Parent Effectiveness Training – by Dr. Thomas Gordon
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Do you want your home (or workplace, for that matter) to be a place of peace? This book literally got the author nominated for a Nobel Peace Prize. Can’t really get much higher praise than that.
The title is “Parent Effectiveness Training”, but in reality, the advice in the book is applicable to all manner of relationships, including:
- romantic relationships
- friends
- colleagues
- …and really any human interaction.
It covers some of the same topics we did today (and more) in much more detail than we ever could in a newsletter. It lays out formulae to use, gives plenty of examples, and/but is free from undue padding.
- Pros: this isn’t one of those “should have been an article” books. It has so much valuable content.
- Cons: It is from the 1970s* so examples may feel “dated” now.
In addition to going into much more detail on some of the topics covered in today’s issue of 10almonds, Dr. Gordon also talks in-depth about the concept of “problem-ownership”.
In a nutshell, that means: whose problem is a given thing? Who “has” what problem? Everyone needs to be on the same page about everyone else’s problems in the situation… as well as their own, which is not always a given!
Dr. Gordon presents, in short, tools not just to resolve conflict, but also to pre-empt it entirely. With these techniques, we can identify and deal with problems (together!) well before they arise.
Everybody wins.
Get your copy of “Parent Effectiveness Training” from Amazon today!
*Note: There is an updated edition on the market, and that’s what you’ll find upon following the above link. This reviewer (hi!) has a battered old paperback from the 1970s and cannot speak for what was changed in the new edition. However: if the 70s one is worth more than its weight in gold (and it is), the new edition is surely just as good, if not better!
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Singledom & Healthy Longevity
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Statistically, those who live longest, do so in happy, fulfilling, committed relationships.
Note: happy, fulfilling, committed relationships. Less than that won’t do. Your insurance company might care about your marital status for its own sake, but your actual health doesn’t—it’s about the emotional safety and security that a good, healthy, happy, fulfilling relationship offers.
We wrote about this here:
Only One Kind Of Relationship Promotes Longevity This Much!
But that’s not the full story
For a start, while being in a happy fulfilling committed relationship statistically adds healthy life years, being in a relationship that falls short of those adjectives certainly does not. See also:
Relationships: When To Stick It Out & When To Call It Quits
But also, life satisfaction steadily improves with age, for single people (the results are more complicated for partnered people—probably because of the range of difference in quality of relationships). At least, this held true in this large (n=6,188) study of people aged 40–85 years:
❝With advancing age, partnership status became less predictive of loneliness and the satisfaction with being single increased. Among later-born cohorts, the association between partnership status and loneliness was less strong than among earlier-born cohorts. Later-born single people were more satisfied with being single than their earlier-born counterparts.❞
Note that this does mean that while life satisfaction indeed improves with age for single people, that’s a generalized trend, and the greatest life satisfaction within this set of singles comes hand-in-hand with being single by choice rather than by perceived obligation, i.e., those who are “single and not looking” will generally be the most content, and this contentedness will improve with age, but for those who are “single and looking”, in that case it’s the younger people who have it better, likely due to a greater sense of having plenty of time.
For that matter, gender plays a role; this large survey of singles found that (despite the popular old pop-up ads advising that “older women in your area are looking to date”), in reality older single women were the least likely to actively look for a partner:
See: A Profile Of Single Americans
…which also shows that about half of single Americans are “not looking”, and of those who are, about half are open to a serious relationship, though this is more common under the age of 40, while being over the age of 40 sees more people looking only for something casual.
Take-away from this section: being single only decreases life satisfaction if one doesn’t enjoy being single, and even then, and increases it if one does enjoy being single.
But that’s about life satisfaction, not longevity
We found no studies specifically into longevity of singledom, only the implications that may be drawn from the longevity of partnered people.
However, there is a lot of research that shows it’s not being single that kills, it’s being socially isolated. It’s a function of neurodegeneration from a lack of conversation, and it’s a function of what happens when someone slips in the shower and is found a week later. Things like that.
For example: Is Living Alone “Aging Alone”? Solitary Living, Network Types, and Well-Being
What if you are alone and don’t want to be?
We’ve not, at time of writing, written dating advice in our Psychology Sunday section, but this writer’s advice is: don’t even try.
