The Role of Spirituality in Health Care by Dr. Victor Sierpina, MD

Lone Tree in SnowSpirituality and religious beliefs may seem like an inappropriate topic to discuss in the health care setting. Perhaps such conversations are best held by a pastoral counselor, clergy, or the hospital chaplain. Patients and their families always have some value system in place, whether based in traditional religious structures, personal spirituality, or some philosophy of life. It is often helpful to elicit these beliefs in order to understand a person’s support system, how and why they make health care choices, and how they might affect palliative care or end-of-life choices.
One model for addressing spiritual belief systems has been developed under the auspices of the John Templeton Foundation and is taught to health professionals through the George Washington Institute of Spirituality in Health. It is called FICA. This is a rather straightforward approach that allows a neutral, non-threatening, and supportive approach to inquiring about the patient’s beliefs. FICA is an acronym for:
Faith and Belief. A question like, “Do you consider yourself spiritual or religious?” can open up rich dialogue on personal values and beliefs.
Importance. A physician or health provider might ask, “What importance do your faith or beliefs have related to your health.”
Community. “Are you part of a spiritual or religious community?” This helps determine the support system.

balanceAddress in care. “How would you like me, as your healthcare provider, to address these issues?” They may not want to go any further at this time, but at least we now have permission to enter into this level of conversation.
In my experience, patients are eager and open to discuss spiritual beliefs with their doctor, yet most physicians feel uncomfortable initiating such discussions. By normalizing this kind of conversation and including it in the routine intake history with a patient, it becomes a matter of record and, with practice, easier to discuss. This requires more than dutifully recording the patient’s religious affiliation in the medical record. It also helps to avoid making the patient feel like they are at death’s door, as their doctor is suddenly talking about their belief system or religion.
Of course, healthcare professionals must be cautious not to proselytize their own religious beliefs on patients and to be diligently mindful of any conscious or even unconscious bias about someone of a different faith or spiritual belief than their own. We are there to explore the patient’s support system, to understand how they process the mysteries of life, and how they make decisions. If a patient and provider share the same religious outlook, patients often feel reassured by discussion, prayer in the office, sharing scriptures of relevance, and the like. Be attentive for “faith flags,” like religious symbols, certain verbal expressions, religious jewelry, T-shirt mottos, reading materials, even tattoos, as these might give a clue to a patient’s spiritual orientation and thus occasion a deeper discussion.

In his landmark book, Victor Frankl, a Jewish psychiatrist and death camp survivor, observed that even under the horrific conditions of the concentration camp, those who held onto some kind of personal goal, hope, or meaning for their life frequently survived. Often, those right next to them without such a spiritual construct were the first to die. Without hope, without meaning, without spirit, the body shuts down.
Our goals as health providers are to value our patients as human beings, mind, body, and spirit; to relieve both physical and metaphysical suffering; and to offer love, support, and caring on as many levels as the patient is ready to accept. Spirituality belongs in the clinical setting for these reasons.

Sierpina_Victor_5x7About the Author: Dr. Victor Sierpina is currently the director of the Medical Student Education Program at UTMB, Galveston. He is a WD and Laura Nell Nicholson Family Professor of Integrative Medicine, and also a Professor in Family Medicine. He is a University of Texas Distinguished Teaching Professor. His clinical interests have long included holistic practices, wellness, lifestyle medicine, mind-body therapies, acupuncture, integrative oncology, nutrition, and non-pharmacological approaches to pain.

Forgiveness: Spiritual & Medical Implications by Christina Puchalski

This is an interesting article taken from The Yale Journal for Humanities in Medicine.

“Forgiveness: Spiritual and Medical Implications”  by Christina Puchalski, MD.

