Body Image: Remember the Future

Let’s talk about body image. It’s come up a lot, lately, and I went to the beach yesterday wearing my yellow polka dot bikini and could not help but bask in my own enjoyment of my body. I won’t lie–I did compare my body to the very thin body of the friend next to me and long for smaller thighs. But I smashed that thought like an ant at a picnic. I wouldn’t trade this hour glass for anything! And any kids I end up having will benefit from that hard-won attitude.

Take a look at few things I’ve come across just this morning (I did not google “body image”–this all showed up in my Facebook news feed):

Moms pass on body hatred to daughters: Your kids are listening.

Moms buy a children’s book about going on a diet for their daughters. No, I haven’t come across this in any of the homes I work in. If I do, I’ll be having a conversation with the parents, ASAP.


Photoshopping Phoniness: Beauty altered out of reality and, often, out of beauty.

Fighting Childhood Obesity: The fight to improve childhood nutrition.

First, one unusually great thing about my childhood: my parents served really healthy food, and I’m now glad that I never won my campaign for white instead of brown rice and/or bread. Partly for financial reasons, we never had soda, sugary cereal or salty snacks just lying around the house. Treats were treats. You know what? I don’t want to spend my money on junk, either. So my body is thin and my skin healthy in part because I have always eaten healthy foods.

I didn’t manage to have a great body image, though. Not even a good one. I didn’t believe that I was pretty, not really, until I was about 19 years old. I was convinced that I was probably fat from the moment my body started changing; growing from a lanky, athletic, into a curvy woman was miserable for me. I didn’t know that there would be an awkward phase. I thought it was all supposed to happen so gracefully. Wearing the clothes that I thought I should fit into instead of clothes that actually fit me meant that I wore a B cup bra when I was already a D–in the eighth grade. To be perfectly honest, I still haven’t forgiven the boy who said, “Anne-Marie? Is she the one with the huge boobs?” I’d really rather never see him again. The point is that I didn’t look in the mirror to see how I looked, I looked at Seventeen magazine to see how I should look. I had days when I felt pretty, and I did not have any type of eating disorder or disordered eating. But I was most definitely hiding.

I directly my compulsive energy towards school. I did homework the way other kids played sports. I talked about colleges like other girls talked about boys; no really, I started researching colleges at age fourteen. Once I chose Barnard College in New York City, I wore my sweatshirt almost every day. It was too big and very comfy. I may have also stopped washing my hair… not entirely, just not every day or even every other day. To put it simply, I was unhappy. With myself, my body, my surroundings, my family, boys–you name it, I was angry at it. I didn’t feel like I could tell anyone, so I hid.

I was still hiding when I got to college, but I made friends. The best friends. They saved me. They helped me knock down some of the walls I had built around my real self. And they pretty much forced me to buy clothes that fit my actual body. Not the one I thought I had–not the overweight body that didn’t actually exist or the tiny, skinny body I had so wanted–but the body that I really had. I also became pretty active and ate less ice cream because, well, I got happy. So I lost a lot of weight. I bought a whole new wardrobe. And please, if you meet my friends from college, don’t mention “polo shirts” or “khakis” because they still enjoy laughing (with me, of course, not at me) about the over-sized polos and khakis I was wearing when I met them.

Here’s the big bad body image trap I sidestepped–I did not ignore my body enough to have sex too young or take too many crazy risks. I knew that there would be emotional fall-out from sex, so I waited. (It helped that, like I said, I hid under a hoodie during high school.) I made mistakes, but I knew they were mistakes while I was making them.

Here’s why I think it’s related to body image and therefore to self-esteem: if young people don’t like themselves, they don’t like their bodies and they don’t think that it matters if they take these risks. I suspect that this is true because when my self-esteem was at its lowest (oh, say, around the time I went to the psych ward), I stopped taking good care of my body. I ate sporadically because I just didn’t care. I stopped doing laundry because I just wore my pajamas. I know it’s gross. I didn’t shower often enough. I really just didn’t feel that it mattered. And my future? That seemed really, impossibly far away.

So, this morning, I saw a discussion on the Pigtail Pals Facebook page about young women’s attitudes about casual sex and unplanned pregnancy, and I read that Melissa Wardy finds it “Shocking in how cavalier they are towards their bodies, health, and futures.” I felt like I was zooming back through my own sexual experiences and my friends’ stories about their sexual experiences.

