Main Category: HIV / AIDS

Also Included In: Women’s Health / Gynecology;  Sexual Health / STDs

Article Date: 29 Nov 2011 – 1:00 PST

email to a friend   printer friendly   opinions  

Current Article Ratings:

Patient / Public:
Healthcare Prof:

A large-scale clinical trial evaluating whether daily use of an antiretroviral-containing oral tablet or vaginal gel can prevent HIV infection in women is being modified because an interim review found that the gel, an investigational microbicide, was not effective among study participants.

On Nov. 17, an independent data and safety monitoring board (DSMB) recommended that the Vaginal and Oral Interventions to Control the Epidemic (VOICE) study evaluating daily use 1 percent tenofovir vaginal gel be discontinued because there was no difference in effect demonstrated between the drug-containing gel and a placebo gel. The DSMB found a 6 percent HIV incidence rate among participants in the tenofovir gel group and the placebo gel group.

The study is being conducted by the National Institutes of Health (NIH)-funded Microbicide Trials Network (MTN). As the trial’s primary sponsor, the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, concurred with the DSMB’s recommendation and has requested that the MTN discontinue use of tenofovir gel (and placebo gel) in the VOICE study. Because the trial is continuing, all other study data remain confidential, so NIAID cannot speculate about why tenofovir gel showed no benefit among VOICE study participants. Factors that may have contributed to this outcome are being further investigated.

Importantly, the DSMB found no major safety concerns with either the tenofovir gel or oral tablets containing tenofovir and emtricitabine given to women in a different arm of the study. Oral tenofovir and emtricitabine, a combination drug called Truvada that currently is used to treat HIV infection, will continue to be investigated in the VOICE study to determine whether it can prevent HIV infection in women in this trial.

The VOICE study, or MTN-003, began in September 2009 and originally enrolled more than 5,000 HIV-uninfected women in South Africa, Uganda and Zimbabwe. The trial was designed to test the safety, effectiveness and acceptability of two different, daily HIV prevention strategies. One was an investigational microbicide gel containing tenofovir. The other involved oral tablets containing tenofovir either alone (Viread) or co-formulated with the drug emtricitabine (Truvada). The tablets were designed to be taken by HIV-negative women in an approach known as pre-exposure prophylaxis, or PrEP.

The study was first modified in September 2011, following the DSMB recommendation to discontinue evaluating oral tenofovir tablets based on interim data demonstrating that the study would be unable to show a difference in effect between tenofovir tablets and placebo tablets in preventing HIV infection. No safety concerns with oral tenofovir were found. Since that time, the study participants who were taking oral tenofovir have been informed of the discontinuation of this arm of the trial, and currently they are undergoing their final study-associated tests and procedures.

Based on its Nov. 17 scheduled review, the DSMB recommended that the roughly 2,000 women in the tenofovir gel and placebo gel groups stop applying the study product.

The study team will immediately begin informing all VOICE participants of this new development and will soon start the orderly discontinuation of the two gel arms of the trial. Participants who were using the tenofovir gel or the placebo gel will stop using the product at their next scheduled clinical site visit. They will then return eight weeks later for a final evaluation before exiting the study. At that visit, they will be given information about where they can continue to receive HIV testing and counseling, contraception and other medical and support services. Follow up for all of the VOICE study participants is expected to be completed in June 2012, with final study results anticipated in early 2013.

Although it is disappointing that the study first found oral tenofovir and now daily 1 percent tenofovir gel to be ineffective among the VOICE participants, NIAID recognizes the scientific importance of having clear outcomes and is pleased that the trial will continue to examine the question of whether oral Truvada is a safe and effective HIV prevention measure for women in this study. NIAID thanks all VOICE study participants and site staff for their significant contribution to furthering HIV prevention research. This study is an important component of NIH’s comprehensive HIV prevention research program articulated in the HHS National HIV/AIDS Strategy Operational Plan.

NIAID remains committed to supporting research to develop HIV prevention tools that women can implement. Slightly more than half of all new HIV infections globally occur in women, mostly through unprotected sex with HIV-infected men. Safe and effective female-controlled HIV prevention methods would be particularly helpful to women who find it difficult or impossible to refuse sex or to negotiate condom use with their male partners.

• Additional
• References
• Citations

Editor’s Choice
Academic Journal

Main Category: HIV / AIDS

Also Included In: Women’s Health / Gynecology

Article Date: 25 Nov 2011 – 7:00 PST

email to a friend   printer friendly   opinions  

Current Article Ratings:

Patient / Public:
Healthcare Prof:

In this week’s PLoS Medicine, an researchers analyzed the experiences of stigma and coping tactics among HIV-positive women in Ontario, Canada.

Using focus groups, Mona Loutfy of the University of Toronto, Canada and colleagues discovered that women attributed their experiences of discrimination and stigma to HIV-related stigma, racism, homophobia, transphobia, involvement in sex work, sexism, and gender discrimination.

According to the women, they used coping tactics, such as:

• Resilience (at a micro level)
• Challenging stigma (at a macro level)
• Social networks and support groups (at a meso level)

The researchers explain that:

“Overall, this investigation highlights a complex system of intersectional stigma that necessitates multifaceted strategies to promote health and equity for HIV-positive women.

Findings can inform treatment, care, and support guidelines and practice recommendations for health care practitioners, social workers, HIV prevention and support workers, and mental health specialists working with HIV-positive women.”

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Editor’s Choice
Academic Journal

Main Category: Nutrition / Diet

Also Included In: Diabetes;  Alcohol / Addiction / Illegal Drugs;  Women’s Health / Gynecology

Article Date: 25 Nov 2011 – 7:00 PST

email to a friend   printer friendly   opinions  

Current Article Ratings:

Patient / Public:		5 (1 votes)
Healthcare Prof:
Article Opinions:	1 posts

Females in middle age who drink alcohol moderately and consume large amounts of refined carbohydrates have a 30% lower chance of developing diabetes type 2, compared to women with similar dietary habits who don’t drink, researchers from the Harvard School of Public Health wrote in the American Journal of Clinical Nutrition. Examples of refined carbohydrate foods include sugary drinks, white bread, some pastas, and (polished) white rice.

The authors explained, as background information to their report, that very little prior research has focused on whether there might be an association between glycemic index load, glycemic index, alcohol consumption and diabetes type 2 risk.

Dr. Frank Hu and team set out to determine what impact alcohol intake (or lack of it) might have on diabetes risk in middle aged women whose refined carbohydrate (carb) intake was high. They tracked 81,827 women for 26 years. The women had participated in the Nurses’ Health Study and were all free of diabetes type 2 when the study began.

Their cumulative averages of glycemic index, glycemic load, total carb intake and total alcohol intake were calculated every two to four years using questionnaires.

During the follow-up period 6,950 participants developed diabetes type 2.

They found that the women with a high refined-carb intake who consumed moderate amounts of alcohol had a 30% lower chance of developing diabetes type 2 compared to women whose refined-carb intake was also high but consumed no alcohol.

In an interview with Reuters news agency, Dr. Hu said:

“If you eat a high carb diet without drinking alcohol, your risk of developing diabetes is increased by 30 percent.

However, if you eat a high carb diet, but (drink) a moderate amount of alcohol, the increased risk is reduced.”

The authors concluded in an Abstract in the journal:

“Our findings suggest that a higher alcohol intake (≥15 g/d) attenuates the positive association between GL and T2D incidence.”

The moderate drinkers in this study consumed an average of 0.8 once (24 grams) of alcohol each day, the equivalent of approximately two drinks each week. A very small percentage were classed as heavy drinkers – consuming at least two ounces of alcohol each day – they did not have a lower diabetes type 2 risk.

The authors stressed that their study should not encourage people to start drinking if they do not do so now. Rather, they encourage a diet low in refined carbs and high in whole grains. If you are a drinker, they added, you should do so with moderation.

Refined and unrefined grains

Refined grains have been milled so that their outer bran coating has gone, leaving just the endosperm. Examples include white rice, white pasta and white bread. When referring to rice, the term polished is often used with the meaning ‘milled’.

Unpolished long-grain rice with bran

Polished Indian sona masuri rice grains

In whole grain products, the germ and endosperm are still there. Bran is a good source of fiber, while the germ has protein, minerals and vitamins – the endosperm has carbohydrates (mainly in the form of starch).

Whole grains, also known as unrefined grains (unrefined carbs) are rich in antioxidants and phytochemicals – these help protect us against diabetes, some cancers and coronary heart disease. Some studies have demonstrated that individuals who consume at least three portions of whole grains each day have a lower risk of developing heart disease compared to people who don’t.

Here you can see the bran, germ and endosperm

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations

Main Category: HIV / AIDS

Also Included In: Women’s Health / Gynecology

Article Date: 25 Nov 2011 – 0:00 PST

email to a friend   printer friendly   opinions  

Current Article Ratings:

Patient / Public:
Healthcare Prof:

In this week’s PLoS Medicine, Mona Loutfy of the University of Toronto, Canada and colleagues report their study examining experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada.

Using focus groups, the researchers found that women attributed their experiences of stigma and discrimination to HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. The coping strategies they used included resilience (at a micro level), social networks and support groups (at a meso level), and challenging stigma (at a macro level).

The authors state that: “Overall, this investigation highlights a complex system of intersectional stigma that necessitates multifaceted strategies to promote health equity for HIV-positive women. Findings can inform treatment, care, and support guidelines and practice recommendations for health care practitioners, social workers, HIV prevention and support workers, and mental health specialists working with HIV-positive women.”

• Additional
• References
• Citations

Main Category: Cosmetic Medicine / Plastic Surgery

Also Included In: IT / Internet / E-mail;  Women’s Health / Gynecology

Article Date: 29 Nov 2011 – 3:00 PST

email to a friend   printer friendly   opinions  

Current Article Ratings:

Patient / Public:
Healthcare Prof:

You know they couldn’t possibly look that good. But what did those models and celebrities look like before all the retouching? How different is the image we see from the original?

Dartmouth Computer Science Professor Hany Farid and Eric Kee, a PhD student at Dartmouth College, are proposing a method to not only answer such questions but also to quantify the changes.

As Farid writes, “Impossibly thin, tall, and wrinkle- and blemish-free models are routinely splashed onto billboards, advertisements, and magazine covers.” He says that this is “creating a fantasy of sorts.” Going beyond considerations of aesthetics or any dishonesty of photo editors or advertisers, Farid and Kee voice public health concerns.

In a paper published in the Proceedings of the National Academy of Sciences (PNAS) on November 28, 2011, they point out that these highly idealized images have been linked to eating disorders and body image dissatisfaction in men, women, and children. The authors note that the American Medical Association has recently adopted a policy to “discourage the altering of photographs in a manner that could promote unrealistic expectations of appropriate body image.”

There have already been repercussions in the United Kingdom. A Reuters news story from July 2011 reports: “Two L’Oreal cosmetics adverts [advertisements] featuring actress Julia Roberts and supermodel Christy Turlington were banned in Britain by the Advertising Standards Agency, following complaints by MP [Member of Parliament] Jo Swinson. Liberal Democrat MP Swinson said the magazine adverts for foundations made by Maybelline and Lancome, both owned by L’Oreal, were misleading because the photos had been digitally altered.” On a prior occasion, L’Oreal had been forced to add a disclaimer to another ad.

But Farid and Kee assert that outright bans or simple disclaimers may not be addressing the issue fairly or completely. They are seeking a way to for advertisers to truthfully and accurately characterize the extent to which an image has been altered while allowing the public to make informed judgments. The goal is to create a metric that provides an objective assessment of how much alteration has been made.

The authors propose a rating system that takes into account common practices such as cropping and color adjustment while providing assessment of other kinds of modifications that dramatically change a person’s appearance. They consider geometric alterations such as slimming legs, adjusting facial symmetry, and correcting posture, as well as photometric manipulations that might include removing wrinkles, “bags” under the eyes and skin blemishes.

“We start with the before and after digital images from which we automatically estimate the geometric and photometric changes, effectively reverse engineering the manipulations that a photo retoucher has made,” Farid says.

In the study, to crosscheck and validate their metric, human observers were asked to compare and rank the differences in hundreds of pairs of before and after retouching images. The results correlated highly with the mathematical metric.

“Such a rating may provide incentive for publishers and models to reduce some of the more extreme forms of digital retouching that are common today,” the authors conclude, but they add, “It remains to be seen if this rating can mediate the adverse effects of being inundated with unrealistic body images.”

• Additional
• References
• Citations

Relationship difficulties and pain happen to all of us. They are impossible to avoid, which is why we need to learn about the time-proven principles which are available to address what typically happens in all relationships. The following list of habits is a humorous look at some of the things we sometimes do. But it’s “funny” how blind we can be to these habits, especially if we don’t make conscious efforts to resist engaging in these annoying behaviours.

Habit #1: Smart-Aleck Behaviour

Let’s get this straight. You are the boss and it’s vital that you frequently remind your partner that you’re more intelligent, more gifted and quicker than them. Let them know that you can deal with their responsibilities and behaviours better than they do.

For instance, if you’ve been cleaning the house since you were a young thing, feel free to tell your partner exactly how they should be approaching this task. Point out all the things that are not done according to your standards and especially highlight where they haven’t been using your methods.

Similarly, if you’re good at managing money, it’s entirely appropriate to tell your partner how much to spend on what. In fact, you should probably get into their online bank account and manage it, purely to show them that you have their best interests at heart.

If you for one moment allow them to entertain the notion that you’re not more intelligent and better than them, they’ll assume that they can clean the house and manage their budget reasonably well. You don’t want that! They must always be reminded that you’re smarter than them. That way they won’t get above themselves.

Breaking this habit

Resist pointing out what you believe are inadequacies in your partner’s behaviours or how they manage their responsibilities. Calm yourself down first, thank your partner for doing the job and then arrange a suitable time when both of you can have an honest discussion about your different approaches to tasks. Work towards negotiating acceptable differences in your methods and remember that this will be an ongoing process. You can always renegotiate if something’s not working for either one of you.

Habit #2: Your Partner Needs Managing

Relationship experts keep repeating the message (yawn) that teamwork and sharing of power is important, but the bottom line is that the only important thing is you maintaining control. Relationships are all about power and control, and if your partner is glum about that, well, it hurts you more than it hurts them.

This does not mean that you shouldn’t be concerned about your partner’s morale. Make a point of elaborating, in minute detail, why their morale is of crucial importance to you and the rest of the family. Even better, repeat this message often, to ensure they know what you’re going to say even before you start. In addition, be certain to inform them when they’ve gotten a bit sloppy and don’t appear totally enthusiastic about being with you.

Breaking this habit

Just like in dancing, if you’re always leading your partner’s only option is to follow. An excellent dance duo can only come about with both contributing equally and doing their best as individuals to move in harmony with their dance partner. This requires exquisitely fine-tuned teamwork and the sharing of power, with sometimes one leading the dance and other times gracefully relinquishing the lead to the other. Negotiating power is part and parcel of all human relationships, so power and power imbalances are inescapable. Like dance partners, it’s about restoring your own balance first, then helping your partner adjust theirs to keep the dance fluid. You can’t help your partner if you’re off balance by always leading (or following).

Your partner’s morale is a possible indicator that something’s not right in their world. Take some time to inquire about their day, how they’re feeling and if there’s anything on their mind that’s concerning them. Make yourself available to listen and remember not to take it personally, especially if it’s something about you. They’re attempting to communicate feelings (which are not facts) and if you can listen without being defensive, this will go a long way to creating a platform for you both to have conversations about sensitive issues.

Habit #3: Resist Change

Who said variety is the spice of life? If it ain’t broke, don’t fix it. Make sure that the entire way the relationship is organised guarantees that you stay in power by resisting anything new. Given that you’re the boss, making sure everything stays the same is the only viable alternative.  Why would you even think about making changes? Note: the only people who really like changing are babies with dirty nappies.  For all the rest of us, maintaining the status quo is the way to go.

Even if everything isn’t going all that well in your relationship, at least it’s familiar and predictable. It’s important for you to be able to know ahead of time the ways you both interact and react to each other, the regular routines you’ve established, and the predictable triggers for arguments. Why bring anything new into this picture? It might make you uncomfortable to have to adjust in any way.

Breaking this habit

Remember that if neither of you change the patterns of interaction between you, what you get is a dull and boring relationship. Without nurturance, diversity and novelty, relationships die. Influence between people in relationships is mutually dependent and reciprocal. You react to your partner and your partner reacts to you, and on it goes. This cycle can be broken at any point. If you change your behaviour and responses consistently and noticeably, your partner’s reactions will change, which in turn changes your reactions. This gives the relationship a way to stay vibrant and alive.

Habit #4: Lies and Slander

Making sure that your partner hates their friends and relatives is a foolproof way to maintain control. For best results, you also want to make certain that your partner’s friends and relatives are full of resentment and offence – all aimed at your partner and not you.

There are many ways to do this.  First, make sure that you tell everyone involved a different version of one story, so that when they talk to each other the seeds of doubt about who’s lying sprout in everyone’s mind. Never say what actually happened or tell the same story as your partner. You are totally in charge of what gets said.

Second, use every possible opening to set your partner and their friends and relatives against each other by passing on harsh things they’ve said about one another.  Tip: if nothing’s currently going on, use your imagination and start a rumour.

Third, at all times blame someone else if there’s been a mistake.  Remember you are squeaky clean, so you should make sure everyone gets a go at being the scapegoat, that way all of them have the experience of feeling really bad. This gives them the chance to blame the next sucker who’s in the spotlight.

Last, but not least, it is imperative that you at all times have the last word in an argument, naturally to “keep the peace in the family.”  Doing this means you get all the accolades for a job well done.

Breaking this habit

Honour your partner’s needs to have meaningful time with their friends, relatives and hobbies. Give each other room to breathe, as this will make you happier and enables you to bring new influences and ideas into your relationship. It keeps things interesting, just like in the honeymoon stage where you were both a fascinating mystery to each other and spent time exploring your differences. Allow for the fact that both of you, as well as your partner’s friends and family, each have unique perspectives and different ways of being in the world. Honouring and respecting this, even though you may not agree with their truth, goes a long way towards creating tolerance. Gossip, blame, avoiding the consequences of your own mistakes and having the last word are poisonous to relationships. Do your very best to avoid these whenever you can.

Habit #5: Don’t Seek Help from Anyone

There’s a golden rule that fits all occasions: “If you want something done right, do it yourself!”

You know you can’t rely on other people for anything. As an achiever, take over and do the job right, by yourself! For example, if you’re the relationship manager, it’s always a good idea to jump in right away to whatever’s happening. Demand to be involved in everything your partner does and direct their actions. It’s obvious that you can’t depend on inefficient people to do anything, especially since you’re the superior person.

Next, wait until your partner’s just about to complete something then dive in and put on the finishing touches that will make the project top class. Isn’t it a manager’s duty to make certain that everything is done according to your plans?

Finally, don’t believe any rubbish about the importance of delegating.  That’s just for wimps who can’t get things done.  Ignore all that silly advice about sharing tasks and responsibilities or asking for advice from people who have specialised training in relationship skills.  What would they know? Do achievers delegate? Of course not!  They take charge and do it themselves.

A huge payoff from this habit is that sooner or later your partner may decide that they can do nothing without you.  Now that’s security!

Breaking this habit

There’s another aspect to the golden rule that applies in relationships: “Would you rather be right or happy?” Insisting on being right in all circumstances makes you and your partner very unhappy. It’s smart to give up being right over small, inconsequential issues. Standing up for your values is important, yet doing so in a non-aggressive way is equally important. Allow your partner room to move, breathe and make their own mistakes. Offer to help, yet respect their need to do it in their own way.

In a healthy partnership, teamwork is of utmost importance. Just like in softball, the pitcher relies on the catcher to return the ball or to catch fouls. Each player has their position and skill-set and cooperates with the other players to make the team run smoothly. Teamwork means the two of you deciding together to delegate and/or take on tasks, provided each of you has agreed to take on that task for and by a specified amount of time. It frees you up to devote your energy to things you’re good at or have agreed to take on because they need to be done, trusting that your partner will do their bit. Remember you can always renegotiate until you find a way that works best.

Habit #6: Mindreading is Compulsory

Making sure your partner never knows exactly what you’re thinking or doing is obligatory to keeping your partner in a state of alertness.

If you know you’ll be working back, don’t phone to inform them of this. If you plan to go somewhere with your friends, don’t mention it. If you know there’s no food in the house, never offer to go shopping. If your partner asks you to buy the milk on the way home, forget to do it. If your partner asks your opinion on something, your standard reply should be: “That’s still to be determined.”  If they want a decision, be sure to answer: “I’m thinking about it” and don’t ever bring it up again.

When you ask your partner to do something for you, always be imprecise about what you’d like.  This is a great way to inspire innovation.  When they’ve finished and seek your feedback, say only: “That’s not it.”  Then look upset, give your partner the cold shoulder, and say: “You’re not trying hard enough!”

The simple fact is, relationships are like poker, and winning at poker requires you to hold your cards close to your chest and be brilliant at bluffing. Excellent poker players never reveal their strategy to the other players.

Hold in mind: Staying in power demands that you keep your partner perplexed and bewildered.  Think about it, why would they need you to manage them if they know what they’re supposed to be doing?

