Mother Turns Grief Into Action Preventing Eating Disorders

A Mother’s Loss, a Daughter’s Story

Melissa Avrin, 16, in the summer of 2006.

By ROBIN POGREBIN, for the New York Times
Published: April 21, 2010

ANDREW AVRIN sits on a beige couch in a nondescript room, a fruit still-life partly visible on the wall behind him, twisting his fingers while, off-camera, an unseen interviewer prompts him to talk about his sister, Melissa, who died last year at the age of 19 after a long battle with bulimia.

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MOTHER-TURNED-PRODUCER Judy Avrin collaborated with Jeffrey Cobelli, left, on a film about her daughter, Melissa.

Melissa at 18 in May 2008, with her mother, Judy.

“There was no food in the house,” he says, looking off to the side as his eyes fill. “If I went out with friends, I could not bring leftovers home because they would be gone by the next morning.”

Once, he explains, in the middle of a bitterly cold night, he looked out the window and saw Melissa on the curb, going through the garbage. “I went outside and I yelled her name,” he recounts in the interview, his voice breaking. “Just the way she looked back at me — it was so empty, vacant. It was a deer in the headlights, but that doesn’t even explain it.”

It is a hard scene for anyone to watch, but even more so for the film’s producer — Judy Avrin, Melissa’s mother, who decided to make a documentary about her daughter’s life and, ultimately, her death.

People deal with grief in their own ways, and those who have been spared the loss of a daughter or a son can only imagine how they would choose to try to cope. For Ms. Avrin, coping meant confronting her anguish and trying to make something good come out of it.

The idea for a film didn’t occur to her immediately. In the weeks following Melissa’s death, Ms. Avrin mostly avoided her daughter’s bedroom, and tried to resume some semblance of normalcy, going back to work three days a week as the coordinator for a consortium of academic libraries in New Jersey. But one day she sat down to read Melissa’s leather-bound journal.

Someday …

I’ll eat breakfast.

I’ll keep a job for more than 3 weeks.

I’ll have a boyfriend for more than 10 days.

I’ll love someone.

I’ll travel wherever I want.

I’ll make my family proud.

I’ll make a movie that changes lives.

The film, called “Someday Melissa” and now in the editing stages, has become for Ms. Avrin salve, distraction and cause — a way to get the word out to other families grappling with eating disorders that they are not alone; to sound the alarm that eating disorders have the highest mortality rate of any mental illness; to help make sense of the senseless event that was losing her teenage daughter.

“I kept saying, ‘This is an amazing way for me to channel my grief,’ ” Ms. Avrin said. “But it also allowed me to put off grieving.”

Ms. Avrin, 56, got the idea for the film from one of Melissa’s therapists, Danna Markson, who introduced her to Jeffrey Cobelli, 27, a filmmaker. Over the last several months of working on the project, Ms. Avrin has come to know more than she ever intended to about eating disorders — how their seriousness has been underestimated, their treatment underinsured, their deaths underreported.

The process hasn’t been easy, and some, like her ex-husband, initially questioned the impulse to do it at all. Melissa’s best friend since first grade, Nicole Kendrick, who also suffers from an eating disorder, said she was incredulous when she first learned that Ms. Avrin was making the film. “I thought she was crazy,” Ms. Kendrick said. “I guess I didn’t realize how deep a mother’s love can run.”

But Ms. Avrin said that making the film has been easier than doing nothing at all. “I’ve never once thought this was more than I could bear,” she said, in an interview at her home in Totowa, N.J. “If anything, the more I continue, the more I know it’s the right thing to do.”

The difficulty of reliving her daughter’s decline has been mitigated by the public response. “Sometimes I think: ‘I’m a suburban mom. Who am I to think I could make a difference in the world?’ ” Ms. Avrin said. “But then I read the messages that keep coming in from people I know and people I don’t know who say Melissa’s story has motivated them to fight one more day.”

On Melissa’s Facebook page and on the film’s Web site — somedaymelissa.com — Ms. Avrin continues to get feedback. “Thank you,” says one entry posted on the Web site’s guestbook page. “This could save one person’s life. That life may be mine.”

Ms. Avrin and Mr. Cobelli have interviewed Melissa’s family members, doctors and friends, along with prominent experts in the field, like Dr. Thomas R. Insel, the director of the National Institute of Mental Health; and Dr. B. Timothy Walsh, the founding director of the Eating Disorders Research Unit at the New York State Psychiatric Institute, and Dr. Evelyn Attia, the director of the Columbia Center for Eating Disorders, both at Columbia University Medical Center.

“I get a lot of requests, but there was something about this one I thought was particularly striking,” said Dr. Insel of the mental health institute. “I wanted to hear more of the story.”

“It was such an extraordinary expression of love,” he said, “a powerful way of honoring and remembering the daughter she lost.”

Although those closest to Melissa agreed to be interviewed for the film, participating wasn’t easy. William Avrin, Melissa’s father, said that he might have preferred to keep his experience to himself and that he was in no hurry to revisit his memories of Melissa. “I have a hole in my heart and it will be there forever,” he said in a telephone interview. “I don’t really try to describe what it’s like to lose a child.”

