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In This Issue

Develop a Master Calendar for Your Family
It’s natural to focus on our frailties. It helps us guard against the things that can damage
us. But in doing this, we often overlook just how resilient human beings tend to be. Many
people endure great emotional or physical trauma and manage to recover from it. It’s
important to appreciate our resilience and to understand that we can increase it by
strengthening our positive traits.
Controlling Self-Defeating Automatic Thoughts "Watch your thoughts; they become your words. Watch your words; they become your actions. Watch your actions; they become your habits. Watch your habits; they become your character. Watch your character; it will become your destiny." -Author Unknown Many of the thoughts we have are automatic, as opposed to being purposeful or reasoned. But even those automatic thoughts can increase our level of arousal and affect our behavior. When you run into a difficult situation, you may automatically think, "I can't do this," or "I'm a failure." Negative thoughts like these can make you give up on your weight management plan. Thoughts impact behavior, so be aware of what's going on inside your head! Replace negative thoughts with positive ones, such as, "It won't be easy, but I can do this." We can also change our perception of events and our behavior by replacing distorted thoughts with rational ones. Do you recognize any of the common thought distortions below? Generalization: assuming that because something happened once, or was true in
one situation, it will always happen or be true in others
Perfectionism: feeling that we (or others) should always perform perfectly
Either/or thinking: seeing situations or people in absolute terms, such as good or
Shoulds, oughts, musts and have tos: believing that things ought, should, must
or have to be the way we would like them to be
Emotional thinking: reactions based only on feelings without logic
Now that you are aware of the different types of cognitive distortions, you can change your thinking by replacing distorted thoughts with rational, positive ones. In the table below, list your automatic thought in response to an internal or external trigger in the first column. In the second column, identify the cognitive distortion. Next, write down a rational response to your automatic thought. The first line is filled in as an example. TRIPLE COLUMN TECHNIQUE
Automatic Thought
Cognitive Distortion
Rational Response
sleep earlier tonight and work out tomorrow. Automatic Thought
Cognitive Distortion
Rational Response
Pay attention. The next time you find yourself thinking irrationally in response to the trigger you listed here, try replacing the thought with the rational response. You may discover that your feelings and actions are not caused by the trigger but rather how you think about it. When you are depressed, it is common to think about all the negative things that you have to do, and just thinking about them can make you feel more depressed. When you wake up in the morning, focus instead on something enjoyable that you are going to do, for example going to lunch with a friend. Before you go to bed, think about something good you did that day. If you had a bad day, try to keep it in perspective. It was just one day and instead of dwelling on it think about how you'll make tomorrow better. MOVING TOWARDS THE POSITIVE WITHIN
After a week or two of writing down your positive thoughts in your mood log, you will be ready to learn how to use these positive thoughts to change your negative thinking. Select the most common of your negative or depressive thoughts on your list. In addition, select, at first, those thoughts you feel would be easiest to change. Find a comfortable place where you can sit and relax. Take a few deep breaths, and slow down your breath. Repeat 2 times in your mind, each time you exhale the negative thought you are trying to modify. Make a mental note how depressed this thought makes you feel using the scale of 0 to 10. For the next ten breaths, begin to repeat the positive thought you wrote down. At the end of these 10 repetitions, note again how depressed you are on the rating scale. Open your eyes and write down the respective scores in columns 2 and 4. If you have time, repeat this exercise, with the same thought 2 or 3 more times. Later in the day, if you have more time, repeat the exercise again. Keep working on this thought until your depression score is 0 or 1. After this, you can select another thought. When you can, practice this exercise at the time of the day, and/or in the location the negative thought is most likely to occur. Stick to the exercise as described. Only proceed to more difficult and negative thoughts when you have mastered less difficult ones. Overtime you will gradually build on the gains you made with thoughts that are easier to modify. Proceed at a pace that is easiest for you, to guarantee success. If you try to deal with more difficult thoughts at first, you will only end up feeling frustrated and disappointed. In this way, you will begin to gradually learn to automatically substitute more positive and healthier thoughts for those that cause you to feel depressed. Imagery Tools Golf sensation Jack Nicklaus once wrote, "I never hit a shot, not even in practice, without having a very sharp in-focus picture of it in my head." Athletes, business people and performers have used visualization for years to improve performance. Also known as "guided imagery," this simple, low-cost tool can motivate us and help us overcome fear and anxiety to achieve our weight loss goals. Research shows that if we can picture a new skill, we are more likely to master that skill. Let's explore how to use this powerful technique for weight loss. 3 WAYS TO USE GUIDED IMAGERY FOR WEIGHT LOSS
To get the most out of imagery, you need to reach a state of deep relaxation. Start by finding a quiet area where you can sit or lie comfortably with your eyes closed. Slowly relax your body, starting with your eyelids and then working through each muscle, down to your toes. Then picture yourself sitting down for a meal. See yourself taking smaller bites of food, chewing for a longer time, pausing between each bite, leaving some food on your plate and feeling great about your new behaviors. Another guided imagery exercise involves imagining how you would look, act and feel at a healthier weight. Make your mental image as real as possible by involving as many senses as you can. For example, picture yourself at a park. Feel the sunlight warm your back and breathe in the woodsy air. Visualize how fit you look and how strong you feel as you start walking up a trail. You can also use guided imagery to picture a desirable outcome to a situation where it's easy to overeat. For instance, imagine you are in the office cafeteria and see doughnuts