful warm-faint-glow from a time when time was a mystery and when life was magical.
When Mom passed away in 1985 something left Christmas and Christmas trees everywhere. But for each of the past ten Christmas’s Mom has returned with a very special gift, a remembrance of love and devotion past, but not gone.

When I go to church on Christmas Eve I can never get through the singing of Silent Night without my eyes watering, my nose running, and my words choking into silence. It is then that the images of the twin giant christmas trees on the alter blur, glisten, and radiate with cherished images from my childhood.

For that moment time does not exist, the magic returns, and once again Mom dresses and illuminates not one, but two giant Christmas trees–

Just for me.


God Bless and Merry Christmas!

Dr. Tom (From Christmas, 1992)

Tuesday, December 22, 2009

Red's Gas Station


I will forever wonder how old I was.

We lived in an upstairs apartment where there was a little cubby-hole between a bannister, with a long and scary drop into the dark stair-well below, and a little window that looked out over our roof and across the street to red's gas station.

I didn't know about time. I didn't know about minutes, hours, or clocks; and I didn't know the months of the year or about calendars. I only knew that if I waited a long time and asked mom, "when will it be here ?" often enough, she would eventually say in a happy tone, "it won't be long now!" Then I would begin to watch out my little window.

I watched through the rain and the sleet, and eventually I watched through the glistening patterns that jack frost painted on my little window. I watched out through the snow that sparkled under the light-post and across the street to red's gas station which was bathed in a floodlit swirl of white. I watched many times each day, for “countless days”, but it did not come.

Then one tired and doubt-filled night it happened, just like before! I could hardly believe my eyes.

Out through the little frosted window and out through the night and the glistening shower of falling snow-----they were there! Bathed in a blinding glow of refracted light, they stood waiting quietly at red's gas station.

In the pure white radiance, they were a special and beautiful green, and they were as tall as they could be, and there were "millions" of them--everywhere. The Christmas trees were back at Red’s Gas Station.

It took forever-----but Christmas had come again!

P.S. Children everywhere still innocently wait and hope for the joys of similar and different miracles in their lives.

If humankind would only bless these children with the warmth of it's love and devotion, this miracle of miracles would reflect and echo for all time.

Merry Christmas and Happy New Year! (2009)

God Bless,

Dr. Tom

I will forever wonder how old I was.

We lived in an upstairs apartment where there was a little cubby-hole between a bannister, with a long and scary drop into the dark stair-well below, and a little window that looked out over our roof and across the street to red's gas station.

I didn't know about time. I didn't know about minutes, hours, or clocks; and I didn't know the months of the year or about calendars. I only knew that if I waited a long time and asked mom, "when will it be here ?" often enough, she would eventually say in a happy tone, "it won't be long now!" Then I would begin to watch out my little window.

I watched through the rain and the sleet, and eventually I watched through the glistening patterns that jack frost painted on my little window. I watched out through the snow that sparkled under the light-post and across the street to red's gas station which was bathed in a floodlit swirl of white. I watched many times each day, for “countless days”, but it did not come.

Then one tired and doubt-filled night it happened, just like before! I could hardly believe my eyes.

Out through the little frosted window and out through the night and the glistening shower of falling snow-----they were there! Bathed in a blinding glow of refracted light, they stood waiting quietly at red's gas station.

In the pure white radiance, they were a special and beautiful green, and they were as tall as they could be, and there were "millions" of them--everywhere. The Christmas trees were back at Red’s Gas Station.

It took forever-----but Christmas had come again!

P.S. Children everywhere still innocently wait and hope for the joys of similar and different miracles in their lives.

If humankind would only bless these children with the warmth of it's love and devotion, this miracle of miracles would reflect and echo for all time.

Merry Christmas and Happy New Year! (2009)

God Bless,

Dr. Tom

Saturday, December 19, 2009

Wake-Up America---Rules Rule!

Wake-up America—Rules Rule!

Whether you are a Christian, a member of some other God-Fearing (where did the fear go) belief system, an agnostic or an atheist, rules are rules. In the world, when you break its’ rules for survival, you will suffer the consequences.

And it matters not, whether you see the world as a happy confluence of improbable events, or as the act of a Supreme Being. If you jump off the Empire State building, without a parachute, you will go splat.

You may rage at the rules of the universe, or you may pray to God on your way down, but you will go splat.

What happens to you after you go splat is a debatable issue, and I will not debate it here. You may believe what you will on the matter of an after-life with no argument from me.

Whether a confluence of improbable events or an act of God, you and I are here together and so are around 308 million of our fellow Americans. The rules upon which this great Nation was created were thought by our founding father to be God’ rules. You may view them as “rules of nature”, if you so choose.

Being a little ol’ fashioned, I prefer the former assumption to the later.

Anyway, make your own choice. Because with respect to what governs the quality of our collective behavior, good or bad, the rules and consequences that we apply to ourselves through our elected local, state, and federal governments will determine our success or failure in the world. These rules and consequences that we apply to ourselves will have a very large impact upon the future viability of our culture.

To live well requires that you learn God’s (or Nature”s) physical rules and the rules of human behavior. The physical sciences and the behavioral sciences have discovered much that we need to know. Now, what we must do is live by those rules and also help others learn to live by them.

I cannot discuss all of the rules in this short posting, but the following few Principles of behavior are a good start.

The Law of Effect: Consequences control behavior. Reward bad behavior and it will increase in frequency. Reward good behavior and it will increase in frequency. Punish good or bad behavior (or withhold rewards from them) and these behaviors will decrease in frequency.

The Law of Contiguity: Those stimuli that are paired or associated together tend to occur together more often in the future. In other words the infidelity, sex, drugs, violence, irreverence, disrespect and violence shown in our entertainment media will occur in certain situations or contexts and all of this will be associated with and the feelings we have when watching them (happy, excited or titillated). What is called Propaganda affects the ways humans think, feel, and behave in the same ways. Also, through repeated presentations and the behavioral principle Habituation, we naturally adapt to or ”get used to” that which formerly offended, upset or disturbed us.

Through rules and Principles of Social Learning a great deal more of what we see and experience affects our thoughts, feelings, and behavior. In short we tend to remember and imitate the behavioral patterns of those with power, those with fame, and those who we find attractive. They become our models and we are inclined to imitate their actions. Contrary to modern thought,” the whole” of the behavior patterns of our media-popularized celebrities (entertainment, sports, political) do matter. We are inclined to imitate much more of what they do than their ability to sing or dance, make a basket, make a touchdown, swing a golf club, or look good and talk persuasively. On this issue, you can fill-in your own celebrity names and think about their effects upon the behavior of our youth and impressionable adults. I will say no more on this, you know exactly what I am talking about.

Beyond God’s-Given rules to live by, or Nature’s rules if you prefer, is another matter.
This matter is one of motivation. What will best motivate a great population to follow certain rules that bring increasing patterns of good behavior?

If you think that the best strategy is to simply teach humans that they should be good and treat the earth and other living things with kindness and respect, you had better think some more.

Please take the time to view the following video on the role of faith in America’s past successes.

I want to thank Linda Mawhinney for forwarding this video to me.

Dr. Tom 12/19/09

Friday, December 18, 2009

From The Golden Rule

From The Golden Rule

A wonderful rule to live by is the Golden Rule. It is not easy to do, but trying to live by the Golden rule is worth our effort. Normally, very very good things emanate from this religious and philosophical guide to our behavior.

We have such deep feelings of love, affection and tenderness for our children. Looking at my own young children, and now at my young grandchildren, I have found myself fervently hoping that that other people in their future will also treat them in loving, kind, and gentle ways.

After many years of marriage it is all to easy to take our life-partners for granted.

As an extension of the Golden Rule we should treat our husbands, wives or life-partners with the same love and gentle kindness that we have shown to our children..and also in those ways that we fervently hope unknown others will treat our children during the rest of their lives.

Dr. Tom

Thursday, December 17, 2009

Rewarding Good Behavior and Ignoring Not-So-Good Behaviors

Rewarding Good Behavior and Ignoring Not-So-Good Behaviors

It is important to look for good behaviors in our children (or adults) and to naturally reward them when they occur. By strengthening good behaviors in this way, you naturally weaken bad behaviors.

A way to help this excellent approach to be even more powerful is to develop the habit of ignoring not-so-good behaviors. Withholding your attention from mildly bad behaviors can often reduce their frequency over time. All too often, criticising, scolding, lecturing, showing irritation and anger, even spanking, can actually cause bad behavior to happen more frequently in the future. Remember, any form of your attention (even negative attention) to your children's not-so-good behaviors can be a reward for them.

When bad behavior is not dangerous and not too disruptive it is normally best to ignore it. Then, wait until your child is behaving well and praise these good behaviors at a later time.

The rule of thumb is: look for good behavior that is incompatible with the bad behavior that is of concern. That is, good behavior that will interfere with the bad behavior of concern. The following are several examples of what I mean.

