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4.30.2012

Best for Bebe? Global Perspectives on Perfect Parenting (from www.education.com)


Best for Bebe? Global Perspectives on Perfect Parenting
By Roberta Munoz
Like every parent, you want your individual child-rearing style to be the best for your baby. But is your way the greatest—or simply good enough? Thanks to the popularity of new parenting manuals, American moms and dads are now having some doubts.
Recent books like The Battle Hymn of the Tiger Mother and now, Bringing Up Bébé, have caused controversy and chaos among new parents. The books themselves present very different perspectives on child-rearing. Tiger moms practice strict, structured and traditional ways of raising a child, with a heavy emphasis on discipline and academics. On the other hand, Bringing Up Bébé touts the laid-back, less "child-centered" style of French parenting as superior.
You heard me right—superior. Not just good or better, but best. When the authors of these books claim that their way's the "best" to raise a child, you might start to feel that what you're doing is flawed or foolish. Are you right?
Dr. David Lancy, Professor of Anthropology Emeritus at Utah State University and an expert on cross-cultural parenting says that the problem lies in the very idea that there is a "best" way to raise a kid. He calls it "the problem of optimization." According to this model, Lancy says, "Parents believe that children can be 'optimized'—and that it's the parent's job alone to see that this happens."
For optimizer parents, this means providing perfect parenting for their children at every stage of life. Along with this concept is the idea of the "critical window"—the idea that if parents don't provide the right experience at exactly the right time, it's too late, and their youngster has already missed out. "This model of parenting places an unnecessary burden of guilt on parents," says Lancy. "It's not up to parents alone to provide perfect experiences for their child every step of the way."
Once you discard the idea that there's a perfect system to create an ideal child, you can read about cross-cultural parenting practices with less panic. You aren't doing it all wrong—really! So discard the "optimizer" model and keep these key points in mind:
  • The Promise of Perfection. Despite what Tiger mom and bébé's mère tell you, perfect parenting is a myth. The academic excellence that comes from hours of studying math is an important tool for success, but doesn't assure a flawless future for your child. French children may develop independence and maturity, but these qualities aren't a passport to a pain-free life. These mothers are simply striving to develop the qualities in their children that they—and their culture—value most. Not buying into the myth of the "perfect parent" allows you to zero in on the specific qualities you'd like your little one to develop, such as good grades, being a good listener or having compassion for those in need.
  • A Bit of This, a Bit of That. Instead of focusing on one magical method, take parenting step-by-step and don't focus on a single system. You don't have to adopt just one method—such as the French or Asian model—wholesale. Like that Tiger mom's kids are musical masters? Use Amy Chua's "tough love" technique and force your child to tirelessly practice the piano. Want to teach patience? Ditch the guilt and practice the French method of delayed gratification. Be flexible and try different approaches to learn what works for you and your child.
  • "Unpack" Your Parenting Style. A 1983 study in the Handbook of Child Psychology defines four primary parenting styles—from high control and engagement to low discipline and disengagement. French and Asian moms fall along this continuum—and so, most likely, do you. When Amy Chua enforces structured homework sessions and music lessons for her children, she is practicing a strict, disciplinary style of parenting. French moms aren't "better"—they just spend less time planning play-dates and more time on adult conversation—typical of a type of low-control, disengaged parenting. Find out where you fit on this scale.
  • Define Your Goals. Perhaps raising an independent thinker's more important to you than producing a violin prodigy—and that's okay! You can't consciously choose a parenting style, or be critical of your own, without well-defined goals. If school success is important in your family, then plan and supervise regular study sessions for your child. If you want your child to be altruistic or socially aware, encourage her to volunteer or help her participate in community activities. When you read about a new and improved parenting practice from another time or place, ask yourself—is this consistent with my goals (and not somebody else's)?
  • Optimize—or Opt Out?: According to Dr. Lancy, one of the biggest problems for "optimizer" parents is that some qualities that they want their children to develop are things that can't be directly influenced. For example, perseverance and resilience are often desirable qualities for young children—but when optimizer parents hover over their child's experiences to ensure success, the speed bumps in life are eliminated, and kids never learn how to bounce back on their own. Don't intervene in every small playground fight. Allow your child learn to play by herself. The better-behaved French bébés are quite possibly a product of less parental attention, not more. Often, children simply need to be left alone to practice self-sufficiency.
Above all, don't fall into a "bad better best" trap. Read about, study and observe the child-rearing customs of other cultures—not to make yourself feel bad—but to enrich and enhance your own parenting practices.

4.29.2012

How to Fix ADD

Rick Hanson PhD
Feb 23, 2012

Seven steps to taking control of your attention

Moment to moment, the flows of thoughts and feelings, sensations and desires, and conscious and unconscious processes sculpt your nervous system like water gradually carving furrows and eventually gullies on a hillside. Your brain is continually changing its structure. The only question is: Is it for better or worse?
In particular, because of what’s called “experience-dependent neuroplasticity,” whatever you hold in attention has a special power to change your brain. Attention is like a combination spotlight and vacuum cleaner: it illuminates what it rests upon and then sucks it into your brain – and your self.
Therefore, controlling your attention – becoming more able to place it where you want it and keep it there, and more able to pull it away from what’s bothersome or pointless (such as looping again and again through anxious preoccupations, mental grumbling, or self-criticism) – is the foundation of changing your brain, and thus your life, for the better. As the great psychologist, William James, wrote over a century ago: “The education of attention would be the education par excellence.”

