Balance and Wellness

Balance and wellness. What does it all mean? How do I do it? Who has the time?

First off, I don’t think there is one correct definition or way to go about these things. A lot of people talk with an official sounding tone or with professional letters behind their name, but that doesn’t mean they have the right answers. That includes me as well. We are all just figuring it out. And it’s confusing. In that way, we are all in it together.  

I think that these things are a practice held together by an awareness. Let me get into how I view my practice, the principles it is based on, and where I train my awareness. It may be the same for you, or it may be different.  

For me it starts with a principle that I first recognized in parenting when my daughter was starting school. As with all children, my daughter came into this world with her own temperament and personality. I love her. I think everything about her is beautiful—as is the case with each unique human. We are each beautiful in our own individual ways.  

I wanted to protect my daughter’s ability to be herself as she entered the school system. At the same time, I wanted her to learn what she needed to learn so that she could function, enjoy, and perhaps be successful in the society in which she will live. This dialectic, I have come to believe, is the crux of parenting.  

With time, I realized that this was also what I wanted for myself. I wanted to protect my ability to be myself while also participating in the world around me. For me, all wellness practices stem from that balance—which can also be a struggle.

So, what types of wellness practices create more of a balance and less of a struggle between those two tasks? That, in my opinion, is not the correct question.

The better question is—where should I be training my awareness, so that I readily notice when I am in balance and when I am not? The actual wellness practices will vary widely from person to person based on personality, location, access, etc. The key is self-awareness and knowing when you need an adjustment.  

I try to be aware of the feeling of connection. I would like to feel connected to myself and/or others at any given moment in time. Times without a sense of connection feel empty. And could also be described as unwell. A wellness practice would be something that puts me back into that feeling of connection.

In striking a balance between being myself while also participating (effectively, pleasurably, positively) in the world around me, the feeling of connection allows me conscious agency in shifting my weight to one side of that balance or the other. I want to feel connection with myself during my times of solitude. I want to feel connection with others when I am with others.

So, I check in with myself. Am I feeling connection? Or am I feeling something more akin to loneliness or overwhelm? The latter two would be a signal that it is time to shift my environment, rest, or do something (a wellness practice) to bring me back into connection.

Connected to Myself

The quest to find happiness has brought many of us disappointment and disillusionment. Feeling happy is an elusive goal and trying to achieve it can lead to frustration and potentially problematic habits. I say that we should not seek to feel happy.

Instead, we should try to feel connected to ourselves. Which may or may not feel good. When I am connected to myself, I may feel hungry, tired, lonely, satisfied, overfull, restless, joyous, irritated, frustrated, or lost.

The more-and more often-connected to myself that I am, the earlier I catch each of these sensations and the less of a big deal it is. When I catch my hunger early, I make appropriate nutrition choices and I eat to satiation. When I allow myself to get to starving, I eat whatever is in front of me and I tend to eat until uncomfortably full.

When I catch my sleepiness early, I easily fall asleep. If I allow myself to get overtired, I can get hyper, active without direction or intention, and I can crash into a feeling of sad without being able to put myself to sleep.

When I catch my loneliness early, I have the time to consider who and what I need. I can reach out to the people who will make me feel loved or stimulated in the right way and make the time to connect in the manner that brings out what I need. If I wait too long, the loneliness can get existential in nature or I can get desperate, hanging out with a random someone who happened to be available, resulting in me feeling a lack of resonance and further loneliness. 

Each of these feelings is cyclical. No matter how many times I satisfy my hunger, I will get hungry again. The same is true for fatigue and loneliness.

It is impossible to feel good or happy all the time. But, we can endeavor to stay connected to ourselves, which then allows us to maintain our inner homeostasis.

Shame

The conversation these days in therapy and on social media is all about accepting our emotions, feeling our emotions, and trusting our emotions... but not shame. The current zeitgeist is decidedly anti-shame with many people on a quest to overcome shame and “deshameify” themselves. But why is shame less valid, real, or natural than any other emotion? Shame is a part of our real and healthy emotional spectrum.

The issue is in what we allow to generate the feeling of shame. It’s hard to find a clear and consistent definition of shame. Many people associate shame with arbitrary social insecurities or with external standards, which put them in a position of being powerless in regard to shame. A common distinction is that guilt is connected to what you do and shame is about who you are. In this blog post, I am putting forward a specific understanding which I think would be a more useful definition and approach to shame.

In contrast to shame, guilt is a more cognitive feeling. A recognition we have broken the rules and we need to apologize and repair. Shame is an almost somatic feeling. As I assert here, it arises from a violation of our deepest values. We feel it in our body, in our heart, in our psyche. That’s why it hurts so much and can feel so bad. It’s visceral. In spite of the fact that it shakes us to our very core, there is nothing wrong with shame. The problem is with what we hold as our deepest values and what triggers those experiences of shame.

