Tag Archive for: True North Teen Therapy

Should I get involved with my teenager's therapy? Parents and teen therapy

Why Should Parents Get Involved in Your Teen’s Therapy?

We have learned that true and influential change comes from numerous helping hands. Want to know how you can help in your teen’s journey through therapy? Here’s a few tips we have for parents that want to be more involved without overstepping boundaries.

1. You are with your teen WAY MORE than the therapist is.

You live with your teenager; therefore, your influence is more frequent than any therapist! It can be helpful to have several people working towards the same goal. For example, if your teen and therapist are working on improving depressive symptoms, it can help to have parent(s) or caregivers at home to remind the teen that they are doing a good job, are not alone in their struggles, and may need to try their therapy skills.

2. You can provide a different perspective.

The therapist and teen only have their own views. Adding in what caregivers see can greatly influence what is discussed, attempted, and a part of treatment.

3. You can help your teenager with their goals.

All humans need help. What would that look like?

  • Reinforcing what is taught in therapy at home
  • Encouraging your teen to do their therapy homework.
  • Practicing a therapy goal at home can influence change outside the therapy room into the teen’s whole world.
  • Could look like a family discussing and reflecting on the therapy session.

4. Your teen needs reassurance.

From my experience, when working with teens and bringing in their parents or caregivers, the teens are often happy we did. I’ve heard things like, “I’ve never talked like that before with them.” “It felt good.” “I didn’t know my mom thought that.” “I know my parents care about me, but it feels different; good different to know they really do.”

How do I get involved?

Your therapist may suggest you join a session or two. If that doesn’t happen, try asking the therapist if it would be helpful to join for your child’s treatment.

This blog was written by Meredith Edelen, Marriage and Family Therapy Associate, LSW. Learn more about Meredith and her work by calling True Counseling at 502-777-7525.

Healthy Aging Series by Mark Neese

How to Have a Killer Retirement: 3 Principles for “Writing Your Own Script” | Healthy Aging Series: Part 18

I was sitting at a McDonald’s a few years ago and overheard a conversation between two men. Both men were in their early 60’s. I recall that one of them had already retired and he was trying to convince the other man to retire. His argument was that when you retire, your time is your own.

It’s interesting the way we are programmed about retirement. Work all your adult life until you turn sixty-five. Stop working. Live on your retirement income. End of story. That’s how it’s written. I get it. I can’t imagine working a job when I’m eighty or ninety. Or maybe I can. I met with a couple this morning. They’re owners of an agency called, “The Center for Conscious Aging.” Chris, who is seventy-three, has a mother who is ninety-three. She retired at eighty-seven. Chris is still working. Maybe, that’s not how it’s written.

My brother-in-law is eighty-four and still working. People continue to work into their seventies and eighties for several reasons. They want to make a difference. They need to supplement their retirement income. They need to stay connected with people. They simple love what they do. Lots of reason. There is no right way or wrong way to spend your senior years. Retirement is a social construct. It’s a pre-written script that many, many individuals during retirement age refuse to follow. Maybe, we can write our own script for retirement.

I’ve been reading a lot of books on aging and one phrase that has come up a few times is: “You need to write your own script.” Maybe the word ‘narrative’ resonates with people today. 

Creating Your Own Script/Narrative.

The beauty of the retirement years is you get to decide what they look like. They are YOUR retirement years. Not mine. Not your children’s. Not your co-worker’s. Not your wife’s. You only get one crack at your senior years. Maybe thirty or thirty-five years if you’ve taken care of yourself and if you’re lucky. You get the chance to craft a life for yourself that will bring you happiness and contentment. Sure, there are limits to what you can do, limits to what your narrative will look like, but still, regardless of your limits, you can craft a life that suits you. You can write a script that mirrors what you value and what you find important.

How does one write their own script?

For some of you reading this, it’s too soon to start writing you script. You’re in your forties and fifties. The last thing you’re thinking about is retirement. But it’s not too soon to start dreaming about your future self, about what your life might look like in your seventies and eighties.

But if you’re in your late fifties or early sixties, it’s time to start, and here are some principles that I have used to write my script.

First Principle: What Gives Me Meaning and Purpose in Life?

My script reflects my desire to make a difference in this world. I can’t imagine not doing what I do. I get up each week, knowing that I help people face and solve their problems. It’s tiresome at times, but a good kind of tiresome. I work with a teen that is struggling with gender identity issues. I work with an elderly woman that lost her husband. I work with a young man that has lost his way. And a woman that struggles with her life choices. My script involves working  as long as I’m able to listen and express care and concern. What gives you meaning and purpose? Making furniture? Volunteering at the local homeless shelter? Crafting? Being a mentor to young people in your church, synagogue, or neighborhood? Being a Friendly Visitor? Whatever it is, write those things into your script.

Second Principle: What do I value?

My Script reflects the relationships that I value. I value my relationship with my wife. No surprise there! I value my relationship with my sons, with my grandchildren, and with my friends. My script reflects the people that I value. My script has me home most of the time with my wife. My script has me spending some evenings during the month with my son, Derrick, and every three months with my other son, Trevor, and my two granddaughters, Sophie and Harper. My script has me hiking with my good friend, Sam, and a couple of young men that challenge the hell out of me, Chris and Stacy. I have written people into my script.

Third Principle: Taking care of Myself.

My script reflects the importance of taking care of myself. I remember visiting my father after a very long and grueling backpacking trip in the Sierra Mountains. His response was, “Kimberly (the name he called me), that doesn’t seem like fun to me!” I said, “We’ll Dad, it wasn’t fun. That’s not why I do it!” His script didn’t involve challenging himself, mentally and physically that way. Mine did.

