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Archive for the ‘Psychotherapy’ Category

What are you Waiting For? Limbo vs. the Meantime.

Posted in Cultural Context, General Identity, Loss, Psychotherapy, School Stress, Therapist as Mom, tagged , , , , , , on October 1, 2012| Leave a Comment »

“I’m waiting to hear.”

“I’m waiting to find out.”

“We were hoping to close before the end of the month but the buyers are stalling.”

“The doctor thinks it’s benign but we won’t have the results for another day or two.”

“My son applied to sixteen colleges.  We won’t hear until February.”

What are you waiting for?  I can’t shop until I know their schedules.  I can’t revise until I’ve gotten feedback.  Hear that message?   I can’t do X until another person does Y.   I’m in Limbo.  You’ve probably said that to someone recently.  If not, I’m sure you’ve heard it.

Webster’s defines Limbo (the secular definition) as “… an intermediate or transitional place or state … of uncertainty.”

Limbo is a hard place to be.  Your life has been hijacked; everything is on hold, your eyes fixed on the uncertain future.  You’re a prisoner to the whims of others.  Checking your voicemail, the mailbox, the email, again, and again.  It can be a recipe for anxiety, irritability, and depression.  But guess what?  Limbo doesn’t own you.  You can choose to be free.

I know a woman who has survived cancer, bravely enduring the diagnosis and the painful, sickening rigors of treatment.  Then more treatment to make sure the first treatment really worked.    Then more tests and continued monitoring.  The waiting is never over for her, but somehow she refuses to see it that way.   “I can’t live my life in fear of the future.”  She has children who need her now; she has a husband, and a job, now.   She takes pleasure in her family and her garden, in beautiful weather and in rain, in cooking and in reading.  She gets scared sometimes, sad sometimes, and frustrated with people who try to make her dwell on illness when she’s focused on health.  But mostly she lives now, surrounded by people who love her, who appreciate her joie de vivre and who join her in the seizing of each day.  She’s grown strong on the love of life, exchanging hats for headbands, losing the headbands as hair grows back in.   Maybe one day it will be gone again, but now is what matters, her children and husband and friends.  The little things, like a phone call or an email that hasn’t come yet, some editor’s elusive approval—these wouldn’t faze her.  She may yet have all the time in the world, but she won’t waste a minute of it in Limbo.

Personally, I try my best to learn from this and I’m getting better.   When I start to get anxious and hyper-focused on the future—on the parts I have no control over (whether whether I can make a feuding couple hear one another, whether my daughter will make friends in middle school)—I do a few things:

  • I sing.  In the shower, in the car, with my kids:   show tunes, the Beatles, Queen, Journey, Katie Perry, Taylor Swift, The Little Mermaid … anything.  Just sing.  It feels good, and I actually read a study once that found singing enhances your mood.
  • I treat myself as if I were my own client.  I nurture myself, reality check, point out my own strengths or the strengths of my kids if it’s their uncertain futures I’m worrying about.
  • I breathe—like a yogi.  Full disclosure: I don’t do yoga, (the only reason being the time; if I have it to spare I’ll dance, which I never get to do enough).  However, a yogi friend of my husband’s taught him a series of deep breathing exercises, which he taught me.   And though this is third hand stuff, the deep breathing really does help get me out of future-panic mode and back into the moment, the present.
  • I read.
  • I connect with people I love and miss.  You know—the ones you’re too busy and angst-ridden to see?  Hearing about their lives takes you out of your own.   Cheer them on, console them if they need it, share yourself, laugh together.  Be in the moment together.
  • I think  about my mom, how she worries about me and my family just because we’re her children—how silly I think she is for doing it. Everything is going to be fine, Mom, it really is.  And saying it to      her, I believe it.
  • I play with my kids.  Because they are the moment.
  • I hang out with my husband (oh yeah—him!)

These things are the opposite of Limbo:  they are how I make the most of the meantime.

When my father was dying, when my mother and I knew it would be soon, we were in a very trying kind of limbo.

“It’ll be any day now,” said the visiting nurse.  Any day now seemed like a pretty big margin of error.   In any case, we were in a holding pattern, as my mother described it.  We didn’t want to go too far or commit to anything.  We were determined to be with Dad when he passed.  The waiting went on for two whole weeks.

Then, the night before he died, my mother and I watched a movie together on the small TV set in the living room.  Though it wasn’t a comedy, the relief of doing something besides wait got the better of us and soon, we were both in stitches, enjoying each other, enjoying this small piece of life, though my father was leaving us gradually in the other room.

