Individual, Family & Group Psychotherapy
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Dec 14

How to Spot a Psychopath


How to Spot a Psychopath.

I love finding–or inventing–ways to categorize people. I agree with philosopher Isaiah Berlin, who observed, “Every classification throws light on something.”
I’ve devised several of these, and of the ones I’ve come up with myself, my favorites are the Abstainer/Moderator distinction and the four Rubin Tendencies.
Because of this interest, I was intrigued to come across the Psychopathic Personality Inventory, a personality test for traits associated with psychopathy.
I think that we can all agree that one thing that does not contribute to a happy life is a relationship with a psychopath. But what traits are associated with psychopaths?
The test seeks to measure:
Social influence — a tendency to seem charming, persuasive
Fearlessness — a tendency to embrace risk without fear or anxiety
Stress immunity — stays cool in difficult circumstances
Machiavellian egocentricity — a tendency to consider only personal needs
Rebellious nonconformity — a tendency to neglect of social conventions and regulations
Blame externalization — a tendency to assign blame for problems or obstacles to other people
Carefree lack of planning — limited willingness to make future plans
Cold-heartedness — no guilt or remorse
People throw around the terms “sociopath” and “psychopath” quite frequently, but these are technical terms with very specific meanings. That said, if there’s someone in your life who seems to show many of the above traits, it might be useful to reflect on that.

Dec 13

Help for the Daydreaming Child



Girl Looking Up While Sitting With Head In Hands In Class

Children who display disrupting behaviors, such as hyperactivity, talking when they are not supposed to, aggression, fidgeting, and other more challenging behaviors are often the children who receive the most attention in terms of being identified as a child in need of support services in school or as a child who’s parents are struggling to find what discipline and other parenting strategies to use at home. However, there are other children who receive less immediate attention from adults and the school systems because they are not displaying these more disruptive behaviors. Instead, these children often daydream which does not lead to many adults feeling the need to create any interventions for the kids. The kids who daydream may or may not need support services. As a parent or professional working with a child, it is important to consider whether a particular child’s daydreaming warrants further monitoring and possible intervention or not. Read the following information to find out more information about children and daydreaming.


Amy Fries’ article, “The Power of Daydreaming” on Psychology Today presents the positive aspects of daydreaming. Fries makes reference to a few research studies that provide support for how daydreaming helps children develop social skills, creativity, and helps them to process information.

Daydreaming can help children to create, practice, and process dialogues they may have with others. Daydreaming, or the wandering mind, may provide the benefit of allowing a child to improve their creativity by its very nature of allowing the mind to free associate meaning the mind more freely flows from one thought to another which can lead to more creative ideas, more thinking “outside the box” (outside the current situation being experienced). Research has suggested that nighttime dreaming helps individuals to process information they learned during the day as well as process the experiences they had. This may also be true of daydreaming, as well.

Daydreaming is certainly not all bad. Adults should not attempt to stop children from daydreaming completely. According to Joseph Stromberg’s article, “The Benefits of Daydreaming,” at the, daydreamers may actually have better working memory particularly in the face of distraction which can definitely be a useful skill in these busy and sometimes chaotic times.

Is-Daydreaming-Good-For-You[image credit: Alive Campus]


Certainly some daydreaming can be a symptom of certain mental health or neurological disorders (such as ADHD, schizophrenia, Autism, etc.). Some daydreaming can be problematic when it impairs functioning in academics, in social situations, or at home. Daydreaming can be a side effect of a learning disorder or may contribute to a learning disorder. Daydreaming may be problematic when it negatively impacts a child’s connection with others, as well.

Many teachers, parents, and others often attribute daydreaming to an attention disorder like Attention Deficit Hyperactivity Disorder (ADHD). However, this is not necessarily the case although some children with ADHD may also daydream.

When daydreaming occurs so frequently that your child or a child you work with is experiencing negative outcomes frequently within any area of life, it is worth taking a serious look at the cause and possible solutions for addressing daydreaming.


As mentioned above, daydreaming is not a problem. The problem occurs when daydreaming impairs a person’s functioning in an area of life that creates significant problems for that individual in comparison to most of their peers. Even then, without knowing your particular, unique situation, I can’t say that daydreaming is for sure a problem. Daydreaming can be beneficial to a person’s overall well-being. Trying to eliminate daydreaming may not be the answer. The answer is more likely to help a child know when and how much to daydream and to know how to snap out of daydreaming when necessary. For instance, a child’s educational performance may suffer tremendously if they daydream during all reading lessons for weeks in a row.

