• This is a very informative, well done video about Neurofeedback services, like those that I provide in my clinic. The video is done by some of the leaders in my field, and it does an excellent job of discussing Neurofeedback therapy.
• If you have any questions about Neurofeedback, or if you are interested in seeing if and how it might help you or your children, please give me a call.

ALZHEIMER’S ASSOCIATION LAUNCHES TRIALMATCHTM –
FIRST-OF-ITS-KIND CLINICAL TRIAL MATCHING SERVICE IN ALZHEIMER’S
 
Alzheimer’s Association TrialMatchTM Connects People with Alzheimer’s with Potentially Life-Altering Clinical Studies
 

 
July 12, 2010, San Antonio, Texas – The Alzheimer’s Association announced today the launch of Alzheimer’s Association TrialMatchTM, a confidential and free tool that provides comprehensive clinical trial information and an individualized trial matching service for people with Alzheimer’s disease and related dementias. 
 
The Internet (www.alz.org/TrialMatch) and phone-based (800-272-3900) service debuted during the Alzheimer’s Association’s 2010 International Conference on Alzheimer's Disease (ICAD) in Honolulu, HI.
 
There are as many as 5.3 million Americans living with the disease and every 70 seconds someone in America develops Alzheimer’s disease, according to the Alzheimer’s Association’s 2010 Alzheimer’s Disease Facts and Figures.
 
“Alzheimer’s disease is reaching epidemic proportions with devastating impact on families, and the potential to wreck Medicare, Medicaid and the health care system,” said William Thies, PhD, Chief Medical and Scientific Officer at the Alzheimer’s Association. “The immediate need for advances in diagnosis, treatment and prevention has led to an unprecedented need for clinical study participants. This, combined with challenges specific to recruitment and retention of participants with Alzheimer’s, has created a particularly difficult situation for the field. That’s why the Alzheimer’s Association has launched Alzheimer’s Association TrialMatch.”
 
Recruiting and retaining participants for clinical studies is one of the greatest obstacles to developing the next generation of Alzheimer’s treatments.1
 
“We’re looking to physicians to play a leadership role in referring their patients to clinical trials in Alzheimer’s and dementia,” said Marilyn Albert, PhD, Professor of Neurology at Johns Hopkins and Director of their Division of Cognitive Neuroscience. “As healthcare professionals, there is more we can do to help our patients post-diagnosis.  By referring our current patients to trials, we offer access to potential cutting-edge treatments while unlocking the door to potentially more widely-available treatments for people with Alzheimer’s in the future.”
 
There are no treatments available to slow or stop the brain cell deterioration that occurs with Alzheimer’s. However, more than 100 clinical studies in Alzheimer’s and dementia are currently taking place and dozens more experimental compounds are moving from the laboratory to clinical testing.
 
“Families affected by Alzheimer’s need better diagnostic and treatment options now, and the lack of participants in clinical studies is a significant public health issue,” Dr. Thies said. “Alzheimer’s Association TrialMatch is a powerful and user-friendly tool for people with Alzheimer’s, their healthcare professionals, caregivers, and healthy volunteers to learn about and take part in cutting-edge research going on right now. By volunteering for clinical studies, people with Alzheimer’s and their caregivers can play a more active role in their own treatment while also contributing to scientific discovery and benefiting future generations. It is public service in the best possible sense.”
 
Alzheimer’s Association TrialMatch is a “dementia friendlier” service than others in this space, with web and phone support, specially trained staff, and tools developed with input from people with Alzheimer’s.
 
The strength of this Web- and national 800 line-based service is that Alzheimer’s Association TrialMatch contains a comprehensive, constantly updated database of institutional review board-approved Alzheimer’s, mild cognitive impairment and other dementia trials taking place across the U.S. Specialists at the Alzheimer’s Association’s national Contact Center – available 24-hours a day – assist in the process of matching individuals to clinical trials for which they are eligible based on study inclusion/exclusion criteria, diagnosis, treatment history and location. The technology and platform for Alzheimer’s Association TrialMatch is provided by EmergingMed.
 
Alzheimer’s Association Contact Center specialists will not recommend any particular clinical trial, but will describe all studies for which the person is eligible. They will answer questions about the trial process and connect individuals with trial sites based on their unique profile.  Patients and caregivers will be encouraged to share their trial matches with their healthcare professionals to help decide whether a clinical trial is appropriate.
 
Alzheimer’s Association TrialMatch can be accessed at www.alz.org/TrialMatch or by calling toll-free, (800) 272-3900.
 
The Alzheimer's Association is the leading voluntary health organization in Alzheimer care, support and research. Our mission is to eliminate Alzheimer's disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health. Our vision is a world without Alzheimer's. For more information, visit www.alz.org.
 

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References
1.      National Institute on Aging. National Institutes of Health. U.S. Department of Health and Human Services. Participating in Alzheimer’s Disease Clinical Trials and Studies. September 2009; 09-7484. Accessed on April 8, 2010: http://www.nia.nih.gov/Alzheimers/Publications/trials-studies.html.
 

