September 11, 2005

A Small Hospital Takes on a Big Job

Tim Bush, RN, is Administrative Supervisor, St. Elizabeth Hospital, Gonzales, Louisiana.

I can't begin to document the events of the days after hurricane Katrina made land fall in southeast Louisiana. I was reminded of recent medical mission trips to impoverished countries abroad, mainly because of the enormous need and the same unselfish acts I witnessed by those working beside me.

St. Elizabeth Hospital is  a small hospital just west of New Orleans, with an average inpatient census of 35. On Tuesday morning after the hurricane we were the closest fully functional hospital outside the city. We began receiving patients almost immediately. An ER that usually sees about 1600 patients a month saw over a 1000 in a few days! Our inpatient census more than doubled

Several adjustments were made in an effort to accommodate the influx. Triage stations were set up in our auditorium and PACU and clinical and nonclinical team members were used where ever there was a need.

Challenge

I was thinking about my life the other day, which I often do and about my observations of others.

I realized that I don't have any challenges in my life, compared to a lot of other people. By that I mean, my life is going along smoothly and the things I want pretty much come to me.

I was thinking "that's a good thing, not to have to work so hard for what I want."

But then another thought popped into my head :"Yeah but your life is boring. You don't have any challenges, that feeling of intense satisfaction you get when you have to give all you have to overcome a huge obstacle. There isn't anything better than that."

I started to think about overcoming obstacles and the satisfaction associated with it.

Then I realized, a challenge is just resistance to what you want. An obstacle is something you put there, in order to have a challenge. If you weren't resisting what you wanted, it wouldn't feel like an obstacle and there would be no challenge!

I started to think about that great feeling you get when you overcome the obstacle and demonstrate success. That feeling is just the lowering of the resistance you put up in the first place! I then realized, again, that you're your own worst enemy and your best friend.

I realized for the umpty-umph time that I create everything in my life.

Here's an example: 

Say you wanted to start a new business. You've never been self-employed before, so it seems daunting at first. There are 2 ways you can approach it:

• you can envision your new enterprise as something that will require a tremendous amount of work
• or something that will naturally fly right.

If you approach the venture with the attitude of hard work, you're already resisting all of the people, money and things which would come to you, through the universal property of 'like attracts like.'

The more you work on your business with this attitude, the harder it gets. Now you're facing challenges every day, probably experiencing anxiety, worry and some upset along the way. But you persevere and eventually get it done. Now you're happy.

Or, you could approach the new business with a detailed vision, a vision in which you're expending very little effort and the resources you need come to you easily. The more you work on your business with this attitude, the more the universe matches you up with the people, money and things which you need in order to be successful.

The powerful universal property of 'like attracts like' immediately goes to work for you, just as it did in the previous example. But now, there's very little worry, anxiety and upset. Things just fall into place for you with relative ease.

The business starts slowly but becomes very successful. In both cases, a business was created.

But in the first case, there were a large number of obstacles to overcome. You gutted it out, successfully overcame all of the challenges. Now, you talk to your buddies and they all say "great work! You really stepped up and battled hard. Now, you can enjoy your reward."  You feel good about yourself.

In the second case there were almost no challenges. Obstacles, yes, but these didn't appear to you as something to worry about. You felt good almost all the time and when you're done, you feel even better.

Now I ask you 2 questions:

Which scenario would you rather experience? And secondly,
Which business do you think will be easier to run and be ultimately more successful?

If you're like me, I'll take the 2nd experience. I'll leave the worrying, the anxieties and the upset to the other guys. It would seem to me that the guy who was in a good feeling place the whole time will have a more successful business, because  you can't get to a happy place by treading a path feeling rotten most of the time.

The law of 'like attracts like' will bring you more of the same, so you will likely experience a lot of difficulties operating your business, if you're a 'overcome challenges' kind of person

Lets analyze what happened.

The 2nd guy didn't have a lot of resistance to his goal. He did his homework and got together a really good business plan, one he was really excited and confident about. The he just went about executing that plan without a lot of worry about it.

Mostly he just had fun along the way.

The first guy also had a great business plan, but he worried a lot that maybe the economy would go into a recession. He wondered whether he'd be able to get good employees. He had doubts about his own ability to get it done. But he went ahead into action anyway, figuring he would 'accept the challenge.'

And that's exactly the experience he got!

The second guy had his energies almost completely aligned to his goal before he started. The first guy went into action before he had felt comfortable about his new goal.

All challenge is self-imposed. Obstacles & challenges come about from not completely aligning your energy to what you want before you start!

Of course, this example would be a little different if the goal were strictly a physical activity. Say you were a rock climber & you decided to go free-climbing that 500 foot mesa. Now you definitely are going to experience a little anxiety!!!

But the principle is the same.

If you approach your task with the idea that it'll be almost impossible & that you might get killed, I guarantee you will have a series of near-death experiences on the way up!

But if you're really clear on your vision of the climb, you'll probably take extra practice, working on your holds & your technique.

You won't attempt the climb until you feel excited about it, for when you have that excited feeling, that's the sign you're letting the life force energy flow freely thru you in regard to it. A feeling of anxiety is a blocking of that life force energy.

The better you feel about the climb, the easier it'll be, again by the property of 'like attracts like.'

If you feel good about the climb, you'll naturally gravitate to those areas where the holds are optimum, where the rock is solid & where there are a minimum of difficult passages.

If you're anxious about the climb, you'll be attracted to those areas where the holds are difficult, the rock is loose and you'll experience some difficult passages.

The first guy gets off the mesa & practically collapses. The second guy gets off the rock and is still excited. He is really tired, had some difficulties, but feels exhilarated at his experience.

The first guy goes to his buddies, after a week of recovery and starts bragging to them all what a monster he is. He tells them all about the time he almost fell off and all the rest. They look at him in awe.  

The 2nd guy goes to his friends and he tells them how much fun he had. He tells them about his anxious moments, but he describes how good the rock is, how the climb can be successfully negotiated. He shows them the route he took.

The 1st guy's buddies are scared to death to attempt the climb. They look at him like a minor deity.

The 2nd guy's buddies are all excited to try it for themselves. The energy of the whole group is really high and they all decide to climb it together with the 2nd guy leading the way.

The 1st guy overcame big-time challenges. The 2nd guy did as well, but his climb was marked by an excitement that comes from a lack of resistance to the goal.

Challenge is mostly self-imposed, regardless of the activity. Anything that can be done with resistance, can be done easier with a lack of resistance. And with a lot more fun as well! 

Those who're aware often fail to recognize the extent of a woman's distress, or make comments that seem to minimize the experience, such as, "You'll have another," or "It wasn't meant to be."

In the support groups I conduct for women who have experienced a miscarriage, the following are some of the questions asked most frequently.

How common is miscarriage and what causes it?

Currently, 15 to 20% of known pregnancies end in miscarriage. The percentage is likely to be even higher in the future, for at least 2 reasons.

1st, pregnancies are being detected earlier and as a consequence, couples are becoming aware of unviable pregnancies that they might not have known about in the past.

2nd, women are postponing childbearing to a later age, when miscarriages are more frequent. The rate of miscarriage roughly doubles from age 20 to 30 and then doubles again from the early to late 30's.

More than 80% of miscarriages occur during the first trimester with  75% of these occurring before the 8th week.

A miscarriage is caused most frequently by:

• problems in the fetus, usually chromosomal abnormalities 
• problems in the maternal environment
  • uterine and placental problems
  • progesterone deficiency 
  • less commonly, infections and systemic disease

Exercising, having sex, or lifting heavy objects don't cause a miscarriage. A fall or a blow is also unlikely to cause a miscarriage unless it was life threatening. No reliable evidence exists to show that emotional distress causes a miscarriage.

Why do I feel such an intense sense of loss when I never even saw my baby?

Most women form an emotional attachment with their developing baby very early on. By about the 10th week of pregnancy, it's usual to have a distinct and definable mental image of the baby and detailed daydreams of his or her arrival.

Procedures such as sonograms and amniocentesis greatly facilitate the formation of these mental images and the pictures produced by these procedures tend to be the images most frequently imagined after the loss has occurred.

Is what I'm feeling normal?
Immediately following the loss, most women experience a great deal of emotional distress. It's usual to feel a profound sense of:

• grief
• guilt
• anxiety
• a depressed mood

For the majority of women, these feelings peak and begin to lessen between the 4th and 6th week after the miscarriage and are almost fully gone by the 3rd or 4th month.

