The Things We (Emotionally) Carry

As a therapist, I often hear about all kinds of things going on in people’s lives that are legitimately hard. For example, the spouse is working long hours and/or traveling a lot.  Or there is a serious illness i.e. cancer etc. in the family, or a child is on the spectrum and causing all kinds of havoc for self and other family members.  Yes, these things are all real.  They required support and validation, and sometimes even an all hands-on deck approach from our family, friends, and the wider community.

If this weren’t bad enough (which it is, by the way), these hard life events often trigger other very hard life events (one could say trauma) from the past.  And what’s even worse, we aren’t even aware that this second part is happening.  What we are aware of is the anxiety, depression, panic, intrusive thoughts.  We are also often aware of the negative judgments we attribute to ourselves when the symptoms of anxiety, panic etc. rear their ugly heads, for instance, “There’s something wrong with me” or “I am losing my mind” or “I am out of control” or “I should  be able to deal with this by myself”.  Since we’ve often been suffering from these negative past events for a long while, we grown accustomed to the weight of them.  We don’t realize how heavy that weight really is.  And so we suffer because of the current life happenstance and for the past traumatic event that we’re not even aware we’re carrying.  No wonder it feels so hard!

Let me give you an example.  (This example is fictional to preserve the confidentiality of my clients.) A young girl (let’s call her Susie) grows up in a home where the parents divorce.  Common enough, you say.  Yes, it is. But in this family, no one ever talked to Susie about the divorce.  She felt the tension between her parents and when they divorced, she dutifully went to see her dad (or mom) on every other weekend and Wednesday evenings.  Her non-custodial parent, however, did not dutifully see her.  Sometimes s/he showed up for the visits and sometimes she didn’t.  He often had a good reason, but reasons matter little to a young girl wanting so desperately to see her daddy or mommy.

 It wasn’t the worst divorce in the world (nor marriage for that matter), but since no one ever talked to Susie about it, she grew up believing that if she just had been better, her parents would not have divorced. She knew in her heart, her entire being, that it was her fault that her mommy (or daddy) didn’t always show up for visitations.  Now, like any little girl, Susie grew up.  She had lots of good things in her life too:  friends, vacations, a dog etc. She even got into a top-ranking college and got the job of her dreams after graduation.  Many things were going well for this young adult.  Between manageable bouts of anxiety and a touch of depression, she often forgot about the heaviness connected to her parents’ divorce for long stretches of time.  

But when her first child was born, Susie became anxious, more anxious than she ever imagined was possible.   And when it came time to leave her darling daughter at daycare to return to work, she fell apart completely.  Now, separation anxiety from baby is normal when a mom goes back to work.  But this was different.  Susie’s anxiety became paralyzing.  She suffered from terrible intrusive thoughts where she or her child died in violent and disturbing ways.  Susie thought she was going crazy, but she wasn’t.  Susie was suffering from a combination of normal mom anxiety piggybacked on top being triggered by the childhood trauma connected with her parents’ divorce.  She was reexperiencing those moments when her mom or dad failed to show up and she felt so alone. 

 Suzie had heard about postpartum depression, but not postpartum anxiety and certainly had no clue about the driving force behind her intrusive thoughts. She had no idea she was carrying this extra burden.  Without any knowledge that her past trauma could so severely affect her current moments, Susie blamed herself for her symptoms and became depressed in addition to anxious.  She also felt guilt and shame for reacting the way that she did.

It wasn’t until Susie went to therapy that she started figuring some of this stuff out.  She didn’t feel completely better immediately, but even during the first session she realized that intrusive thoughts were a common symptom of mothers experiencing postpartum mood complications.  This knowledge definitely helped. 

As an outsider reading this vignette, you may think that the connection between Susie’s parents’ divorce and her anxiety post-baby are obvious.  And perhaps they are, at least if you aren’t Susie.  But it often impossible to understand this dynamic when you are the one in the middle of the storm.  Being triggered can feel like being in a trance that you don’t even know that you are in.  That’s because the emotions feel very real and you experience being triggered as if the moment from the past was happening all over again.  That is the nature of trauma. 

Susie was in therapy for about a year and a half.  During this time, her intrusive thoughts stopped (and sooner rather than later).  She was more easily able to drop the baby off at daycare. While it is extremely challenging to have intrusive thoughts as you make that difficult adjustment to parenthood, Susie was ultimately grateful for her thoughts because she learned so much about herself and was ultimately able to free herself from the history of her past.  Susie realized and genuinely moved past the beliefs that it was her fault that her parents divorced and that her mom (or dad) didn’t always show up because she was not worthwhile. When Susie left therapy, her emotional backpack or the things that she carried was considerably lighter. Now if only the laundry and the crumbs in the car would slow down a bit 😊.

