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Coping With Everyday Life

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What This Blog is About

This blog is devoted to discussing how to cope with everyday life, and your hosts (see menu listing of your four blog hosts) will post information from the world of psychology, counseling, and education. Our message revolves around three basic themes: First there is acceptance. There are certain basic truths in life that we simply must accept before we can decide how to act. Second is the notion of meeting challenges. Unfortunately, too often we avoid challenges that confront us because it’s the easy thing to do. Successful coping, however, requires us to take a more difficult road and meet life head on. Third, we must learn what things are under our control. We get in all sorts of difficulties when we try to control things we can’t. The truth is there are only two things we can control: Our own thoughts and our own actions.

We invite our readers to join in our discussion and share their own insights. This blog is not an advice column, but a forum in which to share ideas.

If you are interested in pursuing the psychology literature on any topic we cover, feel free to contact us by email at charlesbrooks@kings.edu. We also encourage you to visit our website (www.subtlesuicide.com) to learn about our published books on subtle suicide, dysfunctional giver/taker relationships, and research on how psychology applies to everyday life.

TOO MUCH PSYCHOLOGY!

Recently I noticed a newspaper piece dealing with the importance of college internships. The writer noted that these opportunities not only give a student a good feel for the demands and skills involved in a particular vocation, but also provide valuable experience that will look good on the resume’ when searching for that first job. In fact, the article made me remember an occasion years ago when one of our senior psychology majors came to see me about three weeks into her internship working one-on-one with an autistic child.

“How’s it going?” I asked. She replied, “Well, I’m going to see this thing through the end of the semester because the parents really appreciate it when I’m at their home to help out. But one thing for sure, I’ll never look for a job working with autistic kids! It’s not for me. I thought this was what I wanted to do, but now I see that reading about it in a book just doesn’t show the stress and frustration involved. What an eye-opener!”

We chatted some more and we both agreed that even though it was going to be a challenge to stick it out, this was already a very successful internship because of what she had learned about this line of work.

But let me get back to the newspaper article because I’m not blogging about internships. The news writer gave an example of a student who was doing an internship in computer science during the spring semester of her junior year in college. Thanks to the internship the student discovered that she was more of a people-person and didn’t find the CS work fulfilling.

The writer commented: “Imagine the emotional stress of having to find a new career path one year shy of getting your college degree.”

Oh, for heaven’s sake, stop it with the emotional stress garbage! Why does every unexpected event, every challenge to one’s plans, every conflict, every OMG intrusion into one’s world have to be psychologically debilitating? Dozens of times in my classes over the years I called this phenomenon the “psychologizing” of society, and cautioned my students that every personal issue is not necessarily a psychological crisis. Emotional stress my derriere!

I can’t begin to remember how many times a student came to me in the junior year and said, “I’ve decided to change my career plans. I always thought I wanted to be a psychologist, but now I don’t!”

Never once did I reply, “I’ll give the Counseling Center a call so you can deal with the stress and anxiety you must be feeling!” In fact, such a thought never even occurred to me in 41 years of college teaching. Never! My reaction was always along the lines of, “Cool! You’re learning about yourself! That’s what college is all about.”

I remember one particular case that was kind of extreme. A second-semester junior came into my office late in the spring and said, “We have to change my schedule for next fall. I’ll keep Senior Seminar so I can finish my psyc major, but after taking this Principles of Management course this semester I’ve decided I want to apply for an MBA degree after graduation, not a Masters in psyc.” Naturally I reflexively reached for the phone to call the Counseling Center  (JUST KIDDING! LOL!)

I said, “Good for you! Shows you’ve been doing some good thinking lately. The first thing I want you to do is go to the Chair of Bus Ad in the business school and get an advisor in that department. Find out what courses you need at a minimum to be considered a serious candidate for an MBA program, and what ones will be offered next year, including over the summer. I have no idea what they would be so find out at the source. Then get back to me and we’ll work with your business advisor on changing your schedule for the fall and even look ahead to the spring. A summer course may be needed. I agree about keeping Senior Seminar. That’s the last course you need to complete the psych major.”

