These are signs one should be aware of when entering a relstionship. I copied this information from Pamela Jacobs and have reprinted it below. This is too important not to share.
Early Warning Signs of an Abusive Relationship By Pamela Jacobs 1. He will romance you. He will buy you flowers and gifts. He will likely be the most romantic man you have ever met. He will pay attention to you and make you feel special and wanted. You may find yourself thinking that he is too good to be true — because he is. He needs you to trust him and develop feelings for him, because it is much easier to control someone who loves you. He will make you feel like you are his entire world — because he wants your world to revolve around him. Of course, just being romantic is not necessarily a sign of abuse. But, an abuser will often use these gifts and romance to distract you from other concerning behaviors, such as control and jealousy. 2. He will want to commit — quickly. He will say that it’s love at first sight, that you are made for each other, and that he can’t imagine his life without you. He will sweep you off your feet, and tell you he has never loved anyone this much. He will insist on being exclusive right away, and will likely want to move in together, or even get married, very quickly. He needs you to love him, and to belong to him. You may feel like the relationship is moving too quickly — trust your instincts. 3. He will want you all to himself. He will glare at other men for looking at you and question you about your male friends. You may think this jealousy is cute, or even loving — at first. But soon, he’ll make you feel guilty for spending time with friends or family. He will call or text you several times a day, and may accuse you of flirting or cheating. He will say he loves you so much, he can’t stand the thought of anyone else being near you. And soon, no one else will be. This is the beginning of isolation. 4. He will be very concerned about you. He may get upset if you don’t call him back right away or if you come home late. He will say it’s because he worries about you. He will start to question who you saw, where you went, and what you were doing. He will mask his control as concern for your well-being. He will start to make decisions for you — who you spend time with and where you go — and claim to know what’s best for you. Soon, you’ll be asking his approval for every decision. Your control over your own life will slip away, as his power and control grows. 5. He will be sweet and caring — sometimes. He will be the sweet, loving man who everyone else sees, and who you fell in love with. But, sometimes, he will become the man who puts you down, makes you feel guilty, and isolates you. He will make you believe that if you just did something differently, loved him more, or treated him better, he would be that sweet, loving man all the time. You will stay because of your hope for the man you love, but will spend most of your time being controlled by the man who hurts you. Eventually, you won’t be able to tell the difference. 6. He will play the victim. If he gets in trouble at work, it’s someone else’s fault. If he has a bad day, someone is out to get him. And if he is upset, he will blame you for his feelings and actions. He will expect you to make him happy and fulfilled — and when he’s not, he will blame you. He may apologize for yelling, putting you down, or hurting you, but will always find a way to make it your fault. He will say things like, “It’s just that I love you so much,” or “I wish you didn’t make me so crazy.” Eventually, he will blame you for making him hit you. If these warning signs are happening in your relationship, even if he has not hit you (yet), this is abuse. Control, jealousy, and isolation are not love. And abusive behavior will not change — no matter how hard you try, or how much you love him. This man may seem like your dream come true, but soon, he will become your worst nightmare. You deserve better. You deserve to be safe and respected. And you deserve real love, not control. If you or someone you know is being abused, you do not have to face it alone. Advocates are available to help, anytime, at 1-800-799-SAFE (7233). Please make the call, and take the first step toward freedom and safety today. You’re worth it. Pamela Jacobs is an attorney, advocate, and speaker dedicated to ending sexual assault and domestic violence. Learn more at http://pamelajacobs.com. Note: The gendered language in this post is meant to portray the vast majority of abuse that is perpetrated in heterosexual relationships, which is most often perpetrated by men against women. However, abuse occurs at similar rates in same-sex relationships and can also be perpetrated by women against men. The warning signs are the same. We all deserve to be safe — regardless of gender or sexual orientation.
