5 Tips on how to talk to your daughter about her body?

Blythe body comparison
Blythe body comparison (Photo credit: wellapptdesk)

Recently, I came across a compelling,  well written, and well-intended blog post advising  people NOT to talk to their daughters about their bodies, except to teach them how it works, (like this one).  It was not the first one of it’s kind- the notion that commenting on a young girl’s looks is detrimental to her well being seems common.

As a clinical psychologist who treats eating disorders and body images issues, I thought I’d chime in.

My reaction to this is: NO!!!!

You’ve got the right intentions, but you’re going about it in a way that only speaks to a shame and discomfort with bodies. Therefore, not talking about bodies with your daughters only perpetuates the problem.

Here are some ideas as to how to approach our daughters throughout their childhood years.

DELIGHT.  REFLECT. TEACH. OBSERVE.  LISTEN.

1) DELIGHT

Express DELIGHT where it naturally emerges.

DELIGHT in your daughter’s looks as she grows up no more or less than you would delight in her other attributes.  Do not pretend to like something, or offer fake compliments in order to artificially boost her self-confidence.  DELIGHT is not the same as praise.

To connect to the feeling of DELIGHT, remember back when your daughter was a baby, when delight in her appearance came naturally. Her smile, everything about her face moved you completely.  Remember her chubby wubby yummy thighs, so big and wonderful and juicy, they made you squeal aloud, and you had to resist the urge to pinch.   Try to find that natural channel of delight in your daughter’s appearance as she grows….how her hair is growing thick and long, like aunt Sally’s , and how she has eyes that change color depending on the setting, and how her toes are long and strong and unusually tan.  Or, marvel at how she looks so much like the girl in that Renoir painting that you saw at the art museum- that will mean the world to her.

The delight you express in her appearance, as in her other attributes, is the delight she will eventually internalize- it is the voice that she needs to hear when she looks in the mirror, the voice that will drown out other less friendly voices, such as the media’s.  (Don’t praise her body only when she loses weight).

Share with her your DELIGHT in food.  Introduce her to all kinds of foods and show her that food is sensual, and enjoyable: cheese, quinoa, chocolate, raspberries, juicy hamburger, avocado, kale…. all of it!  The experience of DELIGHT adds beauty to the body.   Teach her that it is attractive to eat with relish and then take DELIGHT in her delight of food. (Don’t show her how to count calories or restrict her appetite).

DELIGHT and share awe in the wonders of the body: the body knows exactly what to do at different stages of development, has perfect timing for when she will get her period, and develop secondary sex traits, and the body will take over when she conceives a child and craft a perfect little specimen without any conscious effort on her part. WOW! Similarly, the body has a built in mechanism that helps her know when she is hungry and when she is full- she can listen to it and trust it. Delight in her ability to listen to these internal hunger and satiation cues, despite what others are saying she should do. (Don’t model or encourage dieting; don’t interfere with these internal cues).

DELIGHT in her aesthetic choices even if they do not match yours exactly- they are expressions from deep inside of her, the colors, or styles that move her.  Putting herself together in the morning is a creative and effort-ful act- know that her body is her canvas, and understand that these creative expressions speak volumes about her.  Get curious rather than critical about what she is revealing about herself. (Don’t try to control how she looks or interfere with this creative process).

2) REFLECT

A young girl doesn’t know how she is perceived in the world. She does not understand the impact of her body, or that the way she presents herself is a communication.  You teach her how her actions affect others, and so you teach her how her body and appearance affect others.

Having tattooes and piercings, wearing pearl earrings, wearing a bra, not wearing a bra, showing cleavage or not, wearing the skirt long or short, or just in the latest color, smiling in a situation, or not, are all external expressions of the inner self.  They are not good or bad in and of themselves, but they do have a certain impact.  Encourage her to make choices for her body that reflect what she feels on the inside.   Help her understand the impression she makes on others given her physical attributes as well as the choices she makes in presenting those.  You can reflect back what you see, particularly when she asks for feedback. Give her some space here too. Let her make some mistakes. She will have to experiment a bit before fully applying what she has learned. (Don’t criticize and don’t lecture her).

3) TEACH

Teach that confidence is an important aspect of beauty.  Being at peace, rather than at war, with your body carries it’s own kind of beauty.  Compare a “beautiful” girl who is constantly criticizing her looks to a woman who by conventional standards is less “ideal”, but is content with herself…you will see that very contentment in every pore, fiber, strand of her body, and in the glint of her eyes.  That inner confidence and contentment become an actual physical trait.  I’ve seen girls who are “beautiful” by conventional standards but their bodies are battle grounds for psychological issues, and it shows….it ain’t pretty.