(http://info.med.yale.edu/intmed/hummed/yjhm/spirit/forgiveness/cpuchalski.htm)

 

MP900385327“On a societal level, we face social injustice, urban crime, terrorist acts and war. These realities of society can also lead to resentment, territorialism and hatred. While many of these aspects of our society are wrong and perhaps even warrant a justifiable anger and hatred until we can forgive even the most horrendous of these acts, how can we as a society, or as a civilization, live together in peace? Thus, forgiveness is the basic building block of a tolerant society.
There have been many studies looking at the role of forgiveness in health. Unforgiving persons have increased anxiety symptoms, increased paranoia, increased narcissism, increased frequency of psycho-somatic complications, increased incidence of heart disease and less resistance to physical illness. Others have found that people who are unable to forgive themselves or others also have an increased incidence of depression and callousness toward others. The act of forgiveness can result in less anxiety and depression, better health outcomes, increased coping with stress, and increased closeness to God and others.
MP900440326There have been numerous studies looking at forgiveness interventions. The interventions involved counseling and exercises which were used to help people move from anger and resentment towards forgiveness. In one study, incest survivors who experienced the forgiveness intervention had at the end of the intervention increased abilities to forgive others, increased hopefulness and decreased levels of anxiety and depression. In another study, college students were randomized to a group that received a forgiveness education program and another group who studied human relations. The group that received the forgiveness education program showed higher levels of hope and an increased willingness to forgive others. This greater self-forgiveness was associated with increased self-esteem, lower levels of anxiety, lower levels of depression and a more positive view of their patient.
In many of these studies, it was shown that people who are able to forgive are more likely to have better interpersonal functioning and therefore social support. In terms of social support, there is a large body of literature that demonstrated the value of social support. Social support has been shown to reduce cardiovascular risks, promote faster recovery and increased survival rates from several types of cancer. Therefore, forgiveness, since it improved interpersonal functioning, might mediate these better health outcomes through the ability of people to have increased social support.
MP900289480Thus, act of forgiving from a research end seems to indicate that forgiveness can improve personal, interpersonal, and societal well-being.”

Understanding Self Harm By Jamie Porter

Young Woman Biting Her Finger NailI’m often asked WHY cutters cut. For those that do not cut, they have difficulties seeing how something that appears to be so painful can cause a relief? It’s beyond their mind’s capacity to understand why someone would do this to themselves. The hardest part about trying to answer what appears to be a simple question is that there is not a simple answer. I’d like to take a moment to share with you what I have experienced as a clinician, what I have read from books, collected from research, and have heard from the mouths of my clients. Secondly, I’d like to share some basic tools or coping skills to gather and use as a lay person, a parent, a friend or a therapist. My greatest goal is that you build an ability to be open-minded to help those that are hurting.
Cutting is a form of communication. At the basics of cutting, self-harmers live in a world where they are either afraid to speak their true emotions, will be criticized if they do, or lack the ability to articulate their emotions. Our job as clinicians is to help bridge the gap. We must help our clients find a healthier coping skill, build verbal communication, and help mend emotional turmoil.

1.  First, we must assess the cutters. Most cutters cut to avoid suicide. This is a very important concept we must teach the parents’ of cutters. However, there is a small number that actually have suicidal ideation while cutting, and an even smaller number (4%) that have actually died from self-harm. If this is the case, it is important that we refer our clients to the nearest hospital and make sure that their families are aware that they must be under greater supervision than one-hour a week therapy sessions.

 

2.  We start to help our clients to build a vocabulary list of emotions felt before, during and after conflict-cutting.

 

3.  We help them go over coping skills that can be traded for cutting. We need to help our clients heal the internal and external pain. We must be compassionate for each client will have a different reason for cutting. ‘I want to feel alive’, ‘ I want to stop the bad feelings’, I want to feel numb’, ‘It makes me feel numb’, ‘It’s my way to avoid people, punishment, consequences’, ‘It’s my way of control’, ‘I’m bored’, ‘It’s my way to punish myself’, and/or ‘I want to be paid attention to’. If we can understand their pain, we can help our clients communicate that to those around them.
For parents, some basic tools include opening lines of communication, listening to your child, not judging, not giving ultimatums/threats/punishment, help aid their cuts and provide medical assistance if needed, and help them find professional help to process their pain/emotions. Most importantly, for a parent to remind their child that they deserve to be happy and that you are trying to be there for them, not against them, could be most beneficial.
Sick Young Woman Lying in BedFor the therapist/clinician, starting off with an impulse-control log, can help your client start to document how often, where, when, with what tool, and emotions attached to the behavior. You can also help start to identify some healthy coping skills including writing, drawing, music, physical activity, art, meditation, etc. One of the greatest tasks as a clinician is to help the client vocalize their emotions to their parent and to get a response that will not only verbally and emotionally be a safe response, but physically. Most of our clients lack a relationship of verbal comfort or even physical comfort (hugs). It can be a long process for clients that are fearful to open up. We must instill safeness again and remind our clients that their current level of coping is not healthy for themselves or their families.
Cutting is a topic that some clinicians stay far away from and that parents are highly fearful of. I want to remind both clinicians and parents that suicide is not the ultimate goal for cutters. I want to demystify the behavior and build a sense of clarity and compassion for those who are fighting the battle and those that watch the fighting battle. For ‘self injury is a sign of distress not madness’. – Corey Anderson

