Avoiding Power Struggles with Fair Fighting

I just posted an article about how parents can avoid power struggles with their teenagers especially when the teenagers answer in a disrespectful manner. In addition to power struggles, disrespectful behavior can result in arguing.  Therefore, this post regarding fair fighting in conjunction with the one one disrespectful behavior should be helpful to parents.

We must remember that a teenager’s brain is not fully developed.  The prefrontal cortex is still developing in teenagers.  This part of the brain is responsible for reasoning and other executive functions.  Therefore, while teenagers look mature enough to have a reasonable conversation, their brains may not be mature enough therefore they are more likely to argue.  However, an argument is not always bad.  There are ways to have a healthy argument and ways to have destructive, hurtful arguments.  Most of us never learned how the have a healthy, reasonable disagreement.

Many people feel that a disagreement or fight is always a bad thing for a relationship.  However, this is not true.  If you handle a disagreement or argument fairly, it can be a very healthy thing for a relationship.  It can help you overcome past miscommunications or help you to resolve a problem.

As I stated above, parents who are dealing with teenagers need to remember that for teenagers their Frontal Lobes in their brains are still developing.  Therefore, they cannot always reason like adults and often have difficulties having fair disagreements.  I have included a list by TherapyAid.com which explains fair fighting rules.

Yes this might sound odd, but you can have a disagreement that is fair.  You do not always need to use insults or not listen to each other.  By using these rules, you and your teenager may be able to resolve an issue or at least come to an understanding without saying things that will hurt one another.

Parents what I suggest is that you sit down with these rules with your teenager and discuss that you would like to start to using these rules in your family.  Take the time and go over each rule so you both understand the rules.  Also make a copy for yourself to keep, your teen to keep and a copy to put on the refrigerator to remind everyone.  Remember, these rules will be a change for both of you so don't be surprised if it takes you some time to get use to these rules and use them on a regular basis.  Change usually never occurs over night.

While these rules are beneficial for parents and teenagers, these rules are also useful for couples.  Very few people in our society were brought up learning how to clearly communicate.  Just look at how many arguments occur due to miscommunication if you need proof.  For couples I would recommend the same steps as parents and teens.  First sit down and go over the rules so you both have the same understanding of the rules and keep a copy for yourselves.  The next time you have a disagreement practice using these rules. Keep practicing until you become comfortable using these rules.

Fair Fighting Rules

1.  Before you begin, ask yourself why you feel upset.

Are you truly angry because your partner left the mustard on the counter? Or are you upset because you feel like you’re doing an uneven share of the housework, and this is just one more piece of evidence? Take time to think about your own feelings before starting an argument.

2.  Discuss one issue at a time.

“You shouldn’t be spending so much money without talking to me” can quickly turn into “You don’t care about our family”. Now you need to resolve two problems instead of one. Plus, when an argument starts to get off topic, it can easily become about everything a person has ever done wrong. We’ve all done a lot wrong, so this can be especially cumbersome.

3.  No degrading language.

Discuss the issue, not the person. No put-downs, swearing, or name-calling. Degrading language is an attempt to express negative feelings while making sure your partner feels just as bad. This will just lead to more character attacks while the original issue is forgotten.

4.  Express your feelings with words and take responsibility for them.

“I feel angry.” “I feel hurt when you ignore my phone calls.” “I feel scared when you yell.” These are good ways to express how you feel. Starting with “I” is a good technique to help you take responsibility for your feelings (no, you can’t say whatever you want as long as it starts with “I”).

5.  Take turns talking.

This can be tough, but be careful not to interrupt. If this rule is difficult to follow, try setting a timer allowing 1 minute for each person to speak without interruption. Don’t spend your partner’s minute thinking about what you want to say. Listen!

6.  No stonewalling.

Sometimes, the easiest way to respond to an argument is to retreat into your shell and refuse to speak. This refusal to communicate is called stonewalling. You might feel better temporarily, but the original issue will remain unresolved and your partner will feel more upset. If you absolutely cannot go on, tell your partner you need to take a time-out. Agree to resume the discussion later.

7.  No yelling.

Sometimes arguments are “won” by being the loudest, but the problem only gets worse.

8.  Take a time-out if things get too heated.

In a perfect world we would all follow these rules 100% of the time, but it just doesn’t work like that. If an argument starts to become personal or heated, take a time-out. Agree on a time to come back and discuss the problem after everyone has cooled down.

