4905 Del Ray Avenue, Suite 301, Bethesda MD 20814

We think you will enjoy many great features about our new space. It is larger and quieter than our current office. In addition, it should be much easier for our clients to find parking — there are many metered spaces on the street just outside the building, and a large metered garage just down the block. For clients who travel to see us by Metro, the walk from the metro station is about half a mile. Alternatively, you may take the Bethesda Circulator bus, which is a FREE service offered by the city of Bethesda. The Circulator runs about every ten minutes from the Metro station, and has a stop on Old Georgetown Road between Cordell and Del Ray Avenues. You can view additional information about the Circulator (including specifics about routes and schedules) here.

One important change at the new building is security. If you arrive for your appointment after 7:30 on weeknights, after 2:00 on Saturdays, or anytime on Sunday, you will find the front door of the building locked. To enter, simply use the call box next to the front door to reach building security, tell them you are there for an appointment with Lindsey Hoskins & Associates, and ask them to buzz you in. If you have any problems with this process, please telephone your therapist directly. Additionally, please note that if your therapist is unable to answer her phone when you call, it may be because she is finishing up another session.

If you have any questions, please don’t hesitate to contact your therapist directly, or email hello@lindseyhoskins.com. You can also call Lindsey at 301-785-7184.

We look forward to welcoming you to our new office, and hope that it will be a place of healing for you. See you soon!

A meal together as a family can be any meal – it doesn’t have to be dinner and it’s important to make the meal work for you! Maybe breakfast during the weekday or weekend works best with your schedules. Involve children from the beginning, if possible. Ask them what they’d like to eat and if they can help prepare the meal. Even young children can be involved in the kitchen by tearing lettuce or mixing ingredients in a bowl.

To make the most of this time together, shut off the television and cell phones. It should be a time for conversation, to check in with each other, and to learn more about one another. I can remember sitting down for dinner as a child and my parents asking the typical question “What did you learn in school today?” While that inquiry may work from time to time, here are some other conversation starter suggestions, adapted from www.co.dakota.mn.us:

• What is something you want to learn how to do and why?
• If you could start a new family tradition, what would it be?
• What was the best thing that happened to you today? What’s something that happened that you would have liked to change?
• What is the most important thing in being a good friend?
• How do you know when you can trust another person?
• What is the best or worst thing about being the oldest/middle/youngest/only child in the family?
• What do you think makes a person successful?
• What makes you happy?

Let us know how your family meals are going! What are the struggles or barriers you are facing? What works well when eating together with your family?

]]> http://lindseyhoskins.com/2012/01/making-the-most-of-meal-time/feed/ 0 http://lindseyhoskins.com/2011/12/happy-couples/ http://lindseyhoskins.com/2011/12/happy-couples/#comments Thu, 22 Dec 2011 16:23:40 +0000 Emily http://lindseyhoskins.com/?p=785 This past semester, I’ve been teaching undergraduates at the University of Maryland all about couple relationships.  What a great idea for a college course, right?!  Learning about the aspects of successful and unsuccessful couple relationships is just as important as learning about world history or macroeconomics.  We covered a full range of topics relevant to couples—from marriage and divorce, to infidelity and abuse, to communication and sex.  But my last lecture was all about turning their new knowledge into behaviors.  The topic? How to be in a happy couple.

I had PowerPoint slides about the importance of talking with their partners about money, about setting financial goals as a couple, and about discussing spending habits early.  I had slides about the importance of open, kind communication, about how listening is as valuable as speaking, and that mind-reading doesn’t work.  I had slides about the importance of balancing time together and time apart, about how having fun together doesn’t need to wait until the weekend, and about keeping something exciting to look forward to.  I had slides about the fact that couples will disagree sometimes, but that this isn’t the problem; rather, it’s how they argue that matters.  I reminded them that by remaining respectful, avoiding the Four Horsemen, and remembering (even when you’re angry or hurt) that your partner is a good person with good intentions, disagreements can strengthen the couple bond instead of destroying it.

I ended the lecture with some advice from happy couples and couple therapists that I know, and even a few of my family members.  Sometimes, quotes are just more powerful that bulleted lists on a lecture slide.  The students really appreciated them, so I thought you might too!

“A successful marriage requires falling in love many times, always with the same person.” –M.M.

“A healthy marriage is one in which only one person is crazy at a time.” –H.K.

“Always kiss goodnight, even if you’re still angry.”-D.B.

“Communication! And not just talking at each other, really listening and saying it so your partner can hear you.” –E.B.

“Don’t expect him to read your mind”-E.P.

“Love is a feeling and an action: one without the other is of little use.” –H.O.