Let’s pause for a minute: I have always been shocked at a cavalier attitude toward body, health and future, in my peers, in younger women, in older women, in men of all ages, but the reason for this is odd. You see, I was raised by a puritanical father to believe I could control any and every sexual impulse. He liked to lecture. “What would people think of me if I wore a short skirt! What would people think of me if they knew that I had spent time alone with a boy!” He actually made sure that I knew he would be sleeping on the couch for the few weeks we lived with my stepmother before he married her. I was eighteen at the time. I believe that my reaction to that was “Daaaaaaaddddd! I don’t want to know!” In my house, before I left for college, any conversation about sex was pretty over-the-top. I swallowed, hook, line and sinker, my dad’s line about sex being this peripheral, almost unnecessary thing we don’t really need to talk about. I thought as a teenager that I would become a Self-Realization Fellowship nun so I talked to quite a few. (SRF doesn’t have much in common with the Catholic church, but our nuns do practice celibacy.) For the record, my dad’s craziness is not even similar to anything you would ever come across in any official SRF text or in any conversation with a monk or nun. Fortunately, I did finally realize that all of my dad’s nonsense was, well, nonsense, to put it mildly, partly through talking to actual nuns about why they practice celibacy and why “householders” deserve equal respect to “monastics.” But. Back to the real topic.

Let’s just say that eventually, I got around to exploring my sexuality. The sheer force of sex and my own desire knocked the wind out of me. By that time, though, I was mature enough to handle all those emotions and to take care of my body. I had the bad habit of thinking of my body as something that I couldn’t really trust, but I didn’t have the bad habit of using sex to feel beautiful or valuable. As you might imagine, I am still working through some serious Daddy Issues, and I looked for Daddy’s approval via proxy in plenty of my past relationships. For many reasons, though, I did not go out and look for casual sex in order to feel good about myself. I’m lucky, because the risks I did take never resulted in a sexually transmitted infection or an unplanned pregnancy.

Fast forward: my high school and college classmates and I are going to turn 27 in the course of the next year. More of us are getting married. More of us have kids, or like me, are preparing to have kids. And I can’t help but wonder. So many of us took such poor care of our bodies. So many of us did not really believe that our futures would really, truly, catch up to us. We punished our bodies with alcohol, cigarettes (my vice of choice), unprotected sex, eating disorders. For most of us, it was just for a few years. I quit smoking. I don’t know many friends who still binge drink. For most of the people I’m close to, unprotected sex was not ok, even when casual sex was fun and frequent. But it really is just anecdotal knowledge taken from a small sample of just the people I know well enough to hear such intimate details. Do I know someone whose body is haunted by a mistake she made? Do I know a woman who got an STI when we were young, still has it and must factor that in to current relationships and future plans? Do I know someone who will not be able to become pregnant because she contracted an infection or suffered complications after aborting an unplanned pregnancy? Do I know a man who has become infertile as a result of an early encounter? I don’t know. I don’t know if I want to know. It’s painful to think about consequences actually having stayed with anyone this long after one of our parties or nights out.

It still doesn’t seem real that the cigarettes I smoked could mean cancer later in life. And if I’m honest, that knowledge is not what got me to quit. I quit because I could not be around babies and small children if I smelled like smoke. I don’t just mean that no one would hire me; they wouldn’t. But I couldn’t bring myself to carry that into their worlds. Why could I do it for them, but not for me? The really bad choices–the ones we can only make after silencing the voice that says “Use a condom!” or “You’ll get cancer!”–would anything short of a snapshot of the future stop us from making those mistakes?

Psychotherapy: How Does That Make You Feel?

I want to start this week with a post or two about therapy. There is still a stigma attached to mental illness, and therapy is still widely misunderstood. I also want to write about therapy this week because I have no therapy this week. The wonderful, talented, empathetic and possibly even psychic “L” is on vacation. I am constantly thinking of things to tell her and then remembering that she won’t be back for another two weeks.

A note before I begin: Psychiatrists, psychologists, social workers and people with various other degrees can all practice therapy. Only a psychiatrist should be prescribing any drug or making any recommendations to you about medication. I see a psychiatrist in Manhattan, the incomparable Dr. C, and a therapist with a degree in social work here in New Haven (L). I see Dr. C about four times a year to talk about changes that need to be made, if any, to my medications, and to check in. I’ve been seeing him since 2006. I’ve been seeing L for about eight months. Because I see her twice a week, it’s important that her office is close to home.

Types of Therapy:

The Mayo Clinic website lists thirteen types of therapy. I won’t go through all of them, just a few.

