Barb and Jeff were in my office. We were talking about their relationship and all of a sudden Jeff became very stressed and angry. He tensed up, clenched his jaw and I thought he was going to slap someone. He held his hand tight in my office. Barb was angry too, but her response was different. She began to tremble, started crying, and then said, “I know, I am sorry. This is so difficult.” Looking at the two of them, I was more supportive of Barb, mostly because her emotion makes me feel sympathetic to her. I am a trained psychotherapist so I knew Jeff was hurting just as intensely as Barb but his way of expressing it appeared more hostile and made me or anyone watching him want to get away. Whose fault is this? Why did Jeff react so hostile and Barb so remorseful? It had little to do with intention, but everything to do with their brains and how they are wired.

The most recent research proved through functional magnetic resonance imaging (fMRIs) that the blood flow during stress or anger is very different in men and women. When the scans were completed, neuroscientists consistently found differences between the men's stressed-out brains and the women's. Men responded with increased blood flow to the right prefrontal cortex, responsible for "fight or flight." This is part of the reason Jeff had a need to escape, or do something physical (clenching his jaw, getting tense, holding his arm). Women had increased blood flow to the limbic system, which is associated with a more nurturing and friendly response. This may be part of the reason Barb began to cry and saying she was sorry. Of course environment, the way Jeff and Barb grew up, and their genetics also have influence on how they will deal with stress and anger.

When couples are stressed, whether it is due to financial problems, marital infidelity, or a sick child the adrenal glands produce more adrenaline and cortisol. This is released into the blood stream and speeds up the heart and makes them breathe faster. It also increases their blood pressure and makes them ready for an attack. Most domestic issues don't need the body to be ready for attack, but it is automatic. If it happens frequently with couples it can lead to heart disease and other physical problems. Although this "fight or flight response" happens when the person is extremely upset or stressed, there is also a very low level of stress that can go on for a long time. This too can lead to the person feeling overwhelmed and the body's immune system can be weakened. Couples need relief from stress, and they need a plan to deal with everyday issues that cause anger, frustration, and life's ups and downs.

Tips for couples to deal with stress.

1. Talk about it to each other when you aren't stressed.

2. Write down ideas you can do to help calm your partner when they are stressed. For example, when your partner says they are afraid of losing their job, talk softer to them, tell them you “love them no matter what, and will work it out as a team".

3. Learn to breathe in slower and out even slower. This looks like this: Breathe in to the count of 4 and out to the count of 7. Do this 5 times before you do any action (more if you are prone to physical expression of anger).

4. Go for a quick run or fast walk.

5. Take a nice hot bath with nice smelling bath gels (the olfactory center is known for helping to calm the body with scents such as lavender). Whatever you do, try to calm down before talking or acting on your stress or anger.

MJo

The one area that most couples do not explore before they get married is how to fight. It may seem derogatory or somehow cynical to focus on how you will fight with each other when you are beginning a new life together, but nothing could be further from the truth. Learning to fight fair has health benefits as well as emotional benefits.

Happy couples fight as much as unhappy couples. The difference is that happy couples "fight fair". They are able to clear the air and feel closer after the argument. Nothing is more uncomfortable than being around a couple who doesn't fight fair—you feel embarrassed that you are witnessing something you should not be. Imagine if you are married to someone who doesn't fight fair. Each fight or argument leaves you feeling humiliated, abused, and shamed. If you think you are one of those couples, the suggestions below may help. If you and your spouse fight fair congratulations!!! You have already secured your relationship from one of the main reasons couples get divorced.

Tips for Fighting Fair

1. Use "I" Statements. "In other words, I feel this way when you do that" or "I became so angry when you said this or that". When you use "I" statements you take responsibility for the way you feel and this helps your partner not to feel attacked. This prevents the fight from getting worse because your partner doesn't become defensive.

2. Keep the communication open. This doesn't mean you agree with your partner, but it does mean they have a right to their opinion. There are more ways to do something than your way and acknowledging this helps the other partner soften their stance.

