The Seven Principles for Making Marriage Work – by Dr. John Gottman

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A lot of relationship advice can seem a little wishy-washy. Hardline clinical work, on the other hand, can seem removed from the complex reality of married life. Dr. Gottman, meanwhile, strikes a perfect balance.

He looks at huge datasets, and he listens to very many couples. He famously isolated four relational factors that predict divorce with 91% accuracy, his “Four Horsemen”:

  1. Criticism
  2. Contempt
  3. Defensiveness
  4. Stonewalling

He also, as the title of this book promises (and we get a chapter-by-chapter deep-dive on each of them) looks at “Seven principles for making marriage work”. They’re not one-word items, so including them here would take up the rest of our space, and this is a book review not a book summary. However…

Dr. Gottman’s seven principles are, much like his more famous “four horsemen”, deeply rooted in science, while also firmly grounded in the reality of individual couples. Essentially, by listening to very many couples talk about their relationships, and seeing how things panned out with each of them in the long-term, he was able to see what things kept on coming up each time in the couples that worked out. What did they do differently?

And, that’s the real meat of the book. Science yes, but lots of real-world case studies and examples, from couples that worked and couples that didn’t.

In so doing, he provides a roadmap for couples who are serious about making their marriage the best it can be.

Bottom line: this is a must-have book for couples in general, no matter how good or bad the relationship.

  • For some it’ll be a matter of realising “You know what; this isn’t going to work”
  • For others, it’ll be a matter of “Ah, relief, this is how we can resolve that!”
  • For still yet others, it’ll be a matter of “We’re doing these things right; let’s keep them forefront in our minds and never get complacent!”
  • And for everyone who is in a relationship or thinking of getting into one, it’s a top-tier manual.

Click here to check out the Seven Principles for Making Marriage Work and secure what’s most important to you!

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  • Sesame & Peanut Tofu

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    Yesterday we learned how to elevate tofu from “nutrition” to “nutritious tasty snack” with our Basic Baked Tofu recipe; today we’re expanding on that, to take it from “nutritious tasty snack” to “very respectable meal”.

    You will need

    For the tofu:

    • The Basic Baked Tofu that we made yesterday (consider making this to be “step zero” of today’s recipe if you don’t already have a portion in the fridge)

    For the sauce:

    • ⅓ cup peanut butter, ideally with no added sugar or salt (if allergic to peanuts specifically, use almond butter; if allergic to nuts generally, use tahini)
    • ¼ bulb garlic, grated or crushed
    • 1 tbsp tamarind paste
    • 1½ tbsp tamari sauce (or low-sodium soy sauce, if a substitution is necessary)
    • 1 tbsp sambal oelek (or sriracha sauce, if a substitution is necessary)
    • 1 tsp ground coriander
    • 1 tsp ground black pepper
    • ½ tsp ground sweet cinnamon
    • ½ tsp MSG (or else omit; do not substitute with salt in this case unless you have a particular craving)
    • zest of 1 lime

    For the vegetables:

    • 14 oz broccolini / tenderstem broccoli, thick ends trimmed (failing that, any broccoli)
    • 6 oz shelled edamame
    • 1½ tsp toasted sesame oil

    For serving:

    • 4 cups cooked rice (we recommend our Tasty Versatile Rice recipe)
    • ½ cup raw cashews, soaked in hot water for at least 5 minutes and then drained (if allergic, substitute cooked chickpeas, rinsed and drained)
    • 1 tbsp toasted sesame seeds
    • 1 handful chopped cilantro, unless you have the “this tastes like soap” gene, in which case substitute chopped parsley

    Method

    (we suggest you read everything at least once before doing anything)

    1) Combine the sauce ingredients in a bowl and whisk well (or use a blender if you have one that’s comfortable with this relatively small quantity of ingredients). Taste it, and adjust the ingredient ratios if you’d like more saltiness, sweetness, sourness, spiciness, umami.

    2) Prepare a bowl with cold water and some ice. Steam the broccolini and edamame for about 3 minutes; as soon as they become tender, dump them into the ice bathe to halt the cooking process. Let them chill for a few minutes, then drain, dry, and toss in the sesame oil.

    3) Reheat the tofu if necessary (an air fryer is great for this), and then combine with half of the sauce in a bowl, tossing gently to coat well.

    4) Add a little extra water to the remaining sauce, enough to make it pourable, whisking to an even consistency.