My script involves hiking, biking, and lifting weights. It involves limiting my sugar intake. Watching my weight. Reading self-help books. It involves watching very stupid movies like Sharknado and watching funny series like “What we do in the Shadows.”
My script involves spending time with my extended family. It involves walking every Thursday with my friend Gordon. It involves having some good collegial friends that I can call and consult with about tough cases.

My script involves what we call, self-care. I tell the newer therapists that I supervise, if they want to continue doing what they are doing for the next 25 or 30 years, they need to take care of themselves. How are they going to take care of others, their family, and friends, and their clients, if they are spent? I have written Self-Care into my script. Maybe this is where I should have started.

Writing your own script doesn’t mean that you are literally writing a script. What it means is, you are living the life that you want regardless of what others say. It means following your own compass in your senior years, your True North.

I love the movie, “Citizen Kane.”  The character played by Orson Welles, is on his deathbed, and with his last breath says, “Rosebud.” The reporter that witnessed his death spends the rest of movie trying to figure out, who was Rosebud. I won’t spoil the ending, other than to say that Rosebud was important to him. His final word reflected the script that he had been living.

What will you say on your deathbed? What is your Rosebud? Are you living a script that you’ve written?

I’m not sure what my last words will be in my script. I haven’t written them yet. Maybe they’ll be, “Game over, man!” (I love the movie Aliens) Or, maybe I’ll write something else. Maybe I’ll write what McMurtry wrote into Gus McCrae’s last words, into his script in Lonesome Dove. “It’s been quite a party, ain’t it, Woodrow.”

This is part eighteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Heathy Aging Series: How to Clean up after Yourself, before You Die

How to Clean Up After Yourself, Before You Die | Healthy Aging Series: Part 17

I think about dying almost every day. I know it sounds a little morbid. It’s actually hard to not think about it. I’m not quite pushing 70 but I’m closer to 70 then I am to 60. I have signs that I’m aging and in fact dying. Graying hair. White whiskers. Organs and body parts not working as well as they used to. When my senior friends and I get together, those meetings turn out to be what some referred to as an “organ recitals.” Comparing the last lab work, or doctor visit, or health insurance.

What do I think about when I think about dying? 

At times, I think about how I’m going to get rid of all the junk that I have accumulated over the years. I’ve begun to see my senior years is it time to start divesting myself of material things.  That’s why Margaretta Magnusson’s book, “The gentle art of Swedish Death Cleaning,“ caught my eye. I’m sure we’ve all witnessed death cleaning. My mother cleaned up after my grandfather when he died. I wasn’t living at home at the time, but I remember mom talking about how painful it was. When my paternal grandfather died, I remember my father getting grandpa’s Remington 16-gauge shotgun. I think there was a lottery process that grandma used to distribute his things. That was Death Cleaning

What is that cleaning? It’s the act of getting rid of the things that people accumulated during their life after they die. In some ways, it means cleaning up the mess that people made while they were living. Often, Death Cleaning falls on wives and daughters. They clean up after their family members when they die. 

Magnusson suggest a different approach to death cleaning, one that shows compassion to the ones we leave behind. She advocates that we “clean up after ourselves before we die.” Here are her or her gentle guidelines for the art of doing your own death cleaning. 

First, Magnusson reminds us that there is no sadness in thinking about or doing your own death cleaning. There is no sadness in visiting the things you accumulated one last time before finding them a new home. There is no sadness when you introduce your things to a new owner who will use them and appreciate them. I had a kayak and a mountain bike sitting in my garage. Neither one had been used for five years. I found them new homes with new owners that would use them and appreciate them. There was nothing sad about that desk cleaning. 

Magnusson‘s second gentle guideline involves getting started. Getting started generally involves three phases: 

PHASE ONE OF DEATH CLEANING

Go through your things. Do a survey. During this beginning phase you must get past your sentimentality. I don’t work with hoarders but I’m guessing that it’s sentimentality that creates the problem of accumulating all the things they have. It’s probably the answer to the question: Why do I keep my things and why did I accumulate them in the first place. As you do your survey of things, think about the boxes and boxes of things you have in your basement and in your garage and in your attic. The boxes of your children’s elementary school papers, and childhood toys, old Hallmark cards, childhood books, baby blankets, old tools, old dishes, the small appliances that you haven’t use for the past five years, bicycles you never ride, gifts you’ve never taken out of the boxes, clothing you never wear anymore, and the list can go on and on. Survey your storage unit if you have one

Why are all the new storage units being built? They are going up everywhere! And they are full of the things you’ve accumulated because of sentimentality. And it is sentimentality that is creating this hold on you and prevents you from getting rid of them. People who invest in building storage unts are counting on it. Think about how much people are willing to spend to nurture their sentimentality. Typically, a small unit is $75-$100 per month. Phase One: survey all of the things that you’ve accumulated and keep in mind the reason why you still have them. Sentimentality.

PHASE TWO OF DEATH CLEANING

Sort your Things. In your mind start two piles: The things you want to keep and the things you want to find a new home. Magnusson goes through the survey and begins with clothing. I do this regularly. I pull out totes with clothes that I haven’t worn for the past year or two. I have “keep and giveaway” piles. The giveaway pile I bag up and take to Goodwill. I have three criteria and deciding what goes into which pile. 

Do they fit anymore? Yes or no. Have I worn them in the past year? Yes or no. Would I wear them again? Do I still like them? Yes or no. Keep or give away.

Books. I love books and seeing them on bookshelves in my office. I have developed a new Death Cleaning policy for buying books. For every new book I buy I get rid of a book. I periodically go through my books and ask:

Why do I have this book? If it’s purely sentimental it’s going into the “giveaway“ pile.

I have a problem with coffee cups. I get cups from places I’ve visited. The Starbucks in San Francisco, Phoenix, Grand Canyon, make it hard for me to walk away without a cup. I’ve picked up cups in most national parks. I a new cup from the great Smoky Mountains national Park. I like to drink out of cups from places I’ve been. I’m kind of sentimental about that. But our kitchen cabinet can only handle so many cups. We have boxes of cups we never use. It’s time to sort through them. Two piles. Keep or give away.