3. It is not you against your partner. You are a team. Attacking your partner will build a huge wall and you leave your partner no choice but to defend themselves.

4. Give a signal for time out. If it is your time of the month or if you are stressed with work, it is okay to give a signal you both come up with and postpone the argument or discussion. In fact, sometimes this may solve the problem because you have the time to cool down and think.

5. It is a myth that you have to make up before you go to bed. Whoever started that advice must have enjoyed late night TV on the sofa. Sometimes sleep and letting your unconscious deal with the issue gives you new insights in the morning.

6. Most of us learned how to argue by watching our parents. If your parents set a poor example, make sure you agree with your partner to not repeat the cycle. Go to classes, get counseling, read books—most of us are smart enough to change old patterns that aren't working. Remember that it takes both people to agree that this is an area of importance and a mutual desire to set a better example to their children.

Anger is one of the most passionate and honest of all emotions. Dealt with in a healthy way, it can stimulate the marriage and deepen its bond. Dealt with poorly you risk losing your spouse and/or children and creating a miserable marriage. All new behaviors take practice on step at a time.

MJo

The government and every advertiser understand that we are all afraid. You know this because you watch TV and I read the newspaper; most of the stories and commercials are centered on our fears. Our fears are growing old, losing our children to drugs or alcohol, losing our job, or maybe being sick and having no medical coverage. Our fears of getting obese and losing our sense of esteem. So many fears and all of us, every single one of us are being affected. I see my own, I see yours, and so I write this as a reminder to myself and you that we DO NOT have to be controlled by our fears.

Most of what we fear never happens. When it does, it is the "tape" we tell ourselves that scares us most. We say "If that ever happened I would kill myself or shoot someone". This is "crazy talk" and although we don't mean it, we say it, and it scares us. A lot of my work is teaching patients how to "re-tape" their own fears. Below are some examples to get you started. You can chose any topic and walk yourself through a plan. The best way to overcome fear is to have a plan or a tape that you can recite. This is my personal tape and it works well if you can recite it frequently: "No matter what happens, I will deal with it".

Sample Fears

• Being without a man. This sounds trivial but many women fear this. They tell themselves that they will never have a husband and children and will grow old with no one to care for them. They know it is not rational but they are still terrified.

Overcoming this fear:

First write down exactly what you are afraid of (eating alone, shopping alone, sleeping alone, etc...). Now begin to focus on doing those things you have said you are afraid of. Go shopping alone and enjoy it (add whatever you need to in order to make it fun). Eat alone (go to a fancy restaurant and enjoy each bite, look great when you go). The idea is to practice these things you are afraid of and overcome them. Not all at once.

Next begin to re-think being single. What have you told yourself about being single? If you made it negative, begin to look at the positive aspects (no abuse, no divorce, watching what you want) and always think of how you can get your fears conquered in a healthy way. If you don't like to eat alone, invite someone to go with you. Or have a party. If you want children, baby sit for your friends; make someone happy by reading at a school or volunteer for a boys and girls club.

• Gaining weight

Overcome this fear:

Write down exactly what you are afraid of (your eating is out of control, you will not be able to date, you won't be able to walk, you will be teased). Now begin to focus on doing the things you are afraid of. When you eat, take more control by having smaller plates, eating at home instead of fast foods, plan what you are going to eat. Have "cheat food" (carrots and celery) available at all times. Begin to go out on evenings. Put yourself out there—join on line dating, go dancing. Begin to walk and WALK EVERY DAY. What do you notice when you walk? Think of "come backs" when/if people do tease you. Write them down. Practice with delivery. Be assured that you are taking care of yourself. You are being your own advocate.