But to gain better control of attention – to become more mindful and more able to concentrate – we need to overcome a few challenges. In order to survive, our ancestors evolved to be stimulation-hungry and easily distracted, continually scanning their interior and their environment for opportunities and threats, carrots and sticks. There is also a natural range of temperament, from focused and cautious “turtles” to distractible and adventuresome “jackrabbits.” Upsetting experiences – especially traumatic ones – train the brain to be vigilant, with attention skittering from one thing to another. And modern culture makes us accustomed to an intense incoming fire hose of stimuli, so anything less – like the sensations of simply breathing – can feel unrewarding, boring, or frustrating.
To overcome these challenges, it’s useful to cultivate some neural factors of attention – in effect, getting your brain on your side to help you get a better grip on this spotlight/vacuum cleaner.
But how can we train our attention?
You can use one or more of the seven factors below at the start of any deliberate focusing of attention – from keeping your head in a dull business meeting to contemplative practices such as meditation or prayer – and then let them move to the background as you shift into whatever the activity is. You can also draw upon one or more during the activity if your attention is flagging. They are listed in an order that makes sense to me, but you can vary the sequence. (There’s more information about attention, mindfulness, concentration, and contemplative absorption inBuddha’s Brain.)
Here we go.
1. Set the intention to sustain your attention, to be mindful. You can do this both top-down, by giving yourself a gentle instruction to be attentive, and bottom-up, by opening to the sense in your body of what mindfulness feels like.
2. Relax. For example, take several exhalations that are twice as long as your inhalations. This stimulates the calming, centering parasympathetic nervous system and settles down the fight-or-flight stress-response sympathetic nervous system that jiggles the spotlight of attention this way and that, looking for carrots and sticks.
3. Without straining at it, think of things that help you feel cared about – that you matter to someone, that you belong in a relationship or group, that you are seen and appreciated, or even cherished and loved. It’s OK if the relationship isn’t perfect, or that you bring to mind people from the past, or pets, or spiritual beings. You could also get a sense of your own goodwill for others, your own compassion, kindness, and love. Warming up the heart in this way helps you feel protected, and it brings a rewarding juiciness to the moment – which support #4 and #5 below.
4. Think of things that help you feel safer, and thus more able to rest attention on your activities, rather than vigilantly scanning. Notice that you are likely in a relatively safe setting, with resources inside you to cope with whatever life brings. Let go of any unreasonable anxiety, any unnecessary guarding or bracing.
5. Gently encourage some positive feelings, even mild or subtle ones. For example, think of something you feel glad about or grateful for; go-to’s for me include my kids, Yosemite, and just being alive. Open as you can to an underlying sense of well-being that may nonetheless contain some struggles or pain. The sense of pleasure or reward in positive emotions increases the neurotransmitter, dopamine, which closes a kind of gate in the neural substrates of working memory, thus keeping out any “barbarians,” any invasive distractions.
6. Get a sense of the body as a whole, its many sensations appearing together each moment in the boundless space of awareness. This sense of things as a unified gestalt, perceived within a large and panoramic perspective, activates networks on the sides of the brain (especially the right – for right-handed people) that support sustained mindfulness. And it de-activates the networks along the midline of the brain that we use when we’re lost in thought.
7. For 10-20-30 seconds in a row, stay with whatever positive experiences you’re having or lessons you’re learning. Since “neurons that fire together, wire together,” this savoring and registering helps weave the fruits of your attentive efforts into the fabric of your brain and your self.

4.28.2012

Babies Born Exposed to Prescription Drugs

Hospital seeing more babies born exposed to prescription drugs

By Julie O'Neill, CNN
updated 8:28 AM EDT, Sat April 28, 2012
Newborns battle drug withdrawal
STORY HIGHLIGHTS
  • Tennessee ranks among the top states dealing with prescription drug abuse
  • About half of all babies in intensive care at one hospital suffer from drug withdrawal
  • Opioids, like oxycodone, are the main drugs in these babies' systems
  • Most are diagnosed with neonatal abstinence syndrome, or NAS
Knoxville, Tennessee (CNN) -- Heart-wrenching cries echo through the halls of the neonatal intensive care unit at East Tennessee Children's Hospital. Nearly half of the newborn babies in the hospital's NICU are suffering from prescription drug withdrawal.
For over a year, the Knoxville hospital has been dealing with a dramatic increase in the number of newborns with neonatal abstinence syndrome, or NAS, which is the withdrawal process a newborn baby goes through after in utero exposure to certain medications.
"When I first got into neonatology the most common problem -- and still the most common problem -- that we take care of is premature babies or babies with respiratory distress," said neonatology director Dr. John Buchheit, a 17-year veteran at Children's. "But I had no idea that we would be seeing this issue, to this degree."
Narcotics used during pregnancy pass through the placenta to the baby. Once the baby is born, he or she no longer has access to the drugs and will likely go through withdrawal. According to Buchheit, opioids -- like oxycodone -- are the worst offenders for the babies suffering from NAS at his hospital.
Between 55% and 94% of babies exposed to opioids prior to birth exhibit signs of withdrawal, according to the American Academy of Pediatrics.


The babies are easily agitated and cry constantly, and many cannot be near sound and light. Other symptoms can include a distinct, high-pitched cry, tightening of the muscles and seizures.
While prescription drug abuse is a problem in nearly every neighborhood in America, it is particularly epidemic in Tennessee, which ranks among the top states in the overuse of prescription pain medications.
A recent Tennessee health department survey found that about a third of pregnant women in state treatment programs are addicted to prescription pain meds. As a result, the number of babies born with NAS at East Tennessee Children's Hospital doubled from 2010 to 2011.
This epidemic is tearing apart families in eastern Tennessee, according to Department of Children's Services Attorney Susan Kovac.
"In Knox County, we're drowning," she said. "We've seen the number of children in foster care increase by almost 50% over the last few years, and that's just the tip of the iceberg because we're trying to keep the children out of foster care. We've got lots and lots of relatives who are raising drug-exposed infants."
State caseworkers are called in to handle the worst cases of babies suffering from NAS.
"We come and talk to the mom and try to find out, what's the level of her abuse, what's the level of her addiction, what can we do to get her clean so that she can be in a position to take care of her baby," Kovac explained.
Since the epidemic is relatively new, there is no national protocol on how to treat NAS. East Tennessee Children's Hospital focuses its treatment on two areas: environmental and medicinal. Last year, the hospital created a wing of private rooms that is quieter, darker and easier to control for the massive influx of babies suffering from drug withdrawal.
The hospital also trains volunteers, called cuddlers, to hold and comfort the babies.
Bob Woodruff, a retired marketing professor and grandfather, spends six hours a week giving these babies a little extra love.
"It's tremendously rewarding to take a stressed baby and work with that baby until that baby is feeling better or sleeping," Woodruff said. "It also makes the job of the nurses a lot easier. It's a lot easier for them to come into a room and deal with a calm baby, rather than a crying baby. So I feel like I'm really helping the nurses, as well as helping the babies."
In addition to improving their environment, the hospital has also developed a successful drug treatment program for these babies, according to pharmacist Terry King.
"When I first arrived, we were treating the babies and stabilizing them on methadone and then discharging them to have outpatient treatment," he said. "Then we decided that probably wasn't the safest and most effective way to treat them. So we decided to switch to the morphine."
Terry King developed the drug regiment for babies with neonatal abstinence syndrome.
Terry King developed the drug regiment for babies with neonatal abstinence syndrome.
Treatments are individualized based on the severity of withdrawal and babies are given small doses of morphine every three hours with feedings. Over the following weeks, doses are gradually decreased to wean babies off the drugs. Since adopting the morphine protocol, the average hospital stay for these infants has decreased by several days, now averaging 24 days.
As East Tennessee Children's Hospital continues to treat these defenseless drug-dependent babies and chip away at the underlying causes of drug abuse through education and proper medical care, Buchheit admits that the future for these newborns with NAS is uncertain.
"There is no doubt that they are at an increased risk for problems with their learning and development throughout their childhood, and problems with behavior once they reach school age," he said.
In the meantime, the hospital has become a pioneer in the treatment of babies with NAS. Other states are turning to them for guidance.
"This problem is faced all over the country ... and people are interested in what we're doing because we know it's a safe, successful plan to administer," King said. "The process is complex to wean these babies and we think that what we've developed has helped make the complex, simpler."