A minor but still sizable group of women, however, continue to be distressed for a much longer period of time. The likelihood of having a prolonged period of distress increases the more the following conditions apply:

• the pregnancy had been planned for a long time 

• very high expectations were attached to the birth of the baby

• a long time and/or much effort (e.g. infertility treatments) were needed to conceive

• guilt over prior abortions is present 

• the miscarriage occurred relatively late in the pregnancy

• there's a history of prior losses 

• social support is lacking

• an unhappy relationship exists between the partners to the pregnancy 

• there's a history of poor coping, especially prior periods of depression

A sense of not being oneself or of being in shock is often experienced at the time of the miscarriage. This feeling may be an attempt to adapt by "stepping out of time" until it's tolerable to "catch up" to the distressing reality of being pregnant one day and not pregnant the next.

As the shock fades, there tends to be a preoccupation with thoughts about the lost pregnancy and feelings of self-blame and anger are common. The anger is often especially strong towards health providers for failing to prevent the loss.

Typically, there's also a strong desire to find a reason for what's happened, along with a belief that the miscarriage is unfair. Probably as a result of this sense of unfairness, feelings of envy are frequently felt toward pregnant women and mothers of infants.

With the passage of time, sad feelings often begin to be replaced by anxious feelings, as concerns about conception and the ability to bring a baby to term tend to become central.

Why does my husband seem to feel so differently about the miscarriage than I do? Are these differences likely to harm my marriage? While fathers are likely to be strongly affected by a miscarriage, they tend to experience a less intense and prolonged grief reaction than mothers.

A mother's distress is usually independent of the gestational age of the fetus, whereas the intensity of the father's distress seems to depend a great deal on the length of the pregnancy.

A father's reaction also seems to depend on the degree of attachment he feels toward his partner and the opportunities he has had to experience the pregnancy as a reality. i.e., a father is more likely to be distressed if he's seen the fetus during a sonogram and has felt fetal movement.

In general, after the miscarriage, fathers cry, talk about the loss and get depressed to a lesser degree than their partners and are usually able to return to their normal routines more quickly.

As a result, a father sometimes questions why his partner continues to grieve for so long and with such intensity. When this incongruity occurs, the marriage can become strained; the woman may feel that her partner isn't sufficiently caring, while the man may feel that his partner is overreacting and failing to appreciate what he does feel.

Conflict, however, is avoidable for most couples. In fact, a fairly large percentage of couples report feeling even closer after the miscarriage than they felt before.

How will the miscarriage affect my other children and my own parents?

Children under the age of 5 or 6 don't usually understand that death is a final and irreversible event. Therefore, the reaction of children before this age is primarily determined by how they see others react, especially their mother.

For older children, common reactions include confusion in the face of their parents' distressed behavior, anger and disappointment that the expected brother or sister will not be coming & feelings of self-blame, as if something they did or thought may have caused the miscarriage.

Self-blame and guilt are especially likely if there was resentment about the arrival of the new brother or sister. Finally, there may be feelings of anxiety about the possibility that more bad things might happen, particularly to a parent.

As a result, children tend to have more trouble separating from parents after a miscarriage.

Grandparents also are often profoundly affected by the loss of their "baby's baby." They tend to worry about the well-being of their own child and to feel upset at the loss of the times they anticipated with their expected grandchild.

In addition, in the case of a wished-for male child, they may also feel upset over the lost opportunity for the continuation of the family name.

What can I do to feel better?

It's helpful to try to get the clearest and most complete answers possible to 2 questions:

(1) Why did the miscarriage happen?

And

(2) Will it happen again?

The obstetrician is usually the best person to ask these questions. While he or she may not be able to provide clear-cut answers, it's important to request sufficient time for the consultation to hear the explanations that can be offered and to express the strong feelings and worries associated with these concerns.

Grieving tends to be facilitated when the loss is made as tangible as possible. Thus seeing evidence of the baby's death, such as fetal material, helps concretize the loss, as does naming the baby. Rituals are also helpful in allowing the grief to be expressed.

A candle can be lit, a tree planted, a letter or poem written that puts into words the love, hopes and dreams that were held for the baby. Written statements have 2 additional benefits.

They help couples share their thoughts and feelings and they establish a permanent record of the couple's connection to their lost child.

i.e., the couple can write a letter using the following format: "Dear (name used to refer to the fetus and/or planned name), We're writing to tell you the hopes and dreams that we had for you. We were never able to tell you that..."

Learning about what other people experience after a miscarriage, by reading articles or attending talks, also tends to lessen distress.

Such experiences help validate the normality of what's being felt and allow the individual to anticipate what lies ahead. Preparation is especially helpful in dealing with the undoing of the changes that were made in the house or the purchases made in anticipation of the baby's arrival.

Preparation is also helpful in handling encounters with people who don't know about the loss as well as those who do and who're likely to ask disturbing questions.

The couple can discuss what they picture when they anticipate the circumstance they believe will be stressful, how they imagine they'll feel at this time, what they see as the possible ways of responding and the choice that they feel is best for them.

It's been more than a month since my miscarriage & I still feel awful. What should I do?

A support group of other women who have experienced a similar loss may be helpful. In such a setting, people usually benefit from feeling understood by others; they have an opportunity to acknowledge and express their feelings and can learn how others cope.

Most obstetric practices maintain a list of such groups that are held in the community.

Assistance may also be obtained from a mental health professional who has experience in the area of pregnancy loss. As part of such a consultation, the implications of the loss for the individual are examined, as are any irrational beliefs that may be present, i.e., that the miscarriage is a punishment for some prior, guilt-producing event.

In addition, other sources of stress that may be affecting the individual's reaction to the miscarriage are identified and the adequacy of the person's support system is looked at. Advice is then usually provided to deal with any problems that have been noted, followed by a 3 month follow-up appointment to see if there's sufficient improvement or the need for additional help.

If a woman remains distressed for more than 2 months from the time of the loss, to the point where the demands of everyday life can't be met, a mental health evaluation is necessary.

The clinician will note the emotional difficulties that are present, review past problems with coping and (usually in partnership with the person and someone they choose from their support system ) establish & carry out a treatment plan.

It's important to remember that the majority of woman who try to conceive after a miscarriage go on to have normal pregnancies and deliver healthy babies and that the distress and difficulties in coping experienced after a miscarriage tend to be relatively time-limited.

Thus, while feelings of sadness and anxiety, accompanied by a strong sense of loss, are usual, these feelings ease appreciably in a relatively short period of time.

Norman Brier, PhD, is a psychologist with a special interest in pregnancy loss. He has a private practice in Bedford, NY & is a Clinical Professor of Pediatrics & Psychiatry at Albert Einstein College of Medicine

The Emotional Challenges of Interfaith Marriage

There's a rapid rate of intermarriage among people of different faiths in the US. Estimates are that 50% of Jewish men and women intermarry.

Several articles about the Catholic Church have pointed out that many young people have left the Church and have intermarried. These facts are indicative of the high degree of assimilation and tolerance that is practiced in this country.

In addition, this is taken as evidence of the declining role of faith and religious identity in the minds of many young Americans.

Surveys, in fact, show that many don't identify themselves with any religion.

Interfaith marriage usually occurs between one person who's Jewish and another who's Christian. However, there are increasing numbers of young Catholics and Protestants intermarrying.

Generally, this is viewed as less difficult for the young couple because of a commonly shared theology and culture. Nevertheless, even among Christian sects, interfaith marriage poses serious problems and creates crises for the couple and their respective families.

Separation and Guilt

According to Judith Wallerstein, author of The Good Marriage: How & Why Love Lasts (Warner Books, 1996), for a marriage to succeed, the young couple must psychologically and emotionally separate from their families of childhood.

If the in-laws are against intermarriage, the stage is set for conflict, bitterness and misunderstanding, with damaging and long-lasting consequences for these relationships.

Also, such hostility can provoke enormous guilt for the young bride or groom. This guilt makes the task of emotional separation more difficult to achieve.

Perhaps the greatest task of all is coping with feelings of guilt about having left the fold and defied the family. Until recently, there was little help for those who wanted to marry someone from another religion.

Many such people agonized over the fact that they were leaving their religious heritage. Many priests, rabbis and ministers who were alarmed at the number of people who appeared to be abandoning the Church and the synagogue reinforced that guilt

For Jews in particular, there's the guilt of contributing to the possible demise of their religion through the process of assimilation and intermarriage. Intermarriage confronts the Jew with the specter of the Holocaust and the memory of German Jews who believed they were assimilated until Hitler reminded them that they were Jews and not Germans.

Here, too, members of the community accuse the person who is about to intermarry of being a Jewish anti-Semite, believing that the reason for the marriage is to escape a Jewish identity. They also blame this individual for contributing to the future disappearance of the Jewish people through intermarriage.

Faith, Conversion & Religious Identity

The Christian partner doesn't fare much better. For this person, there can be the problem of coping with latent prejudice, which spills over when the family is faced with this new reality. Then, too, there's the matter of faith.

