Gratitude Can Improve Your Mood

Feeling GoodIt may sound trite, but science has shown that being grateful for what you have is one good way to increase your happiness. In one study conducted in 2003, a group of student volunteers who wrote daily about 5 things they were grateful for increased their happiness scores more than those who wrote daily about “hassles” or neutral “events.” The “gratitude” group felt better about their lives, were more optimistic, had fewer health complaints, and even exercised more than the other groups!

I have found that in keeping a “gratitude journal”, it’s most helpful to write more than a few words. Writing details tends to help you feel even better. For example, instead of writing “I am grateful for my children,” you might write “I am grateful for the way my little son looks so happy to see me when I pick him up at day care.” Instead of “I’m grateful for the good weather,” you could write “I’m grateful for the way the sun makes all the colors seem brighter today.” If it’s hard to think of things to be grateful for, remember the very small things: “I am grateful that I can breathe.” It could be otherwise…

Here are some more exercises which can help increase your gratitude – and your happiness:

Make a “gratitude visit.” Visit, write, or call someone who has helped you and express your appreciation for what they have done.  This strategy is especially helpful in strengthening your social support system, which is also a good way to prevent depression and increase happiness.

Write daily 3 good things that happened to you that day, and also write down why you think they happened. For example, “My cable was turned back on, because I was finally able to save enough money to pay the bill.”

Write about something funny that happens every day.

Write a list of kindnesses – kind things you did for someone else, or kindnesses you received from others.

If you think you have little to be grateful for, remember the small things.  For a bit of nostalgia (if you’re old enough!) and a lift in your spirits, check out this  video of Ethel Merman singing the Broadway tune, “The Sun in the Morning and the Moon at Night!”

Improving your Mood with Food

Food for thoughtAs we continue to learn more about the mind-body connection, many physicians and therapists have become aware that poor eating habits can worsen symptoms of depression and anxiety, while a more healthful diet can lift your spirits and help keep you energetic and productive all day long

Most of us have heard by now that refined carbohydrates are “bad” for us.  These foods, like white bread, pasta, cake, soda, and candy, may taste delicious and tempt us to eat more than we should.  But refined carbs causes our blood sugar to rise suddenly, and then drop.  We may enjoy the “sugar rush” for a short time but we are left feeling tired and cranky afterward.  Instead of filling up on refined carbohydrates, we may need to increase our protein intake.  We also need to keep eating healthy foods at regular intervals all day long, rather than starving all day and coming home to “pig out” at night.

When we are under chronic stress, we are more vulnerable to reactive hypoglycemia (low blood sugar), which is a result of an excessive release of insulin following a meal high in refined carbohydrates. The low blood sugar then leads to a drop in mood as well as irritability, nervousness, shakiness, and even confusion.  That’s why it’s especially important for both children and adults to start the day with a healthy, high-protein breakfast.  After “fasting” all night while we are sleep, breakfast is necessary, even if you think you don’t have the appetite for it.  Appetite rises and falls in part according to your habitual meal schedule.  If you shift your schedule, your appetite will gradually shift along with it.

Dr. Leslie Korn ( is a psychologist and nutrition expert who suggests that both adults and children can withdraw from sugar and refined carbohydrates by going on a protein-rich diet for 7 to 10 days.  People are advised to eat small amounts of protein (meat, fish, eggs, dairy, beans, or nuts) six times a day (every three to four hours) as well as one to two servings of a root vegetable, such as a sweet potato or carrots topped with butter or olive oil, along with salad or green vegetables.  She also informs her clients that artificial sweeteners such as aspartame has been found to be a possible cause of neurological, psychiatric, and behavioral disorders.  Some people also get headaches or panic attacks after consuming aspartame. Stevia, a plant native to South America and now readily available in powder or liquid form (often sold as “Truvia”), is a better sugar substitute.

To learn more about food and mood, there are a number of good books on the topic.  Try, for example, Food & Mood by Elizabeth Somer.  You may also talk with your doctor, therapist, or nurse practitioner.