4.27.2012

Infertility - and Things You Shouldnt Say

Tracey Cleantis

great piece from Colleague, Tracey Cleantis!

I don't know if Miss Manners, Martha Stewart or any other blond woman keen on handing out the rules of genteel and polite society has come out with a primer on things best not to say to women who have been pumped full of mind-altering hormones and endured an alphabet soup of invasive procedures (ART, IVFs, ICSI's, IUI's), miscarriages and/or had failed adoptions.
So even though I am only a redhead who occasionally confuses my desert fork with my salad fork, I thought I would take this matter into my own hands and create a guide of what not to say to someone who is infertile, going through infertility treatment or has just had a miscarriage. Perhaps if I do this I and others who are in my position will stop enduring these comments that hurt more than a progesterone shot in the rear.
For those of you who have endured any or all of these statements you might want to print this and pass it out to all your family and friends to stop them from further inappropriateness. And, those who work in a reproductive endocrinologists office, you might want to give copies of this to each patient and have them give it out to their friends and family as they begin treatment. I am only half joking about this. Really, people need to learn what is okay and not okay to women who have extremely high levels of stress and estrogen.
These following statements are just not okay:
1. "You must not really have wanted to have a child or you would have one." Really, is that the problem? Me and Hillary, we just didn't want it enough. Thanks.
2. "You must have some psychological block that is preventing you from getting pregnant." I am guessing that means Jamie and Britney Spears are totally free and clear of psychological issues. Good to know.
3. "If you would just change your beliefs about all of this, you would get pregnant. Have you seen 'The Secret'?" This question always makes me want to ask the well-meaning questioner if they have seen my middle finger. I believed I would get pregnant -- I mean, I believed. I believed so strongly that I had names and furniture and preschools picked out. If I didn't believe, I wouldn't have shelled out $100,000 in my attempt to conceive, and I certainly wouldn't have endured that kind of pain and suffering.
4. "If you would just quit trying you would get pregnant," or, "If you would adopt you would get pregnant." No, this myth is just that: a myth. According to RESOLVE: The National Infertility Association, "Studies reveal that the rate for achieving pregnancy after adopting is the same as for those who do not adopt" -- and the percentage of people who get pregnant after failed infertility treatment is even smaller. I find the notion of adopting in order to get pregnant totally unconscionable. If you want to adopt then you adopt, but you don't do it as a means of getting pregnant.
We haven't been trying to get pregnant for almost four years and not once in all of these years of not trying have we managed to get even a little bit pregnant.
5. "God has another plan for you. God doesn't want you to be pregnant," or, my personal non-favorite, "God wants you to be in service and if you had a child you couldn't do God's will." Please, please, I beg you, unless God has phoned you up or shown up in your living room with choirs of angels, would you please do me a favor and not be a spokes person for any deity on my behalf. Oh, and if God has visited you and given you an inside scoop to my life purpose, I would suggest you find your way to the nearest psychiatric hospital.
6. Another of the God ones that should to go unsaid: "Maybe God knew you wouldn't have made a good parent." Following this logic one would have to infer that all the people who have children are great parents. One trip to Mc Donalds will disprove this absurd theory. "God" gives all manner of incompetent people children. I know many parents that any higher power in its right mind would have never chosen to care for a houseplant let alone a helpless child.
7. "Do you want to throw me a baby shower?" No, I don't. I love you. I love you very much, but I just cannot throw you a shower or even go to your shower. Sometimes the mere act of taking a shower makes me cry. Going to a party to celebrate someone else having a baby is out of the question. Also, I am not going to birthday parties 1-12. Once they are 13 and are driving you to drink, I will happily attend and I will come and celebrate your suffering. I hope you understand.
8. "I am thinking about having an abortion." No, do not tell me this. I am all for choice. Really, I am. I just cannot hear about your choice just now.
9. "Do you want to go to Chucky Cheese, Disneyland, Toys R Us or to the American Doll store with me?" No, no I don't. I want to go to a bar and drink a bottle of Vodka and smoke a carton of cigarettes -- would you care to join me?
10. "I had six kids, and as soon as I had them I realized I didn't want to be a mother." It was 6th child that made you realize this? When talking, it is important to be aware of your audience. This is not something you say to a woman who was not able to have one child.
11. "I have a very small family, I only have four kids." Please be quiet.
12. "You can be a mother to your friends kids." I know people mean well by this. But, to those of you who say such things, let me tell you that babysitting for your kids is not the same thing as being a parent. It just isn't.
13. "Well, why didn't you try and adopt?" I did, and it hurt more than the IVF when the mother decided she had changed her mind and she would instead go on welfare and drop out of school so she could keep her child. I can't do it again. And by the way, even if I managed to adopt, I would still be grieving the loss of not being able to have my husband's child.
14. Here's one I am getting a lot of lately: "Get over it." I am not likely to get over it. This is a wound and emptiness that will be with me forever. Infertility is, as Shelagh Little writes, "like a low-level, lifelong bio-psychosocial syndrome. My physical inability to produce children has emotional and social consequences that I struggle with, at least to some extent, every day."
15. "You are soooooo lucky not to have kids." I can take this one now and then, but on the day after a failed IVF, I could not stand to hear how lucky I was and how horrible kids are. I know it may be true. I know the statistics about how childless couples are happier and have more satisfying marriages -- but we were going to be the couple with the house filled with kids, bikes on the lawn, and a tree house in the yard. We would not be the couple who spends holidays at others' homes -- we were going to have a family, or so I thought.
16. "Don't ever give up. Keep trying. You can't stop now. Maybe just one more IVF and you will get pregnant." This is one that really gets to me. I once asked a friend of mine who has worked with the terminally ill if when people in the late stages of cancer decide they can't bare any more treatment if they are met with this same kind of attitude. She assured me that they aren't. With cancer and other terminal diseases there seems to be a collective understanding that at some point that the compassionate thing to do is give up and die with dignity. The same kind of understanding does not seem to be there for us infertiles. I suppose that it seems to an outsider that there is always something more you can do and that if you "really wanted a baby you would do it." We did IUI, IVF, and ICSI. That is as much as we could do. We could not do egg donor or hire a surrogate or attempt another adoption. There was a time when we could do no more. There was a point when trying to have a baby started to feel like it was killing my spirit, damaging my relationships and draining our finances. However, since there are more things we could have tried, I often get the sense from others that I don't deserve to grieve over our childlessness, that we should keep going, and only when we have exhausted every option do we then deserve to grieve.
Infertility treatment, according to the statistics, is likely to cause anxiety and depression equivalent to that experienced by those with cancer or H.I.V./AIDS. With infertility there is guessing, hoping, and odds that are often different in theory than in practice. Infertility treatment takes a significant toll on your body, relationships and finances -- and it is up to each individual to determine when she can take no more.
My suggestion on what to say when you learn that someone is suffering from infertility is very simple: If you find yourself at a loss what to say or an impulse to say any of the previous things that you shouldn't, just say a heartfelt "I'm sorry" -- that is plenty.
This post originally appeared on La Belette Rouge.