Religious families decry the abandonment of the Catholic or Protestant way & fear for the soul of the individual who's departing from “the one true road to salvation.”

Many families resist the idea of a clergyman from another religion presiding over the wedding ceremony. If it's a Christian / Jewish marriage, they resent the possibility that no mention will be made of Christ.

The Church has, in fact, become more tolerant of priests presiding over interfaith weddings, even if the non-Catholic doesn't convert. However, this tolerance may not allay the fears of religious family members.

All of this becomes even more difficult if one of the families refuses to attend the wedding due to religious differences & disapproval of the match. If the couple tries to appease the resistant family by agreeing to conversion, the other family may become so angry that they'll refuse to attend.

In some cases, if the couple refuses a religious ceremony of any kind, neither family may attend.

It's generally easier for a couple if one or both partners don't possess strong religious convictions or if one partner is willing to convert. Under those circumstances, the areas of conflict are reduced because the family & religious leaders of the religion to which the individual is converting more easily welcome the one who is converting.

Questions of who is to preside over the wedding ceremony & how the children will be raised are automatically resolved.

The one possible exception to a harmonious resolution in these instances is the reaction of the family whose member is leaving the fold to join another religion.

In a family where there's no real religious conviction, the problem disappears. In a family committed to their religious heritage & practice, the reality of a member leaving the fold can be traumatizing. It can result in all ties being severed.

i.e., a practicing Orthodox Jewish family will find the notion of intermarriage impossible to accept. In addition, Orthodox & Conservative rabbis will not preside over interfaith marriages.

Similar problems can occur with Catholic & Protestant clergy.

Many young people reject the idea that they must have a religious identity at all. Consequently, they're not interested in traditional marriage ceremonies.

This lack of interest is reflected in the fact that they refuse to have clergy from any religion presiding over their weddings. Family members are often angered by this rejection of religion.

Nevertheless, the fact that the couple has a shared value system makes it easier for them to cope than for those who come from very diverse backgrounds with different value systems.

Building Intimacy

There's no more important task in marriage than the achievement of a deep level of intimacy & commitment between the marital partners.

According to the Random House Dictionary, the word intimacy refers to the state of two people being close, familiar, affectionate & loving.

It reflects a deep understanding & love for the other, with feelings of passion.

While sharing one religious tradition in marriage doesn't guarantee success in this endeavor (as the divorce statistics indicate), it at least increases the likelihood that 2 people have a certain mutual understanding because they share a common ethnic &/or religious background.

With intermarriage, the task of achieving intimacy is all the more daunting, since there's so much that is taken for granted when a person grows up in a particular type of home or community.

There are all the non-verbal gestures & facial expressions, the idiomatic sayings & the types of foods & holiday celebrations that characterize a particular cultural experience.

There are also the symbols of the different faiths, such as the Cross & the Star of David, which often evoke powerful emotional responses in people.

All of these things, which people of one faith & cultural background can understand & identify within one another, help to build intimacy. When 2 people from different backgrounds & faiths come together, there is less common ground.

The opportunities for misunderstanding, confusion & hurt feelings are plentiful.

After the Wedding

New challenges emerge when the wedding is over & the couple faces life as husband & wife. A crisis can erupt w/the birth of the first child if the couple hasn't come to some decisions about child rearing, education & religion.

People who marry within their faith usually make assumptions about these things based on how they were raised & on a commonality of experiences.

Jewish couples assume that male children will be circumcised. Christian couples assume that all their children will be baptized. When the young parents come from different religions, none of these assumptions can be made.

In a Jewish / Christian marriage, a common stumbling block can occur at Christmas. The Christian partner may want to place a tree in the house to celebrate the holiday. The Jewish spouse may object to the tree.

Something that seems natural to one partner appears foreign to the other. This is the kind of problem that is easily avoided before marriage but must be confronted sometime afterwards.

Embracing Both Religions

One solution, which works for some couples, is to follow the rituals & holiday celebrations of both religions. Among these families, children attend church & synagogue services. They learn about the heritage of both of their parents & can decide for themselves, when they're adults, which faith they prefer to follow.

There have been a number of commentators who have stated that the mental health & well-being of children depend upon their having a clear religious & ethnic identity.

In addition, the practice of religion has been found to help children avoid the influences of drugs, alcohol & adolescent sexual relations.

The point that is missed by these commentators is that it's less the presence of a single religious identity in the home & more the parental style of discipline & involvement with the children & with each other that produces well-adjusted children.

Research shows that children whose parents were firm, consistent, involved & affectionate did best in school & in their relationships later in life. In other words, the particular religious affiliation of one or both parents is less important to good adjustment than the fact that the parents love & support their children.

Help For Those Who Need It

Interfaith marriages can & do succeed. Many couples, however, experience significant & lasting benefits from professional support & counseling both before & during marriage. Fortunately, help is now available from many sources in the mental health & the religious communities to assist young couples facing the emotional challenges of an interfaith marriage.

This is a guidebook, an instruction manual & a source of inspiration whenever you get discouraged. You can't pick up this book & not find something you can use. And while it may not seem sexy, if you consistently follow its suggestions, it'll do more for your sex life than any sex manual you can buy.

The ideas in this book come straight from our own experience - both personally & professionally. We've been married for 41 years & have spent the past 20 working with hundreds of other couples on their relationship issues.

These experiences have brought us a new clarity about what's important in making love last. But you don't have to take our word for it; you can verify the ideas in this book from your own experience.

You'll see that this stuff isn't "pie in the sky." It's very basic & solid. And since it grew directly out of our own struggles to make love stay, it's based on reality. We faced most of the problems that any couple faces. We didn't have insight into how to avoid them (or how to deal with them if we couldn't avoid them), but we survived & we learned from our experiences.

Inspiring You to Take Charge of Your Love

Falling in love is easy, but staying in love is quite another matter. Apparently it's one of the most difficult things any of us ever attempts. Because of the high divorce rate & the large percentage of remaining marriages in which couples don't have a vital love relationship, you may have come to believe it's inevitable that love will fade with time. Or perhaps you've already experienced the discouragement of seeing the love you once shared somehow slip away.

When we married at age 19 we had no real concept of what was involved in making love stay. We believed our love was so special that it could withstand anything. We had the typical tendency to take our relationship for granted & "forget" all the things we really knew were important to keep our love strong. Thru the years we confronted many of the standard problems that can drive a wedge between a couple if they aren't paying attention.

i.e., early in our marriage we found ourselves involved in one of the most common problems of all - losing touch with each other because of so much focus on career & children. We didn't lose touch just because we were focusing in different areas; it was because we didn't maintain the bridge between those 2 areas (& between ourselves) by talking straight to each other about how we felt about the situation.

We just went along, thinking this was the way things had to be. We didn't realize that you don't have to change "how it is;" you only have to change "how you deal with it."

Unfortunately, we simply didn't deal with it. So we started down a path of distance & isolation from each other & lost that special  connection on a deep level that's critical to making love stay.

The weakening of our basic connection made us vulnerable to all kinds of other problems that can create difficulty in long-term relationships. One of the most common is simply the familiarity that comes from being together over the years. We started taking each other for granted - seeing each other primarily in terms of our roles as "husband" & "wife" instead of who we were as individuals.

This shift in our thinking was gradual (we didn't even realize it was happening) but we fell into stereotyping each other as one of "them," with all the negative baggage that carries with it. This included a lot of "ain't it awful" kind of thinking & talking about each other.

"Men are so distant, so preoccupied with their own interests, so insensitive, so uncommunicative..." And on the other side, "women are so emotional, so smothering, so demanding, so talkative..."

Naturally, each of us thought we were right in our assessment of what was wrong with the other one. And commiserating with others only served to reinforce these stereotypical ways of reacting to each other.

Slowly, but surely, we joined the masses who view the opposite sex not as individuals, but as members of a mysterious group that you don't understand & can't change, so you just have to tolerate. This attitude further increased the distance between us & decreased the strength of the loving aspect of our relationship.

These standard problems became like a cancer, slowly robbing us of the closeness we had originally felt. It wasn't that our love was gone; it's just that it was getting buried under the sense of isolation & distance created by the mounting pressure of fulfilling our roles while losing ourselves.

What finally got our attention was a crisis - dealing with the issue of extramarital affairs. It shook us to the core & forced us to learn, or relearn, a lot of the basic principles we'd forgotten. We'd thought we were good communicators because we did talk.

We'd never fallen into the trap of using the "silent treatment" to deal with differences, but it was only when we were confronted with a situation that required some really deep talk that we began to learn to communicate effectively.

