How childhood trauma can affect mental and physical health into adulthood

Editor’s Note: This article is the first in a series exploring how research into adverse childhood experiences – or ACEs – is helping therapists, parents, educators and the medical community better understand the lasting effects of trauma on mental health.

For millions of children in the U.S., poverty, neglect or abuse is a reality of everyday life, though these struggles are often hidden from view.

Adult survivors often feel ashamed about and stigmatized for their childhood adversity. This makes it difficult to recognize that these events occur.

While it’s easier to turn away than to face these issues, we can no longer afford to do so. Stress, mental illness and substance abuse – all health outcomes linked to childhood trauma – occur in the U.S. today at very high rates.

In 1999, I joined the Centers for Disease Control and Prevention (CDC) as an early investigator on a study to examine how childhood trauma can impact health decades later. Little did I know that I was about to begin both a professional and personal journey that would forever change my understanding of medicine, public health and the human capacity to heal.

That seminal study provided insight into the lifelong health consequences of adverse childhood experiences (ACEs). It was the beginning of our understanding that these experiences can have negative effects on childhood development, leading to physical and mental health problems throughout life.

It brought to light the importance of preventing ACEs from ever occurring. It also drew attention to the healing and recovery needed to prevent these experiences from having an impact across generations.

The ACE Study

In the early 1990s, Vincent Felitti, a physician at Kaiser Permanente in San Diego, questioned why patients who successfully lost weight dropped out of a weight loss program. He could not make sense of it. He interviewed each patient individually and learned that the weight loss made patients feel vulnerable. A large proportion of the patients disclosed experiences of childhood sexual abuse. The weight protected them.

Felitti’s findings caught the interest of Dr. Robert Anda at the CDC. Together, they launched the CDC-Kaiser Adverse Childhood Experiences Study.

The ACE Study was one of the first and largest research efforts conducted to examine the impact of childhood trauma on health decades later.

From 1995 to 1997, more than 17,000 adult members of Kaiser Permanente in San Diego took part in the study. Researchers gathered information on their health and behaviors. Participants also answered questions about adverse childhood experiences, including physical, emotional and sexual abuse; physical and emotional neglect; and growing up in a home with divorced parents, domestic violence, substance abuse, or mentally ill or incarcerated household members.

One day, while reviewing the completed questionnaires, I came across several notes penned by the study participants, thanking us for asking these questions. One said, “I thought I would die never having told anyone about my childhood.” The messages were a true testament to the hidden nature of childhood adversities.

Key takeaways

The ACE Study offered groundbreaking insight into childhood trauma.

First, the ACE Study showed that childhood trauma is very common, even among white, highly educated adults with health care.

This was a novel finding, given that populations of low socioeconomic status and racial minorities are disproportionately represented in child welfare systems. For example, a large percentage of African-American and Native American children are seen in the child welfare system. The ACE Study helped us understand that childhood trauma cuts across multiple populations.

We learned that close to 30 percent of ACE study participants experienced physical abuse as a child. Fifteen percent experienced childhood emotional neglect.

A separate study showed that one in six men and one in four women reported childhood sexual abuse. Both men and women experienced similar risk for health outcomes like alcohol abuse and symptoms of depression.

Most importantly, we discovered that the 10 separate categories of abuse, neglect and related household stressors we assessed rarely occur as single events. For example, among adults who reported sexual abuse, 80 percent reported at least one additional ACE and 60 percent at least two. A large proportion of study participants, sixty-seven percent, reported at least one of the 10 ACEs.

It’s true that, during adolescence, youth tend to engage in risk-taking behaviors. Our research showed that childhood trauma increased the risk of alcohol use by age 14 and illicit drug use by age 15. Childhood trauma also contributed to the likelihood of adolescent pregnancies and adolescent suicide attempts.

But the story doesn’t end there. ACEs were also found to be associated with multiple adverse outcomes in adulthood, such as cardiovascular disease, liver disease, chronic obstructive pulmonary disease, suicide attempts, alcohol dependence, marital problems, intravenous drug use and many more.

If there is one common thread to many of the preventable diseases we face in the U.S., why are we not paying closer attention?