Why the Giving Tree is Such a Terrible Book (and Facebook and Pinterest have issues as well)

There isn’t a single mom that I see in treatment that doesn’t work really hard to care for her baby, her children, the house, the schedule, the partner, the older generation and the outside-the-house and/or volunteer work .  And yet, there still isn’t a single mom who hasn’t struggled with guilt about doing enough, being enough.  Given how hard everyone is working, what the devil is going on?

Well, some of it is socialization.  Women have been culturally trained to be the nurturers, the caregivers. We take pride in this role, soothing the hurt knee, bringing down the fever, reading that book on dinosaurs again and again and again.  We love our children and feel good about keeping our family loved and safe.  And even if the laundry is often in a perpetual state of happening and there is more clutter in the house than there used to be, we still do the vast majority of the work, keeping the house safe and clean or at least clean(ish).  Now add on top of all that the  added expectations of being busier than ever and working full-time, or half-time or in the cracks at home when the baby is sleeping, and it’s a recipe for stress.  But why guilt?  I don’t think that women could be working much harder, certainly not without breaking down or just plain old losing it.

So, here’s where the Giving Tree comes in.  We’ve been breathing in through the air and the water and the books we read and the screens we watched (Leave it to Beaver) or watch (Youtube), that we not only need to be on top of everything but do it with style, happily and with well-coifed hair and tasteful make-up.  And we need to make interesting meals and make cute projects for our children or with our child. We are trying to be good people, good mothers, but we are doing even more than that: we are trying to be perfect.  Like the beloved children’s book, The Giving Tree, we are giving away our leaves and branches until all we have left is a stump. And it’s not working.

It’s likely that many of us know this, at least on some level.  We are human beings first and foremost.  We get tired, we get cranky especially when sleep deprived. We have issues from our childhood that pop up here and there.  And typically it’s our very child that we love so dearly and wanted so badly who unintentionally trigger us.  Our thinking, rational brain knows the reality. We aren’t a tree that can happily give until there is nothing left but a stump.  But we often forget that Facebook photos are literally snapshots in time that show the best highlights of a family’s life, not when the kid is having a tantrum or when the rotovirus (think throw up) visits the house.

But even when we skewer up the courage to ask for help (which isn’t easy by the way because we’ve been socialized not to ask) and actually take some time off or off-load a responsibility, we feel guilty. The irrational side of our brain actually knows the scores, is tuned into what the world expects from us.  What now we’ve internalized to expect from ourselves.  We don’t want to be judged for the disarray of our house, or be blamed for our misbehaving children, or even for our husband being a few pounds overweight (as if we could control that anyway).  But sometimes, we actually are blamed or at least imagine that we are. One thing is sure, our internal critic is judging.

And so, we work hard and often and become exhausted, and overwhelmed, maybe even irritable or angry. It’s really an untenable situation. Because no matter how hard we try, we can’t be perfect.  And isn’t that really the goal? The perfect wife and mother in a beautiful house with the perfect, well-behaved children and trim husband because we serve appetizing, yet healthy meals.  We’ve haven’t come as far as we think we have from Leave it to Beaver. Ok, I’m exaggerating, but not as much as you’d think.

So what is a loving caring mother to do to be there for her family but also and equally for herself?  Well, I think it begins with rejecting the current paradigm.  Whether or not you get off Facebook, it’s important to see the cultural expectations as the fantasies that they really are.  If perfectionism is part of your struggle, read one of Brene Brown’s books. She talks about how perfectionism backfires.  Since there is no such thing as perfect, that is an absolute set-up for failure every single time. And no matter how we keep house, or raise our kids or go to work outside the house (or not), someone will disapprove our lifestyle anyway since there is no pleasing everyone.

The only real option is to control what we can, meaning ourselves, and to not worry about what others think.  It can start by at least taming or befriending our inner critic.  Working to transform perfectionism into merely high standards (or even low standards on things that just don’t matter).  We can start to find sanity by discovering (or rediscovering) our true selves, and actually nurturing our own inner child when she needs a break, or extra help or permission to leave a few things on the chore list until tomorrow (or perhaps forever). We can redefine what it means to be a “good mother” focusing more on kindness and patience and less on appearances of all kinds.  And we can work to find our voices, sharing our inner selves with our partners, our world, perhaps taking up just a little bit more space than we used to.  We can give up the cultural voices that demand perfectionism and a very narrow view of motherhood and womanhood, and start listening to our own definitions of these roles.

I recently started parting my hair differently.  My new part shows my grey hairs more than before but my hair stays put better because this is my hair’s natural part.  In some ways this makes me feel more vulnerable.  But on the other hand, I am no longer hiding anything and I feel like I am declaring to the world, “Here I am”.  I’ve noticed that taking this small risk has made me feel better, not worse about myself, and so far, no one has even judged me for it.  Sometimes the worst critic is the one in our heads.  So I invite you to take a small risk, one that speaks particularly to you.  Whether it is asking for more help or more respect or anything else, I bet that your life will be a little bit better than it was before for your effort. 

