Marriage Problems? Don't Wait to Get Help

Brought to you by Lois Fischer, MA, LMFT

If your marriage is having problems, you shouldn't wait too long to seek professional help.

From some recent reading I've done, in addition to my own experience in working with couples, I am sharing some  information on what type of couple gets the most from marriage counseling and what type of couple receives the least from marriage counseling.

Answer These Questions:

•    Did you marry at an early age?
•    Are you in an inter-faith marriage?
•    Did your parents divorce?
•    Do you criticize one another?
•    Is there a lot of defensiveness in your marriage?
•    Do you tend to withdraw from one another?
•    Do you feel contempt for one another?

If you answered "yes" to most of these questions, then you are statistically a higher risk for divorce than couples who have realistic expectations of one another and their marriage, communicate well, use conflict resolution skills, and are compatible with one another.

The Effectiveness of Marriage Counseling

A study by the American Association for Marriage and Family Therapy (AAMFT) shows that families do want therapy and place a high value on the experience.

What Type of Couple Gets the Most From Marriage Counseling?

•    Young couples.
•    Non-sexist couples.
•    Couples who are still in love.
•    Couples who are open to therapy and change.

What Type of Couple Receives the Least from Marriage Counseling?

•    Couples who wait too long before seeking help.
•    Marriages with one or the other spouse set on getting a divorce.
•    Married individuals who are closed to any suggestions that may save the marriage.

Solutions Learned From Happy Couples

Dr. John Gottman's research looks at happy couples for solutions. He has discovered that even though all couples experience conflict in their marriages, happy couples apparently know how to handle their disagreements because of a foundation of affection and friendship.

Unhappy couples do not have this skill.

Gottman's research suggests that the goal of couple therapy needs to change. Rather than trying to change marriages, he thinks counselors should teach communication skills to couples.

Don't Wait
If you think your marriage is in trouble, do not wait.  Call Lois Fischer for an appointment at 763-546-5797 and get your relationship back on track.  


Dr. David Alter presents "Keeping Memory in Mind: Remembering Our Past, Enhancing Our Future"

Dr. David Alter presents "Keeping Memory in Mind: Remembering Our Past, Enhancing Our Future", at tomorrow's prestigious Rosenthal Retreat of the Minnesota Society of Clinical Hypnosis. In this day-long workshop, Dr. Alter will teach about: 1) the key structures in the social brain that enable the encoding and subsequent retrieval of lived experience and; 2) how hypnosis can be used to impact memory, to remember and to forget.  Dr. Alter is the clinical director of the Institute for Brain-Behavior Integration at Partners in Healing. To schedule neuropsychological evaluations for adults, teens, and children, contact Dr. David at 763-546-5797 or This email address is being protected from spambots. You need JavaScript enabled to view it..


Neuropsychological Evaluations at the Institute for Brain-Behavior Integration

When behavioral, cognitive and emotional problems develop and interfere with daily functioning, it may be time to call  The Institute for Brain-Behavior Integration (IBBI). IBBI was created to provide those answers to brain-based challenges using comprehensive neuropsychological evaluation services.  

For many parents, the start of the school year is a time filled with questions about how best to help their children achieve success in class and with friendships.  For adults, the season may refocus attention on work performance difficulties, organizational challenges or other issues impacting success in daily life.  For adults and for parents of children and adolescents who have questions about how to manage challenges with…

  • Managing attention (e.g., ADD/ADHD)
  • Developing effective study habits
  • Establishing SAT/ACT, LSAT, GRE, MCAT accomodations
  • Establishing friends
  • Learning at a pace consistent with their expected potential
  • Behavioral self-control
  • Anxiety/Depression concerns
  • Substance abuse concerns
  • Concerns of aging (e.g., dementia)
  • Other developmental concerns

…where can you turn for answers?

Institute for Brain-Behavior Integration (IBBI)
David Alter, PhD, LP, ABPP, ABPH and Nancy Foster, PhD established the Institute for Brain-Behavior Integration (IBBI) at Partners in Healing to provide comprehensive brain-based neuropsychological evaluation services to address developmental challenges of childhood through older adulthood. Neuropsychology is the subspecialty field in psychology that uses standardized measures tailored to the needs of each individual to evaluate aspects of brain functioning in order to determine what may be impacting thinking and behavioral functioning.

Our IBBI evaluations focus on pathways between brain functioning and daily behavior. Our evaluation services help to identify the resources within the client and in their environment to help improve day-to-day functioning.