    5) Assemble; do it per your preference, but we recommend the order: rice, vegetables, tofu, cashews, sauce, sesame seeds, herbs.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • How To Avoid UTIs

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    Psst… A Word To The Wise

    Urinary Tract Infections (UTIs) can strike at any age, but they get a lot more common as we get older:

    • About 10% of women over 65 have had one
    • About 30% of women over 85 have had one

    Source: Urinary tract infection in older adults

    Note: those figures are almost certainly very underreported, so the real figures are doubtlessly higher. However, we print them here as they’re still indicative of a disproportionate increase in risk over time.

    What about men?

    Men do get UTIs too, but at a much lower rate. The difference in average urethra length means that women are typically 30x more likely to get a UTI.

    However! If a man does get one, then assuming the average longer urethra, it will likely take much more treatment to fix:

    Case study: 26-Year-Old Man With Recurrent Urinary Tract Infections

    Risk factors you might want to know about

    While you may not be able to do much about your age or the length of your urethra, there are some risk factors that can be more useful to know:

    Catheterization

    You might logically think that having a catheter would be the equivalent of having a really long urethra, thus keeping you safe, but unfortunately, the opposite is true:

    Read more: Review of Catheter-Associated Urinary Tract Infections

    Untreated menopause

    Low estrogen levels can cause vaginal tissue to dry, making it easier for pathogens to grow.

    For more information on menopausal HRT, see:

    What You Should Have Been Told About Menopause Beforehand

    Sexual activity

    Most kinds of sexual activity carry a risk of bringing germs very close to the urethra. Without wishing to be too indelicate: anything that’s going there should be clean, so it’s a case for washing your hands/partner(s)/toys etc.

    For the latter, beyond soap and water, you might also consider investing in a UV sanitizer box ← This example has a 9” capacity; if you shop around though, be sure to check the size is sufficient!

    Kidney stones and other kidney diseases

    Anything that impedes the flow of urine can raise the risk of a UTI.

    See also: Keeping Your Kidneys Healthy (Especially After 60)

    Diabetes

    How much you can control this one will obviously depend on which type of diabetes you have, but diabetes of any type is an immunocompromizing condition. If you can, managing it as well as possible will help many aspects of your health, including this one.

    More on that:

    How To Prevent And Reverse Type 2 Diabetes

    Note: In the case of Type 1 Diabetes, the above advice will (alas) not help you to prevent or reverse it. However, reducing/avoiding insulin resistance is even more important in cases of T1D (because if your exogenous insulin stops working, you die), so the advice is good all the same.

    How do I know if I have a UTI?

    Routine screening isn’t really a thing, since the symptoms are usually quite self-evident. If it hurts/burns when you pee, the most likely reason is a UTI.

    Get it checked out; the test is a (non-invasive) urinalysis test. In other words, you’ll give a urine sample and they’ll test that.

    Anything else I can do to avoid it?

    Yes! We wrote previously about the benefits of cranberry supplementation, which was found even to rival antibiotics:

    ❝…recommend cranberry ingestion to decrease the incidence of urinary tract infections, particularly in individuals with recurrent urinary tract infections. This would also reduce the [need for] administration of antibiotics❞

    ~ Luís et al. (2017)

    Read more: Health Benefits Of Cranberries

    Take care!

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  • An unbroken night’s sleep is a myth. Here’s what good sleep looks like

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    What do you imagine a good night’s sleep to be?

    Often when people come into our sleep clinic seeking treatment, they share ideas about healthy sleep.

    Many think when their head hits the pillow, they should fall into a deep and restorative sleep, and emerge after about eight hours feeling refreshed. They’re in good company – many Australians hold the same belief.

    In reality, healthy sleep is cyclic across the night, as you move in and out of the different stages of sleep, often waking up several times. Some people remember one or more of these awakenings, others do not. Let’s consider what a healthy night’s sleep looks like.

    Bricolage/Shutterstock

    Sleep cycles are a roller-coaster

    As an adult, our sleep moves through different cycles and brief awakenings during the night. Sleep cycles last roughly 90 minutes each.

    We typically start the night with lighter sleep, before moving into deeper sleep stages, and rising again into rapid eye movement (REM) sleep – the stage of sleep often linked to vivid dreaming.

    If sleeping well, we get most of our deep sleep in the first half of the night, with REM sleep more common in the second half of the night.

    An older man sleeps peacefully in bed.
    Deepest sleep usually happens during the first half of the night. Verin/Shutterstock

    Adults usually move through five or six sleep cycles in a night, and it is entirely normal to wake up briefly at the end of each one. That means we might be waking up five times during the night. This can increase with older age and still be healthy. If you’re not remembering these awakenings that’s OK – they can be quite brief.

    What does getting a ‘good’ sleep actually mean?