left over from a meeting. Picture the doughnuts, smell their sweet chocolate scent, let your craving develop and then see yourself walking away. Remember -- mind management is an important part of weight management. Practicing guided imagery regularly can improve your chance of losing weight and keeping it off. Are you surprised at how badly you sometimes treat yourself? We should be our own best friends - our biggest fans. Instead, when we get into a difficult situation, a voice in our head screams: "I couldn't carry a tune in a bucket" Sometimes it seems like it never stops. But it can. Negative self-talk is a habit that people develop to protect themselves. They use it to keep themselves from trying things that may be scary or uncomfortable. "I can't do this" may really be a way of saying: "I don't want to deal with failing at this." We are strongly influenced by our feelings; they often determine what action we ultimately take. If you're feeling uncomfortable, that negative voice kicks in, and you may decide to take no action at all. But our feelings don't have to control us. We have the ability to choose the emotions we have. If you don't like feeling guilty, frustrated or doubtful, you can choose not to. It's not easy, but in order to become successful at making healthy choices, you must avoid negative self-talk and begin to cultivate the habit of positive thinking. IDENTIFY KEY SITUATIONS
The first step is to understand and identify those situations that give rise to negative feelings. Does an inner voice say you're an unhealthy eater if you give in to that ice cream craving? Does it scream you're a failure as your colleague ridicules you in front of your boss? As you begin to understand your reasons for negative self-talk, and the situations in which it occurs, you'll find yourself recognizing it more quickly when it starts. Eventually, with practice, you can replace the negative thoughts with positive ones before they even occur. As you practice, it's very important to consistently acknowledge the positive changes you make in your life. Did you make healthy food choices this week? Did you speak to the colleague about her behavior? If so, give yourself a mental pat on the back. STRATEGIES
1. List any counterproductive thoughts that occur to you in a given situation. 2. Develop a list of challenges or counter-beliefs (positive self-talk) that counteract the negative thoughts. These should be realistic, useful, believable and believed. Direct them towards one's thoughts rather than ones feelings or emotions, and make them as powerful or persuasive as possible. 3. Once you have identified counterproductive thoughts and developed challenges to those thoughts, practice substituting the challenges until they are second nature in real life. Remember, there are bound to be times when you feel frustrated, depressed or inadequate. Positive thinkers know that these feelings are valid, and they don't try to ignore them. Just acknowledge the thoughts, work to understand them, and try not to blame yourself for the conditions that lead to those feelings.
Also in this issue:
Teens and Temper
Anger often becomes a pressing issue when children enter their teenage years. As they approach adulthood, adolescents begin resisting parental controls taking a stand as individuals in their own right. This happens just about the time parents feel the need to put restrictions in place around things such as friends, driving and social activities. The resulting friction can heat family tempers to boiling point! It helps to remember that this difficult stage is temporary and you can reduce your family's stress by being thoughtful about the rules and limits you apply. Adolescents need flexibility in family rules and control over their own choices whenever possible. Likewise, they should begin to take on more responsibility for the decisions they make. By gradually increasing the freedom and accountability your teens experience, you can help them prepare to become healthy, mature adults. Safety is the bottom line, so rules about issues such as curfew or alcohol and drug use are essential. If your teen is making poor choices in these areas, it's not appropriate for you to extend more freedom. But decisions about such things as dress, homework and diet need to be turned over to your adolescent so they can practice making good decisions in preparation for launching out on their own as young adults. FOCUS ON WHAT THEY DO, NOT WHAT THEY SAY
Your 16-year-old daughter is getting ready to go out and starts that weary old argument about curfew. She rants and raves in front of her friends and insists she will come home when she's good and ready. But as the clock reaches 10:59 and not a moment before you hear her key in the door, and she's made it back home safe and on time once again. And that's just fine. The important thing here is your child's behavior. She is complying with the rules, even though she's saying she won't. Don't let her words alone fool you into thinking she's misbehaving when she's not. Some anger over having to do something she doesn't agree with is not only natural; it's a good thing. You want her to be in touch with her feelings, not disconnected from them. If you insist she must be cheerful or "have a good attitude" about keeping curfew, you are asking her to feel the same way you do about this issue or at least pretend she does. And that doesn't help either of you. As long as she is not verbally disrespecting you (threatening or name-calling, for example), let her be upfront and honest about how it feels to have to follow a curfew she opposes. REMEMBER - YOU'RE THE ADULT
If you ever find yourself pulled into a shouting match with your kid or hear yourself spitting out words usually not allowed in your home, don't despair! Teens can be especially adept at hooking parents into heated arguments, and most parents lose their temper on occasion. However, do be aware that this type of interaction can be destructive and is best avoided. If you start exchanging insults with your teen during a disagreement or insist on having the last word, recognize that you are escalating the fight rather than resolving it. As the parent, you're the one responsible for upholding family rules about what's OK when someone gets mad and what's not. That means no name calling, no threats, no taunting, no matter how hot under the collar you feel. Identify what it takes to calm yourself down when you're close to boiling over, and do what it takes to cool down before you get to that point. Do you need to leave the room for a minute? Call in a spouse for reinforcement? Table the issue until everyone has calmed down? These tactics don't mean you are backing down or losing the argument - they mean you know how to handle your anger in a mature way. And that's a great model for those teens who just can't wait to become adults themselves.
How to Quit Smoking