 

Resources:
Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Mental Health of America: www.mentalhealthamerica.net
Cornell Research Program on Self-Injurious Behavior in Adolescents and Young Adults: www.crpsib.com/researces.asp
S.A.F.E. Alternatives (Self-Abuse Finally Ends):  www.selfinjury.com
Self-Harm: Recovery, Advice and Support: www.thesite.org/healthandwellbeing/mentalhealth/selfharm
Self-Injurious Behavior Webcast:  www.albany.edu/sph/coned/t2b2injurious.hmt
KidsHealth: www.kidshealth.org
Christianity Today: www.christianitytoday.com/cl.2004/005/29.18.html
American Academy of Child and Adolescent Psychiatry: www.aacap.org
Book:
Strong, Marilee (1998). A Bright Red Scream. New York, New York: Viking Press.
Conterio, K. and W. Lader, Ph.D. (1998). Bodily Harm. The breakthrough Healing Program for Self-Injurers. New York, New
York: Hyperion.
Magazine:
The Prevention Researcher. Parental Guidelines for Preventing and Constructively Managing Inevitable Self-Injuring Slips, 19, February 2010

 

Jamie Cropped2About the Author:  Jamie Porter has a Master’s degree in Marriage & Family Therapy from UHCL. She has worked in non-profit settings working with women, adolescents, children, families, couples, and equine assisted psychotherapy. She is currently the Sugar Land Center for Couples & Families office manager, and  an AAMFT approved supervisor.

Enjoy the Taste of Eating Right by Erica Hansen, MS, RD

VegetablesWhy do you eat what you eat? Are you eating right? If you are like most Americans, according to research, taste trumps all other deciding factors. Surprised? Probably not.

We live in a time and place where food is abundant and you have a lot of food choices to make, as many as 200 per day according to researcher Dr. Brian Wansink. Can you think of a place where you can’t find food? It’s in movie theaters, malls, airports, your workplace, gas stations, and even available at sporting events. Each year about 50,000 new food products are introduced to your grocery store shelves. With so many foods to choose from many Americans have the luxury of choosing to eat the very best tasting things.

Unfortunately, some of the foods that are packed with essential nutrients have been given a bad rap in the tasty foods lineup. According to national surveys, less than 25% of Americans eat the amount of vegetables we should (about 2-3 cups per day). When I meet with patients the number one reason they cite for avoiding vegetables is, you guessed it, taste.

Vegetables are running up against some tasty competition. The foods you find on supermarket shelves are literally made to win; loaded with added fat and sugar they are created to taste great. Why? Because you buy things that taste good and we are hard-wired to enjoy the taste of fat and sugar, both high in life-sustaining energy. From a marketing and business perspective it makes sense for a food manufacturing company to add taste–unfortunately, even at the cost of compromising nutritional quality.

Vegetables are naturally low in fat and simple sugars, but you shouldn’t give up on great tasting vegetables just yet. When aiming to fill half your plate with fruits and vegetables each meal, consider these three suggestions to add flavor and flair:

1. Vary your veggies
Don’t get stuck eating the same vegetables night after night. While corn, peas, carrots, and potatoes are great, they aren’t the only veggies out there.

Consider writing out a list of all the vegetables you like eating by going through all of the colors of the rainbow. What are all of the red vegetables you like? Orange? Green? Sometimes having a tangible list of possible choices will help you realize how many you actually do like and give you ideas to add to your grocery list.

