Family and friends can be powerful tools in improving health

David Asch MD and Roy Rosin, MBA of The Center for Healthcare Innovation at Penn Medicine have published an article  in The New England Journal of Medicine that supports the involvement of family and friends in improving health and health care outcomes.

At The Center for Couples and Adult Families, we are thrilled to  share this vision: that the quality of one’s relationships matters and has important and measurable impact on health and well being.

Holiday Tips from a Family Therapist

Fir Branch With Pine Cone And Snow Flakes

 

Each year around this time, conversations with clients turn to the predictable stress of time with family over the holidays.

Like ghosts in the night, old issues, long dormant, reappear at holiday time. How is it that an adult with partner and children can walk into their parents’ home and instantly feel 10 years old again? The anticipation of a holiday encounter can lead any adult to feel slightly unhinged in a way that few other situations do.

Let’s face it, no one can upset you like a family member.

Here are some ideas to try on this holiday season. They are born of basic tenets of family therapy theory and are utterly applicable to a variety of anticipated holiday situations:


1. Plan and be strategic. 

It’s always a good idea to warn someone that you are going to make a change before you actually do:

“I was thinking about the holiday, and this year I might do something a bit different.”

You don’t even have to be sure of what specific change you’re going to make, the point is to warn others first. That way, you can attempt to avoid their shock and surprise when you decide not to follow the family script – you know, ‘the way it’s always been and everyone (but you) wants to continue’.

This can be particularly useful when, for example, you have young children and want to begin to create your own traditions around the holidays. Perhaps you feel the stress of traveling with small children in an effort to please everyone, or because ‘you’ve done it every year, and they’re counting on you.’ So let people know in advance and find allies to support your change.

Which brings me to the next point.

2. Expect a reaction.

It is true that relationships have much in common with physics: for every action there is a reaction. Families attempt to maintain a homeostasis – a state of balance, maintained by familiar patterns and expectations. Think of the tremendous impact it has upon relationships when a family member joins or leaves the system; these points of normative developmental crises, birth, adolescence, marriage, or death, each require a renegotiation of previous roles and rules in the family system. Holiday traditions are valued as markers of continuity, so changes, however minor, can feel disruptive and unsettling.

3. Focus on yourself.  

You can change only your behavior, not the behavior of others.

Admittedly, this is a tough one. It’s the balancing act between giving up the dream of what can be, and accepting what is. There is much integrity in changing one’s own behaviors in a respectful and compassionate way, and it’s sad to realize that, for now, others may just not be who you want them to be.

Developing a curiosity about yourself may help. This might be a good time to entertain the questions:  Why does this person still hold so much power over me?  Why do I still need my mother/father/sibling to compliment or recognize me? How is it that I have come to this place in my life carrying that old wound?

4. There’s always next year.

Your opportunities to practice being different in your family are boundless. Try to think of this as one of many steps toward change. It will most likely take more than one conversation and there can be complicating factors: addiction, trauma, divorce, remarriage. Relationships take time, so keep in mind the long term; families are full of surprises and unpredictability as the family life cycle inevitably moves into the future.

When I hear a person in their 20’s or 30’s say “I’ll never have a relationship with my brother, I respond, “Well, let’s think about this for a moment. If you both live until you’re 80, are you telling me nothing will happen over the next 50 years? Most likely, your parents will predecease you, and you and he will together become the oldest living generation in the family. You may each partner with someone, and perhaps become aunt and uncle to each other’s children.”

There are endless circumstances that create opportunities for us to evolve in our family system.

Lastly, I try to remember at this time of abundance and giving thanks, that to even think about the quality of relationship is, of itself,  both a blessing and a privilege.

With all my best to you and yours during this special season,

Jacqueline Hudak

 

 

The Changing Family and How it Influences Identity: Penn Spectrum Weekend, 9/23-25

CCAF Clinical director, Jacqueline Hudak, will present on a panel about “The Changing Family” during Penn Spectrum Weekend.

Held during alumni weekend, Penn Spectrum “brings together alumni for dialogue centered on issues of cultural identity. We welcome alumni and allies from all backgrounds as well as current Penn undergraduate and graduate students. The conference focuses on issues pertinent to the Black, Latinx, Native, Asian, and LGBTQ alumni and student communities.”

For a full schedule of events, check out the link here.