Giving up smoking means conquering two forms of addiction: physical addiction to nicotine, and psychological or behavioral addiction to the act of smoking itself. Both need to be broken. That's why it can be so hard to quit. NICOTINE ADDICTION
The U.S Public Health Service has described nicotine addiction as "the most widespread example of drug dependence in our country." You may not think of nicotine as a drug like heroin or cocaine, but it is, and it's just as addictive. And like those drugs, you'll experience withdrawal symptoms when you come off nicotine. These symptoms will begin within a few hours of your last cigarette and can last from a few days to several weeks, often peaking after two or three days. While in withdrawal you may feel irritable, depressed and restless. You can have headaches, trouble sleeping, and difficulty concentrating. You may also want to eat more. This period will be hard, but there are ways to mitigate these symptoms with medications and nicotine replacement (see below). PSYCHOLOGICAL ADDICTION
The pleasurable effects of smoking lead the brain to create strong associations between having a cigarette and the activities, locations, or times of day that you regularly smoke. In other words, smoking becomes "paired" with things like driving, drinking in a bar, or watching a sports event. So these activities immediately alert the brain to expect a cigarette, triggering a powerful urge to smoke. Breaking these connections is vital, especially as they can cause you to start smoking again long after the physical addiction has gone. The connections can be so strong that in the early stages of quitting, it's very helpful to avoid these situations altogether to remove one of the causes of your craving. COLD TURKEY
It's the simplest and probably the hardest method, but it has worked for millions of ex-smokers. If you are truly determined to quit and have plenty of will power, this may be a method for you. If you're going to try it, set a date, throw out the cigarettes and follow the "Tips for Quitting" below. If you don't make it the first time, don't despair. Many smokers need a few tries to kick the habit, and these "practice" runs do often help. MEDICINES AND THERAPIES
The steps in "Tips for Quitting" are also helpful if you choose to use the medicines and methods described below - and we suggest that you do. In 2000, a panel of physicians and researchers appointed by the surgeon general, looked at over 6,000 studies of quitting and recommended that people use nicotine replacement (or other medications). They also reported that counseling and support groups can really help. NICOTINE REPLACEMENT
The panel found that nicotine replacement therapy can double your chances of quitting successfully. These therapies deliver a controlled (and ever decreasing) amount of nicotine to your brain, through your bloodstream, to gradually wean you off the drug. They come in a number of forms: gum and skin patches are available over the counter; for inhalers or nasal sprays you need a prescription. When used correctly, all nicotine replacement products are of roughly equally effectiveness. MEDICATION
For some people, medications can reduce the urge to smoke and ease the worst withdrawal symptoms. Researchers found that some patients using non-nicotine prescription medication, such as Bupropion (Zyban), could quit smoking more easily. It combats symptoms such as irritability, anxiety, restlessness and depression - making the withdrawal phase more bearable in some cases. Talk to your doctor to see if medication is right for you. COUNSELING AND SUPPORT
Counseling, classes and other forms of social or behavioral support can be very effective. The surgeon general's panel argued that these groups should be used by all people who are trying to quit smoking. When choosing a group or counseling program, duration of sessions and program length are important. According to Quitnet (an online resource for people trying to quit smoking), sessions should be at least 20 to 30 minutes long; there should be at least four to seven sessions; and the program should last for at least two weeks. The group leader should also be specifically trained in smoking cessation. In short, expert opinion says that you probably shouldn't try to quit alone or without some form of medication. Consider counseling or classes, and use nicotine replacement or other medications if recommended by your doctor.
Develop a Master Calendar for Your Family

