Author Archives: Lori Edelman

Take Off the Cape

The Superwoman Syndrome

Recently, a highly accomplished woman said to me, “I am absolutely overwhelmed.”

She told me she cannot keep up with the responsibilities of three children of multiple ages and needs, graduate school classes, job, her family and in-laws, family pets, a recent move, health concerns, and lastly (very much last), self-care. She was in a constant state of upset. And she was in a constant state of upset about being upset. In actuality, she was more than keeping up, but the cost to her mental (and physical) health was accumulating quickly.

In the early 1980s, Helen Gurley Brown, the long-term editor of Cosmopolitan magazine, which was then a hugely popular media source replete with sex tips, feminism, friendship advice, office tales, recipes, and beauty recommendations, wrote one of the most innocuous and dangerous books ever, “Having it All.” It sat on the bestseller lists for years.

Brown argued that one did not have to give up anything: career, money, adventure, children, marriage, friends, beauty, romance, perfect dinner parties, and an immaculate apartment could all be yours. She even threw in a chapter about how to cheat on your partner, should you desire, within your busy schedule. While beguiling, the book left out a very important component: no one can have it all.

In 1984, the American Psychological Association termed the myth of having it all the ‘superwoman syndrome’, defined as a set of characteristics aspired for by a single individual, who attempts to perform all the duties typically associated with SEVERAL different full-time roles, such as wage earner, mother, homemaker, friend/colleague, and partner/lover.

Fast forward to 2021: The Modern Superwoman Syndrome still means maintaining the demands of multiple roles- businesswoman, mother, spouse, daughter, sister, homemaker, friend, breadwinner, caretaker, volunteer, chore and homework supervisor, family chauffeur, chef, personal shopper, intimate partner, family therapist, or some mixture of these and more.

Unfortunately, it comes at a cost. Women today show increased rates of anxiety, depression, chronic stress and fatigue, migraines, heart disease, strokes, and infertility.

The Research:
Studies have consistently found that BIPOC women have an over-abundance of the Superwoman Syndrome. For example, in medical and psychology research, Black women consistently prioritize family, child, and household responsibilities over self-care, with concomitant health problems, particularly cardiovascular. (See Being an African America Superwoman Might Come at a Price).

A recent survey found that mothers were the primary providers of support to children during virtual school during the pandemic, at a whopping 80%. Most were simultaneously working from home on their side gig, full-time employment.

Women experience twice the rate of depression than men do, regardless of race or ethnic background. From their teen years until around age 50, women are also twice as likely to suffer from anxiety as men, according to the Anxiety and Depression Association of America.

Women are more likely to experience difficulty falling and staying asleep (63% vs. 54% of men), to experience pain at night (58% vs. 48%), and to experience fatigue during the day, according to a National Sleep Foundation poll.

According to the Migraine Research Foundation, women make up 28 million of the more than 38 million reported sufferers of this severe health condition. Women’s migraines also occur more often, last longer, and are more severe than men’s.

Common Superwoman symptoms:

  • Bouts of irritability
  • Inability to sleep or excessive sleep
  • Memory issues
  • Muscle tension
  • Anxiety
  • Sweating when not physically active
  • Inability to concentrate
  • General aches and pains
  • Restlessness
  • Loss of libido
  • Over-reactivity to minor stressors
  • Difficulty relaxing, even when “off the clock “

Accumulated stress can also be the door to a multitude of chronic health issues, including early aging, heart disease, diabetes, obesity and gastrointestinal conditions.

Some tips:
Ask for help
You cannot do everything yourself, so designate a sidekick with whom you can share tasks and delegate duties. This can be a friend, roommate, co-worker, partner, or family member.

Take time out for you
Schedule breaks into your calendar and hold yourself to it. In my practice, I have clients write a big M in their planner or calendar, where they will be focusing on themselves. It’s scheduled in and protected ruthlessly.

Daily Om
Daily meditation, mindfulness practice, or yoga will relieve stress and help you to slow down.

No-Guilt Downtime
Take a break by getting a massage, reading a book, watching your favorite show, or taking a walk.  The key is to start taking care of yourself, and to rest and replenish.

Learn to say no
Start saying no to things that you don’t want, or don’t have the time, to do.
Figure out what your priorities are and say “no” to everything else. With practice, it will become second nature.