That’s not nihilism or even cynicism, by the way; it’s actually a kind of optimism. The trick is just to let them come to you.
(sample size of one here, but this writer has never looked for a relationship in her life, they’ve always just found me, and now that I’m widowed and intend to remain single, I still get offers—and no, I’m not a supermodel, nor rich, nor anything like that)
Simply: instead of trying to find a partner, just work on expanding your social relationships in general (which is much easier, because the process is something you can control, whereas the outcome of trying to find a suitable partner is not), and if someone who’s right for you comes along, great! If not, then well, at least you have a flock of friends now, and who knows what new unexpected romance may lie around the corner.
As for how to do that,
How To Beat Loneliness & Isolation
Take care!
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Navigating the health-care system is not easy, but you’re not alone.
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Hello, dear reader!
This is my first column for Healthy Debate as a Patient Navigator. This column will be devoted to providing patients with information to help them through their journey with the health-care system and answering your questions.
Here’s a bit about me: I have been a patient partner at The Ottawa Hospital and Ottawa Hospital Research Institute since 2017, and have joined a variety of governance boards that work on patient and caregiver engagement such as the Patient Advisors Network, the Ontario Health East Region Patient and Family Advisory Council and the Equity in Health Systems Lab.
My journey as a patient partner started much before 2017 though. When I was a teenager, I was diagnosed with a cholesteatoma, a rare and chronic disease that causes the development of fatty tumors in the middle ear. I have had multiple surgeries to try to fix it but will need regular follow-ups to monitor whether the tumor returns. Because of this, I also live with an invisible disability since I have essentially become functionally deaf in one ear and often rely on a hearing aid when I navigate the world.
Having undergone three surgeries in my adolescent years, it was my experience undergoing surgery for an acute hand and wrist injury following a jet ski accident as an adult that was the catalyst for my decision to become a patient partner. There was an intriguing contrast between how I was cared for at two different health-care institutions, my age being the deciding factor at which hospital I went to (a children’s hospital or an adult one).
The most memorable example was how, as a teenager or child, you were never left alone before surgery, and nurses and staff took all the time necessary to comfort me and answer my (and my family’s) questions. I also remember how right before putting me to sleep, the whole staff initiated a surgical pause and introduced themselves and explained to me what their role was during my surgery.
None of that happened as an adult. I was left in a hallway while the operating theater was prepared, anxious and alone with staff walking by not even batting an eye. My questions felt like an annoyance to the care team; as soon as I was wheeled onto the operating room table, the anesthetist quickly put me to sleep. I didn’t even have the time to see who else was there.
Now don’t get me wrong: I am incredibly appreciative with the quality of care I received, but it was the everyday interactions with the care teams that I felt could be improved. And so, while I was recovering from that surgery, I looked for a way to help other patients and the hospital improve its care. I discovered the hospital’s patient engagement program, applied, and the rest is history!
Since then, I have worked on a host of patient-centered policy and research projects and fervently advocate that surgical teams adopt a more compassionate approach with patients before and after surgery.
I’d be happy to talk a bit more about my journey if you ask, but with that out of the way … Welcome to our first patient navigator column about patient engagement.
Conceptualizing the continuum of Patient Engagement
In the context of Canadian health care, patient engagement is a multifaceted concept that involves active collaboration between patients, caregivers, health-care providers and researchers. It involves patients and caregivers as active contributors in decision-making processes, health-care services and medical research. Though the concept is not new, the paradigm shift toward patient engagement in Canada started around 2010.
I like to conceptualize the different levels of patient engagement as a measure of the strength of the relationship between patients and their interlocutors – whether it’s a healthcare provider, administrator or researcher – charted against the duration of the engagement or the scope of input required from the patient.
Defining different levels of Patient Engagement
Following the continuum, let’s begin by defining different levels of patient engagement. Bear in mind that these definitions can vary from one organization to another but are useful in generally labelling the level of patient engagement a project has achieved (or wishes to achieve).
Patient involvement: If the strength of the relationship between patients and their interlocutors is minimal and not time consuming or too onerous, then perhaps it can be categorized as patient involvement. This applies to many instances of transactional engagement.