PHASE THREE OF DEATH CLEANING

Get rid of the “find a new home“ pile. Magnusson has a couple of suggestions that make it a little easier on us as we confront our sentimentality. First, she suggests we take our time. This process can take place over a period of years. I’ve set aside some books my mother gave me for my granddaughters. I’ll give them the books. in a few years. I gave away four guitars to my sons. I think the important part of phase 3 is to begin the process of finding your things a new home. Her second suggestion is to start with less sentimental items and slowly move toward the more sentimental things. This helps “prime the pump.” You experience the satisfaction of getting rid of things that are less sentimental, and then you’re willing to try it with more sentimental things to experience the same satisfaction.

Stop accumulating things!

One of the best ways to begin cleaning up after yourself before you die is to avoid making a mess of things before you die. 

Quit buying things you don’t need!

Quit accumulating sentimental things that have no practical value.

Start finding things a new owner by never giving them a new home in the first place. 

Resist your sentimentality.

My Mother’s Death Cleaning

The day my mother died, I stayed in her little apartment. She didn’t have much. She had already given away most of her things. I had asked for her Gladys Tabor books a few years earlier and they had found a new home. I had given her Joseph Campbell’s, “Hero with a Thousand Faces,“ for her birthday a few years earlier. I did a little Death Cleaning and took it with me along with a knitted blanket and Clock. Her grandchildren were invited over a day or two later to claim the things they wanted. 

Mom made it easy for us because she had cleaned up after herself before she died.

I have a lot of stuff, a lot of things. I’m guessing you do, too. Do the loving and considerate thing and start the process of Death Cleaning now. 

Avoid making a mess in your life, that someone else will be forced to clean up, by walking away from the things you never needed in the first place. And give the rest away!

This is part seventeen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Healthy Aging Series Which Old Woman Will You Be?: A Book Review (Really My Reflections on a Book)

Which Old Woman Will You Be? A Book Review | Healthy Aging Series: Part 16

In this week’s entry to the Healthy Aging Series, I offer my thoughts concerning Debbie Hensleigh’s book, Which Old Woman Will You Be? Do’s and Don’ts for Living Your ThirdThird on Purpose.

Which Old Woman Will You Be?: Do's and Don'ts to Live Your Best ThirdThird on Purpose by Debbie Hensleigh

Image via Goodreads

Hensleigh writes:

“Start being that old woman you want to be… on purpose. Determined to live on purpose, intentionally forecasting which old woman you will become.”

I enjoyed this book. Simple. To the point. I use the slogan, “You’ve got to prepare for the last
10 years of your life.” Hensleigh agrees. She begins her book talking about an experience at a
nursing home where she meets two of the residents. One woman is somebody that she admires
and the other woman, she finds annoying and even offensive. She asks herself, which old woman
will I become. Maybe a trip to the nursing home would benefit all of us.

I shared an experience in an earlier blog about an elderly man that I called “Kroger Man,” an
individual that demonstrates that there are people who have reached their 70s and 80s, that none
of us want to become. Hensleigh’s book provides a very simple but meaningful outline of
do’s and don’ts that you can begin implementing right now if you’re in your 40s and 50s to
ensure that  your senior years will be meaningful and happy. I’ve used the “You have to
prepare for the last 10 years of your life” slogan because people tend to be mesmerized into
thinking that they’re never going to be old and they’re never going to have trouble as they get
older.

Hensleigh‘s book is an optimistic and positive approach to looking at preparing for your senior
years.  I liked it. I keep saying that. She has seven do’s and don’ts that I believe are a wonderful
outline for preparing for those last 10 years.

The Do’s and Don’ts

1. Quit Comparing Yourself to Others.

I think we’re living in a day and age where competition and comparison are toxic. They create a
frame of mind that can ruin your happiness and well-being. Life isn’t a competition. We should
strive to become our Authentic Selves. This means living a life that is based on your values and
beliefs, living a life that is completely distinct from what you think other people want for you, or
what others want you to be. It’s liberating!

Many writers that address the issue of aging talk about the idea of writing your own script.
Don’t allow others to write the aging script for you. Be true to yourself. Don’t allow yourself to
fall victim to the social pressures of comparing your body, or your finances, or your children to
those of others. Stop!!!!

This chapter was very helpful in looking at that life that is lived on its own terms and not on the
terms of others.

2. Being More Interesting.

I remember when I was in my early 50s. I found myself to be a rather uninteresting person and I
made a commitment to becoming more interesting and started with the area of music. My son
had downloaded many songs on our computer in the 90s. He left in the 2000s and  I started
exploring the computer and discovered thousands of wonderful songs and music that inspired me
to become a more interesting person.

I’ve begun the process of exploring life and exploring the world and exploring people. I’ve done
some studies on archetypes and one of my archetypes is an intellectual. I’ve discovered as a feed
that intellectual archetype I am more in tune with who I am and more satisfied with my life. 
Being interesting means broadening your life and your life interest to explore this wonderful and
beautiful world and culture that we live in.

3. Refuse to Be Lonely.

Early in my educational process, one of my professors disclosed that all his relationships were
intentional. I think he meant that he had relationships, not based on the idea of numbers but,
based on what he needed  and how those friendships met that need.

My mom, as she aged, developed relationships around a Hardee’s restaurant down the street
from where she lived. She would walk there every morning and spend a couple hours talking to
her friends and having coffee and a sausage biscuit. Those friends became a very important
part of her life.

I’ve developed a community of people in my life that revolve around my interest. My wife and I
share our travels, our personal development time, our TV series, and kitties. I have hiker friends.
I have intellectual friends. Of course, I have my extended family and my work family. Surround
yourself with good people.

