The Messy Truth About Obsessive-Compulsive Disorder

I hear comments all the time:

“My place is so perfect. I’m so OCD.”
“No, it has to be neat and clean. I’m so OCD.”
“You should see how I organized my Star Wars collection. I’m so OCD.”

I was born with Obsessive-Compulsive Disorder (OCD). I struggled throughout my childhood, through multiple high schools and left college after just one semester—consumed by my obsessive thoughts. I barely made it through my twenties. In my early thirties, I hit rock bottom. I was bedridden in my parent’s guest bedroom, paralyzed by OCD.

One year included three psychiatric hospitals; intensive outpatient therapy; two months at the OCD Institute at McLean Hospital in Boston; being kicked out of said OCD Institute; and living on the streets of Boston in the middle of winter with little money, no transportation, no job and severe OCD and separation anxiety.

It took hitting rock bottom to get the help I needed. After eight scary therapeutic months, I was “reborn” and moved to Los Angeles a healthy, happy and thriving member of society. I finally understand the point of the therapy my loved ones had desperately been trying to get me into.

Why do most people believe the myth that OCD is just about a hyper-organized desk or color-coordinated closet? The reality is that most of the 3 million people with OCD in this country struggle just to function on a daily basis. They’re not bragging about the “benefits” of OCD.

Well, Hollywood’s general portrayal and perspective of OCD is limited. Movies and TV present OCD as quirky or fun. Characters often use their symptoms to their advantage, almost like a skill or superpower. Hollywood has created the belief that OCD is just double-checking, hand washing or a strong dislike of germs. Hollywood and the media rarely address the reality of this serious condition—it simply seems funny to watch, and not too difficult to live with. So, many individuals with OCD continue to struggle in silence, afraid to seek help.

OCD typically looks nothing like what you see on television. I didn’t wash my hands; I didn’t check, organize or clean; I wasn’t afraid of germs. My OCD was based in my fear of losing control. OCD is complicated like that; it preys on your unique fears and anxieties that have no basis in reality. For some people that’s germs, for others (like me) it’s extremely taboo topics, like self-harm.

To you, these fears and anxieties seem irrational and easy to brush aside, but the actual experience of having OCD is losing that rational perspective. Your brain can’t shrug off these fears. It’s a constant battle between uncertainty and truth inside your brain. That’s why the disorder is a far cry from: “I love when my kitchen is put away perfectly. I’m a little OCD.”

 

Ethan S. Smith currently lives in the Los Angeles area working as a successful writer/director/producer/author and OCD Advocate. Ethan was born with OCD and struggled most of his life until receiving life-changing treatment in 2010. Ethan was the keynote speaker at the 2014 annual OCD conference in Los Angeles and is the current International OCD Foundation’s National Ambassador.

https://www.nami.org/Blogs/NAMI-Blog/March-2018/The-Messy-Truth-About-Obsessive-Compulsive-Disorde

Understanding Self-Harm

Self-harm is difficult to understand because it goes against the natural human instinct of self-preservation. Maybe that’s why some people react to it in a negative, judgmental way. They can’t imagine ever being in a state of mind where they would hurt themselves, so they can’t understand why anyone else would.

This lack of understanding can lead to insensitivity and stigma towards people who are often already struggling with serious emotional turmoil. Self-harm is usually a sign that a person is having a tough time coping with their emotions. It’s frequently “used” as a coping mechanism for unmanageable mental health symptoms, although the experts don’t completely understand why some might self-medicate with drugs or alcohol, while others self-harm.

Several mental health conditions are associated with self-harming behaviors, including borderline personality disorder, depression, eating disorders, anxiety or posttraumatic distress disorder. People experiencing these conditions might self-harm for one or more of the following reasons:

  • To help manage unbearable emotions and symptoms
  • To help regain a sense of feeling (for those experiencing numbness)
  • To help relieve stress and pressure
  • To help feel in control
  • To reenact a trauma in an attempt to resolve it
  • To protect others from emotional pain

Any person can self-harm, but the largest percentage of people who engage in these type behaviors are teenagers (17.2%) and young adults (13.4%). According to psychologist Dr. Jennifer Muehlenkamp, “Those are the key ages because youth are experiencing multiple changes at the same time. They’re becoming more independent and transitions such as from junior high into high school or to college creates a lot of change. There’s a lot of new stress and pressures.”

What Should I Do?

Self-harm seems to provide some level of relief from emotional pain, and can become addictive. Like alcohol and other drugs, self-harm is a behavior that a person might feel they need increasingly more of to feel the same effect. It could also lead to other self-destructive coping mechanisms. So, if you or someone you know self-harms, here are a few first steps you can take to change this behavior.

Seek Treatment

Self-harm is a serious mental health symptom that requires evaluation and treatment. If you are having difficulty coping with intense emotions without the use of self-harm, consider talking with a mental health professional about one of the following treatment methods:

  • Cognitive behavioral therapy (CBT) focuses on recognizing negative thought patterns and increasing coping skills.
  • Dialectical behavioral therapy (DBT) helps a person learn positive coping methods.
  • Psychodynamic therapy identifies how negative behaviors have been caused or influenced by past experiences and unresolved feelings.

Practice Positive Coping Mechanisms

It’s helpful to understand what triggers you (or your loved one) to self-harm. That way, you can implement healthy coping mechanisms to manage those triggers. Some examples are:

  • Direct the urge at something else – Use a punching bag, scream into a pillow or rip up a magazine
  • Self-soothe – Take deep breaths, take a bath or try meditation
  • Express yourself – Write how you feel or write creatively
  • Create something – Paint, draw or craft
  • Focus on music – Listen to your favorite song or play an instrument
  • Exercise – Run, dance or just go for a walk
  • Avoid alcohol and drugs – Substances can lower your self-control and increase risk of self-injury

Self-harm is a challenging mental health symptom to overcome—and lack of understanding only makes it that much more difficult to work through. When it comes to serious mental health symptoms like self-harm, we need to show others and ourselves compassion rather than judgement. There is no shame in needing support and help.

What To Do If Your Workplace Is Anxiety-Inducing

There are so many aspects a job that can cause anxiety: having tight deadlines, trying to harmonize a work/life balance, dealing with office gossip and politics, meeting your supervisor’s expectations… the list goes on.

Thanks to all this, most people who work will experience some anxiety at some point. But what do you do if your workplace makes you feel that way on a regular basis? When you dread stepping foot into the office day after day. When something about your job makes anxiety your norm. When you have an anxiety disorder and work constantly triggers your symptoms.

Depending on your situation, it might be helpful to evaluate whether your job is right for you. But if you aren’t able or don’t want to change jobs, there are ways to manage workplace anxiety.