We all daydream to an extent. The voice in our heads that gives us an idea, that plans ahead, that decides what’s for dinner, or that replays a situation that occurred to us previously in the day or further in the past are all forms of daydreaming. Our minds are focusing on something else besides the particular situation we are currently in. So most of us daydream regularly but daydreaming is only problematic for some people.

Sometimes people daydream when they are in a situation that is not as entertaining, not as interesting, not as attention-maintaining, or not as reinforcing as what is necessary to hold their minds to remain focused on the current situation. It may be more difficult for some people to remain “mindful” in the present moment particularly in these less preferred situations.

If daydreaming is a problem for a child you know, consider the following tips:

Don’t try to stop a daydreamer from daydreaming (not completely anyway). Instead, teach the child to become more self-aware by helping them to catch themselves daydreaming and to learn the skills to re-focus their attention.
Teach the child to monitor their own behavior. One way to do this is described by Additude Magazine. The idea was also introduced to me by my supervisor at the Autism Center of Central Michigan, Leasa Androl, MA, BCBA. The technique is to provide the child with a device that will vibrate or make a sound every so many seconds or minutes (whatever amount of time you decide for your child). When the device vibrates or makes a sound, the child is to mark on a provided piece of paper or index card whether, in that moment, he was daydreaming (or paying attention to the task whether it’s his homework or listening to the teacher). The parent can help the child to learn how to do this and then he can try it on his own.
Practice (or have the child practice) “mindful breathing” to help keep daydreaming to a minimum. To do this, one study by Smallwood and Schooler (2012) cited by Urge Surf suggests focusing on your breathe for eight minutes a day. When your mind wanders from the breathe, bring your attention back to your breathe.
Consider the child’s environment & your teaching strategies. Are there things that can be changed in the child’s environment to help them daydream less often? For instance, if you are a teacher or an educator of some sort, can the curriculum be provided in a more engaging manner? (Please don’t take offense if you are a teacher. I am sure that most teachers and parents do the best job that they can and teachers are not always able to keep every single child engaged at all times.) If you are a parent, are there things you can do for your child that will enhance their focus during homework time, such as make it a race to finish the homework in order to earn a reward?
Improve nutrition. Healthy foods are, of course, good for many reasons. Eating nutritious foods can certainly help a child to have better control over their attention as well as have more focus on the task at hand throughout the day.
Get enough rest. Being sleep deprived can also lead to more daydreaming. Sleep deprivation can make it easier to drift off into one’s own mind especially in a not so entertaining environment.

Dec 12

Addicted to Affluence



Shoe shoppingMany people mistake affluence for self-worth. You can buy what you want to buy. Live where you want to live. Own what you want to own. You’ve made it! What a worthy, wonderful person you are!

So how come you’re still feeling that it’s not enough? You bought what you wanted to buy. You feel great. Yet, a day later, rather than feeling pleased, you’re bored.

So, you rack up additional purchases on your favorite digital device. It’s so easy to shop these days. Or, tired of shopping, you plan another trip. You create another social event. And still it satisfies only for the moment.

In the quietness of your solitude, you wonder what’s wrong.

A reassuring voice quickly tells you, “It’s going to be all right.”

“Umm, maybe it’s not,” whispers another voice. Deep down, addicts always know that something’s wrong, even when they are vehemently denying it.

So what’s the problem here? Isn’t affluence supposed to make life easier? More carefree? More tranquil? Yes, but not if one mistakes affluence for self-worth. Having a lot of money does not alleviate your anxiety or depression. Indeed, it can make it worse.

The adage, “little kids, little problems; big kids, big problems,” has much truth to it. Since big kids act out their difficulties on a bigger stage, problems that arise from their bad behavior have more serious consequences.

Similarly, people who live modest lives are so busy simply trying to keep themselves afloat that their problems are typically more mundane. In contrast, those who live life on a larger scale may find that their neurotic behavior creates emotional, social and financial debacles, worthy of headlines in People magazine. This is true not only for those who are affluent but for those who falsely convey an image of wealth and success but are deeply in debt.

