A Therapist's Perspective on Trump

"When someone shows you who they are, believe them the first time."
-Maya Angelou

I know we’re all ready for this election to be over. I may not change anyone’s mind at this point, but I want to offer what wisdom I have based on ten years of experience in mental health. There has been a lot of speculation about Trump’s mental status. Is he narcissistic? Sociopathic? Brilliant? On cocaine? And how do we cope with the grossness of this election? In an attempt to detach myself from the noise and outrage, I have started looking at Trump with my therapist hat on.

Right now I work at a hospital, doing assessments for addiction and psychiatric services. I can tell you that if Donald Trump walked through our doors, I would immediately:

1)     Give him a drug screen. Sniffling aside, his speech and behavior are so erratic that I would suspect he was under the influence of something.

2)     Flag him as someone no one should be alone with. His emotional dysregulation sends up red flags that he can’t be trusted to stay calm and respectful.

3)     Recommend that he get treatment appropriate for personality disorders.

While it’s not appropriate for anyone to diagnose someone without interviewing them in person, we have a LOT of information to go on based on interviews, decades in show business, and dozens of sources. And although I cringe when the word “narcissist” gets thrown around too much, it has clinical meaning and is actually quite appropriate in his case. Narcissistic Personality Disorder involves a special combination of grandiosity, ego-centricity, entitlement, and insecurity, and it would be first on my differential.

The thing about this disorder, though, is that it can’t be treated the way depression can. If Trump had a mood disorder, I’d say we should extend compassion and make sure he gets treatment, because there is goodness and humanity in him as well. Personality disorders are different. They are pervasive, pathological character traits that extend throughout all areas of life and throughout a person’s lifetime.

Can they get better? Sure. But they are not “healed.” They are unlearned. A person has to have enough motivation to learn entirely different ways of behaving and thinking. What motivates them are rewards and consequences. Trump will not change because someone tells him, “You hurt me.” Appealing to empathy won’t work because he doesn’t have any and he doesn’t see the benefit. He might be motivated if someone told him, “If you keep acting this way, you lose your wealth/we cancel your show/we don’t vote for you.”

 Unfortunately, our culture often rewards certain pathological traits. That’s why many people with high levels of psychopathy, for example, make great CEOs and surgeons. Donald Trump has been rewarded throughout his lifetime by making money, getting attention, getting attractive women to marry him, and now getting votes. He sees far more reward in staying the same than he ever would in changing. The man is SEVENTY years old. I hate to say this as a therapist, but he’s probably a lost cause.

I think Trump’s supporters are hoping that he will use his cunning for the good of the country. Instead of acting in his own self-interest, he will act in the best interest of the country. However, based on all the evidence we have about him, I see no shred of evidence to say that he is capable of acting in the best interest of a group:

·       Not his investors. (Mark Cuban, an actual billionaire who pays taxes and has never declared bankruptcy, asked an important question: Has anyone said, “Donald Trump made me rich”?)

·       Not his contractors. (He stiffed them and claimed they did low-quality work. We’ll never know. Remember the USA Freedom Girls who sang and danced at one of his rallies? He stiffed them too.)

·       Not his employees. (He ran casinos into the ground because it made him money.)

·       Not his charity. (He used his charity to pay off lawsuits and buy paintings of himself.)

·       Not his family. (Note the number of wives and mistresses and accusers.)

What makes people think that, if elected President, he would suddenly be able to think communally rather than selfishly? His history shows that he acts only out of self-interest. Period. Why do we think electing him would change him?

Just because he’s pathological doesn’t mean he isn’t smart. He’s a world-class con artist. He tells people what they want to hear and makes them feel what they want to feel. As a result, masses of people project onto him what they want to see. When people meet with him individually, they are charmed and sing his praises. That’s entirely in line with narcissism: social interactions are carefully calculated to win people over toward his own gain.

So what are we to do?

How do we keep ourselves from sinking into the dark hole of despair? What bothers me most is the fact that so many people hear Trump’s hatred and say, “Well, I don’t like it, but it’s not a dealbreaker.” By supporting him, we continue to reinforce his self-centeredness and bad behavior. He forces his supporters to rationalize his behavior. By doing that, he gets his slime all over them.