But he felt he had to do it for the film. “Clearly, Judy’s a champion of this project,” he said. “I’m a little bit more personal and inward. I’m still struggling with the whole thing. This is her way of dealing with it, and I respect that.”

In the documentary interview, filmed at his home in Hamburg, N.J., Mr. Avrin visibly struggles to describe what it was like to be thousands of miles away in Japan on business when he found out his daughter had died. At first he appears almost devoid of emotion, delivering his words in flat, deliberative sentences as he sits in a blue button-down shirt in front of his fireplace mantel. But then you can see tears trickling down into his salt-and-pepper mustache. “What was I thinking?” he says, repeating the question. “I was thinking my daughter is dead. That’s not supposed to happen. I couldn’t believe it. I didn’t — didn’t know what to think. I was in shock.”

Upon returning from Japan, Mr. Avrin decided not to view his daughter’s body. “Judy thought it would be better if I didn’t,” he said, “that I’d remember her like the last time that I saw her.”

Melissa died on May 6, 2009. Cause of death: heart attack due to complications from an eating disorder. Just a few days before, Melissa learned she had been admitted to Emerson College. The official letter of acceptance arrived a week after she died and sits unopened.

Melissa’s brother, Andrew, who is completing his Master of Science degree in engineering, said he believes the documentary has become essential to his mother’s emotional resilience. “It’s the only way she knows how to move forward,” he said.

At the same time, Andrew said he worried that the documentary would ultimately prove to be just a Band-Aid, postponing the heartbreak that is bound to rear its head when the film is completed. “The trick becomes moving forward with life but not letting everything this project is fill the void completely,” he said, “so the second this project finishes, you don’t crash.”

To be sure, Ms. Avrin doesn’t always hold it together. She did not conduct the interviews with her ex-husband or with her son (her collaborator, Mr. Cobelli, did). “We would have just sat there and cried,” she said.

In the interviews she did do, there have been times when she has broken down during or afterward. In concluding her discussion with Dr. Leslie Sanders, one of Melissa’s doctors, for example, Ms. Avrin starts to cry, and the cameras keep rolling. “I still remember being in your office and — I think her potassium was off — and you said, ‘I’ll be your quarterback,’ ” Ms. Avrin tells Dr. Sanders. “I didn’t know who to turn to next and I felt like I was in such good hands with you.”

Dr. Sanders responds: “I think what I remember about that first visit is just being struck at how little her life had become — I think at that point she was barely in school — and how much she was struggling, not just physically, I think physically was the least of it, but just emotionally and how we needed to do something intensive, and quickly, to get her life back.”

BORN Dec. 21, 1989, Melissa seemed in her early years to be a happy little girl. Her family lived in Wayne, N.J., and then in Pine Brook, N.J., spending two years in Coral Gables, Fla., in between, where Mr. Avrin was transferred for his work with a specialty chemical company. Melissa did well in school — producing A’s and short stories.

But at age 13, thing started to change. Melissa’s mood darkened; she didn’t want to go to school or do extracurricular activities. She developed stomach problems and constipation. Ms. Avrin took her to a pediatric gastroenterologist who said Melissa probably had an eating disorder. “I reacted the way most parents do: ‘That’s not possible,’ ” Ms. Avrin said. “We didn’t go back to him.”

In the early stages, the Avrins did not really see what was going on, in part because Melissa wasn’t visibly underweight, in part because they didn’t want to. But clues started to show up that were too stark to ignore — logs of cookie dough that disappeared from the freezer along with whole boxes of cookies from the cabinet. Empty pizza boxes. “I found containers with chewed and spit-out food and I’d never heard of that before,” Ms. Avrin tells Dr. Sanders during their filmed interview. “Is that very common?”

Ms. Avrin wrapped the fridge in locks and chains, hid her purse and made sure never to leave money lying around. “It didn’t have to be good junk food — if she wanted to go on a binge, it could be a dozen eggs,” Ms. Avrin said of Melissa. “Anything that wasn’t nailed down, she would eat.”

Ms. Kendrick, in her own interview for the film, alternates between smiling recollections of her childhood friend and sad eyes as she recalls Melissa’s downward spiral. “People who knew her in the last two years never really saw who she really was,” she says. “She was so energetic and funny and just ridiculous but not, like, in an obnoxious way. And then, as she started to worry about what other people thought, that’s when it started to be in more of an attention-getting way. When things got really bad, that kind of all just slowly disappeared and it just became very monotone — down. And we didn’t really see that energetic, fun Melissa anymore.”

Eventually, Melissa was sent away for professional help against her will and thus began a series of programs over the next few years that had varying degrees of success. It wasn’t until Melissa’s third round of in-patient treatment — when she and other young women testified about their eating disorders in front of their families — that her father began to fully understand. “I really said, ‘Wow this is almost like heroin addiction,’ ” he says in his film interview. “They need to purge because it makes them feel high and it’s something they need to do. I never appreciated that.”

