Category Archives: Uncategorized

How To Cope with Divorce

As a marriage counselor, I’m asked if couples are really helped by therapy. The truth in my practice is that I don’t know. I have not performed outcome studies. My perception of the outcome is skewed because couples who seek my help are motivated. Couples who have predetermined they want a divorce don’t often present themselves in my office. I’ve seen marriages that appeared emotionally dead, spring to life. I’ve also seen marriages that appeared quite healthy, choose to divorce. I cannot predict with certainty which couples will buckle down and adopt suggested changes or practice the assigned techniques. I’d like to believe that the majority of couples I’ve counseled improve their skills and stay together, but I don’t know what happens after they stop sessions.

I had written a column in May of 2015 titled “Is It Time to Move On?” In it I laid out indications that it is time to move on from an unsatisfying job or marriage. Bottom line reasons follow:

When the situation consistently causes more pain than joy.

When you feel angry and resentful more days than not.

When you have made yourself small to accommodate an intolerable situation.

When the situation is killing your spirit – causing depression, anxiety or medical illness.

When you act against your core values and lose respect for yourself.

When you have tried everything to fix the situation, and there are no options left.

When you have exhausted your options and turn to irresponsible activities like the use of alcohol or drugs to numb yourself.

When you feel abused by the situation.

If the answer to one of these is resoundingly yes, you would likely be happier if you divorce. If you determine that you should move on, you may still lack the emotional where-with-all to do so.

Divorce is a traumatic event. Some traumas do not heal with time. It has been said, “Time heals all wounds.” Rose Kennedy does not agree. “The wounds remain. In time, the mind, protecting its sanity, covers them with scar tissue, and the pain lessens. But it is never gone”. The truth is that some things that happen to us will never heal. Relational brokenness is no less significant than physical brokenness. We may never be quite the same.

It is unfortunate that we are forced to make significant life decisions when in our most vulnerable state. Friends may recommend you find an aggressive attorney, your family may determine that your once loved partner and valued in-law is an abusive person. Your friends take sides, some leaving you alone and lonely. Divorce can be ugly for couples who fight over children or finances. If the soured relationship isn’t enough cause for depression, a long and protracted divorce could cause PTSD (Post Traumatic Stress Disorder) symptoms in which you are left embittered and seething with revenge.

So here’s what I recommend to people in this vulnerable state. Start with your values and make your desired outcomes secondary. Reflect on what is important to you and how you want to carry yourself through the process. For example, you may aspire to be fair, to be kind, to be brave, and to seek the benefit of all involved. Meditate on these qualities frequently so that when you make difficult decisions in a settlement, you can be proud of your choices and the manner in which you carried yourself. Let the details take shape around your aspirations.

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Fairy Tales Are Not For the Homeless

I have to admit that I look forward to the fairy tale wedding of Prince Harry and American actor Meghan Markle. I remember watching the wedding of Charles, Prince of Wales, and Lady Diana Spencer in 1981. Their marriage was the “wedding of the century.” It was watched by a global TV audience of 750 million people. We later grieved Diana’s death and enjoyed seeing her young sons grow into men. And, we can take pride in a British-American union. One of our own is becoming a princess. Let’s face it, American women are a bit envious of the English and their hats. When the Queen wears a hat, dress code etiquette states that all women wear hats for formal events.

A fairy tale extravaganza doesn’t happen magically. I’m reading that Windsor Castle prefers that guests and tourists not rub elbows with the homeless and potential panhandlers. It was suggested that vagrants and their belongings be “dealt with” before the wedding. This has stirred up controversy over the root causes of homelessness and the most effective methods of addressing the problem. Rather than sweep the homeless under the rug there should be public policy designed to improve the life and health of the homeless.

I get it. There may be safety concerns. And it is difficult to enjoy a party in the presence of suffering or smelly people. But to hustle them off the streets and out of sight seems morally wrong.