Follow Tracey:  Tracey Cleantis is a writer and psychotherapist. She writes from both sides of the couch, providing her readers with real world applications of psychological theories; at the same time, she frankly and openly shares insights from her own work in therapy. Her blog, La Belette Rouge, was named one of the top ten blogs for Francophiles by Blogs.com and is rated one of the top 10 psychology and memoir blogs. In addition to La Belette Rouge, Tracey writes “Freudian Sip,” a weekly column at Psychology Today. Tracey has published essays, fiction, and poetry in various publications (including the Sojourner and Mode Magazine), and her writings on her dog-aughter Lily appear in Jamie Cat Callan’s Bonjour, Happiness!. Her essay “Prada Goeth Before the Fall,” will also be included in a yet-to-be-named anthology about women and shoes. She has been featured in Yahoo News, Salon.com, Forest and Bluff and Sheridan Road.

Tracey holds a Master’s Degree from Pacifica Graduate Institute in Counseling Psychology and has studied at the C.G. Jung Institute of Los Angeles. Currently, she practices in Valencia and Pasadena, CA. She lives in Sunland, CA with her dog-aughter Lily.
CA. She lives in Sunland, CA with her dog-aughter Lily.

4.26.2012

Male Sexual Abuse


James Dean, Carols Santana, Greg Luganis, Robert Blake, Axl Rose and Henry Rollins were all victims of sexual abuse. A sexually abused male will frequently hide his experiences, only to suffer depression and other Post Traumatic Stress-related symptoms as an adult. Symptoms of Post Traumatic Stress Disorder include:




  • hypervigilance for one's safety 
  • moodiness
  • bursts of anger
  • physical complaints (such as headaches, stomach distress, back and neck pain)
  • sleeplessness
  • inability to trust others
  • feelings of hopelessness 
  • emotional numbing
  • intrusive thoughts, reminders, triggers of the event
  • anxiety, nervousness, panic attacks
  • poor concentration
  • physically/emotionally distancing from loved ones
  • self-destructive behaviors (such as driving fast, binging on drugs/alcohol, sexual promiscuity) 

~Types of sexual abuse: Exposing a child (minor under the years of 18) to sexual materials,  sexually inappropriate language or teasing, asking a child to watch the perpetrator masturbate, asking a child to masturbate, touching of a child's genitalia (either over or under clothing), coercing a minor to touch another's genitalia (either the perp. or another person's), forcing a child to give or receive oral copulation. Less common sexual abuse includes anal intercourse (sodomy) and insertion of objects.
~The abuser does not need to be of adult age - 18 or older. Courts typically recognize abuse when the predator is 2-4 years older than the minor child, e.g. victim is 7 and the abuser is 15. 


  1. Men rarely disclose their past childhood abuse to girlfriends or wives because they fear "looking bad" or being perceived as weak. In fact, men frequently spend an entire lifetime keeping this painful secret from everyone. The most common examples of abuse typically include molest by a) older male sibs b) older male relatives, and c) men in positions of trust or authority.
  2. Men abused as children will ask themselves, "Why me?" "Maybe he didn't intend to hurt me," "I should be over this by now," or "I could have done something to stop it." No child ever does anything to warrant or deserve abuse, sexual exploitation, or physical violation.  Children are weak and vulnerable; they trust adults and are taught to follow direction.  Sexual behaviors are strange and unfamiliar; children usually have no way of understanding what is exactly happening in the midst of their molest encounter. In the face of stress or confusion, children will freeze, or "go along. " Frequently, children comply with an abuser in order to protect another sibling or a parent, "If you tell, I will hurt your sister." Children are easily tricked, lured, or emotionally manipulated into believing that they (the child) will be in trouble, or, a parent will be angry or upset at them, so they don't tell. Again, it is never, ever - not ever - the child's fault. 
  3. Men who have been abused do not usually become abusers themselves. Men who abuse almost always have been abused. Men who have been victims of sexual molest or rape will not/do not become homosexual because of this trauma, yet, these fears and shameful thoughts deeply affect male survivors ("If I was picked as a molest victim by another male, I must be gay," or, "Since I developed an erection while I was molested, I am obviously attracted to men." )
  4. If a child tried to tell a mom or dad, and was not believed, this victim may grow up feeling rage, rejection, helplessness, or worthlessness. These feelings will intensify over time and ignoring them - pushing away the memories or thoughts -  will not be effective over the course of a lifetime. Yes, repressing or distracting will work for awhile, but eventually the truth of our life experience must be brought into the light. 
  5. Research indicates that men who have experienced childhood sexual abuse view themselves in a negative light, feel contempt for their partners and become defensive more frequently than men who have not been abused.
  6. The sooner abuse is dealt with, the better off the individual will be. It's common for adult survivors to "wait" to deal with the experience until things are calm enough to be addressed, financial security is in place, or some major milestone in life is achieved i.e. college, promotion, grown kids, etc. But, typically, men seek therapy when the banana's have hit the fan; relationships are stalled or empty, substance abuse has hit break-neck speed, or a partner is urging you to "deal with your past." Some common thoughts that prevent men from seeking counseling: "Why does it matter now?" "I should be over it at this point," "Talking about it will only make it worse," or "If I allow myself to go there, I will flip out/go crazy/want to kill someone." Therapy helps an individual recognize the reality of their life experience, reconcile the events into some form of acceptance, distance enough to maintain healthy relationships with safe people, and finally feel validation for the intensity of their painful and confusing thoughts and feelings. Talking about the abuse, while difficult, will be the difference between a happy life and an unhappy life, closeness to your children, intimate partners, and learning to trust others. An experienced clinician can work through this complex emotional terrain with you. 