During your next trip to the grocery store, pick-up a new vegetable or one you haven’t tried for a while. I don’t recommend filling your cart with new options, it can be too overwhelming. Start small and add to your list of vegetable ideas.

tradition 32. Mix up your methods
Though a healthy choice, steaming or boiling your vegetables can at times lead to a bland product. Try roasting, broiling, grilling, or stir-frying in a little oil. Many vegetables (zucchini, cauliflower, broccoli, and red potatoes) are fabulous when tossed in olive oil, salt, pepper, and freshly grated parmesan cheese and then roasted or broiled on high heat. Ratatouille is prepared in a similar way.

Salads are often a go-to vegetable, and for great reason, but don’t get stuck in a salad rut. Try taco salads, an Asian salad with mandarin oranges and toasted sesame dressing, throw in fruits and nuts for something sweet, or try a hearty chef salad.

Cooking vegetables in broth instead of water or oil, seasoning them with fresh herbs and spices, soaking them in rice vinegars (delicious on cucumbers!), and dipping or topping them in salsa, hummus, or nut butters are also great, tasty, nutritious choices.

3. Be sneaky
It is easy to get stuck thinking in terms of vegetables as side dishes only, but vegetables can be incorporated into what you’re already eating:

• Add sautéed or fresh vegetables to your pizza
• Cucumbers, peppers, and sprouts add great crunch to sandwiches and wraps
• Carrots and onions in your rice make for a nice pilaf
• Include beans in your soups, stews, salads, and casseroles
• Zucchini, tomatoes, peppers, or artichokes are tasty in pasta
• Spinach or kale in a fruity shake is nearly undetectable
• Creamy butternut squash in homemade mac n’ cheese makes for sweet, nutty, and extra creamy comfort food

I don’t know about you, but my mouth is watering as I wrap up these lists; no small accomplishment for veggies with less than tasty reputation.

Remember, all forms count–fresh, frozen, dried, juiced, and canned vegetables. Start small, but start today to make vegetables a regular part of your plate!

Health & Wellness by Dr. Spencer Scoville, DO

Vegetables‘Health and Wellness’

What can we do to improve our health & wellness? I think this is a great question for the New Year or any time of the year. We spend the majority of our time focused on work, family, church and community responsibilities. We get our kids to school and all their activities. We race to the Doctor when we are sick. We try to lose weight when our pant size increases or exercise a little when we see our muscles sag. Many of us don’t spend a lot of time thinking about our health or wellness until we are in deeply in need of it.

I think it is useful for each of us to spend a little time defining what health and wellness is to ourselves. Benjamin Franklin in his early autobiography tracked qualities that he felt needed improvement. If we do not define what we want in our health, I see it difficult for us to achieve the health goals we desire.

I define health or life as movement. Think of the things you enjoy doing. Even if it is going to the movies, it is much easier to enjoy them if you are able to move yourself to get there. I love to run. I have a goal of being that 90 year old guy out running. I am almost 40 and already have quite a bit of gray hair—so I am already “that old guy” when I am running. I want to do everything I can to maintain my health or ability to move and do the things I love as I age.

I talk to people every day about health. Many of these people are sick and we focus on the specific health concern they have that day. It may be a sinus infection or a back ache or a well visit. With all of these visits, I have an overriding desire. It is to help them improve their health. The 2 things at the top of my list to talk about are quitting smoking and getting moving. If you don’t smoke, I can think of few things that will improve your health over the years as much as getting moving.

Athlete Running Through Finish LineGetting moving, statistically decreases our risk of death. It may be painful when we start to be more active, but movement generally helps us. Exercise helps us control our weight which is directly linked to all-cause mortality in multiple studies. In one study midlife running speed predicted cardiovascular health 30-40 years later. “Heart disease risk increases markedly for every minute longer it takes you to run a mile.” We will be healthier if we exercise consistently.

I often feel an improvement in my mood when I exercise. When I exercise, I am accomplishing something I understand to be good for me. So that thought, makes me feel better. I will often feel an elevation in my mood as I exert myself. I feel a little silly as I am pushing to finish a run and have a hard time suppressing a huge smile.
These studies and personal experience tell us that activity is good for us. I am not talking about drastic life changes that require spending hours at the gym. I am talking about thirty minutes of daily movement. This can be as simple as a daily brisk walk.