Teach her that she does not have to be the most beautiful or the thinnest to have a happy and fulfilled life! The proof is everywhere- look around.

Teach her that no matter how beautiful she is there will always be someone who does not find her beautiful, or some other woman who is more beautiful….so what?  That’s completely okay and doesn’t take away from her worth or her opportunities in the slightest. There’s room in this world for all of her beautiful sisters.

Teach her that even though the current social ideal is to be thin, every woman has a natural weight range that is, more or less, genetically determined.  Trying to change her weight in any dramatic fashion is like deciding to wage war against herself and against nature.  It’s possible to be at the lowest reaches of her range, but her body will rebel against her: osteoporosis, amenorrhea (loss of menstrual period),infertility, thinning hair, premature aging, and electrolyte imbalances that can be life threatening….

Teach her that being “overweight” (based on a measure of Body Mass Index) can be healthy and possibly even associated with a longer life span- (it amazes me that so few people know this!). Bodies of many sizes can dance, and move, and sport beautifully- they are healthy.  (For more info on this click here and here).

4) OBSERVE

Some people wish to separate the inside from the outside, to make the soul more important than the body.  But the truth is the two are intertwined.  What is inside will eventually show on the outside too.  Your daughter’s body will reveal her deepest feelings, if you will only let yourself see.

If your daughter slouches because she is a head tall above the rest of her friends, then you can be sure that her sloped shoulders are telling you something- they are telling the story of her hidden feelings about herself.  You can choose to ignore it or you can talk to her in a way that is supportive and not shaming.  Instructing her to stand up straight every time you see her slouch is NOT helpful- that is not a conversation about her body or her feelings and will only make her more self-conscious in your presence.  Approach her with loving kindness and curiosity, and tell her that you’ve noticed that she is slouching more recently and ask whether something might have prompted this.   If she trusts you, she will tell you more about her feelings.

If your daughter suddenly gains or loses a considerable amount of weight in a relatively short period, then you can be sure something is going on inside of her.  Sometimes this is your daughter’s way of trying to get your attention!  Her body is speaking to you, because she can’t. She is begging for you to talk to her. Her sudden binge behavior and her extra (or missing) 30 plus pounds are an expression of the pain she feels inside. Encouraging her to lose weight in this situation does not address her pain and only perpetuates the problem.  Many girls I have worked with are furious with their parents for not noticing these dramatic changes in their bodies, and pretending that everything is okay.  Ignoring these kinds of changes in your daughter’s body sends her the message that you’d rather not deal with what is plaguing her.  Either you can’t handle her feelings or you’d rather stick with your story that “everything is going swell with our family”.

5) LISTEN

We often forget that listening is one of the most important aspects of engaging in conversation with another human whom we value.  If you approach your daughter to talk to her about her body, remember that the main thing for you to do now is LISTEN.

Build a trusting relationship with your daughter throughout her childhood years (not one with a history of you criticizing your daughter’s body.) That way she feels comfortable to talk to you about anything that is difficult for her. Your years together have shown her that you can handle her difficult feelings.  She’ll be able to bring up any issues she has about her body.  If you two can talk about BODY, then you know you have a trusting and deep relationship, and not one that just keeps things light and positive.

If you feel that you have a strained relationship with your daughter, or you fear that you may have engaged in some unhelpful criticism of her in the past, it is never too late to reach out to her. A loving and compassionate gesture from you can be extremely healing to both of you and to the relationship. If speaking to her about what you see feels overwhelming, try contacting a family therapist to help reopen the line of communication between the two of you.

Remember: talking to your daughter about her body is talking to your daughter about her deepest feelings.

All the best,

Dr. Anat

To learn more about my services: https://dranat.com/

Here are some other resources that promote a healthy approach to bodies:

The Health At Every Size movement: haescommunity.org

Elizabeth Patch’s images at moretolove.net

Also, there are some beautiful letters from moms to their daughters on-line about their bodies, like this one.

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On Emotions: Part 1

waves

Emotions have a natural flow that we can liken to waves. They build, crest, and then merge back into the ocean. They are events with a starting point and an end point.

Continue reading “On Emotions: Part 1”

I’ve been a spiritual person all my life: Why am I still stuck?

dreamstime_xs_13767454“I’m spiritual, I try to be a good person, I try to have positive thoughts, and embody all that is virtuous….I do yoga, I meditate, I eat healthfully, I’m kind to others……Why am I still unhappy? Why can’t I find a relationship that works? why do I feel stuck?

I’ve tried lots of different therapies, emotional freedom technique, tapping, positive visualization and imagery, but I still feel that I’m not at the place that I’d like to be?”