4. Read Books

Hensleigh encourages people to be readers. I love books. Not in the same way that I love my
wife, children, and grandchildren, but I love books. Books are a way of exploring for me. My
mother introduced me to books when I was in high school, and I’ve been reading books ever
since. My office is full of books. I love buying books. I love reading books.  Books scratch me
where I itch. Hensleigh suggests that books are important for personal growth and broadening
ourselves as individuals. I agree.

5. Don’t Be Boring (Or Maybe, Don’t be Bored)

I think what she is suggesting here is that we  provide nourishment to our brain. She talks about
learning new things. She reminds us that nurturing our brain and providing nutrition for a brain
must be intentional.

6. Know Your Purpose

I’ve spent most of my adult life in the helping profession and certainly this is very important to
me.  I work with young men largely. But I also work with people within my own agency and
love watching and helping them grow and develop as clinicians and as supervisors. I would say
that helping others is a big part of my purpose in life. I believe as you age, you’re going to lose
opportunities to be involved professionally with other people. The word Elder, or Eldership
becomes more meaningful during this time. I hear a lot of older adults talk about their
grandchildren and how important that relationship is. Eldership is utilizing the experience and
the wisdom that you have and helping others benefit from your wisdom.

I believe it’s important to have a reason to get up  every morning. There’s lots of research to
suggest that having a purpose and meaning of life is very important as your age. Hensleigh has
provided several opportunities or ideas on ways to develop that purpose.

7. Don’t Get Stuck

The way to avoid getting stuck is to become more resilient. I’ve shared in the earlier blogs
about resiliency and how resiliency is the ability to bounce back from adversity. I believe this is
what Hensleigh is talking about. Developing resiliency is a very important part of aging and one
that we would all do well to begin focusing on as were younger.

Hensleigh‘s book is the Cliff Notes version of aging. Simple and to the point.
She hits on a high note. She shared some of her experiences with her physical fitness and
wellness and would probably do well to spend more time talking about that. But as far as her
focus on mental and psychological  resiliency, I think she’s done a wonderful job.

Who are you becoming? I want to be the type of older man that attracts, rather than repels
others. People tend to become more isolated as they age. Maybe it because it’s partly due to
the kind of person you’ve become.

This is part sixteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Improving Posture Can improve your aging and quality of life

How to Look Decades Younger | Healthy Aging Series: Part 15

There was a crooked man, and he walked a crooked mile,
And he found a crooked penny and he had a crooked smile,
He bought a crooked cat which caught a crooked mouse,
And they all live together in a crooked little house.

I remember the crooked man nursery rhyme. The image I got was of a man bent over shuffling along a crooked road. I saw the image of a crooked house, and the image of a crooked cat and mouse. It all seems a little nonsensical. There is a political interpretation that has to do with crookedness, as in dishonesty or “I’m not a crook” (I’m sure you get the reference.) But I’ll stick with the literal image.

When I look around in the community, much like the crooked man, I see lots of crooked people, bent over, twisted, shuffling, and often times using a cane. Or, another way of putting it is, people with poor posture. Unfortunately, poor posture is associated with being elderly.

Poor posture is a problem. One of the more obvious problems, if not superficial, is poor posture is associated with aging. 

In other words, poor posture makes you look older.

My wife and I were visiting Saint Augustine a few years back and we went to a place that they called the Fountain of Youth. “Drink the water and gain eternal youth.” I’m not one of those people who wants to deny getting older. My mother taught me that there’s no better age for you, than the age that you are right now. It’s more than just vanity to want to continue looking youthful. One of the ways that you can  accentuate your youthfulness is with good posture. 

Problems Created by Poor Posture

Beyond this somewhat superficial problem, there are other problems that poor posture creates. 

Poor posture can create mobility issues and put a person at risk for falling. When you are standing straight your body is positioned over your center of gravity.  As you become more bent over, your body leans out, forward of your center of gravity. It would be similar to you taking a 10-pound dumbbell and holding it out in front of you and maintaining uprightness as you do. It puts a lot of strain on the body and puts you at risk for falling over.  

Poor posture can cause back pain and other joint pain. It puts constant strain on your lower back muscles. And for those with more severe posture issues it can cause problems with your breathing by limiting the full range of motion that you need to inhale and exhale fully.

What Causes Posture Problems?

There are a few obvious answers to that question. These are habits that are usually out of our control.

  • Accidents

There are times that posture problems are created from accidents. I have family members that have a difficult time standing up straight because of back injuries due to car accidents. There are genetic problems that are completely out of your control that can cause posture problems. 

  •  Gravity

One of the more obvious problems that every human being deals with is gravity. Gravity is constantly pulling you downward. 

  • Aging

Another issue that we all face as we age is the lack of elasticity in our ligaments and the fragility that are bones experience as we age.

And here are the controllable, lifestyle causes for poor posture:

  • Poor Postural Habits!

Poor posture is more often than not related to two or three preventable issues that we all encounter as we age. Poor posture is often-times related to poor postural habits that we practice throughout our lifetime. This is in large part due to the fact that we sit a lot, stooped over a desk, or over a steering wheel, or just simply don’t resist the effects of gravity on our body. 

  • Loss of Muscle Mass

Throughout our lifetime, as we age, we lose muscle mass. Of course everybody is different, but beginning in our 40s and 50s, we slowly lose muscle mass due to a decrease in growth hormone and other hormones. I mentioned this condition in other blogs related to resiliency, this condition is called Sarcopenia. Our body needs muscle in order to stand straight. Muscle and ligaments hold our joints in place. Of course I’m oversimplifying this but a loss of muscle mass contributes to poor posture. 

  • Loss of Muscle Strength

This involves the muscles in our core, and those muscles that contribute to mobility and stability. It isn’t just the loss of muscle mass, it’s a loss of muscle strength and endurance.  It takes strong muscles to fight the never ending pull of gravity on our body. 