Patient advisory/consulting: Right in the middle of our continuum, patients can find themselves engaging in patient advisory or consulting work, where projects are limited in scope and duration or complexity, and the relationship is not as profound as a partnership.
Patient partnership: The stronger the relationship is between the patient and their interlocutor, and the longer the engagement activity lasts or how much input the patient is providing, the more this situation can be categorized as patient partnership. It is the inverse of patient involvement.
Examples of the different levels of Patient Engagement
Let’s pretend you are accompanying a loved one to an appointment to manage a kidney disease, requiring them to undergo dialysis treatment. We’ll use this scenario to exemplify what label could be used to describe the level of engagement.
Patient involvement: In our case, if your loved one – or you – fills out a satisfaction or feedback survey about your experience in the waiting room and all that needed to be done was to hand it back to the clerk or care team, then, at a basic level, you could likely label this interaction as a form of patient involvement. It can also involve open consultations around a design of a new look and feel for a hospital, or the understandability of a survey or communications product. Interactions with the care team, administrators or researchers are minimal and often transactional.
Patient advisory/consulting: If your loved one was asked for more detailed information about survey results over the course of a few meetings, this could represent patient advisory/consulting. This could mean that patients meet with program administrators and care providers and share their insights on how things can be improved. It essentially involves patients providing advice to health-care institutions from the perspective of patients, their family members and caregivers.
Patient advisors or consultants are often appointed by hospitals or academic institutions to offer insights at multiple stages of health-care delivery and research. They can help pilot an initiative based on that feedback or evaluate whether the new solutions are working. Often patient advisors are engaged in smaller-term individual projects and meet with the project team as regularly as required.
Patient partnership: Going above and beyond patient advisory, if patients have built a trusting relationship with their care team or administrators, they could feel comfortable enough to partner with them and initiate a project of their own. This could be for a project in which they study a different form of treatment to improve patient-centered outcomes (like the time it takes to feel “normal” following a session); it could be working together to identify and remove barriers for other patients that need to access that type of care. These projects are not fulfilled overnight, but require a collaborative, longstanding and trusting relationship between patients and health-care providers, administrators or researchers. It ensures that patients, regardless of severity or chronicity of their illness, can meaningfully contribute their experiences to aid in improving patient care, or develop or implement policies, pilots or research projects from start to finish.
It is leveraging that lived and living experience to its full extent and having the patient partner involved as an equal voice in the decision-making process for a project – over many months, usually – that the engagement could be labeled a partnership.
Last words
The point of this column will be to answer or explore issues or questions related to patient engagement, health communications or even provide some thoughts on how to handle a particular situation.
I would be happy to collect your questions and feedback at any time, which will help inform future columns. Just email me at [email protected] or connect with me on social media (Linked In, X / Twitter).
It’s not easy to navigate our health-care systems, but you are not alone.
This article is republished from healthydebate under a Creative Commons license. Read the original article.
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HRT & Your Heart
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝So the reason that someone on estrogen has a slightly higher chance of a heart attack is…what? Is it just because there’s a higher body fat?❞
There shouldn’t be higher chance of a heart attack once everything’s been taken into account, and indeed estrogen has some cardioprotective benefits, along with competing properties, e.g:
❝The cardiovascular effects of estrogen require a careful balancing act between possible advantages, such as enhanced lipid profiles and vascular function, and possible concerns, like increased thrombotic risk.
Estrogen has cardioprotective properties in premenopausal women❞
Source: The Relationship Between Myocardial Infarction and Estrogen Use: A Literature Review
The risks and benefits of HRT are numerous, and/but a lot of the risks are associated only with animal-derived HRT rather bioidentitical, so you might want to check out our previous article:
HRT: A Tale Of Two Approaches (Bioidentical vs Animal)
Would you like this section to be bigger? If so, send us more questions!
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Can Ginkgo Tea Be Made Safe? (And Other Questions)
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I’d be interested in OTC prostrate medication safety and effectiveness.❞
Great idea! Sounds like a topic for a main feature one day soon, but while you’re waiting, you might like this previous main feature we did, about a supplement that performs equally to some prescription BPH meds:
❝Was very interested in the article on ginko bilboa as i moved into a home that has the tree growing in the backyard. Is there any way i can process the leaves to make a tea out of it.❞
Glad you enjoyed! First, for any who missed it, here was the article on Ginkgo biloba:
Ginkgo Biloba, For Memory And, Uh, What Else Again?