In the course of making the film, Ms. Avrin has become something of a public service announcement on eating disorders. She was a featured speaker last October at the first walk to raise money for the National Eating Disorders Association. At its benefit dinner in March in New York, the evening opened with a clip from Ms. Avrin’s film. She is due to be in Washington in late April to lobby Congress as part of an Eating Disorders Coalition.

She said she is happy to play the role of advocate, to help try to remove the stigma that still cloaks eating disorders and keeps people from acknowledging the disease as the cause of death in obituaries. “I want it to come out of the shadows,” Ms. Avrin said. “I want people to talk about it, for people to get treatment faster, to reach doctors on the front lines. I want parents to open their eyes and not be swayed by being glad that their kid fits into size 4 jeans — to stop focusing on looks.”

Ms. Avrin is aiming to finish her documentary project by June, in time for summer film festival deadlines, and she said she is determined to get theatrical distribution. It would seem the ultimate act of acceptance. Yet in her film interview with Dr. Sanders, Ms. Avrin sounds like a mother still wrestling with remnants of denial.

“I’ve always been the glass half-full — I’ve always been an optimist,” she says, reaching under her eyeglasses to wipe away tears. “I always believed that she really would be somebody who could recover, even though, looking back, I realized the odds were stacked against her because of the level of her illness.”

“But I never lost hope and, you know,” she adds, “I still believe that she could have beaten it.”

A version of this article appeared in print on April 22, 2010, on page E1 of the New York edition.

ADHD Meds show no increased risk of death

Drugs to treat attention deficit hyperactivity disorder, (stimulants such as Ritalin/methylphenidate or Adderall/ amphetamine) for ADHD, don’t appear to put kids at higher risk of heart problems or death.

Scattered reports of sudden deaths among children on the medications have caused concern among parents and doctors in recent years, and several of the drugs now carry warnings about heart complications and behavioral side effects.

New research findings are reassuring.Funded by Shire, the researchers examined claims data from Medicaid and a commercial insurer. The study includes more than 240,000 kids ages three to 17, who received ADHD drugs and were followed for 135 days on average.

The researchers then compared those children to more than 965,000, who didn’t take the drugs but were of similar age and gender and came from the same states as the users.

That weasy officially for the researchers, because often the claims data didn’t match the hospital records.

Based on the data they could calculate, investigators estimated that there would be six sudden deaths or cardiac arrests per 1,000,000 kids taking ADHD drugs for a year.

That’s slightly more than the four per 1,000,000 kids in the comparison group. But because the numbers are so small, the difference could easily have been due to chance.

There were no strokes or heart attacks in the ADHD group, and the researchers estimate it’s very unlikely that the true rates would exceed 24 cases per 1,000,000 per year.

Rates of death “from any cause,” which were the most reliable numbers in the insurance data, were 179 per 1,000,000 kids per year in the ADHD group and 300 per 1,000,000 in the comparison group.

“For kids who would benefit from ADHD medications, the potential cardiovascular risks should not dissuade physicians from prescribing the drugs,” Hennessy told Reuters Health.

The findings, published in the journal Pediatrics, are in line with two previous reports that didn’t find evidence of a link between sudden death and ADHD drugs.

However, they run counter to one small 2009 study that found stimulant use was more common (1.8 percent) in children who died suddenly from cardiac arrest than in those who died in car accidents (0.4 percent).

One expert who was not involved in the current study said the results were hard to interpret due to the small number of deaths and heart problems.

“The new findings confirm that if there is an association between stimulants and cardiac events, it is quite rare,” Almut Winterstein, of the University of Florida College of Pharmacy in Gainesville, told Reuters Health.

But she added that at this point, there is no telling how the millions of kids on ADHD medicines will fare down the road.

“We will need to wait another decade to understand whether even slightly increased blood pressure and heart rate over several years during childhood results in increased cardiovascular risk in later life,” she said in an email.

The risk of death is certainly no higher in children who take ADHD medications than in children who don’t,” said Sean Hennessy, a pharmacist at Philadelphia’s University of Pennsylvania, who led the work.

Hennessy acknowledged that studying cardiovascular events using insurance data in youth is complex, and that he awaits the results of The U.S. Food and Drug Administration’s large safety study on stimulants.

Antidepressants to treat depression: profit versus effectiveness

The Controversy

The media has continued to highlight the high-stakes battle that pharmaceutical companies have waged to make a profit by convincing doctors to prescribe antidepressants. Recent articles have focused more on the fact that pharmaceutical companies were not made to release studies that failed to demonstrate effectiveness of their products. Some articles have focused more on the failure of manufacturers to reveal potential adverse reactions or side effects.

This unbalanced media coverage has the potential to undermine effective treatment of psychiatric disorders. While the pharmaceutical companies stand to profit by convincing people that mental health conditions are medical conditions, the potential to profit does not necessarily mean that their facts are wrong.

Depression as medical illness

Depression is a medical condition. Studies of the brains and the biology of persons with depression have proven that there are real functional and physical changes that take place when a person is struggling with depression.  Depression, and 7 other mental health conditions, are identified by the World Health Organization as among the top 10 most disabling medical conditions worldwide.

