Communication with your spouse or partner isn’t always easy. Today’s busy life styles have created shorter periods of time to sit and talk.  Much of our communication is through short conversations or even texts which can leave out details.  We are communicating more by phone and e-mail which can be informative but we miss out on body language and sometimes mis-perceive tone and intention. If you have concerns about communication, maybe that you are not being heard or if you are worried that you are arguing too much here are a few tips:

Take time to talk and really listen. Find time to be together alone, no TV, No phone, No pressing engagement, No multitasking.  Relationships need to be maintained. This takes a bit of work.  Think about what you want to say, and then say it the right way. Use I statements. I need… I feel… Not- you did this or you said this. You statements sound blaming. If you love to write you may want to take the time to write a letter to your partner and give it to him or her as a way to get things started.

Listen, really listen. There is no communication if one person is speaking but the other didn’t really hear or understand. This may sound silly but repeat back what was just said to you. It lets them know you heard them and can be an indication of empathy. It feels good to really be heard.

Stay Focused. It’s tempting to bring up other problems or past incidents but this will only complicate an already difficult issue. Stick to one problem at a time and you will make more headway.

Try not to blame or judge.  This can be difficult if you are trying to resolve a conflict. If you hear your partner becoming defensive, chances are your previous statement was judgmental or was perceived that way.

Try to see their point of view. We spend most of our time in conflict trying to be heard or to make our point. Ironically, if both people do that then neither person feels heard and it is doubtful the argument will get resolved. If you try to see your partner’s side it is more likely he or she will listen to your side.

If the conversation starts getting heated or argumentative and blaming, take a break. Very little good can come from raised voices or blaming, much less screaming and yelling. Those conversations usually lead to unresolved problems and too many unresolved problems can greatly weaken a relationship. While you’re taking a break, try to see what you did to escalate the conversation. Then communicate that to your partner, and start over.

These tips are the cornerstone of good communication. They can be found in almost every book on communication. Many of us have either learned them or at least heard them before; however, I think they bear repeating, as they really do work. Often we learn skills but don’t use them. After many years as a therapist I can state that if you practice these simple communication skills, it will decrease the blame and defensiveness in your conflicts and improve your relationship.

**Finally, if you are concerned you are nearing a breaking point or a break-up, seek out professional help. These tips can be helpful but if you are very unhappy a trained professional can teach the skills you both need to enjoy your relationship again.

Lori

 As a marriage and family therapist, relationships are very important to me. I have spent years studying and examining just what keeps couples and families together. What makes some work and others fall apart?

There are 3 necessary components to relationship maintenance.

1. Love
2. Commitment
3. Communication

At any given time, at least one of these 3 aspects of relationships is what keeps families and/or couples together. When times get tough, as they inevitably always do, it may be the strong feeling of love that holds you together. Maybe you are very angry at your partner, and it may be the idea of commitment that holds the two of you together. Love is a feeling, you either feel it or you don’t. Commitment is an idea you either believe in it or you don’t.

Communication however is a skill, a behavior or set of behaviors, that has impact on our thoughts (one of them being commitment) and feelings (one of them being love).  Communication entails expressing a message through words or body language and listening. For the purpose of this post, I’ll simply focus on the impact of some of our “words”.

 If our communication is frequently critical, defensive, blaming or extremely negative, it will create a “cycle of negativity” (Gottman 1994). It is not just that repeated negative communication is unpleasant, it is the impact of this negativity on both people and how they think and feel about each other. Take a look at this simple example: There is a   complaint about a problem “I wish we had more money.” Which turns into, “Why don’t you work harder?”(Criticism) Or “If you didn’t spend so much money on needless things we would have more money to do things together.” (Blame) Your partner will inevitably become defensive and often strike back. “I spend my money on things that relax me because I work so hard. Why don’t you work harder?”(Defensiveness and Blame)…See where this is going? More blame, more criticism, more negativity.  We have all been in conversations like this, they are natural. This only becomes a problem if it is the norm. If all of your problem solving takes the form of blame, criticism and defensiveness then problems don’t get resolved. They simply come up again and then don’t get resolved again and so on. It leads to feelings of resentment and even contempt. When the amount of negative feelings outweighs the amount of positives feeling a relationship is in danger.