If you are addicted to affluence (or the appearance of affluence), know that it does not cure the anxiety of insignificance. It does not provide you with a life purpose. It does not satisfy a neurotic need, which, by definition, is a need that can never be satisfied. In short, affluence does not equate to self-worth.

So, during this holiday season, if you are affluent (or a wannabe affluent), be aware of whether your riches are liberating or enslaving:

Are you being led astray by your ability to get (or consume) whatever you want, or are you controlling your impulsivity, getting what you truly want or need?
Are you having difficulty choosing what to buy (or do) because you know you can have it all, or are you making good choices and maintaining good discipline even though it’s not an imperative ?
Are you letting your affluence destroy your ability to find a purpose in life, or are you using your affluence to better your life and the lives of others?
Are you letting the tumultuous parts of your personality guide you into perilous pastimes, or are you willing and able to tame those impulses?
Are you only enticed by the superlative (the biggest and the best), or do you make your choices utilizing a wide range of options?
Are your kids adversely affected by their easy access to money, or are you making it a point to raise them with good values?
If, in your experience, affluence is not everything you thought it would be, be sure to admit what your issues are and take appropriate action before your problems become too big to solve.

Dec 10

By JANICE WOOD Associate News Editor

People with a high level of education who complain about memory lapses have a higher risk for stroke, according to new research.

“Studies have shown how stroke causes memory complaints,” said Arfan Ikram, M.D., associate professor of neuroepidemiology at Erasmus University Rotterdam in The Netherlands. “Given the shared underlying vascular pathology, we posed the reverse question: ‘Do memory complaints indicate an increased risk of strokes?’”

As part of the Rotterdam Study, 9,152 participants 55 or older completed a subjective memory complaints questionnaire and took the Mini-Mental State Examination (MMSE).

By 2012, 1,134 strokes occurred: 663 were ischemic, 99 hemorrhagic, and 372 unspecified, according to the study’s findings.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts or ruptures. When that happens, part of the brain cannot get the blood and oxygen it needs, so it and brain cells die.

According to the American Stroke Association, about 795,000 Americans have a new or recurrent stroke each year.

In the latest study, the researchers found that memory complaints were independently associated with a higher risk of stroke, but a higher MMSE score wasn’t.

The researchers also found that those with memory complaints had a 39 percent higher risk of stroke if they also had a higher level of education. The finding is comparable to the association between subjective memory complaints and Alzheimer’s disease among highly educated people, according to the researchers.

“Given the role of education in revealing subjective memory complaints, we investigated the same association, but in three separate groups: Low education, medium education, and high education,” Ikram said. “We found that the association of memory complaints with stroke was strongest among people with the highest education.

“If in future research we can confirm this, then I would like to assess whether people who complain about changes in their memory should be considered primary targets for further risk assessment and prevention of stroke.”

For this study, the researchers defined low education as primary education only; intermediate education as primary education plus some higher education, lower vocational education, intermediate vocational education, or general secondary education; and high education as higher vocational education or university training.

“The study results apply evenly to men and women,” Ikram added. “More than 95 percent of the study participants were Caucasians living in Rotterdam, so future studies should include more racially diverse groups,” he added.

The study was published in the American Heart Association journal Stroke.

Source: American Heart Association

Dec 8

By JANICE WOOD Associate News Editor

A new study has discovered that the brains of obese children literally light up differently when tasting sugar.

The study, led by researchers at the University of California, San Diego School of Medicine, does not show a causal relationship between sugar hypersensitivity and overeating. However, it does support the idea that the growing number of America’s obese youth may have a heightened psychological reward response to food, according to the researchers.

This elevated sense of “food reward” — which involves being motivated by food and deriving a good feeling from it — could mean some children have brain circuitries that predispose them to crave more sugar throughout life, the researchers explain.

“The take-home message is that obese children, compared to healthy weight children, have enhanced responses in their brain to sugar,” said first author Kerri Boutelle, Ph.D., a professor in the Department of Psychiatry and founder of the university’s Center for Health Eating and Activity Research (CHEAR).

“That we can detect these brain differences in children as young as eight years old is the most remarkable and clinically significant part of the study.”