Understanding how & why we'd gotten to that point, working thru the hurt & rebuilding trust gave us a new appreciation of the healing power of honest communication. Since that point - almost 20 years ago - we've consistently tried to implement the ideas & suggestions we're now offering to you.

We know these ideas work because our love & trust are now deeper & stronger than ever - solidly based on a shared, ongoing commitment to honesty & fairness.

We're not holding ourselves up as a perfect couple. On the contrary, we fully expect to continue the process of learning & working on our relationship. We still have high expectations of love, but they're based on experience & realistic possibilities rather than magical thinking.

We invite you to use our understandings & insights, not as the final answers to your problems but as a means of helping you find your own answers. You have the power to make your love last & this book can help you do it.

Of course, the title of this book is misleading if you take it literally; you can't arbitrarily & unilaterally make love do anything. On the other hand, love doesn't come & go capriciously. This book is about the understandings you can reach & the specific things you can do that will make all the difference in the world in whether or not your love will stay.

Understanding Love & its Place in Your Life

Throughout the book we'll be giving you all kinds of specific actions to help make your love stay - but you really need a clear understanding of some basic ideas before you start.

The first of these understandings is to recognize what's at stake. We're not talking about some little fringe issue in your life here. When all is said & done, having a long-term, loving relationship ranks toward the top of the list of the best of what life has to offer.

This book is different from most others in that it respects love's significance. We're presenting a way of looking at your love relationship in the context of your life as a whole.

Our goal is to help you achieve a love that provides a solid place to stand in the world. Your love can be the kind of positive force in your life that lets you go out & face the world on a completely different basis than you could do otherwise.

In focusing on this goal, we're trying to avoid the pitfalls of the "romantic" approach to making love stay. We're elevating the meaning of a loving relationship beyond just achieving temporary pleasure. Part of our motivation for writing this book came from our growing frustration with the popular advice that's based on this short-sighted, superficial approach to sustaining (or reviving) love.

This is a book of substance for people who want the most from what love has to offer. It's simple without being simplistic & it's serious without being stuffy. We're suggesting a wide range of interconnected actions that are based on a deeper understanding of the nature of lasting love.

The Changing Nature of Love

The first step in making love stay is to understand that lasting love isn't the same as the exciting, heady feelings of "falling in love." Love changes; it never remains the same & trying to keep it from changing is sure to snuff it out.

Let's follow the course of the changes in the way you're likely to experience love. First, you fall in love. What a wonderful feeling! It's intoxicating & all-consuming. You can't think of anything else & you can't keep your hands off each other. (Personally, we still refer to the beginning of our own relationship at age 17 as our period of "young, hot love"—but, of course, these feelings aren't restricted to young people; they're typical of any new love at any age.)

Falling in love, or "new love," produces some of the most intense feelings you'll ever experience. At its best, it seems too good to be real. It's real, but it won't last - at least, not in that form. Enjoy new love for the fantastic experience that it is, but recognize that much of the intensity of the feeling is inherent in its newness & novelty.

You may wish these feelings would never end & you may go to all kinds of lengths to sustain them or to rekindle them when you feel them changing. But the popular tricks & gimmicks for maintaining that particular kind of excitement are doomed to fail.

While romantic touches are wonderful for stimulating exciting love-making & adding spice to your relationship, they aren't sufficient by themselves to build a lasting love. They may give your relationship a temporary shot in the arm, but it will quickly fade & you'll be right back where you started. This superficial approach just won't work over the long haul.

If the romantic fix doesn't work, you may wonder why there are so many books & so much advice about how to recapture the first flush of love & put the zing back in your marriage. Well, it's really not too hard to figure out. In a couple of key ways, that kind of advice about love is a lot like the books & advice about crash diets - based on the fantasy that there's a quick & easy way to do it.

Just like you can quickly lose some weight with a crash diet, you can quickly create a spark in your relationship with a sexy gimmick. Just as it's much easier to go on a specified diet for a specified period of time than to change your overall eating habits for life, it's also easier to pursue some specific sexual encounters than to change your overall ways of relating for life.

But in both cases, this approach doesn't last. With the diet, you wind up regaining the weight & feeling even worse than before. And with your relationship, the temporary surge of feelings inevitably fades & things settle back to the way they were before (or worse) & you wind up feeling even more discouraged than ever.

Every failed attempt at dieting or failed attempt at reviving the feelings of "new love" leaves you feeling hopeless that anything will really work. At some point, you need to say NO to this up & down yo-yo & get serious about making real change. If you finally feel like saying, "I'm mad as hell & I'm not going to take it anymore," then you're ready for this book & its solid, long-term approach to making love stay.

Letting Go of Myths

Myth: Love never changes.

Unfortunately, you sabotage your chances for lasting love if you think that the feelings associated with "falling in love" are the ultimate in loving. Romantic love is just the first stage of love & it either evolves into a deeper, richer love or it withers.

Rejecting this myth is the only way to move beyond the initial stage of love to achieve the richness that's possible in a loving relationship. To make love stay, you must face your fear of losing it & consciously support the transition from new love to lasting love.

Lasting love isn't a less desirable state; it's just different. It has its own unique form of intensity & excitement, both of which emerge from a deeper knowing of yourself & your partner. Eventually, in the best relationships, lasting love is based on the pleasure of full openness to another person - without anxiety, uncertainty or fear. It surrounds you with a feeling that is both calming & deeply satisfying. In fact, it touches you at your very center & gives you a special sense of the worth of life itself.

Myth: Love conquers all.

You need to reject this myth because it takes a lot more than loving feelings to deal with the problems inherent in building a life together. Depending on love to sustain your relationship misses a crucial point. Life isn't one beautiful sunset after another. Life includes some beautiful sunsets, some gray days & some full-blown storms. You need a more solid basis for your love, one that gives you a better chance of enjoying the sunsets & weathering the storms.

Myth: We have a special love that will always bind us together.

While deep loving feelings can create a strong bond, it's an unfair burden to expect it to be sustained without being supported by your daily ways of relating to each other. A strong love is a great beginning, but building a life together takes a lot more than being in love.

It takes compassion, understanding, compromise, communication & creativity. Joint decisions have to be made about money, children, relatives, sex, time & work. Values come into play that weren't considered at all in the decision to marry.

Myth: We were meant for each other.

It's great to feel you've found the "right" partner, but it's short-sighted to think that's all it takes. As childhood sweethearts who had known each other all our lives, we certainly felt we were meant for each other. But realistically, there's no such thing as only one "Mr. or Ms. Right" in the whole wide world.

Certainly, it helps to feel you're starting off with the right person for you, but people change throughout their lives, so the right start only makes it possible to make your love stay; it's no guarantee.

Myth: We can't live without each other.

Grand passion certainly has it's place, but lasting love requires a great deal more. You need a relationship that's based on caring, commitment, respect, a sense of fairness & a generally loving attitude toward your partner.

Achieving this kind of relationship goes far beyond simply being "in love." In fact, the idea that you can't live without each other reflects a certain desperateness about the relationship that's likely to sabotage it's strength & vitality. This attitude causes any problem in the relationship to be seen as a life-or-death matter. Since all relationships have problems, this sets you up for a life of high anxiety.

Myth: Love just happens; you either feel it or you don't.

No, love isn't magic. It can feel magical when things are going right. But love is actually the byproduct of all the attitudes & behaviors each of you brings to the relationship. Holding on to the idea that love exists in a vacuum only reinforces the false notion that the magical feeling of the first flush of new love is synonymous with love in its full, lasting richness (the kind that provides you a firm place to stand in the world).

So why should you reject these myths? Because they bring you to a love relationship with very unrealistic expectations. Conflicts & misunderstandings are probably inevitable as you struggle to cope with a world you never imagined.

Initially, new love keeps these in the background, but it won't do it indefinitely. As the initial passion of new love burns lower, the nitty-gritty issues of building a life with another person move into the foreground & reality hits you like a boulder.

By rejecting these myths you can be prepared to deal effectively with life's daily issues as they arise instead of being shocked & discouraged by their presence. So the idea isn't to avoid problems (which is impossible); it's to deal with them in a way that strengthens your relationship instead of weakening it.

What's needed is a life-long commitment on the part of both of you to deal directly & constructively with the myriad of issues involved in building a life together. Without such a commitment & without good coping skills, the anger, hurt, jealousy & resentment that most partners collect from their unresolved issues gradually extinguish the love they believed would never die.

It need not be so. You don't have to join those who dissolve their relationships when they're unable to live together happily & you don't have to resign yourself to hanging on in a relationship that is increasingly lifeless. You can direct the course of your love in a positive way, but you first need to rethink some of your attitudes & assumptions about love.

This isn't a simple matter for most of us. The very fact that our ideas about love are based on assumptions means that we never thought thru them in the first place; we just accepted them at face value. Unfortunately, most of our attitudes are based on fantasy & on the myths we've just discussed.