The student ended up taking two business courses over the summer at a community college near his home. Over the course of his senior year he took 9 business courses, plus psychology senior seminar. Spring of his senior year he applied to three MBA programs and was invited to interview at all three schools.

The interviews went well because, as the he told me, “Once it was determined that I had the business course prerequisites, all the interviewers wanted to talk about was my psych major! They asked me what psyc courses I saw as most relevant to the business world, what did I see as the role of psychology in business, all sorts of stuff like that, just like you said they would. Good thing I was prepared because I really had some good answers, at least I think and hope I did!”

I guess he did because all three MBA programs accepted him. I don’t know how things worked out in the long run because he didn’t keep in touch. Still, to me the lesson is clear: When the best-laid plans suddenly and unexpectedly go off track, your life is hardly over. Emotional stress? Don’t buy into that psychologizing message. Use your resources to adapt to the challenge of change.

Don’t get me wrong. Over the years I had many students who suffered genuine crises in their lives, events that understandably gave them a lot of stress. They needed help getting through those times, and some ended up dropping out of college. I’m not talking about those types of cases. What I’m irritated about is students (and newspaper writers) who take the slightest mishap and turn it into a psychological crisis. And you know why it happens?……Because it’s stylish to “play the psychology card.” Society not only allows this card to be played, but also encourages young people to make the stress, anxiety excuse.

Recently I was talking to a retiree about this and he gave me his story: “My first-semester midterm gpa was 1.3. Good start, huh? Sure I was in the wrong major and a little overwhelmed, but I was also spending a lot of time in the student center shooting pool instead of studying more and going to the tutoring center. Final first-semester gpa? How about 1.7? But you know what? Never did anyone, no friend, no parent, no teacher, no advisor…….no one ever said to me, ‘You should go to the Counseling Center.’

“But a wise teacher said to me before I left for semester break: ‘Why don’t you drop one of those D courses for next semester, maybe Chemistry, and substitute something totally different.” Over the holidays one of my parents casually mentioned one day, ‘You could try sociology. I really liked that in college.’

“What the hell, first thing I did when I returned to campus was see a Dean and drop Chemistry and pick up…………you guessed it, Intro to Sociology. Played less pool, too. Ended up with a C in sociology and a second-semester gpa of 2.7. Also decided that I wanted to take more sociology!” (He ended up as a social worker and eventually Director of a county child-care agency.)

Here’s the thing, folks. No matter what the issue, effective coping does not mean wearing a badge saying “anxiety sufferer” on your chest and seeking professional help. If you’re psychologized see what you can do to deal with your stress. Empower yourself and go into attack mode! Confront the stress and take charge of your life. More on that next time.

 

 

 

CHILDREN WITH AUTISM, PART IV

This post, fourth and last in a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Working With Your School System

A confusing issue for many parents is that there is a difference between getting a diagnosis of autism outside of the school setting, and how it is diagnosed within the school setting.  Medical doctors, Psychologists and other professionals who evaluate children outside of the public school setting use criteria in the fifth edition of the Diagnostic and Statistical Manual (DSM V) to ‘diagnose’ the presence of Autism. Public schools, on the other hand, use Special Education Law with specifically defined disabilities.  Unfortunately, the two sets of guidelines may not match exactly, and this disconnect can cause confusion for parents. Both sets of guidelines, however, do have two major commonalities:

Children with autism have significant communication deficits, both verbal (the words we use and how we use them) and nonverbal (facial expressions and gestures we use when we communicate).

Children with autism show significant deficits in social interaction skills.

Parents should have their child evaluated by their local school district because it is in this setting that educational strategies must be put into place. The school system will generally have qualified professionals who are most familiar with in-school Special Education programs, plus they know how the educational system works. That familiarity is important, and is why many school districts may want to do their own evaluation, even when parents have already had a private evaluation from a professional, or have a medical diagnosis from their family physician.

When having your child evaluated for autism by school professionals, you need to be aware of the need for a comprehensive strategy. Make sure you are dealing with qualified professionals who have specialized training in autism.

Professional titles you should look for include School Psychologists, Speech and Language Pathologists, Occupational Therapists, and the Special Education teachers themselves. Others might include Educational Diagnosticians and Physical Therapists. All should be willing to partner with you, the parent. The professionals should be knowledgeable about Special Education laws and the specific programs provided by the public schools in your district.

