Matters of the Heart

As a family therapy clinician and teacher, I am constantly talking about the importance of relationships.  I’m thus thrilled when those outside of my specialty acknowledge that as well – especially when it comes from my colleagues and collaborators in the medical community.

In “Why Your Cardiologist should ask about your Love Life,” Dr. Sandeep Jauhar discusses the link between heart health and our emotional and relational worlds:

We have learned, for example, that fear and grief can cause serious cardiac injury. During emotional distress, the nerves that control the heartbeat can set off a maladaptive “fight or flight” response that causes blood vessels to constrict, the heart to gallop and blood pressure to rise, resulting in damage to the body.

Those of us who are present daily to the intensity of marital strife can certainly attest to this fact. What is more tender to the heart than being hurt by someone we love?

It is becoming a known fact that the importance of relationship, and the quality of relationship, directly impact one’s health and well being.  Researchers here at Penn Medicine have examined the impact of marital status upon the recovery from cardiac surgery, as well as the involvement of family and friends in improving healthcare outcomes.

For example, colleagues at The Center for Healthcare Innovation studied how to engineer social incentives for health, and suggested that more of our healthcare delivery system take advantage of the highly influential nature of social relationships.

Other research focused on the connection between marital status and recovery from cardiac surgery, and found that married people may fare better than those who are divorced, separated or widowed.  Although there is a lot more to examine relative to this connection, it is heartening to see the significance of relationship included as a key factor in promoting health and well being – yes, even in recovery from cardiac surgery.

Indeed, cardiologist Sandeep Juahar suggests we deploy a paradigm shift away from the individualized mode of thinking:

We will need to shift to a new paradigm for heart problems, one focused on prevention, to continue to make the kind of progress to which patients and doctors have become accustomed. In this paradigm, psychosocial factors will need to be front and center. Treating our hearts optimally will require treating our minds, too.

Thank you, Dr.  Jauhar.  I could not have said that better myself.

Grow your Family’s Relationship Superpowers

I’m so pleased to share this recently published book by my friend and colleague, Dr. Saliha Bava, and her partner, Mark Greene.

Although we might agree in theory that parenting is indeed a relational endeavor, our language belies this perspective. For example, we describe the child as “oppositional defiant” as though she existed in a relational vacuum, without that ‘other’ person she must oppose.

Diagnostic criteria focuses on the individual and obscures the parts of the relational system that promote imbalance and ill health.  This extends beyond the family system to the school, community and environment in which families are situated.  But responses to poverty or racism are not part of our diagnostic nomenclature.  We focus instead on the interiorized pathology of the individual, as if divorced from her community and relational world.

Bava and Green eloquently describe what happens in the relationship between parent and child:

“As we are shaping them, they are shaping us”

Indeed, we are changed as we parent,  uncovering parts of ourselves as we are buffeted from one intense emotion to the next.

Green talks about the opportunities in this process:

“for me to discover that I have some agency in those relationships, in those spaces, that there are ways I can operate that help me not fall prey to my own doubts, fears or concerns. “

The doubts, fears and concerns we harbor as parents are openings for change:

“If we have more flexibility, if we can look at problems from more angles, if we can hold our fears and concerns more lightly, if we can be more playful and collaborative,

If we can wait and see what’s emerging before we name and define our responses, all of these things are possible .”

 

I invite you and yours to hone your “family relationship superpowers” by engaging with this brilliant and captivating guide.  The Relational Book for Parenting: Raising Children to Connect, Collaborate, and Innovate by Growing our Families’ Relationship Superpowers is now available.

Enjoy this video by the authors https://player.vimeo.com/video/267271358“>video by the authors and you and your family can grow your relationship superpowers!

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

 

 

CCAF Event 9/28/16 Supporting Transgender Young Adults: Working Collaboratively with Family and Individual Treatment

Join colleagues at Penn Medicine and CHOP for this exciting panel, lead by transgender activist and family therapist, DR. ELIJAH NEALY.  They will address the importance of family therapy in the treatment of transgender young adults.

Dr. Nealy will be joined by Jacqueline HUDAK, PhD., LMFT, The Center for Couples and Adult Families, Perelman School of Medicine, Linda HAWKINS, Ph.D., Gender and Sexuality Development Clinic, CHOP, and Benoit DUBÉ, MD, Perelman School of Medicine.

 Wednesday, September 28th, 2016

6-8PM

16th Fl., 3535 Market Street

Philadelphia, PA 19104

A light dinner will be served

 RSVP sean.smith@uphs.upenn.edu

For the past 25 years, Elijah C. Nealy, PhD, M.Div., LCSW has worked extensively with LGBTQ adolescents and adults in both pastoral and social service capacities. Currently an assistant professor of social work at the University of Saint Joseph, West Hartford, CT, his clinical practice has focused on transgender and gender diverse youth and their families. Ordained with Metropolitan Community Church, Dr. Nealy regularly preaches and provides trainings for clinicians, faith communities, and organizations. An openly identified transgender man, Dr. Nealy lives in West Hartford with his partner and is the proud father of three amazing young people. He is the author of Transgender Children and Youth: Cultivating Pride and Joy with Families in Transition [Norton, February 2017].

 

 

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.