Who Am I Now?

Who Am I?  My New Life as a Mom

I give my new clients extensive biographical questions and screenings to complete when they first start therapy with me.    One of the items on a screening that I give states, “I don’t know who I am anymore”. It is a rare mother that I see who doesn’t endorse this item. 

Becoming a mother (or father) is one of the biggest life adjustments that most people will experience in their life time. It’s bigger than getting married, graduating from college or moving across country. Let’s face it; it many ways, becoming a parent fundamentally changes your identity.  You go from being a child of (usually) two parents to the parent of a child or children.  That is a foundational shift!  Not only that, but you do it while you are the most sleep-deprived you’ve even been, while your hormones are dramatically shifting, and where almost every minute of every day is spent taking care of a little one who only communicates through crying or some other body language.  This is a recipe for not knowing who you are anymore!

While the first three months of a baby’s life can feel like a sprint for survival, at some point you begin to realize that this is your life now.  In many ways, you really are still yourself with the same interests and quirks that you’ve always had. Only you’ve forgotten this in the haze of never coming up for self-care air.  I ask perinatal clients all the time how often they needed to socialize before kids or what their interests and hobbies were.  Sometimes they laugh when I ask this question.  It’s almost as if they’ve forgotten they had a life before baby.  Because of your new life circumstances, you may never go back to your interests in exactly the same way as before.  There is, however, a compelling reason to find a way to get a little bit of yourself back: if you don’t, you are much more likely to become anxious or depressed and almost certainly resentful.  As much as you love your baby (and I know that you do), they don’t talk, they don’t offer helpful advice, and they certainly don’t have opinions on your sister’s new boyfriend! Caring for a baby all day does not satisfy most people’s social needs which are important to recognize and honor. It also doesn’t fill your bucket.  And when your bucket is empty you are no good to anyone including your baby. 

Now, the other part of figuring out who you are now is acknowledging that you have changed in some ways.  Maybe you used to go to bars a lot, but now it doesn’t appeal nearly as much with the sleep deprivation, nursing considerations (if you are nursing) and the logistics of who will care for baby.  Maybe you ran marathons, but that is most likely not happening anytime soon. It is likely that you also feel a very strong nesting instinct and increased vulnerability in the world. Babies tend to do that to parents, especially mothers. Maybe you’ve never been prone to anxiety but now you worry more about climate change, or pesticides in the food chain, or whether you can do this nebulous job of keeping your little one alive.  No matter the worries, this is not the you that you’ve known and loved for the past 2, 3 or 4 decades.   You don’t recognize yourself in the mirror (maybe it’s the unwashed hair and dark circles under the eyes.)  Equally likely, it’s the new you who feels like you have part of your heart in a teeny, tiny human being that you have been tasked with keeping alive 24/7.

So what’s a new mom with an identity crisis to do?  First and foremost, know that it is normal.  Know that the passage of time will ease of at least part of your identity confusion.  Second, make the effort to find a little bit of your pre-baby self somewhere in your life.  If work has always been a big part of your identity, think about how and when you want that back in your life: part-time, full-time, with flex hours, going out your own as a free lancer or as your own boss?  If you decide to be a full-time stay-at-home mom, you have many options. But if you take this option, it is important that you have something, an activity or a passion, that is yours and yours alone.  Maybe now is exactly the right time to return to that photography class.  Maybe you’ve always wanted to explore Tai Chi.  What better time than the current moment?

Whatever you end up doing or find too difficult to explore at this current moment, try to be generous with yourself. While it took a while for me to return full-on to my work life, my current love of yoga began from taking pre- and postnatal yoga classes. Since becoming a mother, I’ve stayed home with my kids full-time, worked very part-time, worked in a job related to but not what I was trained for and now, work full-time in the career that I was trained to do.   There’s no right way to do any of this and what’s right can change from month to month, year to year.

Your identity crisis may also be stemming partly from being “new to the job”.  Many parents nowadays have never really cared for a very young infant. So there is a steep learning curve to feeling confident in your role.   Parenting is not the kind of activity that breeds confidence anyways.  Just when you feel like you have it figured out, your child changes and it’s back to the drawing board. Additionally, there many opinions on what makes a “good” parent and far too few opportunities for feedback.  Instead of waiting for the world to validate your parenting choices, try to cultivate your own parenting voice.  You might find books helpful, but take them with a large grain of salt.  As you develop your parenting chops, your confidence will increase.  When you feel like you know who you are as a parent, you will also feel more like you know who you are a person as well.