Practice Self-Awareness

Before you can improve your situation, it’s important to understand what exactly is creating your anxious feelings or worsening the symptoms of your condition. Even if the root of your anxiety is something you can’t change, like having more work than you can handle, knowing the cause can help you figure out next steps. It’s a lot harder to reach a destination without a map.

Share Your Feelings

It may be helpful to talk to a trusted coworker as they can relate to and sympathize with your anxiety. If you don’t have a coworker you trust, you can talk to a friend, family member or mental health professional. Talking about anxiety with the right person can help you process these intense emotions and it can be validating if the person is supportive and understanding. They might also have ideas or suggestions to help you cope.

Release Your Thoughts

Anxiety feeds off itself and one anxious thought can turn into 100 pretty quickly. There’s no way I will meet this deadline. What if something else comes up? What if Steve thinks the project is terrible? If you’re feeling inundated with this kind of thought-spiral, it can be helpful to release your thoughts.

One of the most effective ways to do this is by writing them all down. Do a brain dump of all your anxious thoughts—not to understand them, but just to get them “out.” If you’re at home (or somewhere you feel comfortable) thinking about work drama, you can also sing your thoughts. The idea of these practices is that you can’t write or sing as fast as you can think, so you’ll actually be slowing down while you release your unhelpful thought patterns.

Know When To Ask For Help

If you’re drowning in work, having a hard day or feeling like you can’t meet your supervisor’s expectations, ask your colleagues for help. While it may feel like everyone handles their own work and stress independently, and you should too, this is often not beneficial to anyone. Asking for help when you need it alleviates your burden and builds trust among coworkers. If you feel guilty for taking up their time, offer your support the next time they need help.

Take Time Off

Every six months or so, take some time off work and disconnect as much as possible. Don’t feel guilty about it. You deserve time to yourself or with your loved ones. There is no shortage of research about how important it is for your mental health to get regular breaks from work to decompress and reset. It gives you something to look forward to, time to reflect and practice gratitude. Time off also helps build resilience.

Accept Anxiety

The more you fear anxiety, the more powerful it can become. Part of reducing anxiety is accepting that sometimes work is going to make you feel that way. This is a lot easier said than done, but it comes with practice. So, next time you feel your thoughts and heartbeat start to race, take a moment, sit at your desk and tell yourself: “I feel anxious right now and that’s okay. I’m uncomfortable with this feeling and that’s okay. I don’t know how long this will last, and I’m okay with that.” Tell yourself these things and mean them. It can be surprising how much this small act can help.

Workplace anxiety happens to everyone. But for those who experience it regularly, it’s not something you should push aside or ignore. Even if you feel stressed out and under pressure, it’s important to take time to manage your anxiety. Work is important, but it’s not worth your mental health.

 

By Laura Greenstein 

https://www.nami.org/Blogs/NAMI-Blog/February-2018/What-To-Do-if-Your-Workplace-is-Anxiety-Inducing

The Problem With Yelling

“The problem with verbal abuse is there is no evidence,” Marta shared. She came for help with a long-standing depression.

“What do you mean, lack of evidence?” I asked her.

“When people are physically or sexually abused, it’s concrete and real. But verbal abuse is amorphous. I feel like if I told someone I was verbally abused, they’d think I was just complaining about being yelled at,” Marta explained.

“It’s much more than that,” I validated.

“The problem is no one can see my scars.” She knew intuitively that her depressionanxietyand deep-seated insecurity were wounds that stemmed from the verbal abuse she endured as a child.

“I wish I was beaten,” Marta shared on more than one occasion. “I’d feel more legitimate.”

Her statement was haunting and brought tears to my eyes.

Verbal abuse is so much more than getting scolded. Marta told me that there were many reasons her mother’s tirades were traumatizing:

  • The loud volume of her voice
  • The shrill tone of her voice
  • The dead look in her eyes
  • The critical, disdainful and scornful facial expression that made Marta feel hated
  • The long duration—sometimes her mother yelled for hours
  • The names and insults—you’re spoiled, disgusting and wretched
  • The unpredictability of that “flip of the switch” that turned her mother into someone else
  • And, perhaps worst of all, the abandonment

Being frequently yelled at changes the mind, brain and body in a multitude of ways including increasing the activity of the amygdala (the emotional brain), increasing stress hormones in the blood stream, increasing muscular tension and more. Being frequently yelled at as children changes how we think and feel about ourselves even after we become adults and leave home. That’s because the brain wires according to our experiences—we literally hear our parents’ voices yelling at us in our heads even when they’re not there.

Attachment and infant-mother research confirms what we all intuitively know: Humans do better when they feel safe and consistently loved, which means, among other things, being treated with respect. What is news to many of us is that we are born with fully matured, hard-wired, core emotions like sadness, fear and anger. And when fear, for example, is repeatedly triggered by a harsh environment, like one where there is a lot of yelling, automatic physical and emotional reactions occur that cause traumatic stress to a child. The stress in their little brains and bodies increases from anything that makes them feel attacked, including loud voices, angry voices, angry eyes, dismissive gestures and more.

Children do better when they are calm. The calmer and more connected the caregiver, the calmer and more secure the childAnd the healthier it is for the child’s brain and body. Knowing this, here are some things all parents can remember to help young brains develop well, by ensuring our children feel safe and secure.

  • Know that children have very real emotional needs that need proper tending. In general, the more these needs are met, the easier it will be for the child to be resilient in the face of life’s challenges.
  • Learning about core emotions will help your child successfully manage emotions.
  • You can affect your child’s self-esteem by being kind, compassionate and curious about their mind and world.
  • When a break in the relationship occurs, as often happens during conflicts, try to repair the emotional connection with your child as soon as possible.
  • You can help your child feel safe and secure by allowing them to separate from you and become their own person. Then welcoming them back with love and connection even when you are angry or disappointed in their behaviors.

When you’re a parent, it’s not easy to control your temper or realize when you’ve crossed the line into verbal abuse. There is a slippery slope between being a strict disciplinarian and traumatizing a young brain. A little awareness goes a long way. Being aware of one’s behavior, listening to our tone of voice and choice of words and watching our body language will keep us in check. Little children, who can act tough, defiant or even indifferent to our actions, are still vulnerable to trauma.

Our own childhood experiences—wonderful, horrible and everything in between—need to be remembered and honored. And we can all strive to help ourselves and our families evolve for the better: to increase the best, gentle experiences we received as children and reduce the painful ones. Marta, for example, worked hard to recover from her abuse. She strove to develop compassion for herself and self-soothe her distress, both necessary but challenging parts of healing.

Several years into our work together, Marta came in following a distressing weekend and shared an amazing experience. A fight with her mother had left her reeling: “I told myself, my distress will soon pass and I’ll be okay. I named, validated and felt the sadness in my body as I gave myself compassion. After I spent time with my feelings, I took a walk through the park and looked at nature. I felt better.”