Reducing criticism can help the whole family.

How to criticize without damaging your relationship

Reducing criticism can help the whole family.

Reducing criticism can help the whole family.

Couple therapist and marriage researcher John Gottman says there are 4 communication patterns that are so unhealthy for a marriage that when couples do them frequently, they often end up in divorce court.  These 4 patterns are Criticism, Contempt, Defensiveness, and Stonewalling.  Gottman calls them the “Four Horsemen of the Apocalypse.”

I’ve chosen to focus here on Criticism, not just because I’m a highly experienced Criticizer myself – and know from decades of personal experience how hard it is to change that pattern! – but also because it seems to be at the root of the other 3 patterns.  Contempt is an even more serious problem than Criticism, but you don’t usually get to the point of being contemptuous until you’ve criticized for a long time.  Defensiveness is a natural and automatic reaction to feeling attacked, which often happens when we are repeatedly criticized.  And Stonewalling, or shutting down completely, is the frustrating reaction that is very often triggered by a pattern of criticism and contempt.

So, cut down on criticizing your spouse, children, siblings, employees… and weaken the other three patterns as well, while improving the chance of having a more satisfying relationship.

Susan Page, in her wonderful book Why Talking Is Not Enough, suggests that you simply try to eliminate negative comments completely for 2 straight weeks.  It’s very hard to do! and yet if you try, I think you’ll find  your whole relationship can warm up and become more loving and satisfying for you.

Gottman has an approach to eliminating criticism which is more easily sustained than simply keeping your mouth shut.  He refers to “Complaints” as a more effective strategy than Criticism when you are frustrated with someone.  Instead of criticizing (“You are always late!  You never do your chores!” etc.), try “Complaining” in this fashion:

First, state your feeling about he problem behavior: “When you are late I start to worry about your safety, and also, dinner gets cold.”  Then, tell the person what you want: “Please leave work by 6 p.m. tonight so you can be home in time for dinner, and please call me if you are going to be more than 5 minutes late.”

That way the person is less likely to feel attacked and so gets less defensive; and, it is much more likely that you’ll end up getting what you want!  The best that can be hoped for the Criticism version (“You are always late!”) is that the other person will try to prove you wrong by being on time.  It’s an approach that sometimes works, but more often leads to defensive retorts (“I am not! You’re late more often than I am!”) and also to shutting down “Stonewalling”).  At worst, the person you love may begin to delay coming home even more.

Finally, go easy on yourself.  All of us are critical sometimes, especially when the person we care about repeatedly does something that frustrates or worries us.  You don’t have to pretend to be happy with someone when you are not, but you do have a right to express your needs.  Your partner (or child or employee) may continue to react defensively at first, especially if they have felt repeatedly attacked over a period of time.  But by turning a Criticism into a Complaint, you are on your way to having a partner (or child or employee) that doesn’t argue back or shut down – and therefore you’ll probably feel a lot happier yourself.

To read more, see books by John Gottman:

The Relationship Cure;   Seven Principles for Making Marriage Work

by Susan Page:  Why Talking Is Not Enough, How One of You Can Bring The Two of You Together

How Psychotherapy Can Help

   by Nate Prentice, MSW, LCSW, CAS-PC
Therapist and client (male)If you are reading this, it is probably because someone suggested that you may benefit from talking with someone about things which are bothering you and causing repercussions for you in your home, your work, or your relationships with other people.  It is probably not a comfortable thing to hear, but you want to feel better, so you are considering your options.  Or, perhaps you have tried other things including medication, but feel stuck and are interested in exploring other options to help you, because, after all, you want to feel better.
What are the benefits of psychotherapy vs medicine alone?   Consistently, in study after study, psychotherapy has been shown to be as effective as medication alone with many mental health issues. More importantly, many mental health issues such as anxiety and depression respond even better to a combination of psychotherapy and medication than psychotherapy or medication alone.
Why is this?  Many people do get a sense of relief from taking medication.  However, they may lack the skills to cope with life stressors, especially when nothing else in their life has changed.  So symptoms may persist.  Or, people may use ways of coping that create their own problems, such as substance abuse (self-medicating the symptoms), yelling at family members, workaholism, etc.  Psychotherapy, because it focuses on skill development and problem solving, helps with these issues.

