I want to feel good

feel-goodThis last week, my youngest daughter was visiting from New York. She is a newly minted “Family Nurse Practitioner” and is providing primary care at a Community Health Center in New York. She observed how many patients come in and want prescriptions for tranquilizers (Xanax, Valium, Ativan), pain pills, or stimulants (presumably for ADHD). “They tell me that when they take Xanax they feel good,” she said. She tells them—“Wanting to feel good is not an indication for Xanax!”

Many of my adolescent patients tell me the same thing about marijuana. “It makes me feel good”, they say. Of course, a glass of wine or a drink in the evening also makes adults “feel good”. After all, why serve alcohol at social gatherings? It’s a social lubricant. And, it makes people feel good. Read more »

Surviving the myth of the perfect parent

myth-perfect-parentWhen my oldest daughter was 3 years old, I had my first (pre)school conference. The teacher kindly explained to me that my daughter was “shy”, but otherwise was “no problem”. I was stunned! My entire parental life flashed in front of my eyes. She must be shy because we moved when she was 6 months old. Perhaps I was too strict, or maybe not strict enough? What had I done to make my daughter shy. I must have done something wrong. I was wracked with self-doubt. Read more »

The Boomerang generation: Living at home after college

boomerang-college-back-at-homeMy close friend Sarah’s 28-year-old son is still living at home. He went away for college, but ended up back in his childhood room after graduation. Why? For one, he graduated in 2009, which was a terrible year for college graduates looking for work. Furthermore, he had no idea what kind of career or vocation he might pursue. Living rent free at his parent’s made sense to everyone while he figured it out. The problem—six years later he doesn’t seem any closer to knowing what he wants to do when he grows up! Read more »

Five lessons kids teach parents

kids-teaching-parentsAfter all of my years of practice working with kids, I’ve come to realize that there is one thing that has remained the same…children have the best insight on how adults should parent!

Recently I was reminded of the time when I decided to visit my daughter’s fourth grade class in search of parenting insight. The teacher, knowing I was a psychologist, allowed me to conduct an informal “consumer” survey. I asked the children simply, “What makes a good parent?” After all, they are the recipients of our parental services. Twenty years after my survey, their nine-year-old words of wisdom are still ring true. Read more »

More about help for elderly adults: One size doesn’t fit everyone

more-helping-elderlyAs I get older, I hear more from friends and colleagues about their struggles with their aging parents. A close friend is headed to Colorado to meet with her siblings to discuss care arrangements for their declining 90 year old father. Her dad doesn’t want to hear about obtaining help, assisted living, or any plans for hospice. He’s an independent, strong-willed, self-reliant cowboy who likes being in control. His 10 adult children see the writing on the wall. His quality of life is going to spiral downhill in a hurry. They worry that a crisis will force his hand. They want to come up with a plan today that their Dad will go along with.

Another close family friend, age 93, was recently diagnosed with Ovarian cancer. She lives alone. One of her kids is disabled, and the other lives 3000 miles away. Her oncologist told her a few weeks ago that there was no more treatment available to her. She is philosophical and accepting. But it’s difficult for her to understand the value of signing up for hospice before she has a health crisis. Read more »

How to shape your kids’ values

children-valuesMy wife and I recently returned from a week-long trip to New York City to visit our adult daughters. They live two blocks away from each in the wilds of Brooklyn and are both doing very well in their chosen paths.

It seems like yesterday when they were young and like all parents, my wife and I worried about their future. What kind of adults would they turn out to be? Would we like them? Would they like us? Would they be happy? Read more »

The developing brains of teenagers

teens-brainsThis weekend, while on call for our behavioral health department, I received a call from a distressed mom of a teenage girl. While this careful mom was reviewing the contents of her daughter’s cell phone (not a bad idea!), she found “selfies” that had been sexted to her boyfriend. The pictures were pretty graphic! Her mom just couldn’t understand why her daughter would do such a dumb thing. “Doesn’t she realize that these photographs could be posted all over the Internet?!” The fact is that teenagers don’t think much before they act. Their brains are still developing, and their pre-frontal lobes, which are the guardians of intelligent behavior, are still maturing. Read more »

Seven ways to fine tune your marriage

seven-tips-marriageDo you change the oil in your car every 3000 miles?
Do you vacuum your house or apartment weekly?
Do you clean your furnace yearly?
Do you weed your garden and mow your lawn?

It’s amazing how much time we spend keeping our property and prized possessions shipshape. If we don’t, cars begin to rattle, roofs start to leak, and furnaces, well, they’re likely to break down in the middle of winter. Yet, of all of the things we need to maintain, we often spend the least amount of time tending to thing that needs it the most—our marriage. Read more »

Preparing for death and life

Pauls_momI read an essay in The New York Times this winter (“Ashes to Ashes, but first a nice pine box”, February 2, 2014, by Jeffrey Piehler) that was very moving, despite it’s dark theme. Dr. Piehler was diagnosed with Stage 4 prostate cancer eleven years ago. But finally, the warranty on his life is running out, and he suggested to his wife that he build his own coffin. Of course, she was horrified. But the process of designing and building his own pine coffin enabled him to find peace in the nearness of his end.

I experienced this kind of wisdom in my mother’s death this spring. She fully accepted the inevitability of her end after her second heart attack this winter. She faced each choice with incredible equanimity—having the breathing tube withdrawn in the hospital, going to the rehab unit, joining hospice, replacing her bed with a hospital model, accepting comfort care so she could die at home, and waiting for me to leave before she passed away. She told her aide that she didn’t want to die with her “baby”, (that’s me) present. She died holding the hand of my niece and stepsister less than 48 hours after I walked out the door. My good friend Tracy tells me that she wrote the book on facing death with openness and acceptance. I agree. Read more »

Tips to making the most of your family vacation

tips-family-vacationSchool is out. The birds are singing and the days are longer. It’s that time of year again. It’s the season for that time-honored tradition… the family vacation!

For many families, this yearly pilgrimage to the mountains, the San Juan Islands or an exotic destination is part of a family tradition. The frantic pace of the school year, filled with obligations and complex schedules takes its toll. Summer in the Northwest invites a slower pace. The family furlough brings the clan back together again to re-group and to be restored. Read more »