Addressing ACEs

In 2012, the American Academy of Pediatrics called for a focused effort to prevent and address childhood toxic stress.

The policy was informed by the ACE Study and research on the impact that childhood trauma has on brain development. Neuroimaging of people who have experienced ACEs shows changes in the structure and function of areas of the brain responsible for memory, learning, and emotions.

What’s more, many of the outcomes associated with ACEs among adult survivors – such as substance abuse and mental illness – may make it likelier that the next generation will experience ACEs as well.

But not all hope is lost. Research strongly suggests that humans have an innate capacity to adapt and positively transform, even after traumatic and stressful events. Most importantly, positive, supportive and healthful activities can contribute to positive well-being among adult survivors of childhood adversity. Change has to start with ourselves first, so we can provide children with the safety, support, love, and protection they need.

We must recognize – without judgment, but rather with compassion – that trauma is widespread, affecting children and adults across generations. We cannot afford to wait any longer to address trauma and break the cycle of childhood adversities.

Shanta R. Dube, Associate Professor, School of Public Health, Georgia State University

This article was originally published on The Conversation. Read the original article.

How a drug can help prevent 5000 girls being infected with HIV every week

South Africa has became one of the first African countries to license a fixed-dose combination of anti-retrovirals to be used as an oral pre-exposure prophylaxis.

Pre-exposure prophylaxis, more commonly referred to as PrEP, is the use of anti-retroviral drugs by people who do not have HIV to prevent them from becoming infected. The World Health Organisation recently recommended it as an additional HIV prevention choice for people with a high risk of being infected.

The recommendations are based on studies showing that daily doses of the drug effectively reduce the HIV risk in men and women. This was irrespective of age, mode of HIV transmission or the drug regimen used. The only common factor in the level of protection was how well people adhered to the drug regimens.

The studies also showed that pre-exposure prophylaxis is safe to use in healthy populations as there was no evidence of increased side effects in trial participants.

Breaking a new frontier

South Africa’s Medicines Control Council has ruled that the drug Tenofovir disoproxil/emtricitabine (TDF/FT3), more commonly referred to as Truvada, is safe and effective for use as pre-exposure prophylaxis in the country. This paves the way for the government to issue a tender to procure the drug.

South Africa’s license is incredibly important for HIV prevention in the country as well as the region. It is a critical step to including pre-exposure prophylaxis in publicly-funded HIV prevention programmes. The licensing also means that other countries in the region are likely to follow.

Several policy, programme and procurement processes need to be followed before the drug can be distributed through the healthcare system.

The government is likely to start with pilot sites as it did with anti-retrovirals given to mothers to prevent mother to child transmission. This will help it learn:

• how to identify populations who need and want to use PrEP,

• what systems are needed for delivery, and

• how best to monitor health so that it doesn’t overburden the health service.

A solution for young women

One of the critical steps in developing programmes is defining who will most likely benefit from them. Mathematical models suggest that it is likely to be cost-effective in settings where there are three new infections in every 100 people each year.

In Africa, the populations that have been prioritised to date are sex workers, men who have sex with men and couples where one partner is HIV infected and the other is not.

But research shows that unless HIV prevention in teenage girls and young women is prioritised, the ambitious targets set by UNAIDS to end HIV by 2030 will not happen.

Every week more than 5000 adolescent girls and young women acquire HIV. And the vast majority of them live in southern Africa. Young women are up to eight times more likely to be infected than their male peers of the same age in eastern and southern Africa. This is despite the rate of new HIV infections declining or stabilising in many other populations.

And although their HIV risk is driven in part by individual behaviour, other factors also play a role. These include:

• poverty,

• gender inequality and high exposure to violence,

• limited economic options, and

• the low social power of young people.

Adherence pitfalls

For PrEP to be effective, it will need to be integrated into existing HIV prevention services.

People at high risk for infection and who wish to start PrEP will need to be tested for HIV before they start and then every three months while taking the drugs. This will ensure that those with an early HIV infection are detected and don’t develop anti-retroviral drug resistance. They will also have their kidney function tested as Truvada can cause kidney problems in some people.