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Taming or teaching the tiger? Myths and management of childhood aggression
Publish date: February 27, 2018 By Barbara J. Howard, MD Pediatric News How to deal with aggression delivered by a child’s peers is a common concern and social dilemma for both parents and children. How does a child ward off aggressive peers without getting hurt or in trouble while also not looking weak or whiny? What can parents do to stop their child from being hurt or frightened but also not humiliate them or interfere with their learning important life skills by being over protective? Markus Wegmann/Thinkstock Children do not want to fight, but they do want to be treated fairly. Frustration, with its associated feelings of anger, is the most common reason for aggression. Being a child is certainly full of its frustrations because, while autonomy and desires are increasing, opportunities expand at a slower rate, particularly for children with developmental weaknesses or economic disadvantage. Fear and a lack of coping skills are other major reasons for resorting to aggressive responses. Physical bullying affects 21% of students in grades 3-12 and is a risk factor for aggression at all ages. A full one-third of 9th-12th graders report having been in a physical fight in the last year. In grade school age and adolescence, factors known to be associated with peer aggression include the humiliation of school failure, substance use, and anger from experiencing parental or sibling aggression. One would think a universal goal of parents would be to raise their children to get along with others without fighting. Unfortunately, some parents actually espouse childrearing methods that directly or indirectly make fighting more likely. Essentially all toddlers and preschoolers can be aggressive at times to get things they want (instrumental) or when angry in the beginning of their second year of life; this peaks in the third year and typically declines after age 3 years. But for some 10% of children, aggression remains high. What parent and child factors set children up for such persistent aggression? Parents have many reasons for how they raise their children, but some myths about parenting that persist promote aggression. “My child will love me more if I am more permissive.”Infants and toddlers develop self-regulation skills better when it is gradually expected of them with encouragement and support from their parents. Parents may feel that they are showing love to their toddler by having a “relaxed” home with few limits and no specific bedtime or rules. These parents also may “rescue” their child from frustrating situations by giving in to their demands or removing them from even mildly stressful situations. These strategies can interfere with the progressive development of frustration tolerance, a key life skill. A lack of routines, inadequate sleep or food, overstimulation by noise, frightening experiences (including fighting in the home or neighborhood), or violent media exposure sets toddlers up to be out of control and thereby increases dysregulation. In addition, the dysregulated child may then act up, which can invoke punishment from that same parent. Frustrating toddlers with inconsistent expectations and arbitrary punishment, a common result of low structure, makes the child feel insecure and leads to aggression. Instead, children need small doses of frustration appropriate to their age and encouragement from a supportive adult to problem solve. You can praise (or model), cheering on a child with words such as “Are you stuck? You can do it! Try again,” instead of instantly solving problems for them. “Spare the rod and spoil the child.”Parents may feel that they are promoting obedience when they use corporal punishment, thinking this will keep the child out of trouble in society. Instead, corporal punishment is associated with increased aggression toward peers, as well as defiance toward parents. These effects are especially strong when mothers are distant emotionally. As pediatricians, we can educate people on the importance of warm parenting, redirection instead of punishment for younger children, and using small, logical consequences or time out when needed for aggression. “Just ignore bullies.”It is a rare child who can follow the command to “ignore” a bully without turning red or getting tears in his or her eyes – making them appealing targets. We can coach parents and kids how to disarm bullies by standing tall, putting hands on hips, making eye contact, and asking the peer a question such as “I do not understand what you’re trying to accomplish.” Learning martial arts also teaches children that they are powerful (but not to fight outside the class) so they can present themselves in this way. Programs that encourage children to get together to confront bullies supported by a school administration that uses comprehensive assessment and habilitation strategies for aggressive students are most effective in reducing aggression in schools. Anonymous reporting (for example, by using a cell phone app, such as STOPit) empowers students to report bullying or fights to school staff without risking later retribution from the peer. “Tough teachers help kids fall in line.”While peer fights generally increase from 2nd to 4th grade before declining, student fighting progressively increases when teachers use reprimands, rather than praise, to manage their classes. Children look to teachers to learn more than what is in books – how to be respectful and in control without putting others down. The most effective classroom management includes clear, fair rules; any correction should be done privately to avoid shaming students. Students dealt with this way are less likely to be angry and take it out on others. Of course, appropriate services helping every child experience success in learning is the foundation of positive behavior in school. “Children with ADHD won’t learn self-regulation if they are treated with medicine.”Children who show “low effortful control” or higher “dysregulation” are both more aggressive and also less likely to decline in aggression in early childhood. ADHD is a neurological condition characterized by such dysregulation and low effortful control. Children with ADHD often have higher and more persistent aggression. These tendencies also result in impulsive behaviors that can irritate peers and adults and can result in correction and criticism, further increasing aggression. Children with ADHD who are better controlled, often with the help of medication, have more positive interactions at school and at home, receive more praise and less correction, and develop more reasoned interaction patterns. “I am the parent, and my child should do what I say.”When adults step in to stop a fight, they are rarely in a position to know what actually happened between the kids. Children may quickly learn how to entrap a sibling or peer to look like the perpetrator in order to get them in trouble and/or avoid consequences