Does this describe you? Do you try SO SO SO hard to be happy, and be the ideal you and yet you still feel stuck, only to pick up again and try the next alternative healing modality that promises to finally bring you to that new happy state of being that you’ve longed for?

The driving force behind spirituality and transcendence is beautiful and noble and poetic and tragic all at once. There is so much to be said for wanting to soar to the sky, and reach highest heights of human nature and existence. However, even our western mythology warns us that if you soar so high, your wings may get burned and you may end up falling into the ocean (See the myth of Icarus and Dedalus).

So what’s going on?

Being a spiritual person who always aims for an ideal state sometimes brings with it quite a bit of agony. It is very VERY easy to fall short of an IDEAL, and therefore very easy to be in a perpetual state of disappointment. That is the paradox inherent in aiming for lofty goals. That doesn’t mean, by the way, that one shouldn’t aim high or have ideals. But the ideals need to coexist with a good dose of self-acceptance which also allows flaws, negativity, shortcomings, and disappointments.

Here is another way to think about this: You cannot operate an amusement park without having a sanitation department. Or, try this analogy: you can’t have a body with a digestive system without also having an excretory system. You can’t relish gastronomic delights without also having a built in system to rid yourself of the waste matter from these delicacies. Make sense?
That means that you need to have a way of dealing with negativity, dirt, grit. You can’t just try to keep it out of your amusement park. No one would be pure enough to enter, because everybody is going to bring in some of their garbage. And you’ll end up spending all of your time warding off the negative, or being afraid of it

I’ve worked with many clients who bring in their beautiful spiritual aspirations. They keep trying so hard to embody those, without the awareness that it is precisely this desperate NEED for an ideal that causes them psychological distress. Why do they keep feeling angry at their boyfriends, why do they still stew in self-doubt. Why can’t they just get rid of these despicable emotions and always be content and calm and thinking of positive things?

IMPOSSIBLE. If you are a being that is in touch with yourself, you will run across a gamut of human emotion. They are like multiple colors of a spectrum. Trust me, you don’t want to get rid of any of the colors- if you do, your world will start to look gray or two dimensional. Even if you meditate non-stop, you will not eliminate human nature of feelings. However, you will learn how to ride the emotions in a way that does not seem so overwhelming. You will learn to experience the range of human emotion, positive and negative, and learn how to constructively run a human life that can contain all of those emotions. You will not be trampled by the many inevitable feelings that arise for us all as we walk through life, good and bad.

Therapy is one place where you can learn how to sit with negative feelings, and train yourself in the art of juggling a wide wide range….so that ultimately you can also enjoy your spiritual aspirations. Mindfulness (and other types of meditation) when practiced in this context also ultimately help people achieve this level of contentment and self-acceptance.

If you have any questions or thoughts on this, please please comment.

Regards,

Dr. Anat

Ghosts in The Nursery: How the Past Affects the Present

The title of the 1975 paper “Ghosts in the Nursery” by Fraiberg, Adelson and Shapiro haunted me as I became a mother.
Why should I be haunted?  I’m a therapist, I know the past affects the present.  Yet, how chilling….to vividly imagine that some nurseries are riddled with quite very many ghosts.  The ghosts that Fraiberg refers to are the kind that are unseen, tormented, and tormenting.  They don’t have voice, or body, or substance, but they have impact.  How?  They often manifest as symptoms, deep emotional wounds, and broken relationships.  Sometimes, the symptoms and problems are experienced immediately in the form of children acting out, or tension in the home.  Other times, these symptoms come out only years later in the form of a relentless depression, anxiety, or an eating disorder through adulthood.

Where do these ghosts come from?  They are your father’s or mother’s mother’s mother.  Sometimes it can be great great grandfathers and great great grandmothers too.  They represent the voices of the past.  According to the article, they are usually, the abusive voices.    The father’s voice who abandoned the family; the mother’s who favored the first born and neglected the others; the parents’ who wanted to control too much.  Theirs are the voices of ghosts that linger, and haunt, and continue the inter-generational transmission of past trauma.

In the above mentioned paper, the thesis and conclusion are clear.  The authors suggest that many people experience pain or difficulty during childhood, but not all parents inflict that same pain on their children.  What distinguishes those that do repeat the past trauma from those that make a conscious effort not to repeat the pain of the past?  The authors emphasize the importance of remembering the pain.  If one can remember the pain, then one is less likely to fall into “identification with the aggressor” (see below for explanation of this psychological concept) and hence the reenactment of the past.

