My parents are 77 and 87 years old. My mother has moderate stage Alzheimer's disease. My father, though 10 years older, is generally in good shape.  They are currently in an Assisted Living Center where they have been sharing a room. As my mother's Alzheimer's has progressed, she is more disoriented, her balance is worse and she is experiencing some toileting issues.  The administrators at her current center are recommending that she move upstairs to the locked memory unit. There they can keep closer watch on her, provide activities geared towards her level and keep her from falling.  My dad is devastated. While they have offered for him to move to the unit with her, he has declined because it is too painful to see so many others in the final stages of the disease. He maintains that he watches over her and cares for her.  Our argument has been that we want him to stay healthy and not get sick and it's too much responsibility.  His retort-"What else do I have to do?  If I die from taking care of your mom, that's OK with me."

I watch my neighbor with Parkinson's. He is 77, wobbly on his feet but walks with quick determination. He loves to work in his yard. His kids- who live out of town want him to stop because they are afraid he will fall and hurt himself. As I watch him outside every day, I imagine that if he fell and hurt himself or even died doing yard work, he would die happy.

As an adult child, I want to do what's best for my parents.  I want to keep them safe and protect them from harm. As they age, their bodies sometimes take them back to a metaphorical childhood where they need to be "watched" by their own kids.  As I have experienced this process myself, I struggle with the balance of "watching my parents" to keep them safe while also allowing them the independence and right to have some control over their own life.  I worry that if I take too much control to keep them safe, I might rob them of their will to live.

There are no easy answers. It truly is a matter of balance but through this process I better understand how important it is to consider the wishes of the aging parent and respect their wishes as much as possible. I did this with my parents, moving them to another facility where they could live together and my dad could tolerate the other not as advanced patients in the memory wing. It certainly wasn't the easiest solution but it was a compromise that respected his wishes while assuring their safety.  Sometimes I hear of adult children who make arrangements for their parents solely to meet their own needs.  I hope that this message can help temper these types of decisions.

This and many other life transitions, can be discussed with the therapists at Wellspring Center.

This week I will be blogging about a topic that is very near and dear to my heart, infertility. This week, from April 20-27, marks National Infertility Awareness Week.  For those who are officially considered infertile and are going through the roller coaster journey, they are very aware every day that they are facing this experience.  For couples who are beginning to struggle or suspect that they may have difficulty conceiving, this may stir up some hard feelings or questions.  My hope for everyone is that this week can bring to light the resources, education, and support that exist for this journey.  Infertility is defined as not being able to conceive a child after twelve consecutive cycles of regular, unprotected sex.  In the United States between 10% and 15% of the population struggle with infertility and that number is growing.  Infertility, when a specific cause can be found, can be related to factors occurring in both males and females.  In fact, about 30% of couples’ infertility is male-related, 25% is female-related, and 35% is related to both partners having fertility complications.

Now that we have a few of the numbers, let’s talk a little about its emotional impact.  It’s pretty common knowledge that infertility incurs major financial costs with treatments or adoption coming with a price tag of several thousand dollars.  However, the emotional pain experienced by couples facing infertility is equivalent to that experienced by people facing cancer and chronic pain conditions.  It is a roller coaster of anticipation and devastation.  At some points you may have to live as though you have conceived, watching what you eat, drink, or do, only to follow it with the letdown of a negative pregnancy test.  This emotional pain can be difficult for some to handle and can potentially cause trouble in almost all aspects of your life.

You may want to talk to a therapist about fertility if any of the following apply:

• You feel sad, depressed, worried, or anxious (including panic attacks) most of the time
• You are having a hard time functioning at work or in everyday life
• You and your partner aren’t on the same page about how to try to grow a family
• You avoid events with family and friends  or being out in public because you find it too difficult
• You are facing egg/sperm donation, surrogacy, and/or adoption
• You are considering a childfree life

Infertility can be a difficult journey but you do not have to do it alone or without support.  Additionally, you do not have to wait until you feel completely overwhelmed to speak to a therapist about your journey.  A therapist can assist you in processing your feelings regarding infertility and developing healthy coping skills for the experience.  For further information I recommend the American Society of Reproductive Medicine and RESOLVE: The National Infertility Association.

Can we all be as new age as Gwenyth and begin to call our divorces "Conscious Uncoupling"?  What exactly does that mean? I did a little research on Goop, Gwenyth's site and read the information from Dr. Habib Sadeghi and Dr. Sherry Sams to understand the terminology and to see if it is a concept that might apply to those of us in the "regular" world.

