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What's New - Dr. Cruse's Blog

We moved to 2 new locations on August 1, 2014, call 1-405-942-8888

 3832 N. Meridian, Oklahoma City, OK 73112 and

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What's  New is Dr. Cruse's professional blog.    We will periodically report on  current and classic issues of interest in  Christian and secular counseling.  

We offer our counseling services at Christian Clinic for Counseling,   

The Secret-Real, True, Improved (posted 2-25-2008)  Toward the end of 2006, Rhonda Byrne published a book and a movie entitled, The Secret. (A previous #1 on the New York Times best seller list.)   Both the book and the movie have been highly controversial.

The Secret contains: (a) a psychology (b) a group of philosophies and (c) a collection of theologies and religions.  I will review and comment on each. 

 On February 13, 2008, I accessed the Amazon.com ratings of the book.

Out of 1,985 total reviews, 49.2% of people gave the book the highest rating (5 stars).  Conversely, 22.5% of people gave the book the lowest rating (1 star).  The Amazon.com ratings of the DVD were somewhat more positive.  The average was 4 out of a possible 5 stars. 

I accessed Netflix.com on February 13, 2008 and found that out of 86,768 ratings of the DVD, the average for The Secret was 3.4 stars, about a C+ rating.  In scanning the written viewer comments, I found a wide diversity of opinion. 

Employing a sampling procedure, I took fifteen reviews from the first, middle, and last sections of the total 199 reviews existing at the time.  I next divided the resulting 45 sample ratings into positive (4 or 5 stars) or negative (1 or 2 stars).  Ratings of 3 were eliminated.  I found that 82.2% of the reviews were positive and 17.8% were negative.  There was a growing trend towards negativity in later ratings. 

An interesting possibility is that the ratings could reflect the personalities of the raters as much as the ideas presented.  Perhaps roughly 80% of the population are optimistic, and perhaps about 20% are pessimistic.  The optimists would be more likely to believe that the secret works, so they would praise the idea.  The pessimists would be negative, not easily convinced, and criticize the secret as unworkable.  

There are a lot of positives in The Secret and I want to summarize its positive message.  The positives are almost exclusively in its psychology and not in its philosophy or its religious outlook.  The writer reminds readers of very well-known psychological truths. 

The secret lies in the importance of what you think.  Thoughts cause feelings.  If you celebrate your good feelings, you create additional good feelings.  Whatever you focus on increases.  You can shift your awareness and shift your emotions.  You have the power to turn around your day and create the kind of day you want.  You can begin to feel good feelings even if you do not presently have them.  You can shift bad feelings into good feelings. 

Listen to beautiful music, it can lift your mood.  Begin singing an upbeat tune with positive, happy lyrics and your feelings will improve.  Inspirational poetry, books or reading material can make a positive imput.  The questions is:  What are you feeding yourself?  Your outcomes depend upon what thoughts you are bringing in. 

It is helpful to decide what you want, get very clear about it, intend it, and write it down in a positive statement.  Use the format: "I am so happy now that I have ______(goal)".  Such a statement includes feeling the feeling and bringing the future into the now.  I already have it.  You can act "as if."

You can ask, believe, and receive.  Ask the Universe (God) for it - what you want.  Believe you can have it.  Have unwavering faith.  Receive it.  Feel good now.  Feel the way you will feel in the future when you have it.  Anticipate the feeling and feel it in the present.  Feelings add drama, strength, power and passion.

Open yourself up to your possibilities.  Drop your limiting thoughts.  No longer allow yourself to be confined by your past or your current circumstances. They are only your past and your present; your future possibilities are limitless.  You can even break out of dysfunctional family experiences if you believe it to be possible.

To create good and positive feelings, begin with a gratitude exercise.  Write down the things for which you are grateful.  Visualize them.  Create a picture in your mind and feel the positive feelings.  Focus on what you do have right now, and climb into positive feelings.  Visualization and feelings are powerful additions that enhance positive thoughts.

Use a smooth touchstone that you carry with you to remind you everytime you see it or touch it.  Say aloud something for which you are grateful. 

Always focus on the final outcome you want (your goal).  Don't be derailed by negative thoughts.  Shift them into positive thoughts.  Feel the joy, happiness, and excitement now, as if your goal already exists. Do this daily but don't make it tedious.  Make it a happy exercise that invigorates you. 

You may want to use a vision board where you post words or pictures that repersent your goals. Place the vision board where you will see it daily.  Focus on it. Meditate and rehearse your goals.  Believe your goals are possible.  Declare your goals, voice them, think them, visualize them, feel them, believe them, and act as if you have presently achieved them.  

Your actions must correspond with your intended goals.  Make certain that your talk is congruent with your actions and your inner intentions.  Whatever you focus on will be achieved.  Watch your focus.  Whenever you get distracted, refocus.  (Along these same lines, Mahatma Gandhi said:  "Happiness is when what you think, what you say, and what you do are in harmony.)  

The secret can be applied to realizing whatever kind of success is important to you:  material goals, career, friendships, romantic reationships, happiness or finding meaning and purpose in life.  

You have to love yourself. For relationships to succeed, you have to be filled with love so that your love can overflow to others.  You must learn to focus on your beloved's good and positive traits, things you appreciate, things you love.  Then think on these things.  As you express these positives in your relationships, you will receive more of what you think, verbalize, visualize and actualize.  Only you can be in charge of creating your happiness.  That is your job.  Sometimes you may give the job of creating your happiness to someone else, but you can't control others.  No one else can do it for you, but you can decide to be happy and create your own happiness.

Some doctors believe that disease may be viewed as the result of some kind of stress.  The more you think about disease and talk to other people about your disease, the more you stay in disease. If you focus on healing, health and wellness, then you create a more robust biochemistry.  The body was designed to heal itself.  One doctor said, "Incurable means curable from within."

One man given the dire prognosis of remaining in a chronic vegetative state after an airplane crash said in regard to his healing, "They (doctors) said it was impossible, but it didn't matter what they said.  It was what I thought and believed that mattered."  He miraculously recovered.  His faith was a crucial ingredient in his recovery.

Focus on what you do want.  Embrace what you want.  Don't allow yourself to focus your attention on what you don't want.  Most people, in fact, do think about what they don't want and thereby create the negative.  There is a tendency to let the mind roam free and fail to intentionally focus it in a helpful, healthy and positive direction.

Follow your passion, your enthusiam, your bliss.  Inner happiness fuels success. 

This ends my summary of The Secret's psychology.  It is basically what is today called cognitive-behavioral therapy.  The author falsely claimed that efforts had been made to suppress the secret, and conspiracies existed for some to keep it only for themselves.  In truth the powerful effects of thought upon one's life have been openly written about for centuries, beginning as early as about 970-930 B.C. with King Solomon's Proverbs in the Old Testament. 

There are other errors in the pop psychology of Rhonda Byrne.  Perhaps the most egregious of which is the overly dramatic insistence that the law of attraction works all the time with everyone.  Nothing does, including the law of attraction.  That law is stated too mystically.  The thought - feeling -behavior connection is well-established scientifically and does not require postulation of a mystical, magical force, called.  "The Universe."

