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The Good Enough Mom

The Good Enough Mom
The Perfect Mom

Are you a Pinterest-worthy mother? Do you create edible dioramas, crafted only out of bamboo shavings, low-glycemic fruit, and unconditional love? Have you found the perfect tipping point in meditating alongside little one, balancing modeling a spiritual practice and self-control, while attending to the ever-flowing needs of baby? Do you playfully conjugate verbs in your child’s third language to and from school, unless you’ve established a more teachable political, philosophical, or entrepreneurial point for that day? If not, you’re probably comparing yourself to a number of unrealistic standards that exist around motherhood today.  We internalize these expectations from social media, mom blogs and mom groups, and exposure to a culture that demands full-time, expert performance from mothers and women in general.

Here are just some of the expectations that modern mothers face:

  • You choose between working mother and stay-at-home-mom, and whichever your choice, you have some regrets and a number of people who judge you for it.
  • Of course you breastfeed, and you do so for at least a year, ideally two.
  • You baby-wear, based on your personal attachment to attachment parenting.
  • You never let your baby cry, especially before sleep. Instead, sleep onset is a deliberate, hours-long operation of rocking, singing, and chanting, culminating in an expert transfer of the sleeping infant, a precise maneuver, the likes of which are witnessed only on neurosurgical operating tables.
  • You prepare nutritious, organic, whole food for your children. You practice baby-led weaning, which you researched long before your child was born.
  • You don’t use screens as “babysitters” and avoid any screen time until your children are at least two, ideally older.
  • You parent peacefully, focusing on natural consequences. Discipline is unnecessary if you’re doing this correctly.
  • You are never “that mother” with “that kid” at Target.
  • You purchase only products and toys that enrich your child’s emotional, intellectual, and physical well-being. Better yet, you provide all that enrichment yourself.
  • You potty train your children not a day before they’re ready but of course before it’s required for school.
  • You are “room mom” in your child’s class and effortlessly coordinate teacher gifts, holiday parties, fundraisers, and the like.
  • You provide your children access to a variety of stimulating and skill-building activities. You encourage, but never force, participation in classes for which you’ve signed up, despite any anxiety about the scheduling and financial commitments you’ve made.
  • You invest in your child’s emotional development and well-being and listen patiently and understandingly when your child screams, “I’m mad at you!” each time you gently suggest a shower. You reply that you understand how your recommendation would trigger this emotion and quickly default to your philosophy of bodily autonomy.
  • You understand that you are there to guide, not control, your children, even if that means a 30-minute socks-and-shoes motivational inquiry when you’re already late for school, work, and life.
  • You consistently put your children’s needs above your own.
  • What energy you have left, you invest in your partner, if you have one, because it’s even more important to nourish that relationship when parenting. Date nights, visiting the in-laws, etc. are priorities, even if you’re tired and desperate for some time to yourself. If you’re flying solo, this time is better spent doing anything above even better.
The Good Enough Mom

Long before Pinterest was worthy, British pediatrician/psychoanalyst Donald Winnicott coined the term the “Good Enough Mother.” Winnicott’s theory suggests that mothers can fail their children at times, not meeting each and all of their needs, and that, essentially, that’s okay. In fact, Winnicott contends that as babies grow, their development is enhanced by some delays in mothers meeting their needs (maternal “failures”). Infants begin to understand that they are not the center of the universe and develop more realistic expectations of others and the world around them. According to Winnicott, a mother does not have to be perfect, just “good enough.”

So, what does a “good enough mom” look like in real life? She need not adhere to all of the above standards in order to mother a healthy, resilient child. In fact, the good enough mom might:

  • Make a practice of attending to her own self-care.
  • Get as much help and support as she can.
  • Remember that she is a multi-dimensional being, not just a mom, and invest in growing herself in different arenas.
  • Forsake comparisons with other mothers.
  • Make mistakes and then amends, focusing on repair, not perfection.
  • Evoke that old, airplane-oxygen-mask analogy (i.e., adults’ masks go on first).
  • Consider that each stage of childhood requires a new maternal role with an evolving set of demands and responsibilities and is patient with herself as she learns the ropes.
  • Do the best she can.
  • Remind herself that she is doing the best she can.

For help with navigating maternal expectations and demands, along with the distress this can elicit, and with practicing becoming a good enough mom, please contact us at Gatewell.

Fighting Insomnia with Reverse Psychology

Insomnia

Do you have trouble falling asleep? Does bedtime create significant stress for you? You might be struggling with insomnia.

According to the American Sleep Association, 10 million adults experience chronic insomnia, while 30 million adults have periodic bouts of difficulty falling asleep. Insomnia can have various causes and may be related to other mental health conditions, such as anxiety or depression. Other culprits are medications, substance use (including alcohol, nicotine, and caffeine), poor sleep habits, and stress.