“We are all a team working towards a common goal” –W.T.

“Love each other every day.”-E.T.

“Respect your partner. See them as your equal and your best friend.”-A.C.

“Live your life together as your best selves.”-E.C.

What is your advice for how to be in a happy couple relationship?  Please post your comments!

In my last post I discussed some of the basic points about hereditary cancer syndromes. This next post focuses on genetic testing, or the process of learning whether or not a cancer-related mutation is present in a given individual.

Ideally, the process of genetic testing begins with a visit to a genetic counselor. These healthcare professionals are specifically trained to assist individuals and families as they navigate the complex information and decisions that are likely to arise when genetic information becomes known. You should expect that a first appointment with a genetic counselor will involve lots of information — about what the specific mutation being tested for means (if a mutation has already been identified in your family), or about the mutations that will be tested for if you are the first in your family to be tested; about what both a positive and negative test result would mean; and about any cancer screening or risk-reduction strategies that would be relevant if you were to test positive. You should also have the opportunity to discuss what the emotional and relationship implication of either testing outcome would be. If you have concerns or fears about how you will share your results with your loved ones, or how you might deal with the emotional impact of your test results, you should have an opportunity to discuss these with your genetic counselor. He or she will likely have some good insights about such issues, and will refer you to a qualified therapist if ongoing work around such issues seems helpful.

After the educational part of genetic counseling is complete, your genetic counselor will ask you if you are ready to make a decision about testing. Remember that at this point, it is perfectly acceptable to decide not to take the test if you are not ready. The decision is yours, and yours alone — and it is important to be attuned to your “gut instinct.” One important thing to think about is how the information provided by the test would change your behavior or allow you to make any decisions. For example, if you can say with certainty that if you test positive for a BRCA mutation, you’re prepared to undergo regular screening, share your mutation status with family members whose own risk would be affected, or consider risk-reduction strategies, you may be ready for testing. But if you believe that you won’t do anything different after you know the results, the right time for testing may not have arrived yet.

If you do decide to move forward with testing, the actual test is a fairly straightforward process. Your blood will be drawn and sent to a lab, and the results are usually back within a month (how long this takes depends on a number of different factors, and in some cases it’s much quicker). When your results are ready, you can expect to meet with your genetic counselor again to receive the results and talk about what they mean, and next steps if applicable.  You should feel comfortable bringing a loved one with you for support to this appointment.

In sum, the process of genetic counseling and decision-making about genetic testing are deeply personal. Working with a certified genetic counselor (as opposed to having a doctor order the test directly and skipping genetic counseling) provides the best possible assurance that all of your questions will be answered and that you will feel ready to make a confident decision.

The National Society of Genetic Counselors provides a directory of certified genetic counselors, and you can search online to find one near you.

We are all born with the ability to self-regulate when it comes to food, to know when we’ve eaten enough and too much is too much. Ideally, allowing children to serve themselves would begin when they are toddlers. Relinquishing the idea that your child must finish all of the food that you deem necessary to feed them is the first step. Then, put your trust back in your child’s own ability to know when she is hungry and when she is full.

Remember that as the parent, you get to decide what, when, and where food is served. The what is very important here. The new USDA My Plate recommends that half of your plate at meals should consist of fruits and vegetables. What is served for dinner should reflect an effort to enable all of your family members to have ½ their plate be delicious veggies and fruits; with these foods being the centerpiece of the meal and with protein, grains, and dairy being secondary. The USDA has incorporated the strategy of allowing children to feed themselves in their Core Nutrition Messages – One of which says “Let them learn by serving themselves. Let your kids serve themselves at dinner. Teach them to take small amounts at first. Tell them they can get more if they are hungry.”

The next time you sit down for a family meal, consider allowing your little one serve themselves. It will help build their self-confidence and reawaken their ability to self-regulate.

After a day of multitasking at work, it is all too easy for partners to continue in the same way with each other.  We put a load of laundry in, read the mail, take out the recycling, pick up clutter–barely starting one task before moving to the next.  Or we’re sitting over dinner, talking about our days (are we listening?), texting on our phones, and chewing all at the same time.  We’re like proverbial chickens, except we’re running around with too many heads that are going in too many different directions.  And when we’re distracted in this way the distance between us becomes greater as the space we take up in each others lives becomes smaller and more fragmented from other competing influences.

What would it be like if we stop multitasking our relationships?  How much more connected might we feel if we give our partners our full attention?  It might be scary– maybe we haven’t connected in a long time and we’re unsure what it will be like.  But maybe it will also be glorious. We can find peace and stability in each other again, amidst the harried business of work and household.  The benefits of full attention are great: increased intimacy and attachment, deeper connection and understanding, and greater capacity for empathy.  Giving full attention also facilitates active listening skills, which improves communication.