Depression can be treated effectively. Studies have consistently shown that medications can treat depression. It is not a one-drug-suits-all approach. Treatment requires some trial and error. But the same is true for the treatment of hypertension. In addition, much like changes in one’s life circumstances can alter a person’s severity of hypertension, so, too can a change in one’s life circumstances make depression better–or worse! Some psychotherapeutic interventions, such as cognitive behavioral therapy or mindfulness based cognitive therapy have been shown to improve depression as well.

The controversy that exists about antidepressant medications is not about whether they are effective, but instead about whether the drive for profit has resulted in overarching assertions that these medications are THE ANSWER for EVERYONE.  While the controversy continues, people continue to experience depression at alarming rates, and many people seek help to minimize the impairment that their depression produces. It remains very difficult to analyze the data to determine whether antidepressants will for an individual patient.

So, what is the depressed person to do?

Find a provider that is willing to listen, to ask for details, and to take the time necessary to assess whether an individual patient is responding to the treatment efforts.

Find a provider who is willing to provide education and answers about their treatment decisions, and to include the patient’s preferences in their decision making.

Find a provider who can be flexible and adaptive  in their approach, willing to try something different if a patient is not responding, and who is willing to obtain consultations from other experts when necessary.

Juvenile life without parole: Do they deserve a 2nd chance?

In May 17, 2010, the U.S. Supreme Court ruled on Graham v. Florida that sentencing Florida juveniles to life in prison without parole for crimes less than murder was unconstitutional.  Graham v. Florida was the first time the court had applied the 8th Amendment’s prohibition against “cruel and unusual punishment” to anything other than the death penalty. In its ruling, the Supreme Court declared that juveniles were ineligible for life without parole because they were different than adults who committed the same crime. They were not yet fully developed human beings mentally, emotionally and physiologically. The parts of the teenage brain that rule impulse, the ability to think ahead, the understanding of consequences, is not yet fully formed.

The justices made a distinction between teens who commit crimes as part of their “transient immaturity” and those who are permanently “incorrigible.” The decision as to whether a juvenile criminal is one or the other can’t be made while they are still teenagers, but it can be determined after they’ve fully matured, the court said in its 6-3 ruling.

The court’s ruling meant juveniles who were sentenced to life without parole for crimes such as armed robbery, assault, rape and attempted murder needed to be resentenced. Of the dozens of juveniles serving life sentences in the United States at the time of the Graham decision, more than half of them were in Florida.

Barry University law professor, Gerry Glynn, established the Juvenile Life Without Parole Defense Resource Center  in June 2010,  to coordinate efforts to represent the Florida inmates who were sentenced as juveniles to life without parole.  There are 115 cases of juveniles sentenced to life in Florida, and the cases are extremely complex.

In preparing for a resentencing hearing, the defense resource center must help attorneys tell judges about three important aspects of the inmate: the life of the juvenile before the crime, the crime itself and the inmate’s life behind bars.Attorneys must be able to show the dangerous juvenile who committed the crime has changed inside prison into a mature, reformed adult. They must explain why the juvenile committed the crime and why that same person, years later, is no longer a threat to society

Juveniles convicted of serious crimes must be given a “second look” after they have achieved full maturity to determine whether they have outgrown the impulsive, thoughtless, risky behavior typical of teenagers — or whether they remain dangers to society. One way to determine whether that change has taken place, the court ruled, is to see whether juvenile inmates took advantage of education, vocational and rehabilitative opportunities while in prison. However, the problem for inmates sentenced to life in Florida is that they do not have access to educational and vocational programs, since the Department of Corrections gives priority to those inmates who are within 3 years of being released.

There aresome inmates who, having  no chance of release, have engaged in self-motivated rehabilitation. For example, a  41-year-old Hillsborough inmate sentenced to life without parole at 17 for attempted murder and sexual battery in 1989 has completed 20 self-improvement programs, including three he created himself.

Gainesville State Attorney Bill Cervone argues that the relatively small number of juveniles sentenced to life without parole reflects the atrocity of their crimes and their continued threat to public safety. He believes that the crimes they committed are very serious  and that these behaviors indicate the risk they pose to the community.

Those who support the Supreme Court decision agree that there are people in prison who committed crimes at 16 who will continue to be a danger to society later, but that each youth deserves the chance to be evaluated.

Thus far,  a handful of Graham-eligible inmates have been resentenced under the court’s ruling, and none has been released from prison. The resentences vary from 30 years to 107 years. No one has been resentenced yet in Central Florida courts, but among those who are eligible is Michael S. Johnson, who was 16 in 2005 when he and two others kidnapped, robbed and raped two women.

In a similar case in St. Petersburg, Jose Walle was 13 when he participated with two others in the kidnapping, robbing and raping of two waitresses. In November 2010, Walle was resentenced to 65 years by a judge who rejected the Supreme Court’s opinion that life without parole for juveniles was cruel and unusual.  Walle, now 16, will begin serving his 65 year sentence after completing 27 years for another Pinellas County rape. Under the consecutive sentences, Walle will be eligible for release when he is 91. His attorneys say they will appeal the sentence as violating the intent of the Graham decision.