A common treatment for insomnia involves improving “sleep hygiene,” a variety of behaviors designed to ensure a good night’s sleep. A sleep hygiene protocol might involve reduced daytime napping, avoidance of stimulants, such as coffee, close to bedtime, and reduced exposure to stimulating content prior to sleep (e.g., conversations, television shows, etc.). Patients with insomnia are generally instructed to avoid any screen time close to bedtime, as the blue light that cellphones and other devices emit interferes with melatonin production. Melatonin is a hormone produced in our brains that regulates our sleep-wake cycles and signals us it’s time to go to sleep.

While it is often helpful to develop a solid sleep hygiene routine, sometimes that isn’t enough. Patients with insomnia often complain of anticipatory anxiety leading up to bedtime, anxiety that interferes with them relaxing and falling asleep. They worry that it will take hours for slumber to set in, or as they lie in bed awake, they think ahead to how tired they’ll be the next morning with only four or five hours’ sleep. They watch the clock with worry and dread as the minutes tick away. They try so hard to fall asleep that they can’t.

Enter paradoxical intention, or in lay terms, purposely engaging in a feared behavior. In this case, the feared behavior is not being able to fall asleep. So, the paradoxical intention is to try to stay awake. Paradoxically, if someone changes the goal from desperately trying to fall asleep to trying to stay awake, the anxiety around falling sleep decreases, allowing it actually to happen. Most people who struggle with insomnia aren’t too keen on the idea of trying to stay awake longer than necessary, but they can usually understand the rationale and often report that when they shift the goal, anticipatory anxiety diminishes, and sleep occurs more readily.

If you are interested in working with a therapist on insomnia or related concerns, please contact us to schedule a consultation.

The Link Between Exercise and Eating What You Want (Hint: It’s Not What You Think)

exercise

I remember spotting a woman at the grocery store not too long ago, wearing a shirt that read, “Will Work Out for Fries.” The problem with this sentiment, along with similar ones, is that it posits physical activity as compensation, or penance, for consumption, a problematic belief that can trigger disordered behavior. When we believe that fries must be “burned off” through physical activity, we up the ante at the gym, a slippery slope toward compulsive exercise and/or toward creating a dangerous pairing between eating and compensatory behaviors.

So, what is the link between exercise and eating fries – or cheesecake or pizza or anything else that diet culture tells you not to eat?

Engaging in physical activity is a health-promoting behavior. We know that movement improves our physical and mental health. Exercising might clear your mind, create a challenge for you, distract you from your daily stressors, or provide you some much-deserved “me time.” A flexible relationship with food, one that allows you to satisfy cravings and engage with food socially, naturally, and spontaneously, is also a health-promoting behavior. It results in reduced binge/emotional eating, reduces obsessive thinking about food, and increases the ability to relate to food easily and non-emotionally – all of which promote general well-being.

Also, eating intuitively and in response to particular cravings at times is fun. It’s enjoyable. It’s what gives life flavor and spark. Moving your body, if done intuitively and non-punitively can serve a similar function. Physical activity is innately rewarding, unless you devise a set of rules or expectations that rob it of its inborn joy. Spend some time watching children move to remind yourself that this is true.

So, eat the fries and go for that walk or run – not because you have to “burn them off” – but because both are examples of healthy and life-affirming being in this world.

Rejection Therapy and Social Anxiety Disorder

social anxiety

Meet Jia Jang. He’s an entrepeneur, author, and TED Talker. He’s also the owner of Rejection Therapy, a game designed to help people overcome their fears of rejection.

A couple of years back, Jia sought to conquer these same fears by participating in a 100-Day Rejection Therapy Challenge. According to his TED Talk, Jang endured early experiences of rejection and shame that led him to fear any future rejection. As any student of behavioral psychology would do, he decided to address his anxiety via desensitization – or exposure to the feared stimulus – in this case, rejection. Jang took on 100 rejection exposure challenges, anything from asking his local Domino’s if he could deliver their next pizza to asking President Obama for an interview.

Cognitive-behavioral therapy (CBT) suggests that the more you engage in something you fear, the less you will fear it over time. As Jang experienced rejection after rejection, he started to become desensitized to the experience – to dread it less. He even made rejection his business. Jang shares on his website: “My journey has revealed that the stings and slights of rejection are universal among us as humans, but that with conscious intent we can turn rejection into enterprise, insult into ambition, and regret into courage.”

Fear of rejection is a hallmark symptom of Social Anxiety Disorder (SAD), sometimes referred to as Social Phobia. Individuals with Social Anxiety Disorder often suffer from intense fear or shame regarding real or perceived judgments or evaluations from others and might avoid at all costs situations in which scrutiny is possible. The most extreme form of another’s judgment is, of course, rejection.