Set achievable goals
Set goals according to how you want to live. If you don’t know where to start, try making a list of all the important areas of your life (family, job, friends, pets, community, etc.). Draw a circle and divide it up like a pie chart, according to how much each area is taking up of your life. Does it match up with how you want to live your life? If not, list small actions you can take to shift the circle so it aligns more with your ideals.

Let go of perfectionism
Remember that your house doesn’t have to be clean 24 hours a day, dinner doesn’t have to be on the table every night, getting a B in a class is not going to be the end of the world, your friends will not be mad at you if you can’t make it to an event, and you can’t be the perfect employee all the time.

When needed, seek professional help.
Sometimes stepping out of the circle of your friends, family, and colleagues may be vital to get an objective view on what seems “normal.”

Also see my blog post on Mental Health and Women’s History Month.

Life as Fiction.

Movies and Psychotherapy

Recently, I’ve had the honor of being a consultant for a movie, currently in production, where a lead character is a clinical psychologist in a futuristic world. I was approached to provide some insight about what it’s like to do my work, and imbue the character with some of my personal traits. I have no doubt that the very talented actor in this role has numerous awards in her future, and it was a humbling experience to talk with her about what I do.

What’s interesting is the self-reflection required for the role “advice” I gave opened a window of inquiry for me, personally, that was reciprocally insightful.

Her: Are you able to touch your patients? (Holding hands, etc.) Or is that considered unprofessional and inappropriate?

Me: You shouldn’t touch your patients, Especially holding hands or hugging. You should hold them with your eyes and your attention. Once I’ve gotten to know somebody, I might touch them lightly on the shoulder, when they’re leaving. But mostly I use my eyes. People have a lot of feelings about touch, and they might end up feeling that it’s a sexual thing. Touch is highly personal. They may not be able to tell you that it makes them uncomfortable. Or they might not realize it later. You don’t have to touch to connect.

Her: Got it! That helps. Thank you. This is very helpful.
Her:  If you don’t mind, I also wanted to ask you:
1.) What is your goal when you work with your clients?
2.) How does it make you feel when your goal is achieved? How is it rewarding for you?

Me: First, I ask them what immediate events have led them to seek therapy. Sometimes it’s something that’s been building for a while, other times it’s more acute- like a crisis. The timing of what is happening is absolutely important.

Goals- It’s hard to tell when your goal is achieved. Sometimes clients leave and you don’t know how well they did, or not, until later. Sometimes you never know. Other times when people are in therapy for a long time, you actually see their accomplishments as they occur.

Therapy is not linear, so you see a lot of ups and downs. It’s rewarding to me when people are doing well, of course. But more importantly, it is the process. For example: many people have never spoken openly about their traumas or mental health. It’s been forbidden in their family to talk about feelings. So, creating a safe space where they can actually speak is unbelievably moving and an honor to bear witness.

Success can also mean teaching people how to speak an emotional language, often unfamiliar, where they can be themselves. Many people have never had the opportunity to be or experience who they really are, without punishment or criticism. It’s literally learning a foreign language. The inflection, parsing, syntax, and timing are completely new. And then you see them feeling heard. You see it in their eyes. There is nothing better, truly.

I call these seemingly small moments of accomplishment stones across the river in my practice. You can use these steppingstones to get across raging rapids. And you keep laying them down. Practice. You might fumble or slip, but you don’t fall.

Her: Beautifully said! This is brilliant! I’m using this for my work. THANK YOU!!! You’re amazing. I respect you. I’m dedicating my role to you.

Depression Is:

Depression Is:
Emotional: Your baseline enjoyment of life decreases. In other words, you start constantly feeling a sense of suffering, or emotional pain, for no clear reason. Your are more negatively impacted by set-backs, and find it harder to enjoy the things that bring you pleasure and joy.

Physical : You have less energy. Just about anything feels like a tiresome undertaking, and you often feel like just lying down and doing nothing. It may seem impossible to do the smallest of tasks. Getting out of bed, taking a shower, brushing your teeth, cleaning up, or checking your email can feel like Herculean tasks.

Mental: Your thinking becomes distorted and negative. Your self esteem decreases, so that you feel worthless. Thinking and concentraing becomes harder, as if trying to see something through a fog. It’s hard to imagine things becoming better, or to form a positive idea of the future in general. You have a variety of intrusive negative thoughts; these thoughts can happen regardless of however much you believe or agree with their content.