Another major criticism has to do with the largely missing link of intense effort and work.  Thoughts, fantasies and imaginations can become actualized, but they don't materialize without a great deal of time-consuming effort and hard work.  Rhonda Byrne and colleagues seem to favor the concept of ease more than the idea of effort. 

Ironically, for such a positive psychology, the philosophies presented are almost totally negative.  There is plenty of secular humanism (humans are gods) and godless materialism (get all the stuff you can). They say it won't make you happy, but they don't act as if they believe that, because most of their examples involve aquisition of material goods.

Human omnipotence is promoted.  You are the power that draws from the universe.  They say that you are god.

Egocentrism is stage center.  You are the center of the universe.  Get all you can for you, because it's all about you.

Hedonism abounds.  If it feels good, do it.  You are continually admonished to feel good.

Entitlement is highlighted.  You deserve it - whatever you wish for. 

The Secret's theology and religion are its most flawed features.  One of the problems in the religious/theological outlook is that the writer doesn't specify explicitly what her worldview is.  So the discerning reader is left to infer what is being taught.  There are certainly elements of ancient Eastern mysticism, many elements of which are now commonly labeled "New Age."

There are themes of universalism, frequent references as to how "The Universe" brings things into being for you if you think positive thoughts, (have the right thought frequncy vibrations), thus aligning yourself with "The Universe." Christians would label the supernatural force as the power of God rather than some vague, mysterious power out in the universe.  

Also, note the fallacious scientism ("junk science") where thoughts are purported to have frequencies and the magnetic forces in the law of attraction cause like to attract like.  Electromagnetic force is a poor metaphor because the scientic law is that positive is attracted to negative and vice versa. 

The reader is left with the sense that Rhonda Bryne believes in pantheism, the notion that god is out there in everything in nature or that everything is god.

The Christian features and teachings of Jesus are twisted into an unrecognizable distortion of self-centered thinking as Ms. Byrne presents her "ask, believe and receive" formula.  She is guilty of syncretism, joining pure Christian thought with an amalgamation of other secular and religious ideas so as to render the whole into a non-Christian form.  

There is no Jesus Christ-based system of virtue, morality. and ethics.  Readers are simply advised to "do what you love and feel good." 

Personally, as a Christian, I want to have the goal of loving what Jesus loves.  He loves to show us what God is like.  He loves to show us our need for God.  He loves to help us see that we can have personal forgiveness for our sins if we place our faith and trust in Him.  He loves to help us to personal salvation and growth as a Christian, which includes emphases on virtues, justice, morals, and ethics.  Jesus teaches us to love the family of God and to sacrifice ourselves in service to other people.  Christ teaches us always to submit our own desires to the more perfect will of God.  The Good God will predictably bring us more good that we can possibly imagine or bring to ourselves.  

Rhonda Byrne embraces human moral relativism as reflected in the statement, "Whatever you choose is right."  Asinine, I say!  What if I choose to feel good with cocaine, promiscuous sex, driving 100mph on the freeway, and misleading customers in order to make a sale?  

I do have free will and the power to choose.  I have the capacity to choose what is good and right.  Equally, I have the capability of choosing the bad, the wrong, the evil, the sinful.  I may choose selfishness, pure pleasure, empty materialism or shallow, surface apperarances.  If I choose the good, I choose depth, and substance, and character.

As a Christian, when I choose the philosophy and teachings of Jesus Christ, I choose "the way, the truth, and the life."  

The wisest man who ever lived, King Solomon of Israel, said (Proverbs 14:12 NIV): "There is a path before each person that seems right, but it ends in death."  An Old Testament prophet, Jeremiah, said (Jeremiah 17:9 NIV): " The human heart (mind) is most deceitful and desperately wicked.  Who really knows how bad it is?"  No, Rhonda, we humans need a reliable moral compass to assist us as we make our choices, so we will choose what is right.  I don't just want to choose what seems right for me (moral relativism), because I am fully likely to choose wrong if I am merely left to my own self-centered ways.  

The question is, what am I going to build my life around?  I want The Rock, something and someone substantial.  I don't want to build my life around that which is ethereal and flimsy - self and wealth.  Omitted in the Secret are serious issues about meaning and purpose in life.  What is your purpose?   I hope you will build your life around Jesus Christ.

One of the speakers toward the end of the DVD, "The Secret", gave his opinion on purpose.  He said something to the effect that there is no purpose.  You create your own purpose and no one can stand in judgment of your purpose.  Such statements will lead you astray, or more bluntly - straight to hell.  Jesus himself taught that there is a judgment.  You will be asked if you believed on the Lord Jesus Christ and received salvation from your sins.  You will also be asked what you did with the new life that he gave you after he forgave your sins and extended to you his love, and mercy, and grace.  The all-important judgment of Jesus Christ will determine your eternal destiny--heaven or hell and your eternal rewards or punishments.

I want to align myself with the God-given, ancient wisdom of Solomon who wrote a concise purpose statement toward the end of his life.  Solomon was the proverbial man who had tried it all in life.  He had tried pleasure - wine, women, and song.  He had wielded power as a king and leader of government.  He had been a builder of massive buildings.  He had gained knowlege excelling all humans.  He had written widely on practical wisdom.  He was the wealthiest man on the face of the earth.  He had experienced pleasure, power, achievement, and wealth.  He concluded (Ecclesiastes 12:13 TEV), "After all this, there is only one thing to say:  Have reverence for God, and obey his commands, because this is all that man was created for."  The central message: Align yourself with God and His ways--that is your purpose.  

 You must read a modern best - seller, Rick Warren's The Purpose - Driven Life.  Rick Warren immediately grabs your attention with the blockbuster revelation, "It's not about you."  With Rhonda Byrne, you get the opposite, "It's all about you."  She even goes so far as to say you are god, and you can create whatever you want.  I side with Rick Warren and the Lord God Jesus Christ.

Another recent, good book on the subject of purpose and meaning is John Piper's Don't Waste Your Life.  A DVD is included with the book. 

 The methods of The Secret could be adapted to promote justice, peace, the develpoment of character, higher virtues, morality, ethical behavior, sacrificial love and service to others.  If these tried-and-true, cognitive - behavioral methods were infused and informed by Christian Scriptures, they could prove to be exceptionally helpful.  The methods can be used for good or for evil.  I pray that you will use them - for good.

--J. Ronald Cruse, Ph.D., Doctor of Health Service (Clinical) Psychology 

 

 

 

Posted 2-10-2008  Exercise and Depression, Anxiety, ADHD, and Aging

Exercising three times per week may work as well as a daily antidepressant medication.  That is the conclusion of an extremely well-designed study reported on in the Johns Hopkins Depression & Anxiety Bulletin, January 4, 2008.  Those depressed persons in a supervised exercise group improved as much as those who took Zoloft (sertraline).  Those who exercised on their own at home improved almost as much as the other two groups, and significantly more than a placebo group.  It is believed that exercise acts in a way that is similar to antidepressant medication, activating serotonin, norepinephrine, and euphoria-inducing endorphins.  Exercise improves depression and anxiety-disrupted sleep.  Outdoor exercise increases exposure to natural daylight which helps those with winter depression (seasonal affective disorder).  Exercise empowers by giving a sense of self-mastery and control over symptoms.  Physical exercise gives an outlet for tension and supressed anger.  Exercise assists with weight control, so often an issue with depression or medicines used in treatment.  Solely for benefitting mood, 30 minutes or more of moderately vigorous exercise should be undertaken on 4 or more days each week.  If the goal is weight control, then dietary guidelines increase to 60-90 minutes on 4-7 days per week.  Suggested activities include: brisk walking, dancing, swimming, biking, yoga, gardening, or raking leaves. 