The evaluation process should include gathering as much information as possible, from as many different sources as possible (those who know the child the best), and in as many different ways as possible.  In addition to structured interviews and standardized rating scales, parents, teachers, child care workers and others who know the student should be included in the process. The child should also be observed in a variety of environments that might include the home, a child care center, a community site, and a public school classroom.

A professional evaluation within the school system may recommend Special Education programs for your child. To access Special Education programs you must first have the child complete the evaluation process to determine if a disability is present and, if so, what that disability is. There are 13 disabilities defined in federal Special Education law, and autism is one of them.

Before formal evaluation can begin, as parent or guardian you must provide your informed consent. This material should include a description of what will be done, who will be involved, and how it will be done. It is important that you review this information carefully and know precisely what will be taking place during the evaluation process.

Once the evaluation is completed, you should expect to meet with the evaluation team to discuss if any disabilities were found. The team should consist of you, the Administrator of the process, a Special Education teacher, a General Education teacher, and any additional professionals who were involved. You must play an active role in this meeting and ask questions freely. Always remember, you are dealing with your child’s future and your peace of mind.

If the professional evaluators tell you that a disability is present, they next should provide you with any recommendations they have with respect to the need for specialized instruction, support, and services for your child. Remember, being identified as having a disability does not automatically mean that your child will need Special Education services. If such services are recommended, however, once again you will have to give your consent to have your child placed in Special Education services.

Finally, the team will design a plan specifically to meet the needs of your child. The plan will be thoroughly explained to you and you must make sure you completely understand all the features.

As the plan is implemented, you should expect future team meetings to assess your child’s progress and discuss if any modifications in the plan are needed. Such a meeting must be held at least annually, although depending on circumstances more frequent meetings may be appropriate.

A Final Note: What Happened to Asperger’s?

In the profession of psychology, there is no longer something call Asperger’s Disorder. Even though research about Asperger’s is almost as old as that of autism, it was not a separate diagnosis until 1994 when the DSM was revised. Asperger’s was felt to be either something different than autism or the mildest, least severe form of autism.

The newest revision of the DSM (DSM-V) does not include Asperger’s. What is new in DSM-V is Social (Pragmatic) Communication Disorder. The primary features of SCD are difficulty with the use of social language and communication skills, adapting speech to the situation (such as home vs. school), and being able to make non-literal interpretations of written and spoken words.

 

CHILDREN WITH AUTISM, PART III

This post, the third in a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Identifying a Child as Autistic

How do you know if your child might have Autism? Perhaps the most striking behavioral symptom of the condition involves verbal communication problems. When they occur on a regular basis you should be concerned and investigate further. Keeping in mind the continuum we have described in my previous posts, these language deficits can take a variety of forms. The child may:

Never use spoken language to communicate.

Sound like a parrot, simply repeating everything that is heard.

Repeat your question instead of answering it, or repeat songs they have heard or portions of movies they like.

Use odd word choices when they communicate. I pointed out earlier how one child at Thanksgiving talked about getting to “hack” the turkey.

Talk and talk and talk about favorite topics and interests but never ask you a question about it.

Be able to read but not understand the material.

Say unusual things like, “He likes ice cream,” instead of “I like ice cream.”

Be able to carry on a conversation.

Some additional warning indications, although not definitive signs of autism, should nevertheless raise a red flag in your head. These include things like the following:

The child is not talking by 2 years of age. Or, your child has begun using words and then around 18-24 months stops using those same words.

You notice inattentive behavior on a regular basis and think your child might have a hearing problem.

You find yourself wondering why your child rarely makes eye contact with you.

You wish your child would be more interactive with you and others, such as playing peek-a-boo or smiling back at you.

You notice your child regularly prefers to be off alone, even at his or her birthday party or at other family gatherings.

Your child seems to have exaggerated sensitivities to certain sensory experiences, such as lights or sounds.

You notice on a regular basis that your child has difficulty adjusting to change, such as a new routine. The child definitely prefers sameness and predictability, and repetitious behaviors occur frequently.