Now, as that article noted, Ginkgo biloba seeds and leaves are poisonous. However, there are differences:
The seeds, raw or roasted, contain dangerous levels of a variety of toxins, though roasting takes away some toxins and other methods of processing (boiling etc) take away more. However, the general consensus on the seeds is “do not consume; it will poison your liver, poison your kidneys, and possibly give you cancer”:
Ginkgo biloba L. seed; A comprehensive review of bioactives, toxicants, and processing effects
The leaves, meanwhile, are much less poisonous with their ginkgolic acids, and their other relevant poison is very closely related to that of poison ivy, involving long-chain alkylphenols that can be broken down by thermolysis, in other words, heat:
However, this very thorough examination of the potential health benefits and risks of ginkgo tea, comes to the general conclusion “this is not a good idea, and is especially worrying in elders, and/or if taking various medications”:
In summary:
- Be careful
- Avoid completely if you have a stronger-than-usual reaction to poison ivy
- If you do make tea from it, green leaves appear to be safer than yellow ones
- If you do make tea from it, boil and stew to excess to minimize toxins
- If you do make tea from it, doing a poison test is sensible (i.e. start with checking for a skin reaction to a topical application on the inside of the wrist, then repeat at least 6 hours later on the lips, then at least 6 hours later do a mouth swill, then at least 12 hours later drink a small amount, etc, and gradually build up to “this is safe to consume”)
For safety (and legal) purposes, let us be absolutely clear that we are not advising you that it is safe to consume a known poisonous plant, and nor are we advising you to do so.
But the hopefully only-ever theoretical knowledge of how to do a poison test is a good life skill, just in case
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Keep Cellulite At Bay
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝Does anything actually get rid of cellulite? Nothing seems to❞
Let’s get the bad news over with in one go:
Nothing (that the scientific world currently knows of) can get rid of cellulite permanently, nor completely guard against it proactively. Which, given that it affects up to 98% of women to some degree, and often shows up not long after puberty (though it can appear at any time and often increases later in life), any pre-emptive health regime would need to be started as a child in any case.
As with many things that predominantly affect women, the world of medicine isn’t entirely sure what causes it, let alone how to effectively treat it.
Obviously hormones are implicated, namely estrogen.
Obviously adiposity is implicated, because one can’t have dimples in one’s fat if one doesn’t have enough fat to dimple.
Other hypothesized contributory factors include genetics, poor diet, inactivity, unhealthy lifestyle (in ways not previously mentioned, e.g. use of alcohol, tobacco, etc), accumulated toxins, and pregnancy.
Here’s an old paper (from 2004); today’s reviews say pretty much the same thing, but we love how succinctly (albeit, somewhat depressingly) this abstract states how little we know and how little we can do:
Cellulite: a review of its physiology and treatment
However, all is not lost!
There are some things that can affect how much cellulite we get, and there are some things that can reduce it, and even some things that can get rid of it completely—albeit temporarily.
First, a quick refresher on what it actually is, physiologically speaking: cellulite occurs when connective tissue bands pull the skin down in places, where fat tissue has been able to squeeze through. One of the reasons it is hypothesized women get this more than men is because our fat is not merely different in distribution and overall percentage, but also in how the fat cells stack up; we generally have have of a vertical stacking structure going on, while men generally have a more horizontal structure. This means that it can be easier for ours to get moved about differently, causing the connective tissue to pull on the skin unevenly in places.
With that in mind…
Prevention is, as we say, probably impossible if your body is running on estrogen. However, those contributory factors we mentioned above? Most of those are modifiable, including these things that it is hypothesized can reduce it:
Diet: as it seems to be worsened by inflammation (what isn’t?), an anti-inflammatory diet is recommended.
Exercise: there are three things here: 1) exercises to improve circulation and thus the body’s ability to sort things out by itself 2) HIIT exercise to reduce body fat percentage, if one has a high enough starting body fat percentage for that to be a healthy goal 3) mobility exercises, to ensure our connective tissues are the right amount of mobile.