9.  Attempt to come to a compromise or an understanding.

There isn’t always a perfect answer to an argument. Life is just too messy for that. Do your best to come to a compromise (this will mean some give and take from both sides). If you can’t come to a compromise, merely understanding can help soothe negative feelings.

Again, this might seem simple to some people, but communication problems are one of the biggest problems I encounter as a psychotherapist.  We simply don't educate children about clear communication, which creates problems when these children become adults and try to talk with each other. So don't be embarrassed or assume you do not need help in this area.  Simply read the rules and try them in your life and see what happens.

Dr. Michael Rubino is a psychotherapist with over 20 years experience and he specializes in treating teenagers, children and families. For more information regarding his work or private practice visit his website at www.rubinocounseling.com or his Facebook page at www.facebook.com/Drrubino3 or follow him on Twitter @RubinoFamily.

Ways to Avoid Power Struggles with Your Teenager

As a psychotherapist who works with teenagers, I often have parents ask me what to do when their teenager answers back and  always try to to make things a power struggle.  I remind parents that while their teenager may physically look like an adult, cognitively they are still children.  Their brains are still maturing and their basic way of communicating is with “nasty come backs.”  Given this fact, parents need to remember this fact and try not to get sucked into the power struggle.  This is difficult because your teenager has been watching you since they were babies and they know exactly how to push your buttons.

In order to help parents, I have listed some of the common buttons teenagers push with examples how parents can respond to their teenager and avoid a power struggle.  James Lehman, MSW, has noticed the same issue and I have included some of responses below too.  Remember, these responses are guidelines, you may need to alter them to fit your situation.

1. “I Will Do It Later”

When kids act out, they aren’t always confrontational. One way children get around the rules of the household is to procrastinate and put their parents off until they eventually stop asking kids to help out. While many parents rationalize, “It’s easier if I just do it myself,” you need to understand that giving in to your child gives them a false sense of entitlement, a sense that “the world owes them something” and that they do not need to meet their responsibilities. Here is an effective response in the face of your child’s passive backtalk.

Child: “I’ll do it later”

Translation: If I put it off long enough, you’ll give up and I won’t have to do it. You’ll probably even do it for me.

Ineffective parenting response: “Okay, but make sure you get it done.”

Effective parenting response: “Well, that’s fine. But you won’t get your allowance until it’s done.” Or, “Well, that’s fine, but you can’t use the phone until it’s done.”

2. “Whatever”

Kids generally say “whatever” to their parents when they’ve already lost the argument. It’s backtalk that is a final attempt to anger you and to retaliate in some small way for something that your child doesn’t like. Your best bet is to ignore it. If a kid says “whatever,” the odds are that the point has already been decided and you’re in charge of the situation. “Whatever” is their weak way of trying to save some face. If you’ve come out on top, don’t compromise your position by letting them draw you into an argument. If you give the “whatever” power and you accept the invitation to the argument then you will lose the ground that you’ve already gained.

Child: “Whatever.”

Translation: “It doesn’t bother me. I don’t care and it doesn’t matter.”

Ineffective response: “What do you mean, ‘whatever?’ Let me tell you something, young lady…”

Effective response: Ignore it, smile and turn around and walk away. You’ve already won the fight.

3. “You Can’t Make Me!”

At times, children will verbally draw a line in the sand, stare you in the eye and say “You can’t make me.” This is backtalk used to draw you into a fight, and it’s important not to start fighting. By responding with “Oh yes I can,” there’s a threat implied, and it’s only going to further escalate the situation. You’re giving the child control by accepting the invitation to fight. But don’t engage your child on her level; don’t join the fight. Instead, put aside your emotions and focus on the matter at hand.

Child: “You can’t make me!”

Translation: “I don’t want to do what you’re asking, and I’m looking to start a fight with you.”

Ineffective parenting response: “I can and I will if you don’t do it right now.”

Effective parenting response: “I’m not here to make you. But there will be consequences if you break the rules.”

4. “I Want It Now”

Do you dread the threat of a temper tantrum and feel like you give in to your child’s demands in order to avoid an outburst? You can defuse a tantrum and help prevent future tantrums by using an effective response aimed at teaching your child that acting out is not the way to meet his needs.

