Friday, December 14, 2007

Holidays and Should-isms

Often during the holidays we are torn between doing things that we'd like to do for others, and those things for which we feel obliged to do. There's a tendency to use the auxillary verb should to reflect both of these ideas. We'd like to send a holiday card to far-off friends and family, but time constraints keep us from doing so. We might not want to attend a work holiday party, but the idea that bosses look more favorably on employees who attend work social events keeps us from doing what we want to do.

Should-isms can lend a heightened sense of anxiety in an already busy season. In order to keep should-istic anxiety in its place, ask yourself what are the most important activities that reflect what the season means to you and your loved ones? What activities have I engaged in during previous holidays that no longer reflect my preferred meaning of the holiday? Are there activities that I've engaged in that I still value but I could more richly express if moved to a different time? For example, could I send New Year's, summer solstice, or Peace Day (Sept. 21) cards to show connection with far-off loved ones? Would it be just as (or possibly even more) fun to deliver homemade Groundhog Day cookies as Christmas ones? Could I skip my work holiday party, but offer to organize a summer picnic instead? What if instead of giving physical gifts, I gave my friends and family experiences to have at a later date (e.g. taking Grandpa fishing in the spring, taking a friend out to a mid-winter dinner and a movie, or going to a theme park with kids over the summer)?

Untangling the holiday activites we look forward to doing from those which we feel compelled to do can help make the holidays feel more manageable, more enjoyable, and less anxiety-provoking.

Friday, December 7, 2007

Online Help for Anxiety

One of the tricky things about anxiety is that it is often an isolating force in our lives, just at the time when we most need connection. One way to connect to anti-anxiety resources without leaving home is the Internet. The Anxiety Disorders Association of America (www.adaa.org) Web site offers tips to help one sleep better (e.g. don't do your bills just before bedtime--listen to soft music or read a book instead), a listing of therapists and support groups in your area, and self-tests for adults, teens, parents, and family members to determine if anxiety is getting in the way of one's daily life.

If you have a favorite anti-anxiety resource, please let me know, and I'll be glad to write about it here.

Thursday, December 6, 2007

Overcoming Birth and New Parenting Anxiety

Many parents-to-be experience a heightened level of anxiety in the days leading up to birth. One way to abate anxiety's weight is to hire a labor doula who will coach you through labor and delivery. You can expect your doula to have practical knowledge about coping techniques, translating medical jargon, developing a birth plan, even helping you decide what to take to the hospital, or what to have on-hand for a home birth. To find a labor doula in Seattle, check out PALS. Many doulas offer sliding-fee scales to make their services accessible to everyone, so be sure to ask around for a doula who will meet your price point. They are out there. (Thank you, Jennifer!)

After the baby arrives, you may find anxiety nagging you: "Are you sure you're doing this right?" Finding a supportive person to tell anxiety, "Yes, you are absolutely doing this right" may be the best way to end anxiety's nagging. A postpartum doula can help you "find your feet" as a parent. Having a network of people who support your parenting is widely noted in helping new parents keep mood disorders at bay. Again, many doulas also do this work on a sliding-fee basis, making this care surprisingly inexpensive. In the Seattle area, NAPS offers a free postpartum doula referral service and can match you with someone who specializes in your particular need area (e.g. multiples, sliding fee scale, mood difficulties, lactation challenges, etc.).

We are especially blessed here in Seattle to have some especially dedicated, caring, and skillful doulas whose work I just cannot say enough good things about. Helping parents be at their best ensures that their children can also thrive.

Friday, November 30, 2007

A Quarter Century of PEPS

As seasoned parents know, one tried and true way of dealing with parenting anxiety is to have a supportive network with whom you can share your parenting joys, frustrations, questions, and concerns. In Seattle, we are fortunate to have the Program for Early Parent Support (PEPS) do the organizational heavy lifting for us. PEPS connects parents of similarly-aged babies within a neighborhood with a facilitator who guides them in discussions of couples' issues, post-partum mood disorders, returning to work, sleep, and the like. The PEPS model could certainly be replicated by some well-connected and enthusiastic parents in other cities and towns, as well.

For those in Seattle who want to show their support for PEPS and the work it does on behalf of parents, mark your calendar for the 25th Anniversary Luncheon on Tues. April 29, 2008. Speaking at the event will be newscaster Jean Enersen and author of the "Arthur" series Marc Brown.

Wednesday, November 28, 2007

Holiday Anxiety

With the holidays upon us, many of us will feel anxiety's pull more acutely than at other times of the year. Part of the reason for this phenomenon, I suppose, is due to just how different the holidays are than the rest of the year. This difference can be exciting. We eat differently, shop differently, visit different places, see different people. But all this difference can also leave us vulnerable to anxiety's arsenal of tricks. I've often observed with clients how a strong offense is the best defense against difficult transitions. One way to defend against anxiety is to maintain the regimen that keeps one feeling well. What I've noticed in folks affected by anxiety is this recurring theme of needing to strike a balance between personal and public time. This balance may look very different on an individual basis, but the need for balance is universal. Being taken out of our usual work/family/private life routine can be exciting, but aiming for a similar balance during the uniqueness of the holidays may be the strongest innoculation against anxiety.

Some questions to ask yourself may include: When I'm feeling at my best, what does the balance between alone and social time look like? During the holidays, do I expect that balance to shift? If the holidays tend to be a time of greater sociability for me, where are my opportunities for alone time? Are there some social engagements I could cut out if I start to feel too out of balance? If the holidays tend to be a time of greater solitude, where are my opportunities for greater sociability? How might I create opportunities for more public time if I begin to feel too out of balance? Is there someone who could check in with me about how I'm doing in my aim to balance personal and social time?

And with that, I wish you all happy and balanced holidays.

Wednesday, November 21, 2007

Sleeping off the Baby Weight

As we all know, getting enough sleep is important for our mood and overall ability to function. Additionally, new research shows that women who get at least seven hours of sleep a night are much more likely to return to their pre-pregnancy weight than women who got only five hours per night. Just another reason to ensure all moms of newborns are getting the sleep they need for good health and well-being.

Friday, November 16, 2007

Help Karen Kleiman with her Important Research

Karen Kleiman is a tireless author, clinician, trainer, and advocate for advancements in ppmd research and treatment. I cannot say enough good things about the work she does. If you've had a baby in the past year, please consider participating in her latest research project:

As many of you know, I have been collaborating with a research team at the University of Pennsylvania School of Medicine who have expertise in postpartum distress and scale design. We have performed an initial statistical analysis on a new postpartum distress scale.

At this stage, we would like to re-test our proposed scale items, along with established measures, such as the Edinburgh Postpartum Depression Scale (EPDS).

We need approximately 100 postpartum women (with babies up to 12-months old) to complete this phase of the study. I am hoping that you will post a link to the questionnaire, which is offered online, for your members or your clients, to help us further validate this measure.


No problem, Karen! Please click on this link to be directed to her survey.

Saturday, November 10, 2007

Tuning Your Instrument

In the Yoga Therapeutics workshop I attended today with veteran teacher J.J. Gormley, she used the metaphor of body as instrument. I think this is a particularly apt metaphor in thinking about the mind-body connection. When mind is "in tune", everything is in balance. Anxiety and depression can cause our instrument to go out of tune. Depression can cause our instrument to go flat. Tightening up the strings will bring the instrument back into tune. Anxiety makes our instrument play sharp. In that case, the strings need to be slackened.

Depression is an introverting force (or, langana, in Sanskrit) that encourages us to fold inward, close down. To bring the body back into balance (samana), start with the inclination to fold in, and gently coax the body outward. One way to do this is to start in staff pose. Inhale. Exhale and bend at the waist into a seated forward bend with your shins as your drishti, or focal point. Return to staff pose. Now, try seated forward bend, but make your toes your drishti. Come in and out of seated forward bend several times, moving your drishti incrementally higher each time, while noting any differences in your body's tuning in each subsequent staff pose. (Note: in order to keep your neck long, you will be bending less and less at the waist each time, keeping your head, neck, and torso in good alignment.) After doing the seated forward bend with your focal point at different heights, close the practice with your eyes focused on your shins one more time. What differences do you notice on your mind and body between holding your gaze outward versus downward?