How do you choose a psychotherapist?  There are several kinds of professionals trained to do psychotherapy.  These include psychologists, psychiatrists, clinical social workers, marriage & family therapists, and licensed professional counselors, among others.  The specific degree a person has may be less important than how experienced and skilled they are, and how comfortable you feel with them.  Some other issues to consider may be the therapist’s gender (male or female), age, or cultural background, or their therapeutic techniques and philosophy.

What is a typical psychotherapy session like?  Gone are the days of lying on the couch.  Today most therapy sessions are held face to face.  The first session is usually an evaluation, where you may be asked a number of related and unrelated questions to help the therapist discern what your issues are and what outside influences are impacting on your issues.  During or after that session, a plan for addressing these issues will be created.  Therapy sessions are usually weekly at first, and may reduce to biweekly or monthly as you begin to feel better.

Therapy sessions will then focus on how you are coping with your issues, as well as reasons why you have the issues.  When you are feeling better, and are able to get a lot of support from friends and family or other supports in the community, you and the therapist may talk about ending therapy.

What are the best things to do to prepare for psychotherapy?  First, have concrete and specific goals.  “Feeling better” as a goal is not as good as “Able to reduce crying spells to less than 3x/month”.  When you frame your goals, frame them in terms of what you want to be different in your life, not what you don’t want to experience anymore.  For example, instead of saying, “I don’t want to feel sad daily”, frame it as “I want to be able to list 3 positive things per day that make me feel good”.  The problem with framing them in terms of the absence of negative things is that it doesn’t provide a direction to move towards.  Another thing that is important is to come with an open mind, being honest with yourself and open to new ways of looking at your issues.

Finally, be aware that the therapist may not be as anxious as you are to explore why you have a problem.  When people in therapy are desperate to find the root of a problem, they often end up in “analysis paralysis” because even if they know the root of a problem, it doesn’t solve the problem in and of itself.  In order to solve a problem, one must use good coping skills to put out the fire before poking in the embers.  Cope first, find out why as you look back over your shoulder later.

It is hoped that this introduction to therapy is helpful, and that it answers any questions you may have.  Feel free to contact Psych Choices if you have any questions or concerns, or would like to make an appointment.  Our telephone number is 610-626-8085, ext. 213 for new patients; you may also email us using the contact form below, or directly to the Intake department at

Parenting 101: A Simple Guide to Child Behavior Management

by Emily Kahn-Freedman, LMFT

As a marriage and family therapist, I am often asked for suggestions about how to help children behave better .  All parents struggle at times with how to help their children learn to cooperate, do their chores, stop fighting with their siblings, reduce whining or temper tantrums.  In my years of studying the subject – and practicing on my own children, who thankfully survived to healthy adulthood – I have developed the following list of parenting suggestions.

1.  What you pay attention to, you get more of.   We all need and deserve attention.   Try to “catch your child being good,” and rather than using the peaceful time to check off something else on your to-do list, spend a moment paying attention to your child.   By the same token, most parents can simply ignore a lot of negative behavior.  Children (and adults) tend to repeat behaviors that are rewarded with attention.  If negative attention is all they get, sometimes children will repeat negative behavior just to get whatever attention they can.
Positive attention includes:

  • words of love
  • questions, comments “looks like you’re having fun with your toy”
  • affection
  • joining in play, if child wants you to
  • occasional rewards such as special treats, special parent-child time, cash, small prizes

2.  For every negative statement (correction, constructive criticism, consequence) be sure you use at least 5 positive statements. (This works well with spouses too.)

family problems

3.  VALIDATE emotions. “I know you really, really want to stay up and play your game. I bet you’d like to stay up all night long! I used to want to do that when I was your age. Maybe this weekend you can stay up later.   But tomorrow is a school day and I’m turning off the computer in two minutes.”

