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FITNESS HEALTH NATURAL-BEAUTY

Validation: Defusing intense emotions

Gold and silver padlock and a gold key to unlock it; concept is the communication skill of validation

Brittany Jordan-Arthur was at loggerheads with her 7-year-old daughter one recent morning. The little girl simply did not want to head out the door to summer camp, finding any and all excuses to hang back.

But instead of expressing exasperation or annoyance — knowing that would make her daughter dig in her heels even more — Jordan-Arthur, a psychologist at Harvard-affiliated McLean Hospital, decided to use a valuable communication technique: validation. Like many skills, the more you practice validation, the easier it becomes to apply when it’s most needed. Here’s what to know and do.

What is validation?

An approach that can help people feel heard and understood, validation is especially useful when navigating emotionally charged situations. Validating someone shows you understand their feelings and point of view, even when you disagree. It establishes trust, helping the other person feel supported and open to discussing solutions.

And that’s precisely what happened in Jordan-Arthur’s stalemate with her daughter.

“I just sat with her and said, ‘You really don’t want to go.’ It was a great example of saying, ‘I hear you,’ and ultimately I didn’t tell her she had to go or why — she came to that conclusion herself,” Jordan-Arthur says. “We walked out the door without all the need for explanations.”

Many try validation but don’t succeed

Validation is fundamental to a type of talk therapy called dialectical behavior therapy (DBT), which is geared toward people who experience emotions very intensely. Many people use some aspects of validation in everyday communications with family members, friends, and colleagues, but usually fall short, Jordan-Arthur says. How?

“They jump into problem-solving, saying something validating, but then immediately tell the person what they should have done or what they should do next,” she says. “They don’t let that validation sink in. It’s like putting on anti-itch cream and then immediately washing it off.”

How can you offer validation?

Jordan-Arthur shares these pointers for validating another person:

  • Give them your full attention.
  • Make eye contact and nod appropriately, saying “uh huh” while showing your interest.
  • Reflect what you’ve heard by restating their message, such as, “It sounds like you feel worse about this situation today than yesterday.”
  • Verbalize the unspoken, such as, “I hear that you feel you can’t get anything done because of this obstacle,” or “It sounds like you’re frustrated.”
  • Give it time to work! Be sure to let the validation sink in before attempting to problem- solve.

Does validation condone troubling behavior?

Validation isn’t the same as condoning someone’s bad or frustrating behavior, Jordan-Arthur notes. It’s not akin to reassuring them when reassurance isn’t appropriate.

“You may be afraid you’re going to communicate that you approve of their behavior or agree with their actions or choices,” she says. “But if you slow down and validate how someone feels in the moment, before a poor decision is made, validating accomplishes exactly the opposite.”

Try this phrasing instead:

  • “I hear that this is important to you.”
  • “I can see how this has been so upsetting/difficult/scary for you.”

How can you validate teens?

Validating teenagers isn’t dissimilar from the tactics Jordan-Arthur used with her 7-year-old — the problems just tend to be bigger. For example, teens often feel stuck with teachers they don’t like or complain that teachers seem overly harsh.

“Parents have lots of urges to say, ‘Oh, the teacher isn’t that bad’ or ‘I’m sure they mean well,’ defending the teacher and his or her perspective,” Jordan-Arthur says. “The odds are, by the time a kid is a teen, they also have that skill, but it’s going to take them a moment to get there.”

Here’s what to say instead:

  • “I hear that you don’t feel respected.”
  • “It’s so hard to feel helpless.”
  • “It’s difficult to feel your teacher has control over how well you do in class.”

“You can validate their feelings even if you feel the teacher is being respectful,” Jordan-Arthur adds.

How can you validate adults?

Validating other adults in your professional or personal life involves much the same approach. With a colleague who’s feeling undervalued at the office, for instance, try saying, “It makes total sense that you’re feeling really frustrated. I know how important your work is to you.”

If you’re arguing with a spouse or partner, you can believe them as being genuine, Jordan-Arthur says, despite a difference of opinion. Try saying, “I can tell that this issue feels really important to you and you want me to pay attention to what you’re saying.”

It’s also wise to pay attention to the other person’s body language during heated moments. After validating them — but before offering a potential solution to a problem — look for clues that they’re calming down, such as breathing and gesturing more slowly.

“I encourage people to count to 10 in their heads, because we still tend to jump the gun and not wait for the other person to feel that validation,” she says. “If we do that, they’ll often move past the idea that ‘this person wronged me’ and start solving the problem on their own.”

About the Author

photo of Maureen Salamon

Maureen Salamon, Executive Editor, Harvard Women's Health Watch

Maureen Salamon is executive editor of Harvard Women’s Health Watch. She began her career as a newspaper reporter and later covered health and medicine for a wide variety of websites, magazines, and hospitals. Her work has … See Full Bio View all posts by Maureen Salamon

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

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FITNESS HEALTH NATURAL-BEAUTY

Dealing with thick, discolored toenails

The ball of a foot and five toes with different emotions like a sad, worried, or happy face drawn on in pen; background blurred

Wriggling toes in the sand and wearing sandals are warm weather treats, unless you’d rather keep your toes under wraps due to thickened, yellowish nails. Nail fungal infections (known as onychomycosis) are common, affecting up to 14% of the general population. In advanced cases, nails can become brittle, crumbly, or ragged, or even separate from the nail bed.

