Fragile but Resilient

A couple weeks ago I was doing something I’ve done thousands of times in my life, walking on wet grass. This time though, I slipped and managed to turn my ankle in a very painful way as I went down. I knew from the pain and nausea that set in that this was no ordinary ankle twist. Later, an orthopedic surgeon would confirm that my MRI showed torn ligaments and tendons (that sounds more serious than “ankle sprain,” right?). With strict orders to keep weight off my left foot and outfitted with ergonomic crutches, I was about to find out just how much I took the ability to walk for granted. 

It’s a small thing, in the scope of all the possible things that could happen, but this limited mobility had an immediate effect on my life; I couldn’t see clients in my 3rd floor walk-up office, I couldn’t drop my kids off at school, I couldn’t even carry a plate to the table at dinner time because my hands were full of crutches! I had to depend on my husband for most everything and accept that my life was going to be seriously interrupted for a few weeks. 

I’ve been lucky, and three weeks out have been able to ditch the crutches and walk on my own, albeit with a limp. Resilient. But I’ve been reminded by my doctor and physical therapist that I’m still healing and shouldn’t push myself too quickly or I’ll end up re-injured. Fragile. 

This whole process has reminded me that as humans we go about most of life out of touch with our fragility. Because generally we tend to be so resilient we forget that all it takes is a simple misstep and then everything changes. I mean think of how often things go so remarkably right! We drive without crashing, we eat without choking, and on and on. 

Current COVID events have reminded us of our fragility. We’ve entered this world in which it isn’t safe to go to work, get on a bus, attend a concert, etc, etc. And yet, we’re reminded that about 80% of people with this illness have only mild symptoms. So are we fragile, or are we resilient? 

The answer, of course, is both. Most of the time we are amazingly resilient. We walk and don’t fall down, we pick up a virus and fight it off within days. And sometimes, not so much. It’s difficult to be with the reality that we are all fragile beings. I think that’s why there’s a national shortage of hand sanitizer and Chlorox wipes! We want to be in control, to arm ourselves against fragility. And maybe that helps us manage a bit better psychologically, but it doesn’t erase our vulnerability. 

So, as I struggle to patiently wait until I’m strong enough to go on a little hike, I invite you to also be gentle with yourselves during this uncertain time. Yes, we all feel fragile and scared right now. But we are also so, so resilient. 

Leading with Vulnerability: a technique for couples in conflict

I work with a lot of couples who cite communication problems as their chief complaint. “We just can’t seem to talk to each other” and “He doesn’t listen to me” are common refrains. Certainly, this is a real issue and some progress can be made in learning more effective ways to communicate with one another, especially when it comes to feelings. We practice using I statements, not blaming or being defensive, but the most effective, and perhaps the most difficult technique is what I refer to as leading with vulnerability.

I was actually a bit surprised when I looked up the wiki definition of vulnerability: "Vulnerability" derives from the Latin word vulnerare (to be wounded) and describes the potential to be harmed physically and/or psychologically. Vulnerability is often understood as the counterpart of resilience

To be wounded! No wonder we humans are so quick to resist being vulnerable with one another. No one wants to be wounded, and yet . . . we must risk being wounded in order to grow and experience deeper connection. And as the definition points out, the result of risking vulnerability, or it’s “counterpart” is resilience. So showing up with our feelings and sharing them will actually make us stronger! That is a concept I wish everyone could really get.

So, what do I mean when I tell couples to lead with vulnerability? What I’m trying to get at is that when talking, and especially when talking about something difficult, start with your own emotions. Here’s an example of how one might typically bring up a common issue versus how to do it by leading with vulnerability:

Typical statement:

“Why do you always leave your dirty dishes in the sink? Don’t you think I have better things to do than clean up after you?”

Leading with vulnerability:

“I feel really frustrated when I see your dishes in the sink. It makes me worried that you don’t respect my time.”

See the difference? The first statement invites defensiveness by focusing squarely on the partner (notice the overuse of “you”). The second statement shifts the focus to I/me and makes the emotions of the speaker the point rather than the behavior of the partner.