You really can't get about the business of taking control of the course of your love until you question what it is you assume to be true & update your beliefs to reflect reality.

Actually, if you could overcome all anxiety about making love stay & simply think clearly about what makes a difference in whether or not this happens, you'd find that deep down you already know these things.

So we're not telling you anything new here. In a sense, we're giving you a "blinding glimpse of the obvious." You're sure to have a sense of "Aha, I knew that" as we identify the key insights involved in making love stay. Like many of the ideas in this books, they're things you have probably known at some point on some level, but you just forgot. So here's a reminder:

5 Insights about Making Love Stay

You entered your current relationship (or you will enter one) w/a complex set of attitudes & habits regarding what love is about & the proper ways of showing your love.

You learned them from the people that raised you, people you've observed, things you've read, movies you've seen & people with whom you've had loving relationships. The same's true for your partner.

Some of your beliefs & preferences are similar to your partner's & some are different, but when viewed as a whole each of you has a unique way of being in love.

It's not a question of who's right & who's wrong. No one ever has all the right answers. What's important is a willingness to look honestly at what you've already learned about love, a conscious effort to retain the good & throw out the bad & an openness to continue learning what works best for the two of you.

i.e., one of you may think "Love means never having to say you're sorry," while the other thinks "Love means being willing to apologize for hurts & oversights - even if they're unintentional."

One of you may think "The primary way of expressing love is thru words, saying 'I love you' often," while the other thinks "The primary way of expressing love is thru actions: showing love by way of doing loving things."

One of you may think "Love means spending a great deal of time together," while the other thinks "Love means being in each other's thoughts, not necessarily in their presence."

It's disquieting to acknowledge that your views of love can be so different from your partner's, that some of your most cherished beliefs about love aren't valid & that the absolute security promised by true love isn't really possible.

The whole idea of security is actually a negative one; it reinforces feelings of fear & anxiety based on needing constant reassurance. It also takes you out of being "in the flow" of whatever's really happening in your relationship.

It's futile to try to hold on to some static condition while life is moving right along. It's very much like the old proverb about entering a running stream: "You can never step in the same water twice." By trying to hold on to security, you're holding back the exciting growth in your relationship that's not only beneficial, but essential if it's to last.

As you & your partner increase your ability to care for each other & your relationship, you'll recognize that whatever discomfort you feel at discarding your attachment to security will recede into the background. You'll see that you're not really giving up anything that was real in the first place; you're simply getting rid of excess baggage that interferes with lasting love. 

Popular songs tell us that true love overcomes everything & that it lasts forever. It ain't necessarily so. The danger in believing that true love has an omnipotent quality is that you may sit back & fail to do the ordinary day-to-day things that are needed to sustain love. A love relationship doesn't have a life of its own; it has the life you & your partner give it.

While this is a complex undertaking, it's quite manageable when broken down into the specific actions you need to take to sustain the quality of your love. Those actions are detailed in the individual entries that form the core of this book. The entire book is made up of simple, straightforward actions you can take to make your love stay.

This is the best news of all: the actions we're suggesting are within the capabilities of virtually everyone. Viewed one at a time, they're simple & easy to do. That doesn't mean you can simply memorize these suggestions & go thru the motions of doing them in a rote kind of way. The actions will only be effective if they're part of a pattern & if they're performed with genuine caring, understanding & sensitivity.

Most of us sense whether our partner is "being real" vs. just acting in whatever way they think we want them to act. A superficial effort to do & say the "right" things without first getting your heart in the right place is likely to backfire.

As the comedian George Carlin says in one of his routines, "You gotta wanna..." It's not enough to begrudgingly do these things; you've really got to want to do them by virtue of understanding their importance & their benefit - if you're really serious about making love stay.

So as you go thru the book, you'll notice that ideas on any given issue appear in many different places. While we've organized the items according to general themes, the same theme shows up in many places.

i.e., early in the book we talk about a basic issue for most couples:

• finding a workable balance between needs for commitment & freedom.

A little further over in focusing on time & the need to respect individual needs for time alone, we point out how some people are suspicious of their partner's commitment if they spend much time apart.

And still later on in discussing feelings of jealousy, we describe the way possessiveness can feel like an infringement on a person's freedom. So no one page says all there is to say about a given issue. Each entry is like a small snapshot; taken all together they form the bigger picture of what's involved in making love stay.

You may feel that work absorbs a disproportionate amount of your time, attention & energy, leaving too little of these precious resources for love relationships. Many of you are no doubt living in circumstances where you don't know your immediate neighbors & the community support for marriage & family which existed for many of your parents is noticeably missing.

The sheer complexity of life today forces you to make more decisions about how to live than previous generations. But the key to effectively dealing with these outside forces is to see yourselves as a couple, facing these pressures together.

The pressures don't have to place a wedge between you; they can, in fact, strengthen your bond. i.e., we're fond our reminding each other whenever the going gets tough that it's "It's you & me against the world."

So the daily battles of life can be more easily fought when you're clear about where you stand in your relationship. Placing a high premium on the condition of your love doesn't mean not functioning in other areas of your life. Instead, it means having a "place" (like a port in the storm) to take yourselves to continually.

We hope you're getting a clear sense that the ultimate payoff of working to make love stay is much greater than just the quality of your relationship. It affects the way you relate to the world at large. Lasting love tends to broaden your focus instead of restricting you, allowing you to function more effectively in all areas of your life. As we mentioned earlier, it's gives you a special strength from which face the world at large. 

In our society, women have traditionally been expected to take care of relationships. As long as women accept this as their role, there's little incentive for men to do their part. Unfortunately, this creates a lot of misunderstanding. A woman may get pretty discouraged at the condition of the relationship if she feels she's the only one trying to sustain its quality. And a man whose partner is assuming this responsibility may think there's no problem with the relationship as long as she's taking care of it. Meanwhile, the relationship is going downhill fast.

Both you & your partner need to be responsible for the life you're creating together. It isn't sufficient to leave it to either one alone. If you're the only one actively involved in attending to your relationship, you can't force your partner to participate; you can only encourage them by continually improving your own loving skills.

But you also can't expect that your partner will automatically reciprocate just because you're committed to relating in a loving way. You can wait a very long time if you assume they'll eventually respond to your one-sided effort to have a good relationship.

This book can be the vehicle that allows you to cut thru the standoff & clarify what's important to each of you - then concentrate on those specific things. It's a lot easier to focus on a few key issues one at a time than to tackle the whole big issue of "the condition of our relationship."

You can't get by with a once-a-year report like the State of the Union Address the President gives each year on the condition of the country. You need to have an ongoing sense of how things are going so they don't get so far off track that it feels impossible to get them back.

There's a proper place for exchanging formal vows such as those in a public wedding for those who choose to do it & periodically renewing such vows can also be helpful, but putting a promise in writing & reciting it in public aren't enough to make love stay.

That's like buying a beautiful plant & never watering it. It may have cost a good bit & you may profess to value it. You may even have every intention of taking care of it.

But you're busy, you're distracted by other things & you still see the plant thru the image in your mind's eye of its initial beauty when you bought it. Meanwhile, it's gradually losing its vitality & if you wait too long to notice what's happening, it may be too late.

Love isn't so different from a plant in that it too needs nourishment & ongoing attention in order to grow. Consciously doing loving things in a timely way is essential to making love stay. This kind of attention doesn't have to take a lot of time, a lot of money, or a lot of energy. It can be as quick as a smile or a kiss hello.

It can be as inexpensive as the gift of caring demonstrated by an unexpected offer to run an errand or make a phone call. It can be as simple as sitting together watching a sunset or watching your children at play.

You can open this book to almost any page & get a sense of something you can do to enrich your love.  Most of the ideas arise out of a loving attitude. It's not so much the specific act as the attitude with which you do it that keeps your love alive.

Love can't be frozen in time & put on the shelf. So enjoy the memory of whatever initial vows or promises you made to each other, but remember that was only the beginning - not the be-all, end-all of your love.

The Payoff is Well Worth the Effort

If you have some resistance to working to make your love stay, it may be based on feeling that love should be effortless - not something you have to work at.

But it's really not work in the way we usually think of work. Actually, it can be a tremendous source of energy, joy & satisfaction, but only if you reframe the way you think about work & love & only if you reorder your priorities to give it the place it deserves.

Yes, it takes time & energy, but once you get a sense of the incredible payoff for your effort, you won't be able to imagine living any other way.

It's a little like the experience you may have had with exercise. If you start by seeing exercise only as something you ought to do, you're likely to dread the time & energy it takes. Many people never get past their negative attitude toward exercise to experience the true benefits.