The 1975 article reviews two case studies.  The first case  study well illustrates the authors’ point.  In this case, Mrs. March cannot give her daughter Mary affection.  She is emotionally cut off from her, and preoccupied with the thought of abandoning her, and giving her up for adoption.  She is also focused on the possibility that her husband is not the biological father of Mary.  Both of these preoccupations represent obsessions with the past, as Mrs. March herself was abandoned by her mother, and has a family history of promiscuity.  Her unconscious is fixated on the conflicts and dilemmas of past adult figures, and she is repeating their experience (identifying with the aggressor) rather than identifying with the victimized child in the situation.  After some time in therapy she begins to access  memories of her own pain (which she had previously isolated or repressed), and can cry over her own childhood wounds.  Only then can she begin to respond to her baby’s cries.  The case is successful since Mary’s initial developmental delays, lack of interest in the world, and lack of connection to her mother eventually resolve- she catches up to other babies her age in most social, emotional, and developmental categories, and only has some motoric lag.

*  *  *

I love this beautifully written article.  It is moving, and the empathy for the patients seeps through the words.

I agree with the central premise of the article, despite how simple it sounds: those that remember, don’t repeat; and those that don’t remember, repeat.   That is the crux of therapy, to remember.  However, I think it is worth pointing out that in general childhood is hard to remember, ghosts abound, and many of us repeat.

Childhood is such a distant past for us all.  Childhood has nooks, and crannies, and crevices; ghosts, and angels, and wolves, and elves.  It has textures (rough, gooey, soft, prickly), and sounds (caustic, soothing, perplexing), and smells (familiar and curious).  It’s full of things we did not yet understand, foods we could not yet eat, and things we could not yet express.

Who can possibly remember all of those?

I’ve heard it said many times that when you have a child some of the memories and sensations of youth suddenly spring forth.  Hugging my child brings back the hugs of the past, or the lack of hugging.   Seeing my child struggle brings back how my parents dealt with my struggles, or how they criticized rather than helped.  Seeing my kids relate to one another brings back previously forgotten fights with my brother, and how my parents created amity between us or enhanced the hostility.
The ghosts don’t so much whisper in our ears as they actually inhabit our bodies and take over, doing what is automatic to them.

But the ghosts are sometimes friendly ghosts, not just the kind that haunt and torment!  For instance,  they can enhance our well being in suddenly infusing us with the memory of a gentle, and kind touch, the one once received and the one we now offer our child.  Even when we are not traumatized by the past, it inhabits us and speaks through us, for better or for worse.

If our ghosts are more of the sadistic variety rather than a friendly crew it becomes especially important to turn on the lights, and stare the ghosts straight into their core PAIN…the pain that they harbor and the pain they inflict.  That is what therapy is for: turning on the lights so that we can at least see what we are contending with.  When the ghosts are of the friendlier or less toxic kind, it can almost be enjoyable to maintain the nursery’s mystical air, and allow the ghosts to create pretty mirages,  pleasurable reverie, and prompt us into further insight about ourselves.

What is your experience with ghosts in the nursery?  How does your past (the good, bad, and the ugly) affect you in the present?  How does it influence how you parent?

Fraiberg S, Adelson E, Shapiro V (1975).Ghosts in the nursery. A psychoanalytic approach to the problems of impaired infant-mother relationships. Journal of the American Academy of Child & Adolescent Psychiatry,14(3), 387-421.

To read full text article click here

For other Work by Selma Fraiberg:

The Magic Years by Fraiberg, Selma (1997) Paperback

Selected Writings of Selma Fraiberg

To learn more about my services: https://dranat.com/

What to talk about in therapy?

Some clients come in confused about what to talk about in therapy. They want to be helped, but genuinely don’t know what they should be bringing to their session. Some people come with the idea that the therapist will ask the questions that will stir the material. That is sometimes the case, especially in the initial sessions- the therapist will try to gather information, and so she will ask the questions that will help her understand you and the issues you present. For instance, she will ask about the specific problem that has led you to seek therapy. She will ask about the history of that issue, any other related issues that you’ve struggled with (past and present), family history, experience in past therapies, and more. Sometimes it’s the case that clients do a great job in the initial sessions, only to find themselves at a loss for what to talk about after that.

Well, here is what I would suggest:
Talk about what moves you, or stirs you, or pains you, or elates you.

Talk about what goes on for you, on the inside and the outside. Paint me the picture of your life, and your mind and your heart. Bring pictures, or a video clip if you have to, or graphs and charts, if you feel compelled….if you feel that will really help me understand, because I want to.

When you feel more comfortable with me, dare to tell me what’s in the very recesses of your mind….share the thoughts you’ve always found the ugliest, the most unloveable, the hardest for you or others to swallow. The fantasies or dreams that are the scariest or most disturbing. We’ll have to get there eventually if you want to get better, so try to be courageous and go there earlier rather than a few years down the line.