According to Drs. Sadeghi and Sams, the theory is based on the idea that our life expectancies have dramatically shifted over the last few centuries. When people only lived to 50, it wasn't unreasonable to expect a marriage to last a "lifetime" but with life expectancies into the late 70's and 80's it might place "too much pressure" on couples to expect to be with one person for 50 or 60 years.

That information combined with a natural shift in the nature of marriage, can cause conflict. According to the Drs., the first part of marriage is filled with idealization where each partner projects their positive thoughts on the other. Once the "honeymoon" phase is over and reality sets in, partners begin to project their negative projections on each other.  My sense is that means that we see the flaws in our partners and these flaws may trigger old wounds that we have within us.  Partners may tend to blame each other for these imperfections and feel disappointment in the expectation that the other isn't perfect or they can fix the old hurts within. This causes resentment and anger and if the marriage falls apart this is magnified by grief and a sense of failure. Often this is where the divorce process begins.

The idea behind Conscious Uncoupling is to view this process not as a failure but as a natural step in our own personal progression. Instead of shielding ourselves from others and our former partner, the idea is for each of us to "evolve a psycho spiritual spine" that will support us internally regardless of what the environment or any particular partner throws at us. Moreover, it asks that we look at our partners as teachers who have been sent to help us look at and begin to heal our own hurts. Rather than resenting your partner, this concept asks that we thank our partner for the gifts they have given us to help us along on out personal journey.

While I'm not sure that I agree with the evolutionary impossibility of being with the same person for 50+ years, one can't deny that they divorce rate is at 50% or over. For those couples that choose divorce the concept of Conscious Uncoupling is a nice theory.  I agree with the assumption that many divorces are the result of unhealed wounds that are not properly "tended" by a mate. Often the spouse has no idea why their partner is so angry with them and the partner may not even be aware that old childhood hurts are being triggered by the behavior of the spouse.  One of the benefits of couple's therapy is that both partners can become more aware of their own hurts and how they are triggered by their partners. This can result in self growth but it is also possible that once a spouse is aware of the hurts they are triggering, they might be more compassionate in the relationship.

Yet it is true that sometimes this doesn't work and divorce is inevitable. In these cases it would be nice to see the relationship as one step in a personal journey to inner strength. That would be a nice way to think of an ex-partner, especially if there are kids involved in the split. It is respectful and honors the strength of both partners in the relationship. I have met some couples who might be able to do this in the initial stages of a divorce. These couples are usually well grounded, confident people who have the best interest of their children in mind. They consciously do not want to fight and understand that their continued conflict will only further harm the children.  As a therapist who sees both children and adults, I have seen far too many children who would have survived the stress of their parent's divorce without harm, had the parents treated each other respectfully after the relationship ended.

Sadly that isn't the result that I usually see. The idea of Conscious Uncoupling requires individuals to have a great deal of self awareness and to have the ability to see beyond their emotional pain to ways they can use their hurt to improve themselves and not focus on the flaws of their ex. Often this process requires individual therapy but it is possible and it is a noble goal, both personally and for the sake of any children in the relationship.

In conclusion, while I don't necessarily agree with the underlying assumption that humans weren't made to stay in one relationship for their whole life, I do think that in situations where divorce is inevitable, Conscious Uncoupling is a nice goal for being able to move on personally and to help the children of the relationship. Thinking of the ex as a teacher is a nice concept but in my experience, for. most people this will be an end point through a hard process of dealing with hurt. If Gwenyth and Chris are already there, more power to them!

Given the mysterious loss of the Malaysian plane, flight 370 and the disaster of the Oso, Washington mudslide, grief appears to be multifold for the countless survivors of both of these incidences.  With all of the grief work that I have done and will do with clients, I have found that we as humans are not very good at experiencing sadness.

Most people who are grieving don't know that it is appropriate as well as okay to experience a certain amount of sadness when it comes to the loss of a loved one.  The reality is it doesn't even have to be just the loss of a loved one that allows for grief to come into our lives.  The loss of a dream such as a marriage or a job or a relationship, giving up an addiction, infertility, being diagnosed with a disease or chronic illness, as well as disasters such as the missing plane and mudslide, can and do, bring on grief and sadness.