Read more in the article by Jeff Kunerth, Orlando Sentinel

orlandosentinel.com/news/local/crime/os-life-without-parole-barry-20110402,0,5418922.story

Facebook, Social Media, and Adolescent Mental Health

Many teens enjoy keeping in touch with their friends on social networking sites like Facebook and Twitter, but there are both risks and benefits to the use of these sites.  Overuse/Misuse of social media has been linked to mental health issues including depression and eating disorders.

Now, a  report from the American Academy of Pediatrics describes a new phenomenon called “Facebook depression,” in which children and teenagers spend an inordinate amount of time on social networking sites, then develop symptoms of depression.

Facebook depression is UNCOMMON–most children benefit from the use of facebook because they are able to maintain ties with friends and feel a connection with their community, according to Scott Campbell, an assistant professor of communication studies at the University of Michigan.

Heavy use of  Facebook can have serious consequences, so it’s important that parents are aware of their children’s media use, as well as remaining aware of their social lives away from the computer.


Dr. Michael Brody, Chair of the Media Committee for the American Academy of Child and Adolescent Psychiatry, and who was involved with the American Academy of Pediatrics report,  notes that relationships with peers become critical during adolescence, and that Facebook facilitates social engagement with friends.  “Kids become are very competitive, and kids want to be chosen,” said Dr. Brody.  Since facebook allows adolescents to see the number of friends their peers have, some youth may perceive that they are not as popular if they have fewer facebook “friends”. They may also perceive by reading the status updates of their facebook “friends” that they are not having as much fun as their peers. “I think the idea of envy and jealousy becomes very magnified through this medium,” says Brody.

Dr. Brody points out that causation is not suggested by the study.  The evidence does not suggest that Facebook leads to depression. It could be that certain adolescents who are already depressed are prone to spending too much time online, Brody said.

The study is consistent with previous findings of internet use–that depression and loneliness are associated with extremely heavy users of the internet–and also linked with a much lower rate of OFFLINE social connections.


Humans are social creatures, and studies have continued to demonstrate that having a healthy “social rhythm” is protective against mood disorders. It is important to engage with other people in real, offline, socially interactive ways.

Dr. Brody advises that parents encourage their children to engage in a variety of activities, and this can facilitate a healthy social rhythm:

I think kids who have a balanced life, who do schoolwork, who do after-school activities, who are in teams, who are in clubs, who do community service have a much lesser chance of becoming depressed

Read the original article by Rachael Rettner, here:  http://www.myhealthnewsdaily.com/facebook-depression-rare-but-serious-side-effect-of-social-networking–1318/

Dog Therapy at Yale Law School

For three days next week,, Yale Law School will pilot a program allowing its students to check out a “therapy dog” for up to 30 minutes at a time. A memo written by the law librarian, Blair Kaufman, to students noted that therapy dog visits have resulted in  “increased happiness, calmness and overall emotional well-being”.  The program is requesting the students’ feedback to determine whether this program should be a permanent and ongoing program.

Verbal Abuse: How to Be Sure What You Say Doesn’t Hurt Your Child

What you say to your child is important.
Here are some tips to assure that what you say won’t damage your child

Sticks and stones will break my bones,
But names will never hurt me.

Many of us who are now parents understand that this children’s rhyme does not provide true comfort, and that the words of playmates DID hurt us.

Words can hurt children, and the damage inflicted on a child by the thoughtless remarks of a parent or other adult can torment a child–for their lifetime.

In fact, emotional abuse, though it is often ignored, can be far more devastating than the physical abuse that so often captures media headlines.

The emotional abuse of harsh words, spoken thoughtlessly, can lead a child feeling berated, belittled, demoralized. The impact this has on a child’s emotional development is insidious. A child’s spirit can be destroyed, and they may lose any positive sense of self. Emotional abuse destroy’s a child’s ability to feel loveable, to love himself or herself, and has a negative effect on a child’s ability to care for and get along with others. Emotional abuse increases self-destructive and antisocial behavior. Emotional abuse has been linked to eating disorders, promiscuity and suicide.

None of us is perfect, and many of us can recall a time when we’ve lost our self-control, and said something hurtful and demoralizing to our children, over something minor. We might say things like: “You clumsy idiot! You can’t do anything right!”

When words like these are repeated often enough, the child’s sense of self-esteem plummets and he or she begins to agree with his parents’ assessment of him: he or she really is dumb, a jerk, an idiot, a moron. The child begins to learn that love is not without conditions. And since it seems impossible to meet his or her parent’s expectations, the child becomes satisfied with settling for the “loser” role.

In too many homes today, the lights are on but no one is there. People are home but not home. Inattentive and verbally abusive parents are producing children who seem normal but are not what they should be, what they could have been.

There are studies that demonstrate that this abusive, humiliating and demeaning parenting behavior is transmitted from generation to generation, meaning that adults who had abusive parents tend to parent their own children the same way. This pattern will continue until a parent is willing to change their behaviors, change the dynamics, and find a way to interact differently with their own children. They must be willing to see and acknowledge that they are saying and doing to their children.