I think there is a bright side. Donald Trump is forcing our country’s dark underbelly into the light. Our country has a history of denying, minimizing, and smoothing over its dark side. Just a few years ago, the Supreme Court said that we don’t need Affirmative Action because racism is basically over. Now, we can no longer deny that racism is still rampant, misogyny is real, we consistently deny facts and science, and we worship celebrity and wealth. He’s not wrong when he says that celebrities can get away with almost anything. Look at Woody Allen. Look at Joe Paterno (he was honored by Penn State at homecoming this year).

Trump represents the logical extension of cultural problems that were already there. He is forcing us to face the darkness that is still among us. I think he gets some credit for the Black Lives Matter movement gaining so much traction. I think people are listening to sexual assault survivors anew because of his words. We can no longer deny that we have real problems. I am hoping that by becoming our villain, by becoming the symbol of the worst parts of us, he will instigate some sort of catharsis that moves us toward progress and makes us all better people.

We can hope.

Well, we did it. All. Night. Long.

And by "it" I mean, of course, stayed out of his room. Didn't feed him. Didn't soothe him. Let him cry. (Why, what were you thinking?)

I didn't think I could do it. We thought about getting a hotel room and leaving just one of us here at a time. We nearly hired a night nurse just to listen to the monitor and make sure he didn't die.

I never thought it would come to this. When you hold your spouse's hand and dream of being a parent, you don't dream about banishing your baby to the basement to scream among your laundry and boxes.

My fears were 1) That I wouldn't be able to outlast him.
2) That he would choke on his spit/snot/puke.
3) That he would lose a little of the light in his eyes and the bursting joy in his heart.
4) That our bond wouldn't be the same.

Well, my friends, I am happy to report that none of my fears came true.

Two things gave me the commitment to go through with it. First, I realized that every one of us was looking stressed and depressed. Second, I called a pediatrician friend of ours, who reassured me that he wouldn't die. Her exact words: "You know, bad things do happen in this world, but he should be able to handle his spit."

If you're even thinking about doing it, do it. No one even thinks about crying it out unless she is desperate and near her breaking point. I thought it would be like crossing the Mississippi. Really, it was just jumping through a few puddles.

It is agony. It feels like your worst fear coinciding with the most terrible pain of your life; I would liken it to passing a kidney stone while stuck in an elevator. That first night was the hardest. He cried off and on for what seemed like all night. My body was writhing inside. I had hot flashes. I was nauseated. When he wasn't crying, I kept waking up worrying about him. Something primordial in our brain says, "This is wrong! Go get that damn baby!"

But he woke up smiling at me like nothing had happened. In that moment, I knew we were going to be okay.

It took 2-3 weeks before he really settled in to sleeping well, but we had some hiccups (loud heaters, switching back to his room, storms, etc.). During that time, he was fussier and clingier, which was heart-wrenching. But that slowly faded away as his sleep improved, and now I can honestly say that he is EVEN HAPPIER than he used to be. He shrieks with joy every time he sees us.

And even more, I feel like a new woman. I want to cry, I feel so good. I am rejoining the world of the living. I swear I love my children more. For the first time in a long time, I actually have the energy and the desire to play with them. See Scienceofmom.com for more research on why sleep training, though it temporarily stresses babies, probably lowers their exposure to cortisol over the long term because mom (and therefore the household) is so much less stressed. Sleep deprivation is likely the number one contributor to post-partum depression (or just that feeling of depletion), which is undoubtedly hard on babies. Sleep is crucial.

YOU MATTER. Crying it out empowered me. It validated that I can take care of myself, and my kids will be okay. I learned I can set my boundaries as a parent and we'll all be better off for it. It freed me to enjoy parenting.

A Letter to My Son, Before I Make Him Cry it Out

Dean. My smiley, snuggly Dean. My Jupiter. You bathe my heart in warmth and light. A friend of ours said, "When he smiles he looks like he will fly away." You give me life. I feel like I will live longer because of you.

Also, you are killing me.

I was naive. I really thought you'd be a better sleeper. I know more now, I thought. I won't let him get as overtired. I'll know the schedule. I've got more tricks up my sleeve. 