Breaking this habit

Having consideration for your partner’s time and needs is one of the most effective ways of getting your authentic needs met. Keep your partner informed about your plans and what you’d like to do. This is a clear way to ensure they keep you in the loop about their arrangements and makes them more likely to negotiate with you so that you both get the most out of your life together. Learn to share your opinions in an open-handed way, so your partner knows where you stand. If you’re not sure about your view, say so. Tell them you’d like to think about it overnight and that you’ll let them know tomorrow. Then follow through on what you’ve promised! Do what you say you’re going to do. Be clear yet considerate in your instructions when asking for something to be done. That way your partner has the opportunity to say whether they can or cannot do it.

Habit #7: Threaten to end the relationship

This is your trump card! It means that you must always be ready to ditch your partner at the drop of a hat. Holding the “I’m out of here” card makes it easier for you not to care two hoots about what your partner feels. It’s good to keep them guessing about your intentions and commitment.

An excellent time to pull out this card is in an argument. This keeps them in line and teaches them never to express an opinion or need that’s different from yours.

Threatening to break up is a powerful form of emotional blackmail and cunningly manipulates your partner if they don’t do what you want. Its core message is: “If you don’t behave the way I want you to, you will suffer because I’ll be gone”.

Breaking this habit

If you sincerely want your relationship to work, make a promise to yourself never to threaten to end the relationship, especially in an argument. During fights, we often think, say and do things that we later regret. Once it’s done, we can’t take them back. What’s happening is that your emotional brain causes you to go into “fight or flight” mode which hijacks your thinking brain. Instead of thinking or acting clearly, you respond by going into an automatic response to keep you safe. But this is usually done in an unskilful way which you later regret.

All of us are biologically wired to keep ourselves safe and your particular family and relationship history will influence the way it plays out in you. Expect that this will happen and practice taking a healthy “time out” at the first sign of anger or fear, before the wave of emotion picks you up and dumps you. A healthy “time out” is where you tell your partner you’re leaving the room for at least half an hour to quiet yourself down and that you’ll be back to discuss it further when you’re calmer. Make sure you give a specific length of time (for example half an hour) and then reconnect with your partner at the time you told them. This builds trust that you’ll do what you promise. If you’re not ready to interact in a calm way, let them know you need more time, by saying something like “I need another half hour, and I’ll be back then to discuss this further”. This sounds simple, but it’s not easy! It takes lots of practice to rewire your brain to respond in a more effective way to strong emotions.

To find out more about breaking ineffective habits in relationships, give me a call on (02) 9516 4399 or email me today , so I can support you in creating new and healthier relationship habits.

This article was adapted from business writer Geoffrey James

This month I’d like to talk about how helpful mindfulness can be if you want to be aware of what is happening in your relationship, in particular your feelings and thoughts in response to whatever is happening. To begin with, I’d like to define the term “mindfulness”. I’ll use a simple definition which talks about being open to and aware of what’s going on inside of you at the time it’s happening without being caught up in opinions, reactions or expectations. It’s about being open and present to your own experience. Being open, non-judgemental and receptive to yourself actually increases your ability to be open and present to others.

In essence, the more you can be mindful of your own bodily, emotional and mental experiences, the more you can be aware of other people’s internal emotional states. This is an essential ability for those who wish to develop successful relationships. According to Daniel Goleman, studies done at University of Madison and Harvard university demonstrate that changes are made in the structure of brains of people who practice mindfulness meditation. They show that these structural changes occur in the same brain regions that support our empathic communication with other people. How this translates into relationships is that mindfulness enhances your ability as a partner to be empathic to the internal world of your partner, to actively inquire about their feelings and thoughts and to be open and less reactive to their answers.

It is now a scientifically verified fact that mindfulness develops empathy as well as enhances our capacity to be present in increasingly fluid and adaptable ways. Being mindful helps your own health, sense of purpose and well-being, and it also helps your partner and your relationship. In one way mindfulness and empathy could be seen as basic elements of all relationships. They are excellent means by which to create resilience in yourself and your partner.

In the human brain there is a whole system of cells called mirror neurons that are sensitive to the intentions of another person. Dan Siegel says that when someone is empathic, not only are they trying to become aware of and understand the inner world of another person, but built into that interaction is the ability to detect the intention of one person to actually care for and be concerned about the other.

So, by being empathic and caring to your partner, not only are you increasing the sense of connection with her or him, but they’re able to feel your intention to care about them. Their mirror neurons enable them to be aware of your intention to care. They feel it inside of themself and it’s actually helping them feel trusting of you; it’s helping them feel safe. It’s giving them a sense of security in you and in the relationship. That’s what’s happening when you say things like “I feel that my partner really gets me”. All of this is of course happening on a feeling level, much faster than and deep below your thinking mind, unless you’re well practiced in mindfulness.

From the moment of our birth until we die, our interactions with other people involve us trying to assess in a multitude of ways whether we can trust and feel safe with that person. It is biologically wired into our body/mind to want to feel that our partner cares about our well-being and wants to nurture our growth. We all want and need to feel cared about, no matter how young or old we are. In addition, we all need to care for and about others.

