Are you paying ATTENTION?

I was recently interviewed on FOX News about an intelligent woman, a partner in a NYC law firm, who impetuously kicked her daughters out of her car (see Madlyn Primoff's Moment of Madness, 4/24/09).

I empathized with Madlyn's dilemma; I, too, have been frustrated enough to want to kick my fighting children out of the house, the car, the store.

But I didn't do it.

What tipped Madlyn over the edge?

She was trying to do too much; take care of the sibling rivalry in the back seat while at the same time, face forward, she monitored traffic and thought about who knows what else. Her brain was on overload; she couldn't think and she responded emotionally to the situation without seeing the consequences.

How many of us fall into the same trap?

The NY Times recently interviewed Dr. Robert Desimone, a neuroscientist at M.I.T., about his research on attention. Dr. Desimone found that the neural signals we need to attend "can have trouble getting through in a noisy environment." So if the kids are screaming we will not have the brain power to attend to something else that requires concentration.

It's not a good idea to drive or handle other dangerous objects (which abound in our kitchens) while being invaded by noise pollution.

We're surrounded by noise. At the checkout counter at my local supermarket I not only have the treats to withstand and the magazines that pollute the eyes, but now a little television at each register that incessantly blares news and advertisements. At a recent visit to an audiologist to check my hearing, I was confounded by the presence of a large television adjacent to the receptionist featuring a local talk show. Ditto for FOX news at other medical offices.

We're no longer given the opportunity to think.

With enough noise I might indeed lose the ability to think and end up throwing something at the TV, receptionist, or physician for keeping me waiting an hour in that raucous jungle! (Is that why an Iraqi journalist threw his shoes at former President Bush?)

The NY Times article ends with two suggestions for reducing pollution of the brain; meditation and ear plugs. I bought my first pair yesterday.

Congress Will Offer Bribes

One of the first questions I'm asked by parents is, "Why should we pay/reward our children to do what they should be doing anyway?"

We can now ask Congress the same question: Why should you subsidize employers who develop wellness programs for their employees? And why should the workers be paid to take care of their health when they should be doing it anyway?

The answer is simply, "Because it works."

Research has repeatedly shown that when money is involved people act. They'll lose weight, stop smoking and keep their medical appointments. So, rather than castigate people who resist change, lure them with monetary incentives. We'll use the carrot rather than the stick because they're already using the stick on themselves.

A second criticism of bribes is that it removes a person's internal motivation to change.

There is some truth to that observation.

When a person changes his behavior solely because of external consequences, whether positive or negative, the new behavior does not last. As soon as the consequences pan out he'll go back to his baseline behavior. The external circumstances didn't take away his internal motivation; they overrode it. He may have felt a desire to do what's being asked - to do his homework, finish his project, eat healthy foods - after all, it's in his best interest; but now that there's no longer any payoff, he gives up.

External rewards need to be a bridge rather than a destination. They are meant as signposts along a path that the person has chosen, not one that has been imposed. No one can impose change.

So too, a wellness program needs to be voluntary for it to work. And its administrators can ensure success by being its first volunteers.

Depression

Daphne Merkin, a contributing writer for the NY Times Magazine, describes her ongoing battle with clinical depression.

Her poignant description highlights the dilemma of someone who suffers from mental illness. Unlike physical illness

severe depression, much as it might be treated as an illness, didn’t send out clear signals for others to pick up on; it did its deadly dismantling work under cover of normalcy. The psychological pain was agonizing, but there was no way of proving it, no bleeding wounds to point to. How much simpler it would be all around if you could put your mind in a cast, like a broken ankle, and elicit murmurings of sympathy from other people instead of skepticism (“You can’t really be feeling as bad as all that”) and in some cases outright hostility (“Maybe if you stopped thinking about yourself so much . . . ”).

Ms. Merkin's dark memoir of her hospitalization doesn't lend one to hope that there are ways of overcoming depression. Her years of therapy include psychoanalysis but I wonder if the more proven methods of treating depression had been tried, including cognitive behavior therapy.

Yes, there are those who suffer from intractable depression and bravely live day-to-day with the monster lurking in the shadows. Let us hope that the majority of sufferers seek the best treatment available and are able to choose wellness and life.

If Your Pediatrician Ignores You

When my children were small their pediatrician was an older man who seemed knowledgeable and experienced. He had one drawback; he didn't listen.

Being young and inexperienced, I didn't know that a physician should listen to his patient's mother.

As the years passed, I began to trust myself more and, when this pediatrician retired, sought someone who would indeed value my opinion. I joined a group led by an older pediatrician who loved to tell jokes; I was careful to make appointments with the younger physicians as much as possible. They seemed to listen better.

Patients and their advocates are now rocking the boat, and physicians are learning to listen or else they may get slapped with a lawsuit if, G-d forbid, the patient suffers unforeseen consequences.

Furthermore, many illness are now being identified at younger ages, including autism, diabetes and even kidney stones. Thus we need people who know their children best to recognize the signs of a child not feeling well.

That's parents, not pediatricians.

As one professor states, parents need to trust their instincts. In his words, "If the doctor ignores your concerns, seek a second opinion."

Post-Mother's Day

Mother's Day is over
and the children go home
not to yours but to their own.
They're very busy
building their nests
just as you did at their age.

Many years from now
when archeologists dig down,
they will find the cities
laid down
one on top of another.

Your home, your town
will be there, too
so keep building -
the future depends
on you.