4.  Increase motivation by offering simple rewards:   “Do you think you can find a way to put away all your toys before the timer rings? If you beat the timer, you get an extra story at bedtime!”

5.  Never use punishment that hurts or shames a child. Avoid thinking of consequences as “punishment” at all but as a natural result of behavior: “No throwing balls in the house. If I find you you throwing your ball in the house again, I will need to take your ball and keep it for you until I see that you can be more respectful of our rules.”

6.  If you concentrate on building positive experiences with your child, by expressing love and engaging in having fun together, your child will naturally want to please you. In the same way, if most of your time with your child is spent criticizing or correcting, your child will feel hurt and resentful. He or she may be unconsciously looking for ways to retaliate… or may unconsciously realize that negative attention is better than no attention at all.

7.  Avoid responding when you are angry. If a child’s behavior angers you, take a time out – for yourself. Leave the room if possible, or if the child is too young for that, sit and close your eyes and breathe deeply for a couple of minutes before responding.

8.  If possible, don’t decide on consequences right away. You may decide that consequences aren’t necessary, that a verbal reprimand is sufficient. Try to wait until you have time to think it over and discuss with the other parent, if any.

9.  For repeated problem behaviors, have a problem-solving session with your child and develop a behavior contract with rewards for improved behavior and specific consequences for breaking the rule.

Some Helpful Parenting Books:

How to Talk so Kids Will Listen and Listen so Kids Will Talk by Adele Faber and Elaine Mazlish

Giving the Love that Heals by Harville Hendrix and Helen Hunt

Parenting With Love and Logic by Foster Cline and Jim Fay


For further help with your children’s behavior, you may want to contact Psych Choices of the Delaware Valley at 610-626-8085, or email us at   Several of our therapists specialize in working with children and families.


The Science of Happiness: A Free Online Class

by Connie Opfell, LCSW
I’d like to invite you to join me and over 100,000 others in taking the first MOOC (Massive Open Online Course) in Positive Psychology. It’s an 8-week course called The Science of Happiness, and is being offered free by the Berkeley Greater Good Science Center. It started on Tuesday, September 9 (but it’s not too late to join), and it includes a combination of lectures, readings, and “happiness practices.” An interesting aspect of the class is its discussion board — imagine a course with students from all over the world and with lots of different perspectives commenting on each topic!
If you’d like to learn more or register for the class, click this link:

Some Truths About Suicide

depression and sorrowby Nathaniel Prentice, LCSW, CAS-PC

September is National Suicide Prevention Month.  As a way of honoring the importance of suicide prevention, I’m writing today to bring it out into conversation.

        Suicide is one of those extremely difficult conversations topics.  There is a lot of stigma about suicide, as well as a lot of myths.  According to the American Foundation for Suicide Prevention,, these are some of the myths associated with suicide:

Myth: Suicide can’t be prevented. If someone is set on taking their own life, there is nothing that can be done to stop them.

Fact: Suicide is preventable. The vast majority of people contemplating suicide don’t really want to die. They are seeking an end to intense mental and/or physical pain. Most have a mental illness. Interventions can save lives.

Myth: People who take their own life are selfish, cowards, weak or are just looking for “attention.”

Fact: More than 90% of people who take their own life have at least one and often more than one treatable mental illness such as depression, anxiety, bipolar disorder, schizophrenia and/or alcohol and substance abuse. With better recognition and treatment many suicides can be prevented.

Myth: Asking someone if they are thinking about suicide will put the idea in their head and cause them to act on it.

Fact: When you fear someone you know is in crisis or depressed, asking them if they are thinking about suicide can actually help. By giving a person an opportunity to open up and share their troubles you can help alleviate their pain and find solutions.