You can probably see why this might feel vulnerable. Rather than focusing on your partner’s behavior, which you might feel quite justified in doing, you have to stop and ask yourself, “how does this make ME feel?” And in asking that question you might come face to face with some uncomfortable feelings; fear, anger, sadness. These tend to be the feelings we all would rather avoid. But unfortunately, avoiding feelings doesn’t actually make them go away.

And that’s just the beginning of the vulnerability! Because when we are honest with our partners about our deepest feelings, we risk being hurt, maybe even rejected, by them. There is a chance they will say something along the lines of “well so what? I don’t really care that you feel frustrated.” And that would indeed be wounding.

Most of the time, however, offering up your own vulnerability makes it possible for your partner to do the same. Sharing your feelings touches your partner’s heart, and that actually makes them feel safe to share their own true feelings. So instead of the dirty dish fight ending in more accusations and emotional withdrawal, it might go something like this:

Partner: “I didn’t realize my dirty dishes bothered you so much. I definitely do respect your time and I will try harder to remember to clean up after myself so that you don’t feel that way.”

Maybe it sounds like a fairytale ending, but I think it might be worth a shot. After all, according to wikipedia, practicing vulnerability will make you stronger!

Maternal Mental Health Movie Review: Tully (SPOILER ALERT!)

May 17, 2018 by Jamie

Have you heard about the newly released film, Tully, that women are raving is finally an accurate description of motherhood? If you haven’t yet seen it, but plan to, stop reading now. I repeat, SPOILER ALERT to follow!

Well, I was originally very excited to see it, then read some not-so-rave reviews, but ultimately decided to was my duty to evaluate it for myself.

Based on some of the reviews I read (see motherly and huffington post), my main concern was about how accurately, or inaccurately, Postpartum Depression is depicted in the film. Aside from the initial portrayal of mom, Marlowe, as being sleep deprived, irritable, and barely functional post-birth, the film lacked a true view into what PPD looks like. For the 70-80% of women who experience the more common period of “baby blues,” usually ending two weeks postpartum, that initial depiction of Marlowe probably really resonates. Indeed, “baby blues” are marked by a sense of weepiness, fatigue, irritability, and brain fogginess, largely caused by the massive hormonal shift that’s just occurred and amplified by lack of sleep.

PPD, on the other hand, persists past that important two week mark, and although is similar in symptomology, is much more intense in severity. A mother struggling with PPD may also have trouble bonding with her baby, feel an intense sense of isolation and inadequacy, and have trouble sleeping even when baby is sleeping fine.

Unfortunately, Tully doesn’t really show us that struggle. Instead, the movie-goer sees a new mom seem to get better as she gets more sleep and support after hiring a night nanny. She seems happier, more engaged with her children, and just generally better able to cope. That is not what PPD looks like, yet that is the diagnosis given to Marlowe at the film’s conclusion. What the viewer realizes, after an accident that lands her in the hospital, is that Marlowe has completely imagined (read: hallucinated!) this night nanny. Sorry folks, but hallucinations are a sure sign of postpartum psychosis, not depression. Like PPD, postpartum psychosis is a very serious illness, but is much less common than PPD. The inaccurate diagnosis and depiction of proper mental health treatment is, at best, irresponsible, and at worst, outright dangerous to women who might be suffering from either.

It did strike me though, that within Marlowe’s struggle is a yearning that I imagine most new mothers feel. A desire for connection to someone who is supportive and understanding, a nostalgia for the “pre-mom” woman that is no more. You see, in imagining Tully, Marlowe was giving herself both a support system and a connection to a part of herself that felt lost. Remember that 20-something party girl that had life all figured out? Yeah, sometimes reawakening her spirit can be therapeutic. But healthier still would be asking your support system for more help, and perhaps joining some kind of mom community where you can share these complex feelings and very real struggles.