Anxiety, on the contrary, is an agitating force (or in Sanskrit,brhmana), keeping the mind very busy. Start in table-top position. Inhale for 6 counts into cow pose. Exhale for 4 counts into cat. Repeat this a few times. Then equalize your breath for five counts each in cat and cow. After a few repetitions of equal breaths in cat and cow, shorten the inhale into cow to 4 breaths, and lengthen the exhale into cat to 6 breaths. Rest in child's pose. Notice if lengthening your exhale has had any effect on your instrument. Repeat the exercise again, keeping an awareness of how the change in breath alters the tuning of your instrument.

In your home practice, play around with poses using different gazing points or breathing techniques. Note which you experience as calming and which as energizing. When you start to sense anxiety or depression tapping on your shoulder, refer back to your catalogue of poses and implement those counter-balancing poses that could bring your instrument back into balance.

Friday, November 9, 2007

Anxiety and the Present Progressive

One of my favorite book titles is Raymond Carver's "What We Talk About When We Talk About Love." It perfectly sums up for me the sense of talking about a difficult, messy, complicated, and enormous subject while avoiding words that could signify the difficulty, messiness, complexity and enormity of what's being discussed.

I think anxiety falls into that category of difficult subjects to discuss. In trying to understand the role anxiety plays in one's life, I try to think about what is the person's relationship to anxiety. How does one experience the effects of this anxiety? What vision does one hold for their life, and what is anxiety's place in it?

In addressing this relationship, I find it useful (albeit, on the surface a bit strange) to ask questions using the present progressive tense. The implication of the present progressive is that there are actions, intents, beliefs and values already present that can help move toward a desired way of being or move away from anxiety's undesired effects. Some questions I might ask to understand the space between a person and her anxiety could include: When you are experiencing anxiety, what is that experience like? How is it different when you are not experiencing it? How do you see your life moving away from anxiety? If you saw anxiety moving out of your life, what could you see taking its place? What might you see yourself moving toward? From what sources is anxiety drawing strength? From what sources is it drawing opposition? When you are trying to live a life less affected by anxiety, what is involved in the trying? Do you know of others who are engaged in the trying? What strategies are they using in the trying?

I know these questions sound a bit odd, but if you can get beyond their strange constructions, their implied action can help uncover values by which we seek to live, and suggest a strategy through which they may be lived out.

My thoughts on using the present progressive to talk about difficult subjects have been greatly influenced by Johnella Bird. I must acknowledge the tremendous influence her work has had on my thinking, and I encourage anyone who is interested in the use of language to influence how we conceive of difficult problems to read her books "Talk That Sings" or "The Heart's Narrative".

Thursday, November 8, 2007

Great Postpartum Web Resource

All right, so, I'm on the Board of Postpartum Support International of Washington, but I had nothing to do with the awesome revamping of the Web site, so when I say it really is worth checking out, I say it with only the slightest hint of bias. Truly, the fabulous women of PSI have put together a comprehensive list of books, articles, and resources that will be useful to postpartum parents and their beloveds regardless of their geographic location. Even better, if you'd like to support PSI of WA's mission, clicking on any of the recommended books will route you to Amazon where a portion of your purchase will go directly to PSI of WA. (Okay, that last part smacked of Board Member bias/promotion), but really please help spread the word that help for parents is out there!

Wednesday, November 7, 2007

Support The MOTHERS Act

Want to get your activism on today? Please take 3 minutes to contact our U.S. Senators and ask them to support the MOTHERS Act, which will “ensure that new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services” and will “increase research at the National Institutes of Health on postpartum depression.”

Please contact both of our Senators by calling or using their webforms:

Sen. Maria Cantwell
http://cantwell.senate.gov/contact/index.cfm
202-224-3441

Sen. Patty Murray
http://murray.senate.gov/email/index.cfm
202-224-2621

If you call, you may want to use this script: “Hello this is (your name), one of Senator (Senator's name) constituents from (your town). I am calling to ask the Senator to co-sponsor The MOTHERS Act, bill number S. 1375, sponsored by Senator Menendez, which will provide funding for research, education, screening and treatment of postpartum depression. Thank you." Whether you call or email, you may also want to include a sentence or two about why the legislation is important to you.

Thanks!

Not from Washington? Get contact info for your two Senators here: http://www.senate.gov/general/contact_information/senators_cfm.cfm

Friday, November 2, 2007

Pets as Anxiety Repellant

One woman I know had an elaborate ritual for leaving her house. Anxiety dictated the specific steps involved in this ritual in order for her to leave and return to her house safely. The woman owns a dog, with whom she takes daily walks. She and her dog enjoy their walks together immensely. But after some time of performing her house-leaving ritual, anxiety began prescribing more and more elaborate steps to the ritual--so much so, that it began cutting into time walking with her dog. She realized that anxiety was robbing her and her dog of their most enjoyable time of day together. With this knowledge, she has renewed her efforts to limit anxiety's influence on her life.

I relay this story because it illustrates how pets can help us become aware of how anxiety affects daily living and give us a "baseline" for measuring gains in eradicating anxiety's influence. Here are some questions to consider about the anxiety-repelling qualities of pets: Do you hear anxiety's "chatter" more when you are with or without your pet? How might anxiety be useful to a pet in the wild? How is it unhelpful to pets in a household? Do you know of any pets who had experienced great anxiety due to trauma and were able to overcome this anxiety? What environmental factors helped the pet overcome anxiety and trauma? Are these same environmental factors present or absent in your own life?

Pets can console, teach, energize, and calm us. They are valued companions in both difficult and uncomplicated times. In lives increasingly bothered by anxiety we would do well to take stock of how pets can buffer our lives from its unhelpful messages.

Friday, October 26, 2007

The Anti-Anxiety Talisman

Anxiety makes itself known to us when we are too young to even know the word or its meaning. A toddler experiences separation anxiety whenever a parent or loved one leaves. Infants may go through phases of becoming tense or fearful in the bath. My own daughter experienced her first night terror at 5 months--far too young to have experienced anything terrifying enough to cause such a reaction.

Children who experience anxiety also have marvelous coping skills to soothe themselves when anxiety tries to ruffle their feathers. Infants will suck their fingers or thumbs. Toddlers may find a binkie, lovey, or blankie when they're feeling out of sorts. Older children may keep a dream catcher above their beds, look at a favorite picture, or perform some other night time ritual to keep "the wild things" away.

We can learn from children's uniquely intuitive ways of coping and find our own talismans or mantras whenever we sense anxiety's presence. A client of mine repeated the mantra "I am my own safe harbor" as he felt anxiety approaching. A teenage client who often felt overwhelmed by social anxiety brought on by Asperger's Syndrome said he would "lay low" and try to "avoid trouble" like his favorite action-movie star. A woman who was deeply affected by OCD would make a brushing motion over shoulder, as if she were shooing away a pesky fly, trying to discourage anxiety from "landing" on her. The lyric "It may look like my wheels are spinning/I swear they're spinning for a reason" has given me comfort in my own life.

An anti-anxiety talisman will not end anxiety's appearances. It can, however, disallow anxiety from gaining purchase in areas of life where it is not welcome. The imporantant part of creating the talisman--whether it be a mantra, a visualization, a piece of music, or an object--is that it be meaningful and accessible to you should anxiety creep up unexpectedly. Anxiety may catch up with you from time to time, but it doesn't have to catch you off guard.

Friday, October 12, 2007

Coping with Parenting Anxiety, or Doing the Play-by-Play

It is written in stone that at some point, young children will engage in socially-undesirable behavior that will leave their parents mortified. Hitting, biting, scratching, soiling, name-calling, and food-throwing are but a short-list of embarassment-inducing behaviors. Why do kids do these behaviors desite our pleading with them to refrain? In short, kids are innately curious. They are curious about how we'll react; they're curious about what powers they can wield in an otherwise powerless position.

So, unless someone can figure out how to drain the curiosity out of a child (and really, who wants that?), the only avenue left for parents is to control their own reactions to unwanted behavior. If a child senses that a parent's anxiety over undesired behavior got her parent to react strongly, she will be curious to see if she can help bring about a similarly strong reaction again. The child is like a little scientist testing and re-testing her hypothesis. In order to quash the experiment, a parent will have to give the same, uninteresting result over and over again, until the child moves on to a new "hypothesis" to test.