Ignore/ Praise

Running/ Later praise walking
Talking Too Loudly/ Later praise talking quietly
Whining/ Later praise being patient and pleasant
Being unkind to others/ Later praise being kind to others

Watch your child's behavior. When you see not-so-good actions, think of the good behaviors you want to replace them with. Then be sure to look for these good behaviors and naturally reward them with your attention (hugs, praise to them, praise in front of others, and special favors, etc.)whenever you see them or similar behaviors.

God Bless,
Dr. Tom 12/17/09

Tuesday, December 15, 2009

Reward Good Behavior

Rewarding Good Behavior

As I have said before, it is important to "look for" good behavior in our children to reward.

The rewards that I refer to are very natural ones that we have all enjoyed while growing up, and even now.

Descriptive praise is one example. Descriptive praise includes an enthusiastic description of the good behavior you see and a brief statement about why the behavior is good to do. The following are some examples:

* You picked up after yourself! It's so nice of you to help us keep our house clean.
* You helped your brother! That's a good way to show your love for him.
* You are going to bed so well. That helps you to grow strong and be healthy.
* Good, you are holding my hand when we cross the street. Keep watching for cars so we can stay safe.
* I like the way you are brushing your teeth. That keeps them nice and white and healthy.
* Look at you eat your vegetables, good for you! They help you grow big and strong and smart.
* Thanks for doing what I asked you to do! You are really a good helper and I'm proud of you.

The idea is to label the behaviors your child does as good, kind, happy, helpful, caring, unselfish, brave, cooperative, courteous, respectful, gentle, loving, sweet, etc., and then tell them why you appreciate what they did.

The best way to reduce bad behavior is to reward good behavior. Yes, this approach takes vigilance and energy, but in the long-run it really works the best.

Think of it this way: The more good behaviors your child does, the less time they have to do bad behaviors. Remember, its hard to do a good behavior and a bad behavior at the same time.

When you use rewards skillfully, you help your child's good behaviors win the contest!

God Bless,

Dr. Tom 12/15/09

P.S. Descriptive praise works well with adults too!

Sunday, December 13, 2009

Moral and Ethical Clarity

Moral and Ethical Clarity

I do not wish to get too political on this Blog, specializing in individual and family coping skills. However, some political events impact with great damaging force upon individuals and families and the issue that follows is one of those. Therefore, I am posting it here as well as on my Blog related to cultural affairs

I have several friends who bemoan the fact that our politics today are so fractious and polarized. They long for compromising attitudes among our elected officials and among our citizens. Frankly, so do I.

However, some of the issues that are being forced upon us in this Post-Modern Era are not ones that can be settled through compromise.

There are some issues that are literally life and death issues. With regard to these, there can be no compromise. Many of these issues that are being imposed upon us by secular progressive ideology---the overbearing Religion of the radical Left.

I hope you will read the following article by Ken Connor, appearing on

Mr. Connor discusses the immorality of compromise on a few essential matters with great clarity. Also, please do not fail to click on his attachment, "Principles that we are unwilling to budge on", for another treat to moral and ethical clarity.

God Bless,

Dr. Tom

The following are the words of Mr. Ken Connor.

There's nothing in the middle of the road but yellow stripes and dead armadillos."

-Jim Hightower, Texas commentator and humorist

As the political seas continue to churn over issues such as abortion, healthcare, cap-and-trade, bailouts, the war, and Climategate, the ideological divisions between the two major parties appear to run deeper than ever before. On top of this, it's become clear that both the Democrat and the Republican parties are experiencing an internal identity crisis?a problem that makes it difficult for either group to articulate a clear and unified agenda.

Desperate to find a way forward, politicians and pundits are stressing the need for Americans everywhere to set aside the "hot button" issues in favor of working together to find common ground. Focusing on what unites, rather than divides, us?so the thinking goes?would enable "productive dialog," which would lay the groundwork for unity, understanding, and healing.

The middle ground, after all, is where the moderates live; and that's where the majority of Americans hang their ideological hats?or so we are told. It's the "extremists" that are the problem. The muckrakers of the liberal Left and the fundamentalists of the religious Right?they are the ones destroying any chance for America to regain the national spirit that made this country great. If someone could muzzle the fringe, America could make real progress once again.

This proposed solution overlooks several serious questions: Where is this mythical common ground, what does it look like, and what kind of person lives there? What foundational moral, ethical, and philosophical principles guide the "common-grounders?" (Or does the embrace of political pragmatism foreclose consideration of the stultifying dictates of principle?) Where, for example, can one find the common ground between a person who believes that abortion is a fundamental human right and one who believes that all human life is sacred? How does the body politic meet in the middle when some believe that marriage is an institution ordained by God involving the union of only one man and one woman, and others believe marriage is a civil right to be exercised in whatever form or fashion the participants deem fit?

The truth of the matter is that when it comes to the most fundamental questions about human society, culture, and government, the middle ground is not a sensible place to occupy. When it comes down to the fundamentals, things are either right or they are wrong; to suggest that they may be right for me and wrong for you is nonsense. Moral relativism comes into conflict with the Law of Non-Contradiction when operating at the level of fundamental values.

There are, as our forefathers recognized, certain universal and self-evident truths. Human beings?for example?have been endowed by their Creator with an unalienable right to life. It is, therefore, wrong to murder an innocent human being, regardless of whether they are in the womb or in a nursing home. The act of murder is wrong regardless of who makes the decision to carry it out (mother, doctor, family) or how it is denominated (abortion, mercy killing, euthanasia). The character of an act is not changed by the rhetoric that accompanies it or the person who performs it. Such an act cannot be both right and wrong?right for you and wrong for me. It is either right or wrong?period.

There are certain principles that define the world view of Christian conservatives, principles that we are unwilling to budge on.

Here's just one example: We believe that this earth and everything in it bears the signature of a divine Creator, who so loved the world that he sent His only Son to die on a cross for the sins of humankind. Human beings are created in his image and because of the sacrifice made to redeem them, every individual is of infinite worth, value, and dignity. Therefore, all persons?rich or poor, black or white, whole or handicapped, born or unborn?have a God given right to life. That right should be protected by law and respected by society, no matter how "unwanted" or "inconvenient" it may be to others. Government should protect innocent life from the moment of conception until natural death. No public program that uses tax dollars to fund abortion or promote euthanasia should ever be foisted on the American taxpayer.

There are other principles that guide our thinking on marriage, freedom, and the role of government in a free and open society. These principles warrant discussion and debate and critical analysis. But rest assured, we will not yield on these principles no matter how much we are vilified, cajoled, or threatened?and regardless of whether leaders in the House and Senate pitch a hissy fit and the pundits rant and rave until they turn blue. And if we lose in the short term, we will continue to advance these principles in the long term. There are, after all, some hills worth dying on.

In short, there are certain issues in life that are non-negotiable, no matter how seductively the siren song of "compromise" may beckon. We understand that the way of Washington, particularly in the game of politics, is to "go along to get along." However, at some point a line must be drawn, lest you find yourself slicing and dicing away at your core beliefs until you are left with nothing to believe in. As the songwriter says, "you've got to stand for something or you'll fall for anything
." Truer words were never spoken.

Saturday, December 12, 2009

Taking Loved Ones For Granted

Taking loved ones for granted

Our loved ones are normally the most precious gifts of our lives.

The older we get, the more of these wonderful people we loose...and the more we find ourselves regretting that we were too busy to call, write, or to go see them. We may also regret that we did not tell them often enough how special they were to us. This unfortunate and common oversight is an all-to-easy thing to do.

Of course we are often very busy. But we and our loved ones will not be together forever. This is an unpleasant thought and so we have a tendency not to think about it. Therefore, we tend not to be as motivated to express our love for each other as often as someday we will wish we did.

We can avoid being sorry that we did not spend quality time with our loved ones when they are going or gone---or when we "are going or gone"! ;-)

I recommend that we do the best we reasonably
can to let our special people (parents, grandparents, spouses, children, or other relatives and Friends) know how much we care for them and how very special they are to us.

Many years ago I was a consultant at a residential center for developmentally impaired children. One of the many wonderful direct-care staff I worked with was a short, heavy-set woman who was called by her last name (the common practice there). Diggins was a very jolly, and outspoken woman who loved the children she cared for. She was also very loving and kind to all of us who worked with her.

Diggins would sometimes laugh loudly and sing-out: "Give me my flowers now! Don't be wait'in till I'm gone!"

Do this for your loved ones and everyone will be happier, both now and in the future.

God Bless,

Dr. Tom

Friday, December 11, 2009

Look For Good Behavior!

Look For Good Behavior!

The rewards that we provide others are important because they do influence the behavior of their actions. The smiles, praise, touches, favors, treats, etc., that we provide to others following their behavior encourages them to do those behaviors more frequently in the future.