For the study, the researchers scanned the brains of 23 children, ranging in age from eight to 12, while they tasted one-fifth of a teaspoon of water mixed with sugar. The children were directed to swirl the sugar-water mix in their mouths with their eyes closed, while focusing on its taste.

According to the researchers, 10 of the children were obese and 13 were at healthy weights. All had been pre-screened for factors that could confound the results, the researcher said.

For example, they were all right-handed and none suffered from psychiatric disorders, such as anxiety or ADHD. They also all liked the taste of sucrose, the researchers reported.

The brain images showed that obese children had heightened activity in the insular cortex and amygdala, regions of the brain involved in perception, emotion, awareness, taste, motivation, and reward.

Notably, according to the researchers, the obese children did not show any heightened neuronal activity in a third area of the brain — the striatum — which is also part of the response-reward circuitry and whose activity has, in other studies, been associated with obesity in adults. The striatum, however, does not develop fully until adolescence, the researchers said.

The researchers added that one of the interesting aspects of the study is that the brain scans may be documenting, for the first time, the early development of the food reward circuitry in pre-adolescents.

“Any obesity expert will tell you that losing weight is hard and that the battle has to be won on the prevention side,” said Boutelle.

“The study is a wake-up call that prevention has to start very early because some children may be born with a hypersensitivity to food rewards or they may be able to learn a relationship between food and feeling better faster than other children.”

Source: University of California-San Diego

Dec 7


The hope is that they become resourceful adults. The hope is that they learn to take life’s ups and downs and continue on. The hope is that they will recover from setbacks and mistakes, and persevere — even becoming stronger as they go. For most parents, the hope when raising children is that they will grow to be mentally tough adults. And in order to grow mentally tough adults, we have to raise mentally tough kids — as it turns out the process begins very early on. So how do we teach our kids to be mentally tough? Here are five ways:

Teach Don’t Tell. “Sit Down.” “Do Your Homework.” “Clean Your Room.” While these orders may be necessary, they don’t teach your kid anything other than compliance. And often, if said too much, they can cause your kid to tune you out. If you want to teach, the first thing you need is an engaged learner. So how do you get your kid engaged? You stop directing, and start asking. “Do you know why you have to sit down?” “Do you know why you have homework?” “Do you know why you have chores?” Asking your kid these questions — and many more — as oppose to simply issuing orders, causes her to think, become engaged, and learn why she has to do the things you are asking. And understanding the purpose of things not only leads to better engagement and cooperation, it leads to better frustration tolerance — which is a huge part of being mentally tough.

Raise Your Standards. Kids are a reflection of you. Everything you do, what you say, how you respond to others, becomes your kid’s reality. And yet, probably every parent has lost it at some point. But when you lose emotional control in front of your child, when you become defensive, fail to admit your mistakes, blame others, or act unkindly, your kids pick up on this too. And what you expect of yourself, is what you expect of your kids. So if you want your kids to grow to be mentally tough, show them what mental toughness is. Be a model of it. Show them how to take setbacks and use them to become better. Show them how to go after a goal, and don’t stop until you get there. Show them how you hold yourself up to the standards you set. And then when you set the standards for them — or better yet, encourage them to set them for themselves — they will know how to reach them. Having high standards, and reaching them, is a huge part of being mentally tough.

Let Them See Reality. Reality is not a cell phone at 9 years old. Reality is not a big house with a swimming pool. Reality is not the next new video game. Reality, for the majority of the world, is much more basic than that. Food on the table, a roof over the head, clothes on the back. As much as our kids are shielded from it, the majority of the world’s population lives well below our standard of living. Yet this may not be the best thing when it comes to teaching mental toughness. A kid who grows up with a certain standard of living, will expect to continue this standard of living as an adult. Yet unfortunately, this is just not possible for most college grads, who face an uncertain job market, and massive student debt. And this is a huge blow for most kids who grew up thinking that everyone has a nice house, nice car, and new clothes. So instead of shielding your kid from this harsh reality, show them what reality is. Let them see that life exists outside of their world and that people do just fine without cell phones, nice clothes, fancy cars, and big houses. Let them see that mental toughness is about knowing that your strength exists on the inside — in yourself — and is not defined by the things you have.