Additional resources:

What Not to Say to Someone with Depression.

National Emergency Helpline

 

Six Paradigm shifts: mental tweaks that matter.

  • Other than your closest friends and the family that matter, you don’t owe anyone anything. Just because you’re good at (fill in the blank), you don’t have to help somebody else with it. If they value your skill, they will offer to compensate you for your time, help, and energy. You are under no obligation to give away your protocols, strategies, and knowledge without a clear consensual understanding on both sides.
  • Learn to ask for help. It will save you time and grief. Being able to rely on the skill sets of another is a great gift.  See How to Ask for Help Without Feeling Weird for tips.
  • Don’t over-explain but be gracious. Many years ago, I watched a male friend turn down an invitation to a major event. ”Thanks for thinking of me, but I’m not going to be able to make it.” Another friend: “I am so sorry… I am just so busy… The kids and work deadlines… I feel awful, I would totally come if I could.” These are just examples, of course, but frequently we have a propensity to over explain and over apologize.
  • Don’t personalize hurts. Your friends might be busy with their work commitments, children and families, and hopefully self-care. If they are not readily available, it’s not because they don’t love you.
    Also see What to Do When You Don’t Feel Valuable.
  • Ask, don’t assume. Every single time. In my couples therapy sessions, one set of research I use in the work explores the ‘stories’ that everyone brings into their intimate and romantic lives. Universally, there are certain beliefs that people bring with them to most of their interactions that are left unspoken and yet are assumed.  Speaking them matters.
  • Do not put your values and standards on another person. We all need different amounts of rest, sleep, recreation, challenge, hustle, and social time. Differences are not hierarchical.

What are some mental shifts that helped you?

Strengthening Your Empathic Muscles

Image courtesy: Krissy Murphy Benson

We are wired to care, down to the neurochemical level. Oxytocin is a neuropeptide (hormone) that is produced in the brain (hypothalamus) and is then distributed through your body by your bloodstream. It’s commonly know that breastfeeding mothers release oxytocin, as do couples during intimacy and friends during a warm hug. It is also released when we show compassion and kindness to others.

A review of the neuropsychological research on oxytocin states that the hormone has a significant impact on “pro-social behaviors” and emotional regulation, and contributes to relaxation, trust, decreased anxiety, and psychological stability.

Exciting Developments in Empathy Research
Studies have also found that oxytocin may help induce altruism. For example, in one research study, participants were given a nasal oxytocin spray which resulted in increases in generosity. The study participants were given money to keep or to share with others. They were significantly more willing to share money with a stranger with a squirt of the neurotransmitter. As such, oxytocin has been dubbed “the moral molecule,” by neuroeconomist Dr. Paul Zak.

Psychology researchers Nicholas Christakis and James Fowler studied a neighborhood in Massachusetts, and found that many community behaviors are contagious. If your neighbor goes on a diet, you go on a diet. If a person a couple of blocks away started smoking, other people on the street started smoking. However, they found that prosocial behaviors, such as community service and sharing meals and resources were among the most “contagious”. Community members participating in acts of kindness showed significant increases in satisfaction and happiness, and decreases in anxiety.

An MRI study led by Dr. Gaëlle Desbordes at Massachusetts General Hospital indicated that both compassion meditation (also known as Loving-Kindness meditation) and mindfulness meditation training decreased activity in the amygdala in response to emotional images; however, brain activity simultaneously indicated a response to the emotional images. This suggests that meditation can help improve emotion regulation and increase calmness, WITHOUT reducing awareness of emotionally-laden or upsetting information.

How to flex your empathy muscles:
Actively Listen More Than You Speak

    • Commit your undivided attention to the conversation. That means no cell phones, tablets, or computers.
    • Let the speaker actually speak. Give them the time they need to finish their thoughts and avoid interrupting them.
    • Summarize your understanding. Once the speaker has finished talking, summarize your understanding back to them. Then ask, “Have I understood this correctly?”
    • Allow the other person to vent. When someone’s having troubles, they may be emotionally flustered. Give them the space to feel that.

Be Vulnerable
People often fear vulnerability because they worry others may perceive them as weak. Dr. Brené Brown has written that vulnerability actually helps us directly connect with others, by communicating that we’re human; complete with weaknesses, hurts, grief, and fears.

Make it a practice to help one person every day
Clinical psychologist Dr. Sonja Lyubomirsky showed that people who perform acts of kindness (five acts each week in her studies) tend to feel happier and more connected to others after six weeks.