To some degree, all children can display any of the above characteristics at any point in time. Generally you hardly notice them. When they are extreme, frequent, and predictable, however, they catch your attention. It is at this point you may want to investigate further. Also keep in mind that any of the above could be indications of something other than autism. The child might have a language deficit. A condition like fetal alcohol syndrome, due to effects of alcohol consumption during pregnancy, can often look the same as autism. Basically, if you are overly concerned there is only one way to know what’s going on and that is to have the child evaluated by trained professionals trained to do such evaluations.

CHILDREN WITH AUTISM, PART II

This post, the second in a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Behavioral Deficits in Autism  

 In my previous post I talked about the continuum and how it applies to sensory reactions shown by children with autism. The same wide variety of characteristics, that is, the continuum, applies when we consider behavioral deficits. Every parent who suspects autism wants to know what deficits to look for. Being aware of difficulties a child may face is certainly the first step in learning to cope with them, and awareness of these deficits can reduce parental concern and anxiety. The reality is, however, that the expression of autism can vary tremendously from child to child. No two children will look the same.  

 Consider verbal ability. Deficits in verbal language skills can include not using spoken language by the time the child is two years old. Or a child around 18-24 months of age may stop using words already learned. Sometimes the child may sound like a parrot, simply repeating everything heard. Mommy says, “Do you want a drink?” and Johnny replies, “Do you want a drink?” Children may repeat songs they have heard or portions of movies they like as they are going about their day to day activities.  

 Some children acquire good vocabulary but may use odd word choices when they communicate.  My friend Jack talked about getting to ‘hack’ the turkey one Thanksgiving. While ‘hack’ can mean cut, it is not the word most people would typically use to describe carving a turkey. Some children may talk and talk and talk about their favorite topics and interests but never ask you a question about it or ask for your input. 

 Jack was an expert on 50’s and 60’s rock and roll music. He could tell me everything about it, such as who wrote the words, who wrote the music, who produced the album, what recording company was involved, what year it was written, etc. I grew up listening to that music and know a little about it.  However, during the course of providing counseling to Jack over 1½ years he never, ever asked me anything about it. Jack also loved stamps. He had multiple five-inch binders full of postage stamps from around the world, and he could tell you everything you ever wanted to know, and more, about them. But he never asked what I knew.

 I evaluated 4-year old Mary who could read everything on the label of the fire extinguisher as we passed by it in the hall on the way to the room used for testing. She couldn’t answer any questions about what she read, but she had no difficulty pronouncing any of the words she saw. Some children may be able to carry on what appears to be a conversation, but they are really just talking on and on about their favorite topic. 

 When thinking about any aspect of autism, think of the continuum. With respect to language, for instance, at one end of the continuum is the child who uses little, if any spoken words, while at the other end of the continuum is the child who uses lots of words.

 

CHILDREN WITH AUTISM, PART I

This post, the first of a series, is courtesy of Dr. David Jenkins, Sr., a Licensed Specialist in School Psychology and Lead for Psychological Services at Lubbock, TX. Dr. Jenkins has provided psychological services to school districts in Lubbock, Texas and surrounding school districts for over 25 years and has served on the Texas Education Agency statewide networks for autism and behavior.

Sensory Reactions in Children With Autism

 When evaluating the presence of autism you should think of various characteristics on a continuum. Children with Autism tend to either be over-stimulated or under-stimulated, to over-react or under-react, be hyper-aroused or under-aroused to a variety of things.  Putting actions on the continuum is especially helpful when you think of autism and the five senses: sight, hearing, touch, taste and smell. Sensory reactions in autism can vary widely in different children. 

Children with autism may be bothered by certain kinds of lights, or they may like to stare at lights while waving their hands or fingers in front of their eyes.  Some may look at things out of the corner of their eyes rather than directly looking at it. Some may like to watch things spin, any object that can spin, such as wheels on cars (real or toy), plates, a frisbee, a ceiling fan, a top, a coin, etc. Children with autism tend to be better visual than auditory learners.  Temple Grandin, a famous woman with autism, talks about how she thinks in pictures rather than words.  