Practice Gratitude. According to researchers Richard Tedeshi and Lawrence Calhoun, two researchers who study post-traumatic growth, focus group reports of people who have gone through incredibly traumatic experiences and come out stronger, all relate one commonality: a feeling of gratitude. Gratitude for the life they have. What gratitude does is help survivors find a sense of appreciation when everything seems to fall apart — and it ultimately helps them continue on. And in order to teach your kids gratitude, show them what gratitude is — being grateful for what you have, as oppose to always wanting more. Show them how to find the positive in every situation — and there is one. Because mental toughness is about continuing on — even against the odds.

Teach Adaptability. Learning to adapt, according to Tim Harford, author of Adapt: Why Success Always Starts With Failure, is what separates not just successful individuals, but business and corporations, from the unsuccessful ones. The case that Harford makes is that adaptation is an evolutionary principle that has real world implications. Being able to take risks while not selling the farm, making mistakes, and then adjusting the approach based on mistakes, are the three components that define adaptability and as Harford notes, those who do not take risks do not evolve, because the landscape is always changing and what works for today may not work tomorrow. So if we want to be successful, we have to adapt. But learning to adapt is also a part of being mentally tough, because the truth is, things do not always go your way. So how do you teach your kids to adapt? Encourage them to try new things, even if it means taking a risk, and them let them know that mistakes happen, they are part of the learning process, and when they do, ask them what they learned, and what they can do different next time. Lastly, if you want to teach your kids to adapt, show them how you adapt when things don’t go your way.

Teaching toughness to kids is not an overnight process, but it is one that builds upon itself. Because once kids learn what it is, and that it’s something you — the parent — value, they naturally want to do it more. Yet while toughness for most kids is pretty instinctive, it is also highly linked to the environment in which they are raised.

Dec 5

When the Narcissist Becomes Dangerous



Recently at a dinner party, talk turned to the recent news story about Bill Cosby. As the only psychologist at the table, everyone looked at me as one person asked with intense curiosity, “How could anyone victimize women all those years, and still live with himself? How could you sleep at night?”

Since I don’t know Bill Cosby, I can’t speak for him; nor do I know if he is guilty of the accusations against him or not. But generally, in an actual situation like this, there is an answer to the question. The answer is one word: narcissism.

In many ways, it seems like it would be fun to be narcissistic. Wouldn’t it be great to go through life feeling superior to other people, and with unwavering self-confidence? Yes!

But as we all know, there is a dark side to narcissism. That unwavering self-confidence is as brittle as an eggshell. Narcissists don’t move back and forth on a continuum of self-esteem as the rest of us do. Instead, they run on full-tilt until something taps that protective shell of self-importance hard enough. Then, they fall into a million pieces. Under that fragile, brittle cover lies a hidden pool of insecurity and pain. Deep down, the narcissist’s deepest and most powerful fear is that he is a nothing.

With his brash, self-centered ways, the narcissist can hurt the people around him emotionally, and often. His deepest fear is of being exposed as “a nothing.” So he will protect his own fragile shell above all else, even if it sometimes emotionally harms the people he loves the most.

Why is the narcissist in such fear of being a nothing? Because she was raised by parents who responded to her on a superficial level, lauding or even worshiping certain aspects of her which they valued, while completely ignoring or actively invalidating her true self, including her emotions. So most narcissists grew up essentially over-valued on one level, and ignored and invalidated on another (Childhood Emotional Neglect – CEN). CEN on its own does not cause narcissism, but combined with other essential ingredients, it plays a part.

Some narcissists need to do more than just protect their shell. Their need to be special is so great that they also need to feed it with accolades, acknowledgment, or their own personal version of specialness.

This is when narcissism becomes dangerous.

There are four characteristics of the narcissist which can work together to make him a danger. They are:

The need to protect his inflated sense of self can make him desperate.
The need to feed his sense of specialness can drive him to violate others’ boundaries.
Lack of empathy for others can make him incapable of seeing when he hurts others.
His belief that he is special can make it easy for him to rationalize his actions.
Most narcissists do not pose any real danger to the people around them (except perhaps emotionally). The risk comes from #2. What’s his Special Ingredient? What does the narcissist need to feed his specialness?

Does he need to have a “special relationship” with young boys, like Jerry Sandusky (severe boundary violations)? Does he need to be seen as a mentor to Olympic wrestlers like John DuPont, as portrayed in The Foxcatcher (exploitation)?