But the biggest challenge is ensuring that young people, particularly young women, who start PrEP take the pills daily as required. Those taking PrEP daily cannot miss a single dose. While two trials of pre-exposure prophylaxis in South Africa, Zimbabwe, Tanzania, Kenya and Uganda raised questions about whether young women will adhere to pre-exposure prophylaxis, recent open-label studies have shown that when populations at-risk, including young women, recognise their risk and know that pre-exposure prophylaxis is effective in preventing HIV, they are able to use it effectively.

It’s time to implement

Several pre-exposure prophylaxis demonstration projects are either underway or are being planned across southern and eastern Africa. These projects will inform the development of national policies and programmes, adding to the evidence base to understand how best to innovate, integrate and implement Truvada within a combination HIV prevention package.

The challenges of delivery will only be truly understood through implementing delivery projects. Once we have gained insights into the challenges, we will be able to refine an HIV combination prevention programme to meet the needs and preferences of teenage and young women.

Sinead Delany-Moretlwe, Associate Professor and Director: Research at the Wits Reproductive Health and HIV Institute I, University of the Witwatersrand and Deborah Baron, Researcher and Programme Manager: Clinical Research Consortium for Wits Reproductive Health and HIV Institute (RHI), University of the Witwatersrand

This article was originally published on The Conversation. Read the original article.

FactCheck: is having a mum and a dad the very best thing for a child?

“If you ask the Australian people whether you think a child has a right to have a mother and a father, 75% or more will say that is right. If you ask individuals whether a mother is the most important nurturing relationship a child can have, over 90% of mothers say the same. So who are we to deny a child the right of having a mother or a father?… We also know that in the development of a child, the very best thing that can happen is for them to have a mum and a dad who play a complementary role in the raising of that child.” – Liberal senator Cory Bernardi, interview with Fran Kelly on RN Breakfast, July 2, 2015.

A cross-party bill aimed at legalising same-sex marriage and scheduled for parliamentary debate in August has come under a new round of criticism from some politicians, including Liberal senator Cory Bernardi.

Many have argued that children need not be brought into debates about marriage equality, but nonetheless it is worth examining how well Bernardi’s assertions hold up against the research.

The evidence

When asked for a source to substantiate his statement, Bernardi’s spokesperson referred to a 2015 poll commissioned by the Australian Marriage Forum (self-described as “an organisation that has been set up to encourage Australians to discuss the issue of same-sex marriage with some discernment and caution”). The online survey of 1242 people found that 76% of Australians agree that:

… where possible, as a society, we should try to ensure that children are raised by their own mother and father.

Bernardi’s spokesman also pointed to a 2005 study, published on the Institute of American Values website that involved a survey of more than 2000 US mothers (complemented by interviews and focus groups), that found that:

… nearly 93% agreed that a mother’s contribution to the care of her children is so unique that no one else can replace it.

While both these sources give an indication of attitudes towards parenting, neither used questionnaires that had been scientifically developed and tested in a range of settings. For example, when measuring child health the Child Behaviour Checklist might be used. In addition, neither of the sources underwent peer review to ensure academic robustness.

Further, it is important to consider that these sources describe the attitudes of heterosexuals to parenting, and in one case only heterosexual mothers.

The United Nations Convention on the Rights of the Child goes only so far as to state that a child has “the right to know and be cared for by his or her parents”. There is no mention of whether these parents must include both male and female biological parents or that these parents must be married. Furthermore, neither of Bernardi’s sources give a quantifiable measure of how children actually fare in different family contexts.

This goes to Bernardi’s last and most important point:

We also know that in the development of a child, the very best thing that can happen is for them to have a mum and a dad who play a complementary role in the raising of that child.

To support this point, Bernardi’s spokesperson directed The Conversation to a 2011 report commissioned by the Australian Christian Lobby and researched by University of Sydney law professor Patrick Parkinson, specifically a section that said:

… children do best of all growing up with two happily married biological parents.

This particular quote is actually a citation from a paper by US researcher Paul Amato. His paper does not discuss same-sex parents at all. He instead highlights the importance of happily married parents. The focus of Parkinson’s argument is not that biological opposite-sex parents are essential – rather, it is that stable, conflict-free families that are important.