One of the muscles that rarely gets talked about is the Transverse Abdominus muscle or TVA. This is the muscle that is the innermost layer of our abdomen and it is responsible in large part for our stability. It’s the muscle that helps hold our guts in place. And therefore it makes sense that it should be the our focus when talking about posture.

How to Have Better Posture

I was standing in front of one of the young men that I work with the other day and I’m not sure if he meant it as a compliment, but I took it as a compliment. He told me that I stand like someone in the military. It does seem to me that young men and women in the military are taught to stand up straight and suck in their gut, and push their chest out. I felt pretty good about his comment because I spend most of my waking hours focusing on my posture. I do this for several reasons but I also do it for a reason that may not be the most important, but I do it because I want to send a signal to others that one way that you can maintain a youthful look is by focusing on your posture.  So, what do I do, and what can you do to improve your posture? 

Note: If you have been diagnosed with Hyper-Kyphosis, consult a doctor and Physical therapist before doing any flexion exercises that cause you to bend forward. Flexion exercises can increase risk for factures to the vertebrae. Here are a list of dos and don’ts to avoid flexion stresses when exercising and activities of daily living:

  • Maintain good postural alignment during exercise 
  • Strengthen core stabilizer muscles, such as transversus abdominus, obliques, and multifidus 
  • When bending or lifting objects, keep the spine in neutral, and bend at the hips and knees (hip hinge); keep objects close to the body 
  • When getting out of bed, roll onto the side before sitting up (log roll) 
  • When coughing or sneezing, stabilize trunk in neutral by hugging a pillow, or placing hands on knees while hip hinging, or place hand in small of back to help keep back in neutral 
  • Maintain the natural curves in your neck and back while sitting and standing. Imagine that you are lengthening through the crown of your head 
  • Adjust height of the walker and walk within the frame when ambulating
  • Avoid seated rowing machines or upper body ergometers 
  • Avoid crunches, curl-ups, or flexed position (traditional sit-ups) 
  • Don’t twist or bend your spine when lifting objects 
  • Don’t sit straight up from a horizontal position
    Avoid forceful trunk flexion while coughing or sneezing 
  • Avoid leaning over towards your work, or standing in a pelvic tilt 

Ok, for the rest of us, here is what you can do to insure you maintain good posture as you age.

Exercise! You need strong muscles in order to maintain good posture. I do this by resistance training and I focus on muscle strength and muscle endurance. I focus on my back muscles and my core muscles. Strengthening your back muscles, helps to pull your shoulders back and help you stand upright. 

Current best-practices suggest that spine-strengthening exercises and posture training help correct posture problems with older adults. 

I have pointed out in other blogs, that as you age, you need to incorporate instability into your workouts. This means narrowing your center of gravity as you do your workouts and alternating left and right plains of your body as you exercise. 

Stretch! Often times our body is out of balance and that can cause posture problems. For example overly tight hamstrings, the three large muscles at the back of your thighs, and hip flexors, the muscles at the top front of your thigh, can hamper basic movements like walking and running. When muscles are tight, a common result from too much sitting, you’re not able to fully extend your legs and straighten your knees. Inflexible hamstrings have also been seen as one of the causes of lower back pain. Another common problem that stretching can address is having tight chest muscles. These muscles pull your shoulders forward giving you a hunched silhouette instead of a longer, slimmer, youthful looking you. Stretching can also address the issues of joint inflexibility. Joint inflexibility can undermine your balance which can cause life altering falls. Stretching helps with all of these problems.

Practice Good Posture! One of the exercises that I do often is activating my TVA. I stand up, and then pull my belly button in toward my backbone. This is what some call “sucking in your gut.” Practicing good posture also means sitting up straight. It means limiting the amount of time that you sit. 

One of the things that has affected my posture over the years is my drive out to Colorado to visit family. I love those long road trips, but sitting that long, 17 or 18 hours straight, wreaks havoc on my lower back and on my posture.

There is no Fountain of Youth! But there are ways of maintaining your youthful appearance. And ways of avoiding the negative consequences of poor posture. Start working on them now!

This is part fifteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Healthy Aging Series Part 12

Do These Five Things And I Will Predict Your Future! | Healthy Aging Series: Part 14

I’m sick and tired of watching the weather. I have a backpacking trip planed to the Great Smoky Mountains National Park this weekend and they’re predicting rain. An 80% chance of rain. I’m tempted to cancel but I’ve canceled backpacking trips before, when the local meteorologist predicted rain, and I regretted it. 

Predicting the weather is one thing, but what about predicting the future? I remember the beginning of the pandemic. I told the clinicians in our agency to do what they could to attend to the needs of their clients, and then I predicted that it would be over in two months. LOL. I missed that prediction by about two years.

What if we could predict your future? I mean really predict your future. What if we could predict whether you aged successfully? There was a study that was completed a few years ago that looked at the possibility of predicting your future. It was called the HUNT study. It was performed in Norway with about 4500 participants, ages 45 to 59, and it lasted over 20 years. Here is the question that the researchers asked: 

Are there behaviors that you can do, beginning around mid- life, that can predict whether you age successfully? 

Their answer: Yes!

What is “Successful” Aging?

What exactly did they mean by successful aging? They were three criteria:

First, successful aging was defined by the absence of disease. The list of this orders was short. It included serious diseases like heart failure, cancer, stroke, and depression.

Second, it was defined by high cognitive and physical functioning.
The physical criteria generally meant that you could take care of yourself and perform most activities of daily living, to include, showering, dressing, cooking, laundry, shopping, and household task. It was also defined as being able to remember what happened a few days ago.

The third criteria for successful aging was engagement with life. You were engaged with Live if you worked or volunteered in a job or got out of the house at least once a month to do something like going to church, or to a concert, or to a museum.