We hadn’t abandoned him; he was in the care of a nurse who’d get us as soon as we were needed.  But during those two hours, we were free from Limbo, making the most of something beautiful in the meantime … life.

What about you?  When you find yourself in a holding pattern, what do you do to celebrate “the meantime?”

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The Empathy Mantra and How it Can Save Your Marriage

Posted in Couples Therapy, Cultural Context, General Identity, Marriage, Psychotherapy, tagged , , , , , , on August 23, 2012| 3 Comments »

The following is a story of a fictitious couple, Ken and Kendra, and their baby, Max.  For now, since Kendra has opted to stay home with the baby, the spouses have found themselves in traditional gender roles for the first time in their marriage.

Kendra’s life changed drastically when the baby was born—her body, her career path, all her relationships with friends and family. Ken’s life changed too—but not as much.  His work is the same; his body is the same; his schedule is the same.  Actually, what’s changed the most for Ken is Kendra herself.  She’s tired, short-tempered and so focused on Max, she barely notices her husband at all.   Ken and Kendra might sound like people you know well.  I’ve worked with many couples struggling with the same issues: loving couples who turn into adversaries when they become parents.  Marriages where empathy has eroded.

The late Jeremy Blanton, a former ballet mentor who, when teaching a pas de deux (a partnered dance for a man and woman), used to instruct both partners to take full responsibility for anything that went wrong in a lift or another dance sequence—no matter what.  Even if the guy dropped the girl, both of you had to say, “I’m sorry.”  Only then were we aloud to fix the problem.  It’s all about empathy: a leap of faith that allows you to consider the other person’s side, rather than blame him.  So often, I’ve wished I could wave a magic wand and inject empathy into a relationship where it’s missing and desperately needed.  I’m not magic, so, inspired by Mr. Blanton, I came up with the mantra: Your day was just as hard as my day.

So here’s the scenario:

It’s been a long day for Ken: meeting after meeting, inbox filling up by the minute, unrealistic expectations from management, difficult clients.  But now he’s home, ready to unwind.  As soon as the front door shuts behind him, his wife Kendra appears, covered with spit-up and dried sweet-potato puree, holding a squalling Baby Max.

“Here,” she says with an exhausted sigh.  “You take him,” surrenders the baby and vanishes before Ken’s even got his coat off.

Bouncing the baby (who’s squalling harder still, in light of Mommy‘s disappearance), Ken takes in the scene around him.  The house is a mess: board books everywhere; stained burp cloths, plush caterpillars, ducks and fish strewn all over the living room; table covered with parenting books, magazines, breast pump paraphernalia and unopened mail.  Ken sniffs the air, picking up primarily Max and all that he entails—both good and bad.  The one smell that’s conspicuously absent is that of dinner.   Annoyed, Ken turns toward the bedroom, into which his wife has disappeared.

“Look at this place, Kendra,” he says.  “What did you even do all day?”

Back in a flash, Kendra snaps:

“I’ll tell you what I didn’t do.  Spend the day at some cushy office in the city, talking to grown-ups, sitting down to eat actual food at lunch time.  You really want to know how I spent my day?”

Kendra’s furious, but she hesitates.   In fact, part of her frustration is that she can’t articulate how she spends her days.   She’s been up with Max for the past few nights, so it’s not even clear when today began.  Between nursing every few hours, trying to burp the baby, play with him, stimulate him, bathe him, get him to nap and generally interact with him in all the ways the books suggest, the hours slipped away.

Before Max was born, Kendra worked full-time in the city with hours and income similar to Ken’s.   The phrase “home with the baby” had sounded like a marvelous dream.  When friends with children warned her about the unappreciated work, the sleep deprivation, the general loss of autonomy, Kendra secretly believed she’d do a better job of handling it.  How hard could staying at home be?

Now, Kendra’s barely able to get enough distance from the baby to take a shower every day.   She’s so tired, she can’t even begin a “to do” list.  The hardest part is that she can’t make Ken understand why she’s overwhelmed.   Her resentment toward him is growing; lately their whole relationship feels like a competition to see who’s more put upon and miserable.

Now, imagine that Ken and Kendra find the time to go to couple’s therapy, where they are taught the Empathy Mantra:

Your day was just as hard as my day … your day was just as hard as my day … your day was just as hard as my day …

They’re instructed to repeat it to themselves over and over again until each has fully internalized—not only the concept that your partner’s day was just as hard as your own, but also the sense that your partner empathizes  with you and believes that your day was just as hard as his or hers.  In one little phrase you both give and receive enough validation, acceptance and appreciation to stave off a potential fight and open the door to caring connection.