Tell me sweet nothings that occurred to you between sessions. Did you realize something new? Did you think back to a topic we had discussed a week or a month earlier? Was there something new that dawned on you that you thought was imperative to share?

Did you have a dream that confused you but left an impression? Talk to me about your day dreams, and night dreams, and nightmares. Nothing is too shocking or bizarre.

Talk to me about any aspect of the therapy. Nothing is too big or too small. Tell me how you think we’re doing. Is the treatment going well, what’s helpful and what isn’t? We are supposed to collaborate here, so if I’m going in a direction that you don’t like, tell me, don’t tell your best friend that you don’t like the direction your therapy is taking. Or maybe, something more specific happened? Did you have a bad reaction to something I said, or to my facial expression, or mood that particular day? Maybe you don’t like how I dress or my thighs bother you (all real life examples, by the way)? Tell me! Among therapists, this is often considered the most rich material. All of these can lead us in fruitful directions, helping us understand your reaction to people, the things that often bother you and nag at you, that in most social settings you would find inappropriate to bring up. Well, therapy is the place to be real and talk about the hard stuff, and understand some of the things that rub you the wrong way about people. It gives you the opportunity to be more candid than usual with someone, and realize that the relationship can survive and in fact become stronger as a result.

Finally, if there is a pause in our conversation, or a lull, don’t feel like you just have to rush in with something to say. This is not a regular conversation. You’re supposed to be going deep inside and that can take some mindful breathing, and quiet musing. Similarly, if you say something and I don’t respond immediately, bear with me. I am thinking all the time, and have plenty to say. I don’t want to say it too fast. I don’t want to reach conclusions too quickly and close the discussion. I don’t want to engage in day to day chit chat with you. I am deliberately setting a different kind of pace and tone to our conversation, one that is different from conversations that you have with friends outside the therapy room. Why? Because something deeper has to transpire here. You need to have enough space to feel things thoroughly, not just avoid them, the way you usually do out there (because believe me I know, they’re usually too painful to look at). I’m trying to give you room to flesh things out, and I am timing my interventions. And more than anything, I am trying to listen to you with my entire being, and not just offer up the first thing that comes to mind.

Also, to read more tips to clients from another psychologist, refer to this page written by Ryan Howes, Ph.D. He writes a blog for Psychology Today and I found these 21 tips on his website- I think this is an excellent summary of tips clients should know as they begin therapy in order to get the most out of the experience. http://www.ryanhowes.net/id42.html

To learn more about my services: https://dranat.com/

How Does Therapy Work?

Many theorists have written about what we call “the curative factors” in therapy.    There are many opinions and varied techniques for helping people achieve their goals in therapy.

Here are only a few of the main curative factors.

INSIGHT.  Many people pursue therapy in order to gain insight into their psychological dilemmas.  With a therapist guiding a thoughtful and “objective” examination of one’s inner life, people attempt to outsmart their self-sabotaging patterns.  Think about it: how  powerful would it be to observe how you shoot yourself in the foot over and over again.  It is in fact awe-inspiring to notice how you are quick to repeat the same mistakes, and very very humbling.  This is surely an important aspect of therapy.

VENTING/(ABREACTION).  Many people find that they need to vent, at least once a week.  They feel that they have an accumulation of feelings that need airing out, and they feel that they do not want to burden their friends.  Some have believed that feelings build up and eventually create a pressure cooker kind of effect on the person, who then needs to let those feelings out in order to reach equilibrium.  However, there is little in the literature that supports this theory.  Yet, there is evidence that articulating previously unarticulated feelings can do wonders for a person’s mental health.  Talking about feelings, putting them into words, writing about them, helps one feel more in control of one’s experience and less at the mercy of feelings.

CHANGING THOUGHTS AND BELIEFS.  Some begin an inquiry into the nature of their thoughts.  Often people play the same inner tape (of thoughts) over and over again.  It’s like a inner commentary that is on “repeat” despite the external stimuli changing constantly.  Put another way, even though people go through different life experiences their interpretation is often the same.  One example is someone who always concludes that she is to blame, or that something is wrong with her, regardless of the situation.  Therapy begins the work of identifying these repetitive thoughts and core beliefs, and then challenging them.  For instance, maybe it’s time to begin to interpret situations in a new light, and not always take on the blame?

CORRECTIVE EXPERIENCE.  Some people carry emotional wounds from childhood, often inflicted unwittingly at the hands of close caregivers.  Therapy is an opportunity to have a “corrective emotional experience” with a therapist who hopefully takes a genuine interest in the conflicts of the patient, and creates an accepting and supportive environment in which the patient can explore without shame and ultimately thrive.