Proud of the way she could now self-soothe, I said, “What a wonderful mother you were to yourself.”

 

Hilary Jacobs Hendel, LCSW, is the author of It’s Not Always Depression (Random House & Penguin UK)a book which teaches both the general public and psychotherapists about emotions and how to work with them to feel better. She received her BA in biochemistry from Wesleyan University and an MSW from Fordham University. She is a certified psychoanalyst and AEDP psychotherapist and supervisor. She has published articles in The New York Times and professional journals. Hendel was also the Mental Health Consultant on AMC’s Mad Men. She lives in New York City. For more information and free resources for mental health visit: https://www.hilaryjacobshendel.com/

https://www.nami.org/Blogs/NAMI-Blog/February-2018/The-Problem-with-Yelling

Writing Tips That Can Reduce Symptoms

In 1985, psychologist James W. Pennebaker theorized that the effort it takes to hold back our thoughts and feelings serves as a stressor on our bodies. By confronting these thoughts and acknowledging our emotions, we can reduce the stress and negative impact on our bodies. The result? We feel better.

One of the best ways to confront our feelings is through writing. Decades of research have suggested that expressive writing can help improve mood, increase psychological well-being, reduce depressive symptoms, decrease PTSD avoidance symptoms, reduce days spent in a hospital and improve immune system functioning (to name a few).

Writing a letter or journaling is not a new concept; in fact, for many, it’s a fading art form. With all the recent technological advancements, individuals are no longer opting for the standard pen-and-paper means to express feelings, ideas and thoughts. Instead, it’s become much more common to use social media to express “tip-of-the-iceberg” feelings.

For someone with mental illness, taking time beyond a social media post to write expressively can be very helpful to your well-being. Below are a few ways you can use expressive writing practices to reduce mental health symptoms and improve overall well-being.

Focus On A Specific Subject

study conducted by the University of Los Angeles found that participants who wrote in detail about a particular stressor showed the most improvement versus writing about general facts of a stressful event. Participants who did not just recount events but rather wrote about how they felt about the event had marked improvement in their health.

This means: You should write about a specific experience and all its features—how it made you feel, and any thoughts or ideas you had as result. Don’t just rehash what happened.

Give Yourself Time

By dedicating a set amount of time to write, you can dive deeper into your feelings and experiences rather than just brush the surface. Studies have reported that short writing sessions have less impact on improved feelings/emotions in the long run. Giving yourself a focused time, day and schedule to write improves the ability for your mind to dive deeper into processing your feelings.

This means: Try to set aside at least 15–20 minutes a day to write, and try to do it consistently for two to three days in a row. Allow time after writing to collect yourself before moving on to other tasks.

Don’t Worry About Grammar Or Spelling

When writing a research paper or dissertation, spelling and grammar are crucial. However, this isn’t the case for expressive writing exercises. Worrying about grammar and spelling tends to pull an individual’s mind out of the free, conscious “space” they are trying to experience.

This means: Ignore the rules and write without stopping to re-read or edit what you have so far.

Use Positive Words

Using words like “because,” “realize” and “understand” helps increase the positive effects of the exercise. Studies found that writing that included “positive-emotion” words had higher rates of improved health. Words such as hope, love, anticipation and awe are also good words to consider using.

This means: The words you use matter. After writing, identify the number of positive words in your writing. You can also visit www.liwc.wpengine.com and paste your text into their system and see how your writing is translated in a positive or negative sense.

Seek Support

While extensive studies have been conducted, there is still much to learn about the implications of writing about emotional topics such as PTSD, anxiety or depression. Therefore, if possible, seek support from a mental health professional to help you through any challenges that may arise during these exercises. It’s important to have resources available while you uncover feelings and emotions through the writing process.

The art of expressive writing has been researched and studied for decades, and the findings demonstrate that it has a positive impact on symptom reduction and overall well-being for participants who use the process as it was intended. Consider the above five tips when beginning your “writing to wellness” journey.

 

Steven Swink has his Master’s degree in counseling psychology and has been working in the field of mental health since 2009. He has provided direct counseling services and provides supervisory-level work in the mental health field overseeing various programs and service delivery to consumers. In addition to his mental health experience, Steven is co-founder and CEO of www.Letyr.com, a platform for people to anonymously share their ideas, beliefs and feelings in a safe and confidential way.

https://www.nami.org/Blogs/NAMI-Blog/February-2018/Writing-Tips-that-Can-Reduce-Symptoms

Why Don’t More Olympians Talk About Mental Illness?

Many Olympians have talked about various health issues they’ve overcome, but so few have opened up about living with a mental health condition. This is surprising due to the immense mental component of being an Olympic athlete.

Many Olympians have commented that the mental aspect of the game far exceeds the physical. So, coping with symptoms of mental illness would make competing even more challenging, just as a physical injury would. But even if it does make competing more challenging, a mental health condition wouldn’t prohibit someone from being able to compete—or win.

Olympians who have told the world they experience mental illness seem to do so after their career as an Olympian has ended. Of course, there are exceptions, such as bronze-medalist figure skater Gracie Gold who isn’t competing in this year’s Winter Olympics due to her struggles with mental health. She bravely shared that she needed to put skating on hold, due to mental health treatment.

“I am still undergoing treatment for depressionanxiety and an eating disorder,” Gold explained. “It pains me to not compete in this Olympic season, but I know it’s for the best.”

Statistically speaking, Gold is not the lone Olympian in this year’s Pyeongchang’s games living with a mental health condition. There are 244 athletes competing in the 2018 Winter Olympics on Team USA. Since 1 in 5 adults live with a mental health condition, approximately 49 of these athletes live with a mental health condition. Yet only a handful have spoken out.

So why don’t Olympians talk freely about mental illness, if they have it? Probably stigma. Athletes want to be viewed as strong and empowered, and rightly so. They don’t want the public shaming them for any issue or condition, especially one that is so heavily stigmatized in our society.

But the simple truth is: Olympians can prove having mental illness doesn’t mean you’re weak. Being able to manage symptoms well enough to handle the highest-pressure competition in the world proves that mental illness doesn’t have to hold you back. And that some of the strongest, most motivated individuals in the world have these struggles as well.

We need to encourage athletes to open up about their mental health. It could alter society’s perception of what someone living with a mental health condition is capable of achieving. We need to break the stigma that is keeping these world class athletes silent. Join NAMI’s movement to stop stigma on mental illness. Go to www.nami.org/stigmafree and take the pledge to be StigmaFree.