Next, begin to re-think what you have told yourself about being overweight. What words have you called yourself or heard people say to overweight people? What did your parents say to you when you were overweight? Write them down and get them out of your head and on to paper. Don't lose weight for others, lose weight for yourself. Don't focus on a size, but on an activity you want to be able to participate in once you lose weight. How can you help yourself or others going through the same struggle or fear? Participate in support groups, volunteer for a Children's Obese Camp, join or organize a "walkers group". Get active.

The key is to write the fear down and then come up with at least 5 things you can do for each of those fears to alleviate them in a healthy way (this usually means serving/helping others with the management of your fear).

Fear thrives on inactivity and talking about your fear. It cannot thrive on writing down elements of the fear nor can it thrive if you become active. Chose a fear, and begin to act on it today!

MJo

Many of my patients find out many interesting things about themselves after weight loss surgery or any other major health transitions. As they become healthier they realize they are in a relationship which is no longer healthy but that they are dependent upon. Their main concern is how they will make it financially on their own. To stay in a relationship for any other reason than love or commitment to the family is not recommended. This is especially true if the relationship is humiliating, demeaning, or abusive (physically, verbally, or sexually). Due to the fear of poverty, many will avoid taking actions to get out of the relationship. Their children are exposed to abuse throughout their childhood and many times go on to live a life exactly like what they experienced growing up. At some point one must decide to make it on their own to save themselves and their children.

How do you know if you are in a good relationship that just needs a little bit more work or a relationship that is not healthy? Here are a few questions to ask yourself to help you evaluate your personal situation.

1. Is money the only good thing in your relationship?

2. Do you spend most of your day worried about money, bills, and expenses?

3. Does your significant other threaten you with "cutting off money" or support?

4. Do you feel humiliated or abused in regards to your lack of contribution of money to the relationship?

If you answer yes to any of these, you have a red flag in your relationship. Make a date to talk to your significant other in regards to how you feel about this. If you are the primary breadwinner and your partner is draining your savings account as soon as you make a deposit you MUST talk about it. Relationships are a two way street. Many people avoid dealing with relationship issues and medicating with food, alcohol, or drugs. As we become healthier we realize these methods are all inadequate in dealing with the situation of financial security in a relationship. Get active. Write down your concerns and make a date with your partner today. Get the issues out in the open so you can begin to tackle them one step at a time.

MJo

"But man is not made for defeat. A man can be destroyed but not defeated."

--Earnest Hemmingway- The Old Man and the Sea.

Life can be cruel. If you watch the news you see heart breaking stories and you ponder the purpose of life. For so many there is not purpose. They see their life in days they have to get through.

Although life can be cruel and bad things can happen, people can be incredible. They can be honest, inspiring, selfless, and tireless for a cause. People make the difference in life. I have worked with people who have lived a life of shame, abuse, rejection and isolation and, yet, they live their life doing good for others, being helpful, and giving more when many of us hold back. What makes this difference? Why are some people undefeated no matter what happens while others “throw in the towel” with the least bit of frustration? I would like to say it is the way you are raised, but this has not proven true. Parents do affect how children grow up, but some children grow up with nothing and still give everything. I think the difference is that people that feel a need to be better and find a purpose have a faith that many of us cannot comprehend. They believe in something much bigger then themselves—whether that is God, a cause, or a principle they embrace it and live their lives in a manner that will manifest the purpose.

How can we be more like those kinds of people? We must begin with finding our truest sense of what it is we want to accomplish here on earth. We have to begin to tell ourselves every day that we are here for a limited time. We must quit thinking of owning our lives and think more about giving back our lives.

A few tips to finding your purpose and living a more meaningful life.

1. Find one area that you believe you can improve. This should be something small that you think you can begin and finish. Small steps will lead to big ones and completing small ones builds confidence as you focus on larger ones.

2. Take one risk every day. Feel that risk and tell yourself how proud you are of yourself for doing it.

3. Make a dinner and have others over. It doesn’t have to be a big dinner, it can be simple (chips and drinks). You are doing this as a way of listening and serving others. It is one of the easiest and most tangible ways of getting people out and exploring new ideas.