By accepting, feeling, and tolerating shame; we have the opportunity to recognize our most deeply held values. And consider if those tenets make sense and resonate with us or do they confuse us, hindering our functionality. In going through the exercise of evaluating our value system, we develop the agency to choose the set of deep ideals that make the most sense for us at this phase of life, defining the type of person we want to be.

No one can shame you. Shame arises from standards you set within yourself. As opposed to guilt which is externally defined. That’s why you can be found guilty within a court of law. And why doing the “right thing” can sometimes involve breaking the rules.

When someone says, “you should be ashamed of yourself,” what they are really saying is “I think you should hold this particular ideology that I believe in.” It’s up to you whether you would like to consider their suggestion and closely evaluate that particular paradigm for integration into your belief system, or not.

Unlike guilt, shame cannot be resolved by saying “I’m sorry.” Because the violation is to my own definition of good character, impacting my sense of self. Rectifying the interpersonal situation is not enough, shame dictates that I need to recenter myself in a way that I can feel good about the person I am.

There is a lot of shame around women's bodies, which makes no sense to me as a useful social value, except to control women. There are other examples of shame internalized from social hierarchies and used to control, such as when people have shame regarding racial characteristics or caste lines. The internal experience of shame motivated from bodily attributes is demoralizing and oppressive and can lead to problematic behaviors by a person individually and by society as a whole.

On the other hand, there is not enough shame in society today around behaviors such as hurting, demeaning, using, and humiliating one another. Because, as a society, we aren't valuing each other as humans and community members enough.

The times when I’ve seen my husband racked with shame are the times that I have felt closest to him and most confident about him. Because it was in those moments that I could see most clearly what his deepest ethics were. It makes me feel secure in his character to know that he values and feels shame when he falls short of caring for his parents, being there for me, or fulfilling his promises and commitments.

Shame is a powerful emotion. It’s both stinging like a slap across the face and a deep writhing in the belly like a whole night sitting on the toilet. It hurts the way it does because it’s a reflection on how I am seeing myself as a person. It says hey, “that's not who you want to be, you are being a bad version of yourself.”

What kinds of things do I want to trigger that response? How do I define, for myself, what a good person is? What kinds of behavior, if I were to engage in them, would rightly make me feel like I’m not a good person, and if I continued in that way, that I don’t like myself? These are my deeply held values. And when I act in violation of those, shame motivates me to be the kind of person I want to be.

At the heart of it, shame is just a feeling. We can tolerate it. We can learn from it. We can be in control of it by being explicit about and having agency in choosing our deepest values.

Listening to, Validating, and Supporting Children

One of my earliest memories, I must have been about 4 years old, is of standing in my parents kitchen, a woman crouched in front of me, tears on her face, telling me over and over again that she was sorry. A packed suitcase was behind her.

That’s all there is to my memory. I asked my mother years later what the meaning of this memory was.

My mom let me know that the woman had been a friend of my parents and staying at our house for a visit. At some point I had come to my mother crying, letting her know that her friend had hit me. Presumably to discipline me for something.

“You don’t remember?” my mom asked.

“No”

“Well, you wouldn’t have lied. Besides, you were very upset.”

She had confronted the woman immediately, who admitted that she had indeed hit me. My mom asked her to pack up her things and leave our home. My memory is of her apologizing to me before she left.

* * *

Fast forward to my eighth grade year. We were living in a different city, and we were having dinner at the home of another close family friend. I had been waiting for some other friends with a similar age child to show up. I asked the husband of the house if I could use their phone to call them to hurry them up. I was eager to play the latest Nintendo games with a peer, instead of my little brother and sister.

The man had been drinking. He lead me to the bedroom and locked the door behind me. That’s when I realized something was wrong. I wasn’t too worried because I knew my parents were close by in the living room. They were within screaming distance. He grabbed my shoulders in a kind of rough hug and asked me to kiss him. Ewe! Gross!

“No,” I said sternly. And when he asked again, I said I would scream. I reminded him that my parents were nearby. I demanded that he let me go, and he did. I rejoined my siblings in another bedroom where they were playing Super Mario Brothers.

The man approached us and asked if he could talk to me. I said no. I was still sorting out my thoughts and feelings as I stewed next to my unaware brother and sister. He said, “Please don’t say anything to your parents.”

I responded with a slew of curse words that thirteen year old me probably didn’t even use correctly. My little siblings stared in shock.

Soon, my friend showed up, and we all took turns on the video game console. I stayed close to the kids all evening.

In the car on the way home, I said to my parents in the firmest, strongest voice I had. “My siblings and I are never going to their house again, and I don’t want them to ever come to our house either.”