It is all too easy to notice bad behavior. Bad behavior is often irritating and it naturally grabs our attention. Be careful not to focus on bad behavior too much and to accidentally reward it with your attention more often than you reward good behavior with your attention. If you do this your children and loved ones may start to show more bad behavior to you than is good for anyone.

When we are too busy, tired, or otherwise distracted we are prone to not notice and praise, hug, smile-at, thank, touch, or kiss, etc., the good behaviors when they occur

It takes a mind-set and a goal to look-for and notice good behavior in our children and even our adult loved ones. Good behavior is frequently quiet, subtle, even expected, and therefore it is too often ignored. This is a mistake we cannot afford to make.

Like every other precious thing in our lives, good behavior needs some maintenance or it may malfunction and happen less and less.

Reward good behavior in others in natural, kind and loving ways and you will see more of it!

God Bless,

Dr. Tom

Wednesday, December 9, 2009

Generalized Anxiety Disorder

Generalized Anxiety Disorder

Individuals with Generalized Disorder have excessive anxiety and worry, more days than not, for at least six months. They feel that they just cannot help worring about things and having almost constant feelings of anxiety. The anxiety and worry are often far out of proportion to the troubles that would be caused by the actual event, should it occur. Levels of generalized anxiety are apt to lead to restlessness, fatigue, problems with concentration, irritability, muscle tension and troubled sleep.

Because of the great variety of worries involved in Generalized Anxiety Disorder, the pattern is often refered to as "free floating anxiety". This disorder may can begin at any age, but it most often starts in childhood or adolescence. The prevalence of General Anxiety Disorder was about 3% in a community sample, but about 12% of people treated in clinics are diagnosed with Generalized Anxiety Disorder

Possible Causes

There are many pausible explanations of generalized anxiety disorder. Rapid social and cultural changes are stressful to individuals and can produce anxiety symptoms. Media reports of murders, rapes, child abductions, and negative economic trends terrorism and war can do likewise.

The actual problems of living in poverty with its increased crime rates, fewer opportunities for education and employment, poor lowered incomes and job instability, and various threats to family cohesivness and child welfare can all lead to heightened levels of anxiety.

Some psychologists believe that generalized anxiety disorder is related to a childhood history of a lack of what is called unconditional positive regard. From this perspective, children learn “conditions of worth”, meaning that they feel they are worthy of respect only when they are living up to certain parental standards. It is thought that such individuals have learned to be overly critical and harsh in their judgement of themselves. These individuals may try to defend themselves against feelings of inadequacy, but when the defenses fail they may feel anxiety and/or depression. Others see a connection between early abandonment, physical abuse, withnessing violence, and/or experiencing frightening unpredictable chaotic environments.

Another psychological perspective refers to “existential anxiety” as a universal fear in humans about the responsibilites that one has for their own existence, including both the limits and freedoms that they must confront. When faced by the challenges of life, it is thought that many are not authentic, but rather give-in to conformity, fail to exercise their freedom of personal choice, and deny and avoid those things they fear. The avoidance of personal responsibility in these struggles is thought to lead to a variety of anxiety problems.

Cognitive explanations of generalized anxiety have to do with the maladaptive thoughts,assumptions or beliefs that people adopt about themselves and others in their lives. For example some people foolishly believe--to the extreme--that they must be loved and approved of by everyone that they find significant; that it is horrible, awful and catastrophic when things do not go the way they want them to; or that if something could be dangerous or fearsome, one should be highly concerned and upset about it and should dwell upon its possible occurrence. Other psychologists have implicated automatic thoughts that cause anxiety such as “People will know that I am stupid”; “I will make a fool of myself”; “They will laugh at me”; “I know that I will fail”, etc. Indeed, such self-statements can cause one to feel anxious.

From a biological perspective various studies have found that generalized anxiety disorder is more common among blood relatives and identical twins than among more genetically disimilar individuals. Also, a neurotransmitter called GABA (gamma-aminobutyric acid) has been implicated in generalized anxiety disorder. Medications that help neurons to receive GABA molecules appear to allow for increased GABA signals within the brain so it can slow down various anxiety signals that the individual must cope with.

Finally, there is evidence that teaching relaxation methods to those who suffer from generalized anxiety disorders people can offer some help in aiding sufferers to manage this problem more effectively. This and other cognitive interventions suggests that anxiety, to a significant degree, can be helped by personal skills that have been learned.

Those with anxiety problems should see their physician for a physical check-up first and then seek professional help from a psychologist specializing in anxiety management.

God Bless,

Dr. Tom

Tuesday, December 8, 2009

Panic Disorder

Panic Disorder

Panic disorder consists of a series of panic attacks that are unexpected, spontaneous, and without apparent cause. Panic attacks are often described by the sufferer as coming,"out of the blue." A panic attack is an interval of very intense fear and anxiety comprised of a variety of physical and psychological symptoms. These symptoms include a growing sense of discomfort, immediate danger, impending doom, and an increasingly intense desire to escape the situation. During the attack, people variously report experiencing a fear of loosing control of themselves or "going crazy", fear of dying, heart palpitations, shortness of breath, sweating and trembling/ shaking, a sense of smothering, chest pain or discomfort, nausea, dizziness, stomach upset, and chills or sweats. These symptoms arrive quickly, usually peak within ten minutes, and can last for 40 minutes or so.

Panic disorder has about a 1% to 2% prevalence within one year. Major Depression also occurs in 50% to 65% of individuals with panic disorder.

About 33% to 50% of individuals who have Panic Disorder also suffer from Agoraphobia. Agoraphobia is a condition in which those with Panic Disorder also avoid or escape situations that they fear they cannot easily get out of, or fear they would be embarrassed trying to escape from. People with Agoraphobia may also fear that they cannot get help while there in that place (for example, a busy highway, a crowd of people, or a shopping mall). It is thought that Agoraphobia develops out of past panic attacks that have become associated with such situations, or that the individuals begin to worry that their panic attacks could happen in these circumstances and they would loose control of themselves, or could not escape.

Possible Causes

Panic Disorder tends to run in first degree relatives of those who are so diagnosed. Twin studies suggest that panic disorder can have genetic heritability.

Neurobiological factors are also implicated. It is possible that irregular norepinephrine activity in the locus ceruleus of the brain may be involved in panic attacks.

Interestingly, antidepressant medications that alter the activity of norepinephrine reduces panic attacks.

From a cognitive perspective, psychologists believe that how a person thinks about their lower intensity anxiety symptoms determines who will develop panic attacks. From this perspective, a person may be very sensitive to changes in their body and arousal levels. But, such individuals may then create an increasing anxiety spiral ,into a full panic attack, by greatly fearing a loss of control of their anxiety. Throughout this upward spiral, perceived increases in anxiety are noted with increased alarm and even more anxiety. This upward spiral in anxiety eventually reaches a level that we call a panic attack.

Training panic attack sufferers to understand this upward physiological spiral and to control this vicious progression has been very successful. The effectiveness of this intervention lends support the cognitive “fear of fear” theory.

A Case Study and Recommendations

One middle-aged salesman complained that he had recently started to have anxiety episodes while driving his car which were identified as panic attacks. He was already beginning to fear driving, especially on multiple lane city roads with heavy traffic, with few places to easily pull over.

Being able to drive and automobile was essential to his ability to make a living for his family. He was gravely concerned. Psychological testing and clinical interviews led to the diagnosis of Panic Disorder without Agoraphobia, though agoraphobia was in the process of development.

The man was also diagnosed with Major Depression. Antidepressant medication and behavior therapy were successful and this man reported his panic attacks stopped and that his depression improved significantly.

If you or a loved one has similar anxiety symptoms, see your family physician for a physical examination and consider a referral to an psychologist experienced in the practice of Behavior Therapy for Anxiety Disorders.

God Bless,

Dr. Tom

Sunday, December 6, 2009

Anxiety Disorders

Anxiety Disorders

We are all familiar with what anxiety feels like. This uncomfortable gnawing feeling in our body, the fear that we might not be in control, the sense that we are vulnerable, or that something bad or awful could happen is not something that we look forward to.

Occasionally, We may experience an even more powerful emotion that is attached to a situation, event, or stimulus that is a physical danger or threat. Strong anxiety attached to these specific things is called fear. Fear is not always bad. For example, fear related to drowning when around water, being out from cover in a lightening storm, or driving in fast and congested traffic, etc., is normal. If we cope effectively and learn how to swim or put on a life-jacket, seek shelter, or slow down, these normal fears are short-lived and beneficial because they help us survive.

Sometimes a person’s anxiety is not attached to anything identifiable. This form of anxiety is called “free floating” because it is not related to anything in particular and seems to exist "all on its own". Experiencing this kind of anxiety can be very unpleasant and fatiguing.

For some people, anxiety may become a periodic or chronic condition that is not associated with any particular environmental event. But, when it strikes it does so in a rapidly intensifying attack which is relatively short-lived, but is never the less terrifying. The fear of these anxiety attacks can cause individuals to escape and avoid the conditions that have been associated with them. This fear can generalize to other similar conditions. Unfortunately, then, these attempts to escape or avoid the feared circumstances cause these individuals to be increasingly socially isolated and unhappy.