But you have defied all my tricks. So let me defend myself and tell you now that I didn't want to do this. Let the record show that I tried everything. Here is a list of things that did not work:

-Co-sleeping
-Sleeping with you in the same room
-Putting you in your own room
-Various sound machines
-Nursing you to sleep
-Cluster feeding at night
-Waiting three hours between feedings
-Dream feeding
-Later bedtimes
-Earlier bedtimes
-Soothing you every time you woke up
-Letting you cry a few minutes every time you woke up
-Sleeping you in the car, in the carrier, in the stroller, in my arms, or in your own bed
-Trying solid foods
-Getting you on a schedule
-Being flexible with our schedule
-Putting you down within two hours of wakefulness
-Stretching out your wakefulness windows
-Soothing you to sleep
-Letting you learn to fall asleep on your own

I am not proud of it, but I have learned that my brain doesn't handle sleep deprivation gracefully. I'm a shadow of myself. I'm a big hot mess. I need to be there for you, for your sister, and for your dad. I want a brain that works. I want to have the energy to play with you both. I want to remember things. I want to stop having meltdowns. I need to have access to my spirit, and apparently a regular five-hour stretch of sleep is my ticket. Therefore, I have to let you cry it out.

I tell you all this because of my guilt. I am so sorry. It's amazing how hard this is, even though I did it with your sister, and even though it worked beautifully. She has been a great sleeper ever since.

It's harder with you, because you are so snuggly and easy to soothe, and you have a breathtakingly powerful shriek. You are hoarse already from all my check-and-console experiments. I'm afraid my inconsistency has simply taught you perseverance.  

But I believe this is the right thing for me, and for you too. A small army of pediatricians have told me so. It's just that my prehistoric instinct to answer your cry hasn't caught up. But I am sending that instinct a very important message: that I MATTER TOO. I hate all the anti-cry-it-out and attachment parenting militants because they forget to tell moms that YOU MATTER. Your well being matters, and even though for some reason it feels terribly wrong, sleep training will be good for everyone because everyone in this family is important and has needs. There. End of spiel.

I needed to reassure myself. I will write another letter when this process is complete, and I pray it is a happy one. :)

I sort of finished a thought!

A friend sent me this blog tonight, and it made me cry over my phone in my kitchen.

"Right now I am untethered and floating. I am surviving. I am moving forward one foot in front of the other, getting through the morning routine, getting through the days home alone with Fae, getting through dinner and bed time routines, all while trying to cherish them and be in the moment, all while exhausted, all while trying to give of myself to my kids, to my spouse, to my people, and give of myself to… myself. I’m running low on self and I miss old me..."

Oh man. That really hits home. For me, being a mom of two feels like life coming at me from every direction. Most of my brain is a blur. I miss writing edited blog posts, but now I will have to settle for stream-of-consciousness.

 

I grieve that I can't be there for anyone, friends or family, like I want to be. I grieve that we never really got to be a family of two or a family of three for long, because of medical school and residency.  Dean's smile lights up my heart, and then I ache to be there more for Coralie. I long for moments in a quiet, dark room...by myself.

 

The days get incrementally easier and there are more moments that I really do cherish. I'm grateful that I got to have an "old me" for so long. Because of where I live, and the era in which I live, I got to have an extended (if tormented) adolescence where I developed my self. I think about how through most of history women were married as teenagers and started doing this right away and knew no other life. So they didn't grieve that other life. But they also had others around all the time and did this communally. I reaped the rewards of  a "self" -centered society before I had kids, and now I feel the deep need for more community. 

I just visited my family in California. My sister spoke at her church about courage, and told her story of re-learning to walk because her body was so shaken after her second child. I realized I had NO IDEA what she went through at the time. Her whole life, I had no idea what she went through at each pivotal moment, and I was no help. In my life, she knew exactly what I was going through and she helped me tremendously. Such is the older sibling's burden.

Anyway. I'm rambling. Such is my heart, this moment. I am more aware now that that is all I can live. I stand at this intersection of space and time, right now, and that is all I have to live.

My birth story: Redux

If I could sum up my second birth, it would be with this picture:

And with this sentence:

"Why is everybody so ANNOYING?!"

I'm so glad Jason managed to snap that picture. It says everything: messy, tired, overwhelmed, ecstatic. I'll take annoying people over a brush with death any day of the week.

Last time, I felt like I orbited the black hole of my mortality and was lucky to escape. That may be overstating it, but for months I struggled to revive my body and my spirit. This time, I feel like I just circled it from a distance, and it let me right on out. I feel so much better that I grieve a little for how hard I had it last time. I also am relishing the gift of still being here on this Earth, and for Dean being here too.