Multitasking is a skill that has its merits.  There are only so many hours in a day and to-do lists are meant to be done.  But let’s stop multitasking our relationships. Instead, let’s give our partners more of our undivided attention, even for only short periods of time.  Let’s turn off our phones during dinner, and actively listen when talking about our days.  And let’s work to make giving full attention to each other the new normal, not just another item on our to-do list.

If you would like help to stop multitasking your relationships, call Lindsey Hoskins & Associates to set up an appointment today.

In recent years, information about genetic mutations that predispose carriers to different types of cancer has become increasingly visible in the media and more familiar to us as a culture. Most of us have heard stories like that of Christina Applegate; she revealed publicly in 2008 that she carried a mutation in BRCA1, and had been diagnosed with early stage breast cancer and undergone a double mastectomy in her early 30s. Several books and documentaries, ranging from memoirs to more academically-oriented collections of advice and options, have become widely available. As all of this becomes part of our cultural knowledge, more and more families are learning that a genetic mutation is present, and are facing difficult decisions related to genetic testing, family communication, and managing cancer risk individually and collectively.

Most genetic mutations associated with hereditary cancer syndromes are passed from parent to child in an autosomal dominant fashion. This means that the mutation can be passed from both fathers and mothers, that it can be inherited by both sons and daughters, and that there is a 50% chance that a given child will inherit the mutation. Individuals and families are often identified as possible mutation carriers based on the history of cancer on both sides of the family – this is in contrast to commonly held perceptions that family history of cancers like breast and ovarian is only relevant on the mother’s side. Generally, risk factors for hereditary cancer include:

• multiple family members with the same type of cancer
• diagnoses at young ages (i.e., age 50 or younger)
• cancer in paired organs (e.g., both breasts)
• multiple types of cancer in the same person

There are several different hereditary cancer syndromes that can be detected through genetic testing, and we can be sure that as science continues to advance, the list will grow. BRCA1 and BRCA2 mutations, related to Hereditary Breast/Ovarian Cancer, are the most widely known and best understood, because they were discovered among the first mutations identified and because they are a large number of carriers have been identified and studied. p53 mutations, related to Li-Fraumeni Syndrome (LFS), are more rare and are associated with significantly elevated lifetime risk of cancer at a multitude of sites. This syndrome is quite rare, but more research is being conducted all the time to better understand its implications and how to manage the associated risk. Several hereditary colon cancer syndromes (e.g., Hereditary Non-Polyposis Colorectal Cancer/HNPCC, Familial Adenomatous Polyposis/FAP) are associated with cancer of the lower digestive system. Again, as scientific research in cancer and genetics advances, we will continue to better understand how heredity and cancer are related, and possibly develop new tests for additional hereditary cancer syndromes.

If you have questions about hereditary cancer risk, the best first step is to contact a genetic counselor in your area for an appointment. A directory of genetic counselors is available through the National Society of Genetic Counselors (NSGC), available here.

In my next blog post, I will describe the process of genetic testing, as well as provide resources relevant to that issue.

Many parents struggle to get their children to try new fruits and vegetables. Instead, they fall into a routine of always serving the same few healthy foods they know their children will at least take a few bites of. It’s important to be aware of your children’s preferences and getting them involved in the kitchen – by asking for menu suggestions for the week – is a great way to encourage positive interactions with food.

Yet I’d like to offer you, as the parent, some encouragement in providing your children with a healthy food environment where they can expand their fruit and vegetable preferences. Research shows that most children won’t try a new food until the 8^th or 9^th time they are introduced to it. Furthermore, being exposed to a new food a minimum of 15 times is necessary for a preference to develop. Consider the importance of repeated exposure here – the first time you offer a new vegetable to your little one, there’s little chance they will try it. The same goes for the second, third, fourth, fifth…well you get the picture. Chances are that it won’t be until the 8^th or 9^th time that you’ve offered your child that same vegetable that they will actually try it.

So, what can you do in the mean time? Know that any exposure or interaction with the healthy food item is beneficial. This includes smelling, touching, sniffing, and licking. All of these behaviors are a way for children to get acquainted with the foods, and therefore comfortable with them, and finally, to develop a sound preference for or against them.

Consider that many fruits and vegetables come in many different varieties. For example, apples are sweet or sour, juicy or not, green, red, or yellow. If you’re faced with a child who doesn’t like apples, instead of giving up on the fruit all together, try a different brand or variety.