To change this pattern, treatment often requires treating the parent and the child, helping the parent feel respected and empowered, and allowing them to change the ways they respond to their child.
The problem of verbal abuse is REAL, and COMMON, but difficult to document, and, therefore, difficult to intervene to prevent. Certain stressors can increase the problem of verbal abuse, job loss, marital problems, financial concerns. Often, adults attempt to cope with these stressors using alcohol and other drugs, but this tends to make matters worse. Parents then lose their inhibitions, and may say terrible things to their children that they later regret.

How can you be sure your words build up rather than destroy your children?

† Guard your vocabulary. There are some words that people in a family should never say to each other. Words like stupid, dummy, jerk, idiot, worthless and freak have no place between parents and their children.

† Avoid absolute statements such as “You never . . . ” Or “You always . . . ” Have a sense of good manners with your family. This doesn’t mean that you must avoid all conflict or that you can’t set limits.

† Separate the child’s actions from the child. Instead of responding to a tantrum with a barrage of abusive language, let him know that you love him — but not his actions, which are unacceptable.

† When things happen that can set off an explosion, take time out. Wait. And then wait some more. When you hold your tongue until the heat of the moment has passed, it’s a lot easier to respond with love rather than anger.

† Be available. Be willing to stop and peek in on your child’s world. He or she will feel more valuable because of it. Don’t start interrogating the minute the child walks in the door.

Wait until you’re relaxed and instead of probing about his day, why not share your day? Instead of accusing, compliment. Instead of insisting, be silent.

† Active listening refers to a kind of listening and a response that does not judge, ridicule or order. And the more we listen without judging, the more we help our children to accept their feelings, we improve their problem-solving ability and increase their willingness to listen to us.

† Teach by example. Let your kids hear you acknowledge your mistakes. Risk being humble. Dare to say, “I’m sorry” to your children when appropriate. Apologizing reveals that the truth is larger than your ego and their feelings are more important than your pride.

If you can accept yourself in spite of your limitations, all the while working to be the best you can be, you’ve gone a long way to help your kids value themselves.

Based on the work of Jean Guarino, free-lance writer.

Attorney General: Access to Legal Defense for Juveniles, Indigent Needs Improvement

Attorney General Eric Holder  Spoke at the National Association of Counties Legislative Conference in Washington, D.C. ~ Monday, March 7, 2011

He noted that the Association of Counties, and the Department of Justice have common goals, of doing more and more to serve our citizens while resources diminish. He identified two specific priorities for the Justice Department:

“how we can improve the effectiveness of our juvenile justice system, and how we’re going to ensure that every American can access the legal services they need and deserve.”

He noted that “one of the most important lessons I learned as a federal prosecutor, as a judge, as a United States Attorney, as Deputy Attorney General, as Attorney General – and, above all, as a father of three children: that the work of protecting, assisting, and empowering our young people could not be more urgent.   “

He noted that:

  • The nation’s juvenile justice system is in need of change, that it doesn’t spend resources as wisely as it should, and does not improve as many lives as it could.
  • Although African-American youth make up 16 percent of the overall youth population, they make up more than half of the juvenile population arrested for committing a violent crime.
  • Abused and neglected children are 11 times more likely than their non-abused and non-neglected peers to be arrested for criminal behavior.
  • That so many of those who enter our juvenile justice system either can’t afford – or do not know to ask for – access to legal guidance.
  • Some youth even plead guilty to criminal offenses without the advice of a lawyer.
  • Even though many of those who are incarcerated enter the juvenile justice system for non-violent offences, they often emerge violent – or, at the very least – traumatized.
  • A scientific review of nine “Scared Straight” programs around the country showed that children ordered into these programs are nearly 30 percent more likely to offend than youths who are not.
  • In another study, 12 percent of the adjudicated youth in state-operated and large locally or privately operated juvenile facilities reported experiencing at least one incident of sexual victimization while incarcerated.

“A recent Utah Youth Suicide Study reported that young victims of suicide had nearly a seven in ten chance of an association with the juvenile justice system, calling us to question whether the current system is improving lives – or devastating them.”

TRANSITIONING OUT OF JUVENILE JUSTICE

  • Each year, 100,000 young people exit formal custody.   And some of them have nowhere to go.   Too many of these young people return to unstable homes – or end up in shelters, on the streets, or in other potentially dangerous, or violent, situations.   And many are not welcomed back to their community school and struggle to find educational opportunities.
  • Within a year of reentry, one study found that only 30 percent of previously incarcerated youth are involved in either school or work.   The unfortunate fact is that many end up in our jails and prisons.

Robert Kennedy believed that the link between justice and children could never be broken without compromising our founding ideals – and our most sacred principles.   He was right.

Mr. Holder noted that justice in the juvenile system is a moral issue that makes good fiscal sense:

  • “How we treat our children answers the question of who we are as a nation.”
  • “Better serving our young people makes good economic sense by keeping them out of over-stressed and under-funded corrections facilities and saving precious law enforcement resources.”

Mr. Holder advised that we

  • Broaden our approach to juvenile justice and ensure that sound research and respected analysis are a part of our decision-making process”.
  • Transition from a prosecution-and-punishment model to a prevention-and-intervention paradigm.  Adopt  a comprehensive plan of action that engages law-enforcement partners, medical professionals, social services providers, lawyers, parents, teachers, coaches, mentors, and community leaders.