4. It is human nature to focus on the bad or terrible news, but that helps no one. Begin to focus on one good thing that has happened to you and/or another and repeat to yourself at least three times a day “thank you for letting that happen”.

5. As much as is possible focus on today. We get stressed about what commitments we have in the future, but life shows us there is no guarantee of a future. Do what you can today to make a difference.

What a difference we can all make in one day. One day is forever!

MJo

When I was in college I remember having more girlfriends than I could count on all my fingers. These friends were close to me. We shared each others’ lives, problems and joys. Suddenly, as I got older and married I noticed I began to take less and less time to spend with my girlfriends. A recent study conducted by Duke University and the University of Arizona proved that women today report having an average of only two close friends and 24% reported that they had no one they could confide in. This feeling of isolation can lead to depression or worse. We know that a lack of friends can lead to heart disease, cancer, depression and anxiety. Overall, the quality of life is lessened when we are lonely or don’t have any close friends.

Female friendships are so important because they provide a source of close, effective communication which is essential in raising healthy families. Many of my best friends have become even closer with raising children and being married. My friends have provided me with a sense of support and security that my husband could not provide (I need both and so do you). Women give more and therefore expect more from our friendships than men do. We know we can be vulnerable and honest with each other and that vulnerability will be protected with our friends. Women also have a tendency to hold on to their friendships longer then men do. Women feel very hurt when they lose a friend even if that friend wasn’t honest or lied to them.

Women get busy with children, parents, husbands and work, but an area they should never skimp on is maintaining their friendships. It appears to be more significant to women’s overall health than for men. It may be something as simple as setting a date and keeping it for coffee or perhaps even planning a weekend away at a spa. No matter what you do, don’t let the relationship go because you don’t have time. You may lose more then a good friend.

Tips to Maintain your Friendships 1. Be there when it counts. When one of your friends is going through a tough time, on thing she shouldn’t have to worry about is whether will be there. What I remember most about my miscarriage was that my best friend came and just held me. She didn’t say anything just held me and let me cry. This meant more to me then the flowers, calls, or anything else my acquaintances did for me.

2. Friendships change so allow your best friend relationships to change. Being best friends doesn’t mean the relationships will be the same forever. Your relationships will change after high school, college, and marriage, but the love for each other will continue.

3. Make dates to connect. It may take writing things down in your schedule book or blocking your schedule, but take the time to connect and visit. Friendships take nurturing. If you begin to take the relationship for granted and don’t make the time, it will make her believe you no longer value it.

4. The only thing worse than not making a date to get together is “flaking out” on the date. If you make a date commit to it and make sure show up. Much better to meet for a short time than not at all.

Nothing is more symbolic of how you lived your life than being an old woman still very much connected to your girlfriends. Women need other women to mentor, learn from, heal with, laugh with, grieve with, and celebrate being a woman with.

MJo

A common conversation that I am always involved in when I dine with girlfriends is their inability to realize there are multiple good men who want to settle down, marry, and have kids. My friends and co-workers get angry at men. They feel they are misled and used when in fact the opposite is usually true. My friends make a mistake with their thinking and they lead themselves down a path of misery. Julie is a perfect example. She has dated the same guy ever since I have known her. I like this guy—he is funny and always generous with a hug and warm big smile. The problem is Julie wants him to settle down and be the daddy for her children. This is not going to happen now and most likely never. Julie’s boyfriend is not that kind of man. The guy is honest and he tells her directly he doesn’t want to get married or settle down. I don’t think Julie hears him. She keeps saying her name with his last name and asking us how it sounds. It sounds like heartbreak to me.

Julie is not ready to take my advice or anyone else’s. She sleeps with her him, he lives with her, and works when he wants to. He has it made except for one pesky problem…he doesn’t want to marry her and he knows it is going to be messy breaking up with her. So he doesn’t and they remain together.