What Your Doctor Didn't Tell You About Menopause (or Perimenopause)

Menopause.  We’ve all heard about it whether we’re 24 or 57 years old.  It’s that time of life, you know, when you’re a little shorter in patience, sleeping a little less well, no longer getting your periods.  But there is so much more to it than that.  Did you ever realize that many women spend about a third of their life in menopause and that the average age for menopause is around 51.  Personally, I am somewhere in that nether land between end of perimenopause and beginning of menopause, so am speaking from personal as well as professional experience. Menopause can be tough but it can also be a time of rebirth, with the kids are out of the house or at least more independent, allowing women the opportunity to focus on themselves more including pursuing hobbies, romantic relationships, travel and/or career. Post menopause, a woman is more likely to (really) speak her mind; somehow she doesn’t care quite as much about what other people think of her.  And yet, so little is actually known by most women about menopause; they know even less about perimenopause, the years preceding the cessation of the fertile period of one’s life.

Perimenopause can last for up to ten years.  It is the time that bridges one’s peak fertility period (late teens through mid thirties) with the cessation of monthly menses. During this time, our hormones start to fluctuate more and progesterone, the other primary female hormone that is not estrogen, starts to decline markedly creating an imbalance between the two sister hormones. The decline in progesterone may lead to sleep disruptions, and possibly even uterine fibroids. What women are usually not told about perimenopause is that it is harder than menopause both mentally and physically.  It is the time when most women become the most symptomatic, particularly the year prior to menopause.  Other possible symptoms that are less well known during this time include anxiety and/or depression, difficulty with memory (word recall, issues with attention and focus, and the daily struggle to remember all the details of a busy life).  Some women may now have a harder time recognizing faces even though most of their lives they “never forgot a face”.  Other women may struggle to spell words correctly despite always having been good spellers.  In addition to weight gain, there can be other obvious changes in the body including the thinning and drying of skin and hair, heart palpitations and menstrual periods that become more irregular, more painful or lighter or heavier, depending on the individual woman. 

Some women have their own unique variety of symptoms that can even include nausea (like pregnancy morning sickness) or rage.  A lucky minority of women have no symptoms at all.  Those with more severe symptoms may worry they are experiencing early onset Alzheimers or feel like they are “going crazy” or “losing it”.  Needless to say, this is no fun at all especially if they do not understand what is happening.  In many ways, menopause is the reverse of puberty.  In puberty, the brain and body is drunk with female hormones, the skin oily and the sleeping is deep and often late into the morning.  In perimenopause, the brain and body are coping with the withdrawal of these same female hormones.  Skin and hair become drier and thinner, and sleep becomes more elusive, with sleeping in only a pipe dream. 

So how does one manage this challenging life transition? Fortunately, biology is not destiny, and like the postpartum period and that week before your period, what you do matters a lot. Basic self care, including exercise, time for self, supportive intimate relationships and time with friends make a huge difference in how a woman fares. Diet also matters, with a bountiful selection of fruits and vegetables, especially leafy greens, providing the body’s precursors for serotonin production, an important hormone to support positive mood. Just knowing that this time of life is biologically challenging can make a huge difference.  Some women will struggle more than others purely because of biological happenstance.  Like during the perinatal period or the monthly cycle, some women’s bodies cope with hormonal fluctuations better than others.  If your body is more sensitive to the hormonal shifts and you find yourself unmanageably depressed or anxious, you may want to consider anti-depressants to help you through this temporary but tricky time.  Some women have also found relief with alternative treatments such as naturopathy or acupuncture.

More and more commonly in the last few decades, perimenopause and menopause arrive in a woman’s life just as her own daughters are heading into puberty.  This can make for a challenging time for all.  But the more support you get and the more you know, the better off you will be.  Psychotherapy can also be helpful in navigating this transition period.  What better way to start a new phase of life than with a guide to help you read the signposts along the way? For more information on how to successfully navigate menopause and  perimenopause, check out either The Silent Passage by Gail Sheehy or The Wisdom of Menopause by Christiane Northrup.

Crib Notes on Being a Good (Enough) Parent

I was 37 years old when I had my first child.  I had wanted to be a parent many years before this, but this was when the stars aligned in my life to make it happen. Before I had children, I imagined the perfect little family with well-loved little ones with whom I was perfectly attuned.  While the well-loved part certainly became true, the perfect attunement was fantasy.  In reality, my husband and I have done our best to prepare our children emotionally and otherwise to eventually leave us, a bittersweet goal at best.  This takes both appropriate boundaries and unconditional love.  Throw in a little good luck and you can watch your children grow into interesting confident and kind young people.  Still there are those occasional hard days. . . . because parenting is not for the weak of heart.

I became a teacher, parent educator and psychotherapist in my pursuit to learn as much as possible about what young people need. I’ve read books and books, some professional, some for parents, and some more helpful than others.  (And some counterproductive because they just make it seem easy which leaves you wondering what you are doing wrong.) After my many years of working with other people’s children and now my 17th year into parenting my own, I offer the following as the most important aspects of parenting well.  (And still there will be those hard hours, days and sometimes even years.)