By Laura Greenstein

https://www.nami.org/Blogs/NAMI-Blog/February-2018/Why-Don-t-More-Olympians-Talk-About-Mental-Illness

Being The Person My 13-Year-Old Self Needed

It started when I was 13; unbeknownst to me, I was dealing with depression and anxiety. During seventh grade, I was bullied quite a bit. I can clearly remember one time—a few girls were verbally ganging up on me at a lunch table in the cafeteria. Since I was cornered at the table, it was on the brink of getting physical.

Luckily, I had a friend who wasn’t afraid to stick up for me. She was so upset that she slammed the lollipop she had in her mouth on the lunch table and said, “You aren’t going to talk to Brooke like that!” She started arguing with the group of girls and I got up and ran down the hallway into the bathroom and started sobbing. For a week after, I stayed in my favorite teacher’s room, too scared to go back to lunch with everyone else.

When I was 13, I started to harm myself. This lasted for a few years between middle school and high school. Many people ask me, “How could you do that to yourself? How did that make you feel better?” Well, I was hurting so much inside. I didn’t know how to come up from that dark place. I lost interest in everything. I was constantly feeling guilty about everything I did. I felt inadequate. I had negative thoughts racing through my head every second of every day. I didn’t know how to stop it. So, to me, outside pain was the only pain I could control.

There’s a behavioral health center for young adults in my town. I can remember the time I took a pamphlet to an adult hinting that I should go there for help. They said, “You’re too young to be depressed.” I had taken a “Do you think you’re depressed?” test online, and I had checked yes to many of the listed symptoms. I printed the paper off and showed that to them as well. To no surprise, they expressed that I was being dramatic.

Later on, I made an appointment with my guidance counselor. I was crying as she asked me if I ever had suicidal thoughts or if I had ever harmed myself. I said “no” because I felt that if I told her “yes,” I would get in trouble. I didn’t feel safe telling her everything. I left and went back to class with dried tears and a sense of hopelessness.

See, I’m known for having a very outgoing personality. I was always the student who participated in many activities, volunteered, played sports, led the cha-cha slide at the school dances—a social butterfly. So, to other people, I didn’t “fit the mold” of someone who was depressed.

Fast-forward six years: I was diagnosed with depression and anxiety. It was six years of feeling completely alone. Six years of feeling like I was the only person that felt the way I did. Six years of feeling helpless.

I couldn’t sit still without answers, so I dedicated time to research how chemical imbalances in the brain affect us. I learned that so many other people are affected by mental illness as well. Then I thought, “If there are so many people with similar issues, why aren’t more people talking about it?!”

So, I started a project called Crowning Confidence, geared towards young adults experiencing mental health issues and bullying. It all started after I saw a Facebook post by a mother of a 7-year-old girl named Hayden who was being harshly bullied. As Miss Alaska USA, I felt I couldn’t have this go unnoticed. I reached out to her mother and asked if there was anything I could do to lift Hayden’s spirits. She expressed that her daughter loved princesses. Taking that as inspiration, I made her a video message with affirmations and tips on how to deal with bullies. I then proclaimed her honorary Queen Hayden and sent her a crown. I told her that whenever she felt down, she could always put on her crown to bring herself up.

My experience with Hayden propelled me to become the person my 13-year-old self needed, and start Crowning Confidence for all the amazing girls out there in similar situations. This project came full circle for me when I had the opportunity to bring it into my old middle school. In my favorite teacher’s class that I used to hide in all those years ago, I was able to speak to young ladies about self-esteem, mental health and give them all their own crowning moment. I want to do the same in as many schools and organizations as possible.

Ultimately, no one is to blame for my experience. I tried to reach out when I was younger, but they just didn’t know what to do, or the signs or symptoms of mental illness. That is why I am here. I want to make a positive and open space for people to speak and ask questions about mental illness. Increasing awareness and opening up conversations will allow more people to have access to necessary mental health information.

With more information, people can receive the proper help they need, no matter how old they are. I sometimes think of how different my life would have been if I had more information, but then again, I was supposed to go through this journey, because now I know how it feels and I can use my experiences and platform to help people—especially young adults—who feel they have no one to reach out to.

Brooke Johnson is Miss Alaska USA 2018, a NAMI Ambassador and an actress. You can keep up with everything she’s up to at www.brookej.com. She recently started a YouTube channel for people to follow her Crowning Confidence Project, Mental Health Awareness Platform and her journey to Miss USA. Follow her blog/vlog here.

https://www.nami.org/Blogs/NAMI-Blog/January-2018/Being-the-Person-My-13-Year-Old-Self-Needed

6 Keys to Staying in Love

In the dating world, most intimate relationships don’t turn into long-term commitments. This happens for different reasons: Some loving partners can’t get past the challenges that ultimately end their commitment to each other. Some give up early, not wanting to waste time on something that is already problematic; they just aren’t willing to put energy into a relationship that doesn’t seem to be going anywhere. Others, determined to make the relationship work, hold on to the bitter end, hoping that their continued efforts will eventually succeed.

Many of these frustrated relationship seekers come into therapy to try to understand what they might be doing wrong. They’ve made their best efforts and still can’t make a relationship last. And they’re aware that some couples face the same odds, yet stay together. They want to know what these people do differently that keeps their love alive. Are they just lucky people who have magically found the right person, or do they make relationships work no matter what? And if they do, what is their formula for success?

After four decades of working with couples, I have to say, yes, they are different in some ways. Although they face the same issues, couples that remain together approach their problems in unique ways that don’t damage their relationship. It is remarkable to watch these couples face situations that might unravel another relationship, and yet consistently come out caring more deeply about each other.

Stay-in-love couples each have their own style, but they also have a lot in common. These six qualities are the most notable. It is my hope that they will inspire others to find their own successful paths.

1. How they resolve their conflicts.

Every couple argues. If they are honest and authentic, they accept the fact that they will never see eye-to-eye on everything. They know that differences of opinion can add interest and intrigue to a relationship—if those disputes are worked through successfully. They also know that unresolved repeated conflicts can threaten and ultimately damage relationships, and make it much harder for them to get back what they’ve lost.

In contrast, stay-in-love couples ache when their disagreements drive them apart. After a conflict, they strive to resolve the situation and make up as soon as possible. Rather than needing to win, they want to understand why they disagreed and how they could have done it better. Judgment is not an issue—inquiry and learning are. Even when they are hurt or angry, they still want their partner to feel heard and supported.

2. They refuse to assign blame.

During a conflict, so many couples blame their partner for what’s going wrong. It’s hard for anyone to look at his or her role in conflict during the middle of strong emotions. Perhaps to avoid guilt or feeling righteous, some people try to make the other person into the bad guy, hoping they will win the argument that way. Many people will cave in when they feel badly about themselves, and counter-accusations sometimes successfully win the argument.