My hope is that Tully opens a dialogue about maternal mental health, and encourages women – whatever their particular symptoms are – to seek help without fear of judgement. Determining a particular postpartum disorder should be left to professionals (not screen writers), but every mother should know that she’s not alone, and help is available.

*If you or someone you know might be suffering from a postpartum disorder, please reach out for help by calling me at 415-255-2502 or the the Postpartum Support helpline at 1-800-944-4773.

The Serenity Prayer

May 22, 2014 by Jamie

“God, grant me to have the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

I first heard this prayer in my early years as a therapist while working at a recovery center. It is a popular saying in Alcoholics Anonymous, but I find myself thinking of it often and it certainly pertains to those outside the AA circle as well.

I’d like to focus on that powerful first line: Grant me the serenity to accept the things I cannot change. I love the reminder that (of course!) there are things in life we cannot change. This is a hard one for some people. In our fast-paced, do everything society, it can be difficult to know that there are actually things in our lives outside of our own control. And as AA reminds us we cannot control people, places or things. That covers a lot! Actually, the only thing we truly can control is ourselves. Our own actions, choices, and most profoundly, our reactions to all those things we can’t control. Oh, you might be thinking, “but of course I can control things in my life! I can control my career path or (insert whatever you believe to have control over in your life)!” Well, to some extent I suppose you can. You can control the choices you make that influence the direction of your career (or whatever that something is), but can you control the outcome? Not entirely. And that is where the serenity comes in.

Serenity is defined as the state of being calm, peaceful, and untroubled. Sound hard to do? Indeed. Trying to find that peaceful state of mind when you don’t get the promotion you worked so hard for, or your kid gets sick, or your husband tells you he wants a divorce, is to say the least hard. People in AA are encouraged to repeat the prayer as a way of gaining serenity. Maybe prayer doesn’t work for you, but a mantra might. Serenity, serenity, serenity. Or some deep breaths. Maybe you can find serenity in nature, or a yoga class, or a bubble bath. But find it you should, because you will surely need it at some point. Or if you’re like me, every day.

Surviving the season: Dealing with grief over the holidays

December 9, 2016 by Jamie

Sleigh bells ring, are you listening?

Or are you cringing? The holidays are upon us and along with the fervent shopping, singing of carols, and drinking of eggnog often come feelings of loneliness and grief. For many people the holiday season is fraught with anxiety, frustration and sadness. I see many people in my practice who dread December as others might dread a root canal. For some, it’s the financial pressure to buy the biggest and best gifts. For others the stress of traveling across the country and dealing with difficult family members is enough to put them over the edge. But the issue that cuts the deepest is probably revisiting the loss of a loved one over the holiday season.

This reawakening of grief makes sense. After all, Christmas, Hanukkah, Kwanzaa, or whatever you celebrate are traditionally times spent with family and loved ones. Precious memories are created during these special times and familial rituals are observed. These are often peoples’ warmest and happiest memories from childhood. But that can change dramatically after the death of a loved one. These same remembrances become rude reminders of what was and cannot be any more.

Clients talk about missing their loved ones more than usual this time of year. It’s partially those memories that create pain, but also the uncertainty of knowing how to celebrate in the midst of sadness. For some, this might bring up feelings of guilt, particularly guilt about living while a loved one no longer has the opportunity to enjoy the festivity of the season. This can be most cutting when the loved one was especially fond of this time of year. Others experience anger that they can’t share in old traditions with the departed. Confusion abounds as you try to navigate all these feelings, while also living in the chaos of holiday shopping and glitzy parties, making conversation with others who just seem merry and bright.

Whatever complicated feelings you might be experiencing this holiday season, try not to deny those emotional states. Make room for your sadness, anger, disappointment, or fear, and don’t judge yourself for having those feelings. Try talking with a close friend or therapist about what’s going on, or write about it in a journal. If you don’t make room for these complex emotions it’s possible that they will overwhelm you at a less than convenient time. Perhaps you’ve seen such a scene at an office holiday party? You don’t want to be that guy!