Yoga has been shown to reduce anxiety as well as depression.  Low levels of the neurotransmitter GABA have been associated with anxiety and, to some extent, depression.  A recent study showed that people practicing yoga twice a week for one hour increased their GABA levels by 27%, suggesting a reason for exercise's improvement of anxiety symptoms.

The Spring 2008 edition of ADDitude includes an article by John Ratey, M.D., ADHD authority, who offers explanations as to how physical activity/exercise improves brain functioning.  He theorizes that exercise increases dopamine and norepinephrine, neurotransmitters which help to regulate attention processes, motor reflex inhibition, balanced reactions, and control of irritability.  These are especially good for children and adults with ADHD:  martial arts, ice skating, gymnastics, rock climbing, mountain biking, skateboarding, and whitewater paddling.  Thirty minutes or more of vigorous exercise may increase focused attention for a 60-90 minute period.

Arthur Kramer, Ph.D., has shown that older adults who walked three days a week over a six month period improved their working memory and screened out irrelevancies.  He found that they increased the volume of their prefrontal cortex, the part of the brain that is responsible for logical thought and control of impulses.

Exercise helps to improve mental and emotional functioning and reduce negative symptoms.

---J. Ronald Cruse, Ph.D., Doctor of Health Service (Clinical) Psychology


Posted 1-10-06  New Year's Resolutions

Did you make any New Year's resolutions?  Eighty-three percent of Americans do, according to surveys.  The top four resolutions remain the same year after year.  You probably could guess them.

1.  Get in shape  2.  Do better at work or school 3.  Eat better  4.  Stop smoking
Here are a few practical tips to help in achieving your goals.
1.  Be realistic
2.  Plan ahead
3.  Anticipate challenges and obstacles
4.  Make contingency plans
5.  Outline your plan
6.  Use positive thinking and encouraging self-talk
7.  Make it visual--write it or picture it
8.  Talk about it; make public your commitment
9.  Reward small successes, celebrate,  and enjoy
10.Track progress
11.Don't obsess about failures or beat yourself up
12.Stick to it.  Conventional wisdom says that it takes 21 days to form a habit, but it takes 6 months to become part of your personal lifestyle.  Make a commitment.  If you get off track, get back on; don't give up.  This is the point at which most people fail.  It does take perseverance.  You can do it if you believe.  I wish you success!
--J. Ronald Cruse, Ph.D., Doctor of Health Service and Clinical Psychology

     

  

 

Posted 11-4-05   WHY A PSYCHOLOGIST TAKES ST. JOHN'S WORT FOR DEPRESSION

I should be accurate.  I don't take St. John's Wort because I am depressed.  I take it to prevent depression at age sixty-eight.  Neuroscientists have discovered an important neurobiological change that normally takes place as we age.  Chemical neurotransmitters in the brain, serotonin, norephinephrine, and dopamine, begin to diminish progressively as we grow older.  An adequate supply of neurotransmitters helps to protect against depression.  Thus, when I take St. John's Wort, I am merely replenishing my diminishing supply of neurotransmitters.

Elders are known to have high rates of depressive symptomatology, which increases with co-occurring medical illnesses.  Depression complicates and slows healing of chronic medical disorders, especially cardiac disease, diabetes, respiratory problems, and long-term disabilities.

Why not take a prescription antidepressant and be done with it?  Consider efficacy, cost, and safety.  Prescription medicines are no more effective tha  the natural herb, St. John's Wort (SJW).  Prescription medicines for depression will typically cost four to five times more than the best SJW.  Antidepressants usually have 30 to 40 times more unwanted side effects such as weight gain, gastrointestinal upset, sexual problems, and cognitive complications.  Antidepressants are substantially more likely than SJW to negatively interact with other medicines frequently used by seniors, who average 13 prescriptions a year.

Don't go to a drug or health food store and buy SJW off the shelf.  Likely, it will lack in potency, purity, and quality.  Results are likely to disappoint.  In our office, we have available a quality SJW in a standardized form.  About 60% to 80% of adults with depression will respond to the high-quality SJW.  Research has shown that the best response is obtained when psychological counseling is combined with some type of antidepressant.  For further information, please call our office at 405-943-1281.  We will be glad to help.

---J. Ronald Cruse, Ph.D.,  Doctor of Health Service and Clinical Psychology

 

Posted 6-18-2005  Talking about Talking  (Talk Therapy)

The well-known former mayor of New York City, Rudy Giuliani, was much in the news following terrorist attacks on his city.  Recently, he has been speaking out against cancer, following successful treatment of his prostate cancer.   An interviewer asked him how he overcame the fear of cancer.  He simply said that he talks about it.  He went on to generalize.  In his experience, he has found that it helps to talk about anything that he fears.  After talking about fears, they are reduced.  Rudy could well become a spokesperson for mental health counseling, now often referred to as talk therapy.  Rudy spoke about fears, but many other emotions become more manageable when they are revealed and discussed.  Talking gives the talker a bit more of a sense of control over her own emotion, as opposed to the emotion controlling her.  Another person finds that talking helps him to objectify that which was subjective in him; the internal is made external.  Inner capacity is limited, and pressure can build in him as he holds things in.  If he speaks out, there is relief and freedom.  The external capacity of the world is vast and virtually limitless.

Mr. Giuliani has emphasized that his talking about a problem that is widely feared (cancer) has benefitted not only him but numerous other people.  Whatever the problem, there are always multitudes of other people who are struggling with the same issue.  Whenever he or she hears someone of respect talking forthrightly about the problem, he is more likely to admit his problem and seek treatment for it.  Whenever people with depression, anxiety, alcohol abuse, excessive anger, sexual obsessions, or other problems speak out about their problems, they help others get the help they need.

I once had a male client who was a highly-respected and admired person who seemed to have everything:  a responsible position in his church, a strong spirtual life, good looks, strong family, great job, and a nice home.  But he was in inner conflict and guilt-ridden because of his obsession with pornography.  He was head of a growing department in his church.  After much prayer, he believed that God wanted him to become a model of transparency to his group, and he wanted their support and prayers in his recovery.  He had some understandable fears about how his confession would be received.  He confessed to his pastors and asked if he should resign his position.  The pastors asked him to remain, and they pledged their spiritual support as he struggled with pornography.  When he confessed to his young adult group, most praised his openness and vowed their support for him and his wife.  One or two were judgmental.  Afterward, several men privately confided to him that they, too, battled with pornography.  This true story illustrates two points.  First,  many people will be concerned and supportive  when they know about a problem.  The second  point is that when one person starts talking about a problem, it predictably influences others to begin thinking about and then talking about their own similar problem.  That means that help and relief are on the way for them, too.  TALK!  You may need  to talk to a trained listener and talk therapist in order to receive the maximum benefit from talking.  But be assured, talking helps. 
----J. Ronald Cruse, Ph.D., Doctor of Health Service and Clinical Psychology

 

Posted 5-15-2005  A BETTER ANTI-ANXIETY PHYTOMEDICINE (See our 10-10-04 posting on a better antidepressant phytomedicine)

A phytomedicine is simply a plant that has medicinal benefits.  The ancients discovered many plants that produced powerful psychological effects.  For example, the coffee bean, with its caffeine, induced a stimulating and alerting effect.  Other plants were more potent: tobacco, coca, marijuana, opium poppy, and peyote cactus.  Hemlock herbs were deadly when ingested.  Phytomedicines have primarily beneficial effects, although they may have some negative side effects.