The sadness in assigning blame is that it doesn’t work in the long run. There are always two sides to every story, and more than one way to see the truth. Every intimate partner aches to be heard and understood, even if there are conflicting realities. When intimate partners use blame to get their way, they are likely to push their partners into defensiveness, anger, or withdrawal, and risking their capacity to keep their love alive.

Stay-in-love couples know that their partner’s views must be respected and honored, especially if they are different from their own. They strive to understand them to find a truth that allows for both. That doesn’t mean they will always agree, but they know that every connection and every disconnection must be the responsibility of both. It is a “we do this to each other,” and never, “This is your fault because you’re obviously the problem here.”

3. How they respond to requests for connection.

An important part of every quality relationship is the ability for both partners to authentically agree to honor the other’s feelings and thoughts, especially when they are trying to work through difficult emotional issues.

Many partners automatically treat each other this way when their relationship is new, but as their relationship matures, they may come to feel burdened or disrupted by continuous requests for connection, and not want to be immediately available anymore. In trying to dismiss their partner’s desires quickly, they may resort to trying to “fix” the situation without taking the time for deeper inquiry. Or perhaps a preoccupied partner will minimize the other’s feelings to try to neutralize them. An irritated partner may reply in with sarcasm or even withdraw.

Partners who remain in love do not ignore a partner who wants to connect for any reason. Even if they are distracted or preoccupied, they take the time to understand what their partner needs, and decide together how they should handle it. If that cannot happen at the time, both partners make an agreement as to when they will resolve it. And they do not mock, minimize, or disregard the other’s desire to connect.

4. How they parent each other.

In every intimate love relationship there is always an underlying “criss-cross” interaction between the symbolic parent in one partner and the symbolic child in the other. It is impossible to be open and vulnerable to another human being without those interactions happening from time to time.

People are never just the age they are in the current moment. They are a composite of all the ages they’ve ever been. If a partner had heartbreak in childhood and a situation causes it to re-emerge in the present, his or her partner can help ease, and even heal, that pain by acting as a nurturing symbolic parent.

Those automatic responses are notable in the early stages of a love relationship. Intimate partners often refer to each other as if they were talking to young children. They call each other “baby” or “sweetie-pie,” and every couple knows what their unique, tender words mean to both of them. It is a normal interaction.

As relationships mature, many partners begin to feel less willing to give that kind of unconditional nurturing, and might not be as automatically available when the other slips into a younger place. When no longer loved in that tender way, the needy partner may feel abandoned or rejected. They may feel they must behave more carefully, having lost the confidence that anything they say or do will be automatically supported. The symbolic parent-child safety net that was available at the beginning of the relationship is no longer always extended.

Stay-in-love couples understand how important it is to never let those special “sweet spots” die. They know that their partner will sometimes need to feel that guaranteed comfort and safety, and are more than willing to act as the good parent when asked. They know that it is natural for people to feel insecure and young at times, and they want to be there for each other when that happens.

5. How they deal with control.

Many relationships fail because one partner attempts to dominate the other, or fears being controlled by the other. Many people had childhood experiences in which they felt unimportant and were expected to submit to whatever was demanded of them. They often bring those traumamemories into their adult relationships, fearful of being controlled again. Those fears can lead people to push for a partner’s automatic compliance, to allay that anxiety. Many partners alternately pull a partner close and then push him or her away, fearing that intimacy and commitment will lead to entrapment and being controlled.

Stay-in-love partners know that the need to feel in control at times is natural. It allows a person to be fully respected as the stronger one in the relationship at that moment. The other partner has confidence in his or her own autonomy to not react defensively or take it personally. He or she doesn’t feel the need to either counter-control or to automatically submit. Comfort with the situation allows them to seek understanding about what may be driving those behaviors. They also know that they will need to be the need-to-control partner at other times, and will receive the same understanding and respect.

These couples also know how quickly interactions can deteriorate if both want to be in control at the same time. When those situations arise, they work to stay centered and calm, agreeing to take turns listening to what each other need and feel. When they fully understand what both of their desires for control are about, they decide how to best help each other get their underlying needs met.

6. How they respond to urgency.

Newly-in-love couples are most often each other’s first priorities, so they respond immediately to their partner’s distress signals. As life’s obligations intervene and the couple resumes their normal routines, those requests must be absorbed into other priorities. Even though they may realize that being the center of someone’s life naturally somewhat diminishes over time, many partners feel neglected when that happens. They may become more demanding or feel neglected, and begin to blur the line between truly important requests and less urgent ones, fearful that neither may be met.

Stay-in-love couples are authentic, open, and self-reliant, but they also urgently need one another at times. They trust that the other will never take advantage of that immediate availability, and that when an urgent S.O.S. call goes out, their partner will rapidly respond without question or challenge. They trust that those requests are not expressed fraudulently or without concern for the other’s needs. Stay-in-love partners understand the sanctity of personal boundaries, and take pride in their own autonomy. They have learned that one of the most important qualities any person can have is the ability to love again after loss. That drives them to practice forgiveness and humility when a conflict is over. Their mutual goals are to resolve and to reconnect, leaving distress behind as soon as possible.

They know that love must include always living in each other’s hearts, whether they are together in the same place or temporarily separate. They know that the future is unwritten and that they can be taken from each other at any time. The acceptance of that truth continuously reminds them that their relationship is only as good as they are able to re-create it in each present moment.

By Randi Gunther Ph.D.

https://www.psychologytoday.com/blog/rediscovering-love/201701/6-keys-staying-in-love

The Radical Thrill of Intimacy

Becoming close to another person is one of the most thrilling experiences in the human repertoire, both the bedrock of emotional security and a passport to self-expansion. If the relationship is a romantic one—and intimacy is as much the essence of deep friendship as of lasting love—it carries the added charge of desire. Although the term intimacy is often used as a euphemism for sex, anyone with a dear friend knows that physical attraction is not essential for any two people to create a true bond. Intimacy is what you share with another human being who truly “gets” you.

With its inherent expectation of responsiveness, intimacy keeps open a channel for sharing the moments that are too saturated to contain—unburdening ourselves when distressed or disappointed, exulting when joys and triumphs swell our hearts. The antithesis of intimacy—social isolation—bodes badly for us. Science has long established that the lack of close relationships is as much a risk factor for mortality as smoking. The wider our social circle, the better our chances of warding off obesity, high blood pressure, and other corrosive conditions. The depth and nature of our ties to one another matter, too: The degree of support people feel they have from family, friends, and significant others counteract serious health risks.

Small wonder the quest for intimacy is everywhere, from earnest online dating profiles to bursts of social media confessionalism meant to elicit a long line of supportive affirmations and emojis. While such missives may, in the short term, assuage the yearning to connect that most humans harbor, real intimacy can seem elusive in a world where quick text exchanges and apologies for being too busy to get together often supplant real-time, real-space interactions.