What does the narcissist need to feed his specialness, to what lengths will he go to get it, and is his specialness extreme enough to enable him to rationalize his behavior? Those are the factors which determine a narcissistic person’s potential dangerousness.

Jerry Sandusky said that he felt his special relationship with boys was helpful to the boys. John DuPont appeared to rationalize that his money and privilege would make his minions better wrestlers.

If you have a narcissist in your life: a parent, sibling, friend, spouse, or ex, it is possible to manage the relationship in a healthy way. Your best approach is to walk a figurative tightrope. Have empathy for the pool of pain that lies beneath the surface of your narcissist’s blustery shell. Understand that he or she is protecting herself from the hurt that she experienced in childhood. But at the same time, it is vital to protect yourself as well. Keep your boundaries intact.

Do not let your compassion make you vulnerable.

To learn more about the effects of emotional invalidation in childhood, see;or the book Running on Empty: Overcome Your Childhood Emotional Neglect.

Dec 4

By TRACI PEDERSEN Associate News Editor

Employees who sit for long periods of time are at greater risk for psychological distress, according to an Australian study published in the journal Mental Health and Physical Activity.

Specifically, employees who reported sitting for longer than six hours per day had higher rates of anxiety and depression compared to those who sat for less than three hours a day.

Furthermore, going to the gym after work doesn’t appear to protect workers from the effects of prolonged sitting. When study participants were sedentary for most of the work day, even if they were physically active and getting exercise outside of work, they still showed relatively higher rates of anxiety and depression symptoms than did workers who sat for less than three hours a day.

For the study, researchers analyzed data from 3,367 state government employees as part of a broader health outreach program.

Participants were asked to fill out a short psychological assessment on their symptoms of anxiety and depression during the last four weeks. They were also asked to rate their current levels of physical activity, leisure-time activity, and general satisfaction with the workplace.

The results showed a significant relationship between rates of psychological distress and sitting. Employees who reported sitting for longer than six hours per day had increased prevalence of moderate symptoms of anxiety and depression compared to those who reported sitting for less than three hours a day.

There were also differences based on gender, with women reporting higher rates of sitting-related psychological distress than men. On average, male workers reported sitting for nearly five hours a day while women reported sitting for about four hours per day.

“Since men and women in our sample reported similar estimations of work stress, unmeasured factors such as work-family conflict and incorporation of work and parenting roles could be differentially affecting women,” writes psychological scientist Michelle Kilpatrick, Ph.D., of the University of Tasmania and colleagues in the journal Mental Health and Physical Activity.

“Consequently, individuals may be meeting recommended levels of health promoting physical activity, yet their physical and mental health may remain at risk if they are also sedentary for prolonged periods,” writes Kilpatrick.

Previous research has shown a link between prolonged sitting and a number of serious health issues ranging from Type II diabetes to heart disease. Although there was a strong association between long-term sitting at work and moderate levels of psychological distress, sitting was not associated with extreme levels of anxiety and depression.

Source: Association for Psychological Science

By TRACI PEDERSEN Associate News Editor

Brain Activity Just After Quitting Smoking May Predict Relapse
Smokers who attempt to quit but end up relapsing within seven days exhibit specific disruptions in the brain’s working memory system during their time of smoking abstinence, according to a new study by Penn Medicine.

This distinct neural activity — mainly a decrease in the part of the brain that supports self-control and an increase in the area that promotes an “introspective” state — could help distinguish successful quitters from those who fail at an early stage; it may also reveal a potential therapeutic target for new treatments.

“This is the first time abstinence-induced changes in the working memory have been shown to accurately predict relapse in smokers,” said senior author Caryn Lerman, Ph.D. a professor of Psychiatry and director of Penn’s Center for Interdisciplinary Research on Nicotine Addiction.

For the study, published in the journal Neuropsychopharmacology, researchers used functional magnetic resonance imaging (fMRI) to observe the effects of brief abstinence from smoking on working memory and its associated neural activation. The 80 participants, aged 18 to 65, reported smoking more than 10 cigarettes a day for more than six months and were currently seeking treatment.

“The neural response to quitting even after one day can give us valuable information that could inform new and existing personalized intervention strategies for smokers, which is greatly needed.” said James Loughead, Ph.D., associate professor of Psychiatry.

