As with all couples I make certain that there are no medical problems or medications causing sexual dysfunction. I always suggest a complete physical take place if a patient has not had a current one. I take a history. I look at abuse as a child, excessive use of alcohol or drugs, a history of depression or mental illness, early menopause, infidelity. I find out about how they met and what their early sex together was like. And I go into great deal with them about it. How did they get turned on, who initiated, how did they communicate about their likes and dislikes both before, during, and afterwords. I then begin asking them about the sex within their marriage.

What I often learn very early on with these couples is that their sexual relationship changed abruptly after the birth of their children. Women describe being exhausted-spent. Men recall feeling pushed aside both figurately and literally especially when a child is allowed to sleep in the couples bed (sometimes for years). These men watched their wives espress the emotion and affection that was initially for them not directed exclusively to the children. Men frequesntly report that wives become consumed in the raising of the children, hyperfocusing on the child’s education, how he/she fares socially and academically. Marital conversations become more about what Johnny or Susie did today than what might be going on for each partner.

I let couples know that if they are going to work with me they need to know that a relationsip without sex is not an option, especially when it it important to one partner. Sex in a relationship, although usually different for men and women, keeps a couple intimately connected and individually both physically and emotionally healthier. And so we begin the process of rekindling a couple’s sexual life together.

We start by talking about sex. Each partner tells the other what has pleased them in the past and what hasn’t . I ask each to talk about how it feels to hear the other describe their likes and dislikes. What I want to do is to create a safe place for couples to feel that they can openly discuss sex with one another without fear of angering or hurting the other. I make clear that the purpose here is to have people get what they want, not to expect the other to be a mindreader.

Couples are told that they need to carve out a time during the evening to talk about the children. However, the bedroom is off limits for that conversation. The bedroom is just for them. It should be designed so that it is comfortable, asthetically pleasing, and inviting to both. If there is a tv in the
bedroom, it must be turned off by 10pm at least once a week, ditto for laptops.

Couples, especially with children, have to learn to make a date for sex.
The primary focus in improving a couple’s sex life is communication and the comfort one feels in expressing honest feelings. Often a partner (sometimes the man) has no idea of the damage that is caused by refusing a partner sex. Anger builds and even with the most fun loving and seemingly attentive couple, both distance and tension are created. Self esteem is almost always affected. I find that once a partner feels heard and understands the hurt of the other, there is real effort to make change.

Some teenagers lie to their parents about how they are doing in school. They may put more stock in the importance of their peers than they do their grades. Some parents frown upon too much social interaction between their child and his/her peers as it takes time away from studies. Some parents worry about the kind of influence a friend or group of friends may have on their child. Other parents just worry about their inability to control the comings and goings of their child. And many parents are concerned about the amount of socializing that is done on the computer, ie. Facebook, etc.

Many of the kids I know lie to their parents about where they are going on the weekends. They will say that they are sleeping at a friend’s house when really they will be at a party and up half the night. A large number of these kids have tried alcohol and marijuana by the age of 14 and 15. They lie to their parents about their experimentation. Many kids lie about what they are doing on the computer. They will tell their parents that they are doing homework, when in fact, they are chatting with “friends”

Parents don’t want their kids to lie, but they do. What one parent accepts as age appropriate behavior, another does not. But at this stage of a youngsters life, they are separating emotionally and physically from their parents and they need to. They are getting ready to be on their own. They need to experiment with different sets of peers. They need to test their own boundaries and determine what is their limit. For example, your son may not be in the most “popular” group, but his best friend is. This group may be faster than is comfortable for your son. Your son will have to weigh the importance of his relationship with his friend, his own ability to participate with this group in some limited but comfortable way, and his own sense of values and pride. This is the time many of them will make some questionable and even bad decisions. But they do this within a social structure that hopefully includes parents who can “move in” when necessary to protect their kids.

So given that your child will most likely do something that you would not want him/her to do and lie to you about it, here are some suggestions to limit the amount of lying by your teenager and to have a more open relationship with him/her as he/she develops.

1. KNOW YOUR CHILD: Starting at age 11, pay attention to who your child’s friends are. What are his/her interests. Does he/she feel that they have places where they belong. Does he/she feel that they are liked by others. Does he/she feel successful in school? What does he/she do to get attention. How does he/she fix things that are not right in their life. Does he/she talk with you?

2. MODEL HONEST BEHAVIOR IN YOUR HOME: If your youngster sees that the adults around him/her
lie to avoid confrontations or to get what they want, your youngster will learn to lie.

3. MAKE YOUR HOME A PLACE WHERE YOUR TEEN LIKES TO GO: Talk with one another. Share ideas.
Listen to one another. DO NOT LECTURE!!!! DO NOT TALK ABOUT SCHOOL EVERYTIME THAT YOU ARE TOGETHER!!!! Try not to show judgment. Your teen will talk to
you more if he/she feels that his/her home is a safe place.

4. STAY IN TOUCH WITH THE PARENTS OF YOUR YOUNGSTER’S FRIENDS: If you do this when your
kids are young, you can support one another and watch out for one another’s kids as the kids get
older.

5. ALWAYS KNOW WHERE YOUR TEENS ARE: If your 12 to 15 year old says that they are spending
the night at a friends, talk to the parents. Meet them. Make certain that the parents will be
home and supervising that night. Do not drop your kids off at the movies, the Mall, or the beach
for an unlimited amount of time. 12 and 13 year olds need to always be supervised with some
opportunity for independence from their parents.