So, how can a parent give a "boring" reaction to a child's throwing, cursing, spitting, (insert undesired behavior here)? By simply announcing the "play-by-play". This anti-parenting-anxiety technique requires the parent to simply "announce" what the child is doing, what emotions she might be feeling, and other possible strategies for coping with strong feelings. For instance, if a child bites her parent, the parent might say, "I see that you bit me. It looks like you're frustrated. I wonder if this pillow might be better for biting."

Sure, it's not a difficult strategy to use, but in the heat of the moment, it's easy to forget. That's why it's important to do the play-by-play at non-anxiety-producing times. For example, while a child is playing with blocks, you could say, "I see you're playing with blocks. It looks like you're stacking them to make a tower. I wonder how tall you plan on making this tower." I know it sounds a little hokey, but the more you practice it at non-anxiety-causing situations, the easier the words will come to you when anxiety wants you to react differently. When a child hears your calm, consistent reaction time and again, the more likely she is to move on to the next "hypothesis", whatever that may be. Perhaps it will involve some socially-valued behavior, such as sharing, in which you can "react strongly" with enthusiasm, love, and praise.

Thursday, October 4, 2007

Zazen, Shavasana, or the Do-Nothing Meditation for the Mind

In high school, I had an English teacher who had a keen interest in Eastern philosophy. She introduced me to the Zen Buddhist concept of zazen, seated meditation, or as she described it, "do-nothing". In yoga, after a busy practice, one might end in shavasana, or "corpse pose." Both have at their heart the idea of allowing the body to rest, so that the mind might also quiet. Thoughts might enter one's mind--not to be analysed as good or bad--but to be observed with curious detatchment.

In my years of therapeutic collaboration, I have learned many ways of doing zazen from others. One client who has had difficulties with "perfectionism" for most of his life did zazen by lying in his bed, closing his eyes, putting on his headphones, and listening to sacred music or chanting. Some others say they practice zazen by silent prayer, or repeating a particular sacred verse or mantra. Other people I know use restorative yoga poses to help quiet their minds.

I have also found that for those (like me) who find it difficult to be physically still, it is possible to achieve zazen of the mind through kinesthetic activity. I know I have known periods of mental zazen while weeding, walking, running, swimming, cleaning, or doing yoga. I know plenty of knitters out there who would testify to the mental benefits of its simple repeated action.

I offer this idea of mental zazen as a counter-balance to anxiety's desire to "busy" the mind with its endless "chatter." Ask yourself, when do I get a break from thinking? When does thinking turn into "over-thinking"? How can I be more at peace with my thoughts? How can I resist the urge to re-live the past or to anticipate the future? What would it be like to simply observe my thoughts, such as the way an anthropologist might view a foreign culture? What "thinking space" can I open up that is currently occupied by anxiety, worry, perfectionism, or "should-isms"? If anxiety took up less "thought space", what might take its place?

Making time for zazen is not easy, I know--especially for all you parents out there! I hope to hear from readers about even more ways of practicing zazen, its benefits, and how it can become a regular and welcome practice in one's life.

Friday, September 28, 2007

Making Peace With Anxiety

I've been thinking lately about anxiety and why it seems to be taking up more and more of our "thinking space." I don't know that I will ever be able to answer that question fully, but it seems that as we have more transitions (e.g. changing jobs, schools, homes, roles, etc.) to navigate, we can expect anxiety to continue to crop up at these points. I've wanted for a long time to start putting together all the wonderful anti-anxiety strategies that others have taught me or that I've co-created with clients. To that end, I aim to start adding an entry a week about the subject. I hope that after some time of plugging away at it, this blog will contain a sort of anti-anxiety handbook. My general thinking about anxiety is that while it may be helpful to name the source of the anxiety (e.g. money, taxes, relationships, parenting, etc.), identifying the source doesn't make it go away or keep it from cropping up at other challenging life events. Sometimes not knowing the source simply adds fuel to anxiety's fire! Rather than focus on anxiety's origins, I'd like to explore the ways in which we make peace with anxiety's presence in our lives. What "thinking space" are we comfortable allowing anxiety to have? What rituals do we create to acknowledge anxiety's presence and keep it at bay? What can we learn from children about engaging our creative "monkey" minds about finding playful ways of coping? How can we catch ourselves thinking, and then take concrete action to address our thinking? Are there other supportive people out there that we can recruit into our anti-anxiety network?

Over the next few (or many?) weeks, I will share some vignettes about individuals' struggles with anxiety, and the creative tools they've added to their anti-anxiety bags to pull out when they feel anxiety meddling in their lives. Some of their tools are quite simple to use, others require organizing a team. Some involve brave changes in behavior, while others demand thinking about thinking. And some simply ask for detatchment from thinking entirely. From what I've learned about anxiety, there's no one right way to cope. The first step is to accept that it is a near impossibility to live a life free from anxiety, but it is possible to limit its effects on our lives, to make peace with it, as it were.

Friday, September 14, 2007

The Postpartum Pact

Postpartum support guru Karen Kleiman has posted on her Postpartum Stress Center blog what she calls a Postpartum Pact. In signing the pact, couples agree to do certain things, such as watching for shifts in behavior, accepting whatever moodiness or anxiety presents itself, and agreeing to stay together no matter what happens. I could see this pact providing a useful template for couples undergoing any major life change: marriage, caring for an elder, starting a new business, etc. Who doesn't need to hear "You're doing the best you can" or "You don't always have to be perfect" from time to time?

Wednesday, September 5, 2007

Finding a Place for Anxiety

Lately, I've been thinking about anxiety and its relationship to parenting. Sometimes when anxiety rears its head, it's telling you "that carrot is big enough to choke on" or "it would be easy for my child to fall into the deep end of this swimming pool." All good reminders, anxiety--thanks! But recent recalls of toys has me wondering about if all the safety information parents receive leads to a little too much interference from anxiety. Yes, you've heard about "helicopter" parents, the millenial generation being the most needy and narcissistic, the growing obesity childhood obesity problem, etc. Are these random phenomena or could they be correlated by a trend of increasing interference from anxiety on parenting? What I mean is, is anxiety goading parents to step in to "protect" kids, when what a child needs is to experiment and explore--and sometimes fall down--to learn the fullness of her abilities and limitations? This is not to say that there aren't times when parental intervention is good (and indeed, for those children who lack good safety instincts, necessary); however, could there be opportunities that are being denied by anxiety for allowing children to use their own instincts to decide on the level of challenge with which their comfortable? My hunch is that anxiety teaches parents to only allow children to take the easily-calculated risks. This message is then passed on to children who learn to be risk-averse physically, emotionally, and intellectually.

So, what's a parent to do? A lack of anxiety could lead to allowing your 2 y.o. to play with knives? Too much and the kid can't leave the house without a helmet and knee pads. What I want to offer is (the incredibly challenging, I know) proposition that we parents ask ourselves when we sense anxiety's presence, what is this anxiety asking me to do? What are the possible outcomes for acting on anxiety's direction here? What are the potential consequences for ignoring it? Is this anxiety intervening in a helpful or meddlesome way? What are my values as a parent, and is this anxiety in the service of those values? My hope is that when we can find the proper place for anxiety in parenting, children can grow up to be creative, courageous, humble--and safe!--people.

Thursday, August 30, 2007

Making Cliches Meaningful Again

You remember: Your high school English teacher warned you against using cliches, and so you rewrote those papers carefully editing out those hackneyed phrases, lest she come at them with a red pen. Now, we're adults, and cliche-free, right? Sadly, no. Think about all the well-intentioned yet substance-free goals we adults set for ourselves, (and yes, many of these are from my own life-script): I want to be a better parent. I want to deal with racism. I want to find balance. I'm looking for a soul mate. I want to be healthier. I want to be less stressed out. I want to feel better about myself.

All good ideas, yes, but the problem is they're so over-used, they've lost their meaning. Yet, these cliches can be meaningful again if you follow my English teacher husband's advice: Specific is terrific. If, for example, your goal is to be healthier, how will you know that you are healthier than you are now? Is there a goal that can be measured, as in weighing 5 pounds less, or running a nine-minute mile? For some, outcome measurement is an important means of substantive goal-setting. For others, process is more important. In wanting to be healthier, one might join a softball team or sign up for a yoga class. The specifics giving the cliche meaning will depend on the person, but if they are helpful in moving one toward a life intention, all are terrific.