    You’ll often hear that adults need between seven and nine hours of sleep per night. But good sleep is about more than the number of hours – it’s also about the quality.

    For most people, sleeping well means being able to fall asleep soon after getting into bed (within around 30 minutes), sleeping without waking up for long periods, and waking feeling rested and ready for the day.

    You shouldn’t be feeling excessively sleepy during the day, especially if you’re regularly getting at least seven hours of refreshing sleep a night (this is a rough rule of thumb).

    But are you noticing you’re feeling physically tired, needing to nap regularly and still not feeling refreshed? It may be worthwhile touching base with your general practitioner, as there a range of possible reasons.

    Common issues

    Sleep disorders are common. Up to 25% of adults have insomnia, a sleep disorder where it may be hard to fall or stay asleep, or you may wake earlier in the morning than you’d like.

    Rates of common sleep disorders such as insomnia and sleep apnoea – where your breathing can partially or completely stop many times during the night – also increase with age, affecting 20% of early adults and 40% of people in middle age. There are effective treatments, so asking for help is important.

    Beyond sleep disorders, our sleep can also be disrupted by chronic health conditions – such as pain – and by certain medications.

    There can also be other reasons we’re not sleeping well. Some of us are woken by children, pets or traffic noise during the night. These “forced awakenings” mean we may find it harder to get up in the morning, take longer to leave bed and feel less satisfied with our sleep. For some people, night awakenings may have no clear cause.

    A good way to tell if these awakenings are a problem for you is by thinking about how they affect you. When they cause feelings of frustration or worry, or are impacting how we feel and function during the day, it might be a sign to seek some help.

    Weary woman leans against a pole in an empty train carriage.
    If waking up in the night is interfering with your normal day-to-day activities, it may indicate a problem. BearFotos/Shutterstock

    We also may struggle to get up in the morning. This could be for a range of reasons, including not sleeping long enough, going to bed or waking up at irregular times – or even your own internal clock, which can influence the time your body prefers to sleep.

    If you’re regularly struggling to get up for work or family needs, it can be an indication you may need to seek help. Some of these factors can be explored with a sleep psychologist if they are causing concern.

    Can my smart watch help?

    It is important to remember sleep-tracking devices can vary in accuracy for looking at the different sleep stages. While they can give a rough estimate, they are not a perfect measure.

    In-laboratory polysomnography, or PSG, is the best standard measure to examine your sleep stages. A PSG examines breathing, oxygen saturation, brain waves and heart rate during sleep.

    Rather than closely examining nightly data (including sleep stages) from a sleep tracker, it may be more helpful to look at the patterns of your sleep (bed and wake times) over time.

    Understanding your sleep patterns may help identify and adjust behaviours that negatively impact your sleep, such as your bedtime routine and sleeping environment.

    And if you find viewing your sleep data is making you feel worried about your sleep, this may not be useful for you. Most importantly, if you are concerned it is important to discuss it with your GP who can refer you to the appropriate specialist sleep health provider.

    Amy Reynolds, Associate Professor in Clinical Sleep Health, Flinders University; Claire Dunbar, Research Associate, Sleep Health, Flinders University; Gorica Micic, Postdoctoral Research Fellow, Clinical Psychologist, Flinders University; Hannah Scott, Research Fellow in Sleep Health, Flinders University, and Nicole Lovato, Associate Professor, Adelaide Institute for Sleep Health, Flinders University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Vitamin Solution – by Dr. Romy Block & Dr. Arielle Levitan
  • Vision for Life, Revised Edition – by Dr. Meir Schneider

    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.

    The “ten steps” would be better called “ten exercises”, as they’re ten things that one can (and should) continue to do on an ongoing basis, rather than steps to progress through and then forget about.

    We can’t claim to have tested the ten exercises for improvement (this reviewer has excellent eyesight and merely hopes to maintain such as she gets older) but the rationale is compelling, and the public testimonials abundant.

    Dr. Schneider also talks about improving and correcting errors of refraction—in other words, doing the job of any corrective lenses you may currently be using. While he doesn’t claim miracles, it turns out there is a lot that can be done for common issues such as near-sightedness and far-sightedness, amongst others.

    There’s a large section on managing more chronic pathological eye conditions than this reviewer previously knew existed; in some cases it’s a matter of making sure things don’t get worse, but in many others, there’s a recurring of theme of “and here’s an exercise for correcting that”.

    The writing style is a little more “narrative prose” than we’d have liked, but the quality of the content more than makes up for any style preference issues.

    Bottom line: the human body is a highly adaptive organism, and sometimes it just needs a little help to correct itself. This book can help with that.

    Click here to check out Vision for Life, and take good care of yours!