This could be called the physiology of empathy, it’s what actually happens in our bodies. It’s what happens in our nervous systems when two people become a couple. It’s how you and your partner connect, because you both can sense that closeness, through your nerves, through your neurobiology, deep inside of yourselves. Not only are each of you unique, independent individuals who are separate from each other, you can also become a “we.” You both create that bond through mutual behaviours that you are biologically wired to understand as “closeness”. This usually happens in the initial romantic, falling-in-love stage of all relationships, because the inbuilt safety mechanisms creating the healthy boundaries which separate you from your partner are temporarily laid aside. In the later stages of relationships (and there are four othersJ), empathy, caring and trust are major factors that maintain and strengthen your sense of “we-ness”

The development of trust in healthy, empathic adult relationships can actually lead to brain growth. When we sense that another person is tuned into us, is caring, is on our side and can be trusted, the warm, safe experience felt via our nervous system is a highly receptive state which opens us to growth. Louis Cozolino’s The Healthy Aging Brain shows that when we have healthy relationships in our life, we tend to have greater longevity. So relationships of trust and empathy not only help the brain to grow but are profoundly important for our overall health and wellbeing.

Mindfulness is one practice which can help you develop openness, empathy and trust in healthy ways. It helps you be aware of the signals arising in your own nervous system as you constantly scan and respond to others’ behaviour towards you. If your body/mind feels that a person is not being truly caring and empathic towards you, that’s very important information.

Even though mindfulness has been around for thousands of years, it’s only been scientifically studied in the last twenty years or so. These studies show it has a deeply integrative function. When we are informed about how to be mindful and practice producing the kind of experiences and connections in relationships that bring our minds, bodies and brains toward integration, then we are able to move toward healthy ways of relating, which impact the very structure of our brains, bodies and relationships.

If you’re interested in finding out more about mindfulness and empathy, give me a call on (02) 9516 4399 or email me today , so we can work together on restoring empathy in your relationship.

Most of us have not been taught that our relationships require an ongoing investment of attention, time and energy to maintain and enhance their vitality. Many of us work hard, are pressed for time or are caught up in the daily, everyday grind of activities. This often results in the sense that we’re on a deprivation schedule, so fantasising about romance seems like the one place where we can let ourselves be spontaneous and enjoy ourselves.

We’re all familiar with the heady rush of falling in love, the exciting and highly-charged time when we meet a person who seems to be the answer to all of our problems. It’s at this early stage in every relationship that sparks fly, and the charge generated between us and the other person is irresistible. Romantic love can be so intoxicating it convinces us that it’s true love, that this is the right person for us, that they will answer all our prayers and cure all our ills and make up for all the dissatisfaction of our past and present lives. Instead of idealising romantic love with someone other than your partner, or sacrificing everything for someone you hardly know, have you ever considered putting all that energy and charge back into the relationship you already have?

We’re not taught how to be experts on relationships. We’re not prepared for the normal disillusionment that takes place in every healthy, lasting relationship. We wake up one day and for a myriad of reasons feel terribly let down by our partner, so it’s easy to blame them and not have a clue how we’ve contributed to the unsatisfactory state of our relationship. We forget how differently we felt and behaved when we were making an effort to attract our partner. If someone else comes along who appears charming, attractive and sexy, it’s tempting to inwardly detach from our partner and get swept up in something new, different and apparently better. It’s easy to forget that we felt exactly the same at the beginning of our relationship with our partner. What happened? Where did that magic go?

If you cast your mind back to the start of your relationship, you can probably remember that when you thought about your partner and the prospect of having a relationship with her or him, it seemed an exciting opportunity, full of mystery, totally unknown, rich in promise and ripe with potential. Because it was so new and unfamiliar, it felt charged and made you anticipate and plan every contact you’d have with them, every call, or text or email you’d make. You made an effort to present your best self, to be witty and thoughtful. You were interested in her or him and you made efforts to be interesting to them. You thought about what you’d wear, what fun activities you could suggest, you were keen on trying new ways of being and thinking, visiting new places, eating different foods, introducing stimulating topics of conversation, inquiring about your partner’s likes, dislikes, dreams and hopes. In effect you were magnetic! You were inspired and inspiring, full of energy, no effort was too big for you to make in your attempts to show your partner that you cared. You contributed a lot to making this phase of your relationship so dynamic and alive. In fact, when you think about it, there was nothing “spontaneous” about this phase. Spontaneity is a myth that you keep searching for but never actually existed because lots of planning had to take place.

The contributing part of yourself can be re-awakened. Instead of looking for charge and inspiration from others, imagine how you’d like to feel and be, what you can give and contribute, not just what you can get from your partner. Don’t wait for your partner to make the effort first. Don’t expect that a new partner will do this for you because this state will not last without input from you. Looking for others to “do it for you” has many down sides. Have you ever asked yourself what’s in it for them? Why would they want to keep investing their good energy in you if you aren’t making the effort for yourself or for the relationship? Their energy charge, just like yours, is not inexhaustible. You need to ensure that their efforts are reciprocated, that you’re both contributing. This is what makes a good team and an exceptional relationship.

How can you recharge your own energy so that it can be reinvested in the relationship? When you and your energy are fully charged, like the charge you felt at the start of your relationship, you give off a magnetism which is highly attractive and which can reignite the sparks in your relationship. It’s inevitable and normal that your batteries will run flat every now and again. It happens to everyone and to all relationships. But you can recharge yourself by doing things that are new, different, exciting and yet totally in line with your own integrity and the commitments that you’ve made to your partner. You need to convert your energy, by taking physical, emotional, mental and spiritual action so that the increased electric current reawakens your love and your relationship.

I’d like to invite you to start today. Why wait for something to happen? Waiting for things to change can be very frustrating and is often a losing proposition. Unless you take the lead and begin to recharge yourself and the relationship, it may slowly die, just like a worn out battery.

For ideas on how you can focus on making you and your partner feel recharged, read part two in my free report “Successful Relationships for Singles and Couples” which you can download from my website. You can also give me a call on (02) 9516 4399 or email me today , so we can work together to bring the spark back into your life and your relationship.