Friday, August 24, 2007

Beyond the Birth

For those in the Seattle area, Postpartum Support International of Washington's upcoming conference Beyond the Birth: Trends in Treating Perinatal and Postpartum Mood Disorders is worth checking out. (Full disclosure: I'm on the Board of PSI, but biased though I may be, I still think it will be a good conference). Shaila Misri, Rex Gentry, and a panel of PPMD survivors and partners will be speaking. The conference is Sept. 21 at the Meydenbauer Center in Bellevue. To register, click here.

Tuesday, August 7, 2007

Family-Leave and the Family Values Set

During summertime, I find it difficult to read anything beyond the headlines of Us Weekly and People magazines while waiting in line at the supermarket. An article by Eyal Press in the New York Times Sunday Magazine (July 29, 2007) not only held my limited attention, but left me outraged. The Family Medical Leave Act guarantees caregivers time off from work to care for family members in the event of a medical crisis. More and more, employers are passing over for promotions--or in some cases, firing--mothers or others who care for dependents based on the assumption that they will perform less adequately at their jobs than those without such family obligations. Mr. Press details the cases of several caregivers who were passed over for promotions, demoted, or fired because they took a family medical leave of absence. In one case, a man who was caring for his newborn daughter and wife who was undergoing a difficult recovery from delivery was told by his employer that unless his "wife is in a coma or dead, you can't be primary care provider." He sued, and won.

While I generally find the litiginous nature of our society to be detrimental to families (see my earlier post on divorce), I think workers must take a stand that there are times when a family member's care will require a leave of absence WITH the expectation that one will return to work at full capacity as soon as one can. I think it is also high time to disabuse employers of the notion that mothers are less dedicated workers than non-mothers. (Press notes that mothers are paid a starting salary $11,000 less than non-mothers.) As our society ages, more and more workers will require some leave to care for aging relatives. This issue, thus, affects all of us, parents and non-parents alike, for we all are children and grandchildren of people who are aging. Press also notes in his article that if employers are able to flex to help employees meet their familial and work obligations, they are rewarded with employee loyalty unmatched by other companies'. It shows how a little compassion can go a long way.

Thursday, August 2, 2007

Baby's Got Brand-New T-Straps


All right, folks, look out because I'm about to indulge myself in a wholly unserious yet near-and-dear-to-my-heart topic of shoe shopping. Yes, I realize that this blog was started to address more serious topics of depression, anxiety, identity crises, parenting, and the like, but sometimes in life some situations cry out for a little retail therapy. Such as the situation I found myself in the other day when my darling daughter was walking around in sandals that fit her at the beginning on summer, but now her little toes are sticking out over the edge of her soles. (Good thing they're open-toed shoes, or I'd have nothing for her to wear). Fortunately, we were up in Ballard during side-walk sales where I discovered these adorable Umi t-straps on sale for $20 at Market Street Shoes. I was entertaining buying her a pair of See Kai Run shoes because a. they are super cute and well-made and b. the company was started by a local Seattle mom, but I couldn't resist buying these fantastically-priced t-straps from a great independent shoe store. So, here's to all the great independent, local, and mom-owned businesses out there who keep our feet well-appointed and our consciences clean.

Thursday, July 12, 2007

Car Radio Wars

Ah, summertime is here, which means many of you will be hittin' the road with your family for that summer ritual: a roadtrip vacation. One way to keep the peace in the car is to find music that everyone can agree on. How is this possible, you ask? Zooglobble.com has reviews of all the usual kids' music suspects (e.g. Dan Zanes, They Might Be Giants, etc.) and some unexpected surprises. Anyone for Johnny Cash, The Hold Steady, or Belle and Sebastian? Seattlites will be glad to find local favorites Smoosh and Recess Monkey on there, too. And you thought parenthood meant being conscripted to listening The Wiggles, ad nauseum. Finally, your family can make peace with the car stereo.

Friday, July 6, 2007

For The Kids' Sake
Over 1 million children are waiting to be adopted in the U.S. One million! I was shocked to learn this statistic when I was working at an adoption agency in Santa Fe 7 years ago. My hunch is that the number of children waiting to be adopted only continues to grow. The reasons why so many children are waiting for families are:
1. They are over the age of 3
2. They have a sibling from whom they refuse to be separated
3. They have special developmental or physical needs
4. They are children of color

Frankly, I don't know what makes me sadder: the number of children waiting to be adopted or the reasons why they are waiting. The World Association of Children and Parents has a really great Web site for anyone who has ever had an inkling about becoming an adoptive parent. They have a photo album of children awaiting adoption, stories from parents about their adoption journeys as well as other helpful adoption resources, including financial resources for low-income families considering adoption.

I once heard Bill T. Jones say about his decidedly non-traditional-looking dance troupe, "There are lots of good bodies for dancing." I think the same can be said for parents and children. There are lots of good parents for children, and lots of good children for parents. They may not fit the traditional, idealized view of family, but they are beautiful, loving, wonderful families, nonetheless. Please help spread the word to prospective parents who would make a good home for these children.

Friday, June 29, 2007

Great Resource for Families Affected by (Postpartum) Depression

A great resource for "significant others" of those who suffer postpartum mood disorders is MedEd. It offers useful tips on how to support someone affected by a PPMD. I especially like the strategies for explaining to children what's going on with Mom. Their advice for explaining PPMD to children would be useful for all young children who love someone who suffers from a depressive illness.

Friday, June 15, 2007

Seasonal Transitions

As I look out my window, it appears that the summer sun has finally arrived here in the usually cool and cloudy Pacific Northwest. While the cooler months may present challenges for those who prefer their days without rain, the summertime can lead to that familiar refrain from little ones (or maybe even from yourself!): I'm bored! So, what to do this summer? Check out your local parks and recreation department for some activity ideas for even the doggiest of dog days this summer. Lawn bowling, anyone?

Friday, June 1, 2007

The Forgiveness Train

"Forgiveness is the final form of love."--Reinhold Niebuhr

I've been thinking about forgiveness a lot lately. The topic seems to come up a lot in the conversations I have with clients, parents--really anyone who's old enough to have significant relationships with other people. Over the course of these conversations, a metaphor for forgiveness appeared in my mind. When I try to make a visual picture of forgiveness I see a train--a toy train, to be exact where the cars connect through magnets. The locomotive--the train's beginning--is one's self. Forgiveness of others, I think, can only happen once we learn to forgive ourselves for past mistakes, regrets, and unhappinesses. Before any cars can be added to the train, the locomotive must be strong enough to first power itself. Once the forgiveness engine can power itself, that strength can be extended to others. Here's where the magnets come in. I see this attraction quality to forgiveness. With each act of forgiveness, another car is added to the train. Each car attracts yet another car, and soon, all the cars are drawn into this seemingly endless line of cars, driven by one small but powerful engine: self-forgiveness. In the months (and maybe even years!) to come, I hope to research acts of forgiveness (of one's self and others) and be able to report back my findings. Please feel free to share your stories of courageous acts of forgiveness.

Friday, May 25, 2007

Re-imagining Your Life Story

Here's a true-life parenting tale that happened to me just yesterday. I'm going for a walk in the park with my daughter when she starts writhing in her stroller. Soon she has worked her way out of her seatbelt and is climbing out the back, causing the stroller to nearly tip over backwards. People on bikes, rollerblades and foot are watching our commotion. I start to yell, "No, that's not okay. You're going to get hurt! Sit down! Sit down!" My daughter looks up at me and starts to cry.

So that's the movie-script version of what-happened. So what's my life-script version of the story? Two competing versions come to mind...

In the first, I am a bad mother. I should know better. My daughter is writhing around because she knows her Cheerios are in the bag behind her seat. Lunchtime was over a while ago, so she's probably ready for her snack. It's also hot, and she might be thirsty, thinking there's a bottle of water in there too. There are all these people watching us as she nearly falls out the back of her stroller. I could have prevented this if I had only correctly anticipated her needs.

In the second, my daughter and I are victims of a few missteps and bad circumstances. She had a huge lunch, and she's non-verbal, so I just missed her cues that she could be hungry again. It's hot out, and people are watching, so embarrassment and fatigue caused me to react more forcefully than usual. I'm also taking this walk with her in the hopes she might fall asleep. She needs a nap, and my plan to help her meet this need doesn't seem to be working. I really just want to help, and it's frustrating when I can't make things work out for her. I know I over-reacted in the moment, but once I figured out she just wanted the Cheerios, she sat back contentedly in her seat, and my outburst was seemingly forgotten. She never did fall asleep on the walk, but she did go down easily once we were home and she could rest in her bed. We had an otherwise lovely afternoon together.