This is a common problem for therapists to see. We basically confront women like Julie with what we see. Sometimes they get it and leave and find someone who can love them and settle down. Sometimes they end up getting pregnant and having a child who grows up without a dad in the home. All of these situations are so painful, but preventable. If you want to settle down and start a family then find a partner who wants the same thing. Quit deluding yourself that the playboy you are currently with is going to change. You are wasting your time and your ability to love someone and get love in return.

Signs to Look for in a Man who is Ready to Settle Down with You

1. When a man is ready to settle down with you he no longer needs to hang out with single guys. He stays away from parties and exchanging phone numbers with other women.

2. A guy who is ready to settle down takes his work more seriously and rarely goes to a bar or club after work.

3. A guy who is ready to settle down with you is looking toward the future. He has a savings plan as well as a vision for where he will put his investments. If treats his truck better than you then he may not be ready to settle down.

4. A guy who is ready to settle down with you usually begins sharing his future goals with you. Where does he want to be working in 3 to 5 years? How does he see the relationship he has with you? If he tells you “Lets just see where this relationship goes” then he is not ready to settle down with you.

5. A guy who is ready to settle down with you is kid friendly. Watch how he treats kids. Is he angry with them, or patient? Not everyone who gets married wants kids but be sure you know this prior to marrying them.

Write down what you want. If you put getting married on your list, then date men who are ready for this step. It is not okay to curse men just because they did not want to get married to you. Take responsibility for your choice of men you date.

MJo

Many couples are struggling right now during this economic crisis and it seems like there is no end in sight. I was raised in a very poor family and I remember the “money arguments” my parents used to have. It affected me as a child. Children at this age are more insightful than adults give them credit for. They are very sensitive to seeing the main adults in their life upset or unhappy. They do not like marital discord and feel insecure when parents fight.

Children are happiest when parents sit with them and discuss what the family is dealing with and how everyone can help. A child often times feel like they are too little to help with “big issues”. But, a wise family understands the importance of everyone feeling responsible in a family. Your small son can understand what is going on (in 6 year old language) and how he can help. He needs to be empowered by you and your wife asking him what he feels he can do without in order to cut costs. He also needs to be complimented on his ability to help.

Tips that will help you talk with your six year old and use tough times as a great opportunity to bond!

1. After dinner the three of you sit down and come up with three things you can give up or quit spending on in the family.

2. Make a menu so you can begin to make meals at home instead of going out to eat (this will benefit your son as he will learn healthy foods as well as spend time with the two of you).

3. Set small realistic goals. For example your son can begin to do odd jobs around the house to earn money toward a family vacation or a new catcher’s mitt.

4. If you have increased anxiety or depression go to the doctor to assess your medical health as well as emotional. Ignoring a problem with depression or anger will not make it go away.

5. Learn a new coping mechanism. Instead of fighting maybe you and your wife can turn on music and dance to a song. Children love to see their parents happy with each other.

MJo

I think cheating is the single worst thing a married person can do to their partner. It has the power to destroy the marriage, damage the kids (forever), and it touches everyone you knew as a couple as well as anyone you knew independently. It is like herpes; it never goes away but with age and the passing of time you learn how to better manage it. Couples who try to repair the relationship after the affair have an opportunity to actually make their marriage better. There are several myths in regards to cheating that couples find out can be proven untrue. The first of these is once a cheater, always a cheater. The best predictor of future behavior is past behavior but not always in regards to cheating. The second myth is that all cheaters have a terrible marriage. Although this may apply to how you feel about your marriage, not all cheaters do have an unhappy marriage. A few of them actually love their spouse and their marriage and cheat on the side. A third myth is that you need to know every detail about the cheating to heal. Often times this will not help you heal but will be a constant reminder for you of what your husband or wife did and it will actually make healing more difficult.