My parents asked if anything had happened and if I was okay.

I answered “no” and “fine.” Then reiterated my demand.

“Ok. No problem,” they said. And that was that. I never saw those family friends again. I think my parents may have seen him at a few social events, but their friendship petered out pretty quickly since we stopped going to each other’s houses and we no longer socialized as families.

It could have been a trauma, but it wasn’t because my experience and my memory is that when I speak up, people listen and the people who care about me make the changes necessary to help keep me safe. That’s the opposite of trauma. I felt super empowered.

There is a lot that can be said here about the structural issues regarding the treatment of children, sexism, and racism (there were times my parents met with school principals to confront them on racist teacher and student behavior), but that is not the objective of this blog post.

I share this story, not to say anything about my response or even that man’s behavior. But to share the way in which my parents treated me. From one of my earliest memories and repeatedly throughout my childhood, in small actions and dramatic ones, my parents supported my bodily autonomy and my voice. Were they perfect? No. I can think of times where they messed up. Did they always respect my choices? No. We’re South Asian, listening to and following elders is a big part of our culture.

The key is that enough times, they let me know that my body, mind, and spirit were valuable and precious. They let me know that I was more important to them than their other relationships. They let me know that they trusted me.

These messages that they made clear to me are of the utmost importance because these are the primary reasons that I have felt confident speaking up in defense and protection of myself even when I was quite powerless. I have always trusted my ability to evaluate safety because my parents gave me protected autonomy and validated my experiences consistently from a young age.

As parents we cannot protect our children from every bad occurrence, but we can protect their psyches and future ability to protect themselves through how we respond. Instilling a sense of safety, confidence, and reliable intuition begins at a young age. It must be taught by parents because that is our earliest, most long-lasting, and primary attachment. It is taught through parents repeatedly listening, validating, and acting in small and big ways to affirm the autonomy, agency, and strength of their child.

To be a Kinky Conversationalist

Conversations can be divided into verbal and physical. There is also non-verbal communication, which includes eye contact, facial expression, and body language—and typically accompanies verbal communication.

In the category of physical conversation—I include physical play, physical roughhousing or fighting, and physical intimacy. Physical intimacy can include not only sex, but also non-sexual touch between friends and family such as holding hands, a hug, rubbing someone’s back, stroking hair, etc.

We have become a culture that very much elevates verbal communication. A culture that goes to talk therapy, writes prolifically on blogs and social media accounts, debates and explains. The refrain “use your words” has come to be a general rule of thumb. The progress we have made in verbal communication is admirable. We have recognized the importance of give and take (listening and speaking); we add nuance through the non-verbal; we know that authentic, genuine communication is most valuable; and we can flow from the polite and professional to the deep and emotional.

What would it be like to bring that same respect and consideration to physical conversation? First, by simply recognizing and prioritizing physical conversation. Understanding that it is available to us in our close relationships and sometimes might even be the better way of communicating. 

We are generally good at recognizing this with young children. We hug and hold children. We rock babies and toddlers, stroking their hair and wiping their tears. We reach for children’s hands regularly to cross the street and sometimes just to hold.

Adults are really no different than children. At any present moment of time, we are a child of that moment. Holding hands is a beautiful form of communication. Like please and thank you, it’s rarely wrong to reach for someone’s hand and it is the type of thing that can do so much to communicate love, consideration, support, concern, and friendship.

It’s worth talking about sex and the idea of kinkiness. I think of kinky as the ability to have a variety of sexual conversations. As in verbal communication it’s not great to only be able to argue, or teach, or discuss superficial topics like the weather, Tahoe, and kitchen renovations. It can be similarly limiting to be trapped in a single particular type of sex or sex role.

Most types of verbal conversations, can also be sexual conversations. We can argue, negotiate, listen, explain, engage in the polite and superficial, go deep and emotional, even run through logistics. This flexibility to have the conversation relevant and necessary to the moment, I call being kinky. Sexually, that can look like taking a more dominant role or a more receiving or following role, a “quicky,” romantic vulnerable sex, playing pretend, sex that is passionate or fitful and arguing, slow and searching, silly and childish, tearful and remorseful, sex that incorporates toys or accessories or sex that focuses on a particular body part. There’s even a place for boring sex!

Over the course of a long relationship there are many different types of verbal and sexual conversations that are necessary and helpful. And communication can flow seamlessly or fitfully between the two. In meeting new people or in embarking on new relationships, there are particular types of conversations that generally work well to start with but depending on the moment in time and the two people involved, a first verbal or sexual conversation could look any number of different ways.

Just like with verbal communication, sometimes it works and sometimes it doesn’t work. Sometimes you don’t understand each other at all! When that happens, maybe you move on and maybe you give it another go.