So, which version is "true"? Well, they both are, depending on how you look at it (or at least how I'm feeling when I look at it). In the first, my bad parenting moment is a result of being a "bad mother", an inherent character flaw that leaves me little hope of parenting more mindfully in the future. In the second, my bad parenting "moment" is just that, in what is an otherwise fulfilling parenting relationship with my daughter. Some bad circumstances and unmet needs conspired against us, but with this knowledge, I have hope of being more patient, intuitive, and prepared in the future. In the second story, I have a sense of my own agency in being able to overcome parenting obstacles. In the first version, I blame myself: "I should know better." I don't know anyone who improves at "knowing better", so to "know better" seems like a lost cause. In the "story" of my parenting life, the second version feels more like the interpretation I can live with. I had my "bad moment", I got through it, I have a sense of what I'd do differently next time, and the "bad moment" didn't take away all the good moments that preceded or followed it.

In any of our challenging life roles, it's possible to re-imagine the "character flaw version" of our life stories as "overcoming adversity" narratives. Our personalities are not our destinies. In every true-life tale, there is the potential for multiple interpretations. The versions that highlight our agency to overcome adversity enable us to live the best life we can imagine.

Friday, May 11, 2007

T. Berry Brazelton: Alive, kicking, and Helping Families Get to Sleep!

I heard T. Berry Brazelton on the radio and was amazed by a. the fact that he's still alive! and b. how well some of his theories about children's development and parenting have held up over time. Much on the minds of parents of infants and toddlers is nurturing their children's healthy sleep habits. Dr. Brazelton's philosophy is that children have the inner resources to sleep well, but they need their parents' coaching to draw on these resources. He advocates that parents go to their children when they wake in the middle of the night, but rather than pick them up, give them a lovey, binky or some other comforting object and sit with them, repeating this mantra until they go back to sleep: You can do it yourself. You can do it yourself. Just listening to him repeat this mantra nearly put me to sleep. I like this idea that sleep is something that children can be taught to do well, but like all skills, it's something that must be learned from an experienced teacher: the child's parents! Cheers to Dr. Brazelton--and a good night's sleep!

Friday, May 4, 2007

Raising Baby Einstein

A new book by Susan Gregory Thomas, Buy Buy Baby, asserts that toys from Baby Einstein and others are developed not with evidence of child development but by marketing to parents' fears that their child will not be able to succeed in an ever-more competitive world. Well-intentioned parents seeking to give their children whatever edge they can have turned Baby Einstein and the like into very, very successful companies. Meanwhile, children may indeed enjoy the music, books, toys, dvds, etc., but there's no evidence that these children develop into "geniuses" while their non-Baby Einstein counterparts do not. There is evidence, though, that someone is getting rich preying upon parents' anxieties.

So, what's a parent to do? Children do, indeed, learn through play. Play, however, can take lots of different forms, many of them at little or no expense to the family. Here's some tried and true (free!) things to stimulate play with your wee one:
--Turn on the radio and dance (As my daughter will attest, almost any music is good for dancing.)
--Cut holes in plastic food containers (yogurt, sour cream, etc.) and use to sort different shaped objects. One may fit clothespins, another may fit orange juice lids, etc.
--Make maracas by filling old conainers (medicine, yogurt, etc.) with dry beans. Shake your maracas to different kinds of music
--Play peek-a-boo (or cucu in Spanish), which teaches your infant object permanence (i.e. objects remain even when one looks away).
--Sing songs like Patty Cake or Itsy Bitsy Spider or better yet, make up your own!
--Ask your local librarian for beginning book suggestions. The Seattle Public Library, for example, has "baby boxes" with books, music, and adult resource books on specific topics (e.g. zoo animals, toilet learning, music, dinosaurs, etc.)

Please share your favorite free activities to do with children at any age. Helping your child develop doesn't need to be expensive, but all children (and their parents!) benefit from a little creativity.

Friday, April 27, 2007

The Ugly Truth About Divorce

As the most recent story of Alec Baldwin's infamous "pig" phone call to his daughter exemplifies, divorce and custody battles can get really ugly, and the biggest victims are the littlest people: the kids. When going through divorce and custody litigation, it can be so easy to take out the hurt and pain out on the children, saying terrible things to them out of frustration. Should the unfortunate circumstance of divorce happen to you or someone you love, please remember these three things:
1. Have a plan of self-care during divorce. Your limits will be tested, emotions will reach a boiling point, and you will need every ounce of cool-headedness you can muster.
2. The children need to be left out of the divorce; it's the parent's divorce, not theirs. They do not need to know any of the details over money, lawyers, posessions, etc. Talk to the kids about what's going on in their lives, not about what's going on in that of their parents.
3. Kids need to have regular and unrestricted access to both parents (barring, of course, any history of abuse). Whatever feelings one parent may harbor against the other should not in any way be brought to bear upon the child's relationship with that parent. Children naturally love both their parents, and they should not be asked to choose sides. Doing so is unfair to everyone.

If a parent feels unable to do these things, it's important to have someone (friend, clergy person, therapist) to hold him/her accountable, for the children's sake. Sadly, there are more divorced parents out there whose anger has overtaken them and have done terrible things they regret for the rest of their lives.

Friday, April 20, 2007

Lack of Postpartum Resources Not Just an American Issue...

as this article from the BBC points out.

Lessons from Virginia Tech

Mental illness can strike anyone at anytime, though onset tends to occur in early adulthood or late adolescence. Often, a person's problems with mental illness come to light when they leave home for the first time, as Mr. Cho's did while he was a student at Virginia Tech. His teachers and fellow students were right to reach out to him with concerns about his writing and other behaviors. And while some who experience suicidal or homocidal thoughts do act on them, many do not. No one is omniscient; it is impossible to sort out who will harm themselves and others, and who won't. The best we can do is to continue to reach out to those who are suffering, to continue to invite them to get help, and to alert authorities if there's evidence that someone is in imminent danger of hurting himself or others. For the survivors at Virginia Tech, the best advice I've heard about coping with this tragedy was relayed by a Columbine survivor on the radio: "No one has ever gone through this before, so however you handle it is probably right."

Monday, April 9, 2007

Get out of the House!

One of the biggest challenges of being a stay-at-home parent is coming up with fun outing ideas for you and your young one(s). PEPS (Program for Early Parent Support) has compiled this list. While PEPS is Seattle-based, some of their outing ideas might get you thinking about things to do in your town should you not be so fortunate to live in the lovely Puget Sound region. Or better yet, post your great outing ideas in the comments section! Thanks for reading, and now, get out there!

Friday, March 30, 2007

Birth-Right

We just celebrated my daughter's first birthday, which got me thinking back to the days leading up to and including her birth. I had a particularly long though not particularly awful labor that progressed quite naturally until it didn't. Despite all our best efforts (e.g. climbing stairs, doing squats, laboring in the tub, walking the hallways, you name it!), I never dilated enough to push her out. I chose to go on Pitocin which had the effect of causing some particularly nasty--yet ultimately unhelpful--contractions. My doctor tried upping the dosage as a last attempt to bring my contractions into a productive rhythm, but it only caused my daughter's heart rate to decelerate alarmingly. The birth team managed to stabilize her heart rate but after more than 12 hours of no progress, we opted for a Caesarean birth.

Her birth was beautiful. Our labor and delivery nurse and our doula made the atmosphere light and celebratory. We were so excited to finally see our baby. As soon as I was prepped I was wheeled into surgery where our over 10-lb. baby was delivered, healthy as can be.

Something my doula said to me afterward has stuck with me this past year. She said our birth proved that Caesareans can be real births--not just procedures. It seems that sometimes folks from the world of natural/home birth think that medical/hospital birth folks are wrong-headed and vice versa. I wonder if some women get caught up in these "wrong vs. right" birth discourses. It seems that this wrong birth/right birth discussion can lead to the very first seeds of parent blaming (see my previous post for more on that topic). It seems more useful to talk about when Caesarean can be beneficial (as when mom and/or baby seem at risk) and when it is seemingly unnecessary (as a means of convenience, for example).