Child: “I want it now!” followed by a tantrum.

Translation: If I escalate my behavior, you’ll give in, and I’ll get the cookie. This worked the last time I wanted something.

Ineffective parenting response: “Sarah, stop it! I said stop it! Here…(gives Sarah a cookie) now be quiet!”

Effective parenting response: “Don’t act that way. It won’t help you get the cookie.” Then turn around and walk away.

5. “I Forgot”

Children (and adults) can be forgetful and certainly a reminder to do their work or complete a task is appropriate. But when kids use “I forgot” on a regular basis, it becomes a way to justify irresponsible behavior. As an excuse, “I forgot” means the child is avoiding a certain task or responsibility which they don’t feel they can perform and don’t know how to get help with. Or they could be acting lazy and just don’t care. Laziness explains as much irresponsible behavior on the part of children as any other explanation. Sometimes laziness can be interpreted as “I’m tired and I don’t feel like it.” Sometimes laziness can be interpreted as “My life’s not going to get better anyway, why should I try?” In either case, laziness doesn’t empower the child to take care of business. So when your child says “I forgot,” you have to say, “Forgetting is not an excuse to justify not doing something.”

Child: “I forgot!”

Translation: “I don’t feel like it.” Or ”Why should I try?”

Ineffective response: “You didn’t forget! You’re just saying that because you’re lazy.”

Effective response: “Not forgetting is your responsibility. I’ll help you learn ways to not forget, such as creating an assignment book for school or using cue cards to prompt you for the next task. If you would like, I’ll help you develop a list. But you are responsible for remembering what it is you need to do.”

6. “I Hate You”

Of all the backtalk in your child’s arsenal, the words “I hate you” can have the power to reduce any parent to tears or anger. Children know that saying this can paralyze a parent during a fight, which is why they say this to get what they want. Here is how to focus the argument back on the issue at hand and reduce the emotional sting of your child’s words in the process.

Child: “I hate you!”

Translation: You won’t let me go out tonight, so I’m going to talk hatefully to you so you’ll get upset and give in.

Ineffective parenting response: “I hate you sometimes, too!” Or, “I’m sorry, please don’t say that…”

Effective parenting response: “Maybe sometimes you do hate me. But I’m still not letting you go out tonight.”

7. “You Don’t Love Me”

Children often use guilt to manipulate us. This is just another version of “I hate you” and, again, they use this backtalk to get what they want. Don’t give in. Here’s how to deflect the guilt by using an effective response that puts the emphasis where it should be: on your child and the importance of following family rules.

Child: “Why can’t I go out with my friends? You don’t love me.”

Translation: I’m going to put you on the defensive and hit you where it really hurts so you give in and let me go out.

Ineffective parenting response: “You know I love you! I took you to the mall yesterday!”

Effective parenting response: “The issue is not that I love you. The issue is that we have rules in our family about Sunday afternoons.”

8. “It’s Your Fault”

It’s no mystery: children who say to their parents “It’s your fault” when confronted with a task they haven’t completed are trying to avoid taking responsibility for something. Here’s the important thing to remember: don’t talk “fault” but instead talk “responsibility.” Many times, kids will try to lay blame when a responsibility has not been met. So respond with, “It’s not my fault, it’s your responsibility.” The reason why finding fault is not effective is that focusing on the past will not solve your child’s problem. Focus on the present—the present is where problem-solving starts.

You: “Why isn’t your homework done?”

Your child: “It’s your fault I didn’t get my homework done because we went to the movies.”

Translation: “I’m not going to take responsibility for not getting my homework done—I’m going to make it your fault.”

Ineffective: “You’re right, I’ll write you a note, don’t worry about it.”

Effective: “Wait a minute. It’s your responsibility to tell me that you had homework to get done. Next time, tell me what you have to do before we go to the movies.”

9. “Leave Me Alone!”

Children can be adept at shutting down and shutting you out—leaving you with unanswered questions and a whole lot of frustration. If you find your child is shutting down every conversation with “Leave me alone!” or “It’s none of your business!”, here are some ways you can handle their backtalk and make sure the issue at hand gets addressed in the appropriate way without getting into a power struggle. Keep in mind that it is completely appropriate for kids to have their own space and that “Leave me alone” is appropriate and often should be accommodated. But, you should set limits and make clear to your child that being left alone for a while is not a free pass. Don’t overreact to requests for space or time alone and don’t get stuck on your child’s tone unless they’re rude or demeaning.