Notice what’s not mentioned in the definition of successful aging. You can have diabetes, have high blood pressure, use a cane, be a little overweight, be fully retired and not work or volunteer, living solely on Social Security, sitting around the house watching and binging series on Hulu in the evenings, with a vodka martini or just popcorn. The bar is low for successful aging. No general fitness criteria like 18% body fat or being able to bench press your bodyweight. If you are aging successfully, you’re generally healthy, generally able to take care of yourself and you remember what you had for dinner the day before, and generally connected with people in the community. Not a bad prospect for getting older.

What Are the Lifestyle Predictors?

What are the lifestyle predictors for successful aging? Spoiler alert: there are no surprises here.

1. Being a former-smokers or non-smoker.
Notice that if you stopped smoking by middle-age we can predict that you will age successfully. No surprises here. During the height of the pandemic, we were shocked by the number of people that were dying from COVID-19. It was heartbreaking. But before, during, and after the pandemic there were approximately 1300 deaths related to smoking cigarettes every day. Tobacco use accounts for 30% of the incidence of cancer. Smoking cigarettes is one of the major causes of COPD and emphysema. Being a non-smoker or a former smoker is high predictor that you will successfully age.

2. The second predictor is high physical activity. This was defined as exercising one or more times per week and on at least one of these occasions sweating or being out of breath. Again, not a high bar: work out at least two times per week and one of these workouts needs to be more intense. This behavior, along with being a former smoker or non-smoker,  were the highest overall predictors for successful aging. Notice, you don’t have to run half marathon‘s, join a spin class, climb 14,000-foot peaks in Colorado, ride your bike across the state of Indiana, be a bodybuilder, or participate in any extreme sport. Just work up a sweat or breathe hard at least one of the two times you exercise each week.

3. The third lifestyle predictor is having a BMI under 30, which put you under the obese criteria. Notice, there is no mention of any particular type of diet. The lifestyle predictor is, manager your weight anyway you can, using whatever diet strategy that suits your personality. My good friend Sam swears by the zone diet. Some people prefer the whole 30 diet or Atkins diet or Paleo or Mediterranean diet or Dash diet. Some people are vegetarian or vegan‘s. I tend to follow what is referred to as time-restricted eating or what some have called intermittent fasting.  This lifestyle predictor didn’t monitor for any supplements, or the percentage of macronutrients that you’re taking, or calorie intake. It didn’t even stipulate that you can’t be overweight. Just having a BMI below 30 or below being obese.

4. The fourth lifestyle predictor was low to moderate alcohol consumption. The definition of this predictor was drinking five times or less during the past 14-day period, without excess. Moderate/high consumption meant drinking five or more times in a 14-day period with periods of access during that time. Here is an interesting caveat to this predictor. Regardless of high or low alcohol consumption this behavior played almost no role in predicting successful aging. This is partly because most subjects were moderate to mild drinkers. Having said that, the low drinking status did not predict, by itself, successful aging.

5. Social supports. The definition of social supports in the study meant being connected with others and having significant relationships in your life. The criteria included two factors: Do you feel lonely? And do you have a person in your life that would help support you during an extended illness? The less lonely you felt and feeling that you would receive help when ill were predictors for successful aging.

What are Your Odds of Aging Successfully?

Look at your life and count the predictors.

1. Are you a former smoker or non-smoker?
2. Do you exercise intensely at least one of the two times that you exercise each week?
3. Is your BMI under 30?
4. Are you a mild or moderate drinker?
5. Are you connected to people in the community?


Of these five predictors the one that is most important to have in your life is being a former smoker or non-smoker. This means: if you smoke stop now! All bets are off if you smoke!

In other words, if you are a former smoker or non-smoker, you greatly increase your odds for successful aging. Having all five predictors dramatically improves your chances of successful aging.

If I were a betting man and you had the first predictor (former non-smoker) and at least two or three of the other predictors, my forecast would be clear skies ahead for you! 

You cannot predict everything about your future. Will you experience an accident, or exposure to an unexpected virus, or exposure to environmental toxins? No one knows. Those things are out of you control! What things are in your control are the lifestyle predictors that can and will predict your future.

BTW: I postponed my backpacking trip to the next weekend because of the rain chances. I watched my weather app closely that weekend. Not a drop ☺

This is part fourteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Healthy Aging: Physical Resiliency “The older the house more the maintenance.”

“The Older The House, More The Maintenance” | Healthy Aging Series: Part 13

(Read the last paragraph first!)

I remember sitting in a classroom at Portland Community College, Portland Oregon (pronounced aw-ruh-gun, not aw-ruh-gone). It was 1979. The Class was Lifespan Development. The instructor was John Lawrence. The first words out of his mouth were, “The older the house the more the maintenance.” Since then, I’ve owned an older home for twenty years. I know exactly what he meant, except of course, he was talking about the aging process and, yes of course, he meant our bodies. Drive by any abandoned home. Anywhere. Roll down you window and stare at it for 5 or 10 minutes. Now, think about this: That’s you if you don’t take care of your body.

I can predict your future.

What you eat and how much you exercise will determine your future physical resiliency. What you eat and how much you exercise will determine almost everything about your future. Don’t delude yourself. You cannot escape the consequences of bad diet and a sedentary lifestyle.

Exercise: The Silver Bullet.

I’m going to write several blogs on fitness and health and aging, so this will be a brief explanation of the benefits of exercising. Having an active lifestyle is the best gift that you can give to your future self. One of the more important books I’ve read over the past five or 10 years is a book entitled, “Younger Next Year,” by Chris Crowley. It’s a book that promotes a good diet and regular exercise. Read it!