Mr. Holder talked about the success of the Safe Start Program, and  the launch of the Defending Childhood Initiative – the federal government’s most comprehensive effort ever to address and overcome the crisis of childhood exposure to violence, that President Obama pledged $25 million to this initiative in his budget proposal.

Mr. Holder talked about alternatives to juvenile justice involvement for youths involved in minor offenses.

  • He mentioned specifically, the Civil Citations program in Miami-Dade County where youth who commit minor misdemeanors are  referred to targeted interventions aimed at reducing delinquent behavior and providing positive social outlets instead of arresting them and placing them in the juvenile justice system.  This program has reduced recidivism to 3 percent  and arrests by 30 percent for youth that participate in the program.

In addition to his emphasis on intervention and prevention over punishment, Mr. Holder also addressed the failure of our justice system to provide juveniles (as well as adults) with access to legal services.

According to The Office of Juvenile Justice and Delinquency Prevention’s Survey of Youth in Residential Placement :

  • Only one half of young people in detention facilities have a lawyer.
  • In many jurisdictions, youth are encouraged – whether explicitly or implicitly – to waive their right to counsel.
  • When juveniles assert their right to have a lawyer, court-appointed lawyers often enter the picture too late.
  • Across the country, too many public defender officers are underfunded and understaffed

Mr. Holder discussed his Department’s new Access to Justice Initiative:

  • An office established in an effort to ensure that quality legal representation is available, affordable, and accessible to all Americans.
  • Includes an agenda to help counties face the “impossible choice between funding critical health and human services or upholding core Constitutional rights.”

The  Office of Justice Programs is also working to implement solutions for indigent defense and juvenile justice reform by:

  • Establishing the Indigent Defense Hiring Project
  • Working with the National Juvenile Defender Center to establish a National Fellowship Program for law school graduates to become public defenders for three years.

Pursuing the “right” Happiness

The relentless pursuit of happiness–when defined as the experience of pleasure or positive feelings–may be doing us more harm than good. Researchers have found that  this sort of happiness does less to improve our  important  physical health than the type of well-being that comes from engaging in meaningful activity, termed “eudaimonic well-being.” “Eudaimonia” is a Greek word associated with Aristotle and often mistranslated as “happiness”—which has contributed to misunderstandings about what happiness is. Some experts say Aristotle meant “well-being” when he wrote that humans can attain eudaimonia by fulfilling their potential.

Before the world wars, psychologists were interested in the study of psychological health in addition to psychological illness. The intense needs of populations adversely affected by war, meant that most research dollars that were available were available for the study of psychological illness.  Now, “positive psychology” is a rapidly growing area of science once again.

Positive psychologists study “happiness”, “resilience” and human strengths. Some of their research  suggests that people who focus on living with a sense of purpose as they age are more likely to remain cognitively intact, have better mental health and even live longer than people who focus on achieving feelings of happiness.

In fact, in some cases, too much focus on feeling happy can actually lead to feeling less happy, researchers say.

The pleasure that comes with, say, a good meal, an entertaining movie or an important win for one’s sports team—a feeling called “hedonic well-being”—tends to be short-term and fleeting. Raising children, volunteering or going to medical school may be less pleasurable day to day. But these pursuits give a sense of fulfillment, of being the best one can be, particularly in the long run.

Today, the goal of understanding happiness and well-being, beyond philosophical interest, is part of a broad inquiry into aging and why some people avoid early death and disease. Psychologists investigating eudaimonic versus hedonic types of happiness over the past five to 10 years have looked at each type’s unique effects on physical and psychological health.

For instance, symptoms of depression, paranoia and psychopathology have increased among generations of American college students from 1938 to 2007, according to a statistical review published in 2010 in Clinical Psychology Review. Researchers at San Diego State University who conducted the analysis pointed to increasing cultural emphasis in the U.S. on materialism and status, which emphasize hedonic happiness, and decreasing attention to “community” and “meaning” in life, as possible explanations.

Since 1995, Dr. Carol Ryff,  professor and director of the Institute on Aging at the University of Wisconsin, Madison. and her Wisconsin team have been studying some 7,000 individuals and examining factors that influence health and well-being from middle age through old age in a study called MIDUS, or the Mid-Life in the U.S. National Study of Americans, funded by the National Institute on Aging. Eudaimonic well-being “reduces the bite” of risk factors normally associated with disease like low education level, using biological measures, according to their recently published findings on a subset of study participants.

Illustration by J.D. KingSource: Pew Research Center, Social and Demographic Trends Project

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Participants with low education level and greater eudaimonic well-being had lower levels of interleukin-6, an inflammatory marker of disease associated with cardiovascular disease, osteoporosis and Alzheimer’s disease, than those with lower eudaimonic well-being, even after taking hedonic well-being into account. The work was published in the journal Health Psychology.