Past research strongly suggests that if a person can go without smoking for seven days, he or she will likely continue that way for six months or longer, and is therefore highly predictive of long-term success.

The researchers conducted two brain scans: the first immediately after a person smoked and the other 24 hours after abstinence began. Following smoking cessation counseling, participants set a future target quit date. Seven days after the target quit date, participants had a check-up, during which smoking behavior was accessed, including a urine test.

Sixty one smokers relapsed and 19 quit successfully for this period, the researchers reported.

Those who relapsed had decreased activity in the left dorsolateral prefrontal cortex, which controls executive functions, like working memory, compared to those who quit. Working memory is necessary for staying focused, blocking distractions, and completing tasks. They also had reduced suppression of activation in the posterior cingulate cortex, a central part of the default mode network of the brain, which is more active when people are in an “introspective” state.

Although wide implementation of a neuroimaging test is not clinically or economically feasible at this time, these findings on working memory may lead to improved measuring tools, specifically for early smoking relapse.

Source: Penn Medicine

Dec 2

Once again, we had an amazing experience at CHADD’s (Children and Adults with ADHD) annual conference, and we want to share our biggest “aha’s” with you! This year it was in Chicago – and as the snow was falling outside, we were talking with attendees at our booth, learning from other experts, and doing a workshop for parents.

As always at CHADD, we were jazzed by the experience. Over the years it’s become a kind of reunion for us, because we met each other at CHADD in 2010, and we launched ImpactADHD’s website as an Innovative Program in 2011!

While we were talking with parents throughout most of the conference, we did find our way into some sessions and keynote speeches! And as is always the case, there was a lesson to learn from every session we attended!

So we decided to use this week’s Guest Expert article to share a few tidbits of what we have learned from MANY experts over the years – at the CHADD conference, and beyond. Some of these tips may not be new to you, but we’re confident they’ll be useful.

Messages for Managing ADHD

You can’t start treating ADHD until you recognize that it’s real. Acknowledging it – and accepting it – sets you on the road to management. When you stop blaming yourself, or your child, you can take major steps towards improvement.

After acknowledging ADHD, it’s time to get informed! Information is a powerful antidote to self-blame. With better understanding, you can begin to take steps that really help in management.

While the most common recommendation for managing ADHD is medication, in one form or another nearly every professional we encountered recommended coaching. For individuals. For families. For parents. When asked the best way to balance “creativity” with the “need for structure,” Dr. Ned Hallowell responded: “Get A Coach.”

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A strength-based approach to managing ADHD, coupled with a belief in possibility of success, is incredibly powerful. Without intervention or effective treatment, ADHD can devastate lives. With hope and a focus on talents, people with ADHD achieve extraordinary success.

The identification and treatment of ADHD relies on a combination of scientific analysis and informed observation. ADHD is not a one-size-fits-all kind of diagnosis, and treatment protocols are equally as diverse, depending on the individual.

Success depends on the use of structures. Hallowell says, “Team up with someone with structure and yield to it.” But the structures must match an individual’s abilities, and be implemented in the context of positivity and realistic expectations.

In addition to coaching, mindfulness is another non-medication-based approach that can be really effective in managing ADHD. Simply placing attention on what’s most important can shift your approach to all kinds of complications. For parents, mindfulness encourages you to choose priorities – is a clean room more important than academic success?

People “medicate” or “manage” their ADHD in a number of ways outside of prescription medication. Some of them can be very positive strategies (sleep, brain-training, exercise, meditation, nutrition, & food management), and some not necessarily healthy (caffeine, illegal drugs, alcohol, sexuality, thrill-seeking/risk-taking behaviors, anger, procrastination). Recognition of how we are “self-medicating” – for better and worse – can lead us to more conscious management. For example, anger can be something that people with ADHD use to help them focus. Depending on time and location, it can be helpful, or particularly irritating!

Sleep. It’s so important. Can’t underestimate it’s role in complicating ADHD, or helping to manage it better.

Medication alone is generally not a sufficient treatment for ADHD. Accompanying treatments like coaching, therapy, organizational management, mindfulness and others are critical to success over a lifetime!