I recently read “The Power of Habit” by Charles Duhigg. He reports that most of what we do during the day requires no specific decision because it is a habit. I find that if we don’t have to decide in the moment then we can be more successful. Some people want to work-out for 1-2 hours twice a week. This is good, but I like the commitment to daily exercise and the routine that it creates more. If it is not a routine, it is too easy to stop
Many times unforeseen things can interfere with our goals, but having strived for to attain what we truly want with our health will provide benefit. Wellness is a combination of our physical and mental state that allows us to comfortably do the things we enjoy doing. One individual may love to run and they define success by their ability to keep running fast. Another may define it by their ability to play with their grandkids or go for a walk to the park. Let’s define what we want from our health and strive to get moving.

logoAbout the Author: Dr. Scoville is a Family Physician in Utah at the US Synthetic Clinic. He enjoys the outdoors, running, and cylcing.

Kids Are the Future of Tomorrow… So How’s Their Health? By Camille Olson

mid section view of a woman cutting vegetablesHow is the Health of our kids? We have all heard the old adage, “The kids of today are the future of tomorrow.” What happens when the kids of today are less healthy than the kids of yesterday? It is no secret that our children today have many health obstacles to overcome to ensure that they have a bright tomorrow.

I recently read an article by Dr. Mehmet Oz and Dr. Michael Roizen. I could not believe what the research revealed about our children and their future health. I have included below some of my favorite parts from the article.

“Today’s teens are developing heart disease, high blood pressure and diabetes at a younger age than any generation before them. After 40 years of improvement in America’s heart health, they’re likely to live shorter lives than their parents. There is no way to sugar coat this. More than 70 percent of teens studied already had one or more of these red flags: high blood pressure, high blood sugar, high triglycerides (a menacing blood fat), low levels of healthy HDL cholesterol, and lots of excess pounds.

CB100665How did kid’s health get so big? Blame the four S’s:
1. Sugary drinks and snacks: about 30 percent of teens’ daily calories now come from them.

2. Salt: kids eat more blood pressure-boosting sodium than any other age group.

3. Skipping the good stuff: only about 20 percent of kids eat five servings of fruit and veggies a day, or enough whole grains.

4. Sitting around: just 20 percent of teens get an hour of physical activity per day, the minimum for good health.

So as parents, and adult role models, what can we do to help? Truth is, we know what really keeps kids’ hearts healthy, not lectures and weigh-ins. Kids click with what YOU do. Don’t shame them, but focus on positives and their health. Start with these five basic recommendations:

peopleGet every kids’ cholesterol checked. Heart-health experts now recommend that all kids have a cholesterol test between ages 9 and 11 and again at age 17 to 21. Total cholesterol over 189, LDLs over 199 and triglycerides over 114, and healthy HDL below 45 means it is time to eat smarter.

Know your kids’ blood pressure. Your pediatrician can tell you if you child is fine, or needs help.
Change your menu. Today. Don’t wait! Few teens get even half the cholesterol-lowering fiber they need. Serve more fruits, veggies and grains. Toss walnuts and raisins on oatmeal, or Cheerio’s, keep apples and oranges on the counter, make sandwiches with 100 percent whole-grain bread, sprinkle veggies with almonds and serve water instead of sugary soft drinks.” Lead the way.

Downshift on pizza and other teen salt bombs: The single largest source of sodium in teens’ diets is pizza, so make it a once-a-month treat-and start with a big salad so a couple of slices of pizza will fill them up. Cutting back on salt now will cut your teens’ risk for high blood pressure later by 63 percent.
Tun off the TV and get moving: Play back-yard soccer, go to the playground, go skating or play Wii Fit. Simply cutting your family’s staring at TV time in half will help everyone burn calories and build muscle and as a result, self confidence.”

Not only do we need to follow these guidelines from Dr. Oz, but we need to realize the impact (both positive and negative) that parents and peers have on their children. Modeling good healthy behaviors will benefit both the leader and follower. These behaviors include: exercise, healthy eating, taking time for ourselves to “recharge” our batteries, and getting the proper amount of sleep. If you or a loved one is struggling, a therapist or health coach/trainers at Whole Fit can help support your efforts to change.