Well-Known Male Victims of Abuse

4.25.2012

Children With Asthma: Summer Camp is Here!


The American Lung Association in California
Southern California Asthma Management Program
(SCAMP) Camp is a week-long overnight camp for
kids with asthma that combines asthma education
with traditional summer camp activities like hiking,
swimming, arts and crafts, and archery.
When will camp be held? June 24 - June 29, 2012

Where? YMCA Camp Marston
Julian, California (San Diego County)Transportation is provided
Maria Abrica
Los Angeles and Orange County
(213) 384-5864
Maria.Abrica@lung.org

Who can attend?

Children with asthma between the ages of 8-13
years old can participate. Parents must complete an
application form and submit a non-refundable $40
application fee due by April 24, 2012. Please note
that space is limited, and campers are accepted on
a number of factors, not on a first-come, first-serve
basis.

Experienced medical staff are on hand
24/7 to make sure each child receives
proper treatment for their asthma, so
parents can rest while their kids have
a great time!
For more information or to request an application, contact:
Luis Lechuga
San Diego and Imperial County
(619) 297-3901
Luis.Lechuga@lung.org
Fidelia Leyba
Riverside and San Bernardino County
(909) 884-5864
Fidelia.Leyba@lung.org
www.lung.org/california 1-800-LUNGUSA

4.24.2012

How to Properly Dispose of Prescription Medications

 

 

Prescription Drug Take Back Day


Prescription Drug Take Back Day is taking place on Saturday, April 28, 2012. This is an opportunity to drop off unused prescription drugs to dispose of them safely.
The Drug Enforcement Administration (DEA) and government, community, public health and law enforcement partners came together to announce this nationwide initiative, which seeks to prevent increased pill abuse and theft. The DEA will be collecting potentially dangerous expires, unused and unwanted prescription drugs for destruction at sites nationwide, including San Diego. The service is free and anonymous — no questions asked.
Prescription and over-the-counter solid dosage medications (such as tablets and capsules) will be accepted.
Sharp HealthCare will be hosting a drop-off site at the Sharp Corporate Offices in Kearny Mesa. Needles will not be accepted.
When
Saturday, April 28
10 am to 2 pm
WhereSharp HealthCare Corporate Office
8695 Spectrum Center Blvd.
San Diego, CA 92123
Get directions
To find a collection site near you, visit National Take Back Initiative.
Needle DisposalUsed needles will not be accepted, but to find more information on disposing of needles locally, check out the following:

4.23.2012

Oh Sophia

Just a beautiful picture of Sophia Loren. I wonder if a woman who looked like this would be famous today...wide imperfect mouth, dark eyes, large nose, weighty hips...

4.22.2012

April 27th, WWII B-17 Planes fry into Carlsbad



If you've never heard the roar of a four-engine bomber flying overhead, never seen the grace of a prop-driven fighter plane, this is a good opportunity to experience something that won't be available forever.
The planes will fly into McClellan Palomar at 2 p.m. April 27, and will fly out at noon April 30. In between they will be on display and open for tours. Ground tours are $12 each ($6 for children; WWII veterans are free), and 30-minute flights are $425 for the two bombers, or $2,200 in the P-51.
Even if that's out of your price range, if you live in the flight path of McClellan Palomar, it will be worthwhile to grab a pair of binoculars and watch these beautiful old warriors arrive or leave ---- it's a sight and sound like no other.

Read More Here

4.21.2012

Rick Hanson Video on Neuroplasticity


http://www.youtube.com/watch?v=rTPks7XQbSw

Rick Hanson, author of Buddha's Brain, speaks here on neuroplasticity of the brain.

4.20.2012

IBS & New Treatment

Cognitive Behavioral Therapy for IBS

Many studies show an increase in negative moods in those suffering from functional gastrointestinal (GI) and pain conditions like IBS. Are these psychological factors a cause of symptoms – or are they a result of maybe years of disrupted life activities and frequent periods of intolerable symptoms?
Individuals with IBS may not have symptoms of anxiety in general, but only in relation to GI related events or sensations (like meals, abdominal pain, or diarrhea). This is called GI symptom-specific anxiety.
GI symptom-specific anxiety is characterized by increased fear and worry about gastrointestinal (GI) sensations (sometimes even mild ones), and increased attention to them (vigilance). Another part of GI symptom anxiety is avoidance of any situation that might be associated with symptoms and a strong desire to limit oneself to safe places and activities.
These behaviors, which are used to try and limit anxiety in the short run, actually increase and prolong anxiety overall.
There is now a large amount of very positive research showing that certain types of psychological treatments, including cognitive behavioral therapies and hypnosis, can have very beneficial impact on IBS.
Cognitive behavioral therapy aims to help patients change their habitual thoughts, feelings, and behaviors that may magnify stress responses and negative moods by applying a series of self-exploration exercises and stress reducing strategies.
Hypnosis uses relaxation techniques and self-suggestion to help patients gain a more positive feeling about their GI function. It is not surprising that these treatments are targeted in large part to symptom-specific problems such as symptom fears and coping.
An exciting development in this area is a recent study which showed that for many functional GI disorder patients very brief treatments (4 or less sessions) that are well targeted to these symptom-specific problems can be highly effective, and the longer treatment times often used with primary mental health problems may not be necessary.
Unpredictable GI symptoms can lead to anxiety; anxiety can lead to GI symptoms. This creates a vicious cycle. Psychological treatments can lead to decreased GI symptoms and not only changes in mood or coping with symptoms. It should be emphasized that these psychological approaches may be used in combination with medications that improve the disruptions in GI function or nervous system activity that exacerbate symptoms – attacking all sides of the ‘vicious cycle.’