If there’s one thing you can do to improve your resiliency it’s, start exercising. Here are some of those benefits: 

  1. Exercising helps control weight. It helps prevent obesity and accompanying diseases.
  2. Exercise reduces the risk of heart disease, which is one of the leading causes of premature death. 
  3. Exercise helps manage blood sugar and insulin. 
  4. Exercise improves our mental health which enhances in mind-body connection. I’ve written about this in an earlier blog. 
  5. Exercise improves your brain functioning, see future blogs and the aging brain. 
  6. Exercise reduces the chances of falls. See future blogs and fall prevention. 
  7. Exercise helps to maintain muscle mass. Losing muscle mass is a big problem as we age, and dramatically impacts our physical resiliency.

Diet: You Can’t Outrun a Bad Diet

Michael Pollen writes, “Eat real food. Not too much. Mostly plants.” The purpose of a resiliency-based diet is threefold: 

  1. Helps maintain weight and muscle mass. I don’t believe this means starving yourself. It means portion control. Most Americans eat too many calories and not enough protein for muscle mass maintenance. But there is a caveat to promoting muscle growth. You must also couple protein intake by or with exercise.  Muscle mass equals stability and mobility. 
  2. Provides needed natural micro and macro nutrients. Your body was engineered to extract needed micronutrients from real food. If you’re eating real food, unless your doctor prescribes supplements, you don’t need to take them. I was taking zinc because I was told that “it enhances your immune system.” I told my doctor and she advised me to stop. She said that it could interfere with my ability to absorb copper. Some people take a daily vitamin for insurance but if you’re eating right, you don’t need them. Eat real food, to include lots of fruits and vegetables, which provide vitamins and minerals that boost immunity and lead to enhanced resiliency. 
  3. Maintains good gut health, both pre-and probiotics. Never forget that you were eating for two: you and the colony of bacteria or microbiome that lives in your gut. Feeding the micro biome means eating lots of natural fiber, fruits and vegetables, whole grains, and lots of fermented food . This includes kombucha and yogurt.

Here are the benefits of a healthy gut:

  • Improved food digestion.
  • It helps regulate your immune system which promotes resiliency
  • It produces vitamins, which includes B12 Simon and riboflavin.
  • A healthy gut enhances weight control.
  • It improves your mental health by enhancing the brain gut connection. A heathy gut improves cardiovascular health by helping to control cholesterol.

How do we improve our microbiome?

  1. Eat fruit and fermented food to include yogurt, sauerkraut, and kefir. Be mindful that sauerkraut often is not fermented but simply stored in salt brine.
  2. Eat a wide range of real food. Vegetables, beans, fruit, fiber, whole grains. Eat foods that include polyphenols. Red wines, green tea, dark chocolate, olive oil. Limit your use of antibiotics.

Physical resilience is the result of good diet and exercise.

Make no mistake. You cannot eat junk food and neglect fruit and vegetables, on top of living a sedentary lifestyle, and expect to be a physically resilient person. Your ability to bounce back from viruses, broken bones, exposure to chemicals or other toxins, and from genetic minefields, if you do not take care of your body. That’s as simple as it gets. It’s about taking care of your body. If you take care of your body, you will be a more resilient person now and in years to come.

Don’t do what I say, do what I do!

I’ve just finished editing this blog. I’m visiting my granddaughters in Colorado. I’m leaving my room in a few minutes for a 2-hour hike in the mountains. I had a high-fiber, high protein breakfast with some fruit. I work out every day, most weeks. I eat food, not too much, mostly plants, most weeks. 

This is part thirteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Healthy Aging: Psychological Resilience 10 Practices to “Keep Your Head in the Game” of Life!

10 Practices to “Keep Your Head in the Game” of Life! | Healthy Aging Series: Part 12

I’m on a Southwest flight 31. Headed to Chicago and then to Cancun, Mexico. Vacation mode. With my wife. We work hard at helping others. We give a lot of ourselves. Often, times we see a lot of pain and suffering. I see broken families. I see men and women in despair, and yes, I see hopelessness. All of this takes a toll on us on us. That’s what life does.

Life Can Be Messy 

Throughout our lives we experience the loss of  jobs, of first loves, or the loss of money in the stock market. We live through the stress of a spiteful supervisor, the stress of an irrational neighbor, the stress of living in a partisan country. We carry the burden of wayward children and grandchildren, the burden of an ailing partner, the burden of a dying parent. We endure the disappointment of unfulfilled dreams, unrequited love, and undeserved betrayals. Life can be a mess.  How prepared are you for those messes, the mental and emotional upheaval‘s? How psychologically resilient are you? How quickly do you rebound from the disappointments, from the unexpected adversities, and from unwanted changes?

What is Psychological Resiliency?

I have written in an earlier blog about resiliency. In some ways it helps to understand that physical resiliency is the opposite of physical vulnerability or physical fragility. Psychological vulnerability and  fragility are similar in many ways. Psychological resiliency acts as a buffer between us and our adversity and helps preserve our emotional balance or what some call homeostasis. Why is this important and what can we do about it?

Psychological resiliency is important because of the body-mind connection. If we are fragile psychologically or physically it affects our mental resiliency. People that are physically frail often suffer emotionally and psychologically  and vice versa.

If psychological resiliency is that important,  how does one become more psychologically resilient? How does one develop emotional stamina, mental strengthen and endurance? The mindfulness community teaches the phrase “What we practice grows stronger. The AA community refers to the 12 steps and encourages its members to practice the principles in all their affairs.

Becoming and maintaining our psychological resilience takes practice.

In the same way that you need good nutrition and exercise for physical resilience, you need good mental nutrition and mental exercise for psychological resiliency. Becoming resilient and maintaining our  psychological resilience takes practice. Much like you need good nutrition and exercise for physical resilience you need good mental nutrition and mental exercise to grow your psychological resilience. It’s all about diet and exercise

Living My Life by Slogans (Practices)

I have based much of my own psychological resiliency on slogans and  mottos that reflect resiliency practices. What follows are a number of those slogans that I encourage you to practice. 