Pair new fruits and vegetables with other familiar foods. Apples and celery goes well with peanut butter. Veggies can be dipped in low fat dressing. Fruits go well with low fat yogurt dips.

Lastly, don’t be discouraged. If your child reacts in distaste to a new fruit or vegetable, don’t cross it off the list forever. Be creative how you introduce your child to the foods and be persistent!

In today’s world, we’re no strangers to stress.  Our responses to it often manifest into physical symptoms (such as headaches or fatigue), psychological symptoms (such as anxiety or frustration), or relationship issues (such as conflict or disconnection).  And let’s not forget that stress can be positive (like a job promotion or a new baby) as well as negative (like a serious health issue or an over-committed schedule).

Generally, there are two basic ways to deal with stress: either eliminate the stressor or change the way you respond to the stressor.  Sometimes, making choices that help you avoid the stressor is possible.  For example, if too many long work hours are causing stress, you could change your work schedule or even change jobs all together.  But more often, completely eliminating the stressor is just not possible.  It is in these cases that learning and using healthy coping skills can go a long way in reducing the negative effects of stress.

One of the Prepare/Enrich topics for premarital couples is stress management.  Because, let’s face it, wedding planning is one of those positive stressors!  I think talking about stress is one of the most helpful conversations that I have with premarital couples, right up there with merging finances and increasing romance because it helps each partner think about stress in a new framework.  And learning new ways to think about and manage stress is something that is helpful to all individuals, whether you’re in a relationship or not.

To illustrate this helpful framework for thinking about stress, how about an exercise?  To start, grab a piece of paper and make a list of the top 5-10 things in your life that cause you stress.  Now, below your list draw a large box, divide it into 4 quadrants, and label each quadrant with the following information:

Before we finish the exercise, take a look at the different quadrants.  You’ll notice the boxes move from most critical to least critical issues, and are considered along two continuum: priority and ability to change.   Also notice the question in each box; these give you clues about which strategies will be most helpful to reduce the negative effects of the stressor in that box.  Some boxes call for brainstorming actions to change the situation, others call for coping and acceptance.

Now, choose at least four of the stressors on your list and place them in the appropriate quadrant.  Use the questions to consider each stressor and let the two continuum direct your attention towards those stressors that you can do something about, rather than towards the ones that are low on the priority list.  Have you been focusing your energy on low priority stressors?  Have you been trying to “solve” a stressor that would be better managed through other types of coping?  Hopefully, this framework helps you to think about what is currently stressful in your life in new ways.  And once you are able to prioritize those stressors and determine which ones you are able to change, you can begin to make changes that reduce the negative effects of stress.

Does thinking about stress in terms of priority and ability to change help you manage it better?  What are other ways that you reduce stress in your life?  How do you enlist the help of your partner, close friends, or family to help reduce your stress?  Please leave your comments or suggestions below, or give us a call to come talk about the stressors in your life and relationships.  Let the stress reduction begin!

You might have heard of the task where a candy bar is placed in front of a child to see if he or she can refrain from eating it for a period of time in order to obtain a better reward later on. How do children develop the skills needed to regulate themselves so that they can delay their satisfaction? The ability to regulate emotions is influenced by biological processes (e.g., temperament) as well as social learning. Regulating emotions is a process in which children monitor, evaluate, and change their emotional experience in order to meet their goals. If a child has a goal of eating a candy bar immediately, and believes that delaying eating it will cause pain, he or she may eat the candy bar in order to avoid the anticipated feeling of being upset. Alternatively, if the child believes that the anticipated reward might cause greater joy, then he or she may implement strategies to control an immediate response.

While temperament may predispose children towards certain responses to emotional experiences, children can also develop emotion regulation strategies through interactions with parents and caregivers. A parent who demonstrates supportiveness, empathy, and responsiveness can help a child develop better emotion regulation skills. A child having difficulty with homework may display frustration and “regulate” this emotion by giving up. Labeling emotions a child is experiencing (“I can see you’re frustrated with your homework”) can both help a child feel supported and promote emotional awareness. Parents might then suggest alternate ways to manage frustration (“try taking a deep breath”), an alternative strategy to manage the problem (“You might want to work on just this one piece”), and encouragement (such as saying “I like how you’re handling this”).

A parent’s supportiveness, empathy, responsiveness, suggestions, and encouragement can generate abilities to regulate emotions to help children perform a variety of tasks such as initiating social interactions and performing chores, and to manage a variety of emotional experiences. Sometimes life experiences, as well as emotional responses, can feel overwhelming to both parents and children. In these instances, therapy can offer a helping hand to support parents and children in the development of emotion regulation skills.