Make sure you and your partner are in agreement. Young children are expert at playing one parent off against the other. Work out your rules and strategies, and support each other in sticking to them.

Decide what the rules are in advance, and make sure your child knows them too. The limits of acceptable behaviour may vary according to the parents and the individual attributes of the child. It is very difficult to be prescriptive. Make sure that the limits are reasonable, and focus on behaviours that are dangerous to the well-being of the child, or that you find intolerable. Make sure also that the limits are broad enough to allow your child some freedom. Avoid putting yourself in a situation where you are continually saying no.

Be consistent. While nobody can be consistent all the time and in every single situation, try to keep in mind that consistency about rules makes it more likely that the child will learn what the rules are too. Conversely, children will become confused in the face of inconsistency, and their behaviour may get worse. This is because they may feel insecure and need to continue to test limits in order to reassure themselves that they exist. The perceived absence of rules and limits is very scary for young children.

Be matter of fact about discipline. Don’t scream or lose your temper. Talk to your child in a calm, direct way. Stand or sit close to him, make eye contact whenever possible, and speak to him clearly and simply.

Do not threaten your child with long-term consequences. To be threatened with not being allowed to go swimming with his father on the weekend is meaningless for a young child. Suggest short-term consequences of his continued disobedience — ‘If you don’t stop that now, I’ll put you straight in your room’.

*171\90\8*

The working-through process is the same for everyone. The only difference is our personal threshold to stress. Some people may have reached the point where they cannot tolerate even the smallest stress. Other people may have a higher threshold to stress, but it is still low enough to trigger fearful thoughts.

The time it takes people to recover will vary. The individual threshold to stress comes into account, but the amount of effort and discipline we put into our recovery is most important.

The first attack was the result of either a build-up of stress or a major life stress. In other words, the anxiety and/or attack happened when we reached the limit of our individual threshold to stress. This doesn’t mean we are weak. It simply means we have reached our limit to stress, just as most people will reach their limit to stress at one point or other in their life. Continual worry about the symptoms of anxiety and attacks only increases our stress and lowers our threshold to it.

As we begin the working-through process it is helpful if we have an understanding of how low our threshold to stress is and how high our anxiety is.

If our threshold to stress is now extremely low we may not be able to tolerate even the smallest daily stress. Our threshold to stress would be zero, while our anxiety level would be ten. At level five we would be able to tolerate the daily stress/es, but would find our anxiety level rising if there is a break in our normal daily routine. At level ten we would be able to deal with almost any stress without becoming anxious.

The working-through process means working to increase our threshold to stress back to normal levels, while decreasing our anxiety level.

It’s no use just hearing or reading about panic anxiety management skills. We have to practise them. There have been occasions when we say we’re not getting any better, and nothing has changed. If we are not getting results it usually means we are not practising enough, or even not practising at all!

*85\94\8*

Research shows that there is a natural tendency to stretch tow twenty-five hour cycle. Events in our daytime schedules—mealtime, bedtime and time of rising—serve the purpose of re-setting the cycle to fit the 24-hour day. You can probably see this happening, to a small degree, on M morning after you allowed yourself to go off your usual schedule during the weekend. This is also the experience of “jet lag”—when the event experience don’t fit with your biological clock.

Most people don’t have trouble maintaining a twenty-four hour cycle. But for children whose sleep cycles have strayed, this is asking

Sometimes we ask children to go to sleep when their bodies are not ready the sleep cycle. A child would understandably be grumpy and hard to live if his rhythms were not in sync with the clock of his world.

John just can’t seem to get to bed at a decent hour—we always battle bedtime. When he was eleven months old he wasn’t ready to go to bet 11:00 pm. We gradually got it down to 9:00 pm. Then at a year and ñ we noticed it had crept back up to 10:00 pm.

Biological rhythms influence sleep in several ways.

It may be necessary to purposefully take control of your child’s sleep if they have gotten off kilter.

Daytime routines are important to maintain biological rhythms an resulting sense of well-being.

If you implicate biological rhythms as a part of your child’s sleep pro changes need to be made in gradual increments so that a shift of cycles can occur smoothly.

When your child is sleeping better and more regularly, you can expect a happier child.

*14\67\8*

Often your doctor will be able to tell the cause just by taking your history, examining you and arranging a chest X-ray, but sometimes other tests, such as a lung scan, may be advisable.

Once the cause is found, it may be possible to correct it. For example, pneumonia could be treated with antibiotics, clots on the lung with drugs to thin the blood (anticoagulants) and anaemia with a transfusion.

*208/40/1*

This is not due to the hectic pace of life in the highly developed countries, as our brothers and sisters in the underdeveloped world where the pace of life is slower suffer just as often. Even our ancestors were not free from this common disorder.

The pain in your head may be an “ordinary” headache, not dignified by having a specific name or an associated symptom, occurring along with others in the course of some illness, such as one of the infectious diseases.