Kava is an herbal phytomedicine that is scientifically known as Piper Methysticum.  It has been used for hundreds of years.  It produces a calming, relaxing, euphoric effect.  There is evidence from scientific research that Kava is effective in treating anxiety, nervousness, stress, muscle tension, and restlessness.  It is also effective as a sleep aid in cases of insomnia.  Researchers have rated Kava as being as effective as prescription tranquilizers without the serious side effects.

The frequently-prescribed benzodiazepine class of anti-anxiety drugs can lead to tolerance and dependence, so there are potential dangers in their use.  There is also a withdrawal effect whenever those medicines are discontinued abruptly.  The 2004 PDR Drug Guide for Mental Health Professionals lists the following side effects and cautions for Xanax, one of the most popular of the benzodiazepine anti-anxiety drugs:  decreased libido, drowsiness, fatigue, impaired coordination, memory impairment, speech difficulties, sedation, and sleepiness.  It may encourage manic behavior, suicidal thoughts, and intensify the effect of alchohol to the extreme of causing death.

The listed side effects for Kava are much less frequent, milder and less troublesome:  gastrointestinal symptoms, yellowing of skin, impaired or abnormal movement, loss of balance, pupil dilation, and difficulty focusing.  As is the case with anti-anxiety drugs, Kava should be avoided by those with liver disease, pregnant, or breastfeeding.  Neither Kava nor Xanax should  be used with alcohol, sleep-inducing agents, or certain other medicines.  For Kava, the list of forbidden drugs includes mainly other anti-anxiety agents.  For Xanax, the list is much longer, and includes many of the most popular antidepressant drugs. 

The safety and effectiveness of anti-anxiety drugs are unknown with children; that is also true with Kava.  However, if I were selecting an anti-anxiety agent for a child or adolescent with mild to moderate anxiety, I would begin with a trial of Kava.  Kava is likely to work as well as an anti-anxiety drug, and the side effects are likely to be fewer, milder or non-existent.  Tolerance and dependence are extremely unlikely.  I would also choose Kava for adults for the same reasons.

In choosing phytomedicines, it is important to select only those that have "standardized" dosages and that are of "research grade" or produced by those who supply research institutions.  We have such products  for anxiety and depression in our office.        -- J. Ronald Cruse, Ph.D., Doctor of Health Service and Clinical Psychology

2-20-2005  IS YOUR MARRIAGE IN TROUBLE?
Psychologist, Dr. John Gottman, has run the "Love Lab" near the University of Washington campus for years.  He has gotten so good at predicting marital success that in one hour, he can predict with 95% accuracy whether or not you and your spouse will still be together 15 years in the future.  It could well be worth the trip to Washington!  How does he do it?  He has learned where to focus attention; and his focus is on positive and negative emotion in the relationship.  For marital survival, positive emotion must override negative emotion by at least a five to one margin.  Once the ups and downs shift to a negative pattern, about 94% continue in a downward pattern.  The negative emotions that are most important boil down to four:  defensiveness, stonewalling (silence and withdrawal), criticism, and contempt.  Nothing is more destructive than contempt, whether shown by one or both partners.  Contempt involves speaking from a position of superiority and demeaning, disparaging, and insulting one's mate.  It is the epitome of devaluing, dishonoring, and disrespecting one's partner.  When one's beloved companion expresses contempt to him or her, it is so stressful that the immune system is compromised, and one becomes more vulnerable to physical and emotional illness.  Women are more prone to be critical, and men are more likely to stonewall.  It is typical for a woman to start talking about a problem, and the man gets irritated, withdraws, and gets silent.  Then the vicious circle is set up, where the woman then becomes more critical, and the man stonewalls even more.  When it comes to contempt, equality prevails; there are no gender differences.

What is the take home message from all of the above?  If you recognize any of the patterns of negativity and you value your marriage,  go to a marriage counselor who values marriage.  Plan to stay in counseling for at least fifteen sessions (length prediction has been extrapolated from successful treatment of anxiety and depression; and in marital conflict there is an abundance of anxiety and depression).  Sadly, marital counseling tends to last an average of only two to three sessions because people lack the tenacity to stick with it.  Marriages can be saved when there is a strong commitment to do so.  Vital in that process is an inner spiritual renewal, a Christian transformation, conversion or rededication that shows itself in daily meditation on the principles of Christ and recommitment to church attendance at a Bible-teaching church.  It always help to have Christian friends supporting you and praying for your marriage.  Finally, a book on marriage that I recommend is Gary Smalley's, LOVE IS A DECISION.  --- J. Ronald Cruse, Ph.D., Doctor of Health Service and Clinical Psychology  

1-14-2005  Happy New Year!   POSITIVE AFFIRMATIONS - Secular psychology has promoted affirmations as an aid to your mental health.  Christianity offered these helps two thousand years ago.  Many sprang from Jehovah, God of Israel, many centuries before.

Included below are several scriptural truths that are positive affirmations for you to get into your mind.  You should repeat these to yourself daily or multiple times each day in order to counteract negative thoughts.  When we say negative things to ourselves, we inadvertently distort God's truths about us into lies, thus producing emotional damage in the form of depression, fear, anxiety, anger, and the like.   Memorize one or more of these Bible verses in order to have them readily available to strengthen your mind against the onslaught of the negative.   Quietly meditate on these in a relaxed atmosphere, and let the positive truths sink deeply into your mind.  They will operate at a conscious and an unconscious level.  Positive affirmations are one important avenue to a transformed mind.  You may want to create some of your own affirmations as well.  Write them and post them around your home or office where you will see and repeat them frequently.    --- J. Ronald Cruse, Ph.D., Doctor of Health Service and Clinical Psychology

Scriptural affirmations:
...and God's peace which is far beyond human understanding will keep your hearts and minds safe in union with Christ Jesus. (Phil.4:7)  ...The God who gives us peace will be with you. (Phil.4:9)  I have the strength to face all conditions by the power that Christ gives me. (Phil. 4:13  Peace is what I leave with you; it is my own peace that I give to you.  I do not give it as the world does... (John 14:27)  God is our shelter and strength, always ready to help in times of trouble...(Ps. 46:1-2)  ...Let God change you inwardly by a complete change of your mind...(IICor. 10:56)  I ask God from the wealth of his glory to give you power through his Spirit to be strong in your inner selves. (Eph. 3:16)  ...Fill your minds with those things that are good and deserve praise, things that are true, noble, right, pure, lovely, and honorable.  Put into practice what you learned...(Phil.4:8-9)  Remember that I have commanded you to be determined and confident!...for I, the Lord your God, am with you wherever you go. (Joshua 1:9) 

 IMPORTANT POSTING 10-10-2004  RESEARCH EVIDENCE NOW POINTS TO HYPERICUM PERFORATUM (ST. JOHN'S WORT) AS SUPERIOR TO EXISTING ANTI DEPRESSANT MEDICINES.  READ BELOW.