Holding hands is almost always good.

Mantra

What is a mantra and how might it help you? Traditionally, a mantra is something given to you by your guru. It is used in meditation and throughout the day to focus your mind. How many of us have a guru these days? How many of us would trust someone to be our guru these days? But that’s another conversation…

You can create your own mantra. A mantra is simply a short phrase and/ or image that can quickly and easily be brought to mind. Something simple that you can repeat to remind you of your focus, perhaps quiet your mind, create the right mental conditions, or maybe initiate the cascade of thoughts that will bring you to the place of your choosing. A mantra is specific and unique to you at this particular time in your life.

Have you skateboarded, surfed, skied, or skated? Your eyes direct your body and the board. Where you look, that's where the board will go. Though our instinct is to look for danger, so we can try to avoid it… looking at danger can often mean falling exactly into the spot we were trying to avoid. The mantra is like our gaze, keeping us looking and moving to the place we want to land.

Generally, a mantra is best kept private. You may have an urge to share your mantra with friends and family. Sharing a mantra could theoretically create a system of external accountability. Or help you connect with someone. Or assist another person with their journey. But, be careful sharing your mantra. It is intimate and special to you, and sharing it with not the right people can undermine the power of your mantra for you.

That said, I will share some of my past mantras with you to give you an idea of what they can be like. Because I'm choosing to trust you. Some of them are simple phrases. Some are phrases accompanied with a mental image. Here they are listed in no particular order.

"I love you." (Both the I and the you here are myself)

“I love” Accompanied by taking a deep breath.

"Stop." Accompanied with an image of hand raised in stop.

"Rules of the game." Accompanied by a moving image of someone hopscotching between obstacles

"Just keep driving. Every road leads to somewhere." Accompanied by an image of me behind the wheel. 

"First things first. Order of operations."

"I am diving into the sky, and I trust it to hold me up."

"I have but small hands with which to make small offerings." Accompanied with an image of a pair of hands held together in offering. 

You can see how different my mantras have been at various times in my life according to the focus I felt I needed at the time. 

Generally, for me, my mantras have come from within my mind without prompting during times of need. But that is probably as a result of me growing up with this particular framework to begin with. If you need an exercise to start you on your path of thinking of your own mantra, consider this proverb:

Right thoughts, right words, right actions, right life.

I don't know what the "right" is. That is different for each person. And also different at different times of your life. You need to decide on the right for you at this moment in time. When you do, perhaps a mantra can help you along. Warmest wishes on your journey.

Winter Blues

I have this place I go in my mind when I am trying to understand people's struggles today. It is a village, or perhaps a tribe, several hundred years ago before electricity. Before large scale farming. During a time of hunting and simple cultivation of the land. And I wonder how would this issue, the specific problem I am contending with, manifest and be managed in that place?

Often, the answer is that the issue wouldn't have happened in that village long ago. Not that there weren't troubles in extended family groups of the past. Of course, there were lots of problems. Many difficulties, which were solved through agriculture, industry, medicine, and technology. So, I'm not suggesting going back to some idealized notion of the past, but simply saying that I use this imaginary crucible of a tribal unit to work through contemporary conundrums in my head. I also think about animals in the wild--rabbits and gazelles, monkeys, wolves, and lions.

One such conundrum is seasonal affective disorder. The phenomenon that occurs each winter where people get depressed, fatigued, and amotivated. When did this start? Do animals struggle with this? What was this issue like in my imaginary village?

And this is where I have arrived with my musings. I think seasonal affective disorder (SAD) began with electricity. My parents, who grew up in a little village on an island, off an island, off the island of Sri Lanka, were children before the introduction of electricity to their village. They tell stories of reading by candlelight, their eyes getting tired, and falling asleep quickly. Pre-electricity, families slept all in one room to keep from getting cold and make it easier for parents to keep an eye on children at night. My husband, who grew up in Russia and spent school breaks with his uncle's family in a rural village, recalls everyone sleeping in the main room around, and in shelves built above, a roaring fire in the hearth. 

For these two reasons, a lack of reliable bright light and a lack of heating, I feel quite certain that people simply went to sleep once it got dark. Not only that, but to keep warm, they probably went to sleep all in the same room, probably close together. Even the simple act of staying up to read by candlelight meant either keeping other people awake or shivering alone in a separate room. 

We associate hibernation with bears, but when I think of mammals in general, many of them tend to sleep all together in a pile with their pack and many animals function in a sort of hibernation-lite during the winter. Sleeping much, if not all, of the time. Sleeping is also a good way to conserve heat and energy when it is cold. 