David Bennett, director of the Alzheimer’s Disease Center at Rush University Medical Center in Chicago, and his colleagues showed that eudaimonic well-being conferred benefits related to Alzheimer’s. Over a seven-year period, those reporting a lesser sense of purpose in life were more than twice as likely to develop Alzheimer’s disease compared with those reporting greater purpose in life, according to an analysis published in the journal Archives of General Psychiatry. The study involved 950 individuals with a mean age of about 80 at the start of the study.

In a separate analysis of the same group of subjects, researchers have found those with greater purpose in life were less likely to be impaired in carrying out living and mobility functions, like housekeeping, managing money and walking up or down stairs. And over a five-year period they were significantly less likely to die—by some 57%— than those with low purpose in life.

The link persisted even after researchers took into account variables that could be related to well-being and happiness, such as depressive symptoms, neuroticism, medical conditions and income.

Evidence suggests that HOW a person confronts life’s challenges can have a lot to do with HOW a person feels in terms of their health and happiness.

There is some evidence that people high in eudaimonic well-being process emotional information differently than those who are low in it. Brain-imaging studies indicate people with high eudaimonic well-being tend to use the pre-frontal cortex more than people with lower eudaimonic well-being, says Cariem van Reekum, researcher at the Centre for Integrative Neuroscience and Neurodynamics at the University of Reading in the U.K. The pre-frontal cortex is important to higher-order thinking, including goal-setting, language and memory.

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It could be that people with high eudaimonic well-being are good at reappraising situations and using the brain more actively to see the positives, Dr. van Reekum says. They may think, “This event is difficult but I can do it,” she says. Rather than running away from a difficult situation, they see it as challenging.

The two types of well-being aren’t necessarily at odds, and there is overlap. Striving to live a meaningful life or to do good work should bring about feelings of happiness, of course. But people who primarily seek extrinsic rewards, such as money or status, often aren’t as happy, says Richard Ryan, professor of psychology, psychiatry and education at the University of Rochester.

Simply engaging in activities that are likely to promote eudaimonic well-being, such as helping others, doesn’t seem to yield a psychological benefit if people feel pressured to do them, according to a study Dr. Ryan and a colleague published last year in the Journal of Personality and Social Psychology..

There’s nothing wrong with trying to feel happy, psychologists say. Happy people tend to be more sociable and energetic, which may lead them to engage in meaningful activities. And for someone who is chronically angry or depressed, the goal should be to help this person feel happier, says Ed Diener, a retired professor at the University of Illinois who advises pollster Gallup, Inc., on well-being and positive psychology.

Surveys have shown the typical person usually feels more positive than neutral, yet it isn’t clear he or she needs to be any happier, Dr. Diener says. But there is such a thing as too much focus on happiness. Ruminating too much about oneself can become a vicious cycle.

Being happy doesn’t mean feeling elated all the time. Deep stress is bad, but the “I don’t have enough time” stress that many people feel while balancing work, family and other demands may not be so bad. THe important thing is to focus on relationships with people you care about, and to do work that you love.

Freedom to choose leisure activities benefits people with autism

Free time is not always a fun time for people with autism. Giving them the power to choose their own leisure activities during free time, however, can boost their enjoyment, as well as improve communication and social skills, according to an international team of researchers.

“For many of us, we look at recreation as a time to spend on activities that are fun and that are designed for our enjoyment,” said John Dattilo, professor of recreation, park and tourism management, Penn State. “But for some people with disabilities, particularly those who have autism, these activities can be a source of frustration, simply because they didn’t have a chance to make their own leisure choices.”

Dattilo said that a group of 20 autistic adults who participated in a yearlong recreation program that offered them a chance to choose activities, scored higher on personality tests that measure social and communication skills than the control group of 20 autistic adults who were randomly assigned to the program’s waiting list. Participants met for two hours each weekday and could choose among several activities that promoted engagement and interactivity, including games, exercises, crafts and events.

The researchers, who released their findings in the current issue of Research in Autism Spectrum Disorders, said that after completing the program, participants showed significant improvement at recognizing and labeling emotions. The participants scored about 24 percent higher than the control group in the ability to recognize emotions in a person in a picture. The score of the participants’ ability to label those emotions correctly was 50 percent higher than the control group’s score.

Since people with autism are less willing to interact socially, caregivers are particularly interested in programs that help improve social and communication skills, according to Dattilo, who worked with Domingo Garcia-Villamisar, professor of psychopathology, Complutense University of Madrid, Spain.

“The big measure for us in this program was the improvements in social behavior and interaction,” said Dattilo. “The defining quality of people with autism is that they have difficulty in social situations.”

The participants also improved their ability to carry out executive functions, such as setting goals and maintaining attention.

Dattilo said recreation programs that encourage people with autism to make their own leisure choices create a cycle of increasing independence, rather than a pattern of reliance on caregivers to provide recreational activities.

“While people are learning, you can also give them choices,” said Dattilo. “And as they make those choices, they are also learning and are empowered to make even more choices.”

The works of University of Rochester psychologist Edward Deci and author and psychologist Mihaly Csikszentmihalyi inspired the researchers to pursue the experiment, Dattilo said. Deci and Csikszentmihalyi emphasize self-determination as a critical component of human fulfillment.

SOURCE: http://live.psu.edu/story/51689