It is made easier to subjugate groups of people whom we deem different from us. It is a human trait to divide people into Us and Them, ingroup and out group, our kind and the others. We do it with remarkable speed. It is hardwired into our brains.

How do we stop making these dichotomies? One way is through prolonged contact. If we rub shoulders often with people who are different from us, long enough, our similarities start to outweigh differences. Another way is to make the implicit explicit, by identifying our biases through reflection. A third way is a cognitive tool called perspective taking. Imagine being them. Would your feet hurt if you walked in their shoes?

I was a youth minister in Cabrini Green housing projects of Chicago for several years in the early 1980’s. In 1981, Mayor Jane Byrne flattened the Us/Them dichotomy by moving into this low income housing where approximately 9% of the residents were employed. Mayor Byrne walked in the resident’s shoes. She demonstrated a commitment to safety and reform. By moving in she brought civic attention and city services to the buildings. I saw immediate change to the building that she inhabited. The grounds were cleaned of debris, flowers planted, elevators repaired, and security was increased. Her husband coached the local sports teams. I was pleased to see her walk from the projects to work. The experiment only lasted three weeks. And unfortunately, funds dried up when she lost her bid for reelection. Many people thought it was a political stunt, but I admire her investment in addressing a social problem. There was no sustainable change but I appreciated the effort.

Perhaps the Royals of England could learn a lesson here. They could rub shoulders with people who lack stable housing. They can reflect on their biases. And they should walk in their shoes. As a result, public policy is formed.

Ask the Opioid Dependent Patient, Not Law Enforcement, About Incidences of Opioid Overdoses

The Dubuque, IA Telegraph Herald recently featured a news article by Alicia Yager entitled “Law Enforcement Divided on Overdose Intervention.” In it, she references Richard Jones’, the sheriff of opioid-ravaged Butler County in Ohio, refusing to equip his deputies with Narcan. He believes requiring deputies to administer Narcan puts them in danger and the cost of repeatedly treating people with Narcan are “sucking the taxpayers dry.” “All we’re doing is reviving them. We’re not curing them.” Opponents of Narcan believe it has no lasting impact on the death toll.

Nearby sheriff Robert Leahy of Clermont County in Ohio says “from my personal experience it is right thing to do.” The nasal spray makes it simple to administer, it’s not a major burden to track and maintain supplies and that it’s a natural extension of our mission to serve and protect. Leahy further states “no matter what their plight is and how they got to where they are, it’s not for us as law enforcement to decide whether they live or die.”

Ms. Yager then cites local law enforcement leaders in the tri-state area of Wisconsin, Illinois and Iowa, who are happy to include Narcan in their tool box to help people who might otherwise die. The Dubuque County sheriff’s department and Dubuque police department in Iowa carry Narcan. According to Dubuque Drug Task Force statistics, there were 15 opioid-related overdoses with four resulting in death. Those figures are an improvement from 2016 which had 28 overdoses and nine deaths. Dubuque police chief said he is aware of three instances of reviving an overdose victim since July of 2017, when they began carrying Narcan. Officers in Jo Daviess County in Illinois don’t carry Narcan yet but will do so as part of a state wide mandate. Grant County in Wisconsin doesn’t see a need for Narcan yet and have only used it once. Although they don’t see the effects of an opioid epidemic, they are happy for the opportunity to administer it if needed.

But here’s the thing. Law enforcement is not in a position to know how many fatal or near fatal overdoses occur within their jurisdiction. We can’t rely on their statistics for an accurate count of how many people have nearly died.

Why? Given the legal consequences of possession of an illicit substance, people who are in trouble will resist calling for help, unless absolutely necessary. In spite of Good Samaritan laws, in which there are to be no arrests for someone who tries to save a life, drug users are suspicious. They will try to handle the overdose without intervention from paramedics or law officers. With increased distribution of Narcan to the public, we may see fewer reported overdoses and more people being saved by a peer or family member.

