Making Relationships Stronger

April is Autism Awareness Month. Autism Spectrum Disorder and Autism are disorders of brain development that manifest in difficulties in social interaction, verbal and nonverbal communication, and repetitive behaviors. They vary in degree and it is a fallacy to think that all children with ASD lack intelligence. It is estimated that 1 in 88 children in America are on the spectrum. We encourage you to find out more about Autism at AutismSpeaks.org.

As this E-Letter is being written, the tragic events in Boston continue to unfold. We have been lucky here in the United States that we have not been frequent victims of terrorism. However, Boston serves to remind us that there is evil in this world and that many people and groups do not treasure life like we as Americans do. We believe in the good and caring in people and the support provided to others through relationships and caring.

In this April E-letter, we offer suggestions about Making Relationships Stronger, Our Ask the Doc question is about Adult AD/HD, and our email of the month is from standup comedian Patton Oswalt about Boston. We hope you find the enclosed information helpful. As always, we appreciate your questions and feedback.

Research Study. We are pleased to announce that we will be participating in a four month research study with Life Extension Institute assessing the effects of cognitive therapy, nutritional supplements, and medications on weight management in overweight individuals. Dr. Kimmel and Denise Champagne will be conducting cognitive therapy groups for a sample of 40 subjects who will be followed by three physicians. For more information, contact our administrative assistant, Jillian, at 954 755-2885.

Parent Education and Family Stabilization Course. For several months now, we have been offering the Parent Education and Family Stabilization Course. Sometimes referred to as the Divorce Class, it is required by the State of Florida for all parents divorcing or separating even if not legally married. We have provided this course many times and have designed it as a 4-hour, one-session presentation that focuses on ensuring that parents protect their children from the effects of divorce or separation by setting aside their differences and focusing on the children’s need for both parents in their lives. The course also provides information about divorce as loss, gives an overview of the Florida laws and statutes related to divorce and custody issues, and offers information on how children react to divorce based on their ages.  The course is offered live on a flexible schedule, based on the availability of those attending the course.  Please contact our Administrative Assistant, Jillian, at 954 755-2885 for additional information.

Low Cost Counseling. Denise Champagne, M.S., is offering low cost counseling as a mental health intern. She is currently seeing patients and is available to take on new patients. This allows those individuals who cannot afford treatment to obtain it and allows her to get the required training. If you or someone you know is in need of counseling but just cannot afford it, please call the office and ask for Denise. All treatment provided by Denise will be reviewed and supervised by Dr. Kimmel.

Testings. If you are concerned about your child’s school placement for the next school year, this would be a good time to have them evaluated. Recent questions from parents have ranged from should their child be retained to whether they are gifted to whether they have a disability that can qualify for accommodations at school. Our practice does different types of evaluations to help answer those questions and information about these evaluations can be found on our website. If you have more specific questions, please contact Dr. Kimmel who would be happy to answer them.

Qualified Supervisor. Dr. Joel Kimmel has been certified by the State of Florida to supervise mental health counselors seeking supervision to meet the licensing requirements. If you or anyone you know needs a qualified supervisor to meet these requirements, contact Dr. Kimmel for further information.

Our E-Letter this month focuses on relationships and making them stronger. The saying “No man is an island” comes from Meditation XVII by John Donne and refers to the belongingness of man to a greater community. Indeed, it is relationships that give meaning to life and enhance our experiences. Frequently, we hear from our patients that they are reluctant to do things on their own. “What fun is it if I can’t share it with someone?” Yes, being part of a relationship allows for shared enjoyment, stimulation, exchange of stories and ideas, feelings of closeness, and perhaps most importantly, that they are not alone.

Because relationships are so important, we wonder why couples do not value their partners more. How do people who scream and fight with each other in our office claim that they love each other? How do those who pay little attention to or ignore their spouse claim that they are so important to them? How does a man or woman hit those whom they swore to honor and cherish? We wonder why people take each other for granted, disrespect, and mistreat each other. And why do some feel the need to maim and harm innocent people they don’t even know? Perhaps the answers lie in seeing their partners as people with value not just objects, conveniences, or as less than humans. At the heart of successful relationships is respect.

The creation of a strong relationship involves a lot of commitment, effort, and patience. Relationships just don’t happen; they need to be built. They require a lot of perseverance, understanding, and trust. Successful couples have highly developed communication skills as well as conflict management skills. They desire to make their partner better and to enhance their lives. They view themselves as a team, a “we” rather than a “me”. They consider what is best for the both of them not the one of them. They share closeness and intimacy and trust that they will not hurt each other. They are honest, respectful, and open with each other. They take ownership of their behaviors and are able to forgive the other and themselves. The effort pays off as good relationships improve one’s outlook on life, their mental health, their physical health, and their connections with others. Like an investment, the more you put in, the more you get back.