The good news is this is reversible. You can build ways of communicating that resolve conflict and enhance positive thoughts and feelings.  So if you are in a committed relationship, and you have concerns about negative communication or conflict that is frequently not resolved, stay tuned. My next blog will give you some advice on how to build positive communication in relationships.

Lori

Grief is a natural response and usually a multi-step process after loosing someone or some thing very important to you.  There are subjective feelings accompanying a loss such as anger and depression that are always part of the natural process of grief.In 1989 Kenneth Doka, coined the term “Disenfranchised Loss”. This is a loss that is not, or cannot, be openly acknowledged, publicly mourned, or socially supported.Some categories of disenfranchised loss include: abuse and domestic violence, divorce, miscarriage, chemical pregnancy, the loss of a dream such as having a child or a certain kind of life… these ordinary losses often go unrecognized by others. Being unrecognized by others and sometimes ourselves, we often do not mourn them. They get pushed aside or stuck inside of us.

Losses can also have a cumulative effect if they happen too close together especially if they are associated with trauma or if you don’t have a chance to fully process a loss and you experience another. Each loss can be like another trauma, opening the wound of the past and re-grieving all over again. Often people find themselves stuck in a negative cycle of depression and anger. Conversely, working through loss and trauma to a place of peace and acceptance can help us through the next trauma and loss. In her quintessential Book – On Death and Dying (1969) Elisabeth Kuebler-Ross identifies the following stages of grief: shock and denial, anger, bargaining, depression and acceptance. Processing and progressing through each stage brings us to the acceptance.

What I believe is important, is that we realize we can eventually come to a state of acceptance. It is possible. We are all human. We are by design, able to be conscious of pain, death, loss and trauma and move beyond it. Many believe this is the point of life.  Sometimes we work it through one hour at a time, sometimes one day at a time, and with time we find we have longer periods of pain free living.

If you are grieving, and you think you are stuck or it is becoming unbearable, seek out someone who you may find helpful or supportive. There are many avenues to process your loss. Getting there will take different amounts of time for different people and for different reasons.  Ask yourself what it is you need; counseling or psychological help or spiritual help? Are there family members who may be able to help you? There are different paths for different people. You may try just one or a couple at one time. One thing is for sure, be good to yourself. Get plenty of rest and eat well. Know that this will take time but for most of us we will get through all of these stages. Take time to focus on the beautiful things in this moment, like the sunshine, a smile or a funny movie. Noticing that there are moments without pain is part of the healing process too.

If you would like to discuss this or any other subject please feel free to contact me through one of the forums. I’m sure there are many other people experiencing the same or similar pain who would also benefit from your question and my response.

Lori

What is stress? It may come from or take the form of worry, fear, anger, pain, resentment grief, anxiety or depression. It can be any one or more of these feelings that most of us refer to as stress.

We refer to situations as stressful. Who hasn’t said “I had a stressful day at work”. Some pleasant events are stressful; weddings, family gatherings or a first date. Even vacations can be stressful. As we prepare for our first family trip to Disney World, so many people say “A week at Disney? You’ll need a vacation after that one”

Stress is subjective. Why is it that 2 people can be involved in the same stressful incident but react much differently?  The answer lies in HOW they react to it. Our emotional reactions to situations come from our perceptions and temperaments. It is partly how we have learned to perceive our circumstance and partly heredity.

The good news is that whether it is learned or inherited you can choose to change your reaction to stress and decrease your anxiety, anger and other negative emotions. This is true for small or pleasant stressors or long term chronic stress.

It is important to know how you react to stressful situations? Are you the type of person who is more anxious and becomes upset easily? Or are you more of a just go with the flow – let it ride type of person?  Most of us have a combination of traits. Long term stressors such as pain, grief and loss and infertility, can cause even the easiest going, accepting individuals to suffer depression and/or anxiety and all of the other negative emotions we associate with stress.

You also need to be able to tap into how you think about things. Our minds are very powerful. What we think affects how we react.