Additionally, in cases of fatal overdose deaths, families may choose privacy over public stigmas. The death certificate may list cause of death as respiratory failure and not opiate overdose. These deaths may not get counted in statistics. Stigma, such as perpetuated by Richard Jones in Butler County, Ohio, prevents people from openly sharing that a loved one died of the disease of addiction. There is no such stigma of a family member dying of cancer.

In Yager’s column, she references a fear of violence from someone who has been revived with Narcan. Sheriff Jones said that people can be combative when they come to, and “an officer bent over giving Narcan could get a brick to the head.” This language is unnecessarily inflammatory and sensational. It is true that an opiate dependent person who is revived with Narcan will wake to pain. Narcan works by stopping the overflow of opiates to receptors leaving them with no opiates in their system and inducing withdrawal symptoms. However, they are no more likely than any other patient in pain to react with aggression. Officers are trained in tactics of restraints and will surely remove any nearby bricks that could cause harm to themselves.

When Jones says “All we’re doing is reviving them, we’re not curing them” he is correct. Narcan is a tool to keep people alive. It is not treatment. Law enforcement is not expected to provide treatment. Their purpose is to serve and protect, even if it takes 20 uses of Narcan to protect them. He also says Narcan has no lasting impact on the death toll. This may also be correct and some statisticians believe the epidemic will get worse over the next six years. But even one more day of life to a loved one is precious. Can you look into the eyes of a grieving parent and justify withholding Narcan because it would have no lasting impact on the death toll? Of course not.

So where do we turn for more accurate figures? To the patients who are dependent upon opioids themselves. I did an informal survey of opioid dependent people in this tri-state area two years ago and repeated it last week. In 2015 I surveyed a group of ten people who were in drug treatment for addiction to opioids (heroin or pain killers). Among these ten people, they had experienced eleven overdoses. When asked how many overdoses they had witnessed or known of among their peer group, they counted more than sixty. When asked how many of those overdoses resulted in death, they counted twenty-two.

Last week I again surveyed a group of seven people who are in treatment for an opioid dependence. Six people had experienced a total of eleven overdoses. When asked how many overdoses they had known of among their peers, they counted eighty-four. Among those eighty-four overdoses, thirty-two had died as a result of the overdose.

Admittedly, this is not a scientific study but it does indicate that patients are better informed than law enforcement officials. News columns that look to law enforcement to understand the nature and extent of an opioid crisis can mislead the public. It is important for law enforcement to be equipped with Narcan, but it is imperative for patients to have Narcan and easy access to treatment.

Are You an Impostor?

Papotia Reginald Wright, of Brooklyn, New York, said that he was proud of his 25 years in the Army. He served as a Special Forces Green Beret. He told stories of his military days including one where a person cut out his kidney. He was living with one kidney. When in uniform he was an impressive Green Beret. Wright became a well-respected military figure in his community. He founded an organization in Brooklyn to help veterans. However, his personal history wasn’t true. He was recently exposed as an impostor. One veteran who worked for this organization said he was “played for a frigging fool” after learning that Wright was a fraud. To add insult to injury, Wright was behind on rent for the organization.

There are legal consequences for this kind of deceit. Wright is being investigated for possible violations of the Stolen Valor Act. The Stolen Valor Act states that fraudulent claims about military service is subject to a fine, imprisonment up to a year or both.

We’d all like to be someone else from time to time. We fantasize of a life where we’re rich, famous, or a hero. We may embellish our accomplishments and stretch the truth on occasion in an effort to impress. Imposters not only embellish their traits. They are pathological liars.

Pathological liars suffer from a mental illness or personality disorder. The lies bring attention to the person and make the person or situation look better. One probable cause for pathological lying is low self esteem. The person is trying to make themselves feel better about themselves in terms of their accomplishments. It is a rare condition that affects a small percentage of people.