In this way, and in others, fears and anxieties can become attached many situations, events, or stimuli that are not dangerous, possess no real threat, and that are normally enjoyable and beneficial.

Anxiety disorders are the most frequent of all psychological disorders. It is estimated that anxiety disorders afflict around 19% of our adult population each year.

Fortunately, most anxiety disorders can be treated with good effect.

My next several postings will focus upon several of the most common anxiety disorders.

God Bless,

Dr. Tom

Saturday, December 5, 2009

Preventing Suicide Among Children and Teens

Preventing Suicide Among Children and Teens

Suicide rates among children and adolescents have increased very significantly over the last several decades. Suicidal children and teens often take overdoses of prescription drugs in their home and guns(they must be kept safely)are increasingly used in suicides.

Child suicides are often linked to the loss or anticipated loss of a loved one, family stress, unemployment in the parent, parental abuse, and severe depression. Children who commit suicide frequently show a deterioration in the quality of their behavior including withdrawal from family and friends, temper tantrums, destructive and delinquent behavior, including running away from home.

About half of teen suicides are related to severe depression and feelings of hopelessness. Other factors that appear to be involved are poor family relations and conflict, social isolation, boyfriend/girlfriend problems and school pressures.

Child and adolescent natural emotional immaturity and tendencies toward impulsiveness, suggestibility (the imitation of others), anger, and heightened sensitivity are relate to increased rates of suicide. Drug and alcohol abuse and the weakening of family ties (divorce, family mobility, and the reduction in extended families) are a significant part of this problem.

Also, a history of suicide attempts within the family (or individuals that the adolescent loves or admires), a history of self-inflicted injuries (cutting or burning,etc), or actual suicide attempts should alert parents or guardians to a heightened danger of suicidal thinking or behavior in their children or teens.

If you worry that your child or adolescent is at any risk for suicidal thinking it is essential that you talk to them about their feelings, and take their emotions seriously. If you suspect that they may be thinking about suicide, ask them about it directly. If suicide is mentioned or even hinted at in small ways get professional help immediatley. If emotional problems persist,even without concerns of suicide, get professional help and do not put it off. It is important to consult your family physician to rule out medical issues and then have your child or teen evaluated by a psychologist. Individual and family counseling can reduce emotional problems and the risks of suicide. If there are severe psychological disorders involved (depression, anxiety, mood-swings, etc.), medication management may be necessary.

Please visit the following websites for more information about preventing suicide in Teens and in children:

God Bless,

Dr. Tom, 12/05/09

Friday, December 4, 2009

Suicide Prevention

Suicide Prevention

Suicide is not a classified diagnosis in the DSM-IV, but I will include it here because it is a very costly and damaging individual and cultural problem. Increased rates of suicide are correlated with depression, bipolar disorder,alcohol and drug dependence, and schizophrenia.

Suicide can be defined as a self-inflicted death in which a person makes and intentional, direct, and conscious effort to end one’s own life. Contrary to popular belief, all suicides are not a result of classifiable psychological disorders.

Factors that may lead suicide

Among adults, it has been repeatedly observed that suicide victims have suffered significantly more recent stressors than matched groups that did not commit suicide. The loss of a loved one (rejection, breakup, divorce or death) is a very common stressor preceding suicide. Other stressors may include natural disasters, ,job loss, or severe financial problems. These and other stressors may pile up, or they may simply exist for a very long time and lead to feelings of hopelessness.

Other factors associated with suicide are:

1. Depression and other mental disorders
2. Alcholoism and drug abuse
3. Suicidal thinking, talk, and preparation
4. Prior suicide attempts
5. Lethal methods available
6. Social isolation, living alone, loss of support
7. Hopelessness and ridged thinking
8. Being an older white male
9. Modeling, suicide in the family and perhaps genetics
10. Economic or work problems and certain high stress occupations
11. Marital problems and family dysfunction
12. Stress and stressful events
13. Anger, aggression, and irritability
14. Physical illness
15. Repetitions and combinations of factors 1-14

What to do

If you have thoughts of suicide, seek professional help Immediately. Suicide is a permanent solution to a temporary problem. Tell your loved ones, call your doctor, get a referral to an experienced psychologist for evaluation and psychotherapy. Seek professional medication assistance, if necessary.

Many people who attempt suicide do not succeed. No matter how serious the attempt, there are frequent failures. Some attempts leave people seriously impaired for life as a result of the residual damage that they have done to themselves.

There are much better and more effective ways to cope with any trouble that you may encounter. Just get competent professional help and you will see!

Then, there is the matter of Behavioral Contagion. Suicide and suicidal thinking is contagious. When one member of a family commits suicide,it damages their loved ones. Their loved ones are then prone to emotional problems and are more likely to consider suicide as a realistic option when they meet life’s certain stresses and strains. Do not be the cause of your loved ones emotional problems and suicidal thinking through your suicide attempts or completion.

There are much better and more effective ways to cope with any trouble that you may encounter. Just get competent professional help and you will see!

Finally, if you know someone who is thinking about suicide do everything in your power to get them to seek professional help. Do not be sworn to secrecy. Inform their loved ones and ask that they use their influence to get help to the suicidal individual.

If you feel that suicide is about to happen, call the police and tell them of the immediate danger. They can do a “welfare check” and if they find that the individual is in danger, they can hospitalize the person, thereby interrupting the suicide and providing the professional assistance that is needed.

For more detailed information about preventing suicide, please go to the following link:

Dr. Tom

Thursday, December 3, 2009

Good Vs. Bad Behavior

Defining Good vs. Bad Behavior

I am a psychologist and therefore I have deep respect for psychology's most robust laws and principles: The Law of Effect is one such law.

I like to think of it this way: The Law of Effect is one of God’s truths discovered by science, but known by perceptive humans through all time.

The Law of Effect states that: Consequences Control Behavior.

The facts are that individuals, groups and sociocultures that do not abide by this law will suffer the consequences of increasingly chaotic behavior patterns. Much of this behavior will be bad because bad behavior normally requires less organization and planning, less patience, less effort, and leads to fast, or even instant, gratification (rewards). My general definitions for bad behavior is dumb, short-sighted, self-defeating, maladaptive, self-and-other destructive, damaging, irresponsible, mentally disturbed, criminal, selfish, addicted, murderous, or suicidal behavior, etc..

Defining and differentiating bad behavior and good behavior is not always a simple matter. Attempting to do so invites criticism, even social censure in this day and age. But we all do it. Its just that many of us have been intimidated, by modern political correctness and the prevailing philosophy of moral relativism, into keeping these judgements of good/bad or right/wrong to ourselves. By giving-in to these social pressures, we become incompetent at encouraging good behavior, in ourselves, our loved ones and others. This form of ethical incompetence is self-destructive for individuals, groups and sociocultures, which is the point of this discussion.

The growth of ethical ignorance and incompetence, and its predictable consequences, is exactly what is happening to America.

I have struggled with the problem of defining good behavior and bad behavior for many years. The best that I have been able to do is to blend several criteria as an aid to making such evaluations. Though this method is admittedly imperfect, in my judgement, it is far better than declaring that there are no rights/wrongs, or goods/bads, and embracing the behavioral chaos which naturally results from this perverted anti-ethical philosophy.

I define bad or undesirable behaviors as all behaviors (thoughts, attitudes, beliefs, and important physiological events such as extreme anger, fear, and anxiety) that:

A). Are prohibited by law. These criteria can change overtime, but they are generally a helpful guide.

B). Are represented as a Psychological Disorder in the Diagnostic and Statistical Manual-IV-Revised (DSM-IV). This is the diagnostic manual used by physicians and mental health professionals to determine who is suffering from significant mental problems.

C). Are listed in the International Classification of Diseases, 10th Edition (ICD-10). This diagnostic manual is used world round to diagnose both physical diseases and mental disorders.

D). Are behaviors competitive or incompatible with the main features of a healthy human personality as identified by psychologists Carl Rogers and Abraham Maslow.

E). Are proscribed by the benevolent religions of the world.

I define Good or desirable behaviors as those behaviors (thoughts, attitudes, beliefs, and important physiological events such as good feelings, happiness and affection) that compete with, or are incompatible with, definitions A. B. and C., and those that are consistent with D).,Roger's and Maslow's definitions of a healthy personality and E)., the behavior patterns recommended by the benevolent religions of the world.

Again, the general criteria stated above are only a general guide. You may wish to research each of the references mentioned in order form your own opinions.

I believe it is essential to encourage good behavior and discourage bad behavior in our private lives and as citizens of our American Republic. There are many ways to do this through teaching, showing desirable role models, rewarding good behavior, and withholding rewards from bad behaviors. Much less frequently, in exceptional cases, it will be necessary to appropriately punish bad behaviors.