So here is my conclusion, we struggle with seasonal affective disorder these days because we have deluded ourselves into thinking that we can keep a summer schedule in the winter. Through electricity, centralized heating, and electric lighting; we can flip a switch, program a temperature setting, jump in a car and continue on according to the reading of a clock as opposed to the natural rhythms of the Earth and our bodies. 

It is this behavior and pressure to perform out of sync with the seasons, which causes winter depression. Which isn't depression really, but extreme fatigue because we are supposed to be in a sort of semi-hibernation during the cold, dark months of the year. I think that we actually need much, much more sleep in the winter than the summer. And the vast majority of us aren't getting it. 

So this season, when you flip on the lights and start to put your makeup on for another holiday party or pick up your phone to scroll through your Instagram feed long after the sun has already gone to bed, ask yourself what would my village and cavepeople ancestors be doing right now?

I think they would be going to sleep. 

Are We In A Mental Health Epidemic?

People say we are in a mental health epidemic. What does that mean? Mental illness is not contagious. It doesn't spread.

A lot of people are suffering these days. The incidence of depression and anxiety is on the rise. Many more people have been struggling with suicidal thoughts. How do we conceptualize this? One possible frame is a mental health epidemic. It's a very medicalized framing. It puts the onus of sickness on the individual. It's a framing that forces me to question the basis of psychiatry and psychology. 

Even before the COVID-19 pandemic, incidences of ADHD, autism, and other mental health diagnoses were on the rise. But people don't exist in a vacuum. We exist in society. If so many individuals are being diagnosed with mental illness, maybe the issue isn't with those individuals. Maybe society is sick.

The problem with the fields of psychology and psychiatry is that they are culturally bound. Meaning that the framework that they use to view, analyze, and judge the people around them are creations of the culture they exist in. Thus, the mental health disciplines are good at seeing, diagnosing, and treating individuals who aren't fitting well in the culture around them, but the professions are not good at seeing, diagnosing, or treating society or culture.

Mental health, psychology, psychiatry, and wellness culture put the responsibility of mental illness and health on the individual. And provide treatments for the individual to fit in, function in, and tolerate the society and culture surrounding her. 

I want to shine a light on society itself. The burden of pathology is too much for a human to carry alone. An individual should not have to carry the yoke of wellness for a sick society. 

We exist in a dichotomy where there is a reality that we need to function in. We need to hold on to our job. We need to pay our bills. We need to pass our final exams. We may have to "go along to get along" to a certain extent. But we don't need to believe that our struggles are the result of a personal deficiency. We don't need to accept the lie of individual illness that diagnosis feeds us. We don't need to add the pressure of wellness on top of the pressure to perform in a struggling society.

We have dual agency to work on our own personal healing and growth as well as to create healthy community and affect change in society around us. We can use tools like voting, speaking up, asking questions, and listening. When we are struggling, we can think about ways to do better, while we also wonder how many other people are struggling in the same way. And we can look to the source—community, society, and culture—to find the wound and how to heal it.

I know that it is not my job or place, as a psychiatrist, to heal society. I work with individuals. My job is to help individuals. But I want us to be real. I want honesty. I don’t want to see children or adults, human beings, individually bearing the burden of societal disorder.

Women in the Age of Coronavirus

As work and school both shift to home, many women find ourselves carrying increased responsibility for homeschooling children, cooking dinner, and managing a household all while trying to maintain our paid job from a corner of the house. Many women may have increased worries about potential effects of coronavirus during pregnancy or on a newborn. Many new parents may be struggling to manage life with a new baby without any extended family or other supports. Many of us are worrying about elderly parents. 

We can do this. First, we need to get in the right headspace. Humans like to make analogies, and I’ve heard a lot of people comparing this period to an apocalypse. If you are like me, that is not a comforting or helpful analogy. Since I feel kind of like a school marm in a one room school house, I’m kind of thinking about this as a time travel story, where we have been transported to the 1800’s. We are armed with knowledge of the future, so that makes us particularly powerful and capable. Something like Outlander or Dr. Quinn, Medicine Woman. Some of you (who have a safe distance from the actual sleepless nights of a newborn) might find comfort in similarities to the nesting and bonding memories of early motherhood. 

Next, we need to find some balance and some boundaries. I believe that we need some combination of work, rest, and fun each week or perhaps even each day. That can be hard to do when we are in our homes, with the same people 24/7. Take some time to think through the categories. What is some fulfilling and accomplishable work that you might engage with now, how can you rest, and where can you have some fun? I would even write out some lists. Is the work you are thinking of within your paid job? Is the fulfilling work something you want to accomplish around the house—a room that you’ve been meaning to clean or a photo album you’ve been wanting to create. Or an online course you would find enriching. What are some of your restful enjoyments, of course in addition to a reasonable bedtime and good sleep? Perhaps a quiet bath? Baking? Reading a novel? Catching up on a movie? Where can you find some fun? How can you socialize safely? A board game with family members, virtual happy hour with friends, group texting funny memes… My neighborhood has taken to howling each night at 8pm as a show of support to healthcare workers. The howling is a great release and it is fantastic to see my neighbors—old and young—standing on their front porches and howling into the sky.