Child: “Leave me alone!”

Translation: “I don’t want to talk to you about this, I don’t want to perform this task, and I’m going to shut you down so I don’t have to.”

Ineffective response: “I will not leave you alone. I want your attention right now.”

Effective response #1: Again, if your child’s request is appropriate and they’re not being rude or demeaning, simply say, “Ok, we’ll talk later,” and walk away. Or better yet, set a time: “OK, we’ll talk at 7 o’clock.” Another way to handle it is by saying, “OK, when would you like to talk about this?”

Effective response #2: If it’s something where you can’t leave your child alone, simply say, “No, we have to address this now, then you can get back to what you were doing.” If it comes down to it, you can say something like, “OK, we don’t have to talk now, but there will be no more phone use until we do talk.”

10. “You Just Want to Control Me!”

When a child says to you, “You’re just trying to control me,” usually he or she is inviting you to a fight. The perception for parents here is that your child is challenging your authority. If you respond to that, you’re giving them more power. Try not to get into a power struggle or screaming match, and don’t deny the obvious. Sometimes parents say, “No, I’m not trying to control you,” when in fact, they really are. Generally, the best thing for you to do is to avoid that argument. Remember, you don’t have to attend every argument you’re invited to.

Child: “You just want to control me!”

Translation: “I’m not going to do what you’re asking me to do—instead I’m going to argue with you about it.”

Ineffective response: “It’s my house, and I will control you.”

Effective response: “I’m trying to get you to meet your responsibilities, not control you.” Or, “I want you to take responsibility for your behavior. That’s not trying to control you.”

Here is how to use this in an everyday parenting situation. Let’s say your teenage son or daughter refuses to comply with their curfew and comes home an hour late. If you hold them accountable for their curfew time then they may say, “Why are you being such a pain? You’re just trying to control me.” This is an invitation to a fight that will lead to nowhere but more frustration. Keep the focus on the child’s responsibility, meeting curfew, and stay out of the quagmire of an argument by saying, “It’s your responsibility to be home by curfew. That’s not trying to control you.” When a child wants to get out of meeting responsibility, the quickest way to do that is backtalk that is meant to make you angry. Don’t fall for it.

11. “That’s Boring”

When our kids say something is boring, they’re often expressing a low level of frustration. This frustration may come from not having anything interesting to do, or it may be that the task they have to do isn’t exciting and requires attention and energy. So when you say, “It’s time to go do your math now,” and a teen responds, “Math is so boring,” they’re expressing a low level of frustration and anger about having to do their math homework, probably because math is both boring and difficult. I tend to honor these kinds of statements in the affirmative. If a child were to tell me he was bored, I’d say, “Can I help you with any ideas on how to make it easier to deal with?” If he said yes, I’d try to process some choices with him. If he said no, I’d say, “OK, well, if you change your mind, you know where to find me,” and then go on about my business. Remember, as a parent, it is not your job to fix your child’s negative feelings or solve his social problems. It’s your job to teach him how to solve problems such as figuring out something to do. It’s also your job to let him experience the negative feelings that the problem of boredom is triggering.

Your Child: “That’s boring! I don’t want to do my math homework.”

Translation: “I’m angry and frustrated because math isn’t exciting and is difficult.”

Ineffective: “You’re just saying that because you’re lazy and don’t want to do the work.”

Effective: “I know math can be boring, but it’s your responsibility to get it done. Why don’t I help you get started?”

For parents of younger children who say that they are bored the solution is simpler: give them something to do or give them a choice of two things to do. You can start by asking them if there’s something they’re interested in doing, but don’t push them to make a choice. You can also create tasks and jobs for younger children, such as having them help you in the kitchen or in the yard. This can redirect their energy and dispel their feelings of boredom.

12. “My Teacher’s an Idiot”

Almost every kid will eventually have a teacher they don’t like, but that’s not an excuse for them to refuse to follow the rules of the classroom. When you side with your children in this situation, believe it or not, you are actually undermining your own authority in the process. The bottom line is that it’s a mistake to denigrate authority figures with your children, even if you agree with them. Keep the focus on the matter at hand and off your child’s feelings about their teacher.

Child: “My teacher’s an idiot. I hate her.”

