One of the most common concerns that I have heard from my clients who are parents is how to manage their children's screen time.  The increasing presence of video gaming, IPads, cell phones, and computers for children at younger and younger ages presents a complex of issues that many parents of older generations cannot comprehend.  Part of the difficulty is the realization that this generation of parents is often equally involved in screentime perhaps even to excess themselves.  In addition, parents have come to appreciate some of the benefits of allowing their kids to have cell phones, for example.  Now they can keep in much closer contact with their kids and communicate more easily.  Allowing your child to watch a movie on an IPad on long car trips really does reduce the bickering and whining that have long been associated with these rides "Are we there yet?" "He's poking me!" etc.  But screens are mesmerizing, and it can be difficult to set and enforce limits it a constructive way - or even know what limits are appropriate and realistic.  So I was very pleased to read, in a recent edition of the NYTimes (March 20, 2015) a very clear and cogent article entitled "How to Manage Media in Families" .  While the author does not offer simple answers, he does give examples that can help the reader think through their own approach to managing this ever more complex and growing issue. 

Posted on Sunday, March 22, 2015 at 10:15AM by Registered CommenterLee Crespi, LCSW | Comments1 Comment | References1 Reference

Mindfulness Exercise Recording

This is a recording of a mindfulness exercise designed by Daniel J. Siegel, MD.  I hope you find it useful.

Mindfulness Exercise

Posted on Thursday, June 26, 2014 at 06:42PM by Registered CommenterLee Crespi, LCSW | CommentsPost a Comment | References10 References

More on ADHD and Couples

Since my earlier entry on this topic I have been really focusing a lot on the subject, both seeing more and more couples with this issue and doing much reading and research.  I'd like to share some more information for those who might be struggling with this. 

 Often, the problems caused by ADHD in a relationship don't become evident for a very long time. First, because the ADHD partner may have the ability to hyperfocus and during the early days of the courtship and dating (do people still date?) he or she will be hyperfocused on the partner which can be great. ADHD people are often very fun-loving, spontaneous, creative, and intense.  This is very attractive in the early stages of a relationship.  As the couple continues, some of the problems may start be noticed.  Either a seeming withdrawal, as the ADHD partner hyperfocuses on something else - work, or a project. Or, an imbalance in household or familial chores and responsibilities.  Forgetfulness, losing things, not following through on promises, all gradually begin to add up.  At first, the non-ADHD partner may think this is a phase, or something that will change over time. Often the non-ADHD partner will start picking up more and more responsibilities to keep things on track.  Eventually, and this can take a long time, the non-ADHD partner reaches his or her breaking point.  The relationship may start to look like a parent/child one instead of a marriage.  The non-ADHD partner may be feeling increasingly overwhelmed, angry and or lonely. The ADHD partner may either be unaware of the impact of their ADHD on their partner or may be feeling very ashamed and demoralized and defensive. 

This is because, untreated, ADHD symptoms will not go away no matter how hard the ADHD partner tries to "do better" and the non-ADHD partner nags.  It is really necessary to get treatment for the ADHD - possibly medication or a non-medication natural intervention as well as some coaching and /or therapy with some familiar with ADHD.  Couples therapy can be extemely helpful at this point. 

For those open to medication, there are several different types and a good psychiatrist with knowledge of ADHD can help decide which is the right one and the right dose. This will require trial and error but most people report significant improvement from medication.

Non- medication approaches include fish oil, physical exercise, adjusting sleep patterns and diet.  Ned Hallowell in "Delivered from Distraction" provides much information on this area as well as on medication.  

Coaching or therapy will need to focus on helping the ADHD person to develop structures and strategies for remembering things and becoming more organized and focused.  There are many ways to do this and it takes work but it can be done.

Couples counseling will help the couple understand the impact of the ADHD on their relationship. Help the ADHD partner understand the effect on the partner and push through their denial or obliviousness ( people with ADHD tend to live in the moment and easily forget yesterday's fights or unhappiness and need to realize that the partner is still feeling them).  For the non-ADHD partner, a better understanding of the neurological causes of the problems in the relationship can go a long way toward overcoming the anger and despair they may be experiencing.  Often the non-ADHD partner's work is in learning to let go - not do everything - let the partner struggle - stop being a parent - take better care of themselves.  

I hope this information is useful.  I'm going to keep posting on this subject as new ideas occur to me. 

Posted on Wednesday, May 9, 2012 at 06:16PM by Registered CommenterLee Crespi, LCSW | Comments3 Comments | References8 References


Neuroscience and Love
First of all, I have to admit to being a rather lazy blogger.  Maybe one day I should blog about blogger's block.
 In any case, another interesting article in the NYTimes has prompted me to write about this topic.  There have been more and more studies of how the brain responds to various stimuli and we are beginning to actually understand so much more about how the brain works.  Many people don't realize that this is what Freud predicted and hoped for in his writings.  And some of the findings that are coming out of this research are answering age-old questions like "Nature or Nurture"?  The short answer being "Both".
So here are some ideas that are floating around these days that I think are really exciting.
- experiences, particularly traumatic ones, have a direct impact on the brain's wiring
- the brain can be re-wired through experiences and through various kinds of therapies.