6. CLEARLY STATE THE RULES: Rules will be different for your teens depending on their age. But always be clear about curfews. Let your younger teens know that the use of alcohol and drugs is never allowed. (Parents-watch your use at home). Make it clear to all teens that they must call you to let you know if they have changed any plans when they are away from home. Talk to your kids about the dangers of alcohol and drugs and let them have the opportunity to talk to you about their friends’ use as well as their own temptations. Tell your teens that they can never be in a car with a friend who is drunk and driving. Tell them that you will pick them up from wherever they are if they are stuck or feel unsafe because their friends are drunk or disabled in some way. Work out a computer schedule with your kids that allows family time to be included in their day. You might even consider having younger children work on the computer in a public family space as opposed to alone in their room.

7. DISCIPLINE: If your teen is caught in a lie, there needs to be consequences. First, listen to what they have to say. Talk to them about trust and safety. Let them know that they have broken the trust between you and them by lying. Implement consequences. For younger teens, that may mean not permitting them to go to a party, a friend’s home, etc for the next two weeks. For older teens, consequences may mean no use of the family car, no private computer time, your checking up on them wherever they go, etc. If you have a teen in trouble; failing school, truant from school and family, constant lying, overt and covert signs of substance abuse—get professional help immediately.

8. DO NOT BE AFRAID OF YOU TEEN’S ANGER: Kids get angry when parents catch them in a lie. They don’t want you to interfere in their lives even when their choices are unhealthy ones. It is your job to be the bad guy sometimes. You have to keep them safe to the best of your ability.

Marriage is difficult for a lot of people. There are many stressors that a couple deal with everyday. Loss of jobs, ailing parents or children, poor work environments, etc. If you add to those issues, alcohol use and parent’s own low-self esteem and depression, you have a potentially volatile home situation. Nobody feels good. And your children are in real danger from damage that could last a lifetime.

When I talk about the kind of fighting that scares children, I am not referring to random arguments that parents have or even an occasional angry outburst by a parent. I am talking about yelling and screaming on a regular basis. I am talking about one parent humiliating and destructively verbally or physically tearing the other parent apart.

So, stop fighting. Decide that you will not raise your voices to one another in the home. When upset with one another, find a private time and place to dicuss you differences. Wait until children are at school or with a baby sitter or relative. Do not assume children are not listening from their bedrooms when they are suppose to be sleeping. Tell each other how you feel. Start your sentences with I feel….when you…… Agree to disagree. If one or neither of you can contain your anger, get help immediately!!! Do not push this under the carpet and expect it to go away. It won’t. You both know this. In all likelihood, one or both of you grew up in a similar family situation.

Alcohol use can increase as a way to avoid bad feelings.

As I questioned James and Gail about Karen’s behavior, they said that Karen had been a shy quiet child in elementary school with few friends. Her brother was a successful athlete and student and had very little patience for his younger sister. Karen’s behavior began to change when Gail went back to work full time last year. Gail had not discussed this with Karen, but had abruptly told her that there would be a full time housekeeper the following week because Gail would be now working full time.
James had very little to do with Karen as she got older. He shared sports with his son and was frequently involved with him during the weekends.

My initial goals with this family were to 1) help the parents become more positively involved with Karen 2) acknowledge Karen’s frustration and anger 3) avoid engaging in raging battles 4) reward her for appropriate behavior and establish consequences for inappropriate behavior. I also thought that it was important for Gail and James to investigate with the school whether there were any learning issues that were causing Karen to underachieve and to feel badly about herself.

During our first few sessions we talked about activites that each parent could do with Karen. James said that Karen loved to watch the Simpsons. He thought that was something that he could do with her on a regular basis. He also likes to cook and thought that he and Karen could plan a meal together for family. I wanted both parents to find out what Karen’s interests were and to share those things with her. I asked them not to focus on Karen’s school achievement with her at this time I suggested to both parents that when Karen became irritable or angry that it was important to let her know that they could tell how upset she was. They could tell her that they wanted to hear how she felt but that once she became abusive, they would not listen to her. If her anger was escalating they were to tell her to go to her room and that they would all talk about whatever she wanted once she was no longer enraged or abusive.

Cindy W. is a mother of three. She and her husband, John, have been married for ten years. The children’s ages are 9, 7, and 4. Cindy was recently layed off at her job as a bank teller. John works as a security guard on a late night shift. John’s mother, Kathy, has helped with the kids after school and daycare. Cindy says that her biggest problem is John’s alcohol use. Now that she is at home during the day, she has been made aware of just how much John is drinking. She feels that she may be depressed about the family finances, John’s drinking and her job loss, though she is continuing to look for work. She and John are fighting more about finances, disciplining the children, housework, etc. Both Cindy and John grew up in alcoholic families.

Solution

Cindy and I chatted about how badly both she and John were feeling about their lives. I encouraged her to talk to John and to just listen without comment to how he was feeling about their marriage, the kids, and his work. I suggested that she and John find time to just listen to each other. I asked her to talk with John about their experiences growing up in alcoholic homes and how they each thought that affected them as children and then as parents. I encouraged Cindy to do a half hour of exercise everyday. She said that she liked to walk to town and get coffee after the kids were in school. We talked about setting limits with the children in order to get them to cooperate with putting their toys away after playing with them. Cindy will follow up with me next week and we will focus on these issues and others