Social Anxiety Disorder can be treated in individual or group therapy. Using CBT and Jang’s experience, those with social anxiety disorder can tackle fears of unfamiliar individuals, judgments from others, and rejection-sensitivity through a series of exposure exercises. As with other exposures, these experiences become easier to manage over time and, therefore, anticipatory anxiety – and avoidance – can fade.

Why It’s Important to Work with a Specialist

Specialist

Let’s talk about the importance of choosing a specialist when deciding on a mental heath provider.

Recently, in an online professional group, a group therapist shared that leading groups is not that much different than conducting individual therapy. Not true! There’s so much more that goes into working with groups – into studying and working with group dynamics- that I was surprised to hear a professional make this statement. When I think about everything that was involved in earning my Certified Group Psychotherapist credential – the hundreds of hours of experience, supervision, and education required in order to earn this title – I wonder how individual therapists can so comfortably make the transition to group therapist without similar training.

The same goes for working with particular disorders and specialty areas. In my work, I have acquired specific specialties in working with eating disorders and substance use disorders. This goes beyond the generalist training that most therapists receive and that equips us to work with more commonly presenting conditions such as anxiety and depression. For me, the ability to work competently with eating disorders and with alcohol and substance use disorders involved years of supervised experience using evidence-based approaches. Not every therapist knows how to work with these disorders, and even the most well-intentioned therapist can do a lot of damage trying. In the same way, I would never try to work with conditions with which I have no (or minimal) experience treating. If someone comes my way who struggles with a developmental disorder, psychosis, or certain personality disorders (among other conditions), I readily refer out to specialists in these areas.

So if you’re seeking help for an eating disorder or an alcohol or drug problem – or for that matter, any specific concern, ask your potential provider:

  1. How long have you been working with this disorder?
  2. Did you receive supervised experience in working with this disorder? How/where were you trained?
  3. What type of approaches do you use to work with this disorder? Are they evidence-based?
  4. Do you collaborate with other professionals on your cases?

Please Contact Us at Gatewell to learn more about choosing a specialist that’s right for you.

 

 

 

Avoiding Reality via Alcohol/Drug Misuse

addiction

One of the frequent goals of alcohol or drug misuse – which can eventually lead to addiction – is the avoidance of reality. Let’s face it – reality is tough. Whether it’s difficult emotions or circumstances, family members or situations, we often struggle to hang in there, and distraction and avoidance are common coping techniques.

But when we avoid – be it through alcohol or substance use  – or through other avoidance behaviors (think shopping, gambling, gaming, binge watching, eating, not eating, etc.), we’re not addressing the problems from which we’re trying to escape.

We’re not repairing – or moving away from – relationships that don’t work. We’re not experiencing and expressing certain feelings that need to be processed and addressed. And we’re not working to figure out a better path for ourselves. So, the problems don’t improve, and we’re often left with an additional problem (e.g., an alcohol or substance use disorder) in tow.

To capture this idea, someone in one of my groups recently paraphrased a sentiment by novelist Ayn Rand: “We can evade reality, but we cannot evade the consequences of evading reality.” Thus, we can choose to escape and avoid, but what we’re escaping and avoiding will not simply disappear. Furthermore, the consequences of avoiding reality can amplify any original difficulties beyond recognition.

If your alcohol or drug use functions to help you avoid reality, take a moment to check it. There’s only a matter of time before the consequences catch up.

 

 

 

The Five-Minute Journal

Gratitude

A couple of months ago, I was introduced to The Five-Minute Journal. As the name implies, the journal calls for brief entries (two per day: morning and night), nothing more than quick, bullet-item lists.

In the morning, you jot down what you’re grateful for and what would make the day a positive one. You also list a couple of things you like about yourself. Come nighttime, you note what went well during the day and a couple of things you could have done to make the day a better one.

Here’s why I like this journal:

  1. It’s easy and doesn’t require much time to complete the prompts, so for those who struggle with journaling, the task doesn’t feel too daunting.
  2. It encourages a focus on gratitude and positive intention setting, both of which can impact your outlook and functioning.
  3. It forces you to name your strengths in a culture that so often suggests you focus on your weaknesses.
  4. It encourages you to take personal responsibility for making your days more positive.
  5. The journal prompts have a way of infiltrating your daily consciousness, impacting thoughts and actions so that they are more consistent with your values.

If these exercises interest you, you can purchase The Five Minute Journal here. Otherwise, you can complete the prompts on your own. Notice any changes in thinking, behavior, or emotional patterns over time. Let us know what you think!

 

A Call for Reducing Reductive Solutions in Honor of Mental Health Awareness Month

trauma

A while back, a meme was circulated encouraging those who struggle with depression, rather than taking medication, to just go for a run outside.