 It is not unusual for parents to tell me they thought their child was deaf because the child did not always respond when their name was called. A 4th grade student I evaluated asked if I could get the teacher to stop “ticking” (as in “tic-toc”) because it was distracting him. The source of the ticking was the teacher’s pacemaker that he was able to hear! Other children, however, completely ignore sounds. One task often used during an evaluation is to ring a bell while the child is engaged in a task.  Many times, children with autism never turn toward the sound; they appear not even to notice it.   

Children with autism can be particular about the clothes they wear.  They may never wear blue jeans, preferring the softer feel of other materials.  I’ve known children who wear the same shirt every day because it is the only type of “feel” they will tolerate.  One little boy liked the feel of nylon stockings, causing his mother to warn visitors about wearing stockings. 

Sometimes children may like to play with water or sand, letting it run through their fingers. Sometimes they may not like the feel of shaving cream or pudding, which is often used in pre-school settings for finger painting.  Sometimes they like the feel of human hair, smooth surfaces, cool feeling objects, carpet, etc., and the list goes on. The continuum is wide.

 It is not unusual for children with autism to be picky eaters. They may prefer only soft foods, or only crunchy foods, or no meat of any kind, or no veggies, or only foods of a certain color. A mother told me her child would eat an apple, but only if it was whole and unpeeled.  Another told me her child would eat an apple, but only if it was whole and peeled.  Others have told me the apple had to be peeled and cut, or cut and unpeeled. Children with autism may only eat a limited number of foods and will only eat those every day, never trying anything new. The food-preference continuum can be extremely varied. 

The last of the senses is smell. Teachers and parents have told me about how their child can detect when a new perfume or deodorant is used and at the same time do not react to the smell of a skunk near the house.

When it comes to sensory sensitivity and reactions, one size does not fit all. Children with autism can fall anywhere along a wide continuum of sensitivity.

 

ARE YOUR BELIEFS AND ACTIONS CONSISTENT?

Syndicated columnist Paula Dockery wrote about her consternation with the seemingly illogical behavior of the American voter in the 2016 election. For instance, polls showed that approval ratings of Congress at election time were around 20%, and yet virtually every Congressional incumbent was re-elected. Crazy, right? If we disapprove of Congress, why do we re-elect them?

Dockery also cited a Quinnipiac poll taken just before the election that showed 67% of Americans agreed with Roe v. Wade; 60% supported allowing illegal immigrants a path to citizenship; 68% were concerned about climate change and 59% supported regulations to curtail it; and 85% of voters felt those on the no-fly list should not be allowed to buy guns. These were sizeable majorities from a respected poll. And yet, the man who disagreed was elected President. Huh?

Dockery raises a very logical question: If we feel government isn’t working for us, why don’t we vote for those who share our views and shun those who hold different positions?

There are explanations and coping lessons from a psychological perspective that we can apply to Dockery’s contradictions. First of all, inconsistencies between beliefs and actions are not limited to voting behavior. Why would an abused woman stay with her abuser? Why does the bullied kid suck up to the bully and seek to join his gang? Why would someone like Jack (11/27 blog) refuse to face a life-threatening health problem? Why would someone waste away in a dead-end job instead of looking for another position? Why would Dad passively ask the family therapist when the anti-depressant for his 17-year old daughter will “kick in” so she will become normal again? Why would a parent hover over a child and protect him or her from failure? These actions appear to make little sense.

To answer these questions let’s note a basic psychological principle: When you commit to a set of beliefs and a course of action, your mind tends to engage in all sorts of questionable thinking to justify your commitment. About 60 years ago Leon Festinger formally developed this idea in his theory of Cognitive Dissonance, and illustrated it with the following case.

In the 1950s a small cult gathered on a hillside on a date specified by their leader as the day the world would end. According to the leader, God would save them and destroy all else. In preparation for this day, these folks sold all their belongings….their houses, cars, clothes, everything. They made an incredibly strong commitment to their belief.

When the end did not come, the group did not turn on their leader as a false prophet. Instead, they joined him in praising God for rewarding them for their great faith and saving the world because of them. Talk about reality distortion! These folks decided the world continued to exist because of them; their faith saved the earth. Extreme self-congratulatory thinking to be sure, but it worked. Faced with the possibility that they were a bunch of knuckleheads who fell under some idiot’s spell, they kept their mental balance with perceptual distortions and irrational thinking, and continued to worship their leader. That’s not a recipe for psychological stability.