With the help of the mantra, let’s press rewind on the above scenario.  In walks Ken after a hard day at the office.  There stands Kendra, dripping in spit-up and sweet potatoes.  Their eyes meet, they each take a deep breath and recite to themselves: your day was just as hard as my day.  Maybe it gives Ken the space to give Kendra a Hello kiss and say:

“Let me take the baby as soon as I get my coat off.”

Kendra has so far gotten two things out of the deal, a kiss and another set of willing arms in which to place squalling Max.   And maybe, after she goes and pees (at long last), but before she puts her feet up, she’ll make a stop at the fridge and get Ken an ice cold beer.  Because it’s much easier to care for your spouse when you feel cared for.

The mantra won’t work, however, when someone is truly failing to pull his or her own weight.  But no one slacks off out of sheer laziness; there is always some deep-seeded resentment going on.  Ask yourself: Why have I stopped helping around the house?  Why have I stopped adhering to the budget we’d agreed on?  Ten to one, there’s an un-met or perhaps unvoiced need at the root of your slacking.  I suggest you figure out what it is so you can address it with your spouse, difficult as that may seem.  For example, it’s better to say:

“I feel abandoned when you play golf all day Sunday instead of coming to Church with us,” than to undermine yourself and the relationship by “forgetting” to bring his shirts to the dry cleaners for the second week in a row.  Exacting vengeance without clearly communicating why you’re hurting and what you’d like to change is never the answer.

Now, supposing you’ve addressed your resentments and gotten your needs met, but you just don’t believe your mate’s day was as hard as your day?  Well, this may be hard to digest, but I say: pretend.  Suspend disbelief and give you partner the benefit of the doubt.  It’s useless to compete with your partner over who had the harder day, so assume it was equal and face the challenges of married life as partners and teammates rather than opponents.   I’ve seen this empathy thing—be it the mantra or the mutual apology concept—work well in marriages, on the condition that both partners fully commit to it.   It works in my own marriage; it’s worked with couples I’ve counseled.  A little empathy can go a long, long way; the more you give, the more you get.  Maybe once Ken has his beer in hand, he’ll give Kendra a foot rub.  Maybe then they’ll send out for Thai food and then, once Max actually goes to sleep … who knows?  A lot can happen in a three hour interval!

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Sixty Year Old Girl on a Treadmill: Stress, Food and Body Issues at Any Age

Posted in Aging, Body Image, Cultural Context, Eating Disorder Recovery, General Identity, Psychotherapy, Uncategorized, tagged , , , , , , , on August 20, 2012| 2 Comments »

 There’s been a lot of press in the past few years about older women (meaning me and up) struggling with body image problems and eating disorders.   Headlines include: An Older Generation Falls Prey to Eating Disorders ,

Eating disorders are common in older women, study shows, and

Face Of Eating Disorders Changing: More Older Women Struggle With Disorders .

Though the articles are well-written, well-researched and in many ways validating, I couldn’t help thinking: this is no surprise.  I know women of all ages who are affected by how they view their own bodies–enough for things to cross the line into a full-blown eating disorder.   I’ve known women who have moved from their twenties into their thirties, who cannot release themselves from an adolescent standard of thinness, who struggle with infertility as a result.  I’ve known women who develop body image issues for the first time at the onset of menopause.

So … Why do Older Women Wind up with Eating Disorders? 

One reason is relapse.

Now, it’s common knowledge that teenage girls have body image problems. (Not all, and yes: we now know that boys do too, but when we think of eating disorders, we tend to think of teenage girls.  When we watch a TV show in which someone has an eating disorder, that someone is usually a teenage girl or a woman in her very early twenties.)   But you don’t just “get over” an eating disorder because you hit thirty.   Eating disorder specialists know that making the illness go away and stay away is a grueling, often lifelong process.  Therefore, it is not a surprise that many of these “older” women developing eating disorders had them when they were teens.

The psychic reverberations of eating disorders are likely to be felt when stress runs high.  I’ll use myself as an example.  While I never starve myself any more, while I never binge and purge, if I’m really struggling with my work or otherwise going through a rough patch, my positive body image is the first to go.  I can look at myself in the mirror and be perfectly content, then an hour later, after tossing outa whole chapter that just wasn’t working (though I’d been revising it for days), I can look in the same mirror again and see something completely different.  A distorted version of myself that in younger days I called huge.  I wasn’t anything like “huge” then.  I’m not now either, but it was my word for uncertainty.   I was convinced that “fixing” my weight (erasing my own hugeness) would make the rest of my life—if not perfect, manageable.