Like Amato, Parkinson goes on to state that children should be raised in the context of marriage. More than 6000 children in Australia are currently being raised in same-sex couple households. Same-sex marriage would provide access to marriage for the parents of these families.

Reviewing the literature

There is rigorous research on the question of how children of same-sex parented families develop. The Australian Institute of Family Studies has taken a thorough and locally relevant approach.

In their 2013 report on same-sex parent families in Australia they examined and synthesised Australian and international literature on same-sex parented families. The report found that:

… overall, research to date considerably challenges the point of view that same-sex parented families are harmful to children. Children in such families do as well emotionally, socially and educationally as their peers from heterosexual couple families.

This has recently been supported by the largest study in the world to look at child health in same-sex families. This Australian research considered the health and well-being of 500 children from 315 families. It found that, on average, children with same-sex-attracted parents scored pretty much the same as the average Australian child. However, it also showed that in some areas, including how child health is affected by how families get along, children with same-sex attracted parents are doing better.

Research suggests that same-sex parent families function more equitably by sharing parenting tasks. Far from needing a “mum and a dad who play a complementary role in the raising of that child”, as Bernardi suggests, it is same-sex families where complementarity is really proving beneficial.

Verdict

Bernardi, some of his Liberal colleagues, and others, suggest that children need both a mother and father. In terms of actual health and well-being outcomes, the overwhelming body of scientific research suggests that children develop well when growing up with same-sex attracted parents.

More work is required from the academic community to bring this scientific reality to the minds of the community.

Review

This is a fair and academically robust analysis of Bernardi’s statements.

With regard to children’s well-being, there is now a substantial body of international peer-reviewed research in the social sciences on how children are faring when raised in families that do not conform to the married, two biological parent norm.

A comprehensive review I authored for the Australian Institute of Family Studies in 2013 revealed that children raised in same-sex parented families do at least as well as their peers raised in heterosexual couple families when compared on a comprehensive range of social, psychological, health and educational characteristics.

We know that family processes such as levels of conflict between the parents and the relative equity of their divisions of paid and household labour are more influential than the gender, sexuality or number of parents when it comes to children’s well-being. Same-sex couples are known to share parental care and paid work more equitably than heterosexual couples, and this tendency towards greater equity is beneficial for children.

It should also be noted that what people think children need is not necessarily commensurate with “children’s rights”.

When children raised in same-sex parented families are not faring so well, this is often because of their fears or experiences of bullying and discrimination in schools due to the continuing stigma attached to same-sex relationships in some community settings. In the Netherlands, which was the first country in the world to legalise same-sex marriage, children raised in same-sex parented families have higher well-being scores than their peers in the United States, where same-sex marriage has only recently been obtained. – Deborah Dempsey

Simon Crouch, Researcher, Jack Brockhoff Child Health and Wellbeing Program, University of Melbourne

This article was originally published on The Conversation. Read the original article.

The books that shaped the rise and fall of the British empire

Isabel Hofmeyr, University of the Witwatersrand

When we talk about books, we generally think only of their inside - the words, ideas and themes that they contain. But what about the outside? Books are objects in the world. They undertake all kinds of work that exceeds just their words - they forge friendships, decorate our houses, store our momentoes and memories.

Books also have active political lives. They inspire social movements and bind people together. Books can stand as short-hand symbols for larger galaxies of ideas.

A new collection of essays Ten Books that Shaped the British Empire explores the role of books in founding and dismantling The British empire. Written by scholars from South Africa, India, Barbados, New Zealand, Australia, the UK and the US, the volume comprises ten essays, each on a book that shaped British imperial life.

Block-busters and obscure texts

The ten books include five famous block-busters and five now-obscure texts that in their day were influential.

The five block-busters are imperial or anti-imperial classics: Robert Baden Powell’s Scouting for Boys (1908), Charlotte Bronte’s Jane Eyre (1847), Thomas Babington Macaulay’s five volume History of England (1848). The anti-colonial texts are Mohandas Gandhi’s Hind Swaraj (1909) and The Black Jacobins (1938) by CLR James, the famed Caribbean revolutionary thinker.