My study of the sciences of psychology/sociology/anthropology/economics, my experiences as a therapist, and my readings of the history of evolving and declining cultures, have taught me that:

Those who do not do recognize and use the law of effect , and other valuable psychological and social science principles, for the benefit of all, inevitably suffer the disastrous consequences of behavioral chaos.

Dr. Tom

Monday, November 30, 2009

Bi-Polar Disorder

Bipolar disorder

Bipolar Disorder was once called manic-depression. This is a mood disorder that is chiefly identified by mood swings between the two “polar” states of mania and depression.

Manic episodes are periods of persistently elevated, expansive, or irritable mood. While in an elevated mood people typically experience periods of greatly increased self-esteem, decreased need for sleep, rapid speech, floods of ideas, increased activity levels to the point of hyperactivity, with possible hyper sexuality, and risk taking. People in manic states can be euphoric or highly irritable if their goals are blocked or interfered with. The combination of blind optimism, feelings of grandiosity, increased sex drive, and poor impulse control often lead to damaged personal, family, social and vocational relations.

These manic states alternate with periods of depression in ways unique to the individual.

Milder, yet still disruptive, mood swings are symptomatic of a more moderate mood swing problem named cyclothymia.

Case Study

One bipolar disordered grandmother remained rather isolated during depressed periods only to emerge from her depressed states and go on "rampages" that struck fear into the hearts of her adult children and their families. Her behavior was unpredictable and highly problematic. She was arrested by the police for swimming at a small town public beach in her underclothes. One Thanksgiving she pulled unannounced into the driveway of her daughter’s family and let several adult turkeys out of the back of a beat-up station wagon (she had been in numerous accidents) to run through the neighborhood. After all, it was Thanksgiving, and She had “brought the dinner”!

Perhaps this sounds amusing, but her adult daughter was mortified with fear of what was coming next. She was also known to pick-up well-to-do elderly men and spend their money before moving on to other relationships. As is often the case, this individual refused to take the medication, which could have helped to controlled her mood swings. My dear grandmother remained actively bipolar until she contracted a terminal illness in her late 70's.

As a young child I could not understand my mother's mortification at her arrival at my house. To me, she was just an exciting and fun grandma. I loved her dearly and still do.

Community samples suggest a life-time prevalence of .4% to 1.6%. However, the frequency of this diagnosis appears to be increasing in children and adults

Possible Causes

Bipolar disorder is thought to be caused by biological factors. One theory suggests that a combination of low levels of serotonin and high levels of norepinephrine combine to produce bipolar symptoms. Another theory suggest that the improper transport of sodium ions involved in neuronal transmission (or perhaps an abnormality in the neuronal membrane) increases the rate of neuronal impulses and leads to mania. There is also consistent evidence that bipolar disorder may be an inherited condition. Close relatives of those who suffer from bipolar disorder also show higher rates of this problem.

If you or your loved one shows indications of Bi-Polar Disorder see your family physician for a physical. If all is well with your physical check-up, I strongly recommend a psychiatric consultation. A psychiatrist is an MD who specializes in treating serious mental disorders, of which Bi-Polar Disorder is one.

If Bi-Polar Disorder is the problem, it cannot be regulated without medication management. In addition, education and counseling with an experienced therapist is very important for long-term management of this disorder. Bi-Polar Disorder cannot be cured, but it can be managed effectively.

God Bless,

Dr. Tom

Sunday, November 29, 2009

Suspected Causes of Depression

Many potential causes of depression have been identified on the basis of research and keen observation. Various of these factors can interact and summate as they determine the course and severity of depressive episodes.

The following is a brief summary of possible causes:

Genetic factors have been implicated by researchers who study the extended families of depressed individuals and find that relatives have a significantly higher incidence of depression than the general population. Closer relatives of depressed persons have higher rates of depression than do distant relatives.

In twin studies identical twins have a much higher chance of both suffering from depression than do fraternal (nonidentical) twins. These kinds of studies could be taken as evidence for the learning of depressed behavior in families as a result of similar experiences, and learning can be an important factor. Adoption studies have also suggest that genetics can play a significant role in the development of depression.

Biochemical factors may also be involved in depression. Neurotransmitters are molecules that move between the neurons (special nervous system cells in the brain) allowing neuro-impulses to travel from one cell to the next. The search is not over, but so far, two specific neurotransmitters have been found to occur at low levels in depressed individuals. It has also possible that these neurotransmitters could be present in sufficient quantity, but may not used effectively by the brain. These neurotransmitters are norepinephrine and serotonin. Anti-depressant medications are known to increase the availability of these brain chemicals and/or to improve the way the brain uses them, thereby relieving depression.

Hormonal factors may also be involved in depression. It has been found that people who are depressed frequently show elevated levels of cortisol. Cortisol is a hormone released by the adrenal glands when individuals are under stress. Stressful events are often found to have preceded episodes of depression. High levels of another hormone named melatonin have also been implicated in depression. It is thought that the lack of sun associated with winter months may cause a build up of melatonin and produce the depression that is called seasonal affective disorder.

Psychological theories have identified many life events that predispose individuals to depression. Psychodynamic theorists have noted that the death or loss of a loved one early in life increases the likelihood of depression for the person experiencing the loss. The separation of children under six from their mothers has been found to lead to a form of child depression (anaclitic depression). These findings also hold for infant monkeys separated from their mothers. It appears that maintaining early emotional attachments with caretakers is very important to mental health of children and the adults that they become.

Behaviorists have observed that depressed individuals have often lost a significant proportion of the rewarding people, places, things, or abilities that they have customarily enjoyed in life. In some individuals a loss of important sources of rewards are thought to precipitate a downward spiral of depression in which these people do fewer things and therefore obtain even fewer rewards in their lives. Also, studies have demonstrated a behavioral contagion effect in which non-depressed people were exposed to other individuals who acted depressed. The findings were that some of those who were simply exposed to a depressed person began to feel depressed themselves.

Cognitive factors refer to a persons beliefs, attitudes and ways of thinking about the world. Cognitive-behavioral research has found that feelings of helplessness accompanying depressed behavior can be produced by repeatedly experiencing painful events over which the individual has no control. More recent changes to this theory note that a perceived lack of control over such painful events is more important than the actual control which is available.

Other psychologists have examined cognitive factors that can lead to depression. For example people can learn to think negatively about their past, present and future. They can also magnify various minor problems and minimize the good things in their lives. Depressed people also frequently have automatic thoughts which they think in a “reflexive”-like and uncritical way. Such thoughts might include things like: "I certainly am damaged goods", “I’ll never amount to anything”, I'm the biggest screw-up on earth", or "I've got so many problems I just can't take it anymore."

It is good that you have taken the time to become familiar with some of the likely factors that may predispose people to periods of depression. Knowing your risk factors could help you to lower some of them. Perhaps you could share this information with your loved ones. Knowing our risk factors can help us all to be more alert for early indications of depression and to seek professional help early.

As always, prevention and early treatment are the best approaches.

Dr. Tom

Saturday, November 28, 2009

Look Out For Depression

Look Out For Depression

The most severe form of depression is called Major Depression. Major depression is diagnosed when a number of the following symptoms last two weeks or more. Some of its features are a loss of pleasure and interest in almost all activities. There are normally changes in appetite with weight loss or weight gain. Feelings of worthlessness, failure, guilt and inferiority can lead to thoughts of death. Suicidal thinking, planning and attempts may occur. Depressed individuals also have problems concentrating, thinking, and making decisions. They generally look sad and move like they have the weight of the world on thier shoulders, complaining of feeling tired and fatigued. They may complain of physical problems (aches and pains), report sadness, and become irritable, edgy, argumentative, angry and blame others for their own problems. Depressed people ofen withdraw from social activities and from activities and hobbies that once gave them pleasure. Insomnia (difficulty sleeping) and hypersomnia (excessive sleeping) are a common part of depression. Ocassionally, depression can become so intense that it can include mood consistent periods of psychosis in which the individual may develop false beliefs about his world.

Dysthymic Disorder is a more moderate, but still disruptive, form of depressed mood that characterized by at least two years of depressed mood that does not satisfy the requirements for major depression. Depression is often diagnosed in those who abuse and become dependent upon alcohol and illegal drugs.

Depression can be very destructive of the individuals who suffer from it and also destructive of social relationships and families. For example spouses and children of depressed people often feel their anger, negativity, and withdrawal as a lack of love and caring for them. If the depression goes on for years without treatment, as it often does, spouses feel building frustration, resentment, and anger in response to the depressed treatment they receive from their depressed mate. The result is that they frequently seek love and caring outside of their marriage and the ruinous effects of this infidelity then compounds their problems.

With proper marriage counseling and antidepressant medication (when warranted) some marriages can recover to become better than ever, but many simply fail in divorce. The same is true for couples that are not married.

The sad fact is that many of these couples never know what hit them—they simply conclude that they don't love each other any more.