Festinger’s theory is based on the belief that the human mind strives for consistency and harmony. Our minds don’t like disharmony resulting from contradictory beliefs and actions. We would add that dissonance kicks motivational forces into gear because dissonance arouses fear. Consider our questions raised earlier: the abused woman and bullied kid fear retaliation unless they stay close to the enemy (the old Stockholm Syndrome); Jack fears abandonment and his inability to confront challenges (symbolically, his father); the job hunt brings fear of rejection; dad and the helicopter parent fear they will be seen as parental failures if their kids fail. Fear, fear, fear……….In each case it drives the irrational behavior.

Fear also plays a role in voter behavior. You hate Congress but you see your representative as fantastic, someone who brings your district lots of money. When things go south it is obviously the fault of the other party. Voting for your guy, is safe, familiar, and shows your wisdom. Congress sucks because of those other members, especially those in the opposition party. Hardly logical or critical thinking, but it makes sense to you.

The coping message here is clear: No matter what beliefs and actions we’re talking about, when they appear illogical, inconsistent, and contradictory, they are often servicing some inner conflict based on fear that makes it difficult to take a hard and honest look in the mirror. And that is why you must be vigilant and willing to face inner conflicts that can lead you to reality distortion and irrational thinking. You simply cannot cope effectively if your mind is otherwise engaged in making your perceptions consistent with your beliefs. That house of cards will eventually fall because it is based on avoidance and fear.

This posting is not about an election or about your political persuasion; it is about coping poorly by failing to confront your fears (whatever they may be), including the ones beneath your consciousness. If you run from your fears you are digging yourself a deep psychological hole. If it gets too deep you may not be able to escape. Again and again, our postings try to make these fundamental points.

 

COPING WITH FERTILITY PROBLEMS, PART III

In Parts I and II of this three-part series, we discussed the difficulties Sue and Dave were having in producing a successful pregnancy. In Part II we focused on specific steps that Sue could take to cope with the various emotions she was facing concerning their, so-far, unsuccessful pregnancies. In Part III we want to shift the focus to Dave, and ask what coping steps he can take to deal with the stress he and Sue are facing.

—-Dave must maintain totally open and honest communication with Sue. The golden rule of any relationship is, when difficulties arise, communication, negotiation, compromise and acceptance are absolutely necessary to facing challenges in constructive ways.

—-Dave must likewise share his viewpoints. They must discuss how they feel about various options they can choose, and work toward finding a common ground from which to proceed.

—-Dave must reassure Sue that her welfare is his primary concern; conceiving and delivering a child is secondary in his mind to her well-being.

—-Dave must also realize that it is Sue’s energy and resources that are more proportionally focused in the direction of having children. It can be quite natural for him to feel that he is in a secondary position in the relationship, and potentially no longer the primary love object. If Dave has these feelings he must voice them, and he and Sue must come to the mutual understanding that Sue’s focus on having a child does not mean replacing Dave in her heart.

—-Dave must assure Sue that she is not to blame for their situation. He must make it clear that he understands and finds it quite natural that she may feel some guilt. He must help her examine this guilt and critically challenge it as without foundation.

When lines of communication and cooperation are open and functioning, true sharing can take place between Sue and Dave. Eventually, that sharing will lead to acceptance of many truths. For instance, Sue and Dave must consider that pregnancy may not be in the cards for them, and that adoption is their best option. Perhaps Sue should concentrate on her career. Both she and Dave have successful careers and maybe they should focus on just being happy with each other. Some folks willingly accept that what they don’t have in life is far less important than what they have and appreciate.

Sue and Dave’s situation shows us that stress can lead either to deterioration or enhancement in a relationship. By pulling together as a team and confronting any anger, guilt, jealousy, and anxiety in positive ways, Sue and Dave can become more loving, cooperative, understanding and helpful with one another. Earlier (Blog of 9/16/16) we discussed the distinction between stress management and stress enhancement. Sue and Dave can focus on stress enhancement to produce outcomes that will lead to increased personal and emotional growth. Such focusing is precisely the strategy any of us must pursue when we face coping challenges.