A master calendar is a great way to organize your family's chores and activities. Posted in the kitchen or dining room, your family can use the calendar to note a wide variety of appointments, events and occasions. A master calendar helps guard against surprises and missed appointments because everyone knows where everyone else is and what needs to be done. Encourage young children to start using the calendar as soon as they're old enough to read and write. USE THE CALENDAR TO NOTE:
times when a parent must work overtime or travel on business. Use a large, erasable white board and brightly colored markers for your calendar. Make it attractive and fun to use. You can also buy large paper calendars at office supply or stationery stores. There should be enough space on the calendar for each person to note appointments and activities. Leave space for important phone numbers of friends, neighbors and doctors. Review the previous month's calendar before discarding it. What can you eliminate?

Help for the Caregiver

Sometimes, instead of uprooting a senior from his or her home or otherwise drastically changing living arrangements, the best option is simply for a caregiver to get help. This help can take many forms, depending on what the caregiver is willing and able to offer and what the senior needs. The hardest part for a caregiver might be admitting your limitations. Don't be ashamed of what you can't do, or even what you don't want to do. It will be better for everyone involved if you honestly assess what you can do and what you need help with. Following are a few options you may want to consider; check to see which of these services are available in your community. Friends, Family Members and Neighbors
Contact everyone who might be able to help and ask them to commit to a particular
task -- or even just to visit once a week.
Transportation Services
Senior centers, hospitals, cities and private programs all administer a variety of
transportation services -- including vans, buses and chair lifts.
Telephone Reassurance Programs
These volunteer programs have people call seniors regularly to check that everything
is okay. They can then call you if there seems to be a problem.
Home Maintenance and Repair Services
These services, sometimes subsidized, specialize in helping seniors maintain and
improve their homes.
Senior Centers
Often, senior centers serve meals, offer support groups and provide other means of
socialization for seniors.
Care Manager/Social Worker
With training in gerontology, social work, nursing and/or counseling, these
professionals can assess, manage and educate about a variety of care needs,
including financial, legal and medical issues.
Adult Day Care
These programs offer all day, morning, afternoon and sometimes evening care for
Homemaking and Personal Care Services
Provide assistance with homemaking (such as cooking and cleaning) and personal
care (such as dressing and bathing).
Home-Delivered Meals
(Meals-on-Wheels) programs Often run by the local senior center or nutrition program,
home-delivered-meals programs provide meals, usually once a day, for very fair
Home Observation Programs
(available from utility companies and the post office) In these programs, people who
visit the house regularly, to read the gas meter or deliver mail, are trained to notice if
something doesn't look right and report it to the proper authorities.
Home Health Care
Semi-skilled and skilled services are available, for a few hours a day or 24 hours a
day, for people who need medical care at home.

Respite Services

These programs give caregivers a break -- for a day, a week or a weekend -- by taking
in or caring for a senior for a specific period of time.


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