"I am Adam Lanza's Mother"

Trying to make sense of what happened in Connecticut? You must read this piece by the Anarchist Soccer Mom about her struggle to get help for her son who's affected by mental illness in a society that has so few resources to offer them. We must be able to provide better options for people suffering from mental illness than "jail" or "death". Please share her brave and important story...

Surviving Out Loud

Getting a mood disorder is like getting the flu.  It strikes seemingly at random.  No one is to blame.    No one should feel ashamed or guilty that they have it.  There's no vaccine or miracle cure, but there is hope. It sucks, but it will get better with treatment and care.

That's why I love Katherine Stone's album of postpartum mood survivors over on her great Postpartum Progress site.  Just beautiful families who have overcome great hardship to survive and thrive.  As Stone says, "We aren’t defective. We aren’t strange or unusual. We are great moms who were waylaid temporarily by a terrible illness."  And there's nothing shameful in being laid up by a terrible illness.  Indeed, in the same way that catching the flu can make a body more resistant to future illness, surviving a postpartum mood disorder makes a family tougher and more resilient in the face of future struggles. 

Time is on Your Side

I do my best thinking while running.  I did a 12-miler yesterday, and since I'm not a terribly fast runner, that meant I had a lot of time to think.  A LOT of time.

I thought about a former client of mine, let's call her Eve.  Eve would take a walk in the woods by her house every day.  She'd walked the woods so much, she knew them as well as she knew her own reflection in a mirror.  One day, however, Eve took a bad spill on one of her walks, hurting herself pretty badly.  She tried to crawl back to her house, but as darkness fell, she became confused and disoriented.  Eve did her best to take shelter under a tree and spent the night in the woods.

As morning arrived, Eve's neighbor noticed that Eve's car was parked in front of her house, but the house appeared unoccupied.  The neighbor, knowing Eve's evening ritual, went looking for her in the woods.  She found her, dangerously cold and badly hurt.  Eve was rushed to the hospital where she was treated and released--in a wheelchair.

When I met Eve, she had her mind set on learning to walk again, but anxiety tried time and again to talk her out of her goal.  "Sometimes I'll be trying to move my legs, and I see myself lost in the woods again. I don't trust myself anymore. I don't know if I'll ever walk again."

Over the few months Eve and I worked together, I was in training for my first half-marathon.  I hadn't run a step (except to stop my kids from running through the street) for almost five years.  In a sense, I was like Eve, relearning to do something that used to come naturally to me.  I shared with her my training strategy:  Log my time.  It didn't matter how far I ran during that time.  I didn't worry about my pace or any other outcome-based goals.  My goal was to simply log my time.  I believed time + work = results.  That formula guided my training.  I told Eve that if I thought about running 13 miles, I'd give up.  I wouldn't train.  But if I broke it down into smaller increments of time, those smaller goals felt within reach.  I envisioned these smaller bits of time would build upon each other, so that when it came time to do longer and longer runs, it would be hard, but all the experience that came before  would help me get through.

So while Eve started "logging her time" in physical therapy, I logged mine on the trail.  There were certainly high and low moments for each of us, and no shortage of pain and soreness in our joints, but we reached our respective goals.  By the conclusion of our work together, Eve was able to walk with a walking stick, even climbing unassisted into the cab of her friends' truck as we waved good-bye.  And on a follow-up visit, she demonstrated her hard-earned ability to walk unaided around the room.

I ran that half- marathon, crossing the finish line seven minutes ahead of my expected time.  And I"ve done another one since then.  When I run, I think about all my clients who've reached seemingly elusive goals.  Even when doubt  and anxiety tried to tell them it was hopeless, they put in the work anyway.  By logging their time, I have seen them save marriages, end cycles of abuse and shame, reclaim their lives from anxiety and depression, and of course, walk with confidence and grace.

Resolve to Reach Resolution

So, you've made yet another new year's resolution:  to lose weight, to exercise more, to quit smoking, to spend less.  This time, you promise yourself, your sticking to it.  Really.

So where there's a will, there's a way, right?  Well, that's true, sort of, according to a recent article in the New York Times by John Tierney.  Turns out, we all have willpower, it just happens to be finite.  When there's willpower left in the tank, there's a way.

So, how does one keep from spending one's limited supply of willpower?  Avoid temptation.  Easy, right?