On the flip side, it is more common to have a fear of being found out to be an impostor. The impostor phenomenon was developed in 1978 by psychologists Clance and Imes. In spite of being competent, one is convinced that they are frauds and do not deserve the success they have achieved. Common signs that someone feels like an impostor are perfectionism, excessive work hours, undermining achievements, fear of failure and discounting praise. Examples are “I feel like a fake,” “I just got lucky,” “They’re going to find me out.”

70% of people feel like an imposter at times. It is particularly common among high-achievers. When severe, people who experience this condition are subject to anxiety, stress, low self-confidence, depression and shame. This condition robs you of the satisfaction that comes from your accomplishments.

So what can you do? Accept that you have some role in your success. If your condition is severe, seek psychotherapy.

Don’t Be a Sexual Assault Bystander

Six women have filed a lawsuit against Harvey Weinstein, his brother, and board members of Miramax and the Weinstein Company for participating in a conspiracy to conceal Weinstein’s alleged sexual assaults and incessant harassment. In a statement, the women are quoted as saying “Soon after the Weinstein story broke, the world learned that individuals, companies and an entire industry knew about the pattern of abuse we suffered, but covered it up and turned a blind eye.” Many people in his circle enabled the assaults and covered up for him. These six women are angry with bystanders who did not intervene.

This is reminiscent of the 1964 rape and murder of Catherine “Kitty” Genovese in New York. Not a single person, out of 38, who heard or saw her being attacked took action to help.

In a different case, two bystanders intervened to stop the sexual assault and potential rape of an unconscious woman by Brock Turner. On January 18th, 2015, two Swedish graduate students were cycling around Stanford’s campus late at night when they saw Brock Turner in a dark area behind a dumpster. Brock was on top of a woman who appeared to be unconscious. The men confronted him, chased him down and detained him until campus police were able to arrive. When they came on the scene, the police determined that the woman in question was completely unconscious.

So what’s the difference? Why do some people intervene to stop improper or illegal behavior, while others do nothing, and therefore perpetuate the behavior?

Factors in which an individual intervenes include the “bystander effect.” The presence of other people actually prevents someone from intervening to help in an emergency. The greater the number of bystanders present, the less likely it is that a single bystander will intervene to help. They feel less personal responsibility to take action, believing that surely other people have already done so.

We are more likely to intervene when the victim is someone we know. Variables of gender, age, ethnicity, sexual orientation, mental health, disability, social class, immigration status, and homelessness influence our chances of interrupting an assault. We act differently when we perceive the victim as a member of our in group versus an outsider.

Since Kitty Genovese’s death in 1964, there have been studies on prevention of sexual assault. Initial programs focused on sexual violence prevention such as risk reduction for potential victims, such as strategies to reduce the chances of an assault. Secondly, programs focused on targeting potential perpetrators by changing attitudes to prevent people from assaulting victims. More recently the field has shifted from targeting victims and perpetrators to focus on bystanders. Potential bystanders or witnesses can be empowered to interrupt sexual assaults and provide support to survivors.

Many colleges provide Bystander Intervention & Sexual Assault Prevention Training. The 3 D’s of bystander interventions are 1. Direct – Directly intervening, in the moment, to prevent a problem situation from happening; 2. Delegate – Seeking help from another individual, often someone who is authorized to represent others, such as a police officer or campus official; and 3. Distract – Interrupting the situation without directly confronting the offender.

Rules for Bystander Intervention: Do not put yourself at risk; Do not make the situation worse; Intervene at the earliest point possible; Look for early warning signs of trouble; and Intervening does not necessarily mean confronting; Ask for help!

Don’t be a bystander, take action.

 

Who’s In Your Family?

Its holiday time again. It is often a family time filled with love, fun and laughter. Images of Thanksgiving include a large dinner table seated with married couples, grandparents and grandchildren. Images of Christmas morning include Mom, Dad and their biological children opening gifts. However, most households don’t look like the “traditional” families of old any longer. Families come in all shapes, color and sizes.