As a player in the fitness industry for over twenty years, and the author of a study on the mood-enhancing properties of exercise, I won’t disagree that physical activity can often improve how we feel. But it’s not going to help everyone, and an individual suffering from a severe depression might not be in a place to lace up her running shoes and hit the pavement. In cases of moderate to severe depression, treatment isn’t optional. This advice also overlooks those who struggle with eating disorders and/or compulsive exercise, who might have turned that prescription for a “run outside” into something problematic.

We see and hear a lot of these stock approaches to recovery. “Anxious? Try meditation – it worked for me!” “Have insomnia? Cut out [x] food.” And the old, “Why don’t you just eat?” to the individual suffering from an eating disorder. While the comments might be well-intended, they fail to capture the diversity and significance of mental health presentations. A brain (not to mention, a personality, life history, cultural experience, etc.) is a complicated thing, and when we try to compare one to the other, we lose a lot in the process. Suggesting that someone with panic attacks take a meditation class might be akin to asking him to write a book when he’s only capable of drafting an outline. Encouraging someone with an eating disorder to “just eat” without significant structure and supports in place is asking her to accomplish the unthinkable.

In many cases, therapy and/or medication is required in order to make progress from a mental condition. (Side note: Taking psychotropic medication is not unfeminist, as a psychiatrist in New York City suggested in a recent Facebook post.) All of the self-care and self-help exercises in the world are not enough to tame some of the symptoms we see in practice. So, if you know someone who’s struggling, my advice is to back off the advice. Listen and express compassion. Read up on evidenced-based treatment. Ask the individual if there’s anything she needs or wants from you. And then just be there, minus the platitudes and trendy treatments, the quick fixes and what-worked-for-me’s.

Panic 101

Panic

One of the most frightening things that many of my patients experience is a panic attack – or worse, a series of them.  According to the DSM-5 (American Psychiatric Association, 2013), a panic attack is:

“An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four (or more) of the following symptoms occur. Note: The abrupt surge can occur from a calm state or an anxious state:

  1. Palpitations, pounding heart, or accelerated heart rate
  2. Sweating
  3. Trembling or shaking
  4. Sensations of shortness of breath or smothering
  5. Feeling of choking
  6. Chest pain or discomfort
  7. Nausea or abdominal distress
  8. Feeling dizzy, unsteady, lightheaded, or faint
  9. Chills or heat sensations
  10. Paresthesias (numbness or tingling sensations)
  11. Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  12. Fear of losing control or going crazy
  13. Fear of dying”

Many individuals who experience panic attacks present in hospital emergency rooms, afraid they’re having a heart attack. Others are convinced they’re losing control or going insane. In reality, panic attacks are uncomfortable physical and psychological experiences, but they aren’t dangerous, an important distinction to make.

One of the best things someone can do at the beginning of a panic attack is to try not to “panic about the panic.” It’s easier said than done, but this will only make things worse. A panic attack is the body signaling a false alarm. Responding to the alarm as if it’s real validates the symptom. Instead, labeling the symptoms as panic is a helpful first step, as is challenging some of the the catastrophic thoughts that arise (e.g., “I’m dying”). The more you are able to identify the symptoms as panic, accept them, and potentially distract, the sooner the panic attack will pass. Many become afraid that they’ll pass out/lose consciousness during a panic attack, but heightened physiological arousal is generally contraindicated with fainting.

Developing a sense of acceptance around panic – rather than fearing another attack – can go a long way toward recovery. Cognitive-behavioral therapy is an evidence-based approach used in the treatment of panic attacks. Patients might also find meditation, deep breathing, and regular exercise helpful. For some, medication is indicated, with the typical offerings being SSRIs (e.g., Zoloft, Lexapro), taken daily, or benzodiazepines (e.g., Xanax, Ativan), taken briefly or when having or anticipating symptoms. Some patients find that carrying around medication, without ever using it, can ward off panic attacks.

For help with panic attacks, or other symptoms of anxiety, please contact our team at Gatewell.

 

Building an Emotional Muscle

emotions

One of my favorite definitions of mental health is the ability to experience and express emotions in an effective way. It’s simple, but so on point.

Recently, I came across this blog post on how parents can help their children identify and express their emotions. I love how the author encourages naming – and honoring – of emotions from birth.

All too often, though, children are raised without this kind of emotional attunement, or as we call it, “mirroring,” by the adults in their lives. Kids are told not to cry, not to be scared, to get over it, and to be happy – even when they’re not. Parents might have the best intentions – most don’t want to see their children upset – but avoiding and discouraging emotions will invariably backfire.

It’s never too late, though, to build your own emotional vocabulary, to respond to your emotions compassionately, empathically, and with curiosity; and to practice acceptance of the waves of feelings that course through you each day. Can you acknowledge your feelings without negating them? Can you accept what you are feeling without trying to make it go away? Often, the more we accept our emotions – and then less we discount them or try to suppress them – the less power they have over us.