This can lead to positive changes in school or career performance, improve relationship skills with peers, families or couples, and improve overall psychological health. It can also help to fine-tune treatment plans  to make the treatment process more effective and to reach tangible treatment benefits for school and job performance or general daily functioning more quickly. To schedule an evaluation at the IBBI, call 763-546-5797 or contact us through email at This email address is being protected from spambots. You need JavaScript enabled to view it.. By David S Alter, PhD & Nancy Foster, PhD


Increased Celiac Disease Prevalence in Women With Unexplained Infertility

(Brought to you by Deborah Simmons, PhD, LMFT)

I have long wondered how nutrition affects our fertility.  This study from The Journal of Reproductive Medicine lends credence to the notion that our high-carbohydrate diet may well explain why some women suffer from unexplained infertility.  

Increased Celiac Disease Prevalence in Women With Unexplained Infertility

ScienceDaily (Aug. 18, 2011) — A recent study demonstrated increased rates of celiac disease in women who present with unexplained infertility.

Published in the May-June 2011 issue of The Journal of Reproductive Medicine, the study evaluated 191 female patients presenting with infertility. Each participant underwent serologic screening for celiac disease as well as routine infertility testing. The 4 patients who had positive serum test results were advised to seek evaluation with a gastroenterologist. All 4 patients were confirmed to have celiac disease. They then underwent nutritional counseling to change over to a gluten-free diet.

Among the 188 patients who completed testing, the prevalence of undiagnosed celiac disease was 2.1%. While this rate was not significantly higher than the expected 1.3%, the diagnosis of celiac disease in women with unexplained infertility was found to be significantly higher at 5.9% (3 of 51 women). Interestingly, all 4 patients found to have celiac disease conceived within a year of diagnosis.

Though the study numbers are small, the findings suggest that, at least for some women with infertility, dietary measures may help bolster fertility. "Diagnosing celiac disease in an infertile woman would be particularly beneficial if the low-cost (and low-risk) therapy of pursuing a gluten-free diet could improve chances for conception," says lead author Janet Choi, MD, a reproductive endocrinologist at the Center for Women's Reproductive Care at Columbia University. Co-author Dr. Peter Green, director of the Celiac Disease Center at Columbia University Medical Center, said that these results should be added to the increasing body of knowledge concerning the impact of undiagnosed celiac disease on women's reproductive health.


Love Someone Who Is Sick? Here's Great Advice.

I wanted to share this great article today in the New York Times by Bruce Feiler on the DOs and DONT'S of caring for someone who is ill.  I hope that it will be helpful to you.  Please feel free to share it with others.   Dr. Deborah Simmons                                                                                                                                                                          

‘You Look Great’ and Other Lies                                                                        

Published: June 10, 2011
New York Times

My friend sat down and ordered a stiff drink. I didn’t think of her as the stiff-drink kind. An hour later, after our spouses drifted off into conversation, she leaned over the table. “I need your help,” she said. “My sister has a brain tumor. I don’t know what to do.”

Three years ago this month, I learned that I had a seven-inch osteosarcoma in my left femur. Put more directly: I had bone cancer. That diagnosis led me down a dark year that included nine months of chemotherapy and a 15-hour surgery to reconstruct my left leg.

At the time, my wife, Linda, and I were the parents of 3-year-old identical twin girls, and we were often overwhelmed with the everyday challenges of having a sick dad, a working mom and two preschoolers. We survived with help from many people. Our siblings organized an online casserole club, so friends could buy us dinner through a meal service. Grandparents rotated in and out of our basement. My high school classmates made a video at our reunion.

But as my friend’s query suggested, some gestures were more helpful than others, and a few were downright annoying. So at the risk of offending some well-meaning people, here are Six Things You Should Never Say to a Friend (or Relative or Colleague) Who’s Sick. And Four Things You Can Always Say.

First, the Nevers.

1. WHAT CAN I DO TO HELP? Most patients I know grow to hate this ubiquitous, if heartfelt question because it puts the burden back on them. As Doug Ulman, the chief executive of Livestrong and a three-time cancer survivor, explained: “The patient is never going to tell you. They don’t want to feel vulnerable.” Instead, just do something for the patient. And the more mundane the better, because those are the tasks that add up. Want to be really helpful? Clean out my fridge, replace my light bulbs, unpot my dead plants, change my oil.

2. MY THOUGHTS AND PRAYERS ARE WITH YOU. In my experience, some people think about you, which is nice. Others pray for you, which is equally comforting. But the majority of people who say they’re sending “thoughts and prayers” are just falling back on a mindless cliché. It’s time to retire this hackneyed expression to the final resting place of platitudes, alongside “I’m stepping down to spend more time with my family,” or “It’s not you, it’s me.”

3. DID YOU TRY THAT MANGO COLONIC I RECOMMENDED? I was stunned by the number of friends and strangers alike who inundated me with tips for miracle tonics, Chinese herbs or Swedish visualization exercises. At times, my in-box was like a Grand Ole Opry lineup of 1940s Appalachian black-magic potions. “If you put tumeric under your fingernails, and pepper on your neck, and take a grapefruit shower, you’ll feel better. It cured my Uncle Louie.”