The percent of married couples with children went down from 40% to 20% between 1970 and 2012. Households now consist of married and unmarried couples with and without children; single-parent families; blended and step-families; same-sex partnerships and marriages with and without children; grandparents raising grandchildren; committed couples who live apart; people of different races, ethnicity and sexual orientation within a family unit.

Does this worry you? The majority (two-thirds) of Americans think that family diversity is good for society according to a 2010 Pew Research survey. A declining marriage rate does not mean that people don’t value family.

Who do you count in your family? By my standards, our two dogs and one bird are included in our family unit as well as close friends and biological family. For me, family is defined by those whom I love. Some people create families of choice. Made up of people they are closest to, as seen in “Friendsgiving” rather than Thanksgiving.

What makes for a healthy and strong family? Factors of health include nurturing relationships. Nurturing family members show love, stay in touch, and respect each other’s feelings. They support each other’s goals and aspirations. Strong families have rituals and routines that are guided by shared customs. This helps members feel a sense of belonging. Family roles are well-defined but flexible. Members know who to turn to for particular problems and solutions. Strong families are resilient and work together for the best of each member. And strong families connect to a larger community and world.

The factors of health and strength don’t change regardless of the make-up of the family. Any constellation of people who are united as family can exhibit health and strengths.

If your family isn’t “traditional,” it’s OK. You be you. Strive to be a healthy and strong unit. Happy holidays.

Roy Moore: It is Not Ok to Date a Minor

Roy Moore is running for the Alabama Senate and some politicians are encouraging him to drop out of the race in the face of sexual misconduct allegations. It is said that he had a sexual encounter with a 14-year-old girl when he was in his 30s, and pursued romantic relationships with three other teenagers.

A former colleague of Moore’s said that it was “common knowledge” that the Alabama Republican dated high school girls while he was the assistant district attorney for Etowah County. He worked in the district attorney’s office from 1977 until 1982. According to Teresa Jones, former deputy district attorney and his co-workers, they found it strange that he regularly dated high school girls. No one confronted him about the behavior, which included preying on young girls at high school gatherings, at the time, she said. “We wondered why someone his age would hang out at high school football games and the mall…but you really wouldn’t say anything to someone like that,” she said.

What is an acceptable age difference? One rule thumb is to divide your age by half and add seven to find the minimum age of someone you should date. For example, Roy Moore at age 32 should not date anyone younger than 23.

Moore denies the allegations. But when asked if he had ever dated girls who were 16, 17 or 18 years of age, he answered “not generally no.” And, “I don’t remember dating any girl without the permission of her mother.” Let’s be clear on this point. If you need to get consent of a parent, then they are too young to date. They are unable to provide consent to sexual contact.

So what is meant by sexual misconduct in this case? Many people correctly define Moore’s behavior as child sexual abuse. Others are calling him a pedophile. And others want to give him a pass by viewing it as unusual but not improper actions of an older man seeking a relationship with someone much younger than himself.

If the allegations are true, then the events as described constitute sex abuse. Moore met Leigh Corfman, the woman alleging sex abuse, at the age of 14 when Moore was an assistant district attorney in Alabama. Her mother attended a custody hearing and Moore suggested that Leigh “shouldn’t hear all that” and offered to watch her. Her mother thought it was nice of him to take care her little girl. Moore and Leigh met again days later at which time he took her home and removed her clothes, touching her over her underwear and placing her hand on his underwear clad genitals. He also gave her alcohol. She was uncomfortable with it and asked to be taken home.

This description of Moore’s behavior is an example of “grooming” for the purposes of child sexual molestation typical of pedophilia. Pedophiles target a victim, gain their trust, or their parent’s trust, isolate the child and engage in sexual contact. The word pedophile is commonly applied to anyone who sexually abuses a child, but child sexual abuse offenders are not pedophiles unless they have a strong sexual interest in prepubescent children. There is insufficient evidence of pedophilia in Moore’s case.