The lesser-known texts are

• Edward Gibbon Wakefield’s, A Letter from Sydney (1827) , influential in the colonisation of New Zealand and Australia.

• Charles Pearson’s National Life and Character (1893), an Australian book predicting the rise of Asia and the end of the ‘white man’.

• Century of Wrong (1899), the pamphlet setting out the Boer cause in the lead up to the Anglo-Boer War.

• Totaram Sanadhya’s 1914 Fiji Mein Mere Ekkis Varsh (My Twenty-one Years in Fiji) a Hindi pamphlet opposing indentured labour.

• Gakaara wa Wanjau’s 1960 Mihiriga ya Agikuyu (The Clans of the Gikuyu) written in a Mau Mau detention camp.

How the 10 were chosen

The volume is edited by a radical historian of empire, Antoinette Burton from the University of Illinois and myself, a scholar of print culture and book history from the University of the Witwatersrand in Johannesburg.

In our introduction, we say that from the very beginning the book provoked fascination. “Oh wow! Which are the ten books?” was a common response.

While everyone had a different idea of which books should be included, our interlocutors accepted the premise that books could change empires. People envisaged a series of big books that founded empires (John Robert Seeley, Charles Dilke, Frederick Lugard were common examples) and a set of equally significant books that ended up dismantling them Frantz Fanon, Amilcar Cabral, Che Guevara).

How the books shaped aspects of empire

In some cases the influence was direct. In 1901, when Australian parliamentarians debated the Immigration Restriction Bill (a key part of the White Australia policy), the Australian prime minister held up a copy of Pearson’s book and read two passages from it. On the anti-imperial end of the spectrum, CLR James Black Jacobins was widely taken as an allegory predicting the end of colonial rule in Africa.

Yet books equally have more diffuse and longer term effects – Wanjau’s pamphlet for example was less concerned with direct action against the British than with undertaking the long, slow work of preparing people for independence.

Books were deeply enmeshed with empire and were often used as symbols of British imperial authority, calling-cards of ‘civilization’. As one observer noted, “The English literary text … function[s] as a surrogate Englishman in his highest and most perfect state”. Books were held up as the ‘gift’ of empire and were used to portray colonialism as benign while masking its violent nature.

Books and documents were also instruments of ruling – the pass book was used to control the movements of black people during apartheid in South Africa.

But books could equally be used by those opposing empire, a provocation to imperial power and a monumental statement of intent. James’ Black Jacobins, an account of the late 18th-century slave revolt in Haiti initially appeared in a handsome 328-edition from Secker and Warburg.

Some came from humble beginnings

Yet, not all of the 10 books started out as books – many began life as pamphlets or newspaper articles, more humble forms which nonetheless exerted considerable influence. Century of Wrong became a calling card for the pro-Boer cause. Scouting for Boys appeared first as a newspaper series and then in small handbooks, a format that helped make scouting an international movement.

These texts travelled far and wide at times migrating through different media, appearing as newspaper serials and then rising up into books. Aiding their passage was the vast sprawling periodical and newspaper network that carpeted empire. Hind Swaraj began life in Gujarati in a two-part series in Gandhi’s Durban-based newspaper Indian Opinion before appearing as a booklet translated by Gandhi himself into English.

These streams of print culture made up the sinews and arteries of empire, linking its supporters while offering a mode of communication to its opponents. Access to this field of print culture was uneven and unequal, affected by capital, literacy, censorship.

Yet, much of this printed matter was not copyrighted – all periodicals for example legally reprinted material from each other. These carpets of print culture created a type of commons across empire, a zone of textual production not owned by one person.

Books in empire were dispersed across time and space – they were not bounded events. As instruments for and against empire, they formed part of the sprawling assemblage of the British empire, both extending its reach and limiting its legitimacy.

Isabel Hofmeyr is Professor of African Literature at University of the Witwatersrand.

This article was originally published on The Conversation. Read the original article.