This sounds easy but can be difficult.  Do you have expectations that cause self blame or increased worry? Self examination is the first step in changing your thoughts. You can’t change what you don’t know or understand. Accepting your self and how you think and react is necessary if you want to change your emotional reaction to situations.

I am reminded of one of my favorite sayings, by Jon Kabat-Zinn. “You can’t stop the waves but you can learn to surf” I cannot stop negative things from happening to me but maybe I can learn how to cope with them better.

We have all heard this before, we know we need to change our negative thoughts but it is just not that easy. If it was I wouldn’t have a job. So my first piece of advice is this. Accept yourself, go easy on yourself. Decide to make a change and please don’t expect it to happen over night.

Once you have decided to make a change, choose a path. There are many to choose from. Therapy, self help, spirituality or a combination of them all. You probably already have an idea of what will work for you. Explore it.

After years of personal and professional research and observation I have found mindfulness meditation to be one of the most beneficial ways of reducing our reaction to stress. In particular, mindfulness allows us to examine ourselves in a very accepting way. This is key to decreasing our stress reactions.

You can find out more about mindfulness from the Stress Reduction Clinic at the University of Massachusetts which has conducted over 30 years of mindfulness based medicine and research.

http://www.umassmed.edu/content.aspx?id=41252

This year October 24th is Acupuncture and Oriental Medicine Day. I came across a funny music video about the day that was made by someone within the profession. It’s not meant to be a high quality song, in fact some of the words are made up and some of the sentences are really squeezed in to fit the melody but the information in it is true and I thought you would find the video very interesting. (Please note: I do not agree with the one reference made to “not needing doctors and their fancy drugs”. I believe both Medical Doctors and medical drugs are sometimes very important and beneficial. Besides I think it was only put in the song in order to rhyme with another phrase.)I may not keep the video on my site forever but it will be here until at least October 24th.  So in honor of our upcoming National Acupuncture & Oriental Medicine Day…enjoy the video. Please let me know what you think.

Today I want to switch gears and get away from the fertility subject. I’d like to tell you about an incredible event in which I  participated during July 2003 while I was living in San Diego, CA.  It was called the National Stand Down for Homeless Veterans and it was founded in 1988 by the Vietnam Veterans of San Diego. The event is annual and still goes on each July in a park  in downtown San Diego.

What is a Stand Down?
In times of war, exhausted combat units requiring time to rest and recover were removed from the battlefields to a place of relative security and safety. Today, Stand Down refers to a community-based intervention program designed to help the nation’s estimated 200,000 homeless veterans “combat” life on the streets.

VVSD organized the nation’s first Stand Down in 1988. Since then, the program has been widely replicated nationwide. Today, more than 200 Stand Downs take place across the country every year. “The program has become recognized as the most valuable outreach tool to help homeless veterans in the nation today,” according to the National Coalition for Homeless Veterans.

Stand Down’s philosophy is a hand up, not a hand out. The hand up is made possible each year by the dedication of thousands of volunteers and numerous sponsors.

Hundreds of homeless veterans are provided a wide range of necessities including:

• They are greeted with respect and open arms
• They are offered breakfast and coffee and fresh fruit
• Picture IDs are be made for those who need them
• The VA and EDD assist with registration
• Tents are assigned with tent leaders who are there to assist them in accessing services

Their immediate physical needs are addressed.

• A visit to the clothing tent
• Showers
• Barbers
• Medical
• Dental

There are the many other services:

• Homeless court
• Counseling
• Veterans benefits
• Employment and job counseling services
• Acupuncture and massage therapy
• Recovery providers
• Shelters
• Chaplains services
• 12-step meetings for everyone

It is the providing of  Acupuncture services in which I participated. In a 2 day period I and about 15 other student and teacher acupuncturists treated approximately 450 veterans. It was the busiest acupuncture treatment facility I have ever seen and the fastest I have ever had to put needles into anyone. I treated 30-40 people each day. Luckily I could move faster in those days. I didn’t get to sit down once in about 8 hours.  Forget about eating. To say the least, I was mentally and physically exhausted but it was the most rewarding experience of my life. That day I treated a large variety of conditions including Depression, Stress, Anxiety, Sciatica, Arthritic Knees, Plantar Fasciitis and Carpal Tunnel. Our tent was one of the busiest tents of all. The Veterans that attended that Stand Down were grateful for all the services they received and I was grateful for having the opportunity to provide something that they perceived of as great value to them.