As for me, given the circumstances of our birth, I could not have hoped for a better result. It was definitely the right birth for us, and that's all that really matters. Happy birthday, indeed.

Monday, March 26, 2007

Loss and Its Opportunities for Gain

This weekend I was talking with a group of women when one mentioned she had been preparing for her parents' death. I asked her what she was doing to prepare. She explained that her parents are now in their 80s, living in a different state, and it occured to her that there would come a time when difficult decisions would have to be made about their care. Her brother would certainly be involved in these decisions. Problem is, she and her brother have been estranged for 5 years. Facing this difficult realization, she has set about trying to restore an amicable relationship with her brother.

I was interested in her story because I have heard many tell of their experiences in mending relationships with a family member over the birth or adoption of a child. For the child's sake, two people agree to set aside past hurts so the child can have a relationship with all her family members. I've not heard of someone setting about to reclaim a relationship so they can both be present to their beloveds in their final years. I found her willingness to forgive for her parents' sake a moving example of how impending loss can also be an opportunity for transformation.

Friday, March 23, 2007

Welcome to Blameville, Population: A Lot of Parent Critics

I was crossing 125th St. at Lenox Ave.--an incredibly busy corner, even by Manhattan standards--when a man shouted at me from across the street that my baby looked a little low in my front-pack carrier. Then there was the time that as we were getting off the subway, our daughter dropped her binky and a fellow passenger said to my husband, "You better wash that before you give it back to her."

Now, I know intellectually that these people were perfectly well-intentioned; they simply wanted to be helpful. However, I say this from a place of well-reasoned remove, and not in the heat of the moment where I wanted to say, "Thanks, I had no idea what I was doing as a parent until you came along."

I think it's exceptionally strange that a perfect stranger should come up to a parent and offer advice. Think about it: Do people approach police officers and tell them they might catch more criminals if they spent less time in doughnut shops? Do advertising agencies receive anonymous phone calls suggesting catchy slogans or jingles for their advertising campaigns? Somehow, I think not. And yet, parents are regularly advised on how better to do their jobs.

Now, I have a very strong support network as a new mom, and their support acts as a buffer between my ears and my brain when I receive unsolicited pareting advice. But I'm concerned for parents who don't have such a support buffer. What happens when this onslaught of advice takes root and grows into feelings of self-doubt and shame? How do they counter all the parent-blaming messages that are so prevalent in society? If it takes a village to raise a child, I think our villages need fewer advice-givers and a few more residents offering to carry our babies and wash their binkies. May we all live in a village like that.

Thursday, March 15, 2007

Post-adoption Families are At-Risk for Depression, Too

I've written before that I believe the sudden shift in lifestyle can be the cause for postpartum parents' mood changes. Sleep deprivation, social isolation, loss of income, career changes, and strained relationships are common to new parents--whether they birth their baby or adopt. Not surprising then are the emerging stories that are now being referred to as Post-adoption Depression Syndrome (PADS). If you or someone you know is considering adoption or has newly adopted a little one, be prepared that PADS may creep into a post-adoption family's life. It is a normal part of post-adoption adjustment, and like any other health problem, it is treatable. Adoption is a wonderful option for many families, and they deserve all the support and care that any family with a new child needs.

Tuesday, March 13, 2007

Parent Resource List Compiled by the Center on Infant Mental Health at U-W

The Center for Infant Mental Health at the University of Washington has compiled a list of parenting resources that should interest those who like information about parenting young children. My belief is that parenting is equal parts art and science. This resource list can give you insight into parenting "science". You will always be the expert on the "art" of parenting your wee one.

Friday, March 9, 2007

Those Ladies on The View, God Love 'Em!

While I generally try to avoid gossip-laden talk shows, I have to give it up to whomever it is on The View who is spearheading the special editions of The View dedicated to common mental health problems that affect so many people. You'll recall that I wrote about their show about Autism-Spectrum Disorders. Well, today's show was dedicated to equally debilitating illnesses: Depression and Bipolar Disorder. I was especially pleased that they chose to have a panelist, Dr. Hyla Cass whose practice focuses on naturopathic ways of treating mental illnesses. Rosie O'Donnell shared that she suffers from Seasonal Affective Disorder (aka SAD) and demonstrated the inversion treatment that she uses at home. For those of you interested in this treatment, but have neither the money or space for special equipment, you can achieve the same effects by doing this simpler version at home (i.e. viparita karani, for all you yogis out there): Make yourself into an L-shape by putting your feet up the wall while your head and torso rests on the floor. Rest with your palms facing upward. You can stay as long as you like, but to enjoy the benefits of increasing blood flow to your brain, you should stay in this position for at least five minutes. Once you try it, you may not want to get up! To get out of the position safely, bend your knees and roll over to your side. Rest for at least 10 seconds (more if you get head rushes easily) before pushing yourself up with your arms to a seated position. Take several more breaths before standing--and go slowly to avoid dizziness.

Depression affects 1 in 5 people (and perhaps more due to under-reporting). No one should suffer needlessly. There are therapies (naturopathic, talk, and drug) which taken either alone or in combination can speed relief.

Friday, March 2, 2007

Could Britney Spears be affected by a Postpartum Mood Disorder?

Much in the gossip-cum-news lately is Britney Spears's recent visit to rehab after some odd public behavior--a good deal of which involved some unusual shaving practices. Speculation has been bandied about that her behavior might be attributed to postpartum depression. While I will not diagnose Ms. Spears from afar, I think there are details from this story that suggest why she might be at greater risk for a PPMD. Here are the risk factors that put her (as well as lots of other women) at risk for a PPMD:
*Weaning suddenly (I assume she wasn't pumping or nursing while in rehab)
*Lack of support/single parenting
*Personal crisis (such as divorce)
*Using alcohol or other depressants (she reportedly attended an A.A. meeting)
*Having babies born close together (or experiencing some other hormone-fluctuating event, e.g. sudden weaning)

Add to this mix the very public questioning of her and Kevin Federline's adequacy as parents, it's easy to see how a PPMD might gain purchase in her life.

The good news in all of this is that as a public figure, Spears has modeled one of the best things that a postpartum parent can do: Take care of herself. In this regard, postpartum parents would be wise to follow her example.

Friday, February 23, 2007

The Edinburgh Postnatal Depression Scale

This scale was developed to assess depressive symptoms in women after birth, but I think it's one of the most straightforward and easy-to-use screening tools for depression--for anyone!--I've ever come across. If someone you know seems to be suffering from increased irritability, lethargy, social withdrawal or fatigue, please encourage them to take this 5 minute test (and disregard the title if the person is not a new mom!) A score of 12 or higher suggests that problems with depression are having a significant negative impact on one's quality of life.

We probably all know someone who went undiagnosed and untreated for depression. There's no way of telling just how many people suffer needlessly from this illness, though it's fairly safe to assume that the number is well into the millions. With depression, a good offense is a good defense. Being alert to changes in our loved ones' moods--as well as our own--is a good first step in ensuring that no one suffers needlessly from this illness.

Thursday, February 22, 2007

Postpartum Blog Worth Checking Out

Karen Kleiman writes about postpartum issues. I haven't read her books yet, though I'm meaning to get around to it--and add it to the bibliography. In the meantime, please check out her blog at: http://postpartumstress.blogspot.com/. A great resource for parents!

Annotated Postpartum Bibliography

There are so many postpartum books out there, it's hard to know which ones will speak to a person's condition. I'm including a brief list here along with my notes in the hope that it will save some precious time and money for postpartum parents seeking information. If you know of a book or other postpartum resource that should be added to the list, please add it in the comments section. I'm always interested in hearing about what books or resources have been helpful to others. Also: almost all the books I've found have focused on postpartum mood disorders. I'm having trouble finding books that focus on other postpartum family issues (e.g. learning to become co-parents, maintaining a strong couple relationship, grandparenting effectively, balancing financial decisions and family needs, deciding if/when to return to work, single parenting etc.) If anyone knows of books that address these issues, please let me know--or I may just wind up writing the book myself!

Beyond the Blues, by Shoshana Bennett, PhD., and Pec Indman, EdD., MFT. This book has great descriptions of perinatal mood disorders accompanied by women's real life stories. Advises parents on how to choose a therapist and how partners can give support. The appendix on medical and healthcare professional terms is a great vocab lesson!