Intimacy is our emotional slow food, the lovingly home-cooked meal in a world of drive-thru orders. One of the most basic facts of intimacy is that it takes time to achieve. The process of opening to another, of self-revelation, takes patience as well as bravery, and the unhurried pace is a necessity for the creation of trust.

Friendships hold just as much capacity for intimacy as romantic relationships. It’s why people who often start out as friends wind up as lovers and why lovers seek friends to confide in when romance falters. As one new groom recently told a New York Timeswedding reporter, being friends first with his bride allowed him “to be more vulnerable in conversation than if I had approached her in a romantic way.”

Typically, we expect more intimacy from a romantic partner than from a friend, physically as well as emotionally, but intimacy threads through both types of bonds in shared secrets, caring touch, moments of laughter and tears, knowing silences. It’s not only about how two people act together, it’s how they make each other feel: connected and understood. Intimacy is what we’re after when we’re stressed or sick and need comfort, yet it’s also the reason why we value being with loved ones in easier times.  Intimacy is “what most people want in their social life—it’s what people search for,” says psychologist Harry Reis of the University of Rochester, a key thinker about the nature of intimacy and the processes that underlie it.

What does it take to truly become close to another human being, whether in love or friendship? And what does it take to maintain the vitality of intimacy over the long haul?

Intimacy begins when a person shares something emotionally meaningful with someone else. Risk is at the heart of the matter. The person is taking a chance on a hunch that the listener could be trustworthy—but there’s always the possibility the emotional import will be missed, ignored, unreciprocated. As a result, the first steps of intimacy tend to be cautious ones. Social penetration theory, which defines the processes of relationships, holds that in building intimacy, whether with a friend or a romantic prospect, we engage in exploration. We venture forth with impersonal and superficial information to gauge the reaction of the other. A supportive response encourages an advance in self-disclosure, the proffering of more emotionally significant substance.

Researchers liken the process to peeling an onion, removing the layers of our selves and offering attention and support as the person we’re getting close to does the same. As exchanges become ongoing, the two people alternating between confessor and confidant, they build trust, affection, and, at some point, identity as a pair.

The process feels emotionally edgy because we’re gradually letting down defenses we may have maintained since childhood or adolescence, when we learn to hide those aspects of ourselves that trigger social rejection. You can’t really get serious about a love relationship or call someone a close confidant until you’re ready to tell the person about the darkest moments of your life. Indeed, every step forward in intimacy is a gamble. The information you’re revealing could be used to hurt you.

But you’re betting on the sweetness of the payoff. In addition to the catharsis that self-disclosure carries, “if someone responds positively, there’s a feeling of delighted relief,” says James Cordova, a professor of psychology at Clark University. Listening with an open heart and responding with tenderness proves you worthy of the faith placed in you.

Dating is nothing if not a process of gradual and—here’s the important part—reciprocal self-disclosure, and the risks of self-disclosure can feel particularly acute during dating. While establishing closeness in friendship often happens in fits and starts and hews to no blueprint, dating, perhaps more than any other activity in our culture, is encumbered with expectations and entangled with issues of identity, commitment, and time: What do I want out of this? What are we as a couple? Do we have a future?

If you try sharing something personal and it doesn’t go over well, you may feel the sting of judgment, says Steen Halling, a professor of psychology at Seattle University and the author of Intimacy, Transcendence, and Psychology. It’s easy to make a misstep in the pace of intimacy building: A person probes too soon for your deepest secrets or unloads too many of his or her own. In rushing to get to know you, the person fails to truly see you. “You’re on the receiving end of an agenda and become one of that person’s projects,” Halling explains. “That makes you think, ‘Do I have any say in this?'” There’s a difference between being willing to build intimacy and being willful about it, determined to make a relationship happen.

Not everyone in the dating game is seeking intimacy. The traditional notion of romance emphasizes trust, honesty, connection, and other markers of closeness. But people may date for many reasons: to ease feelings of social isolation, to have fun, or to build their own self-esteem, finds Catherine Sanderson, a psychology professor at Amherst College. They may prioritize other goals, such as career, over a close relationship, which takes an investment of time. Having goals that are self-serving doesn’t mean a person is wrong or has intractable “intimacy issues”—even if those goals clash with your own. Better to seek an intimacy-focused relationship elsewhere.

Too, there are people who seem chronically unable to get close to others, routinely dodging opportunities for intimacy. They may have acquired an avoidant attachment style through early life experiences with caretakers who rebuffed them or ignored their needs. Research led by psychologist Phillip Shaver shows that the risks inherent in building intimacy are particularly threatening to such people; the process stirs their vulnerability to rejection, punishment, and loss of control. Evading closeness “comes from a long history of difficulties and the need to protect oneself,” says Debra Mashek, a psychologist  at Harvey Mudd College who researches close relationships. “It’s an adaptive response.”

Even when two people are open to establishing romantic intimacy, being too purposeful can be counterproductive. That’s when the classic date scenario—eating dinner out together—can get awkward, says Halling. The set-up applies pressure to share information and scrutinize each other’s verbal and nonverbal responses, whereas a less stilted act, like taking a walk or doing something entertaining together, could ease self-consciousness while still allowing the opportunity to connect.

Online dating seems to offer an end run around some of the awkwardness of meeting face-to-face. Online exchange allows—even encourages—prospective partners to make intimate disclosures. But extended messaging can dull the thrill of exchange without hinting at the kind of rapport two people will have, says Paul W. Eastwick of the Attraction and Relationships Research Lab at the University of California, Davis. Let the messaging go on too long and expectations rise unrealistically. “Once a face-to-face meeting occurs, those expectations can be violated, which can be distressing,” he says. Cyberspace simply can’t deliver up the whole person, the “warm complex animal gestalt,” as one online dater puts it.

Does Sex Improve Intimacy?

Short answer as of 2017: Yes.

When two people start dating, the question of when to have sex seems pivotal, in part because there’s a widespread expectation that sex brings partners closer together. Desire for emotional closeness and feelings of connection are among the top reasons both men and women cite for having sex, report psychologists Cindy Meston and David Buss. Women are no more likely than men to be motivated by a need for closeness, and men are no more in it for pure pleasure than women, the University of Texas researchers find.

Getting physical certainly stirs up the neurochemistry of attachment, mobilizing oxytocinand opioids that generate positive feelings and encourage more of the same. Once we link those feelings with a particular person, we want to stay with that person. Clinch and repeat.