Let's say your resolution is to quit smoking.  All you have to do is avoid situations where cigarettes lurk.  In Seattle, the smoking ban in bars and restaurants is tremendously helpful.  But there's still the "smoker's corners" outside office buildings.  The ads for cigarettes at every gas station, convenience store, and grocery.  That's a lot of opportunity for temptation to set in.  Choose your daily route carefully.

So, what replenishes willpower?  Positive reinforcement.  What should you do with the money you saved by not buying a pack of cigarettes today?  Reward yourself with another pleasurable purchase:  a fun app for your phone, a favorite magazine, a warm drink, anything that says "reward!" to the pleasure center of your brain.  Longer-term rewards are good, too.  Curtailing a $6/day habit after a year could net you as much as $2000.  Cruise much, lately?

Accountability is another major factor in sticking to the resolution.  Share successes with a close confidante. Share failures, too.  Do a post-mortem on what's going well, and where you'd like to improve.  Saying it out loud to someone, writing it in a journal, keeping a blog, tweeting, putting post-it notes around your home or office (or both!), all of these activities will increase the "stickiness" of the changes you're making and will help hold you accountable to your plan.

There's enough willpower in your account to make the changes you'd like to see in your life.  Spend that willpower wisely, and when in doubt, phone a friend!

The Self-Care Challenge

Making time for self-care is difficult even under the best of circumstances, but throw a baby (or two or three) into the mix, and self-care is often the first thing to be thrown out with the proverbial bath water. With that in mind, Ann Dunnewold and Diane Sanford started this new blog to create a new and sustaining self-care regimen in just 21 days. In three weeks, parents can develop the habits of mind and body to care for themselves as well as they do their little ones.

To Use or Not to Use Antipsychotic Drugs on Children

My friend Ruthie is getting her PhD in couples and family therapy, which is great because (A): she is super smart and hard-working, and (B): she shares her readings with me, so I don't have to go to the trouble of hunting down the latest research myself!

So, this recent article she shared piqued my interest because many families struggle with the question of whether to medicate a young child who has violent outbursts.

I've seen it both ways. Some kids are really helped by medication, but ONLY IF they are properly diagnosed and treated. Others are mis-diagnosed and over-medicated. By the time they reach 13 or 14 years-old, they realize they've been mistreated and are really, really angry and distrustful of the health system and the adults around them. And either way, it still leaves open the question of what the long-term effects are of antipsychotics on young children. We just don't have the long-term case studies to know with certainty what the outcome will be.

Kyle's family's story illustrates that when family's like his are given counseling and other social supports, children's behavior changes. And at least with counseling, we know there are no long-term biological effects. Long-term social-emotional effects, yes indeed, but physiological harm: no way!

Surviving PTSD After Traumatic Birth

Taffy Brodesser-Akner shared her story on Salon.com about how her traumatic birth experience brought on PTSD. Her story serves as a rallying cry for a woman's right to make informed decisions for herself about her care during childbirth. I loved what she had to say about surviving this unfortunate (and sadly, physician-induced) disorder:

"But what my diagnosis has given me is a sense of relief: relief from wondering what was wrong with me, relief from a pricey conveyor belt of specialists who dismissed me as a hormonal, overwhelmed woman. Relief that I don't have to be a person who can handle everything. Relief that other people have gone through this, and survived."

Thank you, Taffy, for speaking out!

When the Bully Rats are our "Friends"

I recently listened to an episode of "This American Life", where I learned that, on average, half of people's relationships are with friends whom we care a lot about, and yet, these relationships are rife with negativity and animosity. So why do we stay in these friendships? We stay for reasons we seemingly impose on ourselves: out of a sense of loyalty, belonging, or hope that the other person will change. We stay friends with "frenemies" because we think we must. We stay despite the feelings of anxiety, anger, and angst these relationships evoke.

Going back to my earlier post about "bully rats", I've been thinking about how to reduce the stress we experience within ourselves and within relationships. So what to do when our "bully rat" is a friend?

Here's a strategy for confronting what's unhealthy in the relationship: First, sit down with your friend and acknowledge what's good and healthy about the relationship. When is the relationship fun, supportive, comforting? Second, acknowledge what challenges your relationship faces. When does the relationship devolve into negativity, competitiveness, blame, shame, etc.? Finally, make a pledge that you will seek to avoid that which makes your relationship undesirable. Ask your friend to do the same. And pledge that you will hold each other accountable to the pledge against these undesirables. If either of you can't agree to the contract or don't uphold the agreement, it's time to move on. Give yourself permission to do this: Everyone deserves to be loved unconditionally by our friends, or else the "friendship" is just another bully rat in our cage.