Send your child out into the world with love and confidence.  Be their cheerleader and delight in their delights and accomplishments. Don’t overpraise but notice deeply what they like and who they are. Welcome them back when they are tired, hungry, defeated or scared with love, comfort and reassurance.  Work on your own stuff, because as much as possible you have to be the steady one, with emotions regulated and the wisdom of having lived longer and seen more about the joys and pitfalls to life. Understand that you will often get the worst of their behaviors because they feel safe with you. Don’t take what they say to you personally (especially when they are teenagers) but set gentle limits so they know there is a basic level of respect that everyone deserves. Treat your children the way you want them to treat you (at least eventually). Punishment will ultimately back fire if you want to grow children who enjoy your company as an adult, and are neither too passive or too aggressive.  Trust that a gentle voice is ultimately more powerful than a raised, angry one. 

Finally, and this is more for you than your child, be gentle with yourself.  The above is all worthwhile doing, but thankfully we don’t have to do any of this perfectly.  At times, we may not be steady and emotionally regulated. (I certainly would not claim that I have always lived up to my aspirations.) The ghosts from the past can occasionally possess us, leading us to make poor choices with our children.  When we do make mistakes, for whatever reason, apologize and then without beating yourself up, assess how you can do better next time. If you are sincere and concerned, your children will always forgive you.  Trust that the bond between yourself and your children is the most powerful tool that you have.  Your children will want to please you most of the time if you have seen them and delighted in them, and loved them enough to say “no” when it was in their best interests. This is both very simple and very hard to do. 

No One Told Me This Post-Baby Marriage Would Be So Hard

“When you have a baby, you set off an explosion in your marriage. And when the dust settles, your marriage is different from what it was.” Nora Ephron

 Among the dirty little secrets that surround new parenthood, relationship conflict with a partner or spouse almost always make the short list, often rising to the very top of the list.  It is not possible to imagine, pre-baby, how much your intimate romantic and sexual relationship could alter so drastically just from the arrival of a 5 to 8 pound bundle of “joy”.  It is equally unfathomable to imagine the amount of work that will be added once baby makes three. Making matters worse , the full story about marriage is rarely told leaving many a mother feeling isolated, like she is the only one struggling in her marriage. Meanwhile, the non-birthing partner, usually dad, is often feeling rejected by the mother, even resentful and jealous of his own progeny. It’s a recipe on both sides for anger, frustration, even rage.

Many mothers complain about being touched out by the end of the day, feeling like sex has become just another chore on the to do list. By far and away the biggest complaint, however, is about the husband/partner not doing their share of the household chores.  It is also usually the mother who does the mental work of the family: keeping track of the doctor’s appointments, and determining the best baby products and baby practices (Are there enough diapers and baby food in the house and what is the best way to carry the baby or put her down for a nap?).  This role often causes tension with the father/partner.  Even when she is not physically exhausted from the endless loads of laundry and feedings, the mother often can’t just relax because even a night out requires someone (usually her) to find and arrange for a babysitter. It is not uncommon for women to  lose power in the relationship after giving birth or adopting because they are no longer earning money outside the house (at least temporarily).  This wouldn’t necessarily be problematic,  but for the value that society puts on making money. The partner may come home from work and ask “What did you do all day?”.  Whether the question is benevolent or not, the mother may believe that keeping a a fussy nap-avoidant baby alive all day has less value than being the family wage earner.  Or the partner may became disproportionately powerful, taking control of the family decisions and finances.

The complaint list for the partner often looks very different. The partner may complain about not having sex, or enough sex. This is often intimately related to emotional closeness.  In short, the (usually) men in question miss the sex but they also miss their partners.  The number two complaint is being shut out of the mother-baby bond.  The partner may desperately want to take care of and bond with the baby, but the mother doesn’t trust her partner and lets him or her know in no uncertain terms that s/he’s not doing it “right”, discouraging the partner from trying at all.

Here are a few tips and suggestions to get through this challenging time when spouses and partners struggle to adjust to their post-baby relationship.

1. Sit down and divvy up the household chores.  Make sure it’s clear who is doing what.  Consider a white board or wall calendar where more urgent chores get listed. Check in regularly, perhaps weekly, to discuss what is working and what is not.  Make sure that one partner isn’t doing more than their fair share of the load. 

2. Don’t be a gatekeeper for access to the baby even if you feel that you would provide better care than your partner. Sometimes we have to let our partners struggle or just caretake differently from us.

3. Find ways to be intimate whether that includes sex or not. Schedule regular dates and times for hanging out with each other with and without clothes on. Don’t expect spontaneity and a burning sexual desire to get you through.  Establishing an emotional connection by holding hands or leaning into each other.  If need be, schedule sex.  You may be pleasantly surprised that it’s not actually such a chore after all. (And don’t be afraid to ask the partner to arrange for the babysitter.)

4. Ask for what you need and prioritize self-care before you’re burning with resentment and rage. No one can continually give from an empty well without withering.  Don’t expect people to read your mind.  Take time every week to exercise, socialize with adults or just be alone and do nothing. 