Do you know what is as contagious as COVID-19? Anxiety. So be careful how much of it you expose yourself to. That especially means limiting your news intake. But it can also mean limiting the amount of time you spend talking about the virus or the news in your social conversations. If you find yourself getting anxious, you could try reaching out to a friend for light conversation, taking some deep breaths, exercising, or staying occupied in work or fun.

Apart from fighting COVID-19, our human world is resting. The world is resting from the seismic stressors* we create along the Earth’s surface. The world is resting from travel, and we are giving the animals and plants an opportunity to roam free. The world is resting from economic activity. And during this time of rest, hopefully our hearts are roaming and growing, so that we are drawn to donate and share as possible. We are pulled to speak up within our governments and advocate within our communities to provide for those who are struggling. Without an eye to our purses, perhaps we are more in tune with our heart songs.

Of course, for those of you who are healthcare workers, grocery store workers, emergency response people, delivery people, and all other essential services, I know that you are not able to rest during this time. You are the night shift, filling in to carry the load for all of us. You are keeping the human race safe and protected. Our gratitude can never be enough. 

This imposed rest also brings financial stressors for many people. The work of right now might include reorganizing budgets, applying for unemployment, or looking into federal aid programs. Feel proud of doing that work. These are hard skills, and also good skills. A lot of people are doing same—tightening budgets, learning to live on less, and asking for help. Don’t let that work and worry take over your entire day. Make sure that you still protect time for rest and play.

People will often give new parents this piece of advice: Sleep when the baby sleeps. It’s a practice that can make all the difference in conserving energy and maintaining sanity. That bit of wisdom comes to me now as I am thinking about COVID-19 and shelter in place. The world is resting and perhaps we can take this time to rest as well. 

We also rest because life is a marathon, not a sprint. This is true for an individual life, the life of a peoples, and the life of a planet. We know that we will be running again. Hopefully when our human strivings restart, it will be with more compassion, more love, and more reason. But however it happens, we need the rest first. 

*Caroline Delbert. Earth is Literally Moving Less Now That We’re All on Lockdown. Popular Mechanics. April 1, 2020. 

Embracing the Midlife Crisis

Many of us have had our head down, focused and working hard, through our 30’s and into our 40’s, when midlife seems to sneak up on us out of nowhere. Suddenly we are not just out of college. We are not “the young people.” We are actual grown ups, perhaps midcareer, perhaps parents, perhaps even caring for our own parents. We are the decision makers. We have a lot of responsibility, some wisdom, and some real effectiveness.

Sometimes midlife also brings a feeling of angst and a questioning of our lives. Different people associate midlife with a different age—a 40th birthday, the 40’s in general, and others with 50. I connect midlife with the time when we have exhausted the path that we set upon in our 20's. In the, sometimes, tumultuous times that were our teens and 20's, we asked ourselves questions about our identity and values. By some point in our 20's, many of us set life goals based on our identity, values, family structure, knowledge, and economic conditions of the time. We worked hard on those goals through our 30's and 40's. And by some point in our midlife, we accomplished many of those goals while other goals fell to the wayside or became irrelevant.

We also might become aware of health and aging. Our bodies ache a little, or a lot. Bodies and minds lay down limits. We can’t stay up as late as we used to. We might not adapt as quickly as we once did. Some of us have real health scares. Heart disease and cancer often rear their ugly heads in the 40’s. We are in the circle of life—sandwiched between aging parents and young children. And, we now live in a world where there exist adults who were born after we became adults ourselves. 

That's where the midlife crisis comes into play. We choose, or are forced into, some kind of redo of our teens/20's and we question basic ideas again. I say, embrace it! It’s a wonderful opportunity to get our lives up to date and relevant. Throw out (or donate) the old clothes that don’t fit, the old values that don’t make sense, the old habits that aren’t working. Hone in on the things you love and make you look and feel great, the traditions that warm your heart, and the skills that make you real money. Rework or pull in new items, ideas, and practices that make sense for you and your family in the current world.

You might need to try on a few different ideas, clothes, and identities to see how they fit you. Just as in our teens, we might end up with a bad hairstyle and a few cringe worthy photos, but hopefully we’ll also emerge from mid life with some incredible identity-defining experiences, close friends, and a set of goals and values for the next phase of our lives.