If Leigh Corfman had filed legal charges against Moore at the time of the offense, he would have been subject to incarceration. The legal age of consent in Alabama, then and now is 16. Someone who is at least 19 years old who has sexual contact with a 14 year old has committed sexual abuse, punishable by up to one year in jail. Enticing a child younger than 16 to enter a home with the purpose of intercourse or fondling of genital parts is punishable by up to 10 years in prison.

Why is it improper for an older person to seek a relationship with someone much younger? As illustrated in Moore’s case, an adolescent or child is not able to give consent. They are vulnerable to manipulation because the power dynamic is skewed. Age of consent laws draw a clear line between people who are too young to date. Young people are by definition, not mature or experienced. It is not only improper to cross these lines, it is illegal. Roy Moore, as an attorney at the time of the offense, knew better. He purposefully crossed the line and should be held accountable for it.

 

 

 

 

 

 

When “Just Say No” Fails, Try These 18 Ideas

More than 140 Americans die daily from an opioid overdose. President Trump declared the opioid crisis a public health emergency. However, a public health emergency is not the same as a national emergency. A public health emergency, unlike a national emergency, does not free up additional funding. Instead it relies on existing funding to be redirected. The nation’s Public Health Emergency Fund has a current balance of just $57,000. But the opioid crisis is a $6 billion problem, at minimum! Although it can be renewed, the declaration only lasts for 90 days. It is said the Trump administration is working with Congress to include further funding for the crisis soon.

Opioid dependence is a complex problem that requires a multifaceted response. It is a different animal from other addictions in that it is a physiological and psychological disease. Whereas other substances are primarily psychological. People who don’t understand this difference may think that all it takes to recover is to “Just Say No”. Kellyanne Conway suggested that the best way to stop drug dependency and the epidemic overdose deaths plaguing the US is for people to not start using drugs. True enough, but DARE and “Just Say No” have proven to be ineffective. And that doesn’t account for the people who inadvertently became dependent on painkillers through a medical condition.

I spoke with a group of people in an opiate recovery support group as they discussed how they would approach the crisis. They hope that bringing awareness to the epidemic is not an empty gesture, but will in fact allocate time, energy and funding to make a difference. They offered the following concrete ideas for treatment and prevention in order to curb the crisis.

  1. Make Naloxone, a.k.a. Narcan, accessible and affordable. Naloxone is the opiate reversal kit to stop overdose deaths.
  2. Make treatment more accessible than pills, heroin or fentanyl. Open more medication assisted treatment programs that offer Methadone and Suboxone such as “mobile Methadone” programs to serve rural areas. Make medication as easily available as your local pharmacy.
  3. Mandatory insurance coverage for addiction treatment.
  4. Prevention that is age appropriate, starts in 4th grade, and progresses to include the science of brain chemistry in high school. Don’t replicate programs that are not evidenced based.
  5. Provide transportation to treatment. Encourage public or private transportation companies to open services to help addicts get to treatment.
  6. Offer mental health counseling to alleviate mental illness and learn coping skills.
  7. Make use of harm reduction programs such as a needle exchange program, condoms, and safe houses.
  8. Make medication assisted treatment available at all levels of care from outpatient to residential programs. Too many hospital based and residential programs refuse to treat people who are prescribed Methadone or Suboxone, and instead require them to stop their medication before receiving care.
  9. Prioritize care to special populations and high risk groups such as the homeless, pregnant women, and veterans.
  10. Offer wrap around services that include addiction treatment, job placement, mental health services, housing, and legal assistance.
  11. Destigmatize the use of medication for opioid dependent people through public education.
  12. Increase family treatment designed to keep families intact and increase social support.
  13. Create work programs to help people pay for their treatment and gain work skills.
  14. Require all correctional staff to get training in medication assisted treatment and allow inmates to take their medication during incarceration. If they are not maintained on a medication during jail time, they should be offered it prior to their release, and at a minimum should be given Naloxone upon their discharge.
  15. Decriminalization of drugs.
  16. Physician / substance abuse counselor teams to treat this population. Physicians are not the most effective first line responders. Require physicians to have ongoing addiction education.
  17. Increase the use of Prescription Monitoring Logs to identify people in need and make appropriate referrals.
  18. Emergency hospital services for people in withdrawal. Provide hydration and comfort, do assessments and make recommendations. If desired, begin a medication, and link to substance abuse providers for continuing care.