If you're a person who values fitness & knows from firsthand experience the benefits of exercise, you know that the positive results outweigh the time & energy it takes & whatever resistance you may have had gives way to wanting to do it.

Of course, just as you need to start with an exercise you enjoy, you need to start with a person you genuinely love. It figures that you can't "make love stay" if you don't start with a real love in the first place. But assuming you start with the raw material, then you're ready to build on that beginning. That's what this book aims to help you do.

Reading sections of it aloud with your partner & discussing your reactions can provide a way to talk about some issues that you may not have found a way to address previously. This can also enable you to nip some problems in the bud & avoid others altogether. Above all, use these ideas in a positive way - to find better ways of relating to your partner - not to show them their attitudes or behaviors are wrong.

This book can be used in several other ways, according to your mood at the moment & your goal. You can use it as a handbook, picking it up & reading it at any point & referring to it at random. You're likely to discover ideas that you'd forgotten or lost sight of & be reminded to focus on them again.

Or you can use it as a reference, going directly to whatever points that deal with the particular issues you see as most relevant to your current (or past) relationship. In fact, we've indexed it so you can quickly find the ideas that are most relevant to some specific issue. But, of course, no issue exists in isolation; everything is connected to everything else.

Or you can read it all the way thru from front to back to get an overall perspective. In fact, you'd miss a great deal of the benefit of the book if you don't do this at some point. So we recommend that you get your own sense of the way the various points in the book fit together by following the way we describe the stages of the process involved in making love stay.

Since this is a complex undertaking, it's impractical to lay out a precise guide that fits for everyone, but there are some fundamental processes that apply to everyone & the order in which you work on these processes can make a significant difference. So we've organized the book in a way to make sense of that process. Each of the 7 chapters addresses one of the steps involved in this process of making love stay.

This first chapter focuses on the importance of getting a basic understanding of the nature of love & its place in your life. In Chapter 2 we'll show you "the path to making love stay" - which happens to be honest communication.

Chapter 3 addresses the critical issues, which we call "core issues," that lie beneath the day-to-day stresses, strains & joys of your relationship. In Chapter 4, we discuss the nitty-gritty issues of daily living that stimulate most of the differences you'll face as a couple.

Then in Chapter 5 we talk about ways to handle the negative reactions to your differences. Chapter 6 describes the strategies & processes you can use to sustain your love. And the last chapter reinforces what you've learned by showing you the benefits of following this path.

So we're taking you step by step thru the building blocks of making your love stronger & better with every passing day. By the time you're finished, you'll have a realistic perspective of lasting love & some tools to help you achieve it. But, of course, we can only make suggestions; it's up to you (& your partner) to make it happen.

In the final analysis, the most important insight we have to offer is that making love stay is an ongoing process - one that's never finished. At first blush, that may seem like bad news, but it's not. After all these years, we still practice the principles discussed in this book & it's not a chore or a burdensome task.

The work of love is an exciting, enlivening process that not only allows you to feel good about yourself & your relationship, but provides a special source of strength & confidence from which to face the world.

So if you're tired of messing around with superficial quick-fixes & are ready to make some dramatic changes in the way you relate, then you're in for an exciting time.

Copyright ©1992 Peggy Vaughan and James Vaughan, Ph.D.

People Tell Their Stories:
Abuse & Violence

Saying good-by to the verbal abuse bond  
 
I grew up with constant verbal abuse. I was told daily how terrible I was. My soul disappeared from view as a result of this & I believed that what I heard was true. I was terrible.
 
I've spent a lifetime trying to recover from this. I've had great trouble because I've made all the choices in my life from a place of thinking I had no worth.
 
Then a few days ago, a long-time friend of mine became verbally abusive for the 3rd time. I struggled greatly with it, thinking, she must be right, I'm all those terrible things she says about me.
 
But then I decided I had to say good bye to her. I didn't want to lose a friend, but I didn't see how to keep the friendship going. And I decided it was time to let go of my bond to abuse.
 
I remember learning in a college psychology course about puppies who were burned slightly by experimenters & still formed strong bonds with them. I felt the same. The bond I formed with my mother was a bond of abuse.

It was the only kind of bond I was going to get. And in order to have any bond at all, I had to in a sense agree to being a "terrible child". It was part of the deal. And so, I've walked around all my life believing that.
 
Today in a meditation I pictured myself letting go of that bond. Because I know I will then be able to see myself as good & special & wonderful. If I say no to that old agreement with my mother, then I'll know that I'm full of love & light.
 
It also seems like by staying bonded to the abuse, I couldn't be in my body. Because I needed that bond as a child & had to deny the truth, which was that my mother was crazy.

Now if I go deep in my belly, I can know what's true & I can be in my body in a very deep way, not just a surface way like I have been until now.
 
I think this is very important to my healing on all levels, including from a chronic illness I have.
 
By saying good bye to the abuse bond, I feel like I'm being born! Like I truly can nurture myself, finally.

The challenges & moral dilemmas facing Muslim families requires an understanding of the shifts in ideological, social, religious & political forces that are shaping the structure & function of families in North America.

Families aren't static or monolithic; each family is unique, yet it's a 'microcosm' of the society at large & is reflective of religious, social & political values. The challenge facing the Muslim family is to not only maintain its Islamic identity, but to initiate change in the social & political spheres in light of the principles of the noble Qur'an.

To achieve these goals requires active participation of Muslims in the political, social, economic & religious aspects of society. Failing this, Muslims will either be segregated or assimilated.

Both processes are undesirable since they lead to the loss of self-identity, which is built on religious & social values acquired from one's family & strengthened through constant interaction with the larger society.

Over the past 3 decades, the North American society has undergone a rapid social, political & religious transformation, resulting in high divorce rates, separation, single parent families & common-law relationships. There are same sex couples, childless couples & increasing numbers of women are choosing to work outside the house.

These changes are reflected in the parameters of the society's functioning on the psychological & emotional planes. The 'Rate of depression has been doubling in some industrial countries roughly every 10 years. Suicide is the 3rd most common cause of death among young adults in North America, after car wrecks & homicides. 15% of Americans have had a clinical anxiety disorder. And, pathological, even murderous alienation is a hallmark of our time,' reported Time magazine on August 28, 1995 (p.38).

The paucity of research on the health of Muslim families makes it difficult to provide specific statistical evidence. However data collected from different sources including this writer's personal practice as a family counselor over the last 18 years, indicates that Muslim families are also experiencing social & personal problems like the rest of the North American society. There is marked increase in divorce rates, separation, domestic violence, child abuse, elder abuse, intergenerational conflict & teenage pregnancies.

The tendency among young married couples is to opt for separation & divorce, rather than work thru differences & disagreements when there's tension or conflict in marriage. Barring violence or psychological abuse in the family, seeking solutions thru negotiations is the Islamic norm. Marriage requires collaboration, commitment & above all a sense of responsibility towards oneself, one's partner, family & the society.

In addition, a significant number of young Muslims are marrying outside the community. One of the major hurdles for young Muslims to find someone to marry from within the diverse Muslim community is the question of ethnicity & culture.

Cultural & racial diversity instead of being a positive factor, as the Qur'an tells us (49:13), is becoming a dividing factor, since every Muslim group wants to preserve its own ethnic & culture purity. This limits the pool of young - male & female - to chose from.

Also, increasing numbers of young Muslim parents, both the father & the mother, are choosing to work outside the house, primarily for economic reasons & are relegating the care & nurturing of their children to daycare centers & elderly parents.

Both arrangements are inherently insufficient because daycare by its very nature lacks individualized emotional, spiritual & intellectual care the child needs. Also, the social environment of daycare is predisposed to producing conformity through the process of socialization & leaves very little room for developing an independent religious or social identity.

Although more equipped to provide emotional, spiritual & nurturing environment, grandparents, too, lack the physical vigor to cope with the demands of growing children. In numerous instances, language is also a barrier putting both under undue stress.

The above social trends in Muslim families point to various degrees of assimilation, or adaptation to existing societal values. This has serious implications for the future of the Muslim family.

In Islam, family is central to creating a stable society & ultimately civilization itself. Therefore, if family as a social system fails to provide sound religious & social values for the total physical & psychological growth of a human being, then society will suffer greatly as is evident from the malaise afflicting western society.

North America has made much progress in science, technology, psychology, medicine, human sciences, as well as in the standard of living. It insists its social, political & economic values are the only viable option to achieve human equality, financial prosperity & peace & justice.

Yet it finds it exceedingly difficult to provide its own citizens the peace of mind & a healthy social environment in which parents can raise their children without the fear of random violence in schools, homes or in the streets.

According to social scientists, the American society is becoming increasingly violent, aggressive, self destructive, narcissistic & uncaring towards those who are less fortunate, including members of the immediate family.