A Budget

Most people are familiar with the idea of a financial budget. Most of us get a set amount of income each month, and we have to figure out a way to make that money last through the month until we get our next check. I think our energy and emotions work in a similar fashion. We wake up each morning with a certain amount of energy and emotional capacity. We spend that throughout the day on work, conversations, relationships, etc. We need to budget our energy and emotional capacity so that it can last us through the day. This is especially true if you are a parent and need to come home with a big smile and a ready hug and say, "Hi sweetie(s), how was your day?"

Just as with receiving a bonus at work or side gigs we might do to augment our income, we can get little influxes of extra “income” by going to the gym or taking a break to meditate. You have to be realistic about how those will play into the budget. These rarely turn out to be the magical lottery winning that eliminates the need to budget.

Now, people do go into debt sometimes to get through the month, but you know that's just going to be a problem later when you have to pay off those credit cards. The same is true when we go into emotional or energy debt. We can borrow against tomorrow and keep pushing ourselves even when we are exhausted, but the bill will inevitably come due. And you could be looking at a painful payment plan - laid up in bed with an infection, medical leave, or an embarrassing public emotional outburst.

Writing out a budget and checking your bank balances regularly make all the difference. Many of us have large fixed expenses -- rent or mortgage, school tuition, health expenses. We have similar large fixed emotional/energy expenses -- parenthood, an ill family member, a difficult boss. Put those in the budget first to make sure that they are accounted for, so that you’ll have sufficient funds for the expenditures that are most important to you.

The other key practice is checking your account often. This allows you to catch problematic patterns or budget shortfalls early. If you check your account once a year and find that a significant amount is missing or your credit cards have been maxed out, good luck figuring out what happened. If your check your accounts weekly, you can quickly notice a developing expensive Starbucks habit or a small charge that turns out to be identity theft. Same thing emotionally -- the more often you check-in with yourself, the easier it is to notice that you are spending more energy than you can afford on a random colleague or Facebook.

A hallmark of a successful budget is having extra funds to save or donate. At some point, hopefully sooner rather than later, we include retirement, rainy day funds, and charitable donations in our budget. How wonderful would it be to be able to include the equivalent in our emotional budget? When we can go to bed at night with a little extra to spare, we could start the next day perhaps a little more bright-eyed and bushy-tailed. We could chose to take the extra time to get to know a stranger, or help a friend move, or have a relaxed conversation with grandma about whatever she wants to talk about.

Listening

I woke up this morning thinking about presidential candidates throughout the history of the United States, and how they have the privilege to travel the country, hearing people's stories. I'm a psychiatrist, so naturally I love hearing people's stories. There are many ways to learn about the diversity of people living in the United States and to connect to their lives -- from watching documentaries to reading biographies. But nothing is as genuine as shaking someone's hand, sitting close with them, and hearing their personal experiences and perspectives.

I feel so privileged to have been able to hear many deeply-held personal stories. These shared stories are the greatest gifts I could imagine. The differences and commonalities are sometimes surprising, but they are invariably understandable and relatable. Through these conversations, over and over again, I am gifted feelings of connection and love. Though I never yearn for the stress or responsibility of holding public office, I woke up this morning wishing to be able to travel our country so that I can shake so many people's hands and hear so many people's stories.

In a way, many of us are about to have that opportunity. Thanksgiving is coming up. Along with the experience of family gathered around a table that is overflowing with food and gratitude, Thanksgiving often brings air travel. Crowded airports full of people from across the country. Blue states and red states, women and men, people of all races and creeds sitting side by side in rows of plastic chairs, waiting for delayed flights. What would it be like to turn to someone, someone who seems like they are probably very different from you, and ask them about their experience? And then, here's the really special part -- just listen with no judgment and no assumptions and really value what the person is telling you. What if you then shook their hand and thanked them for sharing?

Broken Pieces

On the, sometimes, bumpy road of life, things will inevitably break. What we do with those broken pieces creates our unique narrative. I have always found the ways in which we hold the broken pieces together to be profound and beautiful. We form scars and we heal. We lose the unblemished beauty of youth and we grow into complex sophistication. In realizing our frailty, we find our strength. Knowledge of our limits illuminates our path. Our regrets and mistakes, as much as our successes, create our story. They have made us into the people we are today.

Manageable Falls

Imagine a baby learning to walk. The ideal approach for the parent or caretaker is to allow the baby enough space to have minor falls. The kind of fall where the baby can pick herself back up and try walking again. These experiences are important because the act of overcoming them gives the baby a sense of mastery and confidence in her walking. At the same time, you don’t want the baby to take such a serious tumble that she ends up hurt or terrified, and cannot pick herself back up to walk again. As a parent, you want to try, as much as possible, to allow the little one enough freedom where she can experience manageable falls.