SOME ADVANTAGES OF HYPERICUM PERFORATUM (IN ADEQUATE AMOUNTS) OVER SYNTHETIC ANTIDEPRESSANTS

  • HYPERICUM PERFORATUM (HP) IS NOT A DRUG.  IT IS A NATURAL HERB, CLASSIFIED AS A FOOD SUPPLEMENT AND VARIOUSLY REFERRED TO AS A BOTANICAL, FLORAL, HERBAL, OR A NUTRICEUTICAL (CONTRASTED WITH A PHARMACEUTICAL).
  • HP DOES NOT REQUIRE YOU TO SEE A DOCTOR OR OBTAIN A PRESCRIPTION, ALTHOUGH YOUR DOCTOR SHOULD BE INFORMED.
  • HP IS NOT HABIT-FORMING OR ADDICTIVE.
  • HP IS NOT EXPENSIVE.  WE MAKE AVAILABLE A 30 DAY SUPPLY (AVERAGE DOSAGE) AT A COST OF $29.95, ABOUT 25% (1/4 TH) THE COST OF THE MOST FREQUENTLY PRESCRIBED ANTIDEPRESSANTS.
  • HP IS SAFE, FAR SAFER THAN PRESCRIPTION DRUGS FOR DEPRESSION AND ANXIETY, WHICH ARE KNOWN FOR SOME DETRIMENTAL SIDE-EFFECTS,  INCLUDING SEXUAL INHIBITION, WEIGHT GAIN, AND DROWSINESS OR DISORIENTATION.  ALTHOUGH HP CAN INTERACT WITH A VERY LIMITED GROUP OF MEDICATIONS, DRUG INTERACTIONS ARE OF FAR LESS CONCERN THAN WITH THE MOST FREQUENTLY PRESCRIBED ANTIDEPRESSANTS OR ANTI-ANXIETY MEDICINES.
  • HP IS EFFECTIVE.  SCIENTIFIC RESEARCH HAS NOW DEMONSTRATED THAT HP IS MORE EFFECTIVE THAN PLACEBO SUBSTANCES.  MORE OFTEN THAN NOT, HP IS SHOWN TO BE AS EFFECTIVE OR MORE EFFECTIVE THAN SYNTHETIC ANTIDEPRESSANTS.  THERE IS ONE EXCEPTION.  HP HAS NOT BEEN SHOWN TO BE EFFECTIVE IN CASES OF SEVERE DEPRESSIVE DISORDER (LESS THAN 20% OF CASES).

WARNING: DO NOT GO TO A DRUG STORE OR HEALTH FOOD STORE AND BUY THEIR ST. JOHN'S WORT, HYPERICUM PERFORATUM.  MOST BRANDS DO NOT REGULATE THE DOSAGE OF CRITICAL INGREDIENTS, AND IF THEY DO, THERE IS NO GUARANTEE OF PURITY.  OUR SUPPLIER PROVIDES STANDARDIZED DOSES OF RESEARCH-GRADE HP.  THIS DISTINCTION IS A CRUCIAL ONE TO OBTAINING EFFECTIVENESS.  OUR SUPPLIER CONTRACTS WITH THE FEDERAL GOVERNMENT FOR THEIR RESEARCH STUDIES AT THE NATIONAL INSTITUTES OF HEALTH AND WITH MANY RESEARCH SCIENTISTS AT UNIVERSITY CENTERS.  

PSYCHOLOGICAL COUNSELING OR "TALK THERAPY" IS MORE EFFECTIVE THAN DRUG THERAPY FOR DEPRESSION OR ANXIETY, PROVIDED THAT THE TALK THERAPY INCLUDES AT LEAST 13 SESSIONS (SURVEY RESULTS PUBLISHED IN CONSUMER REPORTS EDITION OF OCTOBER 2004).  SERIOUSLY DEPRESSED PEOPLE DID BETTER WHEN THEY WENT TO A MENTAL HEALTH SPECIALIST SUCH AS A PSYCHOLOGIST, CLINICAL SOCIAL WORKER, OR PSYCHIATRIST, AND IT DIDN'T SEEM TO MATTER WHICH TYPE.  AN ADDITIONAL BENEFIT OF TALK THERAPY (PSYCHIATRISTS ARE SOMEWHAT MORE LIKELY TO DO DRUG THERAPY THAN TALK THERAPY) IS THAT IT DOES NOT INCLUDE ADVERSE SIDE EFFECTS.  THE CONSUMER SURVEY REPORTED A MUCH HIGHER RATE OF ADVERSE DRUG SIDE EFFECTS THAN THE DRUG COMPANIES REPORT.  I AM INCLINED TO PLACE MORE TRUST IN WHAT CONSUMERS SAY THAN IN WHAT DRUG COMPANIES SAY.  FORTY PERCENT HAD SEXUAL SIDE EFFECTS, AND ABOUT TWENTY PERCENT REPORTED WEIGHT GAIN.  UNFORTUNATELY, THE DRUG WITH THE LEAST SIDE EFFECTS, BUPROPION (WELLBUTRIN), HAD THE LOWEST EFFECTIVENESS.  ONLY 57% OF PEOPLE SAID IT HELPED A LOT.  iT WAS THE MOST EXPENSIVE, AT $140 PER MONTH.  THE MOST EFFECTIVE DRUG FOR DEPRESSION WAS VENLAFAXINE (EFFEXOR); 76% OF USERS SAID IT HELPED A LOT.  REPORTED COST WAS $117 PER MONTH.  THE BAD NEWS IS THAT 51% REPORTED SEXUAL SIDE EFFECTS, 21% REPORTED WEIGHT GAIN, AND 18% REPORTED DROWSINESS OR DISORIENTATION.

TROUBLING QUESTIONS HAVE RECENTLY BEEN RAISED IN REGARD TO DRUG THERAPIES FOR CHILDREN AND ADOLESCENTS.  VALID ANSWERS HAVE NOT YET BEEN PROVIDED.  ONE QUESTION IS WHETHER BEGINNING DRUG THERAPY CAN PRODUCE MORE SUICIDAL THINKING AND ACTUAL SUICIDES.  A SECOND QUESTION REVOLVES AROUND THE POSSIBLE EFFECTS OF THERAPEUTIC DRUGS UPON THE DEVELOPING BRAIN.  A THIRD QUESTION FOCUSES UPON THE LACK OF PROVEN EFFECTIVENESS FOR YOUNGER AGE GROUPS. I AGREE WITH THE CONCLUSION OF CONSUMER REPORTS THAT INTENSIVE TALK THERAPY BE TRIED FIRST.  I WOULD ASSESS EACH CASE INDIVIDUALLY, BUT FOR REASONS OFFERED ABOVE, WHEN ANTIDEPRESSANTS ARE INDICATED, I WOULD BE INCLINED TO RECOMMEND HYPERICUM PERFORATUM INSTEAD OF SYNTHETIC ANTIDEPRESSANTS.                 