Translation: I don’t like my teacher. Therefore, I don’t have to comply with what she asks me to do.

Ineffective parenting response: “Yeah, she’s really a jerk sometimes. You’ve still got to listen to her, though.”

Effective parenting response: “It doesn’t help to call the teacher names. What can we do to get your work done on time?”

13. “You Love Her More Than You Love Me”

When you have more than one child, from time to time they might ask you if you love one sibling more. This is not unusual, and sometimes children will put the question to you in an offhand way, pretending that the answer isn’t really that important. But the answer is important. And the best answer you can give is, “I love you as much as a mother could love a son. I’ll never love you any less.” And then your child will say, “But what about Jessie?” And you can say, “I love Jessie too, but I want you to know that I love you. Never worry about that.” Kids will sense that you love them, but there will be times when they crave affirmation, and it’s important to give it to them.

Many times, during an argument or power struggle, kids will say, “He always gets his way,” or “You love him more than you love me!” When they do this, they’re either trying to manipulate the situation or distract you as a parent. This has nothing to do with love—it’s backtalk. Do not to get pulled into an argument about who you love more, simply redirect your child to the task at hand. Say to them very clearly, “This is not about who I love more, this is about you having to go finish your homework now.”

Your child: “You love him more than you love me! He always gets his way.”

Translation: “He’s more lovable than I am, so you let him have his way.”

Ineffective: “I love you too, but it’s easier to love him because he doesn’t argue with me all the time. You’d get your way sometimes too if you’d just stop being such a brat.”

Effective: “This is not about who I love more. This is about you finishing your chores.” Or, “This is not about who gets his or her way. This is about the fact that it’s Jack’s turn to be on the computer for an hour. You already had your turn.”

14. “You’re Not My Mom, I Don’t Have to Listen to You”

When you are raising or helping to raise a child that is not biologically your own—whether you’re a stepparent in a blended family, an adoptive parent, a foster parent, or are bringing up your grandchildren—kids may sometimes use your role against you in the heat of an argument. When a child says “You’re not my mom or dad,” what they’re really trying to do is take the power away from you. Focus on your role as caretaker and calmly remind the child what the rules are in your house. The whole idea here is to avoid a power struggle. The child is inviting you to a fight and you should decline the invitation. Instead, just restate your role and the rules. It’s very important that you verbalize no judgments about the biological mother or father. Judgments will only lead to more anger and resentment, which will lead to more power struggles.

Child: “You’re not my mom/dad!”

Translation: “I don’t have to listen to you; you have no control over me.”

Ineffective Response: “You’ll do what I say anyway!”

Effective Response: “I am not your mother. But I am one of the adults in this household who is responsible for you and you are obligated to follow the rules of the household. And if you break the rules there will be consequences.”

Prepare and Practice

It is very frustrating when our kids use backtalk continually when confronted with a responsibility. The same fight seems to repeat over and over again and it wears us down. But, use that repetition to your advantage—prepare ahead of time and have your responses ready for the next time. Being prepared will enable you to manage these episodes with calm confidence and will keep you from getting dragged into a power struggle. So, prepare and practice and then execute when the inevitable happens again.

And give yourself a break if it does not seem to go right every time—this takes practice for you and it may take some time for your child to adjust to your newfound confidence and authority. Finally, if your child says something that you are not prepared for then take some time after the fight to figure out how you will respond in the future.

Dr. Michael Rubino is a psychotherapist who specializes in treating children and teenagers.  He has over 20 years experience working with teenagers.  For more information about Dr. Rubino or his private practice visit his websites www.RubinoCounseling.com or www.rcs-ca.com. 

Should Sixth Graders Be Able to get Condoms at School?

Would you give a boy in the 6th grade a condom?  San Francisco Unified School District and other school districts now provide 6th graders with condoms. All students need to do is talk to a school counselor and a 6th grader can get a condom.

Why are schools considering this option? They are considering this option because research is showing that teens are becoming sexually active at younger and younger ages. It is not uncommon for kids in the 6th grade to be sexually active. Research studies show 5% of 6th graders are already having sexual intercourse. This is not taking into account oral sex. When I work with middle school and high school students these days I need to ask are you sexually active? I also need to ask are you having oral sex? I often hear yes to oral sex and I am told but that is not sex. When I ask what it is, I am told we are just messing around. Many middle school kids equate oral sex with kissing. This is scary.