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  • Crispy Tofu Pad Thai

    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.

    Easy to make, delicious to enjoy, and packed with phytonutrients, this dish is a great one to add to your repertoire:

    You will need

    • 10 oz ready-to-wok rice noodles, or 6 oz dry
    • 5 oz silken tofu
    • 5 oz firm or extra firm tofu, cut into small cubes
    • 1 oz arrowroot (or cornstarch if you don’t have arrowroot)
    • 4 scallions, sliced
    • ¼ bulb garlic, finely chopped
    • 1″ piece fresh ginger, grated
    • 1 red chili, chopped (multiply per your heat preferences)
    • 1 red bell pepper, deseeded and thinly sliced
    • 4 oz bok choi, thinly sliced
    • 4 oz mung bean sprouts
    • 1 tbsp tamari (or other, but tamari is traditional) soy sauce
    • 1 tbsp sweet chili sauce
    • Juice of ½ lime
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Avocado oil, or your preferred oil for stir-frying
    • To serve: lime wedges
    • Optional garnish: crushed roasted peanuts (if allergic, substitute sesame seeds; peanuts are simply traditional, that’s all)

    Method

    (we suggest you read everything at least once before doing anything)

    1) Scramble the silken tofu. For guidance and also additional seasoning pointers, see our Tasty Tofu Scramble recipe, but omit the thyme.

    2) Cook the noodles if necessary (i.e. if they are the dry type and need boiling, as opposed to “ready-to-wok” noodles that don’t), drain, and set aside.

    4) Prepare the tofu cubes: if the tofu cubes are dry to the touch, toss them gently in a little oil to coat. If they’re wet to the touch, no need. Dust the tofu cubes with the arrowroot and MSG/salt; you can do this in a bowl, tossing gently to distribute the coating evenly.

    4) Heat some oil in a wok over a high heat, and fry the tofu on each side until golden and crispy all over, and set aside.

    5) Stir-fry the scallions, garlic, ginger, chili, and bell pepper for about 2 minutes.

    6) Add the bean sprouts and bok choi, and keep stir-frying for another 2 minutes.

    7) Add everything that’s not already in the pan except the lime wedges and peanuts (i.e., add the things you set aside, plus the remaining as-yet-untouched ingredients) and stir-fry for a further 2 minutes.

    8) Serve hot, garnished with the crushed peanuts if using, and with the lime wedges on the side:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • With Only Gloves To Protect Them, Farmworkers Say They Tend Sick Cows Amid Bird Flu

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    GREELEY, Colo. — In early August, farmworkers gathered under a pavilion at a park here for a picnic to celebrate Farmworker Appreciation Day. One sign that this year was different from the others was the menu: Beef fajitas, tortillas, pico de gallo, chips, beans — but no chicken.

    Farms in Colorado had culled millions of chickens in recent months to stem the transmission of bird flu. Organizers filled out the spread with hot dogs.

    No matter the menu, some dairy workers at the event said they don’t exactly feel appreciated. They said they haven’t received any personal protective equipment beyond gloves to guard against the virus, even as they or colleagues have come down with conjunctivitis and flu-like symptoms that they fear to be bird flu.

    “They should give us something more,” one dairy worker from Larimer County said in Spanish. He spoke on the condition of anonymity out of fear he’d lose his job for speaking out. “What if something happens to us? They act as if nothing is wrong.”

    Agricultural health and safety experts have been trying to get the word out about how to protect against bird flu, including through bilingual videos on TikTok showing the proper way to gear up with respirators, eye protection, gloves, and coveralls. And Colorado’s health and agriculture departments have offered a free month’s supply of protective equipment to any producer who requests it.

    But so far, many farms aren’t taking them up on it: According to numbers provided by the state health department in late August, fewer than 13% of the state’s dairies had requested and received such PPE.

    The virus is known to infect mammals — from skunks, bears, and cows to people and house pets. It began showing up in dairy cattle in recent months, and Colorado has been in the thick of it. Ten of the 13 confirmed human cases in the U.S. this year have occurred in Colorado, where it continues to circulate among dairy cows. It isn’t a risk in cooked meat or pasteurized milk but is risky for those who come into contact with infected animals or raw milk.

    Weld County, where the farmworker event was held, is one of the nation’s top milk producers, supplying enough milk each month this year to fill about 45 Olympic-size swimming pools, according to U.S. Department of Agriculture data. Neighboring counties are notable producers, too.