If you have the opportunity to give to our veterans, please do so. Also, please visit the website for the National Stand Down For Homeless Veterans by the Vietnam Veterans of San Diego to learn more about their plight. The link to their site is on the upper left side of this page along with some other links I feel are very valuable. I will be adding other links as time goes on.  Thank you for reading this.

By the way…the results for the most recent Hammonton fertility patient came in and unfortunately they were negative.  You can always count on me to tell the truth on my blog, on the phone and in person. She did however tell me she didn’t regret doing the acupuncture at all and thought it helped her a lot during her IVF cycle anyway.

Jon

In 2006 I scheduled my first patient from Hammonton. She had gone through 3 previous Fresh  IVF  cycles and none of them had worked. When you have already had 3 embryo transfers it’s a sad fact that a 4th transfer has lower expectations of success than any of the first 3. (In the early years of my practice most of my fertility patients were on their last try. I’m sure it was because people didn’t really think about trying something as “crazy” as acupuncture until they were somewhat desperate. In fact, acupuncture for fertility was not that well publicized. Even the doctors were just becoming familiar with the landmark 2003 Acupuncture and IVF study.) She was 36 years old with no children. Of course, she was a little skeptical and some what frightened, so she did what any other good daughter from Hammonton would do…she brought her mother with her to her first appointment. Now I was the frightened one (just kidding…moms are always welcome). She would almost always have either her husband or mother with her when she came for treatments over the next 3 months.  One day she came in with severe lower back  pain from a herniated disc which had occurred over the weekend. I always tell my fertility patients that they will never feel more fertile during their course of treatment but may very likely feel some other troubling physical or emotional condition improve. Well when this patient’s back pain went from 8 out of 10 on the pain scale to 2-3 out of 10 in one treatment it gave her something tangible and positive to feel. From that treatment on she became more relaxed and started to really enjoy the treatments. Of course, to make a long story short, her IVF cycle was successful and her baby boy’s picture is hanging up in my office. But this is not the end of the story. I will now start referring to her as Hammonton patient number 1. She had a very good friend who she worked with and had been going through the same infertility process as she did but with a different fertility doctor. She had been telling her friend about me for months but her friend had been resistant. After her first IVF cycle didn’t work she finally broke down and called me. She will forever be known as Hammonton patient number 2. On her next IVF cycle she came to me for treatments and her baby’s picture is now also hanging on my wall. Patients 1 & 2 worked with a man who’s wife was also going through the same thing and together after months of them talking about me finally convinced him to have his wife call.  Patient 3… came to me during her next IVF cycle and now the picture of her and her husbands triplets are hanging in my office. (I realize this story is already getting unbelievable but it’s absolutely true and not even half over yet.) Patient number 4 did not work with patients 1-2 or husband of number 3, but she was friends with someone who worked with all 3 of them. She became the 4th patient in the Hammonton connection and of course had heard the story of the first 3, which is why she called me. During her next IVF cycle she came to me for treatments and her baby’s picture is hanging in my office. By now you probably are getting where this story is going. Since 2006 I have now had 109 patients come to me through this chain of referrals. 7 out of the first 7 patients all had success during the IVF cycle they did while being treated by me. The 8th patient did not have success during the IVF cycle she did while I treated her but because that was the last IVF cycle she could do, she did one more IUI afterwards and she was successful in that last IUI. That was after having done multiple IUI’s without success prior to starting the IVF process. Patient number 9 unfortunately did not have success while I treated her but I hope with all my heart that something positive did end up happening for her and her husband.  She is no longer coming to me. Patient number 10 has her pregnancy test scheduled for this coming week…so once again, stay tuned.

P.S – I’m going to Hammonton for dinner tonight, they have some great restaurants and have really fixed up the main street downtown. They also have some great Victorian houses. So don’t be afraid to go to Hammonton. There’s nothing wrong with the water!