Myth: Teenagers and college students are the most at risk for suicide.

Fact: The suicide rate for this age group is below the national average. Suicide risk increases with age. Currently, the age group with the highest suicide rate in the U.S. is middle-aged men and women between the ages of 45 and 64. The suicide rate is still highest among white men over the age of 65.

Myth: Barriers on bridges, safe firearm storage and other actions to reduce access to lethal methods of suicide don’t work. People will just find another way.

Fact: Limiting access to lethal methods of suicide is one of the best strategies for suicide prevention. Many suicides can be impulsive and triggered by an immediate crisis. Separating someone in crisis from a lethal method (e.g., a firearm) can give them something they desperately need: time.  If they balk, remind them that it is temporary.  This provides time to change their mind, time to resolve the crisis, time for someone to intervene.

Myth: Someone making suicidal threats won’t really do it, they are just looking for attention.

Fact: Those who talk about suicide or express thoughts about wanting to die, are at risk for suicide and need your attention. Most people who die by suicide give some indication or warning. Take all threats of suicide seriously. Even if you think they are just “crying for help”—a cry for help, is a cry for help—so help.

Myth: Talk therapy and/or medications don’t work.

Fact: Treatment can work. One of the best ways to prevent suicide is by getting treatment for mental illnesses such as depression, bipolar illness and/or substance abuse and learning ways to solve problems. Finding the best treatment can take some time, and the right treatment can greatly reduce risk of suicide. In fact, it can bring you back your life.

There are some warning signs of suicidal thinking.  Here are some listed from the Suicide Prevention Lifeline organization,, which sponsors a suicide hotline at 1-800-273-TALK, which is available 24-7-365.

  • Talking about wanting to die or to kill themselves.
  • Looking for a way to kill themselves, such as searching online or buying a gun
  • Talking about feeling hopeless or having no reason to live.
  • Talking about feeling trapped or in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious or agitated; behaving recklessly.
  • Sleeping too little or too much.
  • Withdrawing or isolating themselves.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

Of course, having some of these does not necessarily mean that someone is fully suicidal or an imminent danger to themselves.  However, it is important to remember to just simply ask and be direct about your concerns to check in with them.  Oftentimes they are anxiously waiting for someone to simply ask.

While helping someone who is suicidal can be scary, it is less scary if you know something about what to do about it.  Http:// suggests the following for tips for how to help someone who is contemplating suicide.  I added a couple as well.

  • Be direct. Talk openly and matter-of-factly about suicide.
  • Be willing to listen. Allow expressions of feelings. Accept the feelings.
  • Be non-judgmental. Don’t debate whether suicide is right or wrong, or whether feelings are good or bad. Don’t lecture on the value of life.
  • Get involved. Become available. Show interest and support.
  • Don’t dare him or her to do it.
  • Don’t act shocked. This will put distance between you.
  • Don’t be sworn to secrecy. Seek support.
  • Offer hope that alternatives are available but do not offer glib reassurance.
  • Take action. Remove means, such as guns or stockpiled pills.
  • Get help from persons or agencies specializing in crisis intervention and suicide prevention.  Calling the hotline above or getting your friend to the nearest emergency room/calling 911 in an emergency is a simple way to get the help.
  • Usually, people who are suicidal don’t actually want to kill themselves.  They want a troublesome situation to change instead.  Explore that with them and help them get help so that they can change their situation without ending a life.

At Psych Choices of the Delaware Valley, mental health professionals are available to discuss these feelings and help people get the proper treatment.  If you are having suicidal thoughts or feelings, please feel free to ask us about next steps.  Please remember that if it’s urgent you can call the suicide hotline, 1-800-273-TALK.

Your life is important.  To us.  To me.

Many of us remember celebrities and/or people in our lives who have died of this.  Respect them by being more open and prepared to help others, and, if needed, taking care of yourself to prevent tragedy for others.