The children of depressed parents (divorced, married, or not) see the same symptoms as the adult non-depressed mate, but they react differently. They often feel unacceptable, worthless, unloved and unwanted. Children also show the sad effects of constant bickering, fighting, or worse between their parents.

From this sad history frequently grows a life-time of psychological and relationship problems for these childdren who grow to adulthood and for their own children. In complex ways, with complex outcomes, untreated depression can easily become contagious across generations.

The life-time risk of Major depression, based upon community samples, is between 10% to 25% for women and 5% to 12% for men.

If you, or member of your family, or perhaps a friend shows signs of depression, talk to them about what can happen if depression is an untreated problem. Encouraged them to seek professional assistance.

God Bless, Dr. Tom

Friday, November 27, 2009

Preventing Depression in Children and Adolescents

Preventing Depression in Children and Adolescents

The symptoms of depression are likely to show themselves in different ways, depending upon the age of the child.

Infants may show listlessness, social unresponsiveness, and slowed physical development. Children up to about 2 yrs. of age are more likely to show little curiosity and interest in play. They may be clingy, fearful, have nightmares and night terrors and show an increase in oppositional and uncooperative behavior.

Between three and five years of age children may show sadness, tiredness, slow movement poor appetite and weight loss. They may also show withdrawal, apathy, irritability and anger. Some children may begin to express thoughts of suicide.

From 6 to 12 years depressed behavior begins to look more similar to that of adults. They may express their depressed feelings as well as suicidal thoughts. They may have difficulty feeling pleasure and show signs of low self-esteem, apathy, withdrawal, and low motivation. Poor school performance is common as are physical complaints, oppositional behavior, social problems, and delinquency

Pre-adolescents and adolescents ages 12-18 years are more likely to “act-out” their depression. They may show volatile moods, rage, various forms of delinquency, substance abuse, sexual promiscuity, suicidal thinking, self-abuse, and over-eating and sleeping. There may be guilt and feelings of worthlessness and the inability to concentrate and make decisions. School under achievement and suicidal thinking are also common.

It is estimated that 2-4% of our children under 17 yrs. Suffer from a major depression and the percent for teens is about 7%. There is no apparent difference in depression rates between boys and girls until about 11 years of age. After this time girls are twice as likely to be depressed as boys.

Causes of Depression

There are many causes of childhood depression. Genetics and changes in brain chemistry appear to play a role as does child abuse, abandonment, divorce, and loss of a loved ones to death or divorce. Other factors that are traumatic or negative life events can also be involved, such as rejection by significant others, imitation of significant depression in others, learning to be helpless, and the loss of rewarding people, things, and conditions. The factors that cause child and adolescent depression are similar to those that cause adult depression. Depression may go undetected by others until they intensify and are identified later in adult years. Frequently, adults will admit that they do not remember a time when they were not depressed. This is regrettable, because depression can severely limit ones success throughout life.

Depression can be improved or cured

A 16-year-old adolescent was brought to a therapist because he was flunking his tenth grade classes and was “into” Goth dress, literature, music and friends. He had ceased communicating with most people, stayed in his room at home, and was found to be using marijuana and cigarets. The teen would not communicate with the therapist. As a result of the various dangers involved in this case, the parents were advised to enter their son in an adolescent treatment center for psychological assessment, intensive individual and group counseling and substance abuse treatment. A psychiatrist prescribed antidepressant medication and after about two weeks he was discharged to his parents care and returned to his psychologist for further out-patient family and individual counseling. The teen’s thoughts, emotions, and behaviors gradually improved greatly in all ways.

It is important to review the known causes of Depression because in doing so we are in a better position to prevent, catch early and effectively treat depression in ourselves and our loved ones. If depression appears to be a problem in your children, schedule a visit with your family physician and also consider a a careful evaluation by a psychologist. Depression is a very treatable problem and it can often be cured.

An once of prevention is worth a pound of cure!

Dr. Tom

Thursday, November 26, 2009

Have A Blessed Thanksgiving

Happy Thanksgiving To You!

I hope that you will take this day to count your many blessings and be with, or think of , your friends and loved ones.

Thanksgiving should also remind us of the great gift we have in America and the sacrifices of all who keep it, and all of us, safe.

It is also good to ask, how can we continue to do our part in this great effort?

God’s Blessings to you and your loved ones.

Dr. Tom


Happy Thanksgiving From George Washington

Happy Thanksgiving From George Washington

George Washington's 1789 Thanksgiving Proclamation

Whereas it is the duty of all nations to acknowledge the providence of Almighty God, to obey His will, to be grateful for His benefits, and humbly to implore His protection and favor; and Whereas both Houses of Congress have, by their joint committee, requested me to "recommend to the people of the United States a day of public thanksgiving and prayer, to be observed by acknowledging with grateful hearts the many and signal favors of Almighty God, especially by affording them an opportunity peaceably to establish a form of government for their safety and happiness:"

Now, therefore, I do recommend and assign Thursday, the 26th day of November next, to be devoted by the people of these States to the service of that great and glorious Being who is the beneficent author of all the good that was, that is, or that will be; that we may then all unite in rendering unto Him our sincere and humble thanks for His kind care and protection of the people of this country previous to their becoming a nation; for the signal and manifold mercies and the favorable interpositions of His providence in the course and conclusion of the late war; for the great degree of tranquility, union, and plenty which we have since enjoyed; for the peaceable and rational manner in which we have been enable to establish constitutions of government for our safety and happiness, and particularly the national one now lately instituted for the civil and religious liberty with which we are blessed, and the means we have of acquiring and diffusing useful knowledge; and, in general, for all the great and various favors which He has been pleased to confer upon us.

And also that we may then unite in most humbly offering our prayers and supplications to the great Lord and Ruler of Nations and beseech Him to pardon our national and other transgressions; to enable us all, whether in public or private stations, to perform our several and relative duties properly and punctually; to render our National Government a blessing to all the people by constantly being a Government of wise, just, and constitutional laws, discreetly and faithfully executed and obeyed; to protect and guide all sovereigns and nations (especially such as have shown kindness to us), and to bless them with good governments, peace, and concord; to promote the knowledge and practice of true religion and virtue, and the increase of science among them and us; and, generally to grant unto all mankind such a degree of temporal prosperity as He alone knows to be best.

Given under my hand, at the city of New York, the 3d day of October, A.D. 1789.

From Founder's Quote Daily

Dr. Tom, 11/26/09

Wednesday, November 25, 2009

Attention-Deficit/Hyperactivity Disorder (ADHD)

Attention-Deficit/Hyperactivity Disorder (ADHD)

Some children seem unmanageable to both their parents and teachers. They have trouble paying attention to things that other children can easily focus in on. They frequently do not follow instructions, do not finish tasks, are careless and messy in their school work, and become frustrated and give up on challenging work. These children are also likely to be disorganized and easily distracted by irrelevant stimuli (trivial noises, or other features of people or the environment), and they have trouble following rules.

Children with attention problems may, or may not, show the additional problem of hyperactivity. What we call hyperactivity consists of frequently and rapidly doing a large number of annoying things such as squirming and fidgeting, running, jumping, shouting, climbing and walking on furniture or tables, all of which can lead to danger and make them accident prone. They may also annoy others by tapping, poking, pulling, and pushing on them, or the various things around them. Such children often talk loudly, rapidly and excessively which makes them difficult and irritating to be with.

Hyperactivity naturally includes actions that we call impulsive . These children may frequently knock things over, bump into people, or break and spill things. They interrupt, “goof around”, “blurt-out” interrupting comments, touch things and people that they should not, and do things that are dangerous without thinking about the consequences of their actions.

Children who behave in these ways tend to do so in a wide variety of settings (school, church, vacations, home), but some settings and activities worsen these problems. Generally conditions that require sitting still, concentrating, and doing monotonous tasks, requiring close attention and concentration, will produce more such troubles.

It is common for children to show some of these behavior patterns when they are younger than four of five years old. If these actions persist and intensify ADHD may be diagnosed in their early school years, when they first begin to encounter public social and educational problems. ADHD is diagnosed much more often in boys than it is in girls.

Untreated ADHD symptoms can lead to other very significant problems and impairments. About half of these children develop various learning and communication problems and about 80% of them misbehave, often quite seriously.

One preschool child showed almost all of these features. He ran away and climbed under the dresses of manikins in stores. In play, he ran jumped and yelled so loud that he could be heard though-out the neighborhood. School problems started in kindergarten when he constantly played and splashed the water in a shallow ceramic gold-fish pond built into the floor in his classroom. He wandered away from story time, and made noises and talked to others at rest time (they used to have children rest upon little mats on the floor). Due to the mischief he caused, teachers naturally suspected him whenever there was a problem of unknown origin. Negative expectations by teachers and others who care for such children is common. He was once accused of stealing things from his kindergarten teachers desk (he was innocent). Later he had great difficulty learning to read and to do mathematics. His parents tutored him and they became exceedingly frustrated while trying. But his parents never gave up and they hired tutors. In grade school, while the teacher was trying to hold class attention, he noticed the first snow of winter and loudly directed class attention out the windows to see that “great event”. He similarly interrupted class to announce that men were working on the traffic light at the corner, just outside of the school, and all of the students ran to the window to see. This boy was quite a challenge.