Engaging Family Supports: Free Online Videoconference

 

Join us for the next CPSP
“Community Psychiatry Forum*”
In Collaboration with
The American Association of Community Psychiatrists

Engaging Family Supports

Learning Objectives – Participants will be better able to:

  • Identify strategies and barriers to engage family members as supportive members of recovery team
  • Enable people in recovery to identify and connect with potential sources of support in the community
  • Describe issues commonly concerning family members and other natural supports and potential approaches for addressing them

CME: You can earn 1.25 CME credits

When: Thursday, April 21, 2016
11:45 am – 1:00 pm EDT

Course Directors: Wesley Sowers, MD
Robert Marin, MD

Guest Experts:

Ellen Berman, MD, Clinical Professor of Psychiatry, Perelman School of Medicine, and Founder and Director of Training, Center for Couples and Adult Families, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA

John Sargent, MD, Director, Division of Child and Adolescent Psychiatry, Tufts Medical Center and Professor of Psychiatry and Pediatrics, Tufts University School of Medicine, Boston, MA


*Community Psychiatry Forum: Free online videoconference offered twice each month. Continuing Medical Education credits

Generosity and Kindness: Key Ingredients of a Long Lasting Relationship

At CCAF, we are committed to bring research about relationships and family life to the public.  In this spirit, I share the article, “Masters of Love” from this month’s Atlantic Magazine.

The article traces the 30 year history of research on marriage; the work of John and Julie Gottman of The Gottman Institute is featured.  Their work is noteworthy for their capacity to  predict, with up to 94% certainty, which couples will be broken up, together and unhappy, or together and happy several years later.

“Much of it comes down to the spirit couples bring to the relationship.”

That’s where kindness and generosity come in.  Those couples who accept each other’s ‘bids’ for contact, who ‘turn toward’ each other, do better in the long term:

“People who are focused on criticizing their partners miss a whopping 50 percent of positive things their partners are doing and they see negativity when it’s not there.”

Gottman found that the more physiologically active the couples were in the lab, the quicker their relationships deteriorated over time. The problem was that these relationships, called the ‘disasters’ showed all the signs of arousal; they were in fact in ‘fight-or-flight mode’—in their relationships. In these highly reactive couples, it was virtually impossible to have a conversation, express feelings, and be heard.

“Having a conversation sitting next to their spouse was, to their bodies, like facing off with a saber-toothed tiger.”

Fortunately, Couple and Family Therapists are trained to coach couples to shift to a less emotionally reactive posture.  In this way, couples can begin to express feelings and desires more effectively, and communicate how their partner’s behavior impacts them.

Read the full article here and learn about how to become more masterful at love.

Dr. Ellen Berman with Marty Moss-Coane and Ron Lieber: “Families and Money”

326aMoskowStudio    CCAF Founder, Dr. Ellen Berman was a guest on WHYY’s Fresh Air  with author Ron Lieber yesterday.  They had a lively and informative conversation about Families and Money.  Ellen and Ron  answer some of the more vexing questions about this important, delicate, and often very difficult to discuss topic.

“Money is all about values,” says Dr. Berman, who draws upon 30+ years of clinical experience with couples and families.  She talks specifically about the cultural shifts that impact ‘adult’ children, and offers clear, specific advice about how to avoid pitfalls and seize opportunities when dealing with the thorny issue of money and the family.

 

 

New Research: Family Psychoeducation Crucial in the Treatment of Schizophrenia

A landmark, government funded study finds that schizophrenic patients who received a combination of drugs, talk therapy and family support made greater strides in the first 2 years of treatment than patients who just received drug therapy.

Featured on the front page of yesterday’s NY Times, the report made clear that  family involvement and “talk therapy” are vital in the treatment of schizophrenia, and this combined approach provided more symptom relief to patients (and thus families) and capacity for higher functioning at the end of 2 years.  The study will be published in The American Journal of Psychiatry, and the article can be found here:

http://www.nytimes.com/2015/10/20/health/talk-therapy-found-to-ease-schizophrenia.html?_r=0

At CCAF we are well aware of the importance of family inclusion and family psychoeducation around certain illness, particularly those that strike in early adulthood.  We collaborate with Dr. Claudia Baldassano and her team of psychiatry residents to facilitate multifamily Bipolar Psychoeducation groups.  We have developed a series of 4 – 90 minute family group sessions during which:

  • information about the illness is presented, and families invited to ask questions,
  • families tell their story about how the diagnosis was made,   
  • families discuss the process of coming to terms with the illness,
  • we discuss how to handle relapse and emergencies, and
  • anything else the family wants to talk about.

The Center for Couples and Adult Families is fortunate to be situated within the Department of Psychiatry here at Penn.  We look forward to further collaboration to develop similar groups for families of schizophrenic patients.