Dr MargiAnne Isaia, MD MPH

1. www.enthusiasticlife.net with Dr MargiAnne Isaia,MD MPH Social Wellness…

2. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS questionnaire DO YOUR RECEIVE SOCIAL SUPPORT FROM FRIENDS? DO YOU ENJOY THE TIME YOU SPEND WITH OTHERS? ARE YOUR RELATIONSHIPS OF HIGH QUALITY? DO YOU EXPLORE DIVERSITY BY INTERACTING WITH PEOPLE OF OTHER CULTURES, BACKGROUNDS, AND BELIEFS? ARE YOU INTERESTED TO MAKE NEW FRIENDS? DO YOU PREFER TO BE ALONE MOST OF THE TIME? DO YOU SEEK INTERDEPENDENT RELATIONSHIPS WITH OTHERS? DO YOU WORK FOR MUTUAL RESPECT AND COOPERATION AMONG THE INDIVIDUALS WITHIN YOUR COMMUNITY? DO YOU DEVELOP THE CAPACITY FOR INTIMACY? DO YOU HAVE FRIENDS OUTSIDE OF THE FAMILY? If you answered "NO" to any of the questions, it may indicate an area where you need to improve the state of your physical wellness

3. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Includes: Balance and integration of the interaction between the individual, society, and nature; Living in harmony with others; Effective communication and healthy relationships with others (including sexual behaviors); The amount of support received and reciprocated and the value attached to the actions of giving and receiving support; Fulfilling relationships (including sexual relations), and intimacy;

4. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Includes: One’s responsibility to give back to the community; One’s attitude toward relationships and seeking help from others; Peer acceptance, altruism, attachments/bonds with others, and social skills (communication, assertiveness, conflict resolution); The quality and extent of interaction with others and the interdependence between the individual, others, the community, and nature; The skills and comfort level one is able to express in the context of interpersonal interactions, as well as the motivation, action, intent, and perception of those interactions…

5. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Father Responsivity Concept: Father Responsivity refers to the degree to which fathers recognize and attend to the needs of their wives and children. It includes attention to their emotional needs, households and child-care tasks, and power and fairness within the couple relationship.

6. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Father Responsivity Case Example: John, 55 years old, was a successful American lawyer who got depressed when one of his two daughters got involved in drugs and prostitution. He and his wife were dedicated Christians who did their best for their family. He was so busy with his private law practice. His wife was very supportive. In fact, she would make everything possible to not disturb him. Their three children could approach him only through their mother. They didn’t even try to say something. They were told that he was the Head of the house and deserved their obedience and respect. This father couldn’t understand the reason for his depression…

7. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Father Responsivity The case example emphasizes what happen when the father is not aware of gender stereotypes. His wife is not aware, also. The entire family is devastated. The concept of Father Responsivity helps clarify father’s role in the family wellbeing. His involvement in the family life is beneficial and important not only for himself, but also for his wife and their children. His awareness regarding her wife’s needs makes him look for satisfying her needs. In this situation, she feels understood, and loved. The children get the message that the parents love each other. In a loving and supportive family atmosphere, children thrive. His awareness regarding his children’s needs makes him able to attend their needs.

8. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Father Responsivity Children feel they are loved, important, cared for equally from mom and dad. It makes them feel secure and grow emotionally healthy. These children will go further in life with a balanced view regarding their own roles in their marriages. The boys will have a positive role model. The daughters will know what criteria to look for when choosing their future partners for life. This concept has relevance for the present status of all of the family members and for the extended family members, alike. Elderly people from the extended family are thriving, also. A responsive father makes a difference in his world. In fact, he is what he was supposed to be the “house-band”.

9. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Gender Norms Concept: Gender Norms refers to specific behaviors, abilities, and attributes that are expected of males or females. They exist within a framework of cultural practices, shared understandings, and language and touch many aspects of love and intimacy.

10. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Gender Norms Case Example: Esther, a 44 years old Jamaican lady, was admitted in a lifestyle center for Hypertension, Obesity and Diabetes. She worked as a RN in an American Hospital for more than ten years, and, in the same time she was the “man of the house”…. She did everything for the family, because this was the style she learned in her native country. As an Immigrant, she did what she considered her part in the family, plus she worked full-time. Her husband was the guest in the family. “I don’t need him”, she told me. “In Jamaica”, she explained, “The woman is supposed to do everything”. She contemplated the divorce, because she couldn’t endure his frequent visiting with his relatives. Her son, 25, was depressed. Even though she was very compliant with the treatment recommendation, there were no improvements in her physical health status. The diabetes worsened and so did her blood pressure.

11. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Gender norms The case example emphasizes what happens when the wife is not conscious about how the social context she grown in has affected her. Living in a culture where the matriarchal code is the norm makes the women get burned out when they immigrate and try to adjust partially to the new culture. In the same time, men are expected to do nothing, or not so much. They are affected and the family stability is in danger. Working in two shifts makes the life unbearable for the women, and they cannot understand their men’s frustration. The men feel like they are not real men and the marital relationship is affected. The boys in the family see their fathers as adult children and are not motivated to mature.

12. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Attunement Concept: Attunement is the desire to understand and respond to the partner’s needs and interests.

13. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Attunement Case Example: Jim was looking for a “happy” car accident. He refused to wear a seat-belt. After many years of working hard to save his marriage, things didn’t improve. His wife was involved in marital affairs for more than 12 years, and his adolescents became more rebellious. He was accused of not meeting her needs. As the bread-winner, he took care of the kids when going home from work, spent weekends with the family and helped the extended family whenever he was asked to. His wife was a “daddy’s princess” with all kinds of “needs”. The family ended in divorce… After years, the boys still remember the good time they had with their father and thank him for very pleasant memories.

14. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Attunement The case example emphasizes the meaning of attunement. Both partners might have the desire to work together for the family stability and happiness. Every partner has to express his/her needs. Depending on the emotional development of every partner, the needs are different. They must be verbalized. There are real and imaginary needs. An emotionally mature person has to express his/her frustration of being exploited by an immature partner who has all kind of imaginary needs which never get satisfied. The reason for imaginary needs could be discovered looking through the “social context” lenses. In this case, the immature person needs to be helped to grow.

15. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Attunement Marriage is for grown up people. Expressing the real needs every partner has is the essential part of their living as a couple. Otherwise, the chances are for very low marital satisfaction level for both. Marital satisfaction consists of emotional support, intimacy, and shared values and beliefs. It is a subjective condition that can only be described by the individual spouse and is their personal evaluation of their overall marriage. The partners describe how their needs, expectations, and desires are being satisfied in their marriage. Marital satisfaction can also be correlated to marital happiness because partners are talking about how happy or satisfied they are.

16. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Shared Relational Responsibility Concept: Shared Relational Responsibility means that both partners are deeply attentive to the relationship.

17. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Shared Relational Responsibility Case Example: Danny, 30, wife and mother of two children, is contemplating the divorce. Her husband, 26, is involved in computer games and has no pleasure to take care of their children... “I thought that, if I would marry a younger man, things would go well in my family”, she said. “I didn’t want to be like my mother: she was never emotionally supported by my father”. ”I noticed that was not appropriate for a woman to have the entire burden in the family”, she mentioned. “I wanted to mother my husband and let him know how to do what I desired”…

18. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Shared Relational Responsibility The case example emphasizes that it is important for both partners of the couple to understand the concept of shared relational responsibility. This is true because everyone has his/her part to accomplish in order for the relation to be successful. The win/win approach in the relationship means everybody intentionally works for the relationship. There are reasons people try to do more than their part or less than their part.

19. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Shared Relational Responsibility The person who used to carry the entire burden has to understand why things are not going well and she/he is overwhelmed, frustrated and sad, even though she/he worked so hard to maintain to family. The person who used to do nothing is challenged and made accountable for capriciousness. Ignorance is not an excuse for the selfishness and laziness of the uninvolved partner. He/she must be given the opportunity to reframe his/her lifestyle and have a precise plan to do this.

20. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS We-Consciousness Concept: We-Consciousness is one dimension of the face concept in the collectivist communication processes. The concept face relates to the importance of the image that couples project in public.

21. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS We-Consciousness Case Example: Clara, 45, has a long history of depression. Her husband, 47, has a long history of sex addiction. They live in collectivist culture, are married for 18 years and belong to a Christian community. When they got married they had good jobs, decent salaries, and friends… After 17 of marriage, she had to admit that there was a problem in their couple: he was sex addicted. In order to save the image of the couple she kept the family secret, because it was “safe” for her. The pastors the couple looked for help many times could not help much; her psychiatrist never addressed the issue of spousal abuse. Clara accepted her husband’s rationalization in regard to his addictive sexual behavior. They were appreciated in their community for their “face”. She is medically retired because she is unable to keep her job. From outside, they are still a “model” family…

22. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS We-Consciousness There are special issues in the couples from Collectivist context. For people coming from former communist countries like Eastern-Europe, or China, or from very conservative religious context there are dramatic situations. It doesn’t matter the educational and economic level, these people struggle to find “stability” in their tragedies. Women still believe that they must be the Messiah for their husbands. There are serious issues regarding their style of expressing their negative feelings. There is an increased stress level for the immigrants coming in The US from these countries who have no more the social support from their family. In these families, the children suffer the most and their identity development in adolescence is greatly affected. They are more vulnerable at adopting risky behaviors.

23. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Social Justice Model Course Concept: Social Justice Model evaluates all problems that interfere with the safety and health of families and communities from a perspective that takes power, privilege, and oppression into account.

24. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Social Justice Model Case Example: Marylyn, a brilliant student, graduated from a Law School. She is happily married with a successful lawyer, but is sad because she couldn’t pass the exams for license because of the test anxiety. Her overwhelming bitterness and anger toward her father are still there. She was the older child in a family with years of domestic violence which ended by divorce. Her mother had heart attack and after few years went through a brain surgery. The father still continues to deny or excuse his abusive behavior. Whenever she approached him on the phone he made her unhappy and she cried.

25. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Social Justice Model There are social norms which favor the inequalities in relationships. Gender stereotypes make men feel that they are superior to women. The Social Justice Model provides the tools necessary to approach the Domestic Violence cases from a different perspective. Domestic Violence is the natural result of inequality in social status between husband and wife, in the family system. This inequality is based primarily on the stage of their friendship. While the husbands look for their interests, the wives try to make thinks work well for the family. This is true in individualistic and collectivist cultures, regardless the socio-economic status, and scholastic education. The reason could be found in the psycho-social development and moral development of the abusive partner. The abusive relationship between parents affects the parenting style of both parents, usually the abusive parent being authoritarian.

26. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS Bible references… “It is no good for man to be alone .” Genesis 2, 18. (New International Version)

27. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net SOCIAL WELLNESS CLASSIC QUOTATION “Husbands should be careful, attentive, constant, faithful, and compassionate. They should manifest LOVE and sympathy. . . .” EGW - AH 228.2 “Give some of your leisure hours to your children; associate with them in their work and in their sports, and win their confidence. Cultivate their FRIENDSHIP”… EGW - AH 192.2

28. Dr MargiAnne Isaia,MD MPH www.enthusiasticlife.net REFERENCES: Granello, D. H., & Young, M., Counseling Today, Foundations of Professional Identity (2012) Roscoe, L.J., Wellness: A Review of Theory and Measurement for Counselors, Journal of Counseling & Development ■ Spring 2009 ■ Volume 87 Knudson-Martin, C., & Mahoney, A. R. (2009), Couples, Gender, and Power: Creating Change in Intimate Relationships (pp. ). New York: Springer Publishing Company Almeida, R. V., Dolan-Del Vecchio, K., & Parker, L. (2008), Title of the chapter. In Almeida, R. V., Dolan-Del Vecchio, K., & Parker, L. Transformative Family Therapy: Just Families in a Just Society. Pearson Education, Inc.