I am both happy and mildly embarrassed to report that this boy was me. I extend my deepest heartfelt appreciation to all of my heroic helpers of the distant past and, especially, to my beloved Mother and Father who did a wonderful job in a time when there was “no such thing as ADHD”. The experts said I was “just all boy”. That was indeed the truth, but it was not the whole truth!

Suspected Causes

ADHD behaviors appear to be caused by many things; and these things appear to summate and interact with each other. Attention-deficit/hyperactive disorder tends to run in families and may have an inherited biological basis (this was, and is, very true in my family). Also, the disorder was once called "Minimal Brain Dysfunction", attesting to the possibility of actual neurological damage attributable to fetal development or birth related problems. There is also the suspicion that ADHD may be caused by slowly maturing parts of the brain that filter extraneous stimuli and which are needed to help concentration.

Also, there is evidence that this pattern of behavior is more prevalent among homes that suffer high levels of stress, chaos and family dysfunction: This suggests that these behavior patterns can occur in children who simply failed to learn to follow rules, organize and attend in orderly ways to their environmental surroundings. As you can see, as with many psychological disorders, there is no one cause for ADHD.

Learning Disorders

ADHD puts children at increased risk of developing significant academic learning problems. A learning disorder is diagnosed when a child’s achievement test scores fall significantly behind those of his normal peers. The child’s existing learning problems then interfere with the learning of new information and the child falls further and further behind the academic achievements of his peers.

When an ADHD child has trouble being patient and focusing upon uninteresting details and activities they will have difficulty learning to read, learning mathematics, and learning to write. Putting information into memory, to a large extent, requires that we focus upon information and work to make sense of that information, or repeat it over and over again (i.e., do rote learning). Doing this effortful work is the main way in which we place our academic information in our long-term memory.

There are ways, other than having ADHD, that children can develop learning disorders. Research has implicated other possible causes of learning disorders such as: Inferior teaching, poor diet, lead poisoning, genetic defects, birth injuries, and sensory and perceptual problems. The true causes of a child’s learning disorder, in many cases, remain uncertain.

Effective treatment for ADHD involves early detection and treatment. The behavior problems involved in ADHD should be treated first with behavior modification methods. After consulting a pediatrician, further professional assistance from psychologists who can teach parents behavior modification skills can be very helpful.

If these methods do not reduce behavior problems significantly, psychological testing for primary school children to screen for ADHD is appropriate. If a formal diagnosis of ADHD is made, and behavior modification methods are not sufficient, treatment with both medication and behavior modification methods may be a necessary consideration.

ADHD is a condition that is preventable when it is a learned behavior pattern. Whether ADHD is a learned condition or not, like all psychological disorders, it is a problem that greatly benefits from early intervention.

An ounce of prevention, or early intervention, is worth a pound of late attempted cure.

God Bless

Dr. Tom

Tuesday, November 24, 2009

Oppositional-Defiant Disorder in Children

Oppositional-Defiant Disorder in Children


An all too common problem in our children is Oppositional-Defiant Disorder: This diagnosis is not given to children over 18 years of age, or to those who qualify for a more problematic diagnosis of Conduct Disorder (discussed preveiously).

Oppositional-defiant disordered children are disobedient, hostile, defiant, and negative toward authority figures. They fight compliance with instructions or requests and they are stubborn and will not compromise with adults or friends. They often test limits and do things to purposefully annoy others. These children show frequent hostility to authority figures and peers by arguing with and, in other ways, deliberately annoying them. They also purposefully break the rules that they are reasonably expected to follow. Oppositional-defiant children are often angry, resentful, spiteful and vindictive. Generally, their aggression remains at the verbal level and any physical aggression, if it occurs, remains mild to moderate in nature.

The oppositional and defiant behaviors displayed by these children are often focused intensively upon those who they are closest to (at home with parents and siblings), but they can also be directed at anyone who sets rules or limits upon their behavior. Psychologists and other therapists may not see a child’s oppositional-defiant behavior in their office (even with the parents present) but it will be abundantly present at home and sometimes elsewhere too. A child’s oppositional-defiant behavior may or may not be in evidence at school.

Rates of Oppositional-Defiant Disorder have been estimated to be from 2 to 16%, depending upon the populations sampled and the measures used.

Over the past 40 years, I have been called into schools to consult with teachers and principals to help with student’s behavior problems. I am convinced that oppositional-defiant rates have increased substantially. Rates of occurrence are higher for males before puberty, but are more equal between males and females after puberty is reached. Even so, males tend to be more confrontational than females.

These children may also show other psychological disorders such as ADHD, depression, anxiety, or learning and communication disorders.

Case Study

One adolescent male was born and raised in a family where the father was exceedingly demanding upon him. His mother was permissive and protective towards the boy and there was almost constant conflict between she and her resentful and compulsively demanding husband over the boys disciplinary issues. The boy was very bright and got good grades at school, but the father insisted upon all A’s stating that he was not living up to his potential. The boy’s behavior at school was exemplary and he was in various clubs and athletics. However, at home, he was manipulative and demanding of money, car privileges, and excessive freedom. His father almost always said “no” to these demands and his mother almost always countermanded the father’s judgement. The adolescent’s tactics involved angry, insulting and disrespectful behavior, and noncompliance with the requests of both of his parents. But, he was most likely to focus his blustery and unrelenting tantrum-like demands upon his mother. This was especially likely when his father was not at home. The mother frequently gave-in to her son’s demands. As you might guess, this rewarded the boy’s behavior and set the occasion for the next round of arguments between the mother and father. This adolescent’s oppositional-defiant characteristics appeared to be born of his parents polarized disunity, his resulting ability to further split and alienate them from each other, the ensuing conflict between the parents, and the family chaos that resulted. The adolescent was therefore in a better position to divide and conquer his parents authority in the future.

Suspected Causes

Oppositional-Defiant Disorder is more prevalent in families that have had many different care-givers and where inconsistent, harsh, abusive or neglectful child rearing methods have been used. It is also more likely to be found in homes where at least one parent has had a mood disorder (depression/bipolar), or other similar, perhaps more intense, disruptive disorders

Oppositional Defiant Disorder is more prevalent in males and children who are temperamental and show low self-esteem and low frustration tolerance. This disorder thrives on disorganization and is more common in homes where there have been many care-takers. Im my experience divorce or multiple mates and pregnancies out-of-wedlock frequently set the stage for this kind of chaos. Also, harsh or abusive treatment, irresponsible and neglectful parents, or significant mental illness, is frequently involved in the lives of children who show Oppositional-Defiant Disorder. Sometimes all that is necessary for the development of this problem is a clash between two parenting styles, one very demanding and the other very permissive.

Prevention or early correction

In many cases, parents can prevent these problems, they will recognize the development of this problem early and seek the assistance of an experienced behavior therapist with very good counseling and behavior modification skills. Almost always, with early intervention and treatment, the problem of oppositional defiant behavior in young children can be improved significantly.

Please pass this on to others who may need to know.

God Bless,

Dr. Tom

Monday, November 23, 2009

Conduct Disorder In Our Children and Youth

Children diagnosed with conduct disorder show a repetitive and persistent tendency to disrespect and violate the rights of others and to break normal societal rules and also laws. Conduct Disorder may be identified in children before 10 years and up to 18 years of age. It can be diagnosed in individuals older than 18 years, but only if they do not meet the criteria for Antisocial Personality Disorder which I will discuss in a later blog. Briefly, Antisocial Personality Disorder is a life-long disorder that is more severe than Conduct Disorder. The early appearance of Conduct Disorder in a child makes it more likely that the problem will continue into Antisocial Personality disorder in adulthood.

Conduct Disorder may be classified as mild, moderate or severe in nature. Frequently, children with mild cases of this disorder can be helped with therapeutic interventions and the problem may improve with maturity. Severe cases are more likely to continue into adulthood and form a long-term pattern of deeply ingrained antisocial behavior patterns that are highly resistant to change. The majority of our prison populations would be diagnosed as Antisocial Personality Disordered.

The list of actions shown by the children diagnosed with Conduct Disorder can be alarming. A partial list of such behaviors is as follows:

Recklessness and risk-taking
Curfew violations
Truancy from school
Running away from home overnight or longer
Lying, deceiving or “conning” others
Early sexual activity
Tobacco, drug and alcohol use
Bullying, threatening, intimidating and fighting
Using weapons (stones, clubs, knives, guns)
Breaking and entering homes, cars, or other buildings
Cruelty of people and/or animals
Property destruction (vandalism)
Robbery, extortion, mugging, purse snatching (while confronting the victim)
Assault and, rarely, murder

Conduct Disorder has increased in prevalence over several decades and rates are around 6% to 16% for males and 2% to 9% for females.