How alcohol makes you friendlier – but only to certain people

Ian Mitchell, University of Birmingham

Drinking alcohol is associated with aggressive behaviour, accidents and ill health. Yet many of us choose to drink socially. This may reflect alcohol’s actions on specific brain circuits which make us feel euphoric and less anxious. Alcohol may also make us more empathic and cause us to see other people as more attractive. But why do these reactions occur and are the positive effects of alcohol expressed towards everybody we interact with?

Alcohol is a drug, one of the three most commonly used in the world, along with nicotine and caffeine. When we drink, the alcohol binds to a specific type of receptor in the brain and boosts the activity of a natural brain chemical called GABA. The effect the alcohol has on us depends in large part on the dose, and the location of these GABA receptors within the brain.

Early on in a drinking session, the alcohol acts on GABA systems to boost the levels of dopamine, the brain’s reward chemical. This gives a sense of well-being and a sense of mild euphoria. Alcohol also acts on GABA receptors to impair the activity of the brain circuits that make us feel anxious and, at higher doses, alcohol inactivates a second set of brain circuits that control fear. So threatening stimuli no longer seem quite so scary. Alcohol also compromises our ability to compute risk so that situations we would normally shy away from may now seem quite inviting.

All of this points to alcohol as a facilitator of social interactions. As well as making us more empathic, laboratory studies have also shown that drinking alcohol can make us trust others more and make us temporarily more generous.

On the other hand, heavy drinking is associated with violent behaviour. This situation, however, is complex. Laboratory studies have shown that alcohol increases aggression. For example, it increases the willingness with which individuals will administer electric shocks to others. However, this effect seems to be largely restricted to those who are intrinsically aggressive in the first instance.

Equally, alcohol can corrupt our ability to understand the intentions of others. The brain contains specific circuits, which connect parts of the prefrontal cortex, amygdala and temporal parietal junction, that handle our social cognitive abilities. So our ability to understand somebody else’s mental perspective and their motivations for acting in a certain way become unreliable.

Very big doses of alcohol can leave the functioning of these circuits so compromised that individuals can appear to be as impaired as patients with some forms of dementia. This is quite a disturbing thought given the number of people who end up in this state in city centres at the end of a good night out.

Alcohol also impedes our ability to accurately interpret emotional expressions in faces. As we drink, we have a tendency to erroneously assume that some facial expressions of negative emotions are happy, and we find it particularly difficult to identify sad and angry faces. This leaves us prone to making embarrassing social errors.

One important, but often overlooked, aspect of alcohol’s effect on social functioning relates to how we perceive members of our in and out-groups. Alcohol appears to encourage us to bond to members of our in-groups. However, this may come at the cost of the way we treat people outside of these groups. Similarly, alcohol makes members of our ethnic in-group appear more attractive but this effect does not extend to members of other ethnic groups.

It must be emphasised that the effects described so far are potentially reversible once the drinker has sobered up. However, chronic heavy drinking can lead to brain damage and irreversible cognitive impairments, especially poor memory function, and psychiatric problems including depression, psychoses, anxiety and suicide.

So overall, alcohol may be a friend, and indeed make us friendlier, but only to a select group of people – and they may not always reciprocate.

Alcohol Friend or Foe? is part of the Pint of Science festival where academic experts talk about the latest in scientific research – at the pub.

Ian Mitchell is Senior Lecturer at University of Birmingham.

This article was originally published on The Conversation. Read the original article.

Avoiding Codependence in Your Family

Avoiding codependence in your family is critical for many reasons. Codependency prevents children from growing into healthy, happy adults, and it is believed to pass from generation to generation through learned behavior. Stop the proliferation of this emotionally damaging phenomenon now by learning how to recognize it in your home. Developing effective parenting strategies and modeling healthy behavior patterns are the best ways to help kids grow up to be independent, happy and capable adults and future parents.