Visualize helping
Every morning, take a few minutes to visualize helping some of the people you know you will encounter during the day. In psychology, this is called “priming,” and lots of new research suggests it’s very effective in shaping behavior. For example, a study by psychologists Mario Mikulincer and Phillip Shaver found that people were more willing to help someone in need after being prompted to think about a caring and supportive figure in their personal lives.

Draw on personal talents
Research shows that people find it easier to consistently help others when they are doing things they are good at. Reaching out in the way that best reflects you has the most longevity.

Acknowledge others in your life
Research by psychologist Christopher Peterson found that writing a gratitude letter made people feel significantly happier for a month.

Read also: The Science of Compassion.

What is Affect Phobia?

To live a full and connected life in the face of difficulty and even tragedy requires the capacity to feel and make use of our emotional experience.
-Diana Fosha, The Transforming Power of Affect.

I have clients who have asked me to teach them how not to cry. It’s seen as fake or a sign of weakness. Others have walked away from those in distress, or even mocked the tears or deep feelings of others.

Affect phobia is literally a fear of feelings and their expression. If someone has internal conflicts with strong emotions in themselves and others, they are functioning in a maladaptive way. The hallmarks of affect phobia are avoidance of strong emotions in self or others, minimization of natural expression of emotions, and even taking pride in being strong or “stoic.” Similarly, they may tell someone in distress not to be vulnerable, sometimes guised as a compliment (you are stronger than that; be a warrior).

While phobias are traditionally associated with things like spiders, heights, enclosed spaces, and public speaking, it goes beyond that. For example, an individual with an aversion to grief might avoid feelings of sadness and become enraged instead. Instead of comforting someone in distress, they may sneer or tell them to stop crying. This can impact their relationships, environment, self-worth, ability to be present, experience joy, and more.

People may come to fear feelings because of early learning in their families-of-origin. They may adopt avoidant feelings, thoughts and behaviors to an extent that they are unaware that there is an underlying feeling that they are avoiding in self and others.

For example, if a child’s parents could not tolerate open expression of their anger as a child, they learn to “shut down” feelings of anger. They also may not be able to tolerate the angry feelings of another, similarly shutting them down, or avoiding them as “dramatic.” If parents said they were being a baby for crying, they may learn to view feelings of sadness as “weak.” As an adult, they pride themselves on being “strong and stoic” and dismiss feelings of sadness as “weak and pathetic.”

Affect phobia are anxiety and shame-based reactions that inhibit our natural expression of emotions. This inhibition often causes various mental health problems, such as anxiety and depression.
Some common indicators of affect phobia:
Guilt over anger
Embarassment about crying
Pain over desiring closeness
Shame about oneself
Avoidance of others who they deem to be overly emotional
Lack of ability to read and respond appropriately to feelings in others

Therapy helps to address affect phobias by identifying and helping to address blocks to feeling. It is often helpful to understand these anxiety and shame-based reactions as adaptations to the kind of childhood environment people grew up in. However, these responses are no longer needed and get in the way of healthier functioning – a tolerance for the FULL range of emotions in our lives and others.

Also see:
(Affect Phobia Therapy, an integrative model of short-term Dynamic Psychotherapy that was created by Leigh McCullough, Harvard Medical School psychologist and researcher, 1997).

The psychology of scotch bonnets

I’ve never fully understood people who tell me that they can’t “handle” spicy foods. Sure, like others, more than once I’ve bitten off more than I should have, and enjoyed delicious spiciness all the while with tears pouring down my face. So why do some people hate hot sauce, chili peppers, and other spicy foods while others can’t get enough?

The answer is based in science, but not genetics, as many people think. It turns out that there is no such thing as a spice-loving gene, and no one is born loving hot sauce. Sure, being exposed to spicy foods at earlier ages can encourage familiarity and even cravings from memories of meals past.

According to science, affinity for spicy foods is learned, a result of repeated exposure to peppers—specifically to capsaicin, the compound that makes chili peppers taste hot and makes your mouth burn. This process of learning to love heat is what Dr. Paul Rozin, professor in clinical psychology at the University of Pennsylvania, who examined the psychology of food tastes, called “benign masochism.” People who eat a lot of spicy food don’t have numbed or injured taste receptors. They are not insensitive to the irritation that extreme spice produces. They actually come to like the same burning sensation that deters many animals and humans that dislike heat. Eating spices that are intense creates a burst of endorphins, the neurotransmitters of pleasure.