Posted 4-10-04  WARNING! TELEVISION MAY DAMAGE THE PRESCHOOLER'S MIND 
Recently published research by a children's hospital researcher in Seattle, Dr Christakis, indicates a linkage between watching TV and attention problems.  In preschoolers, there is a ten (10) percent increase in the risk for attention deficit hyperactivity disorder for every hour of daily TV viewing.  Presumably, a young child who watched TV for eight (8) hours daily would have an eighty (80) percent chance of later developing ADHD.  One thing is clear; using the TV for babysitting or for a youngster's primary entertainment is foolish.  As tempting as it is to introduce a child to television or videos at an early age, it is not a good idea.  The American Academy of Pediatrics has recommended that TV be reserved for children over the age of two.  Studies such as the current one reaffirm the AAP guidance.  Over the age of two years, viewing time should be strictly limited.  Current understanding suggests that the developing brain is undergoing its basic wiring and that stimulation which is exceptionally vivid, intense, and rapidly changing, may produce lasting attention problems.  There certainly has been a noticeable increase over the past few decades in the incidence of ADHD in children.  The increased availability of TV and the decrease in the quality of child care for many children may be possible factors in the increase of ADHD.

Active play stimulates motor development and coordination.  Imaginative play and personal discovery are also much to be preferred over passive reception of someone else's ideas, although there is a place for such.  Television can be enjoyable, but active play and active imagination are better.  Quietness and solitude also have a place in contrast to loudness and fast-paced action.  A brain that is constantly exposed to volume, noise, movement, and fast-paced action may have difficulty with slowing, stopping, focusing, and pondering.  Good thinking and decision-making require the latter set of mental skills.  Every young child should have an opportunity to practice mental control, inhibition, and self-discipline.  Television seems to emphasize excitation, stimulation, visual movement, and release of inhibition.  It is well-documented that children who view aggressive action on TV are much more likely to act out aggressively than  are children who do not view aggression. 

Television is like a sugary treat.  A little is good; an excess is damaging; and an over-abundance can produce a serious disorder.  ---by Dr. Ron Cruse  

Posted 2 - 7 - 2004   YOUR MIND, YOUR THINKING AND YOUR HEALTH
An extremely important 2004 article by Dr. Oakley Ray in the American Psychologist has informed us that certain mental attitudes can heal the body.  Among the helpful attitudes are optimism, hopefulness, and positive expectations of a good outcome. (Did you notice the similarity of the above attitudes to those supported by a strong Christian faith?)  Unfortunately, there are also negative attitudes that are hurtful to the body, and these impair healing.  Pessismism, despair, hopelessness, and expectations of a poor outcome are detrimental to health and healing.  Whatever we believe, true or false, will be uncritically accepted by our body and produce health consequences.

The most prevalent current theory is referred to as the biopsychosocial model.  It begins with the view that thoughts, beliefs, attitudes expectations, and hopes are mental processes.  These thoughts and mental processes are chemical and electrical activities in the nerve cells of our brains.  As we change our minds and thoughts, we actually change our brain biology (neurotransmitters and structural nerve connections).  At the same time we are changing our brain, we are changing the rest of our body.  Our minds and thoughts can influence our endocrine system by changing the flow of hormones.  Our immune systems, including the regulation of cytokines, are affected by our thoughts.  In essence, there is a constant flow of information between and among the mental, nervous, endocrine, and immune systems of the human being.  Mind-brain-body interactions play an extremely vital role in influencing our health.  What we think and what we believe will impact us positively or negatively, depending on what we put in our mind.

Dr. Eric Kandel, a Nobel Laureate in Physiology or Medicine in 2000, has expressed the view that psychological counseling can produce changes in the biochemistry and anatomy of the brain and influence the whole body.  Psychological therapy's power would be due to the operation of mind, thought, and learning.

Dr. Ray outlined four classes of coping skills that help us in dealing with psychological distress or the stress of illness.  One, the more facts and information we have, the better we are able to deal realistically with the issues to be faced. Two, the more adequate and positive one's inner resources, the better.  Included are such things as an optimistic outlook, a sense of internal control, and realistic assumptions.  Three, the better our social support system, the more positive the outcome.  Four,  The more we find strength, comfort, and meaning in our religious faith, the greater our health benefits.  All of these ways of coping are strongly supported by scientific research.  Churches and religious groups are especially well-equipped to help us in the latter two areas and can be helpful in the first two areas.
---by  Dr. Ron Cruse

Posted 9-20-03  Sick From Unforgiveness
Did you know that unforgiveness, or the harboring of grudges, not only makes you feel bad (resentful), but keeping those feelings stuffed inside also can complicate health problems and may actually make them worse?  If unforgiveness doesn't make you sick, it can at least keep you sick.  Forgiveness is healing for the spirit, for the body, and for relationships.  Do you suppose that could be why the Good and Great Physician prescribed frequent doses of forgiveness?  Modern medical researchers are currently being acclaimed for discovering these "new" truths about forgiveness that date to antiquity, to at least the time of Moses.  Read Deuteronomy 28 in a modern translation and you will discover some of these "new" ancient principles that relate health to how well humans follow God's way.  The lifestyle choices we make do, indeed, dictate some of our health consequences.                       ---by Dr. Ron Cruse

 

Posted 10-4-03    Are You Resilient?
Why do some people seem to handle stress and extreme adversity better than others?  One crucial factor is resilience.  Resilient people have flexibility, roll with the punches, come back, and bounce back.  They get knocked down, but they don't stay down.  Some of the factors that contribute to resilience have the ring of some of Jesus' most important teachings.  Social support from family, friends, and religious groups contributes to resilience.
Those who learn empathy, optimism, and hopefulness do better with stress and overcoming its effects.  It is particularly beneficial to reach out and help somone.  Just as Jesus said, when I help someone, I too am helped in the very process of helping.  People who discuss difficult things, and their feelings about the difficulty, are more resilient.  Following adversity, resuming and maintaining normal routines contributes immensely to a sense of security that has been ravaged by abnormal events.  A consistent and predictable home environment can be an important stabilizing force during stressful times.  Healthy people seem to be more resilient.  It is hard to overestimate the importance of adequate sleep, sensible eating, exercise and fitness, while at the same time avoiding smoking, drugs, and risky behaviors such as some associated with sexuality.  It is highly probable that general spiritual disciplines help us  develop greater resilience, although I don't know of research that has supported such an idea.  I do know that one spiritual discipline, church attendance, has repeatedly been shown to be associated with better mental health and better physical health.  So it would seem likely that frequent church attenders are more resilient than those who seldom attend.  The good news is that resilience can be learned.  The bad news may be that it is much more easily learned early in life.
---by Dr. Ron Cruse

 Posted 11-5-03 The Long and the Short of Serotonin
You have heard a great deal about serotonin.  Have you read about recent research indicating that there are long and short forms of the "serotonin transporter gene?"  When exposed to repetitive stress, those with the short form are about two and a half times as likely to develop depression.  The long form of the gene seems to produce some protective effects in the brain, allowing serotonin, the neurotransmitter, to dissipate more rapidly.  As a result, the long form of the gene allows more efficient blocking of unwanted messages in the brain.  My interpretation is that people with the short form would have a much more difficult time with a choice of refusing to think about or be reminded of their stresses.  They might be much more prone to rehearse or obsess about their troubles.  Those who are able to block out disturbing thoughts may basically be more genetically blessed.  Be careful in condemning those who seem perpetually worried about their troubles and stresses; they may be less responsible for their thoughts than we have supposed.
---by Dr. Ron Cruse