MEANING MAKING.  People tell the story of their lives in a particular way.  Beginning therapy can allow a person to tell her story again in a new light incorporating new meaning which arises with reflection.

EXPERIMENTING WITH NEW BEHAVIORS.  The therapist might suggests new ways of being and acting in the world, which represent a departure from previously destructive sets of behavior.  Sometimes this involves literally learning new coping or social skills, and then trying them out in the world.  Often, the therapist and client collaboratively create a list of challenges/fears for the patient to gradually confront in a pace that is comfortable.

Each therapy treatment is different and may involve all or just one of the above mentioned factors.  Ultimately, research suggests that the factor that best predicts the outcome (success or failure) of the therapy is the quality of the therapeutic relationship….it is NOT the use of a specific technique or modality!  That is an unbelievable research finding, when you think about it!  That means that if  you feel connected to your therapist, if you feel she is helping, and that there is a sense of warmth and empathy and collaboration in addressing whatever ails you, then you will most likely perceive yourself benefiting from your treatment.

Good luck with your therapy!  Please take a moment to participate in this poll and share your views on what makes therapy work.

The Psychology of Breastfeeding: Why breastfeeding is not for everyone

In the wake of the Time magazine article on attachment parenting, and its provocative cover of a woman breastfeeding her four-year-old, I wanted to share a few thoughts on breastfeeding from a psychological perspective.

Breastfeeding is one of the most natural and beautiful exchanges that occur between two human beings, mother and child.  There is literally a flow of milk, energy, sustenance in this one act.  It is a gesture in which one human being, the mother, gives of herself so that the infant can survive, grow, and thrive.  It is a one-sided exchange, in which one member clearly gives, and the other simply takes.  In fact, one might call this an altruistic act on the part of the mother, who in moments of sheer exhaustion still reaches for baby and allows her to suckle on the breast.  Quite often, baby fusses at the breast, crying and flailing about, as mom temporarily suppresses her own urges to eat or go to the bathroom or sleep in order for baby to finish her feeding.  At times even, breastfeeding is downright painful for mom, as baby bites mom’s nipple to figure out a workable latch.  Or mom gets mastitis, an inflammation of the breast tissue which can cause severe discomfort and fever.  Still many moms love it…the bodily contact, the sense of connection, the opportunity to participate in the universal act of nurturing.

But breastfeeding is not for everyone.  From a psychological perspective it can trigger unresolved issues in many moms and therefore turn an idyllic mother child exchange into a torture chamber for two. For this act of breastfeeding to feel nurturing to the fullest, I might argue that mom must feel good about breastfeeding, and she should enjoy the experience more than she dreads it.

For many women the act of giving to a baby may bring up memories of a difficult childhood, a childhood in which they did not feel nurtured enough- if mom was not a recipient of love and nurturing, she might find it difficult to give that love and nurturing to her baby. She may then feel resentment towards her baby for demanding so much of her, and may find herself depleted by the act of a baby physically cloying at her in need.  In other words, the pain of mom’s unmet/unfulfilled needs might resurface.

Some studies suggest that women who suffer from postpartum depression have more difficulty breastfeeding.  This can occur for a number of reasons. Often moms become disappointed in themselves if they are unable to breastfeed and therefore start to fall into depression.  Or they are depressed as result of hormonal changes in the postpartum phase, and therefore unable to to weather some of the inevitable challenges that surface with the initial phases of breastfeeding.

For women who struggle with eating issues, breastfeeding might once again stir up some difficult feelings.  If mom finds it challenging to feed herself, what will it be like to feed her baby?  What’s it like to think about the baby’s hunger and satiation cues, if mom is disconnected from her own.  I have worked with moms who have worried about unconsciously transferring their eating disorders onto their infants.  Yet, they have bravely worked hard to reverse the ill effects upon themselves, and to create a safe enough environment for their children to experience their own hunger and fullness.

Women who do find themselves triggered by breastfeeding might choose to courageously work through the issues as they arise.  But even without any of these psychological triggers at play, some women just find breastfeeding physically demanding and expensive.  For instance, many women invest in lactation consultants, and breast pumps in order to boost their milk supply.  They find themselves anxious and worried about getting the breastfeeding going since baby’s growth depends on it.  They spend hours on the pump in order to provide milk, and don’t get to enjoy the first days of baby’s life.  They begin to lose sight of the true purpose of breastfeeding: to connect with baby!- all of their worry and anxiety about breastfeeding in fact leads to the very opposite, distance from baby.

I am a breastfeeding advocate- breast is wonderful.  However, more than anything, as a psychologist I believe in maintaining the sanctity of the psychological space between you and baby- that means making the psychological well being of you and your baby the top priority.  Baby needs a sane, happy, fulfilled mom more than she needs her breast.  If giving your baby the breast is triggering, difficult, or painful to the point of interfering with your mother infant bond….give her some formula instead;)!