Couples come into my office with many complaints, but usually their problems boil down to at least one of three core issues. These issues can be summed up in the “3 C’s of Relationship,” comprised of Commitment, Communication, and Compassion.

Commitment issues include not only emotional and physical affairs but also anything that becomes a priority over the relationship. The one I see most often is the couple who over the years has allowed their commitment to the children take priority over the married relationship. As the children grow, the commitment to the marriage takes a backseat to the commitment to the children. I hear couples tell me over and over that between work and all the children’s activities, although they would like to be with each other more, there is no energy or time left to focus on the marriage. The worse part is that I often hear that they cannot imagine a way to change the situation without hurting the children, which is usually the reason they have come to see me. Giving everything for your children may seem like the most loving thing you can do for them but the truth is if your children grow up learning and seeing that you are more committed to them than your marriage you do them a disservice. Now don’t get me wrong; I am not suggesting that children should not be a priority its just that the main priority should always be to the married relationship. Children need to grow up and learn how to be committed in a relationship. I often ask couples what type of relationship they want for their children as adults and not surprisingly most say that they want them to be in a happy, committed marriage one day (although they will often laugh and say not anytime soon). The question is can you be happily committed in marriage? I believe you can but in order to do so the marriage has to be top priority ALWAYS! This means nothing, not work, extended family, or even children can come between the commitment between you and your spouse. The only relationship that may take priority over your spouse is a spiritual relationship if you and your spouse have one. The key is to communicate through both words and actions daily to your spouse that they are the most important person in your life. If you will demonstrate your commitment to your spouse in all that you do and say the probability of having to deal with the other more devastating commitment issues such as emotional and physical infidelity will decrease dramatically. However, communicating your commitment is often not something that comes naturally so this leads us right into a discussion of the 2nd C, Communication issues, which I will write on tomorrow.

Date: October 7, 2009
Time: 8:30 a.m. until 3:00 p.m.
Location: The Laurels and The Haven

Please RSVP
Contact Number: (210) 404-9005

THE FIRST SIGN: HARSH STARTUP
The most obvious indicator that a discussion (and the marriage) is not going to go well is the way it begins. When a discussion leads off with criticism and/or sarcasm, a form of contempt — it has begun with a “harsh startup.” The research shows that if your discussion begins with a harsh startup, it will inevitably end on a negative note, even if there are a lot of attempts to “make nice” in between. Statistics tell the story: 96 percent of the time you can predict the outcome of a conversation based on the first three minutes of the fifteen-minute interaction! A harsh startup simply dooms you to failure. So if you begin a discussion that way, you might as well pull the plug, take a breather, and start over.

THE SECOND SIGN: THE FOUR HORSEMEN
A harsh startup sounds the warning bell that the couple may be having serious difficulty. As the discussion unfolds, Gottman continues to look out for particular types of negative interactions. Certain kinds of negativity, if allowed to run rampant, are so lethal to a relationship that Gottman calls them the Four Horsemen of the Apocalypse. Usually these four horsemen clip-clop into the heart of a marriage in the following order: criticism, contempt, defensiveness, and stonewalling.

Horseman 1: Criticism. You will always have some complaints about the person you live with. But there’s a world of difference between a complaint and a criticism.
A complaint only addresses the specific action at which your spouse failed. A criticism is more global — it adds on some negative words about your mate’s character or personality.
“I’m really angry that you didn’t sweep the kitchen floor last night. We agreed that we’d take turns doing it” is a complaint — it focuses on a specific behavior.
“Why are you so forgetful? I hate having to always sweep the kitchen floor when it’s your turn. You just don’t care” is a criticism.
Criticism throws in blame and general character assassination. To turn a complaint into a criticism, add the line: “What is wrong with you?”
Usually a harsh startup comes in the guise of criticism.
Complaint. There’s no gas in the car. Why didn’t you fill it up like you said you would?
Criticism. Why can’t you ever remember anything? I told you a thousand times to fill up the tank, and you didn’t. (Criticism. She’s implying the problem is his fault. Even if it is, blaming him will only make it worse.)
The first horseman is very common in relationships. If you find that you and your spouse are critical of each other, don’t assume you’re headed for divorce court. The problem with criticism is that when it becomes pervasive, it paves the way for the other, far deadlier horsemen.

Horseman 2: Contempt. Sarcasm and cynicism are types of contempt. So are name-calling, eye-rolling, sneering, mockery, and hostile humor. In whatever form, contempt — the worst of the four horsemen — is poisonous to a relationship because it conveys disgust. It’s virtually impossible to resolve a problem when your partner is getting the message you’re disgusted with him or her. Inevitably, contempt leads to more conflict rather than to reconciliation.
Often a person’s main purpose is to demean her or his spouse. Couples who are contemptuous of each other are more likely to suffer from infectious illnesses (colds, flu, and so on) than other people. Contempt is fueled by long-simmering negative thoughts about the partner. You’re more likely to have such thoughts if your differences are not resolved. As disagreeing persists, complaints turn into global criticisms, which produces more and more disgusted feelings and thoughts, and finally you are fed up with your spouse, a change that will affect what you say when you argue. Belligerence is just as deadly to a relationship. It is a form of aggressive anger because it contains a threat or provocation.