What sets our good relationships with close and intimate partners apart from those we have with our more casual acquaintances is the quality of the emotional connection we share. Emotions are core to human interactions. Without the ability to understand, use and respond to our own as well as others’ emotions in a healthy way, impaired social interactions and communications result.

There are some basic principles in a healthy relationship which underpin the mnemonic CODE, which stands for Compassion, Openness, Depth and Equality. Developing these emotional qualities requires focusing on compassion, openness, depth and equality towards ourselves as well as our partners, it’s not an either or deal. By focusing on applying these first to ourselves, we’re in a much better position to practice treating others in the same way.

Cultivating the CODE in your relationship requires sustained effort, especially after the initial honeymoon phase wears off. There’s always the risk that one or the other of you may not try as hard as you did at the beginning of the relationship. But if creating a conscious, loving, co-committed and evolving relationship is important for you, focusing on the CODE will be of great value.

COMPASSION

Mutual compassion is necessary, because when either one of you is tired, stressed, sick or under the temporary influence of a mood, caring for yourself at the same time as caring for your partner helps you remember that the development of compassion is an ongoing process. Practicing compassion for yourself and your partner helps you pay attention to your own emotions, which may warn you that you’re walking on eggshells, or are attempting to avoid issues. Noticing your own emotions and using them as information, gives you the courage to raise issues in a caring way without causing unnecessary harm to yourself, your partner, or the relationship.

Compassion is a blend of many of the qualities comprising love. Having compassion for yourself is the basis for developing compassion for others. Genuinely helping others means learning to act for the benefit of others without interference from your own agendas. Compassion begins with loving-kindness, which means friendliness toward yourself and inevitably leads to friendliness towards others. It also implies trusting yourself—trusting that you have what it takes to know yourself thoroughly and completely without feeling despair, without turning against yourself because of what you see. The more you trust yourself, the less need you have to close down to others. Even though others may evoke strong emotions in you, you don’t withdraw. Based on this ability to stay centred and open, you achieve the capacity to relate to others in truly compassionate ways.

It’s common for people to have a distorted view of what friendliness, warmth and self-compassion really mean. We all know that we need to take care of ourselves, but how many of us really know how to do this? When we begin to develop compassion for ourselves— unconditional acceptance of ourselves—then we’re really taking care of ourselves in ways that pays off. We feel more at ease with our own bodies and minds and more comfortable in the world. As our kindness for ourselves grows, so does our kindness for other people.

OPENNESS

In order to be open with others in a healthy way you first have to be open with yourself. It’s important to become increasingly comfortable with who you are. You do this by familiarising yourself with and becoming mindful of your ways of thinking, feeling and behaving. You’ll soon see that there’s much variety and fluctuation in these parts of yourself because nothing is stable and permanent. This knowledge will help you to be open to the ideas and opinions of your partner, a skill which takes time to develop. You don’t need to open up right away and tell your deepest secrets at the start of your relationship. After spending sufficient time together, you’ll learn more about your partner, their likes and dislikes, their strengths and quirks of personality. When you know them better and your mutual interactions have shown that trust has been earned, only then should you begin revealing any skeletons you may have in your closet.

Another aspect of being open is telling the truth. It may feel uncomfortable at first, especially telling a truth that could possibly make your partner upset. In the long-run your partner will respect the fact that you told the truth and it will be beneficial to you as a couple. Openness requires saying what your real opinion is on a matter. It takes courage to think about what you are going to say, and to ask yourself: “Will it make her/him feel an emotion? Are there positive/negative consequences?” If you disagree with your partner, clearly state your reasons for disagreeing. Don’t try to force your opinion on your partner, try to respect their differences. Every couple has its disagreements, this is normal. Explaining what you think and trying to show your partner your opinion in a respectful way may open them up to new ideas and help them to see your point of view. Although it’s tempting to avoid any problems that come up, talking through situations not only helps you get over a problem more quickly, it also helps you bond as a couple. It gives you experiences which prove that you can get through problems. This is essential for a strong and healthy relationship. Leave time to just talk, talking is good for bonding.

DEPTH

A healthy relationship can be a universe within itself. Though still connected with the world around it, the relationship can supply each of you with a deepening home base from which to grow together. You can increase the depth of the relationship by the things you do together. Both of you can foster relationship depth by developing the various dimensions of your relationship, by cultivating intellectual and emotional rapport, by harmonising values and by honouring your commitment to each other.

When you expand the range of activities and interests that you share, you expand the depth of your relationship. Each of you must have a say in what you do and whom you see. The more variety you have in your life together, the more dimension you provide the relationship. A deep relationship is fresh and alive, interesting and vital, no matter how long you’ve been together. The variety can range from relaxing activities like sitting together in nature to engaging in new hobbies to reading some of the same books. The fire of the first months will not blaze forever, so cultivate mutual interests.

Depth in a lasting relationship is not sensational, but subtle. And it’s the appreciation of the subtleties that can move the relationship beyond the excitement of infatuation into deeper and deeper connection. By cultivating mutually respected values, you will instil integrity and depth into your relationship. Real values are personal, ethical, compassion-based and philosophical. Keep sharing your thoughts, feelings and values, bounce ideas off each other, think about your beliefs and be prepared to debate so that your beliefs can mature.