5. Respect each other’s roles and jobs.  You’re probably both working harder than you ever have in your life.  Don’t equate bringing home a paycheck (or a larger paycheck) with who gets more power in the relationship.  If you believe that your stay-at-home spouse isn’t working as hard as you, try caring for the baby for a week to experience first-hand how challenging it can be.

6.  Communicate, communicate, communicate.  Relationships, by definition, include occasional conflicts, and everyone needs to know to how to deal with them. Your partner may not realize that you want him or her to take care of bottles in the sink WITHOUT being asked.. You may not realize that your partners feelings are hurt when you take the baby every time s/he cries..  One way to start a difficult conversation is  “The story that I’m telling myself (about this situation) is. . . . “ Use “I” statements and be concrete in what changes you need to see. In turn, be a good listener and try to hear the story from your partner’s perspective.

Why Trauma is so, well, Traumatizing (and what we can do about it)

Triggering.  It’s a word that gets thrown around a lot these days. You hear it in relation to trigger alerts on college campuses. You also certainly hear it in relation to rape, war and child abuse. But despite it being more commonly known than in the past, most people don’t really understand what it is or what it is like to experience trauma. 

For those suffering from trauma, whether a single-incident trauma like a car accident or childbirth, or more pervasive childhood trauma, it is disorienting at best and crazy-making at worst.  It can lead to lost weekends of binge drinking, with marriages destroyed and jobs lost. To understand trauma, you have to understand a little bit about the brain.

It all starts with the flight/fight response.  When we are in danger, our capacity to think, including planning, analyzing and seeing the bigger picture rapidly goes out the window.  We have gone into survival mode. Blood flows out of our brains into our heart, arms and legs, literally preparing us to run or fight.  A more primitive part of the brain, the amygdala, kicks in. This part of the brain is the emotional memory center of the brain.  It is also the brain’s smoke alarm.  The amygdala has memories, but not storied memories with a beginning, middle and end.  In fact, the amygdala doesn’t even have words, or a sense of time.  So, when the amygdala gets activated which it does in fight/flight, it does so with extremely strong emotions propelling the person into unreflective action mode, or in even more severe circumstances, into deer-in-headlights freeze mode.  The amygdala is also hyperalert after trauma, activating often whenever there is a sensory event even vaguely similar to a sight, sound, smell or body sensation from the trauma.  When the amydala is activated is does so with a feeling of immediacy as if the traumatic event were happening right now all over again.  Shards of sensory memories  like visual flashbacks or bodily sensations roar to the forefront of consciousness along with such traumatic beliefs as “I am in danger” and “It is all my fault”.  Making this all the more confusing and discomfiting, these sensations are completely disconnected from the actual, fuller trauma, and may not even be recognized as traumatic.  Instead, the person often thinks they are just losing it. This is a trigger, and it’s not remotely fun.

The big “T” traumas like rape, child abuse or on the battlefield often result in nightmares, high startle response, emotional dysregulation and a pulling away from various reminders of the trauma in the world at large in attempts to avoid them.  But small “t” traumas like ongoing verbal abuse also pay a very heavy toll.  These kinds of trauma often escape under the radar for even being traumatic, partly because they are woven into the person’s model of the world and partly because there isn’t a single dramatic event to look to and so, “Yes, this is trauma”.  Both types of trauma are, well, traumatizing, and create low self-worth, high guilt, an inability to regulate emotions, feelings of lack of safety, and the inability to just go about your day in relative peace and calm. I personally, have been affected by the lower “t” kind of trauma, and understand how being triggered feels like the “truth” instead of a body memory of the past.  I am also grateful that effective help is now available.

Women, even more than men have been disproportionately affected by trauma.  While most survivors of war trauma are men, a greater majority of women have suffered from abuse at the hands of others, largely, but certainly not exclusively, family members ranging from parents to partners to siblings, coaches and teachers, and, yes, even health care providers.  Women also suffer trauma from childbirth, usually when there are birth complications and the mother does not receive the emotional support that she needs during this challenging time. Regardless of gender, trauma causes great suffering as the ability of the brain to cope with stress is overloaded, and then later struggles but fails to recover from the assaultive stress.

Fortunately, there are effective trauma treatments available now.  This was not always the case, even as recently as 20 years ago.  But now, researchers and clinicians understand how the brain works, and what the brain needs to reright (and rewrite) itself into health. Individual and group therapies have both proven effective in providing the raw materials needed to nudge the brain towards its own self healing. Usually, treatment involves some form of telling a more healing story about the trauma as well as a desensitization and reprocessing of the trauma event in the brain.

If you have suffered from any kind of trauma, I hope that you seek the help that you need and deserve.  Life is brighter without the lens of trauma clouding your life.  It’s like the scene from the Wizard of Oz when the picture goes from black and white to living color.  And what a difference that makes!