4.19.2012

Why Isn't There a Starbush, er, Starbucks in Italy?

Features February 09, 2012, 6:00 PM EST

Grounds Zero: A Starbucks-Free Italy

Why hasn't Howard Schultz brought his coffee giant to the land that inspired it?

If it weren’t for Italy, Starbucks (SBUX) might not exist. After all, it was on a business trip to Milan in 1983 that Howard Schultz had the revelation on which he built his global empire. At the time, Starbucks was a coffee roaster—it didn’t own a single cafe—and Schultz was its marketing director. In a book published after the company had become an international behemoth, Schultz described how he set out one morning, sipping espressos at the cafes near his hotel. By afternoon he had sampled his way to the Piazza del Duomo, home to Milan’s famous Gothic cathedral. The large square was “almost literally lined” with coffee shops, he wrote. The air was alive with the sound of opera and the smell of roasting chestnuts. Schultz noted “the light banter of political debate and the chatter of kids in school uniforms” and watched as retirees and mothers with children made small talk with the baristas behind the counters.
It was at this point that Schultz, no doubt heavily caffeinated, was seized by inspiration. Most Americans were still drinking their coffee at diners, in restaurants, or at the kitchen table; Italians had made cafes part of their community. Coffee didn’t have to be just a drink, he realized. It could be an experience. The opportunity was enormous, and Starbucks, by limiting itself to roasting, was in danger of missing it. “It was like an epiphany,” Schultz recalled in his book. “It was so immediate and physical that I was shaking.”
Nearly 30 years later, the insights Schultz brought home have not only spread deep into American culture but gained millions of adherents worldwide. From the first few cafes that Schultz opened in Seattle, the chain has expanded into some 11,000 locations in the U.S. The company, which declined to comment for this article, has 925 outlets in Japan, 730 in the U.K., 314 in Mexico. Starbucks has stores in, among other places, Spain, France, Germany, Switzerland, Austria, Greece, Turkey, Lebanon, Jordan, Egypt, and Saudi Arabia. On Jan. 30, Starbucks announced that it will open its first outlet in India later this year.
But there’s no Starbucks in the Piazza del Duomo, the site of Schultz’s epiphany. Nor is there an outlet anywhere else in Milan, or indeed, in all of Italy. At a time when Starbucks views global expansion as the key to future growth—and when it is virtually impossible to walk through a major European city without stumbling onto a Starbucks—the company has no presence whatsoever in the country that inspired its founding.
This was not Howard Schultz’s plan. “I am interested eventually in Italy and France,” he said in 2002, as the company was in the first stages of its international expansion. Two years later, Starbucks had branches in Paris and Lyon—but not in Rome or Milan. “We want to go to Italy,” Schultz told Kai Ryssdal, host of public radio’s Marketplace, in 2006. “We’re just—we haven’t looked at it as seriously as we had other markets, but at some point we will go.”
“You afraid a little bit?” asked Ryssdal.
“I don’t think we’re afraid,” said Schultz. “I just don’t think we’re—it has not been as high on the radar because other markets are bigger in scope and offer more potential, but we will go to Italy.”
Six years later, Italy remains the mountain Schultz has yet to climb. The country might not mean much from a pure business perspective; while Italians love their coffee, the market for it is famously crowded and fragmented. But what Italy does represent is the height of coffee culture, the gold standard against which all others are measured. As such, the country represents a reputational risk. There’s only so long the company can sit on the sidelines before Ryssdal’s question to Schultz will start to resonate. When it comes to competing in Italy, what is Starbucks afraid of?


Schultz doesn’t mention which cafes he visited on his trip in 1983, but he would have been hard-pressed to miss Caffè Miani. The Milan institution occupies a corner spot at the entrance to the glass-vaulted galleria that connects the Piazza del Duomo with the La Scala opera house. Its floors are a marble chessboard of brown and white. An art nouveau mosaic of jungle vines and tropical birds runs over the large mirrors behind the bar, above which hangs an antique clock. The baristas—in Italy a cafe is called a bar, and barista simply means bartender—wear white shirts and bowties. In the afternoon they stock the countertop with bowls of olives and pickles sprinkled with ice to keep them cool.
The cafe’s owner, Orlando Chiari, a 78-year-old former stock exchange worker, has the mobile phone numbers of top executives at Italy’s most important coffee companies and the confidence to dial them in the middle of an interview. But when I ask him if he’s ever visited one of the Seattle-based chain’s locations, he answers me with an empty look.
“Starbush?” he says. “No. I’ve never even heard of it.”
It takes a couple of beats to realize he isn’t joking. When the concept is explained, he says, “Interesting. But does it exist in Italy?”
At Caffè Miani, as in all Italian cafes, the customer pays first at the register, just like in a Starbucks. But the similarities stop there. In the U.S., most restaurants, including Starbucks, fill an espresso cup nearly to the top. In Italy, a typical serving rises only about a finger’s width from the bottom. Cappuccinos are strictly for breakfast (or a brief window in mid-afternoon). Ordering one after a heavy meal is the sure sign of a tourist—not considered rude so much as inexplicable. “A cappuccino is considered almost like something that you’d eat,” says Chiari.
In 1988, Chiari took a trip to Denver to a meeting of the Lions Clubs International, along with seven fellow grandees. They’d often order only a single cup of coffee, he told me, and divide it. “There was coffee enough for eight people,” he says.
Unlike in the U.S., where coffee drinking evolved around the steaming mug of drip coffee, in Italy the culture was shaped by the espresso machine. First patented in 1901, the early models consisted of a vertical cylinder, in which water was kept near the boiling point and released through twin valves. Pressure from the steam would push the water through the grounds and into a coffee cup. Later versions added hand levers, pumps, and heat-transfer systems that warmed the water on demand, but the concept remained the same: a hot, fresh drink that could be prepared in less than half a minute and—because coffee quickly loses its flavor—consumed just as fast.
Forget soft couches and easy-listening music. Italians drink coffee the way New Yorkers once took cigarette breaks, as a brief interlude in a hectic workday. Chiari sells at least 1,000 cups of coffee a day, mostly in three short bursts, during which customers press and jostle against the bar. (Ordering it “to go” is unthinkable.) The first rush is at breakfast, on the way to work. There’s another at 10 a.m., when Italians break for espresso, and one more after lunch. A similar rhythm plays out in the nearly 140,000 bars and cafes across the country.
Not only do Italians drink their coffee differently, in many cases they drink a different type of coffee. Part of the legacy of the early espresso machines is that Italians, particularly those living in the south, prefer a stronger, more astringent espresso. Starbucks prides itself on using expensive arabica coffee beans with complex flavors. In Italy, because of cost and market demand, many roasters mix in significant quantities of bitter robusta beans. “The coffee leaves you with a strong, acidic, somewhat sour taste on the side of your tongue,” Schultz wrote to his staff in a report after a 2008 visit to Italy. “This taste was unpleasant and disagreeable.” He added: “For many years now, we have been a respectful inheritor of the Italian coffee culture. We have built our business honoring the very things we saw and experienced. And, in some cases, I am humbled to say, we have improved it.”
For many Italians, however, arabica beans aren’t superior, they’re just different—and not necessarily in a good way. “If I were to open a bar in Naples with 100 percent arabica, tomorrow I’d be closed,” says Gianluca Brizi, who trains baristas for Planet One, an Italian cafe and restaurant supplier. In northern Italy, coffee drinkers do prefer arabica, but they also favor a lighter roast than Starbucks tends to offer, believing it better brings out the flavor of the beans. In 2007, Brizi traveled to Madrid to do a “little bit of industrial espionage.” He spent a week visiting the 21 Starbucks outlets then in the Spanish capital. His conclusion: “Starbucks is a good concept.” The company is masterful at finding profitable locations, streamlining its production process, and ably displaying its merchandise. “What’s missing is the quality of the product,” Brizi says.


In Italy, Starbucks finds itself on the knife-edge of globalization. The company may have taught tea-drinking cultures like China and Japan how to appreciate a cup of coffee. But in the birthplace of the cappuccino, Schultz confronts a more daunting challenge. Can a company succeed in a place where its product is available on every corner, where consumers remain wedded to a culture that’s all their own? Is it possible for an international brand to repackage a local tradition to the very people who invented it?
There’s reason to believe the answer could be “si.” One thing that visitors to Italy notice is that there are few places where you’d feel comfortable sitting with a book or a laptop. What they don’t often think about is that until Starbucks came along, the U.S. wasn’t any different. What Schultz did was take the Italian coffee tradition, fly it across the Atlantic, and infuse it with a Seattle approach to leisure. As a result, for many of its customers, Starbucks isn’t really in the business of selling coffee. Instead, it’s offering a place to hang out that happens to sell coffee. And the market for that in Italy—for a home outside the home, for an office away from the boss, for a place to sit and chat and read and while the day away—is very open indeed.
You can find proof just across the piazza from Caffè Miani where, since 1996, the area’s most prime location—a storefront with an unobstructed view of the cathedral’s facade—has been occupied by a McDonald’s (MCD). And for the last four years, the branch has also been home to what the company calls a McCafé.
When the fast-food giant first opened an outlet in Italy in 1986, the reaction sparked a global countermovement: the invention of Slow Food as an effort to preserve local cuisine and regional diversity. Today, McDonald’s has 411 locations in the country, and in 116 of those there is an Italian-style coffee bar, serving espressos, cappuccinos, and a range of pastries and pies.
McCafés have become the fastest growing part of the company’s Italian business. According to a 2010 company survey, one in five first-time McCafé visitors had never entered a McDonald’s before. Unlike in an Italian bar, where the tradition is to slam your shot of espresso and leave, McDonald’s encourages its clients to linger. Italians may be picky about their coffee, but they’re wide open for a company that offers them a new, slower way to experience it.
The longer Starbucks stays out of Italy, the more competition it may face from imitators who have capitalized on its absence. Just half a block down the street from the Caffè Miani and the flagship McCafé sits another establishment, called Arnold Coffee. Occupying four floors of a historic building, it has an open stairwell and mirrored back wall. On the day I visited, kids were studying upstairs around a long wooden table. A couple of friends huddled over a laptop, and clusters of young women sat and chatted. The menu features American drip coffee, shakes, and caramel macchiatos.
The firm’s founders, Andrea Comelli and Alfio Bardolla, explicitly modeled their business on Starbucks—so much so that soon after they opened their first location, in 2009, they received a notice from the coffee giant’s lawyers. Arnold Coffee’s logo—which included the company name in a double circle—was in violation of the Starbucks trademark. After some back and forth, attorneys for Starbucks presented the duo with 10 logos and asked them to pick their favorite. They chose a steaming mug of coffee set against a black circle.
Arnold Coffee has positioned itself as an alternative to the Italian coffee bar. It caters to young Italians used to spending time abroad, where the best option for reading a book, checking e-mail, or just catching your breath is a Starbucks. At one point, I watched a customer linger by the milk-and-sugar station, pick out a sugar packet, look at the logo, and place it in her purse. According to Comelli, his customers love the paper cups and the cardboard coffee sleeves, an item he was originally unable to source in Italy and had to order from the U.K.
Arnold Coffee has opened six locations, five in Milan and one in the airport in Verona. According to Bardolla, the company’s coffee shops are expected to break even after a couple of years. Last year, sales in the outlet I visited were up 44 percent. “We don’t see any competition,” says Comelli. “When the other bars are empty, that’s when we’re full.” The two partners plan to open another 44 locations in the next five years and then sell.
The last question I asked Comelli was whether he could remember the first time he drank an American coffee. I recalled Orlando Chiari’s verdict, and I was curious to hear about his. Comelli immediately told me about a trip to New York in 2001, when he bought a cup at Dunkin’ Donuts (DNKN). Unsure how to drink it, he sipped through the stirring straw, scalded his tongue, and threw the beverage away. “I couldn’t believe how hot it was,” he says. Looking around his cafe, he seemed taken aback by the memory. “Now,” he says, “I drink more American coffee than espresso.” Note to Howard Schultz: Italy is ready when you are.
Faris is a Bloomberg Businessweek contributor.

4.18.2012

Womens Free Self-Defense Course, Sunday, April 22nd


 April 22nd, Sunday

Time: 11:30 a.m. to 1:30 p.m.
Place: Goju Karate Center, 300 Carlsbad Village Drive, Suite 110A (on the west side of Coyote Bar & Grill)
The workshop is being given by self-defense instructor Michelle Enfield, co-owner of the Goju Karate Center. 
A former pre-school teacher, she is an enthusiastic and highly skilled educator, no matter your age. I should also mention that she is a third-degree black belt.

Sensei Michelle will help attendees learn about verbal boundary-setting skills while imparting practical self-protection techniques through real-world scenarios.

This special event is given as a community service, so there is no charge. The recommended donation is $20, and all funds go to Center for Community Solutions (www.ccssd.org), a non-profit agency that offers a complete range of sexual assault, domestic violence and elder abuse prevention and intervention services throughout the San Diego area. 

Space is limited, so please sign up today by calling 760-434-0353 to reserve your spot. Participants should wear workout clothing (long pants, please) and no jewelry.

4.17.2012

Laura Munson's New Book on How She Saved Her Marriage


Optimal Communication Conditions



Here are some common communication exercises used in my office, with special attention paid to non-verbal gestures, physical sensations, and breathing. All meant to send clear messages, be heard, feel heard, and respond effectively. Can you say more about ___________? How was it for you that ___________? How do you feel about him/her? What do you mean when you say _____________? What's your gut feeling about __________? What do you think about ____________? What is really bothering you? What are you concerned they'll do? What was the most upsetting part of all that? What do you wish would have happened instead? I was hoping that___________. What would it feel like if __________? What is your internal state? How was this like ____________ [i.e. some similar thing] for you? Carlsbadcounseling@roadrunner.com

4.13.2012

Camp Erin for Kids, San Diego Hospice

Camp Erin San Diego is an annual weekend summer camp open to children ages 6 to 17 who have been impacted by a death. This free camp combines a traditional, high-energy, fun camp experience with grief support and education. Camp Erin San Diego will be held June 8-10, 2012 in Julian, California. The Camper Application is now posted! Please click on the "Camper Application" link on the right sidebar. “Sometimes it’s hard for kids to communicate with loved ones and family about their loss,” says Jacqui Small, a Camp Erin San Diego volunteer for the past two years, “The opportunity for campers at Camp Erin San Diego to interact with other kids who are experiencing similar types of loss and grief is priceless.” Information on additional services from The Center for Grief Care and Education available at: 619-278-6480 / griefinfo@sdhospice.org. Camp Erin San Diego is part of a national network of bereavement camps founded by The Moyer Foundation, a non-profit organization established by World Series champion and MLB All-Star Jamie Moyer and his wife, Karen with a mission to help children in distress.

4.10.2012

Triggered, What is OCD?

When Obsessive-Compulsive Thoughts Are 'Triggered'
by NPR STAFF


Triggered
A Memoir of Obsessive-Compulsive Disorder
by Fletcher Wortmann

March 29, 2012
From a young age, Fletcher Wortmann spent countless hours absorbed by his obsessions. In third grade, he became consumed with the idea that every nonwater substance on the planet would soon freeze. He spent hours laying plans for how he and his family would survive. Over and over, he replayed an imagined apocalypse.

Though he wouldn't be diagnosed until many years later, in retrospect Wortmann realizes the episode marked his "first full-blown bout" with obsessive-compulsive disorder.

In his memoir Triggered, Wortmann examines the origins of his anxieties and how he came to be overwhelmed by intrusive thoughts.

"One of the most ... misunderstood aspects of OCD," Wortmann tells NPR's Neal Conan, "is that many people believe that it has to involve visible physical compulsion, such as hand-washing or counting or organizing things."

After his sophomore year in college, Wortmann was diagnosed with purely obsessional obsessive-compulsive disorder — also called "pure O" — where the compulsive behaviors are entirely internal, intrusive thoughts.

"I think everyone experiences these kind of things. Your mind will just sort of settle on something really distressing and upsetting, and ... most people are able to shake it off. Unfortunately, with obsessive-compulsive disorder, the thoughts take on kind of a life of [their] own, and you begin to wonder: 'What do these mean? How can I make them go away?' "

He discusses how he gradually learned to cope with what some call the "doubting disorder."

On the challenges of diagnosis

"I'd had a number of therapists growing up. I eventually had a breakdown and was brought to McLean Hospital, and up to the point of that hospitalization, people misunderstood, misdiagnosed. They would try to reassure me ... those thoughts don't mean anything, which ironically is the worst thing you can do for someone with OCD, because trying to reassure them and tell them that they are safe, it doesn't help with the fundamental issue of uncertainty and just sort of serves as another ritual, another metaphorical hand-washing that can't really give them the absolute certainty they would desire."


On thinking of OCD as a third-person character

"There's an almost schizophrenic aspect to it sometimes. There's a sense of being taunted by someone, the way it continually hones in on your worst fears and traumas and anxieties. There's a very adversarial aspect to it.

"And ironically, I think overcoming that has been part of my successful treatment because eventually you have to learn ... OCD is, it's like diabetes. It's a condition. It's not something I'll ever be able to completely exorcise or cure.

"So accepting it just as a psychological mechanism, rather than as my evil doppelganger, has been very helpful."

On using exposure response therapy to treat OCD

"What I had to do [was] ... sit down and face directly whatever it was I was afraid of without performing the ritual to try to protect myself. ... Mine was tricky and kind of weird to describe because of the purely obsessional thoughts. ...

"I had friends who had contamination issues who would have to sit there with their hands in a toilet for two hours without washing, or with their hands in a bucket of biohazard junk.

"And it's a terrible, challenging, traumatizing process. ... But I found through ERP [exposure response therapy] I was able to really confront the things I was frightened of without obsession and eventually managed my disorder much better."


On taking medication for OCD

"I was very hesitant to take medication, and I think because of this cultural myth we have that medication turns you into a zombie or a robot, or it changes who you are. That hasn't been my experience. I found it's been useful in helping me get into a place where the exposure response therapy ... was more acceptable and doable and less painful.

"And that myth of psychiatric medication as a kind of, you know, giving up or selling out, that really disturbs me because I think that's part of what prevented me from really seeking out this kind of help I needed for so long. And I wonder how many other people out there are resisting therapy when they could really benefit from it."


On procrastination as a symptom of OCD

"It's funny — procrastination can be a symptom of OCD in the sense that because you know a project will require so much of your effort, and you're so frightened of screwing up, it's easy to just keep putting it off and putting it off and putting it off. ...

"I was really excited about writing Triggered. I think my primary issue was in editing and revising it and trying to make the text absolutely perfect. And of course there are any number of changes that have to be made as part of the publication process. ... They'd come to me, and they'd say, 'Oh, you can't use those song lyrics for legal reasons.' And I'd be like, 'Ah, you've plunged a knife into my chest.' "