for themselves, especially if large or harsh punishments are being used. While it can seem tricky to treat children who are very different in age or development equally, having parents elicit or at least verbalize each child’s point of view is part of how children learn respect and mediation skills. Parents who refrain from taking sides or dictating how disputes should be resolved leave the chance for the children to acquire these component skills of negotiation. This does not mean there are no consequences, just that a brief discussion comes first. When fighting is a pediatric complaint, you have a great opportunity to educate families in evidence-based ways that can both prevent and reduce their child’s use of aggression. In one effective 90-minute training program, parents were taught basic mediation principles: to give ground rules and ask their children to agree to them, to ask each child to describe what happened and identify their disagreements and common ground, to encourage the children to discuss their goals in the fight and feelings about the issues, and to encourage the children to come up with suggestions to resolve their disputes and help them assess the practical aspects of their ideas. Praise should be used each time a child uses even some of these skills. Parents in this program also were given communication strategies, such as active listening, reflecting, and reframing, to help children learn to take the others’ perspective. In a follow up survey a month later, children of parents in the intervention group were seen to use these skills in real situations that might otherwise have been fights. When aggression persists, mindfulness training, cognitive-behavioral techniques, social-emotional approaches, or peer mentoring programs delivered through individual counseling or school programs are all ways of teaching kids important interaction skills to reduce peer aggression. Remember, 40% of severe adult aggression begins before age 8 years, so preventive education or early referral to mental health services is key. Dr. Howard is assistant professor of pediatrics at Johns Hopkins University, Baltimore, and creator of CHADIS (www.CHADIS.com). She had no other relevant disclosures. Dr. Howard’s contribution to this publication was as a paid expert to Frontline Medical News. E-mail her at [email protected]. Pages Opioid use of near epidemic levels has hit Wilmington, NC and other cities and towns across the U.S.3/12/2018 FROM PEDIATRICS
Hospitalization and pediatric ICU admission rates for pediatric opioid-related ingestion are increasing, along with hospitalization costs, according to a retrospective cohort study. “In this study, we demonstrate a significant and steady increase in the diagnosis of opioid ingestion and poisoning across all age groups in U.S. children’s hospitals from 2004 to 2015,” wrote Jason Kane, MD, of the University of Chicago, and his associates. “Not only did the absolute number of opioid-related admissions increase but the rate of both hospital and PICU [pediatric ICU] admissions increased as well.” monkeybusinessimages/Thinkstock Using the Pediatric Health Information System database, the research team performed a retrospective cohort study of children aged 1-17 years who had been admitted to a PICU between Jan. 1, 2004, and Sep. 30, 2015. For statistical analysis, the years were grouped into separate epochs: 2004-2007, 2008-2011, and 2012-2015. Of the 4,175,624 admissions to 31 different children’s hospitals around the United States, 3,647 (0.09%) were due to opioid-related conditions. Across the three epochs of the study, the number of opioid-related hospitalizations more than doubled from 797 to 1,504 and concurrently increased the rate of hospital admissions from 6.7 per 10,000 in 2004 to 10.9 per 10,000 in 2015 (P less than .001). Similar to the trends in overall hospital admissions and hospital admission rates, admission to the PICU and PICU admission rates also increased. Of the 3,647 children admitted for opioid-related issues, 1,564 (43%) were subsequently admitted to the PICU. PICU admission rates also increased from 25 to 36 per 10,000 admissions (P less than .001).While the majority of opioid-related hospitalizations are associated with children aged 12-17 years, children under the age of 6 years accounted for one-third of these hospitalizations. Many PICU admissions are severe enough to warrant mechanical ventilator support (37%, P less than .001) and vasopressors (20%, P less than .001). The opioids ingested prior to hospital admission varied between age groups, with 20% (243 of 1,249) patients aged 1-5 years ingesting methadone, compared with 10% (218 of 2,223) of patients aged 12-17 years. Heroin was much more common in this group, accounting for 4.4% (99 of 2,223) of patient hospitalizations. In addition to the human cost of pediatric hospital admissions, there is a significant economic cost on the health care system. The median cost for PICU admission was $4,931. Although these costs have been dropping for the better part of a decade ($6,523 in 2004-2007 to $4,552 in 2012-2015, P less than .001), it still represents a substantial problem. In addition, admission rates are increasing, which will only place a heavier burden on the health care system, according to Dr. Kane and his associates. Perhaps one positive point from this study is that although hospitalizations and intensive care rates have gone up, mortality decreased over time from 2.8% in 2004-2007 to 1.3% in 2012-2015. A possible limitation of the data in this study is that it provides data from subjects whose data is accessible to the researcher, rather than those strategically selected. In addition, referral bias may reduce the ability to generalize the information to non–tertiary care children’s hospitals. “The current U.S. opioid crisis is negatively impacting pediatric patients as the rate of hospitalization and PICU care for the ingestion of opioids by children continues to increase over time,” wrote Dr. Kane and his associates. “Current efforts to reduce prescription opioid use in adults have not curtailed the incidence of pediatric opioid ingestion, and additional efforts are needed to reduce preventable opioid exposure in children.” This study had no external funding. Dr. Allison H. Bartlett has served as a consultant member of the CVS Caremark National Pharmacy and Therapeutics Committee. All other authors had no relevant financial disclosures to report. [email protected] SOURCE: Kane JM et al. Pediatrics. 2018 Mar 5;141(4):e20173335. Relationship issues are challenges we face throughout our lives. Frequently, the end of a romance leaves one feeling lost. The change in status from being a part of a couple to single can feel disorienting. Questions like, who am I?" Or "what do I do next?" are not uncommon. Many begin to reclaim or rediscover their identities.
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AuthorCathy Cosentino, MA, LMFTA Archives
March 2018
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