Posted 11-19-03 How's Your Fuel?
How's your fuel?  A friend was in a terrific hurry, noticed his fuel gauge was on empty, and wheeled into a gas station.  He quickly squeezed off $10 worth and sped off.  Down the road his car abruptly coughed, sputtered, and belched out black smoke.  Then it dawned on him; he had carelessly put diesel fuel in his gasoline engine!  The human body is a highly complex piece of machinery, and the kind of fuel we input makes a difference in its functioning.  Food and drink are fuel.  What are you putting into your body?  Diet books have always been popular.  Recently, three different ones have been top ten sellers.  Dr. Atkins popularized a low carbohydrate, high-protein diet that appears to get results.  It meets the criteria of balance and sustainability.  Hunger follows a predictable cycle with a high-carb diet.  Blood sugar is increased, boosting energy (a definite feel-good experience which causes us to want to repeat such eating).  Unfortunately, the pleasant rise in blood sugar is followed by a decline that decreases energy and produces hunger and a desire for more high-carb foods.  Such a roller-coaster ride produces mood swings in some people and weight gain in most people.  Weight gain can produce lowered self-esteem and despondency.

There is good news.  Comfort foods produce a calming effect.  Have some buttery mashed potatoes or a generous scoop of ice cream.  Researchers from the University of California, San Francisco believe high fat, high-carb foods may inhibit stress-related hormones.  There is bad news: weight gain and possible triggering of the hunger cycle.
An aside, chocolate is a most-preferred food among depressed people.  A tip, a tasty low-carb chocolate is now available.

Dutch studies have indicated less likelihood of depression in those whose diets are high in Omega 3 fats, the healthy ones, found in fatty fish, walnuts, and flaxseed.  Possibly the Omega 3's are involved in raising natural antidepressants in the brain.

Duke University Medical Center researchers are among those studying the weight-loss effects of epilepsy or anti-seizure medications such as zonisamide (Zonegran) and topiramate (Topamax).  Some very dramatic weight loss has occurred in obese people.  One theory is that some obese people may experience uncontrolled electrical nerve firings in pleasure centers of the brain that trigger uncontrolled eating.  If so, they would truly be unable to control their eating impulses.  In similar fashion, epiletics have uncontrolled electical activity in their brain for which they are not responsible.  It produces seizures.  Such a theory would help to explain some puzzling behavior.  Why don't obese people just stop eating so much?  The answer, much to the bewilderment of self-disciplined people, may be that the obese cannot help themselves.  The firestorm in the brain is too overwhelming, just as epileptics are overwhelmed and are unable to control their seizures without medication.  There may be some intriguing extensions of this theory to other habit-control issues, addictions, obsessions, compulsions, mood disorders, smoking, alcohol abuse, and drug addiction.  We cannot say that people with these behaviors are not responsible in any way, but they very well may be far less responsible than we have presumed.  Diabetes may be comparable.  Seldom are diabetics absolutely responsible for causing their disorder, but they certainly are responsible for managing the disorder once they have it.
---by Dr. Ron Cruse

 

 Posted 12-12-03    Parenting and Child Behavior Problems
My remarks are addressed to common child behaviors, although the patterns may have become so extreme or repetitive that they are beyond the norm.  Generally, parents and other adult authorities are seeking compliance or obedience to their requests.  It would be ideal, just perfect, if the child's compliance were accompanied by respect, valuing and honoring of the authority (e.g. as in, "Honor thy father and thy mother.")  Unfortunately, children often have their own interests which run counter to their parent's interests.  In other words, there is a conflict of interests.

Let's consider that parents, being made in the image of God, are given the awesome and God-like responsibility of being the major authorities in their child's life.  Furthermore, their child's response to their authority will likely become the pattern of response to other authorities in the child's life.  At this point I must say that if a child had the most perfect parents imaginable, it would still be possible for the child to have serious behavior problems.  Parents are only half of the equation.  The child is the other part of the equation.  Children begin to develop patterns of compliance or non-compliance before they can walk.  Compliance patterns begin to be more evident by the time a child can verbalize, "Yes" or "No."  Think about a child's response to a simple request, "Come here."  One child comes.  Another child consistently runs in the opposite direction.  A third response is a firmly verbalized "No."  A fourth  response is that of no response (ignoring, delaying, or passively resisting). Finally, there is the child who usually says "Ok", but seldom actually comes.  Whatever response is repeated the most becomes the dominant pattern or habitual way of responding.  As the poet observed about tender young plants, "As the twig is bent, so the tree's inclined." Mature trees require the services of a tree surgeon in order to have any hope of changing their growth direction.  Habits are hard to break; not impossible, but hard, very hard.

Parents, of course have their own childhood histories, patterns of compliance or non-compliance, sets of expectations, disagreements with each other, frustrations, and patterns of parenting.  Return for a moment to ponder  that parents are in the likeness of God.  God has been said to have three primary characteristics:  LOVE, POWER, and WISDOM.  In parenting, it is abundantly clear that we need all three.  We may try to use our love tactics, our power tactics, and our mind tactics at various times with varying results.  All must be utilized in the atmosphere of a positive relationship.  Josh McDowell has been a popular youth speaker and author for decades.  I am struck by the profound truth of one of his slogans, "Rules without Relationship lead to Rebellion."  How is that for a powerful restatement of the "Three R's?" A strong,caring relationship is an essential foundation for a child and his parents.

The behavior training or retraining process that I favor I learned from secular sources, but the fundamentals are deeply rooted in God's methods for shaping obedience.  The 28th chapter of Deuteronomy is a great example.  God clearly states through his designated authority, Moses, several "blessings" of obedience and "curses" of disobedience.  In other words, if you obey, you get blessed (rewarded) in some specific ways that lead to fruitfulness, abundance, prosperity, and defeat of enemies.  If you disobey, you get cursed (punished) in some specific ways that result in lack of success, sickness, and defeat by enemies.  In Hebrews, chapter 12, another of God's authorities, Paul, compares God to the most loving of fathers.  He mentions such concepts as encouraging words, correction, rebuke, punishment, suffering, respect, submission, sadness, gladness, and reward.  Behavioral psychologists use the same concepts, but they are stated in different words.  For example, "BEHAVIOR IS SHAPED BY ITS CONSEQUENCES."  Consequences are all-important.  The primary consequences are reward and punishment.  They produce pleasure and pain.  We learn as we experience consequences for our behavior.  If there are no consequences, we don't learn.  Rewards are more positive and more powerful than punishments.  The consequence rule for parents to follow is:  Give positive consequences (rewards) for positive (desirable) behavior: and give negative consequences (punishments) for negative (undesirable) behaviors.  God, the Perfect Parent, even arranged the consequences of heaven or hell for us, based upon our faith response to Him.  An enormously popular writer, Bruce Wilkinson, has recently emphasized the importance of consequences, both now and eternally, in his book,     A Life God Rewards.  The concepts of consequences, rewards, and punishments are thoroughly biblical.