Creams and lotions
These reduce the superficial appearance of cellulite, without actually treating the thing itself. Mostly they are caffeine-based, which when used topically increases blood flow and works as a local diuretic, reducing the water content of the fat cells, diminishing the appearance of the cellulite by making each fat cell physically smaller (while still containing the same amount of fat, and it’ll bounce back in size as soon as the body can restore osmotic balance).
Medical procedures
There are too many of these to discuss them all separately, but they all work on the principle of breaking up the tough bands of connective tissue to eliminate the dimpling of cellulite.
The methods they use vary from ultrasound to cryolipolysis to lasers to “vacuum-assisted precise tissue release”, which involves a suction pump and a multipronged robotic assembly with needles to administer anaesthetic as it goes and small blades to cut the connective tissues under the skin:
Tissue Stabilized–Guided Subcision for the Treatment of Cellulite
That last one definitely sounds like the least fun, but it’s also the only one that doesn’t take months to maybe see results.
Cellulite can and almost certainly will come back after all of these.
Home remedies
Aside from at-home versions of the above (not the robots with vacuum pumps and needles and microblades, hopefully, but for example homemade caffeine creams), and of course diet and exercise which can be considered “home remedies”, there are two more things worth mentioning:
Dry brushing: using a body brush to, as the name suggests, simply brush one’s skin. The “dry” aspect here is simply that it’s not done in the bath or shower; it’s done while dry. It can improve local circulation of blood and lymph, allowing for better detoxification and redistribution of needed bodily resources.
Here’s an example dry brushing body brush on Amazon; this writer has one and hates it, but I’ve also tried with other kinds of brush and hate them too, so it seems to be a me thing rather than a brush thing, and I have desisted in trying, now. Maybe you will like it better; many people do.
Self-massage: or massage by someone else, if that’s an option for you and you prefer. In this case, it works by a different mechanism than dry brushing; this time it’s working by the same principle as the medical techniques described in the previous section; it’s physically breaking down the toughened bits of connective tissue.
Here’s an example wooden massage roller on Amazon; this writer has one and loves it; it’s sooooooo good. I got it as a matter of general maintenance for my fascia, but it’s also very good if I get a muscular pain now and again. As for cellulite, I personally get just a little cellulite sometimes (in the backs of my thighs), and whenever I use this regularly, it goes away for at least a while.
A quick note in closing
Cellulite is normal for women and is not unhealthy. Much like gray hair for example, it’s something that can be increased by poor health, but the thing itself isn’t intrinsically unhealthy, and most of us get it to some degree at some point.
Nevertheless, aesthetic factors can also have a role to play in mental health, and we tend to feel best when we like the way our body looks. If for you that means wanting less/no cellulite, then the above are some ways towards that.
As a bonus, most of the nonmedical options are directly good for the physical health anyway, so doing them is of course good.
In particular that last one (the wooden massage roller), because that connective tissue we talked about? It matters for a lot more than just cellulite, and is heavily implicated in a lot of kinds of chronic pain, so it pays to keep it in good health:
Fascia: Why (And How) You Should Take Care Of Yours
(that article, also written by this same writer by the way, suggests a vibrating foam roller—those are very popular; I just really love my wooden one, and find it more effective)
Take care!
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100 Hikes of a Lifetime – by Kate Siber
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This is published by National Geographic, so you can imagine the quality of the photos throughout.
Inside, and after a general introduction and guide to gear and packing appropriately, it’s divided into continents, with a diverse array of “trips of a lifetime” for anyone who enjoys hiking.
It’s not a narrative book, rather, it is a guide, a little in the style of “Lonely Planet”, with many “know before you go” tips, information about the best time to go, difficult level, alternative routes if you want to get most of the enjoyment while having an easier time of it (or, conversely, if you want to see some extra sights along the way), and what to expect at all points.
Where the book really excels is in balancing inspiration with information. There are some books that make you imagine being in a place, but you’ll never actually go there. There are other books that are technical manuals but not very encouraging. This one does both; it provides the motivation and the “yes, you really can, here’s how” information that, between them, can actually get you packing and on your way.
Bottom line: if you yearn for breathtaking views and time in the great outdoors, but aren’t sure where to start, this will give you an incredible menu to choose from, and give you the tools to go about doing it.
Click here to check out 100 Hikes Of A Lifetime, and live it!
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