Or the pain may be one of the common specific disorders, such as migraine or tension headache.

Headaches are such a common occurrence that it is usually only the severe, the persistent, the recurrent or the bizarre headaches which make us seek medical attention, or it may be the more sensitive, introspective or hypochondriacal of us who bother to take such a symptom for medical evaluation.

*398/71/1*

This condition is more common in the forties, although it may occur at any age during reproductive life.

It is due to an unbalanced action of the oestrogen hormone from the ovary which acts on the lining of the womb.

Usually ovulation ceases and there is an excess production of FSH, or follicle stimulating hormone, produced by the pituitary gland.

This is often called the master gland of the body and it lies at the base of the brain and produces hormones which control the other endocrine glands of the body.

FSH acts on the ovaries causing the ovum to ripen and produce oestrogen. Over-activity of this hormone may cause the development of a cyst in the ovary which in itself produces oestrogen.

These often spontaneously disappear and rarely require treatment. The oestrogen acts on the endometrium or lining of the womb, causing it to thicken and to develop a greater blood supply.

Then a drop in the level of oestrogen leads to the onset of bleeding and this may go on and on.

*144/71/1*

Many people who live in societies which are undergoing rapid westernisation are developing this type of diabetes. Why ?

It takes time for our bodies to adapt to such major changes in diet. Because our European ancestors had thousands of years to adapt to a diet with a lot of carbohydrate, they were in a better position to cope with the changes in the G.I. factor of foods. That is why people of European extraction have a lower prevalence of type 2 diabetes compared with people whose diets have recently changed to include lots of high G.I. foods.

However, there is only so much that our bodies can take. As we continue to consume increasing quantities of foods with a high G.I. factor plus excessive amounts of fatty foods, our bodies are coping less well. The result can be seen as a significant increase in the number of people developing diabetes.

But, the most dramatic increases in diabetes have occurred in populations which have been exposed to these changes over a very much shorter period of time. In some Australian Aboriginal communities up to one person in four now has diabetes. In some groups of native American Indians and in some populations within the Pacific region, up to one adult in two has diabetes because of the rapid dietary and lifestyle changes in the twentieth century.

*124\42\4*

Seligman called this experience ‘learned helplessness’ and published a book on the topic in 1974. After a 20-year gap he then published what he considered to be the antidote to this, ‘learned optimism’10 in which he utilises a lot of the techniques used by Albert Ellis in RET. Ellis’ approach was developed to counteract his own shyness as a young psychology student and his inability to communicate because of this. He reasoned that this inability was because of the anticipated anxiety he felt every time he went to make contact with another individual (in Mark Twain’s terms his life was full of ‘potential disasters’). Ellis realised that the problem was within himself, because of the way he thought about the situation; it was his belief that he was an unworthy person, because he must always succeed, other people must always treat him well and the world must be good to him. He realised, however, that these beliefs were irrational, and based on no solid, objective evidence. In a similar way, it is the belief of many fat people, that they are unworthy and that others regard them as unworthy, while in reality, others are generally too concerned about their own problems to even consider them This belief can then become self-fulfilling, exacerbating the problem of overfatness itself.

Ellis based his thesis of RET around a very simple format based on the letters ABCD. Ellis claimed: ‘We consciously and unconsciously choose to think and hence to feel in certain self-helping and self-harming ways’ and ‘Once you understand the basic irrational beliefs you create to upset yourself, you can use this understanding to explore, attack, and surrender your other present and future emotional problems’.

Beliefs, according to Ellis, can be rational or irrational. Irrational beliefs which, according to Ellis are the major problem in maladaptive behaviours, are generally associated with musts, shoulds and have to`s, and are usually ‘hot’, or charged with emotion in comparison with rational beliefs which are more ‘cool’ or ‘warm’. An example of an irrational belief would be ‘I MUST NEVER binge or I am a bad person’, or T HAVE TO always be good or I will feel miserable and horrible’.

It is easy to see how these irrational beliefs can lead one into cognitive habits, or thinking patterns, that are self-defeating, self-limiting and self-punishing. Ellis, therefore, adds D or Disputation to his program in order to help overcome these irrational beliefs. An individual should learn to systematically analyse his or her beliefs, he claims, and logically argue against these. This cannot be done by the therapist, but it may be aided. For example, the question can be asked: ‘Why must you always succeed on your diet or eating plan? It may be nice, but must it always happen? What would be the worst consequence if this did not happen? Could you live with this? What are the consequences of maintaining this irrational approach?’ The thought process is thus ‘renamed’ to provide an opportunity to reduce irrational thoughts.

RET is a relatively simplistic approach to a complex problem. It is used for a range of different psychopathologies including fear of flying, fear of spiders and many other phobias. It has potential use in body fat maintenance, although it would not be expected to be applicable under all circumstances. In many instances, such as those that lead to problems of obesity, there may be a role for a more detailed approach to the problem.

*188\186\4*