Codependence and How to Recognize It

The National Mental Health Association describes codependency as "an emotional and behavioral condition that affects an individual's ability to have healthy, mutually satisfying relationships." Unfortunately the hallmark of this condition is denial; consequently, codependent people typically fail to recognize the warning signs. Experts recommend taking an honest look inward, but also to look for the symptoms in yourself, spouse and children. Warning signs are a lack of self-esteem, an inappropriate level of caring for another (or others) and an over-reliance on the approval or love of others. The symptoms and warning signs are diverse, but may manifest in those who try to constantly attract attention to themselves, lack a basic respect for boundaries, have a compulsive quest for acceptance or are unable to spend time alone. Among the stranger manifestations, many codependent people appear to be accident-prone, are often in a hurry for no reason and may choke on food.

Risks and Damages of Codependence

This condition is sometimes referred to as a relationship addiction, leading to adult relationships that are abusive and destructive. Many abuse victims are codependent, unable to break away from their abuser despite continued perpetuation. They self-sacrifice to the point that they lose themselves, enabling the addictions or other faulty behavior patterns of others so they can be needed. Common complaints that accompany codependency include depression, anxiety, stress and anger. Victims frequently suffer ill health because, in immersing themselves in the needs of others, they disregard their own needs. Often, codependent children switch roles with a parent, internalizing the parent's problems as their own and becoming, in a manner of speaking, their parent's caretaker.

How to Raise Kids without Codependence

Dysfunction grows in the family setting when parents are unable, for whatever reason, to meet the needs of their children. This may be the result of parents' own problems (addiction or mental illness, for example) but can also stem from poverty, from parents working too much, or from trauma or loss. Even if you haven't noticed warning signs in your home, you can employ some solid strategies that can help ensure that your kids grow up emotionally healthy and independent. Start by opening communication channels and encouraging kids to freely express their thoughts and ask questions. Respect children, their boundaries and their feelings by taking them seriously. Don't use emotional manipulation or verbal abuse; instead, teach them healthy ways to express their emotions by doing so yourself. Give children responsibilities appropriate to their age and maturity level. Trust them to make decisions, but teach them that this freedom may lead to (appropriate) consequences. Establish rules, but make the punishment for breaking rules appropriate and reasonable. Above all, never withhold love and affection from your kids (or your spouse) as a means of manipulation. Doing so will teach children that this behavior is acceptable.

If you suspect that a level of dysfunction is growing in your family, or if you or your spouse came from a codependent background, seek out a trusted counselor or professional therapist. Getting your family back on a healthy, independent track is important, especially because avoiding codependence will allow you and your children to live healthy, happy and well-adjusted lives.

Photo Credit

Article Source: http://www.articlesbase.com/mental-health-articles/avoiding-codependence-in-your-family-7180494.html

Jillynn Stevens, Ph.D., MSW is a writer and the Digital Marketing Content Director at Be Locally SEO where she is passionate about helping small and medium sized businesses expand their online presense and realize unprecedented success. 

How Homework Help Allows for Overall Development of Students

School students of modern times could use computer system with internet connection to avail various types of homework related guidelines and help with the help of online environment not only in interactive manner, but also at the fast pace as possible. Individuals can avail homework help at free of cost and even by paying some nominal fee. Therefore, you can visit large numbers of websites, which register providers of homework help and offer services to students, requiring valuable assistances related to homework problems even at affordable price as possible.

Private Tutors Make Homework Objective Successful : Parents or guardians and students should always keep in their minds that homework imparted on pupils in the form of assignment to do in homes is of huge significance, as it helps in improving skills and increasing the knowledge level of students. Simultaneously, the allocated assignment helps students to learn doing different types of things by applying various creative ways and by usage of varying skill sets. However, the objective behind the homework allocation to pupils would achieve only when individuals choose for good private tutoring solutions to avail guidelines doing assignments.

Leksehjelp Norge Allows Good Revision of Varying Topics : Homework can be in the form of chapter to memorize properly, mathematics problems to solve, project of science, geography and computer to complete and some important questions related to textbook, which children have to give answer. Homework allows for revising of chapters and topics taught in classroom. Private tutoring solutions allow students to become fully prepared of various important topics and tough subjects, which will come as students' progress to their coming levels. On the other side, homework provides excellent opportunity to guardians and parents to take part actively in the educational and growing process of young kids.