In the olden days (my tweens, teens and early twenties), it was almost as if calling myself something harsh would neutralize my anxiety.  My Punishing Self was in charge and would whip me—my body, my coursework, my dancing—into shape.  I wouldn’t feel so out of control.

At this point, I’ve been in recovery for so many years, I know what my triggers are: mostly worries about not being good enough in some area of my life.  I know how to get through the trigger situations without taking it out on my thighs, but it still happens.  Not the eating disorder itself, but the feelings of self-doubt that once evolved into one.  As a therapist, I’ve had enough training to know how to counter the negativity, to stop myself, to walk away from the mirror and get on with life.  But I can easily see why the recidivism rate is so high among eating disorder survivors.

Another Reason is Holding onto Who We Used to be.

Some of the articles describing this phenomenon mention the usual: unrealistic ideals of female beauty that become more elusive with each passing year.  One mentioned that older women should have more role models with realistic bodies.  I found that a little hard to swallow.  I don’t think at our age we’re looking at the big screen or the small screen for role models.  I also think many of us are surrounded by realistic, healthy. diverse images of female beauty: our best friends, our sisters, our neighbors—we come in all shapes and sizes and the “perfect-looking” girls we were intimidated by in high school are hard now fewer and farther between.

In any case, I just don’t think most women over forty are trying to look like (who’s hot now?) Megan Fox, or Zoe Saldana.  I don’t even think most of us are looking at Kelly Ripa or Gwyneth Paltrow,  and saying god I have to look like that.  I’d wager though, that for some of us, the image we aspire to, hold onto, compete with and, in many cases are tormented by, is that wedding photo sitting on the mantelpiece: our younger, pre-baby, pre-forty selves.  Regardless of how flawed or flawless we think we were, that image has probably evolved somewhat.  Were you known for looking a certain way?  Did you always get compliments for being tiny, buff, a voluptuous hour-glass?  That body-reputation is part of your identity.  As it ages, the changes can be unnerving.  Who am I now?  Accepting a different body image may be part of the life cycle—for some, a hard part.

Coping with Stress: Reaching for another Cookie, or—on the other hand—Refusing to Get off the Elliptical.

Being busy, holding ourselves to high standards in every area of our lives gets brutal sometimes.  Some women use food as a refuge (I’m treating myself, I don’t have time for a nap or a pedicure).  Others get carried away with dieting to “get healthy.”  Decreasing numbers on a scale can be addictive: evidence that we’re accomplishing something, getting results—no matter what else we may be struggling with.

We women seem to put on new hats with each passing year—between work, children, spouses and ex-spouses, caring for aging parents, commitments at our synagogues or churches, book group, cooking, laundry.  With our kids entering adolescence (or wrapping it up and fleeing the nest) we’ve got just as many variables as they do, just as many balls in the air, with menopause fast approaching (or having come, gone and left its mark).  Food is often the one area where we retain some control (who shops in your house?).

As mothers, we are responsible for feeding our families—making it taste good enough for kids and partners to gather ’round the table, but keeping it healthy enough for us all to enjoy each other for a long time to come.  As women, our bodies are changing (yet again), and like it or not, many of us feel responsible for controlling that.   Compulsive over- or undereating for stress relief is not uncommon.

Sometimes it’s Easier to Make a Teen go to the Doctor than to Seek Help Yourself.

I think teenagers are more likely to get help for disordered eating patterns primarily because they are still children and, to some degree, being looked after by parents.  Also, friends are talking about eating disorders, looking for symptoms in one another and seeking the help of adults (hopefully).  Adult women don’t necessarily have that support.  If it’s up to us, we may muddle through until something drastic happens, like collapsing on the treadmill.  That actually happened to a friend of a friend, who’d been feeling victorious about losing thirty pounds, much of which her doctor—and husband–wished she’d kept.  The important thing is for friends, sisters, cousins and partners to look out for one another, for women who suspect their own behaviors around food are changing in destructive ways to seek help: an individual therapist or a support group.

So, Your Body Changes; You’re still You.

Our bodies are inextricably connected to our identities, I don’t think there’s a way of getting around that, but it’s imperative to remember that the shape we’re in is only a small part of who we are.  As women we are all individually diverse, multi-talented, and beautiful in our own unique and ever-changing ways.

Note: this is one of several reposts from  my general blog, categorized under psychotherapy.

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