Horseman 3: Defensiveness. When conversations become so negative, critical, and attacking, it should come as no surprise that you will defend yourself. Although this is understandable, research shows that this approach rarely has the desired effect. The attacking spouse does not back down or apologize. This is because defensiveness is really a way of blaming your partner.You’re saying, in effect, “The problem isn’t me, it’s you.” Defensiveness just escalates the conflict, which is why it’s so deadly.
Criticism, Contempt, and Defensiveness don’t always gallop into a home in strict order. They function more like a relay match — handing the baton off to each other over and over again, if the couple can’t put a stop to it. The more defensive one becomes, the more the other attacks in response. Nothing gets resolved, thanks to the prevalence of criticism, contempt, and defensiveness. Much of these exchanges are communicated subtly (and not so subtly) through body language and sounds.

Horseman 4: Stonewalling. In marriages where discussions begin with a harsh startup, where criticism and contempt lead to defensiveness, which leads to more contempt and more defensiveness, eventually one partner tunes out. So enters the fourth horseman. Think of the husband who comes home from work, gets met with a barrage of criticism from his wife, and hides behind the newspaper. The less responsive he is, the more she yells. Eventually he gets up and leaves the room. Rather than confronting his wife, he disengages. By turning away from her, he is avoiding a fight, but he is also avoiding his marriage. He has become a stonewaller. Although both husbands and wives can be stonewallers, this behavior is far more common among men. During a typical conversation between two people, the listener gives all kinds of cues to the speaker that he’s paying attention. He may use eye contact, nod his head, say something like “Yeah” or “Uh-huh.” A stonewaller doesn’t give you this sort of casual feedback. He tends to look away or down without uttering a sound. He sits like an impassive stone wall. The stonewaller acts as though he couldn’t care less about what you’re saying, if he even hears it. Stonewalling usually arrives later in the course of a marriage than the other three horsemen. That’s why it’s less common among newlywed husbands than among couples who have been in a negative spiral for a while. It takes time for the negativity created by the first three horsemen to become overwhelming enough that stonewalling becomes an understandable “out.”

THE THIRD SIGN: FLOODING
Usually people stonewall as a protection against feeling flooded. Flooding means that your spouse’s negativity — whether in the guise of criticism or contempt or even defensiveness — is so overwhelming, and so sudden, that it leaves you shell-shocked. You feel so defenseless against this sniper attack that you learn to do anything to avoid a replay. The more often you feel flooded by your spouse’s criticism or contempt, the more hypervigilant you are for cues that your spouse is about to “blow” again. All you can think about is protecting yourself from the turbulence your spouse’s onslaught causes. And the way to do that is to disengage emotionally from the relationship. A marriage’s meltdown can be predicted by habitual harsh startup and frequent flooding brought on by the relentless presence of the four horsemen during disagreements. Although each of these factors alone can predict a divorce, they usually coexist in an unhappy marriage.

THE FOURTH SIGN: BODY LANGUAGE
Even if you could not hear the conversation between a stonewaller and the spouse, you would be able to predict their divorce simply by looking at the stonewaller’s physiological readings. When couples are monitored for bodily changes during a tense discussion, you can see just how physically distressing flooding is. One of the most apparent of these physical reactions is that the heart speeds up — pounding away at more than 100 beats per minute — even as high as 165. (In contrast, a typical heart rate for a man who is about 30 is 76, and for a woman the same age, 82.) Hormonal changes occur, too, including the secretion of adrenaline, which kicks in the “fight or flight response.” Blood pressure mounts. These changes are so dramatic that if one partner is frequently flooded during marital discussions, it’s easy to predict that they will divorce.
Recurring episodes of flooding lead to divorce for two reasons. First, they signal that at least one partner feels severe emotional distress when dealing with the other. Second, the physical sensations of feeling flooded — increased heart rate, sweating, etc. — make it almost impossible to have a productive, problem-solving discussion. When your body goes into overdrive during an argument, it perceives the current situation as dangerous. When a pounding heart and all the other physical stress reactions happen in the midst of a discussion with your mate, the consequences are disastrous. Your ability to process information is reduced, meaning it’s harder to pay attention to what your partner is saying. Creative problem solving goes out the window. You’re left with the most reflexive, least intellectually sophisticated responses in your repertoire: to fight (act critical, contemptuous, or defensive) or flee (stonewall). Any chance of resolving the issue is gone. Most likely, the discussion will just worsen the situation.