A Mother's Self-Compassion (or You are Perfectly Imperfect)

It can happen to anyone. We make a mistake and we get down on ourselves. We say things like “I should have known better,” or worse yet, “I’m so stupid.  I always make the worse decisions.” Regardless of the exact words we say to ourselves, making a mistake or not predicting a left turn in our lives can send us spiraling into self-doubt, self-criticism and create or contribute to already existing depression and anxiety.  But it doesn’t have to be this way.  What if, instead of treating ourselves harsher than we treat others, we spoke to ourselves with compassion, like we often do to our friends?  What if instead of saying, “You always goof up” you pretended you were talking to a good friend and said something like, “You did the best you could” or “It’s normal to make a mistake.” How would that feel?  Do you now have a little more energy to solve the problem instead of stewing in your own juices?

If talking more kindly to yourself seems impossible, you may want to consider joining a support group or seeing a therapist to help you figure out the blockage.  A good general book on the subject of self-compassion is aptly named Self-Compassion by Kristen Neff.  

Framing the issue of being hard on ourselves is a broader, societal issue of motherhood and perfectionism.  Since even before we were aware of it, many of us were socialized to not just be a good mother, but to be a perfect one. Aside from the expectation of looking our best and never getting angry, we expect ourselves as mothers to always feed our children healthy food, provide them with the latest educational toys and classes, and be available 24/7 as willing and happy playmates. And the list goes on.  So the next time you find yourself beating yourself up about a mistake, please try to remember that as women and mothers we don’t have to perfect.  Good enough is, well, good enough!

Shame: It Isn't What You Think It Is

Shame.  It’s a relational emotion (meaning one that develops as a result of interactions between two people) that comes on line when where we’re about 18 months old.  No baby is ever born feeling bad about herself because she is incapable of feeling shame.  Shame can be described as ingesting whole cloth the negative reactions of loved ones.  Unlike guilt, which is an emotion that we feel when we've harmed someone, shame is experienced as who we are. A little bit of shame in appropriately small doses is a common and adaptive occurrence.  For instance, a parent tells a child in front of her friend to clean up her mess.  The child feels a little embarrassed and responds by doing as requested.  The mother praises the child for her compliance and all is well.  Unfortunately, the scene is not always so benign.  As children we learn to see ourselves based on the mirror that our parents reflect back to us. They teach us who we are and, most importantly, whether or not we are worthy.  If the parent feels unworthy him or herself, then that message of less than will likely pass down to the child often even without the parent’s awareness.  In its more extreme forms, shame mutates from an appropriate regulator of behavior to a one of the most painful emotions that humans experience.

Children are so vulnerable for such a long time.  They depend on the big people in their lives to literally keep them alive and safe, putting food on their plate and clothes on their back. Without much power or control, children often depend on the survival strategies of compliance and submission.  This is especially true if the parents are emotionally or physically abusive or abusing substances.  But children are even more often shamed by ordinary, ongoing put-downs and parental blaming and yelling. 

Counter-intuitive to our knee-jerk perspective, the shame a child feels, while painful, is often highly adaptive.  Just think about it for a moment.  What happens when you feel shame? Do you get bigger or smaller? Do you speak up more or shrink back into silence? Do you feel more confident or less?  Now, you are probably still wondering how this relates to a survival strategy, so hang in there for a moment.  Think about what happens when you get smaller, quieter and less confident.  Have you become less threatening to the other person?  Are you flying under the radar and doing damage control, reducing the likelihood of being abused or belittled by the other person?  Compliance is a fantastic strategy for a relatively powerless child to survive to the next day.  And that is all that really matters when one is in survival mode.

 Let’s do an experiment.  Sit in a chair in a relaxed position.  Go ahead, no one is looking. Bow your head and get small.  Stay in that position for a moment and notice how you feel.  Are you closer to feeling powerful or powerless?  Are you feeling shame? Now slowly and gently unfurl your spine at little at a time. How is that?  Do you notice any difference? Pull your shoulders towards your ears then let go, with your upper back down but relaxed.  Now how do you feel?  I’m guessing you feel better than before.

So how does this all relate to shame?  Shame is a body experience as much as it is an emotion.  We automatically go into the shame position (think of a chastised dog) whenever we feel shame.  When we are powerless as children, our bodies go into shame as a damage control strategy.  Now here’s the hardest part about shame.  Shame is just an emotion but we often don’t experience it that way.  Instead, we experience it as who we are.  Think about that for a moment.  When shame comes on line and takes over, we are the shame, and we have always been the shame.  It doesn’t get more painful than that. And if we’ve been shamed from childhood constantly or if we’ve been traumatized in any way, shame will kick in and tell us it was our fault or that we aren’t any good or we are less than others.  Now, this strategy of feeling bad about ourselves wouldn’t work if we didn’t really buy into the belief.  If our body didn’t conform to the position of shame.  So we do and it does. And at least as children or trauma survivors (or both), we’ve maximized limiting damage of the external harm with the unfortunately steep price of not feeling worthy and/or feeling everything is our fault.  But we have survived to live another day.  And that is a true victory!