The sheer presence of sexual desire, even when triggered by someone completely unknown, in fact pushes people to do the work of intimacy, says Omri Gillath. He and colleagues at the University of Kansas exposed a bevy of participants to erotic photographs, a known sexual stimulus. Some groups knew what they were looking at. Others were exposed to the images subliminally—flashed so briefly before them that the photographs didn’t register consciously. In both cases, exposure to the images made participants—particularly the ones who didn’t “notice” the photographs—more willing to disclose personal information, make sacrifices to benefit their current romantic partner, and work out conflicts effectively. All those effects are markers of intimacy building.

Sex really does send us down the path of emotional closeness, Gillath contends. He even conjectures that pornography, often assumed to interfere with real connection, might actually play a role in fostering it. “The studies suggest that when we’re sexually aroused, or when our sexual system is activated, we’re more open to intimacy.”

Intimacy in Passionate Love

When romantic intimacy is in full bloom, the intoxication of what happens in bed is rivaled by the charge it gives our lives. The pace of self-disclosure quickens. The drive to connect feels all-consuming. New lovers will stay up until 4 a.m. telling each other everything about their parents, their favorite elementary school teacher, the places they’ve lived, their likes and dislikes. The risk of disclosing every detail of their lives is more than offset by hitting the emotional jackpot of a partner’s interest, attention, and affection. The shared information nudges them down the path of seeing the world through each other’s eyes, abetting the merger into a “we,” the formation of a shared identity. A couple.

Two people essentially enter a zone of shared selves, a willing emotional nakedness. From their joint research on relationships, Karen Prager of the University of Texas at Dallas and Linda Roberts of the University of Wisconsin-Madison have identified three components of deeply intimate connection: self-revealing behavior, unwavering supportive attention, and a sense of exceptional knowingness as partners immerse themselves in each other’s lives, feelings, and routines.

Intimacy changes us. Getting close to someone else enhances our sense of our own abilities and possibilities; it enlarges us. The self-expansion model of close relationships, developed by husband-and-wife psychology researchers Arthur Aron and Elaine Aron, maintains that in becoming close to someone else, we fold his or her identity and resources in our own self. We gain from the availability of the other’s point of view and skills as we sort through a problem. We gain experiences—such as shared meals and outings, especially in the early stages of passionate love—and, later, resources, such as a shared home and bank account. Not least among the additional resources is a long-term commitment to the relationship. Closeness with a significant other also increases our belief in our ability to reach goals and helps us feel more in control of our lives.

“We take on the resources, perspective, and identities of another,” says Mashek, who studies self-expansion. “Your partner becomes a part of you, and you become part of your partner. You and me becomes we.” The rapid expansion that marks the initial rush of intimacy building is an unforgettable time. Getting close can seem enchanted, magical—particularly because staying close, for many couples, is anything but.

Men, Women, and the Work of Intimacy

Intimacy can be challenging to maintain over time. The reasons are rooted in the way closeness begins. Two people come together loving each other’s strengths and quirks. Each promises to be the person the other can confide uncertainties and weaknesses to, and each has permission to let his or her guard down in turn. But having stripped off all emotional armor leaves partners particularly vulnerable to perceived slights from each other, as, over time, the supportive focus on each other competes with the demands of daily life. That means that a grouchy comment or a bout of moodiness from a mate, however normal, can really sting. It takes restraint not to reply in kind or emotionally withdraw.

As a result, closeness tends to diminish over time, which Cordova sees as a normal process of decay. Parenting responsibilities or other everyday stresses exhaust a pair’s emotional resources and lead them down a path of least emotional resistance.

Once that process sets in, reversing its course can feel daunting. Couples often believe that they have to fix all their problems in order to feel close again. In fact, Cordova finds, simply paying more attention to each other is the best salve.

Figuring out how to enhance intimacy takes time, effort, and no small dose of what University of California, Berkeley sociologist Arlie Russell Hochschild calls “emotion work”: managing or even suppressing your own feelings so that you can provide emotional support to others. In committed heterosexual relationships, emotion work is itself often a source of stress because men and women tend to have different ideas about the optimal level of closeness and amount of “emotional space,” says University of Texas sociologist Debra Umberson. She finds that same-sex couples share more similar ideas about intimacy and personal boundaries, and consequently share emotion work more equitably.

Friendship: Are Men Missing Out?

At first glance, the research on friendship seems to confirm traditional gender stereotypes about intimacy—that women value emotional closeness more than men. Male buddies tend to spend time together doing things—playing sports, listening to music—while female friends place talk, often of personal matters, at the center of their time together. Women say that intimate conversation is the most important facet of friendship, helping them understand who they are, improve their sense of self, and solve problems with other loved ones.

But men are not born to shun deep intimacy. In fact, studies show, both men and women value friendships with women—precisely because those relationships tend to be especially emotionally intimate. Outside the Western world, male-male friendships tend to be highly intimate and expressive.

North American men are well aware that sharing personal information will bring them closer to a friend than will doing an activity together, finds Beverley Fehr, a professor of psychology at the University of Winnipeg and the author of Friendship Processes. What stops them from engaging more often in self-disclosure with other men, she says, is fear of rejection. Sharing makes men feel too vulnerable, perhaps because it conflicts with another value men hold—competitiveness.

What would happen if men were put in a situation where they were expected to share private information with other men? Fehr wondered. Would they benefit the way women do?

She turned to a tool widely used by relationship researchers: “36 Questions,” developed by Arthur and Elaine Aron. The questions, which couples ask each other, are designed to create a temporary feeling of closeness, even between strangers, in an experimental setting. Beginning with “Given the choice of anyone in the world, whom would you want as a dinner guest?” the questions gradually escalate in emotional intensity. Question 18, at the halfway mark, gets highly personal: “What is your most terrible memory?” The final question puts interlocutors in intimacy central: They’re asked to share a personal problem and get the other’s insights into how to handle it. By the time they finish their questioning, lab partners are not only sharing emotionally fraught information, they’re essentially acting just as people in real relationships do—being responsive to each other’s needs.

Fehr brought into her lab pairs of men who were already friends and launched them on the 36 Questions. As the conversations progressed to a pointedly personal question, she observed a common response. “Typically, the men looked stunned,” she reports. “Then they fell silent. Then they uttered either the ‘f’ word or commented, ‘That’s deep.'” But to her amazement, they all really opened up in their answers.

So far, Fehr has found that the prompted self-disclosures have increased feelings of closeness between friends as well as boosted satisfaction with the friendship. Time will tell whether the men reap the same lasting benefits women do from friendships— heightened self-understanding and self-worth, an added sense of meaning.

Keeping It Going

Maintaining intimacy in a friendship is not a topic that gets a lot of attention, in part because our society tends to value friendship less than romance. Counseling services abound for committed couples on the rocks, and family and friends rally around them to help them stay together. But faltering friendships trigger neither the same mobilization of resources nor efforts to shore them up. And friends themselves seem to have absorbed the message; they tend to be more passive than couples about resolving conflicts. Friendships can end dramatically through betrayals of trust or an act of disloyalty. But most often they wither from neglect.

Yet they are remarkably responsive to resuscitation—by picking up a phone or meeting for coffee. The way friends stay close, says Fehr, is by going back to what drew them together in the first place: sharing information about their lives, offering support, and spending some time together.

Sometimes, though, intimacy between friends is revived in unexpected ways. Halling finds that experiences of reunification can be startlingly significant, often so profound they deliver transcendence. “You feel close to a person because you are truly open to them, and the feeling of being alone in the world is suspended for a time,” he says.

Murray Suid, a 74-year-old screenwriter, met Bryan, a charismatic professor, when the two were in a Bay Area men’s group in the 1970s. They became friends, then they lost touch. Two decades later, Suid was living in Los Angeles, and Bryan began making regular trips there for cancer treatment. Suid volunteered to ferry him from airport to clinic and back again. The prognosis for Bryan was grim, and he often talked about how scared he was. Suid, in turn, confided that his old friend’s ordeal was stirring up his own fears of death.

Suid had always thought of dying as something that created a wall between people. But “I found that instead it was a door, enabling two men to feel close to each other in a way that hadn’t happened before,” he says. Twenty years after Bryan’s death, Suid still treasures the drives back and forth to the clinic for their otherworldliness. “The intimacy wouldn’t have happened if we hadn’t had the chance to talk, with me in the role of just being his driver,” he says.

That’s the thing about intimacy. It can offer up otherwordliness without fanfare, although Halling finds that moments of deepest connection tend to spring from a shift in circumstances. Going on a trip, being in nature, even working on a project together can pave the way for unselfconscious union, when time falls away and the present moment shines in sharp focus. “We’re open to the person, and touched and surprised by who we see,” Halling says. “It’s an experience of awakening.”

When Intimacy Is Imbalanced

Sometimes, the slow dance of self-revelation—the core of intimacy—becomes a bit lopsided. One partner may be more forthcoming or attached than the other. That doesn’t mean the relationship has to be scuttled. It is possible to help a skittish partner open up..

PRACTICE MAKES PERFECT. 
Self-disclosure is a process not an all-or-nothing proposition. Intimacy takes time. “The more comfortable partner should positively reinforce any attempts,” says psychologist Catherine Sanderson.

SEEK OTHER CONFIDANTS. 
Don’t expect your partner to fulfill all of your intimacy needs. “Nurture connection in friendships by being genuinely interested in your friends’ worlds,” psychologist Debra Mashek advises.

SHIFT THE FOCUS. The direct gaze can be intimate—but also daunting, especially for people who struggle with opening up. Spend time side-by-side instead. “Some intimate conversations occur when driving and the focus is not directly on each other,”  psychologist Steen Halling says.

NURTURE YOUR SOLO SELF. 
If you’re inclined to want to do everything with your partner, try some adventures on your own, suggests Mashek. Go to the movies or take a fun weekend trip alone.

OPEN UP ABOUT OPENING UP. Don’t hide your interest in how your partner is feeling. If your partner seems to be shutting down, let yourself wonder out loud about the reason, Halling recommends.
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BE COMPASSIONATE. People who are reluctant to self-disclose may have been, early in life, punished for talking about emotions or expressing vulnerability. “We have to be kind, encouraging, and full of care for the genuinely fragile heart that we have invited into an intimate relationship,” psychologist James Córdova says. “We have to use our imagination to empathize with what it must be like to be afraid.”

By Lisa A. Phillips

https://www.psychologytoday.com/articles/201701/the-radical-thrill-intimacy

Motherhood And Your Mental Health

As soon as her baby was born, Anna felt a change. Something wasn’t right. She feared for her baby’s safety to an extreme degree. She would sit awake, staring at her baby through the night, terrified something would go wrong, and her daughter would die. After feeding, Anna wouldn’t allow herself to leave her baby’s side for even a moment, worrying something would happen in her absence.

As her daughter grew older, Anna felt intense anxiety that she was doing everything wrong: she hadn’t read to her daughter enough, she hadn’t cleaned up enough, she hadn’t completed enough puzzles with her child. Like many mothers, Anna held it together at work and with friends—the people who saw her every day didn’t know anything was wrong. But on the inside, she was bubbling over with anxiety.

One day, she found herself screaming into a pillow for release, and she knew then she needed help. As supervisor of the Northwestern Medical Center (NMC) Birthing Center in Vermont, Anna was in a knowledgeable position—she knew where to reach out for help.

Is What I’m Feeling Normal?

Feelings of depression, compulsion or anxiety do not mean a woman is a bad mother; they also do not mean she doesn’t love her baby. Many expectant mothers imagine motherhood will be fulfilling and uplifting. But when the baby is born, they may not feel that way at all. Mothers may experience depressionanxietyobsessive compulsive disorder or posttraumatic stress disorder (PTSD).

A mother may experience PTSD as a result of a real or perceived trauma during delivery or following delivery. This can happen due to a feeling of powerlessness or a lack of support during delivery, an unplanned C-section or a newborn going to intensive care. Postpartum Support International (PSI) estimates around 9% of women experience PTSD following childbirth.

If you are experiencing anxiety, flashbacks or nightmares, you are not alone and it is not your fault.

What Should I Do If I Have These Feelings?

There are screening tools to help find troubling feelings. The Edinburgh Postnatal Depression Scale (EPDS) is a 10-question screening tool that asks mothers to consider their feelings over the week leading up to the test. In the NMC Birthing Center, the EPDS is conducted after delivery, within the two or three days that a new mother stays in the hospital, two weeks after delivery and six weeks postpartum.

“[These feelings] can be easy to brush off,” Anna says. “But it’s okay to say, ‘Something isn’t right. I’m not okay.’” When a mother doessay this, nurses might follow up with questions like: “Can you tell me more about that? What does it feel like?” Nurses can help attach vocabulary and understanding to certain feelings. A mother experiencing these unsettling and frightening feelings should not push them away.

Everything can feel strange following a birth, so be gentle and honest with yourself about your feelings. If you are experiencing troubling or upsetting feelings, ask your nurse or doctor if they can help you find programs and resources. Many mental health agencies offer programs that can help, or there may be counselors in your area that can offer the right kind of support.

It can be helpful to find a solid support system that encourages open, honest communication—this can make all the difference for expectant and postpartum mothers. For Anna, talking to her family and her doctor provided her with the support she needed.

Anna hopes that by sharing her story she can help more mothers feel comfortable about expressing their feelings. Every mother is on her own journey, but she need not travel alone.

By Meredith Vaughn

https://www.nami.org/Blogs/NAMI-Blog/January-2018/Motherhood-and-Your-Mental-Health