Is it possible to heal after cheating? YES. However, it is not possible for everyone to heal after cheating. Before you begin a long arduous journey of counseling, have a heart to heart talk with your spouse in regards to why you both want to salvage the marriage. If you are one of those people who cannot forgive the affair or if your partner is in love with the person with whom they had the affair, your chances of healing the marriage or relationship after cheating is poor. Many times affairs happen to couples who have a history together. Couples who share a long wonderful history that involves children, numerous family members and thousands of friends may decide to salvage their marriage after an affair. If you are in this category or more inclined to believe you could work with a partner who had an affair, here are some helpful hints for you.

Tips for healing your relationship after an affair

1. The time for honesty was before the affair, but since you weren’t, there is no room now for anything but honesty. You need to sit down with your spouse and talk about this. Is the affair over, or are you still in love with the person? If you still love them are you willing to cut off all communication to work on the marriage? This is a deal breaker and needs to be done before anyone can continue to work on the marriage.

2. You both need a support system. Whether this is church, marriage counseling or signing up for one retreat a month you need to have this in order to heal the infidelity.

3. You need a time commitment for how long you are going to work on the relationship. I usually suggest 6 months (it will actually take years to get over it) with intense counseling and making immediate changes within the marriage to stabilize it. These changes may include moving the computer to a central level of the home, changing cell phone numbers, changing jobs, etc.

4. This sounds like something someone would tell you from church because it is in the Bible and every religious book I know .You can only heal if you can begin to forgive each other. No one lives in a vacuum, especially one’s spouse. When one spouse is cheating the other spouse knows it whether or not they chose to deal with it. Many times the non-cheating spouse will medicate with food and gain weight, or alcohol and become a drunk. Although this doesn’t help them with the cheating spouse it does help them stay numb and enabling to the cheating spouse.

5. Lastly, you need to think of the family. Who will benefit if this marriage stays together? Who is damaged if this marriage stays together? There are cheaters who cheat due to an unresolved issue from their childhood. If you think you can cure this…you are dreaming.

If you have been cheated on I am really sorry. For anyone who has ever cheated I am really sorry too. You have the ability to make this an opportunity to grow closer in your relationship while healing from an affair. Take your time to reflect about everyone involved before you throw him or her out.

MJo

Back-to-school ads are everywhere. We are preparing our teens for college entrance exams. We are talking to them about their future. Where should they go to college? What do they want to study? These are important questions, but don't forget to talk to your children about confidence. Many parents believe confidence is something with which you are born. You either have it or you don't. Nothing could be further from the truth. Confidence is a skill you can teach your child in just a few weeks.

Tips for teens

Teens starting this exercise with low self-esteem should remember to act like they are confident, and eventually they will feel confident. Here are six things to practice:

1. Make eye contact with others. Practice by talking to the mirror and looking at yourself.

2. Stand up straight and you'll project confidence. Watch TV news anchors — they always have perfect posture.

3. Be willing to put yourself out there to meet new people. This may be difficult for shy teens, but remember, you are just acting.

4. Smile. Not only will you disarm others, but it's an instant mood booster for you.

5. Stay in control by preparing for events ahead of time. That big test coming up? Schedule study time. If you break down big projects into small steps, you can handle the biggest projects in a timely manner.

6. Don't be a doormat. Don't go along with stupid, risk-taking stunts to be accepted by others.

Tips for parents

1. Every teen wants to be popular. Popularity can make most teens feel insecure and doubt themselves. Have an honest talk with your teens about how they view themselves, what they expect from friends and what they want their school years to mean to them.

2. Volunteering is a wonderful way to help your teen learn confidence-building skills. There are churches, assisted-living homes, day cares, parks and nonprofits looking for help.

3. Get your child involved in extracurricular activities. Nothing builds confidence better than having your child surrounded by other people with the same interests.

4. Go over your teens' homework plans for the fall. They may act like they hate it, but teens need their parents' involvement to be academically successful.

5. Your child will feel more confident if he or she looks the part. Look at magazines together and decide which clothes will flatter your teen's body. Help your teen understand the role of clothes in a first impression; how your teens dress will affect how others treat them.

MJo