While you’re doing well to make space for your feelings, also realize that you don’t need to exacerbate your emotional state. There is sometimes a fine line between allowing and wallowing. It won’t serve you to to repeatedly revisit the same painful memories, perhaps complete with sad playlist and bottle of wine. Allow for the feelings to come up, acknowledge them, but then move on.

After you’ve processed memories and feelings, make it a point to do something to honor your loved one. This might mean making a donation to one of their favorite causes, doing some meaningful volunteer work, or participating in an activity they especially loved. Whatever you choose to do, do it with the intention of remembering your loved one and think of it as your “gift” to them.

Mothering Boys: Unlearning White Male Privilege

December 9, 2016 by Jamie

I didn’t really expect to be the mother of boys. I minored in Women’s Studies, and always imagined myself raising little feminist daughters. It didn’t work out that way. I have two wonderful little boys and trust that the universe brought these particular people into my life for a reason. But, I feel a bit out of my element at times and was reminded of yet another boy-related challenge recently while sitting with a client. As she recounted an experience of being minimized because of her gender, a question began to plague me. “How do I make sure my boys don’t become men like that?”

As a female, I have had my share of experiences demonstrating gender bias. Like most women, I’ve been objectified for my body, belittled for having feelings, and made to feel less than intelligent because I’m a woman. I know not all men are guilty of these behaviors. But, as a mother of 2 young boys I’m beginning to think about this issue from a different perspective. It is sobering to realize that it is my responsibility to raise these boys to be respectful, kind members of society. By virtue of their birth as male and white they will benefit in myriad ways that minorities don’t experience. I may not agree with this, and I can’t change the world we live in, but what I can do is raise them to recognize this bias, and not to take advantage of their status. As I consider the type of men I want my boys to become, I’m focusing on the following tenets; and while they obviously are true for girls as much as for boys, I believe emphasizing these principles in males in particular can only stand to benefit our world.

Teach kindness. This is more than just being nice. merriam-webster.com defines kindness as “the quality or state of being gentle and considerate.” It means actually taking into account the effect one’s words and actions have on others. It means teaching empathy. When my son says something hurtful, I point out the impact of his words; “Look at my face, what you said makes Mommy feel sad.” I want my little men to understand that what they do and say impacts others. I’d like them to consider their words before they speak, and to choose words that lift others up rather than bringing them down.

Demonstrate respect for other peoples’ bodies and boundaries. Since the birth of my second son a common refrain in our house has been “keep your hands to yourself” and “give your brother some space.” While it may look cute to see my boys cuddling together, I also see that at times my baby is not so keen on being mauled by his older brother. Teaching personal space and boundaries now will someday translate to the more adult concept of consent. It is imperative that my boys learn that it is never ok to touch someone else without their explicit permission.

Reign in aggressive behavior. Without getting into all the complex reasons, it’s pretty clear that aggressive behavior is a more inherently male trait than a female one. We observe it in crime statistics, but also on the playground. Boys just tend more toward rough-and-tumble type play. It may also be more tolerated in the male gender, as illustrated by that irritating phrase, “Boys will be boys.” As the mother of a boy who does play aggressively, I refuse to buy into this notion. It may seem repetitive, but every time my son pushes, hits or kicks, I have to intervene, explain why it is wrong to hurt others, and demonstrate the consequences of behaving in an aggressive way.

Respect differences. My son is at that age where he is perfectly comfortable announcing (loudly, to anyone who will listen) everything he observes. If he notices someone who looks

different than him you can be sure he will call attention to it. While this can be awkward, it’s important to move toward these observations. I don’t want to pretend that differences don’t exist, which implicitly suggests that they aren’t ok. I’d like to model to my sons that we can acknowledge and accept differences of all kinds, and to see that as part of what makes our world so vibrant.

They may be white and they may be male, but if I have anything to do with it my sons will not be entitled. As they grow older and the lessons become more complex, my hope is that I can continue to model to them the behavior I’d like them to exhibit and that our family fosters an environment of openness and acceptance.