Another way to achieve depth is through commitment. Being committed to each other means that both of you have decided that your relationship is a priority. Neither of you is in it as matter of convenience, but because of devotion to each other. Your relationship will inevitably be tested by a variety of life stressors, but with commitment and loyalty, your relationship can weather any storm. Loyalty means that you’re there for each other when it counts. When either one of you is challenged by others, you know that your partner is there to support you. Your principal allegiance is to each other because you’re a team.

EQUALITY

Equality sets a strong, level foundation on which your relationship is built. Rooting your relationship in equality enhances the likelihood of it being successful for both of you. In an egalitarian relationship, decisions which affect both of you are made together. This is done by asking for each other’s input and listening to each other’s ideas. Each of you bring unique attributes, abilities, talents and sensitivities and drawing on these qualities will enhance the process and outcome of your relationship. Equality also involves respecting each other’s rights for attention, support, time, space and comfort. Because you’re different, you will necessarily have different needs in these areas. Working together to create understanding and learning to negotiate about these is important so that you both feel your needs are respected.

Part of the process of enhancing equality in your relationship is that you assume mutual responsibilities for such things as decision-making, household tasks, pets, finances and kids. This is done by allowing the other to express themselves freely without interruptions or put downs, by asking and not making demands, and also with an awareness that power is shared equally so that no one is the boss of the other. If one of you has more skill in one area, it’s fine to mutually decide that the skilled one take more responsibility in that area. To do this well, transparency is required, so that in putting forward your preferences you trust that the other will complete their agreed-upon responsibilities.

Settle for nothing less than the CODE in your relationship and make sure that both of you share an appreciation of its principles. Both partners need to participate to make a healthy, thriving relationship.

For more information on incorporating the CODE in your relationship, please call me on (02) 9516 4399 or email me today.

Last month, after a few very busy weeks of talking in my counselling practice combined with the end-of-term strain of teaching counselling to students who were worried about their assessments, a sore throat caught up with me. Every time I spoke for more than a few minutes, I would start coughing and lose my voice. My doctor told me I’d strained my vocal cords and recommended that I allow time for recuperation by speaking less whenever possible. I decided to adopt three days of silence at home, which honestly, for me, was blissfully similar to doing a mini meditation retreat at home. I realise for many of you this could possibly feel like hell on wheels, but as a dedicated meditator, I regard retreat times as precious reminders of the subtlety and power of living with heightened awareness. After those initial three days, I promised myself that for a week I would speak 75% less and continued to practice significantly reducing my words.

Because the teaching term was at an end, it meant that in my daily life and my counselling practice I would say a lot less and listen a lot more than usual. I regarded speaking less at work and home as an experiment. What if, 8 times out of 10, I held back my comments? What if I allowed myself more space between what others said and gave a briefer-than-normal response? What if I took more time to ponder what I heard and focused more on watching any reaction I may have to it? This meant counselling using the more traditional way of doing therapy, being less verbally interactive, more reflective. Not speaking is about a lot more than listening. I observed more closely my clients and the people with whom I interacted daily. And I began to question some of my own assumptions about collaboration in interpersonal relationships and daily living in general.

Here are a few insights that you can try in your relationship:

1. Watching is as important as listening.
When you are trying to understand those around you, just listening to someone’s words is not enough. Body language and other non-verbal means of communication like gestures, voice tone, pace and volume provide valuable clues for meaning and intention. Clear non-verbal cues like frowns or smiles, eye contact and eye movements, adjusting clothes, or moving objects while speaking provide valuable information. Half the information we get in a discussion is visual, but we’re often too busy listening and thinking to watch. Rather than thinking of what to say next, take a moment to consider what you see in your partner and focus inward on how that impacts you.

2. Lead with questions, not answers.
During my week of semi-silence, I asked more questions than normal. They’re shorter than statements, and after posing a question you get to sit back, listen and think. Asking questions helps you more fully understand your partner’s feelings and thoughts and gives you additional information. Questions express your interest in what is being communicated and if asked with respect and without prying, are invaluable for creating connection. There’s an old adage that says “If you want to be interesting, be interested”.

3. Pace yourself and acknowledge others.
Sometimes waiting to respond and taking a pause works wonders. There is a fascinating movie from the ’70s called Being There. In the movie, the main character is a very simple, illiterate man who becomes world famous without ever saying anything more than a few basic words. Miraculously, he would elicit a deep level of engagement and intrigue with everyone he met by simply listening and acknowledging. Often, when someone would speak to him, he would take a long pause and smile. The person would then continue to speak, often answering their own question. Then, he would look the person straight in the eye, and say a sincere “thank you.” With a dose of patience and acknowledgement, the world seemed to fall into place around him.

In the real world, we all get anxious about subjects we care about. We like to respond to opportunities quickly, and resolve problems immediately. But perhaps there are times when we should restrain ourselves. In a discussion or negotiation with your partner,  try waiting rather than responding right away. As they say, “good things come to those who wait.” The solution may reveal itself if you give it a chance.

4. Embrace setbacks as learning opportunities.
My voice has recovered and I am again able to speak more liberally. But I am trying to carry on (and share) my lessons. Periods of distress are inevitable for all of us. The only part of difficulties and challenges that we have control over is what we take away from them. The greatest opportunity for self-improvement and growth for your relationship is following a time of adversity with the willingness to absorb the lesson. When this happens in your relationship, practice accepting that setbacks are inevitable.

What’s Your Experience?
Have you ever tried enduring a period of silence, or just focused on listening more? What happened?

For more information on the benefits of less talking and more listening, please call me on (02) 9516 4399or email me today.