Executive function deficits do not necessarily respond directly to medication, and they are at the core of the challenges people with ADHD face every day.

Co-existing conditions, like anxiety or learning disabilities, add to an individual’s frustration, and it’s important to manage each diagnosis, not just treat each one separately. People with ADHD may have to work harder than their peers in some aspects of life, especially in school. Acceptance of that reality can help parents find more compassion, and kids find more determination.

Mastering motivation is key to accomplishing any task for an individual with ADHD. Motivation doesn’t come naturally, necessarily – it needs to be consciously identified.

ADHD symptoms are contextual. Dr. Tom Brown explains that an individual’s ability to perform any given task will depend on the circumstances. If someone is distracted by intense emotions or loud noises, for example, she may not be able to concentrate, even if she could do the same task perfectly at another time.

Dec 1

7 Ways that Parents can Help


Is your child easily distracted? Does homework that should take 45 minutes end up consuming two hours? If so, you are probably a frustrated parent. Chances are you have learned that punishing inattentive behavior doesn’t work. The question is: What works? Here are some ideas that might do the trick for managing ADHD and homework.

Set Up the Correct Type of Study Space
Most inattentive students need a fairly quiet place to study, but a small group of these students thrive on the hum of a busy area. To determine the type of space your child needs, you’ll need to do some detective work. For two days, have your child do his homework in a well-traveled area and then switch to a quieter area for the next two days. If you determine your child does better in a quiet place, find a couple of areas free from household action, but close enough to monitor his activity. Interestingly, kids retain more information when they vary the place in which they study. Switching locations every day or few days is a good idea.

Don’t Fear the Floor
For some students, sitting at a traditional desk isn’t productive; however, there are other options. One is an exercise ball chair (www.sitin¬ which is a sturdy exercise ball in a steel frame with a comfortable back rest. Another option is a lap desk ( — a mini-desk that lies across your child’s lap. With a lap desk, the student can sit on the couch or another chair more comfortably. Some children actually perform better doing their homework standing up. Still others need to stand, pace, or even lay on the floor; therefore, don’t fear the floor!

Make a Mountain a Molehill
Depending on the age of your child, he may only be able to focus well for 20 minutes at a time. Often, the time you spend refocusing his efforts after 20 minutes may be better spent giving him a break so he can recharge and begin again. This can be done in two ways – by task or time.

By task – Fold a worksheet in half. Instruct your child to do the top half, show it to you, and then finish the second half. Allow him to choose the problems or questions he wants to do first. When he’s done with half of them, go on to the rest.

By length of time – Set the timer for 5, 10, or 15 minutes. Tell your child, “Work as hard as you can for this time. When the timer goes off, you can daydream or play for 5 minutes.” Another option is to set the timer for a length of time for which you absolutely know he’ll be successful. When he succeeds, lengthen the span by a minute.

Let Her Fidget
Various studies have shown that distractible students can actually attend better when they are given something to hold or touch. A few good options are the Tangle Junior (, Wikki Stix (, or even a simple stress ball. By simply manipulating these toys in their hands, many students are better able to focus.

Insist On Exercise – The Miracle Drug
Aerobic exercise almost immediately elevates the chemicals in the brain that increase attention and focus. These chemicals act a bit like Ritalin or other medications used to treat ADHD. With frequent aerobic exercise, a distractible student can improve his ability to learn, so be sure to encourage your child to get out and exercise regularly.

Nag No More
If you feel like the only way your child can focus and finish is with your constant reminders, try a different method. Ask your child how many reminders she’ll need to finish an assignment. If she says she’ll need two reminders, then stick to that number. When she’s off track, state that you are giving a warning and then walk away. At any point when you see that she’s doing the right thing, praise her diligence. By giving warnings and positively reinforcing on task behavior, constant reminders will be gone for good.

Keep a Homework Log
Teachers may be unaware that homework is so problematic. They only see the final, corrected product, not the inordinate amount of effort behind it. For at least one week, jot down the date and length of homework. You may also want to document any reasons you see for your child’s homework struggles. Meet with the teacher and share the information you’ve recorded. Ask for suggestions to help your child accomplish homework tasks. Remember, students should be spending about 10 minutes per grade level on homework per night.

Try using a few of these strategies and see what works with your child. Odds are he or she will be focusing and completing work in no time at all!

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