The Qur'an, which Allah says was revealed to the Prophet, upon whom be peace 'in order that you might lead mankind out of the depth of darkness into light,' (15:1), provides numerous examples of what happens to nations, peoples & individuals who exceed the limits prescribed by Allah. 'Have they not traveled in the earth & seen how evil was the end of those who were before them? And they were stronger than they in peace' (35:34).

The recent sexual scandal of US president Bill Clinton is reflective of the moral decay of the American society, yet like Clinton, America is arrogant, consumed by its power & glory. It has unleashed misery & despair in many parts of the world thru its policies. Muslims make up a sizable minority in North America so the question is: should they not be concerned about the state of the family & society & the rest of humanity; or they feel they have no responsibility beyond themselves?

Malek Bennabi in his book, Islam in History & Society, says that corruption & colonization of people can only take place when human beings are in a state of moral & psychological decay. 'Moral paralysis results in intellectual paralysis: when one ceases to perfect oneself morally, one also ceases to modify the conditions of one's life & is reinforced by moral, social & political paralysis.'

Unfortunately, Muslims in North America & the Ummah in general seem to fit Bennabi's description, since their apathy & inactivity indicates that they may be suffering from political, social & moral paralyses. It's easy to blame others for the present predicament of Muslims worldwide, but to hold others responsible for ones own weaknesses & shortcomings contradicts the Qur'anic injunction of personal responsibility. 'God does not change the condition of a people until they change that which is in their souls' (13:11).

If Muslim families are to survive the current social & structural changes in North America, they must actively initiate social changes in the society in which they live. Humanity is told that as a vicegerent of Allah (2:30), it is under moral obligation to reform its own thinking & behavior in order to create a just & morally balanced self & society (3:110).

The challenge in the next millennium for Muslim families isn't from the external environment; it's from within. Islam has a lot to offer to the ongoing debate on the future & status of the family. The practical implications of the answers found in the Qur'an for those who advocate stability of the family & society are immense.

Wahida Chishti Valiante is a psychotherapist, specializing in Family Counseling. She has made numerous presentations on treatment of families from an Islamic perspective to academic institutions and professionals both in Canada and the US.

Source: Muslimedia: March 1-15, 1999

Parenting Challenges: The Importance of Tending to Your Own Emotional Needs
by Robert Needlman, M.D., F.A.A.P.
reviewed by Laura Jana, M.D., F.A.A.P.

During times of crisis, parents usually are careful to minister to the needs of their children. While some children may only need extra reassurance & loving care, many others will show emotional or behavioral problems that demand a response.

And in the meantime, all of the everyday stresses & strains of parenting; the diapers, tantrums, car pools, homework & everything else, don't let up.

There are no magic answers to help parents cope with the added responsibilities that accompany stressful times, but here are some common-sense tips:

• Take care of yourself. Make time each day, even if it's only 10 minutes, to do something relaxing or pleasant. It could be taking a warm bath, reading a good novel, listening to music, doing yoga or anything else that works for you. Remember that parenting is a marathon, not a sprint. You have to take care of yourself so that you can keep going for the long haul.
• Give yourself a break. When you're under severe stress, it's probably not the best time to begin a major self-improvement project. i.e., if you have always meant to stop smoking, a worthwhile goal, indeed, you may want to put that plan on hold for a while. The problem will still be there when you have the emotional resources to tackle it in the future.
• Give your child a break. By the same token, if you have a child with a particular problem, say, nose picking or thumb sucking; this may not be a particularly good time tackle the problem. If your child needs extra help falling asleep, or even needs to sleep in your room for some nights, you may want to relax some family rules to give him the support he needs. At the same time, don't abandon family rules & expectations entirely. Children need the security provided by firm, stable limits.
• Give yourself permission to ask for help. If you have a spouse or adult partner, talk about how that person could perhaps shoulder more of the child-rearing burden.

Think of specific tasks you can share that might now fall completely on your shoulders, such as laundry, cooking, bathing & so on. If you've been reluctant to ask for help from grandparents or other relatives, be it practical support, such as babysitting or financial support, you may find that your extended family is now glad to help out. Consider getting a babysitter just to give yourself some time alone.

• Your children can help, too. There may be ways children can help as well, particularly if they are school age or older. Perhaps one child can take over part of the laundry or housecleaning. A teenage child might take responsibility for cooking some meals. Many children take comfort from being helpful when their help is truly needed.
• Look to your community for support. Churches, temples, mosques & other religious institutions can be a source of comfort in stressful times.

In addition to prayer services, the institutions in your community might offer support groups & even individual counseling. Even if you’re not a member or regular visitor, chances are you’ll be welcomed nonetheless.

Libraries & community centers also offer a range of services that can be helpful, such as discussion & support groups. Many of these programs will be geared to parents & will provide free childcare during meetings.

• Pay attention to stress signs. If you find yourself losing your temper with your child, forgetting things, or not taking pleasure in activities that you used to find enjoyable (such as playing with your child), these can be signs that stress is getting to you. Let these events tell you that you need to step back & take care of your own needs for a bit.
• Beware of self-destructive coping mechanisms. If you tend to cope with stress by using alcohol or drugs, or if you’ve used such substances to cope in the past, (also called self medication) be aware of the temptation to engage in such self-destructive behaviors.

If you feel a strong urge to have a drink to get thru the day or to get high to relax, think hard about doing something else. Twelve-step programs, such as Alcoholics Anonymous & Narcotics Anonymous, can give you crucial support until the self-destructive urges pass.

• Get strength from kindness. On a very concrete level, you may find that committing random acts of kindness, smiling at a stranger or offering to lend a hand to a neighbor, i.e.; may actually help to recharge your own emotional batteries. Such acts also teach your children important lessons about what it means to live in society.

The Challenge of Raising Nonviolent Children
by Dr. Benjamin Spock
reviewed & revised by Robert Needlman, M.D.,

F.A.A.P.

Do I Keep In Mind that it’s Normal for my Kids to Challenge My Authority?

Yet another responsibility we have as parents to our kids, is to help guide & direct their decision making process until finally, they’re able to fully think, evaluate & to decide for themselves.

The goal isn’t to bring them to a point where they no longer need the input of others at all, but we do want them to be able to make decisions for themselves, rather than relying on others to think & to decide for them.

Few of us parents would disagree with this notion. Our goal here is to get them to the place where their response to life's circumstances is basically, "Wait a minute. What do I think?", rather than their original early childhood response of, "If you say so, it must be true". We're again reminded of their early childhood "sponge-like brain" & their ability as infants & toddlers to only absorb what they hear & see, w/little or no capacity to think & to reason for themselves.

One outcome to successfully teaching our kids how to think for themselves is that, somewhere in that learning process, they stop letting us think for them & they stop taking our word for things. They begin to disagree more & yes, to even question our authority. This can happen gradually & over a period of time, but sometimes, for no obvious reason, it seems to happen over night & out of nowhere.

So, since some degree of rebellion & challenge is normal, inevitably & comes as a result of our kids learning to think for themselves, we might as well accept it & learn how to deal well w/it. While we may be able to soften & minimize it when it comes by accepting the fact that some rebellion is normal, it can’t be completely avoided, so don't get your hopes up!

We need to understand too, that rebellion doesn’t have to be destructive & that it can even be mild when we remember that it’s normal & necessary in the process of their learning to think for themselves. Whether or not their rebellion will be constructive or destructive, mild or extreme, will depend in large part on how we respond to it when it comes.

Knowing & understanding that some form & degree of rebellion is normal & even needed, will help us to react in ways that will not intensify their rebellious stages.

As painful as the idea of rebellion might be to us parents - especially when we think of the warm & close relationship we’ve always had w/our toddlers - how could it be any other way? Isn't it our goal to take our kids who accept anything & everything they hear as truth & "design" them to be an adult who is able to think for themselves?

This learning to question & to think for themselves begins in their relationship with us. But when it begins to happen, it’s natural for us to feel "turned against" & to ask, "How can they rebel against me!? Aren't I the one who taught & encouraged them to think for themselves!?"

Rebellion that is normal, natural & inevitable, will likely show up as a result of things like peer pressure, limitations placed on them by us, general identity issues & other insecurities & good old fashioned hormones that begin to kick in.

The destructive & unnecessary rebellion that takes place in our kids isn’t usually the result of these issues, but rather, they occur because we parents forget that this transition from accepting blindly, to questioning just about everything, is normal.

When we think of all rebellion as abnormal & possibly as an affront to us personally, then we’re more likely to overreact in our responses to them. It’s this rebellion - the kind that’s a result of our overreacting to what's really very normal - that can encourage the destructive type that damages our relationship w/them.