I find this image of the baby learning to walk a helpful one to keep in mind, because I believe the concept applies to individuals across the age spectrum, engaging in most activities. We should strive, as much as it is possible, to lead our lives and to open ourselves up to situations where we can experience such manageable falls – and even manageable failures.

We are taught to push the limits. If you fail; try, try, and try again until you succeed. To never fail is to miss out on experiencing the valuable self-confidence that emerges when you succeed at the task you weren’t able to accomplish previously. But to be able to get back up on that proverbial horse, you can’t have been knocked unconscious by the initial fall.

Just as a parent provides a dependable environment for the baby learning to walk, so that she may fail yet still feel safe to try again; we should allow ourselves, no matter our age or circumstance, the opportunity to experience manageable falls.

The Holidays and Family

The holiday season can be a challenging time for many people because it puts a focus on family. People who are without family or whose family is filled with strife can feel particularly alone at this time of year. I think part of the reason that so many people struggle with this is because of how family is typically conceptualized. People equate family with genetic relatives and a traditional family structure.

I think family is a feeling. Family is love, acceptance, and commitment. Family is shared values, traditions, and experiences. When thought of in this way, it becomes clear why family is said to be so important. When someone sees family as a treasured concept, as opposed to a set of people one is born or married into, that person has agency in creating her family. She can choose her family members, creating a group where she “fits in.” A group that will stand by her even during hard times. She can create traditions that will be meaningful, predictable, and comforting. She can share positive, loving experiences with others during the holidays.

Locating the "Crazy"

In today’s dizzying world, change happens so fast and individuals carry so many varying responsibilities all at once. A person can easily feel overwhelmed, falling behind, and even “crazy.” “Crazy” is not such a politically correct word anymore, and many people don’t like to say it out loud. But in the safety of the therapist’s office, it emerges… the secret fear that one is “crazy.”

“What is wrong with me…?”
“Why can’t I…?”
“Sometimes I worry that I am crazy. I feel crazy.”

You may be picking up on something that is real and important. Take that feeling seriously, but don’t jump to the conclusion that it is you. Pause a moment to locate the “crazy.” Many times, especially as women, we assume, or we are told, that the “crazy” is in us. We believe that there is something wrong with us if we are struggling to fit in or we can’t cope. Sometimes that is true, but many times the “crazy” is in the situation. Many times life is just “crazy.” We find ourselves in “crazy” predicaments where not being able to fit-in or cope is actually typical or even “normal.”

When you find yourself in the midst of “crazy,” consider whether the situation can be changed. You might be surprised. You might be able to get the support needed if you speak up. If you step back and assess your options, you might be able to just walk away from the “crazy” situation. Unfortunately, sometimes there is nothing we can do to change the situation and we have no choice but to remain there. You might have to just muddle along the best you can. But to struggle without the added burden of thinking that something is wrong with you is a major improvement in your personal emotional experience.

The Need for New Definitions of “Normal”

I spend a fair amount of time in my psychiatric practice helping women come to terms with the idea that they are “normal.” These are incredibly competent, engaging, intelligent, kind, funny women who juggle work and family, maybe not always with ease, but quite well. In spite of everything they are able to carry on their plate, with only occasional spills, somehow these women doubt themselves. Deep inside they feel that something is “wrong” with them; that they are not doing a good job at life. I have been in this situation so many times that I have come to realize that good, competent women doubting themselves is a norm these days.

Why would this happen with such regularity? How is it that a large proportion of women have gotten the idea that they are “not normal?” First, let’s take a look at how “normal” has been defined. If, let’s say, normal was defined as having a Y chromosome, then 50% of people would, by definition, not be normal. We should then question that definition because it doesn’t make sense, at least for 50% of people.

I’m not saying that normal has been defined explicitly as having a Y chromosome, but maybe there has been a similar process going on. Much of psychological theory predates the women’s lib and civil rights movements. Of course, even more of psychological theory predates the rise of the internet. Sigmund Freud attended medical school in 1881. Although his psychoanalytic theory was informed by his work in psychiatric hospitals and by his research on hypnosis, much of it stemmed from his self-analysis. He often claimed he had little understanding of women.

Beyond the field of psychology, many other cultural ideas about how the classroom and workplace should function predate the large numbers of women who choose or need to work, to earn money, to achieve.

What if the current definition of normal is in fact normal… for a certain percentage of people? And, what if there are also other ways to be normal?

Genomics and medical research keep giving us an increasingly greater number of illnesses and disease models to diagnose with and be diagnosed with. New viruses and bacteria to worry about. New gene sequences that, we are told, encode stress, difficulty, or tragedy.

The world is changing at a faster and faster rate. These changes should not only prompt us to define new pathologies. We also need to continually understand and create new definitions of normal.