Conquering Postpartum Despression, by Ronald Rosenberg, Deborah Greening and James Windell has a good section on alternative treatments for PPD and the importance of a ppd team and a strong social support network. One caveat: They argue mood disorders are more common during pregnancy than postpartum. I would argue that diagnosis is more common during pregnancy because a pregnant woman sees her doctor at least once a month. I believe that ppmds often go undiagnosed because postpartum families tend to be isolated.

A Deeper Shade of Blue, by Ruta Nonacs, MD. I especially like the chapter titled, Helping Yourself, which gives practical medical advice on good sleep, nutrition, exercise, stress management, and parenting practices. It also gives suggestions on how to enlist helpers to support the family while a parent is coping with depression.

Down Came the Rain, by Brooke Shields. Shields is very candid about how ppd affected not just her, but her partner, friends, family, and other support people. Ultimately, Shields recovered with the support of her loved ones, a baby nurse, a good therapist, and medication.

The Ghost in the House, by Tracy Thompson. Part memoir, part investigative journalism. Thompson surveyed 393 women about their experiences with depression and its effects on parenting. Responses revealed that while some suffered PPD, others continued to suffer (often in silence) throughout their children's lives. I especially like Thompson's frank discussion of how depression affects her husband and daughters. The silver lining for Thompson's (and some other mothers') journey through depression is that she was able to recognize the onset and get treatment for her daughter's childhood depression and has been able to model to her kids that--with self-awareness, therapy and medication--she can be a more empathic, hopeful and determined mother than she might have been without depression. Highly recommended!

The Mother-to-Mother PPD Support Book, by Sandra Paulin. This collection of women's stories about ppmd might be good for someone who wants to know there are other people who lived through it and came out the other side but who may not want to join a formal support group.

Overcoming Postpartum Depression and Anxiety, by Linda Sebastian gives very clear definitions of different postpartum diagnoses, treatment options, and coping strategies for the sufferer's partner and support network.

Saturday, February 17, 2007

Dr. Goodnight--Or How I Learned to Love the Baby and Start Sleeping

We Americans, by and large, do not get enough asleep. How many of us have dragged ourselves out of bed and out the door, fueled by too much caffeine and too little sleep? I, for one, can recall plenty of Monday mornings when my body went into shock at being forced out of bed at what seemed an ungodly hour for a human being to be upright. Now, I must admit, it wasn't that I was waking *that* early. No, my morning stupor was brought on by a weekend of staying up--and sleeping in--much later than my usual weekday schedule. Saturdays and Sundays I felt fine, but by Monday my radical sleep schedule departure had caught up with me.

Fast-forward to today: I'm a parent of a 10 month-old, which usually begs the question: How are you sleeping? In short, well. I usually get up once or twice each night to nurse my daughter. In that sense, my sleep is more "disturbed" than it was in my pre-baby days. But when I look at my sleep hygiene overall, I sleep much better than I used to. Raising my daughter has taught me the importance of good sleep hygiene and its effects on health and disposition. If she's not dressed in jammies and in bed by 8:00, I can expect to deal with a tired and cranky baby the next day. Well, my little apple didn't fall that far from this tree. If I'm not nestled snug in my bed by 10:30, Momzilla emerges from the covers come morning.

Parents of little ones often receive loads of advice about how to improve their child's sleep and--by extension--their own. Less common are the questions about how parenthood has improved (yes, improved!) one's sleep. This is not to say that sleep problems can and do exist for many parents; sleep is a serious issue. I am, however, interested in this notion that parents can be taught lessons about good sleep hygiene by studying children's sleep. Some questions for parents of young children might include: What has your child taught you about the importance of good sleep hygiene? Since becoming parents, which lifestyle changes could serve to improve your sleep practices? What cues do family members give to express fatigue, and who recognizes them? Are there bedtime rituals that have been effective for child/ren that could also be effective for their parents? Recall a morning when you awoke refreshed: what happened during the previous day and night that made that good morning possible? Questions such as these can lead to a discussion of a family's good sleep habits--not just their sleep deficits. Increasing a parent's positive thoughts about sleep and decreasing anxiety over not sleeping well may indeed be the first step toward improving sleep hygiene.

Here's to a glass of warm milk, a good book, some comfy pj's, and a really terrific night's sleep!

Friday, February 16, 2007

Unicef Study Finds American Children At Risk

A 2007 study by Unicef finds that children in the U.S. are at much greater risk for poverty-related threats to well-being than children in 20 other wealthy nations. The study looked at six dimensions of children's lives: material well-being, healthy and safety, education, family/peer relationships, subjective well-being, and risk behaviors. Out of the 21 countries surveyed, the US placed 20th, narrowly beating out the UK for the dubious honor of last place. The results are startling, to be sure. But what caught my attention was how poorly American children did on measures of family and peer relationships. The US has more children living in single-parent families and in step-parent families than in any other country surveyed. Now, let me say that the presence of two biological or adoptive parents is not necessarily an indicator of health; however, research has shown a corelation between single-parent households and increased rates of poverty, unemployment, school drop-outs, and poor health. While not included in this study, there is other research that suggests one of the greatest "risk" factors to a couple's ability to stay together is children. So here's what we know: kids do better when they have two consistent parents in their lives, and couples are less likely to stay together once they have kids. Thus, we could improve children's outcomes by investing more in their parents' relationships. Let's hope that this study is a wake-up call for American society to change its priorities and invest more in children and the people who care for them.

Tuesday, February 13, 2007

Swimming Lessons for Depression

One summer my family went to Lake Michigan for a little time on the beach. My sister and I--water-lovers that we are--headed straight for the water. The waves were running a little high this particular day which, to us, was all the better. We had swam out, unbeknownst to us, onto a narrow sand bar. Then, one spectacularly huge wave hit us where we were swimming, knocking my sister and I both underwater. When I surfaced my sister was about 15 feet downshore from where we were swimming. She was flailing about and screaming. I was only about 9 at the time, but I knew enough to know that she was in trouble. I took one step toward her, only to step over the edge of the sandbar into much, much deeper water. Unable to feel the bottom, I surfaced and swam toward her. When I reached her, she was in full panic. I grabbed her around the waist and started swimming toward the shore. She screamed at me to let her go and was trying to squirm out of my grasp. I told her everything was okay and that I would not let her go. (My mind flashed back to swim class where our teacher told us that if the person you're trying to rescue is pulling you under, you should knock them unconscious. With one arm around my sister and the other engaged in keeping us above water, it occured to me that I should have asked more questions about how one might knock a drowning person unconscious while rescuing them.) Miraculously, we made it back to shore, both of us still conscious.

Looking back, I don't know how we survived. My sister was about 6 years old at the time, and while she was smaller than me, it wasn't by much. The lifeguard later told us the waves that knocked her off the sandbar were around 4 feet. I routinely failed my swim test for not having enough stamina to swim the length of a placid pool. The only way to explain how we survived was the power of the emotional bond of siblings. She is my sister, and there was no way I was going to leave her to the waves to fend for herself.

So it is with depression. Depression is like that wave that knocked my sister off the sand bar. A person can be caught unawares by a sudden wave of depression that leaves them flailing. When a loved one sees what's happened, s/he might try to lend support, but in doing so, s/he subjects herself to the power of the waves as well. Now, two are stronger than one, and together they might emerge safely. Depression is strong, but love is often stronger.

If someone you love is struggling with depression, you know that depression affects more than just the person who "has" depression. Depression takes its toll out on anyone close to its wake. In Brooke Shields' memoir, Down Came the Rain, I was struck by just how affected her husband, friends, and family were by "her" post-partum depression. Her story is a strong testament that while loved ones can help one overcome depression, it is dangerous to underestimate its powerful effects on one's support network. When seeking professional help for depression, it would be wise to invite them into the treatment process. Not only may support people be the key to swimming to safety, they may need to be thrown a lifesaver, too.

Wednesday, February 7, 2007

The leaves are red; the leaves are brown.

My father is color-blind. Growing up in Michigan, I enjoyed watching the leaves on the maples turn from their usual green to a deep claret red. My father, too, noticed the change, but for him the leaves went from greenish-brown to a darker shade of greenish-brown to just plain brown. Every fall he'd ask me with an air of detachment, "Are those leaves red?" Sometimes they were; sometimes they weren't. The shift was so subtle that it barely registered to him at all.