Feeling Anxious About Having "The Talk" with your Adolescent?

I read this story about the Birds and Bees Text Line in the New York Times, and thought it might interest parents of adolescents who are feeling anxious about talking about sex and getting it right with their adolescent. With the text line, teens can text a question to a trained public health officer, and receive a response within a few minutes. The article also has links to other useful sex ed sites like Go Ask Alice.

You don't have to have all the answers to your adolescents' questions. It's good to know there's someone out there (who is more informed than the other kids in the locker room) who does.

Important Postpartum Health Study Invites New Moms and Dads to Participate

The UNLV Maternal Health Lab is conducting two surveys on postpartum
mental health. We need 500 postpartum women and their partners, who have had
children within the last year and who are 18 years and older to complete a
30-minute anonymous survey. Please go to this site and click
either the Postpartum Moms or Postpartum Dads links. Thank-you for your assistance.

Tell President Obama Your Health Care Ideas

President Obama is asking for our ideas about improving health care in this country. I have too many to mention here (though universal screening for post-partum mood disorders and decriminalizing drug offenses in exchange for treatment immediately spring to my mind), and I suspect you, dear reader, have some pet issues of your own. Here's your chance to let your voice be heard. Click on this link to be taken to the Obama health care page.

Can we change health care delivery in this country? Yes we can, indeed!

Alternative Treatments for Mood Disorders

With the days growing shorter here in Seattle, it's hard not to notice the way the changing seasons can affect one's mood. Coupled with the recent terrible financial crisis news, there's lots of grist out there for anxiety's and depression's mill.

I've also been thinking about the growing numbers of people who have been laid off (or are due to be laid off) from their jobs, and will be going without health insurance. Without such insurance, the cost of psychopharmacological interventions can be prohibitive. With that in mind, here are a few ideas for (potentially) lower cost alternatives:

Light Therapy: Long recommended as a treatment for Seasonal Affective Disorder (SAD), there is growing evidence (as in this meta-analysis by Gjerdingen) that it can be effective for treating antenatal and postpartum mood disorders. And while phototherapy equipment isn't cheap (I think they go for $250, or thereabouts), it's still less expensive than a month-long trip to Hawaii (which, in my opinion, the government should subsidize for us in the far northern reaches of the U.S., don't you agree?)

Massage Therapy: Gjerdingen also points out that massage therapy has been effective in reducing stress and anxiety symptoms in teenage mothers (a notoriously stressed-out group). Yes, massage therapy can become pricey quickly. It's worth asking at your local massage school or community college about their rates for student massages. (Many charge little or nothing at all in exchange for helping out a massage student.)

Yoga: I've written lots about yoga's beneficial effects on anxiety and depression in this blog. Please see my previous posts for evidence of its efficacy, and particular poses to try for various mood problems.

I'm sure lots of you have ideas about inexpensive ways of coping when mood problems set in. You are welcome to post them in the comments section, so we may all learn from each other's experience and wisdom.

Yoga for Fertility

We are very lucky here in Seattle to have Lynn Jensen among us. Her Yoga for Fertility classes and workshops have helped many women during fertility challenges and other female health problems. Lynn has a kind and reassuring presence and is a genuine teacher of healing the mind and body together through calm and ease. She offers Yoga for Fertility at various Seattle area locations, including West Seattle, University District, and the Eastside.

Catching Up to the Clock

Since it is Spring-Ahead Monday, I just wanted to share a little reminder to go easy on ourselves today, as our bodies and brains try to catch up to the clock. Here are 4 reminders to help us be safe and well this week:

1. Allow yourself extra time to drive where you need to go. Or better yet, walk or take public transit until you feel your reaction time returning.

2. Eat a healthy dinner at least 2 hours before bedtime.

3. Choose a quiet, non-anxiety-inducing activity before bed, like reading, meditation, listening to music, or knitting (unless, of course, you're like me and would consider knitting an anxiety-inducing activity).

4. If possible, try to fit in 20 minutes or more of exercise, preferably in the beginning or middle of the day. Those yogis among us might like to try sun salutations first thing in the morning. Others might like to walk during lunch break, bike to work, or run around the park with your kids. No kids, you say? Then bring a basketball or soccer ball to the park and you are sure to meet some!

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.

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.

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.

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?

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.

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.