Even worse, the recommenders follow up! Jennifer Goodman Linn, a former marketing executive who’s survived seven recurrences of a sarcoma and is compiling a book, “I Know You Mean Well, but ...,” was approached recently at a store.

“You don’t know me, but you’re friends with my wife,” the man said, before asking Ms. Linn why she wasn’t wearing the kabbalah bracelet they bought her in Israel.

4. EVERYTHING WILL BE O.K. Unsure what to say, many well-wishers fall back on chirpy feel-goodisms. But these banalities are more often designed to allay the fears of the caregiver than those of the patient. As one friend who recently had brain surgery complained: “I got a lot of ‘chin ups,’ ‘you’re going to get better.’ I kept thinking: You haven’t seen the scans. That’s not what the doctor is saying.” The simple truth is, unless you’re a medical professional, resist playing Nostradamus.

5. HOW ARE WE TODAY? Every adult patient I know complains about being infantilized. The writer Letty Cottin Pogrebin, who had breast cancer, is working on a book, “How to Be a Friend to a Friend Who’s Sick.” It includes a list of “no-no’s” that treat ailing grown-ups like children. When the adult patient has living parents, as I did, many mothers in particular fall back on old patterns, from overstepping their boundaries to making bologna sandwiches when the patient hasn’t eaten them since childhood. “Just because someone is dealing with a physical illness,” Mr. Ulman said, “doesn’t diminish their mental capacity.”

6. YOU LOOK GREAT. Nice try, but patients can see right through this chestnut. We know we’re gaunt, our hair is falling out in clumps, our colostomy bag needs emptying. The only thing this hollow expression conveys is that you’re focusing on how we appear. “When people comment on my appearance,” Ms. Linn said, “it reminds me that I don’t look good.”

Next time you want to compliment a patient’s appearance, keep this in mind: Vanity is the only part of the human anatomy that is immune to cancer.

So what do patients like to hear? Here are four suggestions.

1. DON’T WRITE ME BACK. All patients get overwhelmed with the burden of keeping everyone informed, coddled and feeling appreciated. Social networking, while offering some relief, often increases the expectation of round-the-clock updates.

To get around this problem, I appointed a “minister of information,” whose job it was to disseminate news, deflect queries and generally be polite when I didn’t have the energy or inclination to be. But you can do your part, too: If you do drop off a fruitcake or take the dog for a walk, insist the patient not write you a thank-you note. Chicken soup is not a wedding gift; it shouldn’t come with added stress.

2. I SHOULD BE GOING NOW. You’ll never go wrong by uttering these five words while visiting someone who’s sick. As Ms. Pogrebin observes of such visits, don’t overstay your welcome. She recommends 20 minutes, even less if the patient is tired or in pain. And while you’re there, wash a few dishes or tidy up the room. And take out the trash when you leave.

3. WOULD YOU LIKE SOME GOSSIP? One surefire tip: a slight change of topic goes a long way. Patients are often sick of talking about their illness. We have to do that with our doctors, nurses and insurance henchmen. By all means, follow the lead of the individual, but sometimes ignoring the elephant in the room is just the right medicine. Even someone recovering from surgery has an opinion about the starlet’s affair, the underdog in the playoffs or the big election around the corner.

4. I LOVE YOU. When all else fails, simple, direct emotion is the most powerful gift you can give a loved one going through pain. It doesn’t need to be ornamented. It just needs to be real. “I’m sorry you have to go through this.” “I hate to see you suffer.” “You mean a lot to me.” The fact that so few of us do this makes it even more meaningful.

Not long ago, I reached out to my friend’s sister, Amy, who had endured three surgeries in the previous six months for a tumor in the thalamus. She was undergoing physical therapy and had just returned to work. What most annoyed her, I wondered?

“I liked having the family around,” she said, referring to her six siblings and their five spouses. “But I had a lot of issues with my room seeming like a party and my not being in a place where I could be down if I wanted.”

The most helpful tip she got? “People reminded me that I had a free ‘No’ clause whenever I needed it. Especially as someone who tends to please, that was helpful.”

So in the end, what would she say to someone like her sister who leaned over and asked for advice?

“Fully embrace the vulnerability of the situation,” she said. “I would never have gotten through it if I hadn’t allowed people in.”

That even included a new boyfriend, who became so intimately involved in her recovery that she allowed him access to her innermost self. The two became engaged in the I.C.U. and plan to marry next year.

  Bruce Feiler’s memoir, “The Council of Dads: A Story of Family, Friendship and Learning How to Live,” has just been published in paperback.