Online Guideline for Homework-Good Platform : Online homework help will act as a very good platform to share valuable knowledge and information. In fact, many students receive plenty of benefits with the help of interactive study mode done via forums and chat sessions advent on internet. Nowadays, the concept behind assistance via internet has become immensely popular in between schools belonging to different cities, regions, suburbs and states of the world. If you give your valuable time, you would likely found large numbers of schools and educational institutions, which involved in outsourcing of their various types of homework-related projects to many freelancers, which complete their suitable assignments and receive good incomes during the complete process.

Home Assignments Online Allow Participation in Extra-Curricular Activities : Many times, because of excessive stress related to home assignments, students do not get their adequate time to involve in other extra-curricular activities, games and sports. However, participation in other activities and sports are also equally important as getting good marks in academic sessions. Hence, in order to resolve the problem and allow children as well as adolescence to make perfect balance between homework, sports and other activities, homework help online has came into existence. These guidelines allow students to complete their work as soon as possible and concentrate on several types of sports and additional activities required for complete development.

Article Source: http://www.articlesbase.com/tutoring-articles/how-homework-help-allows-for-overall-development-of-students-7056621.html

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What psychological complexes really are

A psychological complex is an organized group of present or past THOUGHTS – FEELINGS – MEMORIES – WISHES – EXPERIENCES – PERCEPTIONS that were developed consciously or subconsciously and subsequently resulted in a NEWLY FORMED PATTERN OF BEHAVIOURS AND EMOTIONS. The intensity and truthfulness of these newly formed behaviors and emotions usually result in believing that the force that brought them into existence is also real, although it is just a product of your internal environment.

The set of processes taking place in our brains are presented in diagram 1:

Diagram 1: Definition of psychological complex

HOW PSYCHOLOGICAL COMPLEXES WORK

The following example should help in further comprehending the definition of a complex. Let\'s examine the ‘nose complex\' and assume that John suffers from the belief that he has a big nose. Some possible causes of that complex are that:

-        In elementary school (past) a classmate of John made fun of him that he had a big nose (conscious EXPERIENCE).

-        Although John does not recall of this experience today (present), it has been planted in his mind (subconscious MEMORY).

-        John feels bad (present and past) when people make fun of him (conscious FEELING).

-        John read a magazine article (present) which concluded that small noses are more attracting (conscious PERCEPTION).

-        John used to have dreams (past) where he looked different and people kept complimenting him on his well formed nose (conscious and subconscious WISH).

-        John often observes (past and present) other people\'s noses and tries to think which type of nose he would prefer to have (conscious THOUGHT).

John\'s brain has been processing all the above over the last years resulting in the development and growth of a psychological complex which consists of:

-        NEWLY FORMED behaviors:

• When someone is taking a photo of him, he avoids showing his profile to hide his big nose
• He doesn\'t go out very often because whenever he sees people giggling, he thinks they are commenting on his nose

-        NEWLY FORMED emotions:

• He sometimes acts more aggressive against people with small noses because of jealousy
• He does not feel self confident with his appearance

For further information, refer to the this comprehensive list of popular psychological complexes.

REMEMBER: A complex is nothing more than an IDEA arising and developing from an observation, experience or a series of events. Now is the right time to make the decision and set yourself free from all the negative thoughts that have been poisoning the prosperity of your mind. Start by firstly understanding the mechanism behind a psychological complex, identify the type of psychological complexthat you have and realize where your psychological complex comes from.

Article Source: http://www.articlesbase.com/self-help-articles/what-psychological-complexes-really-are-6443467.html

Morgan K. Taylor is a researcher, writer and coach who was born and raised by a traditional Greek family with strong bonds. The biggest passion of his life is travelling. As his father is a pilot, he had the luck to travel around the world and appreciate the distinctive features of each culture from an early age. He has now travelled in more than 40 countries and he is the owner of 32 ‘hard rock café\' t-shirts, each one from a different country. He has also developed a well-rounded approach to learning through his exposure to the educational systems of 4 different countries – Greece, Sweden, Czech Republic, Cyprus – both as a student and a teacher. These experiences helped him to become adaptable to various environments, remove certain existing mental blocks, develop a ‘thinking outside the box\' mentality and adopt a positive attitude towards possibilities.