Rewards strengthen behavior.  Psychologists call rewards "reinforcers, positive reinforcers."  An obvious comparison is the steel reinforcing bars that are placed in concrete before it is poured in order to make it strong.  The more a parent reinforces a child's positive or desirable behavior, the stronger it becomes.  One of my examples is the process of teaching my grandson, Holden, to be polite, specifically to say, "Please" and "Thank you."  We made an enjoyable game of it.  I'd say, while holding him in my lap with a bowl of ice cream and a spoon, "Say Please."  He would say, "Please."  I would smile and put a spoon of ice cream in his mouth.  Then I would say, "Say Thank You."  He would say, "Thank you."  I would smile and praise him with such words as, "Yes, Right, OK, Good, Good boy, Way to go, You're so polite, You always remember."  And the game would go on and on until the ice cream was gone.  We got in lots of repetitions, lots of rehearsal, good and fun practice.  The reinforcers were: holding (relationship), positive touch, ice cream, powerful authority figure (I controlled the ice cream.) smiling, praise, and words of encouragement.  All those rewards were given to Holden as a consequence of his compliance with my requests.  He said, "Please" and "Thank you."  He learned also a higher order concept, politeness.  After awhile in the game, I didn't have to prompt him every time.  I would merely pause with the spoonful of ice cream, and he would say the polite words.  After a behavior has been well learned, it is possible to gradually fade out the rewards and use them only occasionally to reinforce desired behavior.  Rewards are more powerful than punishments in the teaching of behavior.  Discipline means to teach or to train.  Rewards and punishments are merely tools in the process.  Use many more rewards than punishments.

Now, let's prepare to actually change some child behaviors.  We will use the analogy of a cookbook that has a recipe.  There are lots of ingredients to be combined in just the right order.  First we need to assemble the ingredients.
1. Behaviors (target behaviors, both negative and the positive opposite) to be changed need to be clearly identified (something that can be seen and counted).
2. A label for the behavior, some very brief name by which to call it in order to give audible verbal feedback to the child.
3. A way to keep a record that can be counted, recorded, and  displayed (e.g. a daily behavior chart) for feedback to the child
4. A responsible person(s) to be the counter, monitor, and consistent enforcer for the purpose of accountability (the behavior manager).
5. A list of potential reinforcers (activities, privileges, money, trinkets, foods/drinks, positive words from which your child gets pleasure; don't assume.  Let your child help you make up the list.)
6. A list of potential penalties or punishments (things your child dislikes the most; don't assume.  Let your child help make up the list.)
7. A list of rules that includes  positive behaviors that parents expect to see and the opposite undesired  negative behaviors.
8. A list of consequences (When -x- positive behavior occurs, then the reinforcer that will follow and any conditions.  When -x- negative behavior occurs, then the penalty that will follow and any conditions.)
9. The special case of attention and its handling, including the practice of "time out."  

An actual behavior management plan for 8yr-old Johnny might look like the following.  Be certain to review the plan with Johnny, and be sure that he understands.
1.  Johnny has the problem of arguing, disagreeing with, or defying his parents.  This is the negative target behavior that his parents will work to change.
2.  The positive opposite behavior is agreeing, accepting, complying, or obeying (with no more than a 10 second - count to ten - delay).
3.  Immediately after either the negative or the positive behavior occurs, the parent will label the behavior.  "You are choosing to argue."  "You are choosing to obey."  If negative behavior, be brief in order to avoid giving undue attention or time at this point.
4.  Administer the predetermined consequences.  If arguing occurs, then immediately administer the negative consequence without much talk.  Exercise decisiveness, firmness, absolute limits without any bargaining, negotiating, or discussion.  As the parental authority, you are enforcing zero tolerance for the problem behavior of arguing.  Later, when the problem is under control, you may want to allow more leeway.

Most of the time, use the immediate consequence of "time out" or isolation from human contact.  "Time out" is an abbreviation for "time out from reinforcement."  It involves removing all attention for 8-10 minutes (about 1minute for each year of a child's age).  Attention is the most powerful reinforcer for most children, so removing attention is a punishment.  What should be removed?  Remove any parental talk or acknowledgement of what Johnny is saying.  Simply and firmly tell him to go to time out.  If he hesitates, gently begin moving him in the direction of the time out place (such as on the floor at the end of a hallway).  If he is defiant, bodily remove him to the place.  When a child is out of control, it is reassuring to him that parents can control him and will take control. It is frightening when he is out of control, cannot control himself, and no adult can help with control by firmly imposing it.  If Johnny defies by leaving time out, making excessive noise or becoming destructive, impose even firmer limits or greater penalties.

At the end of the isolation period, give some attention, time and talk.  It is now teaching time.  Try to get Johnny to verbalize what he did (arguing), and what would have been better (obeying, complying, agreeing, accepting).  Or, have Johnny write in a notebook while in time out both what he did and what would be better.  Praise him for reasonably accurate statements.

If obedience, the positive opposite behavior occurs, then immediately administer the predetermined consequence. A list of some tangible reinforcers appears below.  Add plenty of positive talk and expressions of delight.  You want Johnny to know that you are pleased with him.  Always focus on the behavior that just occurred, not on the identity or personality of Johnny.  Also give Johnny some positive social reinforcement.  Social reinforcers include such things as: a smile, positive expressive movements (hand slaps, a pat on the back, hugs, etc.), positive verbalizations, praise for Johnny's obedience, and expressions of positive parental reactions.  Some praise examples are: " Good, great, obeying is good, wonderful, way to go, way to be, all right, super, fantastic, and OK!"  Some examples of positive parental reactions are: "I like it; I am so happy; I'm so pleased; when you obey, it makes me feel so good; I like to give you praise; when you do what I ask, that makes me have a really good day."  Along with positive social reinforcers, include concrete, tangible reinforcers such as something good to eat, money, the privilege of engaging in a desired activity.  Be certain to give something that is highly valued by Johnny at that moment, and be prepared to change reinforcers as needed.

Repetition, repetition, repetition.  Repetition is one of the basic laws of learning.  Johnny has to experience consequences again and again.  As Johnny's parents, don't get discouraged, he is slowly learning.  Be patient.  Expect good days of remembering, and bad days of forgetting or not caring.  Johnny, like others, is capable of behaving with willfulness and rebellion.  It has to be trained out of him.  Pleasure and pain will help him learn to do the right thing (obey parents).  Human beings are wired to seek pleasure and to avoid pain.

5.  Count, record, and chart both obedience and arguing.  The chart can be as simple as a day-by-day monthly calendar with two numbers recorded each day, one for the number of arguments, and the other for number of obediences.  A more elaborate chart can be prepared using smiling faces and frowning faces.  The record shows whether or not the behavior management plan is working.  Begin by rewarding each obedience, then each 2 obediences, each 3, each 4, each 5, each week.  Offer greater incentives for more difficult behavior such as a week of successive daily obediences.

Some reinforcers:  food, drinks, TV. video games, music, computer time, outdoor time, friend visits, phone time, activity with mother, with father, with a special person, store to buy, games, sports, money, praise, attention, stickers, art supplies
Some penalties or punishments:  warnings, scolding, criticism, time out, loss of privileges, spanking, undesired activity (work, restriction, exercise).  Avoid imposing as a punishment anything that is associated with school work or religion.