Like most things child-related, the labor was not as I expected. Last time it was fast and hard. This time it was much longer, and much better.

Instead of a too-fast-too-furious avalanche of contractions, this time I had weeks of them that built up slowly. A few times, I thought I was in labor and started preparing, only to have the contractions fade out. That part was mentally and physically exhausting, but my official opinion is: long labor with breaks is ONE THOUSAND TIMES better than short labor without breaks. I had some restful days interspersed, and for the most part, things felt manageable (comparatively). Plus, feeling so miserable for so long made me actually happy when labor began!

The night I really was in labor, the contractions were getting more painful but were still irregular. I was distracted by my two year-old puking at 3:30 AM, which rallied our household for a few hours. By the time I had a chance to think about my contractions again, they were about five minutes apart. I called my doctor, and she advised me to go to the hospital to be checked.

I had decided to go to a hospital this time, rather than to a birth center, because of the hemorrhage I experienced last time. However, I may have mentioned that I HATE HOSPITALS. I realize my husband spends most of his waking hours inside one, but that doesn't mean I have to like it. Just walking in and standing and waiting and getting my bracelet and "Who are you again?" and "What is your insurance?" and "Only one person with you in the triage room!" and blah blah blah made me remember why I didn't do this last time. The things I will do to maintain my blood supply.

I was four centimeters dilated when they checked me. They weren't sure whether to admit me, so I walked for an hour. I progressed just a little, so we decided to get my show on the road. Here's a selfie with my IV pole.

I was positive for Group B Strep, so I had to get IV penicillin.  OH BY THE WAY THAT HURTS ALMOST AS MUCH AS LABOR DOES. Good times!

After two hours of walking, things got rolling and they rolled fast. This part felt like I remembered. My contractions were long and strong and I could no longer walk or talk much. I got into the position that helped me (leaning over a birthing ball on all fours) and I stayed there pretty much until I pushed. Jason and my mom took turns giving me counter-pressure through the contractions.

I felt much more in touch with the process this time. I could feel the contractions that were opening my cervix, and I could feel when they switched to pushing the baby down. I knew things were moving fast. Hard as it was, I kind of got into a groove and I knew what I needed. When they checked me again, I was at 6 cm. At the birth center, someone would then have said, "You're making progress! Good job! You're doing great! Hang in there and he'll be here soon!"

At the hospital, they just said, "Last chance for narcotics!"

So, I tried some Stadol. :)  It's pretty nice! I was still in pain, but I felt warm and fuzzy about being in pain.

The cast of characters I had to interact with was what irritated me to no end. The resident checking on me didn't know my birth plan. The anesthesia resident had to give me his spiel about why I should probably avoid an epidural (which I already knew), while I was nearing transition and I could barely open my eyes and the pain was becoming nearly unbearable. Thanks, dude. My doctor was in clinic so people kept telling me I'd have to wait to push. Ha! Right! Luckily, I don't think anyone but Jason and my mom heard me blurt out, "Why is everybody so annoying?!"

Then there was Celeste, my labor nurse. God bless Celeste. She was an angel. She empathized; she stood up for what I wanted. She would come in close to me and say something important and I knew that all was well. She offered to catch my baby if my doctor didn't make it and that sounded great to me. I wish everyone had a Celeste in her life.

When it was time to push, there was no stopping me. Luckily my doctor made it just in time (don't they always?). I decided to push in a squatting position on my knees, holding on to a birthing bar they installed over the bed (which blew the resident's mind, I think. I don't think she had seen a Birth Without Stirrups). After the resident broke my water, I pushed hard and I felt him crowning. It hurt like hell. There is no way around how much that hurts. So I just kept on pushing and screaming, "Get him out get him out get him out!!!" He must have heard me because he came sliding right out in less than five minutes. I think he hit the table before they knew it, even though he weighed 8lbs 12oz. I didn't tear, and I didn't hemorrhage. Hallelujah! 

Recovery has been smooth. My body may never be the same, but that's a blog post for another time. I've been fortunate to have a village of family and friends helping me adjust to doubling my number of kids. My spirit is full of love and hope.    

How Birth is Like a Supernova

As I inch closer to my second delivery, I am aware of the slow turning inward that seems to happen during this third trimester. This pregnancy has been a harder one than the first in many ways. Physically, it's been a roller coaster. Emotionally, I've had heart-bursting excitement, but I've also struggled with a lot more fear and dread now that I know more about what's coming our way.