“MY WHOLE HOUSE IS GREAT!!!!!!!!!!!” vs “MY WHOLE APARTMENT IS CRAP!!!!!”

FOR A LAUGH, AND SOME FUN, WATCH THE FOLLOWING VIDEOS IN THIS ORDER:

WHAT HAPPENED?? FROM OMNIPOTENCE TO DEGRADATION, FROM DELIGHT TO DISGUST, musings by Dr. Anat

I don’t have a particular message or idea that I want to convey in reference to these two videos. I just knew that both of those videos, viewed together, struck a chord. I couldn’t resist posting them here, and then letting my stream of consciousness guide me.

The intensity of the positive outlook in the first one is shocking, delightful and entertaining. It’s funny that it stands out as unusual that anyone, even a little girl, might feel so ecstatic about everything in her life. (Despite the childish, you might say naive, overly idealistic outlook of the first video,) I found myself wishing that my child, my patients, my loved ones could also have the experience of appreciating everything in their lives to this degree.

The second video, which is a dramatic commentary on the first, struck closer to home. Even though this one was only an actor’s spoof on the first video, it felt so real to me- it better represented the inner thoughts of the patients that I treat. The mirror experience for many women, particularly women who have body image and eating issues, can be harrowing to the point of triggering a deluge of negative evaluations of self and other. Even though this video makes you laugh, you can imagine that when a person hates everything in her life, she is truly suffering.

Some patients wonder about positive visualization/affirmation/thinking as a technique to improve mood and self-worth. I have many thoughts on this strategy, and sometimes believe that many people use it as yet another way to deny their feelings (-I’ll post thoughts on this in another blog). However, in certain cases, I believe that positive thinking can be VERY powerful! Often people forget to appreciate everything they have in their lives. People tend to magnify their problems and focus on those. They engage in a host of what some therapists call cognitive distortions. Here are some examples of distortions that people typically engage in:

1) Catastrophizing- Focusing on worst case scenario for a given situation

2) Minimizing/Magnifying- minimizing the importance of positive traits or events, and magnifying negative ones

3) Overgeneralizations- Reaching a general conclusion based on an isolated incident. (i.e. after one bad haircut, concluding that all my haircuts are bad. Doing poorly on one exam, and concluding that I’m a generally bad student)

Ceratinly, the 20 year old Jessica of the second video is guilty of these cognitive distortions. Are you guilty of these kinds of distortions as well?

It’s important to identify problems, and then try to solve them. However, overemphasis on the negative is itself a distortion of reality. Let’s not forget to attend to and express gratitude for what is working- let’s notice some good things too.

In terms of body image and self image, it can be invaluable to point out the positives! Body IMAGE has more to do with how you IMAGINE your body than how it actually is. Thinking positive thoughts about yourself, and how good you look can make you feel better. When a woman has positive thoughts about herself, and feels confident, she radiates that- her body movement, gestures, smile all reflect that confidence. If she’s focused on all her worst qualities all of the time, the varicose veins, the cellulite, the large arms, she will appear less magnetic and beautiful.

In conclusion, perhaps a good dose of positive affirmations in front of the mirror, a la Jessica style (of the first video!) might go a long way to improve your self worth? I don’t know!!!- that might be a bit of a stretch for some of you who are feeling rather down. Alternatively, maybe it’s just enough to watch the first video and marvel at this young girl’s self-acceptance and aspire to it, making a little room for that attitude to slowly creep into your life. Why not? you deserve it, or don’t you think so?

Perchance to Dream?

Dreamers at the Rubin Museum of Art

On Saturday I had the honor of participating in the Rubin Museum’s (http://www.rmanyc.org/) special event, THE DREAM OVER. This event was featured as part of a month long series, entitled BRAIN WAVES, which includes lectures and events that explore the science and art of dreams. For the DREAM OVER the museum invited the public to sleep in the space under a piece of art that was chosen for them based on a series of 3 questions: 1) why would you like to participate in the Dream Over 2) what are the three most significant events of your life and 3) What color resonates with you most. I was not among those who slept at the museum. Rather, I was part of a group of volunteers who who arrived early in the morning to wake up the sleepers, and to engage them in a conversation about their dreams and their chosen object of art.

I spoke to 5 people that morning, and listened to them recount a dream or speak of the surreal experience of sleeping in a museum. I tried to get a sense of how the art work or experience influenced the dream imagery. Members of the New York Psychoanalytic Institute will be studying the material more closely.
From a personal and professional standpoint, I was interested in the dreamer’s psyches and the significance of the event and the dream in their lives. However, the nature of the event did not allow the kind of probing and deepening that I am accustomed to in the therapy room. Hopefully, some of the dreamers will be curious enough to explore further what was revealed to them through their dream.