Suspected Causes

Many very bad childhood experiences appear to be tied to the development of Conduct Disorder. Parents who are drug involved, or have mental disorders of their own are more likely to have conduct disordered children. Research also suggests that the tendency to develop Conduct Disorder behavior patterns is genetically inheritable. Children so diagnosed frequently have experienced traumatic events, poverty, family disorganization, abuse, neglect, and abandonment. They have frequently lived in poverty and grown up around violent peers and adults. Children with a biological or adoptive parent with Anti-social Personality Disorder or a sibling with Conduct Disorder, are themselves at greater risk for developing a conduct disorder.

A Case Study

One 15 year old’s father was in prison for killing someone. The boy had visited his father in prison on numerous occasions and sometimes got phone calls from him. Despite his father’s pleadings to him to do good in school, follow the rules and stay out of trouble, the boy was failing in school, frequently suspended, and had been in a juvenile detention center for threatening and attacking other students. The boy’s mother had lived with several other men in the course of his short life-time and he had experienced drugs, violence, and the physical abuse of his mother and himself repeatedly. After frequently running away from home and being involved with older men and drug abuse, he was placed in a long-term adolescent treatment facility. The boys Conduct Disorder was severe in nature, with an early onset, and it was likely that his behavior patterns would continue into adulthood and then be diagnosed as Antisocial Personality Disorder.

We must find ways to save our infants and children from these incredibly damaging influences. The majority of these human tragedies can be prevented before their contagious effects spread throughout our population. Our current late remediation strategies are failing miserably and are doomed to fail by the very nature of this intractable psychological disability.

America must create bold preventive and very early interventions to avoid the continued escalation of the social havoc that we now experience due to our increasing rates of Conduct Disorders.

If you see the symptoms listed above in your own children, or a Friend or family member complains about them in their children, the best advice is to get professional help as soon as this behavior pattern begins to take shape. I recommend a conference with your family MD and if there are no health issues, an appointment with a psychologist with both counseling and behavior modification skills.

God Bless,

Dr. Tom

Sunday, November 22, 2009

Prevent Fetal Alcohol Syndrom (FAS)

Prevent Fetal Alcohol Syndrome (FAS)

Women who drink alcohol during pregnancy put their infants at risk for biological damage. Binge drinking among college students and early alcohol consumption among teens has increased dramatically. Alcohol consumption during pregnancy increases the risks of a newborn infant suffering from fetal alcohol syndrome (FAS). FAS often shows itself in head and facial deformities that tend to create elf-like facial features, slow growth, abnormal joints (feet, fingers, toes), heart defects, tremors and agitation in newborns, hyperactivity, learning disabilities, abnormal brain development and possible mild to moderate mental retardation.

Rough estimates of the occurrence of FAS are 1 to 2 of every 1000 babies. This figure increases to around 29 of 1000 women who heavily consume alcohol early in their pregnancies.

In general, alcohol consumption among our female population has also increased in recent decades. Guidelines for the safe consumption of alcohol during pregnancy are not clear and this has led many health professionals to recommend zero alcohol use during pregnancy.

This leaves society with three major problems: The first is that many pregnant women do not get this message. Secondly, many of the women who do understand that alcohol is dangerous to their in-utero developing babies simply behave irresponsibly: some knowingly take the risks of alcohol consumption during pregnancy. In many other cases pregnant women are addicted to alcohol and believe they cannot control their alcohol intake. Finally, and most diabolically, women may drink alcohol during that early time interval when they have not yet discovered that they are pregnant.

Physical and neurological damage caused by woman who consume alcohol or other drugs during pregnancy cannot be cured. These infants are damaged for the rest of their lives. The effects of these impairments will reverberate for at least three generations: the mother’s life, the child’s life, and the lives of the many others with whom the damaged and growing person will interact. The costs in lost human potential and financial resources of substance abuse to the unborn and society are huge and difficult to establish.

What, in general, are the costs of an impaired child through life? There are the costs of special education, unemployment, medical care and welfare. Insurance costs must increase as well as our taxes. What about the costs of crime, law enforcement, prosecution, and prison?

We seldom think about the costs to us all of the forms of behavioral contagion that I have outlined above. If we fail to control these costs to society through prevention, this human source drain upon our health and viabilitycan destroy America’s health and viability.

We must prevent FAS and other factors that destroy our children.

I am reminded of a nursery rhyme from my childhood:

“Humpty Dumpty sat on a wall. Humpty Dumpty had a great fall. All the Kings men and all the Kings horses couldn’t put poor Humpty Dumpty together again.”

The prevention of our human problems is the best and most cost-effective way.

God Bless,

Dr. Tom

Friday, November 20, 2009

Divorce When There Are Children?

Divorce When There Are Children ?

As a therapist, I find counseling with couples without children who contemplate divorce to be mildly stressful. I always want to help people to solve the problems that they are coping with.
But, with married couples without children who fail to remain together, the pain and stress to them and their families normally does not damage any children and I take solace in that. If one or both are determined to divorce, I shrug my shoulders with resignation and sadly say, O.K., go ahead.

When I am working with a married or formerly commited couple with children who fail to remain together, it is a gut-wrenching experience for me. I am pretty good at letting go of the therapeutic process when there is nothing left that I can do. But, I do everything in my power to persuade married or committed couples to consider the effects of their divorce upon their children.

Please allow me a brief fantasy.

If I were king, I would decree that no couple with children could separate before their children had graduated from high school. After all, the children did not ask to be brought into this world only to be separated from those who they have grown to love and depend upon for life, security. and normal growth and development.

In my fantasy, in this day and age of easy contraception, I would lecture to my kingdom:

"You brought that infant into the world and now it is your obligation to raise that child to the best of your ability. Your personal hopes and desires are secondary in importance to the needs of your child...and your child needs you to stay together to help him or her grow to the age of independence.
Sorry, that's just the way it is. Besides, when you were married you took an oath before God to remain married, 'Till Death Do Us Part'.
Why don't you now just commit to, 'Till Our Children Depart', and worry about the rest later.
Now, let's get to work to do the best job that you can possibly do raising your children and also find as much happiness during this process as is possible".

O.K., the fantasy is over. Don't get was only a fantasy!

The hard reality is that there are several good reasons to get a divorce, in spite of the hazards to the children involved. I am convinced by 30 + years of practice, that when children are involved, the marriage deal-breakers should only be 1. Physical or Sexual Abuse; 2. Chronic Untreatable Emotional Abuse; 3. Chronic Untreatable Infidelity; and 4. Chronic Untreatable Alcohol or Drug Addiction or Abuse.

I believe these family problems normally put children at greater risk for harm than a divorce.

But for all other cases that include children, there is a moral responsibility to the children involved and to society to enter marriage/couples counseling and to try as hard as possible to improve the existing problems. Reasonable estimates of improved relations in couple's relationships are between 60% and 70%.

If you are considering a divorce or terminating your relationship with your partner, and you have children, stop and think about what will happen to them. I ask that you please have the courage to study the following links and then protect your children with all of your might.

This first link describes the harms that are likely to occur to your children.

This second link describes the harms that accrue to society when marriages or couples with children break-up.

God Bless, Dr. Tom


Thursday, November 19, 2009

Protecting America's Children From Abuse

Protecting America's Children From Abuse

One of the most difficult problems we face is the physical and sexual abuse of America's children. The effects of these damaging experiences on children can ripple through at least three generations as its contagious effects stress our mental health, educational, welfare, law enforcement, and our prison systems. The social costs in the form of psychological harm to our population and tax revenues consumed are huge.

In all 50 states, we are required to report child physical and sexual abuse to the appropriate authorities. It is essential to call your regional Child Protective Services Agency (CPS) if you have an honest fear that any child you know is being abused, including your own.

It is very easy to turn away, to assume that someone else will take care of the problem, or that despite your real concerns, abuse might not really be happening. But children cannot protect themselves damaging abuse and it is not our responsibility to determine if abuse is truly happening or not. That is the responsibility of CPS.

It is very difficult to report abuse by members of our own families. Sometimes good people feel that they have found a way to protect their own children from further abuse and feel that the matter can therefore be closed. But the problem is not closed. The abused child may need counseling to minimize their harmful experiences. Furthermore, the abuser will most likely go on to abuse other children. Continued abuse of other children is virtually certain with those who are sexual abusers: whether they be adults, teens, or older children.

It is important that we understand that:

  • We are required to make a report.
  • If we honestly make a report of our fear for a child's welfare, this is called "good faith" and we are protected from prosecution.
  • If we fail to make a report, we can be prosecuted through legal or civil action.
  • We not only have a legal obligation to make a report of child abuse, we also have moral obligation to do so.
America's children are as precious as they are vulnerable. We must protect them.

Please go to the following link to learn more about the legal requirements that we all report suspected child abuse.

Dr. Tom