Unfortunately, this strategy doesn’t work as well for us once we’re older and not in danger anymore.  The danger may have passed but the body experience and the feelings and beliefs do not.  Trauma can be described as the past being misplaced whole cloth onto the present.  That is what shame is once we’re grownups.  Shame also helps us avoid a terrible reality about an abusive childhood or any trauma.  We are not in control of ourselves or our safety.  It is easier to blame ourselves thinking we are the problem, than realize that we truly aren’t (or weren’t) safe, and that the problem lies with the other person who lacks the ability (for whatever reason) to make us feel valued and protected.

I’m no stranger to shame myself.  Intergenerational trauma passed from one generation to next certainly had reverberations in my own family’s life when I was a child.  I remember thinking when I was young that others were just better than me.  I couldn’t explain why but I certainly felt it deeply.  It just was.  And yet, now I know this was not true. The price that I paid for shame’s help was not being as happy as I might have been, but survival always comes first and foremost.  To this day, a younger part of myself will occasionally get triggered and forgets that the shame is just a survival strategy or adaptation to being powerless in an unsafe environment; it isn’t the truth.  The good news is that once you know shame’s m.o., you can help your younger self remember this.  You can take that younger shame part under your wing, and become unblended with it and move back into your wise adult self. 

For anyone who has experienced chronic shame, you know this is not an especially easy thing to do and no small matter either.  It can make the difference in whether or not we find happiness in relationships.  Or finding contentment and peace in our perfectly imperfect lives.

If you struggle with shame, I invite you to engage your wise self to notice how shame functions in your life.  Start seeing shame not as who you are but as a strategy from the past that helped you to survive.  This may be difficult or impossible to accomplish on your own.  I encourage you to talk to trusting others about it or even seek a support group or therapist if need be.  If you are currently not safe (domestic violence etc.), you need to get safe first and foremost.  Only then can you start to see shame for what it really is.

Suffering in Plain Sight

I wanted to be a mother since I was a child.  I remember playing house (and mother) on the empty lot that eventually became the home that I grew up in. It took a long time to realize that dream of parenthood.  When I finally became pregnant in my mid-30’s, I was ecstatic. While I did not suffer from full-blown mood complications, I do remember very clearly experiencing an anxiety that was new and all-encompassing.  I worried about my baby dying of SIDS, or rolling off the changing table.  I felt like I had to hold her constantly in my arms fearing that if I didn't, she would not feel secure.  And the big mother of them all - I worried about me being a good enough mother. I remember family members noticing and commenting on my increased anxiety.   I did not know at the time that the emotional alarm system in my brain, my amygdala, was on hyperalert. This is true for all new mothers in the first two months of a baby's life.  I didn't think to talk to anybody about my fears.  I didn't realize that they were typical.  I wish I had because I think it would have helped. I didn't quite realize how vulnerable that first year after give birth is for all new mothers.

I was ready and willing to bleed myself dry (literally and figuratively) if that’s what it took to make my child feel loved and valued. (I didn’t know how much was enough so I decided to err on the side of giving and then giving more.)  I survived on less sleep than I thought possible. I nursed day and night and day again, feeling sometimes more cow than human. 

In the first year of my daughter's birth, I was fascinated with this whole transition to motherhood.  I read book after book about child development and the changes that women go through as they transition their identity up the generational chain from daughter to mother.  I was already a psychotherapist but did not return to work in this capacity for a while. I did not want to be separated from my daughter and I also did not feel like I had enough left over to give to my clients. I attended an intensive conference on perinatal mood complications and loved it, and simultaneously felt frustrated that I couldn’t put any of it to use just yet.

 As my children grew older, I eventually returned to work as a psychotherapist. (In the mean time, I had been doing part-time work as a parent educator and loving it.) I’d never forgotten my interest in the perinatal period, and so I begin to work with new mothers.  I am struck over and over again by the both the resilience and the pain that these women carry as they walk into my office. They come in smiling and confident, and are often in tears the moment I ask them how bad they really feel. They often do not understand what is happening to them, nearly all stating they no longer know who they are. They blame themselves for their struggles, wondering if they made a mistake becoming a mom, or worse. Some come from other therapists or doctors having been told they are not safe to be alone with their baby or worried about their literal sanity.  (This is only true with psychosis which is extremely rare.)

It is an honor and a privilege to be part of this great sorority called motherhood and to be a guide for those still finding their balance.  As a perinatal therapist, I focus on the practical matters at the beginning: sleep, social support, exercise, and possibly medication.  I instill hope that my mothers can feel better (truly believing that they can). Sometimes the hardest thing they often need to learn is to ask for and accept help instead of being the one to give it.

Aside from being a mother, I never really knew what I wanted to do when I grew up.  Now I do.