Most people are not even sure what grief is.  Kubler-Ross, one of the most prominent psychiatrists to research death and dying found that grief was made up of several stages: shock, denial, anger bargaining, depression and acceptance.  One should realize while this may well be a process, it isn't necessarily a time sensitive one.  Each stage can last for days, weeks, or many months; with the whole process of questionable length.  It is even possible to jump from one stage to another stage or even back track to an old stage. I had a former grieving client who used to ask me periodically which stage I thought she was in that day.  Of course, I would ask her which stage she thought she might be experiencing.

I explain to my clients that grief work is similar to the waves on the ocean - just when you think one sad feeling is gone another one will wash up into our "feeling brain" and hit you and almost knock you over like a wave washing ashore.  You might ask yourself, "Wow! Where did that feeling (wave) come from?" Most people think they can and many do work through these stages without professional help.  Most people think if the sadness lasts too long then they must be depressed and must need medication.  What most people don't understand is that grief is a process, one that we must work through, and short cuts like ignoring the grief work through denial or medication can prolong the process.

A grief therapist will usually have you talk about what has happened in your life to bring about this sadness.  Sharing your feelings with others through talking, writing or artwork can help you express your sadness.  The basics of eating well, sleeping enough hours each night and regular exercise will contribute to a strong body so that you might work through the sadness and stages of grief.  Of course, seeking medication from a reliable doctor is always an option too.

If your grief seems to be too debilitating and you are not able to work, play, associate with others such as family or friends, then you might want to seek the help of a professionally trained therapist.  Go to www.therapistlocator.net to find a therapist close to your home who can help you deal with your loss.

It’s that time of year again.  NCAA March Madness, the potential for pleasant weather and at the forefront of most school kids’ minds, spring break.  Spring break is not just an opportunity to try and hit the beach before summer arrives.  It is a time to re-energize, get necessary down time, and release stress.  When done right spring break can give the academic, physical, and emotional lift your child needs to get through the remainder of the school year.

Since the beginning of the year several circumstances have led to increased stress for students.  The uncommon winter weather had many students either delayed or away from their usual routine.  The state of uncertainty and chaos has been difficult for everyone, but especially so for younger children who need a routine environment to thrive.  Also, many students are coming out of classrooms where more academic information has been squeezed into a shorter period of time and standardized tests or midterm exams have recently been completed.

So how can you help your child maximize the potential benefits for this well needed break?  Here are a few ideas to try whether you are spending the break at home or on the road.

1.      1.  Decompression Day- Allow your child to have a day, preferably near the beginning of break, to relax and do not plan any activities for them.  Encourage them to choose activities that they would enjoy without setting expectations for them.  Conversely, if you have an activity packed day, fun or otherwise; give your child a day or two before returning to school so they aren't exhausted that first day back.

2.      2.  Meet your Introvert/Extrovert’s Needs- Depending on your child’s personality either arrange for them to have 15-30 minutes a day of quiet alone time if your child tends to be more of an introvert or one entertainment focused activity with friends or family each day if they are more of an extrovert.  This will help your child to recharge their batteries.

3.       3.  Do Something New or Be Funny- Each day try a new activity with your child or engage in an activity just to be silly/funny.  Both of these release natural chemicals in the body that boost mood and keep your immune system working well.  This could be as complex as trying a new indoor/outdoor recreational activity or as simple as having a dance contest among family members and trying to eat spaghetti with only a spoon.

If your child can get the break they really need then they will be in the best position possible for the demands being placed on them.  This makes for a more pleasant experience at home and in the classroom.   

Many of my friends and family members are approaching retirement. I turned 60 last year and my husband and I are facing this new stage of life together. But it seems to me that even if we have known this is coming for years, we seldom talk about anything except health insurance and money. Yes, these are two very important issues that will greatly impact our security as we age.  I also believe that there are more fundamental relational issues and personal hopes and dreams that need to be shared first for these projected needs to be accurate.  

Do you really know if your partner wants to earn money after retiring from their primary career? Are they happy with your vision of what those normal days might look like? Do you know if your children would be open to caring for you in their home if you became disabled ? Is your bucket list similar to your spouse's or very different? Are you happy in your marriage since the children have left the nest?

Many of these answers will determine what you need for insurance and money in your later years. You may be very sure what is appealing to you, but what about your partner in this life?  They are headed into a new stage as well and may ask for compromises to be made. If your children and grandchildren are an important part of your plans, talk with them about your vision.  Do they support your goals for the entire family and any legacy you wish carried forward? 

After spending twenty years talking with spouses, children and many people in relationships, I highly suggest you do not make assumptions without direct conversation. Many folks are taken by surprise when they find their spouse or children are not happy with their decisions regarding retirement. If your family has a difficult time talking honestly together, find a Licensed Marriage and Family Therapist to mediate this private, important conversation. Go to www.TherapistLocator.net to find a therapist close to your home who could help you and your family look forward to this wonderful stage in life that you have worked so hard to enjoy. 

If you are a parent eyeing the upcoming weather forecast and feeling somewhat queezy, know that you are not alone. The snow, cold and ice of the Winter of 2014 has taken it's toll on parents.  Complaints like "I just can't seem to get into a routine" and "I can't get anything done" are common given multiple snow days and two hour delays. For some, this is a minor inconvenience but for others who are already impacted by the lack of sunshine and indoor confinement, it can lead to depression and anxiety. This combined with the stress of having housebound children can lead to conflict and snow days that feel endless.  Here are some ideas to get you through the next and (hopefully last) round of snow.

1.  Get out of the house. Play in the snow. If you can't,  bundle up the kids and get them outside. The energy release and outdoor lighting can be a mood enhancer and is well worth the resulting pile of wet clothes.

2.  Plan an "event" or two during the day. The "event" is simply a planned activity to help structure the day. Ideas are baking cookies, playing a board game or playing hide and seek. More adventurous ideas might include a tasting contest where the child is blind folded and has to guess what you give them to taste or a drawing or writing contest between you and the kids. Gear the "events" to what your children enjoy.  Planning some structured events can help with boredom and the inevitable fighting that occurs with siblings with too much time on their hands.

3. Plan quiet time.  Give the assignment of one hour of quiet time to your kids with suggestions of how to spend it. Reading, coloring and playing in their room can provide a well needed break for you as a parent and if the child takes their quiet time as planned it can be rewarded by an "event" that they do with you.

4. Have a dance party.  Exercise, energy release  and fun. What could be better?  Even a fifteen minute dance party can liven the mood of a gloomy afternoon.

5. Near the end of the day, when everyone is getting tired, relax some of the old rules. Extra TV or computer time is OK on a day when everyone's nerves are a bit tight. Just try to save this for the end of the day so that you don't have to fight the kids to get them to participate in some of the more active events.

If you as the parent begin to feel out of control, be sure to take a break. Tell your spouse you need some time and take a nap. If you are alone with the kids, step out onto the porch so you can still see but not hear them and take 5 deep breaths. Remind yourself that this is temporary and it will pass.

Don't give up hope. Spring is around the corner even though we can't feel it. Most importantly know that you are not alone. If the Winter blues of 2014 don't stop when the snow stops, think about speaking to a therapist before it gets too bad.

The Hunger Games is one of the hottest movies out.  Teens and tweens are rushing to the movie theaters and increasing their levels of literacy as they hurry to read the three books in the series.  Yet both the movies and the books feature a great deal of violence.  Should parents be concerned?  It depends on the age of the child and their sensitivity level.

Children who watch primetime TV or play video games may be exposed to violence and aggression on a regular basis.  Parents should monitor their children’s behavior and make sure they know the difference between fantasy play and reality.  Try to help children use words to express their anger.  Examples include saying “I’m angry or frustrated,” with a sibling before hitting or even the parent modeling this behavior by saying “I’m tired from a long day of work and that is why I’m cranky today.”  They should also provide safe ways for children to express their own anger or aggression.  Some ideas for this might include an anger space featuring noodles that the child can hit against the wall, egg cartons to smash, or phone books to tear.

Parents who limit their children’s exposure to violent media may want to read the books themselves to preview the amount of violence or look on a website that rates and describes movie violence.  Parents who decide to allow their children to go may accompany the children to the movie.  Discussion might follow on scenes that seemed the most disturbing so the child can express any feelings they may have on actions that were concerning.  Also tell the child to let you know if they are having bad dreams following the film.  If so reassure them that it is a fantasy story and be available in the event that they need you to provide additional attention as they regain their sense of security.  If a child is young, under 8 or 9 and particularly sensitive to violence or emotional events; it may make sense to tell them that the movie is not appropriate and redirect them to another film.