    Concerns are growing about undiagnosed illness among farmworkers because of a lack of testing and safety precautions. One reason for concern: Bird flu and seasonal flu are capable of gene trading, so if they ended up in the same body at the same time, bird flu might end up with genes that boost its contagiousness. The virus doesn’t appear to be spreading easily between people yet. That could change, and if people aren’t being tested then health officials may be slow to notice.

    Strains of seasonal flu already kill some 47,000 people in the U.S. a year. Public health officials fear the havoc a new form of the flu could wreak if it spreads among people.

    The Centers for Disease Control and Prevention recommends that dairy workers don a respirator and goggles or a face shield, among other protections, whether they are working with sick animals or not.

    A recent study found that not all infected cows show symptoms, so workers could be interacting with contagious animals without realizing it. Even when it is known that animals are infected, farmworkers often still have to get in close contact with them, sometimes under grueling conditions, such as during a recent heat wave when Colorado poultry workers collected hundreds of chickens by hand for culling because of the outbreak. At least six of the workers became infected with bird flu.

    One dairy worker in Weld County, who spoke on the condition of anonymity for fear of losing his job, said his employer has not offered any protective equipment beyond gloves, even though he works with sick cows and raw milk.

    His bosses asked the workers to separate sick cows from the others after some cows produced less milk, lost weight, and showed signs of weakness, he said. But the employer didn’t say anything about the bird flu, he said, or suggest they take any precautions for their own safety.

    He said he bought protective goggles for himself at Walmart when his eyes became itchy and red earlier this summer. He recalled experiencing dizziness, headaches, and low appetite around the same time. But he self-medicated and pushed through, without missing work or going to a doctor.

    “We need to protect ourselves because you never know,” he said in Spanish. “I tell my wife and son that the cows are sick, and she tells me to leave, but it will be the same wherever I go.”

    He said he’d heard that his employers were unsympathetic when a colleague approached them about feeling ill. He’d even seen someone affiliated with management remove a flyer about how people can protect themselves from the bird flu and throw it in a bin.

    The dairy worker in neighboring Larimer County said he, too, has had just gloves as protection, even when he has worked with sick animals — close enough for saliva to wipe off on him. He started working with them when a colleague missed work because of his flu-like symptoms: fever, headache, and red eyes.

    “I only wear latex gloves,” he said. “And I see that those who work with the cows that are sick also only wear gloves.”

    He said he doesn’t have time to wash his hands at work but puts on hand sanitizer before going home and takes a shower once he arrives. He has not had symptoms of infection.

    Such accounts from dairy workers echo those from farmworkers in Texas, as reported by KFF Health News in July.

    “Employers who are being proactive and providing PPE seem to be in the minority in most states,” said Bethany Boggess Alcauter with the National Center for Farmworker Health, a not-for-profit organization based in Texas that advocates for improving the health of farmworkers and their families. “Farmworkers are getting very little information.”

    But Zach Riley, CEO of the Colorado Livestock Association, said he thinks such scenarios are the exception, not the rule.

    “You would be hard-pressed to find a dairy operation that isn’t providing that PPE,” he said. Riley said dairies typically have a stockpile of PPE ready to go for situations like this and that, if they don’t, it’s easily accessed through the state. “All you have to do is ask.”

    Producers are highly motivated to keep infections down, he said, because “milk is their life source.” He said he has heard from some producers that “their family members who work on the farm are doing 18-to 20-hour days just to try to stay ahead of it, so that they’re the first line between everything, to protect their employees.”

    Colorado’s health department is advertising a hotline that ill dairy workers can call for help getting a flu test and medicine.

    Project Protect Food Systems Workers, an organization that emerged early in the covid-19 pandemic to promote farmworker health across Colorado, is distributing PPE it received from the state so promotoras — health workers who are part of the community they serve — can distribute masks and other protections directly to workers if employers aren’t giving them out.

    Promotora Tomasa Rodriguez said workers “see it as another virus, another covid, but it is because they don’t have enough information.”

    She has been passing out flyers about symptoms and protective measures, but she can’t access many dairies. “And in some instances,” she said, “a lot of these workers don’t know how to read, so the flyers are not reaching them, and then the employers are not doing any kind of talks or trainings.”

    The CDC’s Nirav Shah said during an Aug. 13 call with journalists that awareness about bird flu among dairy workers isn’t as high as officials would like it to be, despite months of campaigns on social media and the radio.

    “There’s a road ahead of us that we still need to go down to get awareness on par with, say, what it might be in the poultry world,” he said. “We’re using every single messenger that we can.”

    KFF Health News correspondents Vanessa G. Sánchez and Amy Maxmen contributed to this report.

    Healthbeat is a nonprofit newsroom covering public health published by Civic News Company and KFF Health News. Sign up for its newsletters here.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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