1. You have to adjust to the things that won’t adjust to you. I believe this means living life on life’s terms. There are a lot of stressors and things that happened to us throughout our years and our expectations of life, and these events can create a reactivity to the stressor that takes its toll on us both mentally and physically. Excepting the things that we cannot change is part of the process of developing resiliency.

2.  Easy does it. I have learned to not push so hard when pursuing my wants and needs. As a therapist I’ve learned that working with families involves being a change agent. I use the Easy-Does-It approach when is work with families. This means taking it slow and not pushing so hard for change.

3. The golden rule: Do unto others as you would have them do unto you. If there is any guiding principle in life that I use, it’s the practice of treating others the way that I want to be treated. Practicing this principle eliminates conflict in relationships.

4. Memento Mori: “Remember that you will die.” I think about dying every day. There’s a lot to be said about this. Stoics believed that life only has meaning in light of dying. Resiliency grows as you make the most of each day, and that comes as we appreciate the meaning of each day.

5. “I treat everyone like my peer.” A few years ago I was watching an interview with Norman Lear, the creator of “All in the Family” and “The Jeffersons.” At the time he was 93 and his interviewer asked him how it was that he seemed so youthful. His response was, “I treat everyone like my peer.“ There are practices that can alleviate resistance and difficulty in relationships. This is a practice that helps people or puts people at ease when they are with us and allows us to create it environment for them and promotes your resiliency.

6. Do the Next Best Thing. Life can present us with difficult decisions to make in the future. We fast forward at times into our future and think about all the things that we might face. We become overwhelmed by what “might be.” Doing the next best things means focusing on the here and now and dealing only with the problems that you face now. The future can rob you of your serenity and contribute to your loss of resiliency.

7. Build a Repertoire of Positive Sentiment. I go places with my wife to build a repertoire of positive sentiment. I hike for the same reason. I backpack for the same reason. I read and listen to new music for the same reason. I spend time with my sons and granddaughters for the same reason. This repertoire is a protect bubble that protects you from the hardships of life.

8. Balance Giving and Receiving. I know you’ve heard the slogan: It’s better to give than receive. This is BS. You must be a receiver for someone to be a giver. I love giving, but only being a giver ensures that you will become cynical and burned out. Learn to be a receiver.

9. Balance Work with Play. If you are going to be resilient you must play. You must have fun. You must be a little boy or little girl and play in the mud and make mudpies. You must make playdough cookies. You must laugh. You must tickle and be tickled. 

10. Spend Time Alone in Your Head: -reflecting -creating -using active imagination. There is the saying in the religious world, “Let go and let God!” I prefer, “Let go and let the wonderful, hidden thoughts that you’ve repressed and suppressed express themselves in those quiet moments that you spend by yourself.” I often do this while hiking by myself in the Jefferson Memorial Forest. I also suggest one of the Parklands of Floyd’s Fork parks. Reflect on the day. Reflect on the year. I love thinking back on the old year each New Year’s Day. Not all the memories are good but reflecting in them is necessary. 

These are my life-affirming practices. What are yours? What’s working for you? What gets you through the hustle and bustle of life? What helps you decompress from the stressors in life? What you practice is growing stronger.

This is part twelve in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Trust Based Relational Intervention, TBRI, explains an alternative way to handle siblings in a conflict.

A Way to Manage Sibling Conflict

Trust Based Relational Intervention (TBRI) explains an alternative way to handle siblings in a conflict. The main goal of this intervention is to have your child:

1) stop telling on their sibling to promote healthy relationships, 

2) teach your child accountability, and 

3) manage conflict healthily.  

Now how do we get there?

  1. The caregiver says, “I want to know what you did” or “What did you do?”
  2. Repeat that phrase as many times as it takes until the child tells you what they did, not their sibling.
  3. After the siblings have both shared what they did, the caregiver responds with, “Thank you for telling me what you did; now, how can we do this better? Can we try again?”
  4. Have your children “redo” the situation.
  5. Move on.

There is no “punishment” or “consequence” – we prompt children to redo situations in a healthier way.

Additional options and concepts: 

  • You may need to remove the children from the space to a neutral or different setting. 
  • You may try prompting everyone to take a deep breath before the conversation. 
  • You may separate children and go from one sibling to the next, then bring the sibling unit together for a redo. This ideally is immediately after a fight, argument, or incident. 
  • Prompt with choices if necessary. “You can ____, or you can _____”. 

Siblings have conflict, and this cannot be avoided. But how your children learn, grow, and respond to these experiences matters. Stay connected to both children when using this intervention. Try speaking calmly and maintaining eye contact. If you need help managing sibling conflict, additional ideas could be looking into family therapy! 

This blog was written by Meredith Edelen, Marriage and Family Therapy Associate, LSW. Learn more about Meredith and her work here

Personal Relationships Virtual Class Session at True North Therapy of Louisville

New Adult Personal Relationships Group Therapy Session Starting September 13, 2022

We’re excited to announce another virtual group therapy series here at True North Counseling: Personal Relationships!

This class is open to adults ages 18+. Classes are online every Tuesday, from 12-12:50 pm. They will run for 10 weeks, beginning on September 13th. Classes are $15 per week.
These classes are for adults seeking guidance concerning friendships, romantic connections, and other personal relationships. Each session will focus on learning about new skills to use in different types of relationships. Expect to learn about boundaries, consent, and other important relationship skills.
If you’re interested in joining or have any questions, please reach out to jennifer.kendrick@truenorththerapylouisville.com.
You can also contact us by visiting our Contact Us page or calling 502-777-7525.
See the flyer for the session here:
Personal Relationships Virtual Class Session at True North Therapy of Louisville