- emotional pain triggers the same parts of the brain as physical pain

- a secure relationship can mitigate anxiety

- the cingular cortex - or what some call the "mammalian brain" controls our emotions and is irrational and primitive - always on the lookout for danger
- the pre-frontal cortex controls our thinking and rational decision making but is often slower to react than the cingular cortex which is why when we get triggered emotionally by our partners we react before we can stop and think about it and be "rational".
-attachment needs are primary in humans and can affect our entire equilibrium when disrupted
- happy relationships can be therapeutic, both mentally and physically

For those of you who'd like to read more on the subject an interesting book is "Wired For Love:How understanding your partner's brain and attachment style can help you defuse conflict and build a secure relationship" by Stan Tatkin, PsyD. Stan is one of the leading people in the field of attachment theory neuropsychology and it's usefulness in helping couples.  


Posted on Monday, April 2, 2012 at 02:51PM by Registered CommenterLee Crespi, LCSW | CommentsPost a Comment | References2 References

ADHD and Couples

The same week that the New York Times printed a very good article entitled, "Attention Disorders Can Take a Toll on Marriage"   I was contacted by web journalist Jaleh Weber to be interviewed for a piece on the same topic.  I am so glad to see that this subject is getting attention.  So here is a copy of the interview:

What is attention deficit disorder?

Attention Deficit Disorder (ADD, also referred to as ADHD – the H being Hyperactivity) is a broad syndrome, usually identified in children, and believed to be a neurological developmental difference characterized by hyperactivity, impulsivity and distractibility as well as problems reading visual social cues.   In more recent years, it has been increasingly understood to continue into adulthood and more adults are being identified as having some features of ADD .  Adults with ADD may be highly disorganized, chaotic, and forgetful, often lose things, are impulsive and distract easily. Their social skills may be compromised by their inability to read visual cues, and they may sometimes seem inappropriate or self involved.  Many adults with ADD, despite these challenges, may be highly successful but usually need to work harder and longer hours to be productive. Others, however, may find their work life suffering as a result of their ADD and consequently their self-esteem as well.  Secondary related problems may also include dependence on alcohol and drugs, or depression related to the difficulties in self-management.


What type of impact does attention deficit disorder have on relationships?

ADD can put a great deal of stress on a relationship.  It is easily mistaken for a lack of sensitivity or caring for one’s partner.  Forgetfulness may seem inconsiderate and even hostile.  Disorganization in the home can result in fights over “messiness” and “clutter” and also be seen as inconsiderate, indifferent and passive-aggressive.  Often, adults with ADD marry partners who are competent and efficient and this may result in either the non-ADD partner taking over many of the other’s tasks and responsibilities and feeling resentful and alone in the relationship.  Partners of people with ADD often complain that they cannot ever count on or depend on their spouse and that is a very lonely feeling.   The partner with ADD may feel devalued or experience low self-esteem as a result.  In couples that I have treated in therapy, the ADD is often a major source of conflict in the relationship.


How does a therapist help a person who has attention deficit disorder have a healthy relationship?

First of all, it is very important for both partners to fully understand the nature and impact of ADD.  For the person who has it, there may be some resistance to facing the reality of it because it is so much a part of one’s personality and it is has many positive features such as spontaneity, liveliness, adventurousness, creativity and extroversion.  Behind this reluctance to face the ADD may be fears of inadequacy and shame.  Most people with ADD have had to struggle to do what others take for granted, and blame themselves for being lazy, stupid, messy, etc.  However, by fully understanding the nature of ADD as a neurological difference, the individual may feel a sense of relief and greater empowerment to take steps toward improving their functioning.  This might mean working with an ADD coach who can help with tools and strategies for organizing one’s time and compensating for distractions and memory problems.  It might also mean taking ADD medication such Adderall or Strattera, which help improve focus and concentration. 

Equally important for the relationship, the partner of the person with ADD needs to understand that many of the characteristics that are so frustrating  are not really in the ADD partner’s control and are not the result of unconscious hostility, or a lack of caring, but result from a genuine inability to process information in an organized way.  This doesn’t mean that they shouldn’t or won’t have feelings about being let down, or burdened, or frustrated, but rather that the root of those frustrating behaviors is not a lack of love, but rather a genuine disability. 

What advice do you have for someone who has attention deficit disorder and is having difficulties in their relationship partly because of the disorder?

I would recommend that both partners learn as much as they can about ADD – “Driven to Distraction” is a good book with which to start - and also to visit some websites such as   I would also encourage them to consider couples counseling with a therapist who has experience working with couples where one partner has ADD - both as a way of expressing and processing pent up feelings and also to strategize and find ways to work together to address the ways that the ADD is interfering in their lives. 


Posted on Thursday, July 22, 2010 at 05:53PM by Registered CommenterLee Crespi, LCSW | Comments4 Comments | References36 References
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