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By J. Volkar. Curry College. 2017.

This is followed by anger buy generic cytoxan 50mg on line, then by a bargaining stage order cytoxan 50mg on-line, which in turn evolves into depression, and finally into acceptance. Family and close friends also go through this adjustment process, and children may follow suit in their own way. As grieving evolves into depression in the newly diagnosed per- son with MS, it may be accompanied by loss of sleep, change of appetite, and feelings of despondency. This sequence results from decreased self-esteem; changes in self-image, life plans, goals, and values; and frequently a fear of rejection by family and friends. Resolution of these feelings is hoped for at the end of the cycle, accompanied by the feeling of peace that comes with the under- standing that life must go on. David Welch (personal communication) has observed the following stages of development in understanding MS: 1. Implicit in this admission is that from that moment on all relationships will in some way be altered. The disease requires the subordination of some things to the requirements of others. The element of stress is constant throughout all phas- es of the adjustment process. Its effect on the actual demyelination process is unclear, but in all likelihood stress does not increase demyelination. A flare-up of MS symptoms in a person under stress is not a true exacerbation caused by increasing demyelination, despite the fact that stress clearly enhances the symptoms caused by demyeli- nation. The brain has remarkable powers to compensate for the effects The brain has remarkable powers to compensate for the effects of disease, but it often loses this ability when one is under stress. The person with MS therefore will appear to have increased symptoms and problems, which may in turn lead to more stress. Under normal conditions, stress usually forces one to change and readjust one’s outlook. However, the chronic stress that accom- panies a disease such as MS may instead result in continued decom- pensation and maladaptation.

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Couples with children resist order 50mg cytoxan visa, in many cases discount 50mg cytoxan with mastercard, the temptation to quarrel in front of them. Although this is commendable, and certainly children should never be subjected to screaming matches or physical violence, it conveys an inaccurate message. Children who have never witnessed a minor squabble between parents, and more importantly, its subsequent resolution, develop the unrealistic expectation that adults never fight. The first disagreement with their 54 LIFE CYCLE STAGES spouse at some future date will portend a tragedy of monumental propor- tion. It is far wiser for children to recognize that minor disagreements do occur now and then, and learn from their parents the appropriate conflict- resolution skills. Couples draw closer together through honestly facing the differences in their relationship and working together to find satisfactory solutions. When the same issue arises repeatedly, clearly there is another issue un- derneath the symptom. A wife who is distressed over finding her hus- band’s carelessly discarded dirty clothing strewn about the house may be upset about something more than living with a sloppy husband. Sometimes it is necessary to look for the issue underneath the issue when the same fight keeps occurring. When conflicts do arise, there are basic rules regard- ing conflict resolution and fair fighting that partners should observe: 1. If additional time is needed, another period can be set aside to con- tinue working toward a solution. POSITIVE FEEDBACK AND GRATITUDE In the busy-ness of parenting young children, couples can focus on the dif- ficulties and lose sight of all that is positive in the marriage. One way to af- firm and provide positive feedback is to specifically express gratitude for all the partner has done that day, for the spouse, the children, even the rou- tine tasks (Fischer & Hart, 1991). This has an amazing power to enhance the relationship and assure couples of their mutual love and support.