Whole Fit provides a comprehensive approach to wellness, weight management, and performance training. Our team includes experienced professionals with a wide range of health and wellness backgrounds. To learn more about our team visit us online at www.wholefitwellness.com.

camille2About the Author: Camille Olson is currently working in the marketing department at the South Shore Center for Couples & Families. She received her B.S. degree from Brigham Young University in elementary education. She is married and is the mother of five children.

Courage

quote for fb 3

Adversity

quote for fb 4

Feeling Anxiety? by Garret Roundy, LMFT, MS

Anxiety in response to feared situations or experiences plays a part in everyone’s lives, but for some, calming the anxiety requires a bit more help. Let’s take a look at a few ways to invite more calm into our daily lives.

Stressed BusinesswomanNeuroscientists have identified what they call fear extinguishing circuits in the brain (Herry et al., 2008). These circuits interrupt the basic fear response, so that previously feared stimuli do not activate the physiological and behavioral sequence that you feel as fear or anxiety. In other words, activating the fear extinguishing brain in response to fears keeps you feeling calm and engaged with life. Because anxiety is a response to a perceived threat, anxiety can be calmed if the threat is addressed.
So, what experiences can activate the fear extinguishing circuits? Glenn Veenstra (2013) succinctly cites four: security, safety, tolerance, and mastery.

1. Security is our most basic, inherited form of achieving calm after encountering a fear-inducing threat. We obtain a feeling of security through connection and proximity to other people who can protect us. Sometimes, just knowing we are not alone in a trial changes how we feel about it.

MP9003854012. Safety is achieved when the probability of danger is low. If I am afraid of lightning, safety is attained when I see a blue sky and my brain senses the threat of being struck by lightning is minimal to none. Oftentimes, much of our anxiety is needlessly produced by an overestimation of the probability of danger. Furthermore, this overestimation continues because of anxiety’s chief accomplice, avoidance. As long as the feared situation is avoided, a true evaluation of the danger cannot be made. Having someone help us along (#1, security) in facing our fears can make a big difference in discovering our overestimated threats and attaining a sense of safety.

3. Tolerance of the feared outcome can activate fear extinguishing circuits because the evaluation of “threat” is changed. If I can tolerate the pain of a paper cut and know that I can take care of it properly until it heals, then my mind isn’t threatened by the outcome and will not feel anxiety about reading the newspaper. That’s fine for a paper cut, but what about really big threats, like death? When death itself is a feared outcome that can be tolerated (or accepted!), then its power over us can be transformed into calm purpose in living; we can then live life without anxiously running from an inevitable transition.
For many who carry burdens from trauma, the continual pain caused by that danger in previous experiences remains clear evidence that the danger is not tolerable. The damage, much more than a paper cut, remains a wound that warns them to avoid certain threats because the cost of the danger is too high. Extinguishing this fear through tolerance will not happen until we experience healing and know that we can handle the pain and are stronger than the injury. After healing, the danger is tolerable. That is the earned peace of many people who have reached out to qualified help and received treatment for emotional and spiritual wounds.

?????????????????????4. Mastery is achieved through knowing we have the skill to master the danger. For example, anxiety about meeting new people because of feared negative social outcomes may be extinguished by mastering the skills of social interaction in such situations. A man, we’ll call Jim, avoided social situations with new people because they provoked intense anxiety. His perceived threat was that everyone (#2 overestimation of danger) would think he was strange or awkward and reject or not like him. Jim combined #3 (tolerance) with #4 (mastery) to find calm in this once feared situation. After feeling that he would be okay if some (#2, not everyone) people did think those things about him (#3), he reversed his pattern of avoidance and set the goal of meeting someone new every day. Instead of focusing on his defects or anxiety, he began observing and experimenting in these daily experiences, noticing what he and other people did and tried out different ways of interacting. I caught up with him after he had met over 1,000 new people. With time and practice, and certainly some tolerably awkward introductions, he developed the skills needed to master the danger inherent in social introductions and ultimately became very skilled and comfortable talking with people from all walks of life about everything!

balanceWhen the bottom line answer to our questions is “I’ll be okay because I am resilient and connected with others who can help me when needed,” then calm can quiet our fears and we can enjoy the energy of being fully present in our lives (Siegel, 2012). If you wonder about this possibility in your life, I invite you to hope and choose the path of courage, because greater peace is awaiting you.