How would you direct funds to alleviate this epidemic? Your thoughts and efforts toward a comprehensive public policies could save a life.

It is my firm belief that public policy should be guided through the use of focus groups that consist of opioid dependent people. Wisdom comes from the lived experience of the people that suffer this disease. Many thanks to the individuals who shared their expertise.

Change is Possible, But the Hard Part is Sustaining It

I’m a psychotherapist and an addiction counselor. I’m frequently asked whether change is possible. The short answer is yes, but sustaining change is the hard part.

The rate of relapses among people who set goals is high. Perpetrators of domestic violence are reported to be violence free up to three years after treatment. Figures vary on substance addictions, but approximately 40-60% will relapse. 97% of dieters regain what they lost within 3-5 years. How many New Year’s resolutions have never taken root? How many of your life aspirations have never been fulfilled? It is human nature to return to our set point, or comfort zone.

As a species, we don’t adhere to professional treatment recommendations. 30-50% of people with type 1 diabetes fail to stick with their treatment plan. 50-70% of people who suffer from asthma fail to take their medicine. 50-70% of people with chronic high blood pressure don’t take their hypertension medication as directed. Medication non-adherence leads to worsening of disease, death and increased health care costs. The extent of non-adherence is 10-92%. There are three types of medical non-adherence. First, are prescriptions that are never filled. Second, is non-persistence, in which the patient’s stop a medication after starting it without professional guidance. Third, is non-conforming in which medications are not taken as prescribed.

Whether it is medical non-adherence, or behavior change, we are all at risk of failing. Here’s what doesn’t work.

  • Intentions alone are not sufficient to sustain change. Excitement fades.
  • Negative emotions such as fear-based behavior change doesn’t work. We all experience negative emotions such as regret, shame, fear and guilt when we don’t live up to our ideals. These emotions may serve as a reminder of what we’d rather be doing, but negative emotions are the least effective change strategies. For example, scolding a heavy drinker won’t cause them to stop drinking.
  • Feeling overwhelmed by a desired change leads to all-or-nothing thinking. Break down your goal into achievable components. Don’t try to change too much at one time. Change is rarely just one thing; it’s a lot of connected things, and sustained change doesn’t happen without a consideration off all the steps.
  • Information is not sufficient. Information is only as useful as what you do with it. You can know something and still do nothing. Well-intentioned advice does not produce motivation for change.

How long does it take to change a habit? We’ve all heard that it takes 21 days to create a new habit but in reality, no one knows. Some things stick after you’ve done them once, others take more persistence. Complex goals are more difficult to achieve than simple ones.

There is a saying that if you fail to plan, you plan to fail. Here’s what does work.

  • Commit yourself to a change program. If that program is not working any longer, recommit to another method that has the same end goal.
  • Make your goal known and be accountable to your support network.
  • Create a relapse prevention plan. Look ahead to any scenarios that could lead to relapse and have a step by step plan for how you will handle it.
  • Make a list of your relapse triggers. Triggers are the things that could get you off track. Catch slips before they become larger losses.
  • Have a list of tools that will get you back on track.
  • If you fail badly, assess the damage and find ways to correct it.

If you have lost your motivation, do the things that keep you interested in your goals. Review the reasons you wanted to achieve this goal. Or, immerse yourself in the topic by reading material about the desired change. Talk to your support network.