I've struggled with how to understand birth. I had hoped to find some sort of spiritual fulfillment in it, and I paid close attention to women who really do seem to have that experience. But to me, birth and the newborn period were primarily a blur of agony.

Is it like a trauma? I've mulled this over many times in my mind. In a way, yes--though I don't have nightmares or flashbacks, it was so totally overwhelming and disorienting that it tore me outside of my ability to cope and to integrate it into my consciousness.

And yet, the pieces of me fell back together, and there I was not a year later wanting to do it all over again. All I have to do is notice my daughter's brilliant blue eyes to be reminded of what beauty comes out of that fight. Life-giving, life-sustaining, sublime beauty...

...Which led me to the most appropriate analogy I have found so far: birth is like a supernova. I'm sure astrophysicists would laugh at my comparison, but I've been a bit obsessed with Cosmos and Neil deGrasse Tyson lately, so I've had supernovas on my mind a lot.

A supernova, as I understand it, is the brilliant explosion of a dying star. It creates an incomprehensible amount of energy and can outshine entire galaxies. It emits more energy than our sun will in its entire life. So, basically, it is a violent, extreme, catastrophic event. It's also completely natural--it happens perhaps once per minute somewhere in the universe. Violent, extreme, and catastrophic are words that often describe our universe, it seems to me.

And yet, supernovas are where the stuff of life come from. They often create new stars. They are the primary source of heavy metals in the universe, including the metals in our bodies and our food. Neil deGrasse Tyson likes to say, "We are made of starstuff." Plus, as you can see from the picture, supernovas look absolutely magical and breathtaking.

All of this comes as close to describing birth as I've ever heard. Violent. Extreme. Life-creating. Devastating. Magical. Awe-inspiring. And it's where these precious beings came from.

If that's what it takes for a life to happen, then that's what it takes. I'm going to stare it down again, and in the end, I'll probably end up even more grateful for it.

My Letter to My Daughter About her Body

Step one: Don't talk to your daughter about her body, 

except to teach her how it works.

Don't comment on other women's bodies either. Nope. 

Not a single comment, not a nice one or a mean one.

Recently, an article by Sarah Koppelkam called How to Talk to Your Daughter About her Body, published on the Huffington Post, seemed to be everywhere I looked at once. It is beautifully written and inspiring, and I think it is a great guide for the early years of a girl's life. Something was missing, though. I felt I needed to have my own talk with my daughter about her body.

Dear Coralie,

Your body is strong; it is healthy; it can do amazing things. It can climb mountains and run marathons and move furniture and dance and sing and experience pleasure. It deserves to be cherished. I cherish yours, and I hope you will too. I care for it, feed it, file its nails, rub its back, run with it and wipe its tears because I love it and I love you. Your body is how I communicate with you.

Right now, every time you look in the mirror or see a video of yourself, you light up with pure joy. I hope that "I am awesome!" revelry lasts as long as possible. That's how I wish we all felt about ourselves!

The time will come in your life when everything will change. It's called puberty. And I do not serve you well if I avoid talking to you about the incredible and the harsh realities of growing into a woman. Puberty is awe-inspiring and glorious as it allows you to experience maturity, sexuality, and fertility if you wish. However, it's a time when you're going to be inundated with negative messages about your body and other people's bodies. As they grow up, many women stop enjoying their bodies and become obsessed with how they look. FIGHT BACK. Recognize those negative messages and kick their butts.

Those lies come from people who are suffering in their own self-hatred, or who want something from you, or who want power over you, or who want to sell you things (especially that last one!). They are not the truth. If you buy into them, you set yourself up for misery. You don't have to live that way. I am heartbroken every day over all the women living in a prison of self-loathing. They are caught up in other people's delusions. Other people's definition of good and beautiful. They miss out on so much of life!

Life is what our bodies give us! I felt perilously close to losing my life a couple times, and it gave me a whole new gratitude for my body. Your dad witnesses other people's tragedies every day--people who would give anything for our healthy bodies and their idiosyncrasies.

You are a masterpiece. I hope you can see yourself that way your whole life. If other people don't, ignore them. You and I know the truth about you. I hope you always love you as much as I love you.