Herry, C., et al. (2008). Switching on and off fear by distinct neuronal circuits. Nature, 454, 600-606.
Siegel, D. J. (2012). The developing mind: Toward a neurobiology of interpersonal experience. New York: Guilford Press.
Veenstra, G. J. (2013). Neuroscience advances for improving anxiety therapies. Anxiety disorders and Depression Conference, La Jolla, CA.

Garret Roundy2About the Author: Garret Roundy is a licensed Associate Marriage and Family Therapist in the state of Utah. He earned an M.S. from Brigham Young University and is currently completing his PhD in Marriage and Family Therapy. Garret has developed a specialization in the treatment of anxiety and trauma-related disorders through studying scientific research and completing advanced clinical trainings. He has also presented on these topics in professional and community settings. Garret is a therapist at the Provo Center for Couples and Families.

Can Facebook Harm Your Marriage? by Dr. Mark White Ph.D, MFT

Mature couple with laptop.Can Facebook harm your Marriage?  Although we’ve been hearing since 2009 that Facebook may be playing a role in divorce, a recent study published in the journal Computers in Human Behavior1, appears to be the first to scientifically examine divorce rates, marital quality, and the use of social networking sites (SNS) like Facebook.

The researchers examined two kinds of data. For each US state, they collected recent divorce rates and the proportion of persons in each state with a Facebook account. The second was an online survey of almost 1200 individuals specifically examining marital well-being and SNS use.

Across the 50 states, they found that as the proportion of Facebook users increased, there was a slight elevation in the divorce rate. While this finding is interesting, it doesn’t tell us anything about what’s going on for the individuals in that state. That’s where the individual-level data comes to play.

Attractive couple portrait.The researchers were able to control several variables in these analyses, such as income, education, race, age, and religious attendance. After removing the contribution of such factors, increased SNS use was shown to play a small role in predicting lower marital quality, less perceived happiness in the current marriage, more perceived troubles in the current marriage, and thoughts in the last year about leaving spouse.

Unfortunately, the design of this study did allow the re searchers to identify which is the cause and which is the effect (the perennial chicken and egg problem). Does SNS involvement cause marital problems, or do people in unhappy marriages spend more time on SNS? Although these data cannot answer that question, common sense would suggest that both occur.
For some, SNS detracts from the marriage and also provide an avenue for various forms of infidelity (such as wondering what your high school girlfriend is up to these days). Others seek support and contact with others to cope with an unhappy marriage.

Young Woman Sitting Looking at Laptop ScreenSo how can you prevent Facebook from harming your marriage? Here are 10 common sense suggestions:
1. Don’t hide anything on Facebook from your partner and don’t have anything to hide.
2. Have a shared understanding about how you each will use SNS. Some couples have a shared Facebook site (BradndSusan), others share the password to each other’s account, while others frequently look at Facebook together. There’s no right solution here—I just recommend you reach an agreement about the use of these sites.
3. Do not friend, or promptly unfriend, any person that makes your partner uncomfortable.
4. Analyze how you spend your time—are you spending more time with your virtual friends or your real-life partner?
5. If you discover that you’d rather post another kitten meme or play Candy Crush Saga than be intimate with your partner, it’s time to seek help.
6. Be willing to ask yourself some hard questions if you find yourself tempted to spend time perusing the pages of your ex, old flames, or people you find attractive (either on or offline). What’s going on in your life or your marriage that makes such behaviors appealing?
7. If you are unhappy about some aspect of your marriage, address your concerns with your partner rather than seeking support online.
8. If you both enjoy SNS, use them to flirt and communicate with each other. Message each other and post on each other’s page regularly. Make sure your status updates and photo albums convey that you are happily married.
9. Do not engage in any activity on an SNS (posting pictures, sending messages, etc.) that you would not participate in if your partner were sitting next to you, viewing the same screen.
10. Remember Rule #1.

1 Valenzula, S., Halpern, D., & Katz, J. E. (2014). Social network sites, marriage well-being and divorce: Survey and state-level evidence from the United States. Computers in Human Behavior, 36, 94-101.

markAbout the Author: Dr. Mark B. White is the Marriage and Family Therapy Doctoral Program Director at Northcentral University. He is a licensed marriage and family therapist and AAMFT Approved Supervisor and provides therapy at the Vernal Center for Couples & Families