I understand that the San Francisco Schools are trying to protect their students, but I don't think this is the best way to do it. From my experience working with teens, they usually start thinking about birth control after they are all ready sexually active. Also how much information can be provided in one 30 minute talk. The kids can be told how to use a condom but no one will be discussing the emotional issues and responsibility involved with sex.  Also no one will be asking the child if they are ready for this step and are they prepared if the girl gets pregnant?

If we want to keep our children safe then we need to stop making sex such a forbidden subject. The kids need classes in 4th and 5th grade which explain in detail about different sexual acts and the risk they are taking even if they use a condom. For 6th graders to think oral sex is the same as kissing is crazy. It is also crazy why we are saying to them don't have sex, when society is telling boys if you want to be a “man” you can't be a virgin and girls are told if you want a boyfriend you have to give him sex.

Also we need parents not to be embarrassed or shy about talking to their kids about sex. Parents cannot wait until their child starts High School anymore.  By the time many kids start high school, it's too late to be discussing sex. Sexual activity should be something you discuss with your child from preschool on. Of course not going into specific details, but talking at an age appropriate manner. Start educating them about their bodies. If a child sees you are not embarrassed or ashamed they will be more likely to ask you questions before they do something. If parents act like sex is something to be ashamed about a child won't ask their parents questions.

Also parents you must start the conversation. Many parents tell me they will discuss sex with their child when s/he asks questions until then they will wait. I have teens telling me they won't ask their parents because it's too odd talking to their parents about sex. If they don't ask an adult they are going to learn by trail and error.  I have had to become comfortable discussing the subject because many parents tell their teen to ask me. Yes they are getting the information, but they really prefer talking to their parents. I often encourage teens to try talking to their parents explaining that their parents feel just as awkward as they do, but the embarrassment will pass.

The main problems I see with the school handing a 6th grader a condom is no one is really discussing with the child, are they really ready to be sexually active? There is a great amount of responsibility that goes along with being sexually active. You can still catch an STD using a condom so the 6th grader needs to tell their primary care doctor they are sexually active. A girl can still get pregnant using a condom. Are the boy and girl prepared for this situation if it occurs. Also when I ask middle school students about condoms, they know very little about condoms.  Some middle school students think you have to be 18 in order to buy condoms.  Many middle school students do not even know you can buy condoms.  These facts tell me we are placing middle school students into sexual situations, they are not emotionally prepared to handle.

To become sexually active is is a huge decision to make and I don't think a 6th grader is mature enough to make it. Also 6th graders are not always paying attention so they may not know how to use a condom appropriately.

Yes it is shocking that 6th graders are having sex. I think a better way to handle the issue is to look at what we are teaching them in the movies, television shows and video games they are watching and playing. Sex is not a game and we are treating it like a game. This doesn't help kids in 6th grade. We need real sex education in school and at home.

In therapy often boys will tell me they think they are ready for sex. I ask them are you sure this is the girl you want to have your first time with? I also remind them they only have one first time. I also ask are they ready for the emotions that go along with sex? The biggest one I ask is are you prepared to handle if she gets pregnant? Condoms are not a 100% guarantee. The question that always gets me is when they ask how they can get a condom? I tell them you can buy them at any drug store. I often hear I would be too embarrassed to go buy condoms. My response is if you are too embarrassed to by them then in my opinion you are not emotionally ready for sex. In my opinion handing 6th graders condoms will result in more teens being sexually active who are not emotionally ready to be sexually active. We need to think about that point.

Parents you also need to let your child know they can discuss sex with you. May be you may not agree with them about their opinions, but they need to know they can talk with you and don't have to be afraid of getting into trouble. The main reason I hear from teens about why they don't talk to their parents is they are afraid their parents will get mad, they will get a lecture and get into trouble.

I don't think anyone feels a 6th grader is ready for sex, but it is happening every day. If we are going to do what is best for kids, we need to help them feel safe to discuss sex with us. If we don't the consequences can be severe for everyone involved.

Dr. Michael Rubino has over 20 years experience working with teens in middle and high school and is considered an expert in this area. For more information about Dr. Rubino and his work visit his website at www.rcs-ca.com or visit his Facebook page at facebook.com/drrubino3 or on Twitter @RubinoTherapy.