We offer the following information on Making Relationships Stronger:

• Relationships are like investments; the more you put into it, the more you get out of it
• A good relationship improves your outlook on life and can improve your health
• The foundation of healthy, working relationships is mutual trust and respect (MT&R)
• A hallmark of good relationships is the ability to overcome conflict and not be afraid to discuss issues without fear of retaliation or needing to be right
• Avoid needing to win in relationships as having a winner also means having a loser
• Direct and honest communication is critical so that fears, needs, angers, and misunderstandings can be expressed to build trust and strengthen bonds
• Bonds can also be strengthened through nonverbal cues such as body language, eye contact, touching, and facial expressions
• Spending time together on a regular basis, finding enjoyable activities to do together, and having adventures together keep relationships exciting and interesting
• It’s important to maintain independent identities and interests to bring stimulation into the relationship since no one can meet all their partner’s needs
• In your relationship, practice honesty, communication, trust, respect, compromise, forgiveness, and patience
• View yourselves as a team working and living together and blending your differences into the relationship
• Work hard in maintaining closeness and intimacy; do not confuse sex with love or with everything being ok
• Some relationships go stale when people do not remain engaged with each other and take each other for granted
• Apologies can go a long way as they are a recognition that your partner’s feelings have been hurt and that you take responsibility for your words and actions
• If fights do occur, fight fairly and don’t try to hurt your partner; accept responsibility for your part, admit when you are wrong, and search for a compromise
• Use I-statements to express your thoughts and opinions rather than you-statements which blames your partner and creates defensiveness
• Work to make each other better people
• Surround yourselves with others who have good relationships
• Changes will occur over time inside or outside the relationship and deciding how to meet these changes together will enhance the relationship

• Recognize that relationships involve teamwork and need to be built with patience, perseverance, trust, respect, and honest communication
• Be willing to negotiate and compromise on your wants and needs
• Do not expect your partner to meet all your needs; maintain your own identity
• Try to see things from your partner’s point of view for a win-win outcome
• Be willing to forgive your partner…and your self
• Maintain intimacy, sexual activity, adventure, and spontaneity in your relationship
• Work to bring out the best in yourself and your partner
• Seek professional help early if you have relationship problems that you cannot resolve

RH writes: My 18 year-old son was home from college and driving a friend home. After he dropped him off, he stopped at a stop sign and a bicyclist rode into the front of his car. My son has been quite shaken up and refuses to drive.  The biker was uninjured and the car got a few scratches but he is fearful to drive. He didn’t go back to school and I have to drive him everywhere. What can I do?

Dr. Joel Kimmel replies: Obviously your son needs to be able to drive and to return to college. To do so, he has to be willing to overcome the effects of this accident and manage his own anxiety about driving. I would suggest that you first need to get his cooperation in wanting to get past this situation. Once he agrees to participate, a behavior therapy technique of desensitization as well as cognitive therapy can be quite helpful to him.

Using a desensitization paradigm, your son would gradually be exposed to the fearful stimuli while maintaining a relaxed state achieved through the learning of relaxation exercises. So for example, your son would start out by just sitting in his car and taking deep breaths to achieve relaxation. Once he feels comfortable, the next step at another time would be for him to perhaps drive around the block until he felt comfortable. After that, the distance he drives would increase so that he can get his confidence back. The goal would be achieved when he is able to drive past the scene of the accident without any anxiety and be able to return to college.

I described this exercise in very simple terms but it actually is more detailed and task specific. Along with desensitization, you son would benefit from cognitive therapy where his thinking can be changed so that he realizes that this was a onetime incident and that he was not in the wrong. Goals of cognitive therapy would be to eliminate his driving anxiety and to rebuild his confidence. I hope this helps.

We would like to thank Paul L. for sending us the following email:

Patton Oswalt on Boston

“You watch the videos of the carnage and there are people running TOWARDS the destruction to help out. …. This is a giant planet and we’re lucky to live on it but there are prices and penalties incurred for the daily miracle of existence. One of them is, every once in a while, the wiring of a tiny sliver of the species gets snarled and they’re pointed towards darkness.

But the vast majority stands against that darkness and, like white blood cells attacking a virus, they dilute and weaken and eventually wash away the evil doers and, more importantly, the damage they wreak. This is beyond religion or creed or nation. We would not be here if humanity were inherently evil. We’d have eaten ourselves alive long ago.

So when you spot violence, or bigotry, or intolerance or fear or just garden-variety misogyny, hatred or ignorance, just look it in the eye and think, “The good outnumber you, and we always will.”