So it is, sometimes, with postpartum couples. For one partner, the postpartum period can be the most wonderful time in life. Having a new little one in the family is awe-filled experience, often drawing extended family, friends and kin together to support the baby and her/his parents. This period can deepen one partner's feelings of joy, responsibility, love, creativity, and playfulness.

To the other partner, postpartum can seem like the darkest period of life. Sleep-deprivation; health challenges; tense relationships with extended family; a loss of identity, spontaneity and intimacy can make one long for the days before baby's arrival.

It's easy to fall into the trap of trying to prove who's right and who's wrong when two very different perspectives on the same situation arise. Rather than get pulled into this binary thinking, I am curious about what might be helpful or useful from each of these perspectives.

The view that postpartum is a great challenge could lead to discussion of unmet needs or wants. Perhaps parents need to explore the need for more help--or different types of help--from their support network. Professional support (a doula, a therapist, or a nanny) may be needed. It could be necessary to acknowledge what they've lost as a couple--spontaneity, intimacy, etc.--and to explore ways they can nurture their couple identity while their parenting one is at the fore. And while postpartum can bring about a great deal of love and excitement, what's less talked about is how tough a job being a new parent can be. Sometimes simply acknowledging to each other that there are going to be low moments can help mitigate them when they do happen. And they do happen...

Which is why it's useful to recall what's wonderful about postpartum. This new little one is a gift--often a hard-fought one. No one will know or respond to her needs or wants as well as her parents. Perhaps baby's presence can help mend previously broken relationships in a family. A baby has a way of getting one out of one's serious adult mind and into a more creative, playful one. And babies can be so darn cute.

If one can detach from one's own perspective, it's possible to see how two seemingly contradictory statements can be true at the same time. The leaves are green; the leaves are brown. It all depends on how you see it.

Friday, February 2, 2007

Book Recommendation

I cringe at most parenting books. To me, they come off preach-y, too obvious, or just plain hokey. One book that I can recommend whole-heartedly is Becoming the Parent You Want to Be. As a mom with a little one still in diapers, I especially appreciated the section on "toilet learning" (as opposed to toilet training.) It's one of those rare books that has specific practical advice as well as a "wisdom for the ages" appeal. Parenting, after all, is as much an art as it is a science, and this book speaks to both sides of the brain. It's the one parenting book that I could see myself re-visiting time and again.

Monday, January 29, 2007

Autism on The View

Today's episode of The View was dedicated to Autism Spectrum Disorders. For those of you who know someone with an ASD, you know how debilitating it can be. I have worked with teens who are on the Autism Spectrum, and I cannot stress enough the importance of early intervention. Parents are the experts on their own children. If there's something in your gut telling you that something is not right with your child, be persistent. Unfortunately, doctors sometimes dismiss parents' concerns as undue worrying. But if your child is missing early developmental landmarks for speech and behavioral skills, it could indicate the presence of an ASD. Early behavioral and speech therapy for kids affected by an ASD are the best treatment options available. If diagnosed and treated early enough, children have a chance of better understanding the social world around them and engaging with it. Having parents with a boundless source of hope, patience, and energy, I think, is key to these kids' successes.

For those of you who are wondering what it's like to have an ASD, I highly recommend 2 books. The first, "Thinking in Pictures" is written by Temple Grandin, a remarkable woman who has gained great insight into her own struggle with autism by studying animal behavior. The second is a novel: Mark Haddon's "The Curious Incident of the Dog in the Night Time". While it is a work of fiction, the story is told from the point of view of a young boy with an ASD and gives a unique look at how someone with an ASD engages with the world around him. Funny and moving--it's a terrific read.

Monday, January 22, 2007

Postpartum Depression Happens to Dads, Too

Recent studies indicate that postpartum depression isn't just a phenomenon that affects women; men can struggle with it, too. This Seattle Times article sums up some recent findings on the topic. And while women's ppd may be brought on by hormonal changes, the same is not true for men; thus, the research suggests that dramatic lifestyle shifts--not hormonal ones--may contribute more to ppd than previously thought. When you think about it, it makes absolute sense. A postpartum *family* often experiences sleep disruption, changes in identity, different parenting challenges, changes in intimacy, and greater contact with extended family and/or kin networks. All of these lifestyle changes bring about a certain amount of stress. Taken individually, a family may weather the challenge without much trouble. But when these challenges happen concurrently, it's easy to see how depression might creep into a mother's or father's life. And while American culture does much to celebrate a new baby's arrival (as well we should), what is less discussed is the loss parents incur by becoming parents. With growing awareness about how postpartum depression may affect women, postpartum women and the people who care for them are much more attuned to noticing the signs and symptoms of depression. Now we know that we need to be just as vigilant with fathers, as well.

Tuesday, January 16, 2007

Exercise and the Winter Blahs

We are in the dead of winter here in Seattle, which means it is also the dead of cold and flu season. With my blessings, my darling husband went away for a three-day ski trip with friends while I stayed behind with our sniffly 10 month old daughter. Well, as you might imagine, her little sniffles soon turned to a very nasty--and contagious--cold that put me under as well. Add to this "lovely" mix an ill-timed snow storm, and I found myself sick, alone, and stuck indoors with a sick baby. After three days of hibernating indoors, we were feeling a little better, though we were by no means fully recovered. I reminded myself that my daughter would not die if we walked to the playground and back. Though we were gone less than an hour, we returned home in improved spirits. When my husband returned that night, I could honestly say that I didn't begrudge him for going skiing and having fun without us. While I would have certainly appreciated his company and help over the weekend, he couldn't have magically made our noses drain any faster, suppressed our coughs, or eased our fatigue.

I share this story because I believe if we hadn't gone on that short walk, my mood would have probably been a lot worse when he came home. I might have tried to hold him responsible for my having a trying weekend at home, when really no one is to blame: It's just winter, and so sometimes we get sick and feel terrible. Despite "knowing" the truth in my head, a part of me may have wanted to make him feel guilty for leaving--a part of me that might have tried to pick a fight. Instead, I believe that, with exercise, another part--a better part--of me prevailed that night, and I'm happy to report we had a very enjoyable conversation about our weekends over a long, relaxed dinner. I hope that in the future that our evening together will serve as an important reminder that a little exercise for me can lead to a more harmonious and enjoyable family life.

Thursday, January 11, 2007

Postpartum Support

When working with post-partum women who are experiencing depression, I've encountered this pervasive idea that mothers must be "strong" and take care of their children and families first--and themselves last. Popular culture does much to reinforce this idea. How many commercials have you seen where mothers are driving around in minivans, doing the shopping, picking up children from school, dropping them off at soccer practice, and still manage to have dinner on the table while somehow managing to keep the kitchen immaculately clean? Unfortunately, popular images of mothers do little to reinforce the idea that a mother who takes care of herself IS taking care of her family. The post-partum period (which I think is much longer than many doctors would have us think) requires special attention. Indeed, healthy children need healthy parents. By asking for help and support, parents are doing it not just for themselves, but for their children as well. Here is a good clearinghouse for post-partum parent support in the Pacific Northwest.

Tuesday, January 9, 2007

Obsessive-Compulsive Disorder on the Tyra show

Tomorrow's episode of the Tyra show (10:00 a.m. on NBC for those in the Seattle area) will focus on people affected by Obsessive-Compulsive Disorder. I have no idea how informative her interviews will be, but as someone who has worked for over a year with someone affected by OCD, I must say I have a lot of respect for OCD and those affected by it. By "respect" I mean that OCD uses some rather ingenius tactics to get people to do what it wants them to do; to do anything counter to OCD is an act of great bravery. The "voice" of OCD is very compelling and hard to resist. It may warn someone that something terrible will happen, someone they love may get sick or even die if one doesn't do what OCD demands. The "voice" of OCD often appears in childhood and can remain with someone long into their adult years. For those looking for resources on the subject, I recommend the book "The Sky is Falling" by Raeann Dumont. It is an insightful and practical narrative on one woman's work with people (primarily adults and some children) whose lives are greatly affected by OCD and the steps they took in order to take a courageous stand against OCD and its demands. It's a must-read for anyone seeking to understand OCD and other forms of anxiety and phobias better.

Thursday, January 4, 2007

Seattle parenting resources

For those of you in the Seattle area, Villa Academy offers some free parenting resources that you may like to check out. I'm especially interested in the one on brain science and how it relates to children's social/emotional-preparedness for school.