Doing Life Together

couple-1719666_1920When it comes to a couple’s sex life, what is normal? Twice a week, once a month, every day?” The answer depends on a number of factors, making a pat answer difficult. Things like medications, caretaking young children, taking antidepressants, and more affect a person’s sexual desire.

I laugh at the scene in the movie, Annie Hall, where the therapist asks the couple Alvy and Annie (played by Woody Allen and Diane Keaton) about how often they have sex. Alvy answers, “Hardly ever. Maybe three times a week.” Annie answers, “Constantly. I’d say three times a week.” This funny moment speaks to the way men and women think about having sex.

The key for most couples isn’t about having the same sex drive or being in sync with each other every time desire is felt. It is about negotiation the times when one initiates and the other refuses. What is usually needed is each spouse making an effort to meet the other’s need. Michele Weiner Davis in her book, The Sex-Starved Marriage,   says that a reluctant spouse can make a decision for desire. That when couples prioritize their sex life and put energy into it by flirting, complimenting and being nice, things go better. In fact, many partners who are not in the mood, get in the mood with a little prompting. The key is to stay open and receptive.

So, the most important thing to remember is not what is normal in terms of frequency, but how satisfied you are as a couple with your sex life. Dissatisfaction and disconnection can lead to problems and should be discussed. Sexual difficulties can be triggered by physical, emotional or even stress problems. Thus, getting to the root of dissatisfaction is important. Things like busyness, boredom, childhood trauma, stress reactions, aging and a host of other issues can lead to sexual difficulties and become points of contention.

Couples are often hesitant to bring up the subject of their sex lives even when both may be dissatisfied. However, it is important to start talking, sleep in the same bed together, show physical affection to each other during nonsexual times and make time for intimacy. If you find yourself unable to make changes or even have a conversation about your sex life, consider getting professional help from a therapist who specializes in sex therapy. Doing nothing only continues the dissatisfied and puts the marriage at risk.

boy-1721405_1920Reader Question: My son is two and half and is beginning to stutter. Up until now, he has been a good talker. But when he gets excited, we’ve noticed he stutters, like his brain can’t catch up to his mouth. We are not sure how to handle this and wonder if we should seek help.

It is common for kids to stutter between the ages of two and three. The key is to determine whether your son has what is called, “transient dysfluency of childhood” which typically goes away, or is a true stutterer. The majority of kids who begin to stutter will stop because they are not true stutterers. When they get excited, they can be tired, angry, or upset and can’t quite get the words out right away. They do more fumbling over words rather than having an actual problem getting the words out. This is due to the rapid development a child experiences in his verbal abilities at this age. And as you put it, his brain doesn’t keep up with the pace of his talking.

Stuttering tends to run in families and affects more boys than girls. Current thinking is that it is a speech disorder that has genetic susceptibility and environmental triggers. It is not a physical or psychological disorder, but considered a developmental disorder. However, if your child is a stutterer, the earlier you treat, the better. So talk to your pediatrician and engage a speech therapist. A speech therapist can be very helpful in term of treating your child and helping you respond in a relaxed and supportive way.

Pay attention to whether or not the stuttering bothers or upsets your son. Also notice if it occurs in situations other than when he is excited or anxious.

Does his pitch change and is he struggling to get words out?

Are his repetitions long and frequent?

Does he block words and sounds?

Does he avoid saying difficult words?

These are just a few observations to make. The Stuttering Foundation of America has materials that can help you determine if you need help or you can consult a speech-language pathologist for an evaluation. To find a speech-language pathologist, call your school and ask for help. Schools provide free speech therapy to children as young as three years of age.


child-1629537_1920Reader Question: My eight–year-old daughter constantly interrupts when I am talking with another adult. I have told her to stop a thousand times and she continues. What can I do to stop this? I feel it is rude to interrupt adults.

I agree. It is rude and your daughter needs to learn to wait for her turn. Part of the problem is that you keep telling her and she continues to get your attention. It is your attention that keeps her doing more of the same. Your words do not mean much.

So, here is what I suggest. First, let her know that interruptions are only OK if there is an emergency. Review what might be considered an emergency so she is clear on what constitutes an emergency.

Other times, her interruptions will be ignored and she will need to practice waiting until mom calls on her. Then, tell her that when she tries to interrupt you when talking to another adult, you will ignore her by not looking at her or answering her. Create a hand signal between the two of you to use as a reminder. This can be a raised finger or hand, but don’t give her eye contact. Show her the hand signal and practice. Do a role-play and ask her to interrupt like she usually does. Show her what will happen now.

When using ignoring, you cannot attend to her at all. This means do not talk to her, look at her or ask her to wait. Completely ignore and use the agreed upon signal. After a few times of you sticking to your guns and not attending to the interruption (you can tell the adult you are talking to what you are doing if feel this is necessary), she will eventually give up and stop interrupting. The reason this strategy doesn’t “work” is because parents attend to the child in some small way rather than completely ignoring. It only takes a look or a word to give attention and reinforce interrupting. Therefore, you have to be committed to the ignoring strategy and not give in to her persistance.


tutor-606091_1920Sally is now 25-years-old and has noticed how much her inattention is creating problems at her job. At home, she easily loses things, can’t get organized and is highly distractible. Her friend, who has been diagnosed with ADHD since childhood, told her to be evaluated. “You have a lot of the same issues I do. Maybe you have ADHD.” But Sally was never diagnosed with ADHD as a child. Is it possible she could develop ADHD as an adult?

Some adults who are diagnosed with ADHD as adults do not report childhood histories consistent with ADHD. Even though ADHD is seen as a neurodevelopment childhood disorder that continues into adulthood, three recent studies point to possible adult onset for ADHD.

Study 1 (See below): This study followed 1037 children born in New Zealand to the age of 38. All met criteria for diagnosis of ADHD.  Data was obtained from multiple sources like teachers, parents, testing, etc. The study concluded that those adults studied may not have had childhood onset. The authors raise the question, could adult onset have similar characteristics as childhood ADHD but be a different disorder?

Study 2 (See below): This study followed 5249 people raised in the same town in Brazil from birth to ages 18-19. At age 11, 9% of the children in the study met criteria for the DSM-5 diagnosis of ADHD. They too found that adult onset looked different than childhood and wondered if these are two different syndromes.

Study 3 (See below): The researchers studied a large sample of same gendered twins. They concluded that there is a difference between late and early onset of ADHD but the symptoms look similar.

One question for all three studies is, because childhood symptoms were not reported, does that mean they were not present. Overall, researchers are looking at how people with ADHD diagnosed in childhood may differ from those with adult onset. These studies support the idea that adult onset is possible.



Study 1: Moffitt et al. Is Adult ADHD a Childhood-Onset Neurodevelopmental Disorder? Evidence From a Four-Decade Longitudinal Cohort Study. Am J Psychiatry. 2015 Oct;172(10):967-77. PubMed PMID: 25998281; PubMed Central PMCID: PMC4591104.

Study 2: Caye et al. Attention-Deficit/Hyperactivity Disorder Trajectories From Childhood to Young Adulthood: Evidence From a Birth Cohort Supporting a Late-Onset Syndrome. JAMA Psychiatry. 2016 Jul 1;73(7):705-12. PubMed PMID: 27192050.

Study 3: Agnew-Blais et al. Evaluation of the Persistence, Remission, and Emergence of Attention-Deficit/Hyperactivity Disorder in Young Adulthood. JAMA Psychiatry. 2016 Jul 1;73(7):713-20. PubMed PMID: 27192174.

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