Dr. Rozin termed this a hedonic shift, meaning that folks who like the burning sensation of hot foods actually form stronger associations between pain and pleasure. It hurts so good.

9 Myths About Mental Illness

May is Mental Health Awareness Month. Let’s start off with some important myth-busting.

Myth: Suffering from mental illness is uncommon.
Mental illness is probably more common than you think. According to the National Institute of Mental Health, more than one in five U.S. adults lives with a mental illness. Chances are you know or are somehow connected to someone suffering from a mental illness and may not even know.

Myth: Mental illnesses are not “true” medical conditions
There is plenty of research and empirical evidence that suggest that many, if not most, behavioral health issues involve chemical imbalances in the brain Much like medical conditions, there are often underlying biological causes and/or a genetic predisposition that account for illness. Importantly, chronic stressors including poverty, racism, abuse, and trauma significantly increase vulnerability for mental disorders.

Myth: People suffering from mental illness are more likely to commit a crime or engage in violent behavior. People suffering from mental illness are no more likely to commit violence than anyone else. In fact, studies show that people with mental health conditions are much more likely to be the victim of a violent crime than those in the general population.

Myth: Therapy isn’t necessary for people on medication
Therapy and other forms of self-care are usually an important part of a person’s treatment. All current best practice models indicate that use of pharmacological methods along with clinical/supportive interventions is the most successful approach in helping individuals on their paths to recovery
.
Myth: There is one best answer or treatment for mental illnesses.
Everyone’s situation is different, so treatment methods should be discussed and individualized with a qualified professional. There is no cure-all.

Myth: You can will away your mental illness with positive thought
Though having a positive outlook and belief in one’s recovery is important, behavioral health conditions cannot be “willed away.” People sometimes have the idea that issues like anxiety or depression are all in someone’s head and can be “shaken off,” but the reality is that recovery requires the help of evidence-based interventions, self-care, and social/community support.

Myth: Mental illness is a personal weakness
People do not choose to live with behavioral health issues, and there are a variety of factors involved their development. Stigma and shame are still very much a part of diagnosis of mental disorders and seeking help. Treat struggling people with dignity, and become an advocate for awareness in your community.

Myth: Keeping a job or having a social life is too stressful for individuals with mental illnesses. Those with mental illnesses are no different than your average employee. They are just as productive. And having a job and sense of community is actually beneficial to those living with a mental health issue. It provides structure and a sense of personal purpose.

Myth: Mental health professionals (psychologists, psychiatrists, social workers, psychiatric nurses, marriage and family counselors, etc.) make a ton of money off of people suffering from these disorders, and want to keep them in treatment as long as possible. Mental health care is often the lowest paying, longest work day among the healthcare professions. The majority of behavioral healthcare and related professionals work in this area because they want to, not because of the pay. For every hour that they spend with a client, there are at least two hours of paperwork, documentation, communication with other professionals, and follow up.

What To Do When You Don’t Feel Valuable

It takes work to shift your thoughts, but what is most important that you start taking small actions that signify “I have value.”

Take Small Actions

What does that look like on a daily basis?

  • Offering your opinion.
  • Speaking up in a crowded room.
  • Sitting in the front row.
  • Sending your order back when it’s wrong.
  • Buying yourself a gift that you really wanted.
  • Sharing the artwork or writing you keep secret with a friend.
  • Saying “thank you” (and just “thank you”) when you get a compliment.
  • Saying “no” to things you don’t want to do.
  • Not buying friends. You don’t have to pay for stuff to be loved or valued.
  • Asking for what you need.
  • Asking for what you just want.
  • Giving yourself a day off, an hour off, or even a few minutes off. You don’t have to be on all the time.
  • Making a habit of exerting yourself. You can do this without being an a-hole.

Be Prepared for Pushback
Be aware that when you start practicing “I have value” in your daily life, it can upset the people who have benefited from you not valuing yourself. They’ve been getting a pretty good deal, and now you’re changing the rules! So be prepared for a little push-back, and gently keep pushing forward. Some people might even drift away from you if your value was predominantly for their good, not yours.

What’s ONE action that you can take TODAY that signifies “I have value”?

Embolden Psychology
Embolden

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

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