While completely curing these fungal infections is difficult, the right treatments can discourage the problem from spreading and make your nails look better.

Do nail fungal infections only affect toenails?

No, fingernails can become infected, too. However, toenails are a more common target because of certain habits, including wearing shoes, so we’ll concentrate on them in this post.

How do people get toenail fungus?

“Feet are more likely to be sweaty and damp, which provides a better environment for the fungi, yeasts, and molds that are naturally present on your skin to flourish,” says Dr. Abigail Waldman, a dermatologist at Harvard-affiliated Brigham and Women’s Hospital.

People also can be exposed to various fungi, known as dermatophytes, by walking barefoot in locker rooms, spas, or near swimming pools, or getting a pedicure at a nail salon, she says. A fungal overgrowth can infect the area between your toes and the skin or your feet, causing athlete’s foot. The fungus can then spread to the toenails.

What makes toenail fungus hard to treat?

While antifungal creams can easily treat skin infections, toenails are another story.

“Nail tissue is harder and thicker, so these medications don’t penetrate very well,” Dr. Waldman explains. That’s also true for antifungal drugs taken as pills. Toenails grow slowly and the tissue isn’t very metabolically active. So although the medication gets into your bloodstream, only small amounts end up in your toenails. That’s why it’s hard to get rid of toenail fungus once it takes hold.

What counts as a cure?

Research reports so-called clinical cure rates between 60% to 80%, but this means only the absence of symptoms — that is, your toenails return to their normal appearance. The fungal infection may still be lurking under your nails, says Dr. Waldman.

In fact, in clinical trials when investigators recheck toenail clippings for any residual fungus after treatments applied to nails, only around 10% to 15% show no detectable fungal spores. As a result, recurrences of toenail fungal infections are fairly common.

Despite this, there’s a reasonable chance that different treatment approaches can improve your symptoms and the appearance of your toenails.

What works for treating toenail fungus?

Here is a rundown of the different treatment options, starting with Dr. Waldman’s go-to first-line suggestion, which uses inexpensive products you may already have in your home.

Home remedies

Soaking your toes to soften your nails before applying a fungus-fighting agent will help the remedy penetrate the nail. For the soak, Dr. Waldman recommends mixing one part white or apple cider vinegar to three parts warm water. Soak your toes for at least 10 minutes (but up to 40 minutes is better). Instead of vinegar, you can use Listerine, which contains thymol, the main compound in the herb thyme. Like vinegar, thymol has antifungal properties.

Then dry your feet well and apply an antifungal substance to all the affected nails. One option is a paste of crushed garlic, but most people will probably find the over-the-counter drugstore products listed below more convenient to use.

Over-the-counter products

The best evidence is for 100% tea tree oil, but another popular option is Vicks VapoRub (which also contains thymol and other essential oils that may fight fungus), Dr. Waldman says. Or you can use one of the various creams sold to treat athlete’s foot on your toenails.

Be sure to apply the product right after soaking. The clinical cure rates for each of these approaches vary between products, and depend on the severity and duration of the infection. But about 60% of people notice improvements after a few months of treatment, Dr. Waldman says.

Drugstores also carry several other toenail treatments, including a treated patch you put on your nails overnight. It contains urea, an acidic substance that improves the look of your nails by making them less brittle and discolored. Another product that promises similar results uses a tiny LED light that you clip onto your toenail after applying a liquid containing polyethylene glycol, which softens nails.

Prescription treatments to put on toenails

These topical products, which are best for milder infections, include amorolfine (Loceryl, others), efinaconazole (Jublia), tavaborole (Kerydin), and ciclopirox (Penlac). They are clear lacquers that you brush on your toenails once daily, usually for months. It may take as long as a year to see results. Clinical cure rates range from 35% to 60%.

Prescription pills

More severe infections may respond better to oral drugs, which include fluconazole (Diflucan), griseofulvin (Grifulvin), itraconazole (Sporanox), and terbinafine (Lamisil). These are taken daily in pill form for three months. While the clinical cure rates are higher (around 80%), these drugs have more side effects, including stomach upset, diarrhea, and (in rare cases) liver damage.

Laser therapy

Lasers penetrate and break down nail tissue, helping to destroy the fungus. There are many different types of lasers and protocols. Clinical cure rates are hard to pin down, but some have been reported as ranging between 60% and 75%.

Advice on toenail clippers, nail polish, new shoes, and more

During and after treatment, Dr. Waldman advises people to use two sets of toenail clippers — one for infected nails and one for noninfected nails — to prevent fungal spread. If you’re embarrassed by the appearance of your toenails, it’s okay to use nail polish for short periods of time, she says.

Once you finish treatment, buying new shoes will help avoid reinfection. “I also always recommend people do a diluted vinegar soak once or twice a week after finishing treatment, which helps prevent any lingering fungus from reinfecting the nail,” says Dr. Waldman.

About the Author

photo of Julie Corliss

Julie Corliss, Executive Editor, Harvard Heart Letter

Julie Corliss is the executive editor of the Harvard Heart Letter. Before working at Harvard, she was a medical writer and editor at HealthNews, a consumer newsletter affiliated with The New England Journal of Medicine. She … See Full Bio View all posts by Julie Corliss

About the Reviewer

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD