Tag Archives: self-compassion

Navigating Postpartum Depression and Anxiety as an Expat

Baby_mom

As most parents know, nothing can truly prepare you for what it will be like to bring a child into the world and be charged with raising that tiny, vulnerable creature into adulthood. After reading a dozen books, endlessly questioning my friends with children and buying more baby supplies than anyone could ever need, I thought I was prepared. But, strangely enough, when the nurse put my son in my arms, I couldn’t have felt more unprepared. Somehow, we parents work it out. Our children survive our initially clumsy attempts at diaper changes, feeding and bathing. We navigate the challenges of early parenthood that we could never have anticipated. However, this learning curve is a rocky road, one that leaves many (if not most) feeling overwhelmed, frustrated and perpetually longing for a nap.

Yet, today I write about those parents who feel all of those things but to a degree that is difficult to articulate. Those parents who may, on one hand, feel like what they are experiencing is “normal” adjustment but on the other, suspect their struggle is different from those of their peers, and as such, may be reluctant to voice what they are feeling. It is my hope that this post serves to do a few things:

  • Elucidate differences between the more typical (I want avoid saying “normal” as there really is no such thing) early parenthood experience and symptoms of postpartum depression and anxiety (PPD/A) that might warrant extra attention and treatment
  • Discuss how being an expatratriate might exacerbate early parenthood difficulties
  • Assure any suffering parents that they are not alone- that help exists in the form of effective treatment by a professional or by accessing resources available in our community

Symptoms of PPD/A

Listed below are symptoms that characterize the general experience of postpartum depression/anxiety. Keep in mind that not all of the symptoms might apply or that the symptoms may be somewhat different for you. I provide the list simply to increase general awareness.

For at least two weeks at a time following the birth (or adoption) of a baby, you experience some of the following:

  • Depressed mood (most of the day, almost every day)
  • Inability to find pleasure in the things you normally enjoy
  • Not wanting to eat or overeating
  • Not being able to sleep, not wanting to sleep, or wanting to sleep all the time
  • Feeling physically tired or aching to the point that your level of activity is markedly different from normal
  • Feeling physically wound up so that you feel as if you can’t sit still
  • Lack of energy or fatigue nearly every day
  • Intense feelings of inappropriate or excessive guilt and worthlessness
  • Difficulty concentrating and making decisions
  • Thoughts of harming yourself or someone else
  • Racing thoughts
  • Constant worry
  • Frequent or constant resentment of your partner or child

And most importantly

  • The way you feel consistently interferes with your normal functioning (e.g., decreased socialization, inability to manage responsibilities, decline in hygiene).

The Expat Experience: Feeling Alone in the World

Living in a foreign country far from family and friends can serve to exacerbate feelings of being isolated and alone. There may be fewer sources of support to help you remain balanced and able to care well for yourself in conjunction to you caring well for your baby. There is less access to people who might remind you of your personal resources and help you combat thoughts of worthlessness and hopelessness, people who know how to encourage and praise you when the going gets tough. Not to mention the difficulty involved in simply accessing community resources when you do not speak the native language. Feeling tongue-tied is just one more obstacle to picking up the phone and getting help. Furthermore, expat parents often come to a new country for a work opportunity and having a baby can change or eradicate the existing support network that was provided by simply being at work. Depending on your parental leave situation, all of the sudden, you are out of the office and plunged into life as a mom or dad, which is likely quite different from the work environment.

Just to put things in context, clinical psychologists and other health professionals commonly use a scale called the “Social Readjustment Rating Scale” to measure the degree of stress in a person’s life. To give you a taste, “pregnancy (#12)”, “addition of a new family member (#14)”, “change to a different line of work”, “change in sleeping habits” and “change in working conditions” are among the top 30 most stressful events in life. And this list does not even include “Adapting to a new culture in a different country – far from friends, family, and all that you know”! When a person experiences a certain amount of stressful life events in a year, they are more vulnerable to illnesses. And make no mistake: PPD/A is an illness. It is a condition involving daily suffering from which it can seem like there is no reprieve.

You are not Alone: How to Get Support and Support Yourself

As with any health condition, the best chance you have of it improving is if you take steps aimed at healing. For instance, if you have a cold, you rest, drink fluids and avoid going for a jog in the rain. And just like taking care of a cold, there are treatment options for PPD/A that show excellent efficacy. And the things that work range from intensive psychotherapy paired with medication to the simple implementation of self-care activities that your pre-baby self might have done without thinking. Those self-care activities might include things like exercising regularly, meeting weekly with a friend for coffee and a chat, or ordering take-away food rather than cooking. Doing these things does not make you less of a parent. In fact, taking care of yourself is one of the best things you can do for your child.

When talking to clients, I often refer to the airline safety guidelines requirement that, in the event of an emergency, the adult should put on their own oxygen mask before helping their child put on his. Our children need us to take care of ourselves first because otherwise, we cannot tend to their needs.

It can be unbelievably hard to reach out for help when you have no energy to pick up the phone or feel overwhelmed by cultural differences or believe that you should just grit your teeth and “get through it, it’s normal.” If increasing self-care activities does not diminish the symptoms or if it is just too daunting to embark on these changes alone, it is important to enlist the help of a professional.

To get started, here are some links to online support resources:

To those parents living abroad who are struggling with early parenthood, please know that you are not alone and you are not without hope. There are many parents and professionals who share your experience and who can help you feel more empowered. Enlisting the support of your partner, a compassionate friend, a group of other parents, a medical doctor, a health practitioner or a psychotherapist can transform your experience of parenthood while enriching the relationship you have with yourself and your child.

(Image courtesy of David Castillo Dominici / FreeDigitalPhotos.net)

Parenting in Real Life: Modeling Imperfection

family

We parents are hard on ourselves. It is no secret that the parenting bar is often set ridiculously high. There is some usefulness for these high expectations- they can sometimes provide a boost of short-term motivation or help make clear what is really valuable. But, more often than not, unrealistic expectations only make us feel… well… crappy.

Funny enough, when we find that we cannot leap effortlessly over that high bar we set for ourselves, a common method for dealing is giving ourselves a stern internal talking-to and setting the bar even higher! Most of the time, this strategy- although based on good intentions- only depletes our sense of self-efficacy and further invalidates the very good efforts we are making but overlooking.

There is an alternative that serves to set up a new pattern of relating to yourself and has the potential to impact your child’s relationship with him or herself. As your child’s primary role model, you have the fabulous opportunity to model imperfection. Just as many parents make an effort to help their children realize that the implausible expectations society places on appearance and physical beauty are not reasonable, you can do the same for behavioral and emotional expectations.

You don’t expect your child’s appearance to fit the photoshopped standards of beauty perpetuated in the media. And more than likely, you do not expect them to go through life without making a mistake or never being disappointed in themselves. And you are in a unique position to show them how to embrace the imperfection that helps to make us who we are as individuals. You get to say to them:  “I was really angry today and I can see it did not help the situation. Next time, I am going to try to handle my anger in another way.”

Or: “Yes, I was very frustrated today when I said those words while I was driving. Normally I try not to say those words because they can be hurtful. Next time, I will try to handle my frustration differently.”

And what you are really saying is: “I am not perfect. Sometimes I do things that I am not proud of. But I own that and I am accountable for my mistakes.” That small act of acknowledgment pays dividends. You are actively showing your child how to cultivate self-compassion and how to be vulnerable. Concurrently, you are showing him/her how to take responsibility for their actions, how to be courageous in the face of difficulty and  how to build a innate sense of worthiness.

As discussed earlier, self-compassion is not self-indulgence. Modeling imperfection does not mean that all of the sudden your “expectation bar” is tumbling down to the floor and you spend the rest of your days lying in front of the television with a gallon of Nutella (although that may happen from time to time). It simply means that you make a conscious effort to cultivate a different kind of internal conversation that is more kind, fair and balanced. One that is more along the lines of “Yeah, that did not go as well as I had hoped but I am proud of what I did accomplish” versus the tired old refrain of “Everyone else could have done that and you didn’t. Tomorrow you’ll have to try even harder because failing is unacceptable.”

And how wonderful would it be if you could simultaneously help your children to cultivate this same kind of dialogue?

(Image courtesy of digitalart / FreeDigitalPhotos.net)

Mindful Weekend: Coping Effectively with Distress

This weekend, I invite you to meet distress in a different way. We all know this feeling of distress- good old distress makes himself known in a variety of different ways, whether it be body sensations, thoughts, or emotions. It can be assured that in moments of unease or discomfort or anxiety, distress will very often be along for the ride.

To boil down its definition, distress means “suffering.” We know that pain is inevitable- we will lose loved ones, we will be disappointed, we will encounter difficulties (big and small) around every bend in life. Yet, in spite of this inevitability, suffering itself is not a given. Pain is the natural reaction of the body and the mind to a difficulty. By contrast, suffering involves our reaction to the pain: the story we tell ourselves about how long the pain will last and what it means, our assessment of our resources to deal with the pain, what we think past pain of the same degree could mean for dealing with this current pain, and on and on.

If we could peel away that layer of suffering, we could deal more directly with the pain and respond to it more effectively. But while we are defining vague psychological constructs, what does “effective” really mean?  One definition, or equation if you will, that I think is very illustrative is borrowed from Dialectical Behavior Therapy:

current reality + rules of the universe + values/goals = effectiveness  

All the variables in the above equation are important to factor in when deciding how to respond in a distressing moment. Yes, there are things that you cannot change about the situation and about how the universe works (for example, life is not fair). Even with all those realities in mind, you can bring your values front and center, ultimately choosing to move in a value-driven direction.

Here is an example. Today I found myself in the midst of a little “road rage,” wherein I thought I had the right of way and the other person thought they had the right of way. The other driver rolled his eyes, gesticulating, lowered his window and tried to convince me that he was right. I tried to prove my case (in French- yikes!) but I could see it was going nowhere and drove away. A part of me wanted to stay and try to convince the other driver that I was right. But, the value-driven part of me said, “what do you have to prove? There are more important things to do today than stay to fight a meaningless battle.” The inner core of my distress in that moment was striking fear that I was wrong, that I made a mistake. After getting home and calming down, it was clearer to me that who was right was less important than the fact that no one got hurt and I have more emotional energy for the rest of the day.

Even when distress threatens to overwhelm you, keep moving in the direction of your values
Even when distress bogs you down, you can keep moving in the direction of your values

Distress can feel like a formidable foe. He takes many shapes and forms and often it can feel like he engulfs rational thought.  But this weekend, I hope you can try to meet him in a new way. Get to know him and he will lose his power. I believe it will then be easier for you to connect to your values and to move back in the direction of the things that matter most to you in your life.

So, when you encounter a distressing moment this weekend, ask yourself: What does distress feel like? Can you notice the thoughts and body sensations that correspond with it? How are you pulled to manage distress? Is it effective?  Does it serve you and your values in the long-run? If not, is there something else you can try?

New Pathways

Even when a path already exists, you can make a new one.
Even when a path already exists, you can make a new one.

As a visual person, I use a lot of metaphors in my work. A personal favorite relates to the development of new habits, and particularly, new thought habits. Over time, we build up a certain way of thinking about a situation or ourselves or a difficulty until it becomes more or less automatic. This thinking habit becomes a well-worn, frequently-trod path through the landscape of our mind.

For instance, when faced with the prospect of making a presentation at work, some of us have developed the habit of thinking about the worst thing that could happen. Or, when receiving a stinging comment from the mother-in-law, some of us may descend automatically into self-criticism (or revenge fantasies). There are hundreds of mostly automatic thoughts zinging through our mind on a given day. It can be interesting to take a step back and slow down to see if it is possible to make a new path.

Making a new path does not mean that you can never use the old path. It just means that you are opening up options for yourself, consciously cultivating a different type of thinking (that perhaps is more rational and compassionate) that can ultimately impact how you respond to a situation. It will take time and patience to create that new path, just as it did to create that old one. But the beauty is that as a result of this new response flexibility there is greater awareness of choice and of freedom from (as Jon Kabat-Zinn puts it) “the tyranny of thinking mind”.

Change takes time but our mind is an amazingly flexible vessel for our thoughts and motivations. What kinds of new pathways would you like to create for yourself?

Slowing Down

The Grand Canyon did not form overnight
Slow but concerted effort can create incredible change- in a landscape or in human behavior

The other day, I was late for work. I missed the metro and here in Switzerland, when you miss your first mode of transportation, you can be sure that you will also miss your connection. So, there was nothing to do but wait for the next metro and catch the next train to Lausanne.

Knowing that you will be late is an uncomfortable feeling. For me, there is a simultaneous rush of anxiety and irritation and helplessness that sets my heart pounding and shortens my breath. It is safe to say that I find this experience extremely aversive and do what I can to avoid it. But then I remembered something that I say so often in my practice: When you feel the impulse to avoid, try approaching instead.

And so, I relaxed my body, brought my focus to the breath and then watched the anxious thoughts flooding through my mind. By slowing down and intentionally investigating my internal experience, I found that I could step back a bit, remind myself that even though my thoughts felt like facts, they likely were not. I could bring in a different “voice” to counter these anxious thoughts: If I came to work 15 minutes late, I would still have enough time to prepare for my first client and even if I didn’t have enough time, I have enough experience to be able to manage just fine.

Once the wave of “lateness distress” peaked, I decided to see if I could enjoy this small gift of time I had unintentionally received. I channeled my first mindfulness teacher, Dr. Andy Moore at the University of Wisconsin, who once told us that “If you’re late, you’re late. There is no amount of thinking or worrying that will get you there any faster.” It was so nice to be able to stroll to my connecting train, observing the rush of the morning commute. I listened to the street musicians in the terminal. I stood in a sunny spot on the platform. Honestly, I enjoyed myself!

And three days later, I remember those pleasant moments more than I remember the stress. Even though I do not intend to try and be late in the future, I do feel more empowered to manage this experience when it inevitably happens again. Research indicates that it does not take major changes to routine or behavior to form new habits, it just takes brief but repeated moments of intentionally trying something different. This post is headed by a photograph of the Grand Canyon because I think it is a nice metaphor for what can be created as a result of slow but sustained effort. Turning toward difficulty with kindness and self-compassion can become more routine and automatic with the help of gentle intention practiced over time.

For me, slowing down is a habit I hope to cultivate- even in the face of difficulty and unease. And how about for you? What ways of thinking or behaving would you like to deepen in your life?

Self-Compassion and Parenting: Talking to Yourself Like You Talk to Your Kids

Parenting can be as challenging as it is joyful
Parenting can be as challenging as it is joyful

Following a very fun and thought-provoking workshop about mindful parenting on Monday, I’ve been reflecting on the notion of infusing more self-compassion into parenting. Specifically, how parents can cultivate self-compassion and what responding to difficulty with self-compassion rather than guilt and anxiety would look like in reality. I believe that careful cultivation of self-compassion can provide much needed balance to our habitual reactivity.

First, I think it is important to elucidate what self-compassion is not, as it can easily blend with some of the other “self-” terms that exist in our modern vernacular, like “self-esteem,” “self-indulgence,” or “self-care.” As self-compassion researcher and advocate Kristin Neff explains, self-compassion is not self-pity:

Self-pity tends to emphasize egocentric feelings of separation from others and exaggerate the extent of personal suffering. Self-compassion, on the other hand, allows one to see the related experiences of self and other without these feelings of isolation and disconnection.

Self-compassion is also not self-indulgence. Again, Dr. Neff explains:

Many people say they are reluctant to be self-compassionate because they’re afraid they would let themselves get away with anything.  “I’m stressed out today so to be kind to myself I’ll just watch TV all day and eat a quart of icecream.” This, however, is self-indulgence rather than self-compassion.  Remember that being compassionate to oneself means that you want to be happy and healthy in the long term. In many cases, just giving oneself pleasure may harm well-being (such as taking drugs, over-eating, being a couch potato), while giving yourself health and lasting happiness often involves a certain amount of displeasure (such as quitting smoking, dieting, exercising).  

Instead, self-compassion is an acceptance of our humanness, an acceptance of those things that make us flawed, imperfect and relatable. And it’s about responding to those difficult moments (when those challenging aspects of yourself feel so front and center in your mind that you cannot think of anything else) with kindness and gentleness. Luckily, we parents have an advantage when it comes to cultivating self-compassion because we have a lot of practice with compassion in responding to our kids.

Think about it: when your child comes home complaining about a bully, or feeling sad, or feeling angry- you respond. You likely relate to your child’s suffering and attempt to make your child feel better by responding with warmth and understanding. Ok, now let’s flip the script:  what would it be like to respond in this same way to yourself when you are experiencing similar difficulties?

Self-compassion and mindfulness go hand in hand. Mindfulness allows us to be aware of difficulties as they arise, and to be able to observe them without over-identifying with them. With mindfulness, we can simply notice the experience without judgement and without getting swept away in unhelpful reactivity.

But, like all new thinking habits, cultivating self-compassion takes time and a consistent effort to try something different in the face of a difficulty. It takes a) recognition that you are indeed being triggered in this moment, b) stepping back to decide how to respond and finally, c) deciding not to do the same old thing, like talking to yourself with reproach or self-criticism, but instead noting that a mistake was made and that imperfection is normal (and, dare I say it, even desirable!). See if you can replace the punishing self-recrimination with the idea that you are doing the best you can.

We parents are quite adept at helping our children to cope with the stressors and difficulties that they encounter everyday. But, somehow, it is far less easy for us to treat ourselves with the same understanding and kindness. You’ve likely seen that the “carrot works better than the stick” with your kids, that they are far more motivated and effective when rewarded for good behavior rather than punished for the bad. And what about for you? What would it be like to modify your internal dialogue and talk to yourself more like you talk to your children? With time, you may find that intentionally cultivating self-compassion can help you to be a more effective parent.