So in order for us to minimize this unnecessary & destructive kind of rebellion, it’s important that we keep in mind that some is normal & even needed, if they’re to learn how to think for themselves. When we fail to recognize that it’s an inevitable part of raising great kids who are able to think for themselves, then we may actually help create & encourage the very painful rebellion that can & should be avoided.

This isn’t to suggest that we parents are to blame if our kids rebel in a destructive manner. They must still take responsibility for what they do in response to any mistakes we make. But how we interact with them in this transition period is key to minimizing the kind of rebellion in them that can be so destructive.

When they challenge our authority, if we come down on them in a way that destroys their spirit, rather than their willfulness, then we’re more likely to create within them a greater need to rebel. If we withdraw & reject them when they question our opinion or our way of doing things, then we may encourage the destructive rebellion we want to avoid.

If we refuse to talk or listen to them when they disagree with us, we may increase the tendency for them to rebel in destructive & unhealthy ways. If we use guilt to get them to stop their challenges of us, then we’re setting the stage for greater & possibly more damaging rebellion. It’s these types of reactions from us, that can bring about the very destructive & pointless warfare that we all want very much to avoid with our kids.

On the other hand, when we’re able to keep in mind that rebellion in our kids can be healthy & even constructive to their developing an ability to think for themselves, then our responses will be more likely helpful to them in their transition. And accepting the normalcy of their challenging will also help to strengthen & nurture our relationship with them.

Instead of being the "enemy to defeat" we’re more likely (at least eventually) to become their trusted advocate. When we make the effort to accept as normal and o.k. that our kids are going to challenge our authority, then we place ourselves on the same side, working for a common goal, rather than participating in a tug of war with them.

Certainly, all of this is easier said than done. And it seldom works as smoothly as all of this makes it sound, but it’s possible to survive and to even thrive through the rebellion that’ll come.

There’s another reason that it’s difficult for many of us parents to allow and encourage our kids to think for themselves. Our egos are connected to our success as parents and this is normal and understandable. But too often, what interferes with our healthy acceptance of normal rebellion in them, is our need to look good-not bad-as their parent. And of course we want to look like good parents. But our needing to look good can lead to a, "look how you make me look (as your parent)," attitude.

We fear that when they think for themselves, that their decisions might reflect poorly on us & we want to look good.

Their behaviors & attitudes do indeed reflect on us as their parents. They do have the ability to make us look good or bad to others. But when how we look becomes the motivating factor in how we respond to them when they challenge & insist on thinking for themselves, then we’re more likely to create the type of rebellion that’s destructive & unproductive.

There’s a part of our ego that doesn't really want them to think for themselves. "Just do as I say & I'll look good". "Don't bother thinking for yourself". "Dress like I want you to dress, wear your hair the way I want you to wear it, talk like I want you to talk, have the friends I want you to have, do the chores the way I want them done. There’s no room to think for yourself."

At first glance seem rather extreme, but our responses to our kids & their attempts to think for themselves, can in subtle ways, send these messages to them.

So, once again we’re faced with yet another challenging task that comes with parenting & with "designing" great kids. Being a parent to our kids certainly is difficult at times & it calls for lots of wise, educated, trial & error on our part.

We need to always remind ourselves, though, that our kids simply don’t need perfect parents & that it doesn’t require perfection to succeed at the difficult & challenging task of raising great kids.

However, it does require that we strive to be the very best parents to our kids that we can possibly be.

Hopefully, as a result of reading this first chapter of, A Parents Complete Guide to Raising Great Kids, you’ve increased the prospects of doing just that-raising really great kids who like and value themselves and who likewise, are able to like and value others as well.

Here, you’ve read and considered twenty-one questions that I believe to be foundational to so many other issues that we parents face in raising our kids. There’s certainly far more about the fine art of being effective parents that we need to know and understand, but asking these questions may provide a way for us to evaluate more specifically what’s needed from us to be the kind of parents to our kids that they want, need and deserve.

The responsibility of raising great kids is an awesome task, but an exciting one, indeed!

Parenting Challenges For The New Millennium
by Istar Schwager, Ph.D.

Well, here we are in the 21st century and contrary to predictions, we're not yet living in space stations like the Jetsons. But we're living in a rapidly changing time and need to think about what that means for us as parents.

While we grew up in a more traditional and less technological world, our children have never known life without VCRs, answering machines, video games and computers.

We've had to keep pace with changes in many spheres and discover that every time we open the newspaper we're reading about some major challenge to the old order - be it school violence or school vouchers, the global economy or global warming. What are the implications for us as parents raising children who will be spending the large portion of their lives in the 21st century?

Here are some challenges to consider. Let's remember:

Growing Up Takes Time

Our offspring may seem to exhibit astounding sophistication, but underneath it all they're really just kids. A 5 year old is still just 5, no matter how big his vocabulary, how impressive her computer skills or how many enriching vacations he's experienced.

With all due respect for the intellect and knowledge of a child at any age - it's a mistake to be fooled into thinking that our children can handle all sorts of grown-up challenges. It can be tempting to turn kids into our confidants or ask them to make mature decisions about important matters.

Certainly listen and consider what they have to say. But remember that they still require our steadfast support, reassurance and guidance.

Besides, we'd do well to relish each stage and phase - even the ones that aren't our favorites. Our kids will experience that age only once. In an era of acceleration, where faster is considered better in virtually every enterprise, let's keep reminding ourselves and each other that human development is one process that can't be rushed.

"Downtime" is Essential

We live at a time when there are so many interesting organized activities available it's easy to forget that kids need unstructured time. Not every minute has to be educationally enriching. Kids need time to daydream, think, digest their day, ponder and play.

The rewards of unprogrammed time can't always be measured immediately, but are manifest in creativity, imagination and enjoyment. The benefits are often long-term.

Innovators have always known that the best inspirations come when the mind is allowed to wander ­make unexpected connections and arrive at creative solutions. Kids need hands-on time with tangible materials ­ play dough, paint, blocks and dress up clothes - time to play where the process is more important than the product.

That also means a chance to engage in physical activity that's not part of a performance or competitive game and unhurried time with other kids - ­peers with whom they can cooperate, collaborate or just be silly. What may seem like a waste of time now has immeasurable benefits for the future.

Kids Need Human Contact - With Parents

Our kids need human, face to face time with us parents. That means parent and child in the same zip code, preferably with the TV off.

Technology has made it possible to stay in contact with our kids via cell phone, e-mail and intercom. Yet we all know that there's no substitute for lap time and hugs for the warmth and sharing that exists, not just in Hallmark greeting cards but as a real life possibility when parents and kids share activities together.

Since kids don't talk to us on demand, we are most likely to hear about the bully at school or the dream about next summer when we're spending unpressured time with our kids. The unhurried time may mean a leisurely weekend breakfast, a visit to the library, or sitting together on a bus. It's playing a board game; talking after the bedtime story; driving in the car without anybody in headphones.

Our children can sense when we're too rushed or preoccupied to listen. Time together is the best gift we can give them­ certainly more valuable than the latest CD player.

Growing up, many of us took our parents' presence for granted. Now kids are clamoring for more time with their parents. Even seemingly indifferent teens need us around to defy, ignore and be available for those unpredictable but precious moments when they actually wish to converse.

Technology Demands Scrutiny

While technology has brought us knowledge and convenience, we need to continually assess what role we wish it to play in our kids' lives. We live at a time when the average amount of time American kids spend watching the tube is 24 hours a week ­ that's the same as 3 8 hour work days glued to the set. Media messages proliferate.

Our kids are told what to watch, buy, eat, wear and play by people who don't have their best interest at heart ­ to say the least. The American Academy of Pediatrics is now encouraging parents to fill out a "media history,'' to get TVs out of kid's rooms and to set clear limits. And of course the internet has also posed new challenges to us parents, who are often less computer savvy than our exploratory off-spring.

As the new millennium brings even more technological innovations, it'll be up to us to distinguish the helpful from the harmful. We'll need to set limits on use, since too many hours with even the most wonderful educational shows, games, web sites or CD-Roms takes time away from hands-on play, imaginative pursuits , physical activity, social interactions and other childhood essentials.

Creativity Is Key

As information becomes more accessible, creativity is going to assume a larger role in helping us figure out what to do with all that knowledge. 50 years from now our kids will be grappling with issues we can hardly imagine.

Many will be involved in careers that don't exist today. It's important to encourage curiosity, exploration and the kind of questioning that enables kids to use the facts at hand to develop new ideas, applications and solutions.

If we foster observation and interpretation we'll help our kids look beyond the information they're learning to make connections and find inventive uses for what they know. All of this can go on in very mundane situations - noticing what happens on the checkout line in the grocery store; thinking about how E-Z pass works at a tollbooth.