Sustainable change requires time, self-discipline, and energy. For example, I can teach couples new communication techniques and help them understand each other’s beliefs, perspectives and emotional pain. But couples who make changes in their relationship need a plan in order to sustain their changes. I ask them to set tasks that will serve as a reminder to stay on track. Perhaps they schedule a date night weekly, put it on the calendar, and take turns finding a babysitter. Or, have a scheduled “state of the marriage” conversation monthly. Or, attend a marriage retreat yearly. I even recommend that they keep post-it notes on their refrigerators to remind them what they need to work on. Without these tasks, they will likely return to their old behavior.

If you continue to fail at your desired change, you may benefit from a coach or therapist to keep you on task.

Harvey Weinstein Doesn’t Know Consent from Coercion

Harvey Weinstein, is an American film producer and former film studio executive. He and his brother Bob Weinstein, co-founded Miramax, which produced several popular independent films. You may be familiar with Pulp Fiction, Clerks, The Crying Game, and Sex, Lies, and Videotape. He has been in the news headlines recently with dozens of accusations of sexual harassment and assault, including rape, occurring over 20 years. He is paying the consequences. He has made settlement payments to some women who made allegations of sexual abuse, his wife is divorcing him, the Academy of Motion Picture Arts and Sciences has expelled him, and he was removed from the company he founded. The evidence implies that he wrongfully committed sexual assault on numerous occasions. However, he made a statement that all of these sexual incidents were consensual. His victims disagree.

This is a good time to remind people what sexual consent is. Emory University published a guide to a non-assaultive relationship called “Consent, Not Coercion”. I have reproduced it here.

Consent is when someone agrees, gives permission, or says yes enthusiastically to sexual activity with someone else. Central to the concept of consent is the understanding that every person has a right to control their body, and to not be acted upon by someone else in a sexual manner unless they give clear permission to do so. The person initiating the sexual activity is responsible for obtaining permission from the person or persons they want to engage in sexual activity with. Consent is always freely given, and every person involved in a sexual situation must feel that they are able to say “yes” or “no” at any point during sexual activity. Absence of clear permission means you can’t touch someone, not that you can.

In most cases, consent should be a clear verbal agreement. However, if a person is seeking consent from someone who cannot communicate verbally, they should obtain consent using another agreed upon method of communication. Non-verbal communication includes sign language, writing or typing messages, gestures, nodding or shaking one’s head, and blinking, to name just a few.

Consent is
not:

Body language: If a person makes eye contact, smiles, leans in, sits close to, embraces, or touches someone else in a manner that might be perceived to be friendly or even flirtatious, it does not automatically mean that the person is asking to engage in sexual activity or consenting to it.

Power differentials: When one person holds significant power over another person (i.e., boss/employee or professor/student), it is more difficult to be sure that this difference of power is not influencing any sexual interactions between them.

Dating relationships or previous sexual activity: Simply because two people are dating or have had sex before does not mean that consent is automatically present. Both must always feel they have the right to say no to sex.

Marriage: Even in marriage, consent can never be assumed. Marital rape does exist, and it is just as severe as any other sexual assault. In Georgia, there are marital rape laws that make a sexual assault in a marriage a crime.

Being drunk: Alcohol consumption can render a person incapable of giving consent. Perpetrators often use alcohol as a weapon to target individuals and as a means of excusing their own actions. Emory’s sexual misconduct/Title IX policy and Georgia laws apply to a perpetrator regardless of whether or not they were drinking.

Coercion is a tactic that perpetrators use to exert power and control over another person. Coercion occurs when a person intimidates, tricks, forces, or manipulates someone into engaging in sexual activity without the use of physical force. Perpetrators may also use threats of violence, blackmail, drugs, and/or alcohol to coerce someone into sexual activity.

According to MensWork, a Louisville, Kentucky based nonprofit, legal and healthy consent requires six things to be in place. Equal power and status; both are cognizant and are agreeing to the same thing; both have an understanding of the consequences; neither are under the influence of drugs and alcohol; it respects the legal age of consent; and both partners respect a change of mind without question and without coercion.

If you are still unclear about what constitutes sexual consent, watch a video called “Tea Consent” on Youtube.com. Even if you are clear on sexual consent, watch the video.