Why should I bother with my dreams?

There are many different theories about dreams. Some theories posit that dreams are mere expressions of random neuronal firing in the brain, and that reading into them is like trying to make sense of chaos or noise. However, many traditions see dreams as prophetic, potentially healing, almost oracular. From a psychological standpoint, dreams are a portal into a person’s psyche or unconscious. Freud saw dreams as wish-fulfillment, and Jung saw them as potentially facilitating transcendence. You can learn quite a bit about a person by engaging them in a discussion of their dreams.

In my clinical work with patients, I borrow heavily from the person’s dream imagery to move the work forward. I believe that dream images are constellated around certain emotions that are otherwise dissociated (outside of awareness), vague, and often too daunting for the patient to deal with. The images allow the person to begin to talk about these difficult feelings. I rarely interpret a dream outright. Instead, I ask a series of questions about the dream that stimulate thoughts and feelings, always maintaining an air of wonder and awe at the psyche’s creativity. Here are some of the questions that I draw on to begin this dialogue. Try these simple questions and see where they lead you:

1. Describe your actions in the dream. List them here:

2. Describe the feeling in the dream. List them here:

3. How are these actions or feelings different or similar to actions and feelings that you experience in your waking life?

4. What are the major contrasts and/or similarities in the dream? (i.e. distance/closeness, cold/hot)

5. Do any of the above themes/conflict (contrasts or similarities) pop up in waking life?

6. What are the major symbols/images/figures in the dream? List them here:

7. What are your associations to the different images/figures/symbols in the dream. Start with the one that stands out most.

There’s A LOT more to explore beyond these 7 questions- but answering those would be a good start. You’d get the most out of your dreams if you followed a series of dreams and saw how the imagery changed over time. You can trace certain recurring themes and images and track your psyche’s unfolding narrative and ongoing commentary on your life. The goal is to begin to strike an active dialogue with your unconscious, not to let it completely take over and become the arbiter of your truth….in other words, if you don’t like what the unconscious reveals, you have every right to talk back and disagree!

Good luck in your explorations and feel free to ask me questions. Eventually, I’d like to create an on-line journal for people who would like to keep track of their dreams, and the recurring themes and images therein. Dream On for now.

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National Eating Disorder Awareness Week

National Eating Disorder Awareness Week

As a clinician who works with eating disorders, on the occasion of national eating disorders week,  my heart goes out to the many patients and their families who are struggling with an eating disorder.   For the general public’s behalf, I’d like to point your attention to the following Promo for the movie THIN.  It captures the devastation and despair of a struggle with eating disorders.

Eating disorders can be misleading.  People think that they  are a disease about food and weight, and the pursuit of beauty.  In reality, the obsession with food and weight is merely a manifestation of  underlying feelings, feelings as complex as  self-hatred, lack of control, obsession with perfection, fear of dependence and independence, and unresolved anger towards self and others.   The focus on food and weight is actually the attempt to COPE with complicated feelings.  Yes, the focusing on eating is actually the COPING MECHANISM.  I will try to explain: the person struggling with an eating disorder does not know how to deal with her feelings and instead she focuses her attention on food and weight.  Why? unlike emotions, food and weight are concrete and can be reduced to numbers.  A person who struggles with anorexia nervosa, for example, devises a simple system whereby she feels better if she is in control of  her appetite.  The scale then becomes a gauge of her level of control- seeing her weight go down gives her a self-esteem boost.  Recovering from an eating disorder involves learning new ways of coping with feelings and relationships, and new ways of building self-esteem, mastery, and pleasure.  Confronting previously avoided feelings is the reason recovery is so difficult.  At times it feels like opening Pandora’s box, many patients prefer to keep the lid on.  They’d rather obsess in the mirror than go open that box.

As you’ll see in the movie clip, those diagnosed with anorexia or bulimia do not perceive their bodies accurately.  There’s something heart-wrenching about listening to a woman complain about how fat she is, when she appears skeletal to you.  How do you say to her: my perception of your body is more accurate than yours, when in actuality you are trying to help her trust herself more.  Unfortunately, one of the problems with patients who are underweight/malnourished is that they suffer from cognitive deficits; they are not thinking clearly.  Also, family members often notice personality changes that accompany weight loss.  This adds another order of complexity to the disease, and makes weight restoration even more critical.

If  you or a family member suffer from an eating disorder, contact a clinician near you and get acquainted with local and national resources.

http://www.nationaleatingdisorders.org/information-resources/audio-video.php

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