  • Pyschoanalysis is the opposite of what I do. I am absolutely interested in doing it someday, though, after talking with people who are trained in it. It is easily the most misunderstood type of therapy out there. Yes, it’s what Freud pioneered. Yes, you often lay on a couch. Yes, you often avoid looking at your analyst. Yes, you often go up to five times a week. But today’s psychoanalysts are not judgmental like Freud (anyone read Dora?) and the couch thing is optional. Rather than define it (the Mayo Clinic does that quite well), I’ll tell you why I want to do this someday: I tend to try and come across as perfect, even to a therapist, and not being able to see her reaction seems like a pretty good way to circumvent that impulse. I once asked my therapist in Queens why she wasn’t happy for me when I improved at something (I don’t remember what it was anymore), and she said that she had been trying to keep her face neutral. Why? I was taking her smile as approval from her. She didn’t want me to need her approval. Smart lady. I sure was interpreting a smile as approval and the absence of a smile, or a neutral expression, as disapproval. You can get to those thoughts and feelings that your conscious mind doesn’t really want to think about a little easier when you’re not trying to gauge your therapist’s reaction like that. It can also feel disorienting, I’m told. I haven’t done analysis yet for that reason; the last thing someone with tons of anxiety needs is to feel disconnected and disoriented even in therapy! One day, I’ll be even better at dealing with my anxiety, and that will be the day
  • Interpersonal therapy is what I have chosen. My visits with L feel like visits; we have an ongoing conversation. We focus on my relationships with other people–anyone counts–in order to help me feel less anxious, more connected, communicate better. She’ll ask me to expand on something or to describe my feelings about something. An interaction I with M, my therapist in Queens, is a perfect example of why interpersonal therapy works so well for me: “Anne-Marie, you are interpreting my facial expression as disapproval. I was trying to be neutral. Does that happen often?” “Why, yes, actually, now that I think about it, I’m constantly looking for approval from my boss, my husband, my mom, my sister, in just the same way. And now that I think about it some more, it feels kind of gross for everyone.” What I really like about interpersonal therapy is that the relationship is very close. We’re not friends, and it’s a one-way thing. But the best therapists are even good at talking about their own feelings about your relationship (how can you see someone twice a week and not have a relationship?) in an effort to help the patient understand the other relationships in her life. Note: the concept of transference is a Freud thing, but one that I believe in quite strong. I don’t agree with him in that he tended to think that it was all a kind of romantic love, e.g., Dora thinks she’s in love with me because she can’t work out her true sexual feelings for the other guy or her father. It gets creepy. What is true is that because I never find anything substantial out about who my therapists are outside our sessions, I tend to subconsciously compare the relationship to other close relationships in my life. Claire (long ago and far away) reminded me of my sister. Kate (college days) reminded me of my sister. M reminded me of my sister. L, who is a bit older than any of the past female therapists, reminds me of a really important mentor in college, Nancy Klein Piore. During our first office hours session to talk about my writing, Nancy looked me straight in the eyes and said “Anne-Marie, you are insecure.” I cried. She gave me oreos. I will love her forever. I can totally see L doing the same thing. She would probably say “Do you think you’re insecure?”
Note: the constant questions, coming from a good therapist, are supposed to be real questions. They often know the answer in advance, but if you come out with a totally unexpected answer, they embrace that. We’ve had some huge breakthroughs in undoing harmful patterns when I’ve said “No, it’s not like that, it’s like THIS! I never thought of it that way!” It can be pretty exciting to undo a years-old habit that way. Of course, you can’t just say “NO. I DON’T FEEL THAT WAY!” Because come on, these people deal with denial and lying for a living. You’ve got to have an alternate explanation, and if I personally get angry or defensive, it’s less convincing, even to me.
  • Cognitive Behavioral Therapy or CBT has been an important component of my life in therapy. But because my anxiety is an ongoing thing and my mood disorders are not related to a specific event, like a death, I wouldn’t benefit from straight-up CBT. But say there’s something specific that really bugs you, like being too confrontational and too defensive in your relationships. CBT takes your current unhealthy behaviors (yelling at your spouse), examines them briefly, and then works hard to find alternate behaviors that you can put in to practice. This actually changes the way you think. You get less angry. I’ve used CBT techniques when things like overwhelming anxiety about leaving my house crop up. Example: I HATED walking to the subway. I bought audio books, put them on my iPod and put my iPod on about 15 minutes before leaving the house, while I was getting ready. This habit replaced the habit of procrastinating getting ready to go, with much healthier results. It worked because it distracted me from the anxiety–I get caught up in books really easily. There’s a reason I spent so many years studying literature. If you feel anxiety about something specific, but don’t have generalized anxiety like me, you might find that a set number of sessions with a CBT-trained therapist enormously helpful.
That’s my take on therapy. I hope it helps debunk some myths. Please, ask questions. It’s hard to be objective about something I’m so close to! And, for the record, I cannot wait for Linda to come back. I LOVE that safe space. I’m tempted to ask for keys to her office so I can just hang out there when she’s on vacation. (Joke. That would not be legal.) But seriously, bring on the questions! I love talking about therapy, because it saved my life. Meds only do so much. It’s therapy that actually creates lasting change. And everyone who knows anything agrees that the combination of the two is usually best. Thank you to all the therapists I’ve ever known. I’ve been lucky to encounter some brilliant minds.
A final note: this post is dedicated to someone who is starting therapy relatively late in life. You are brave. You are one of my heroes. I love you. You inspire me daily.

See how it looks like their friends? They're just talking? That's what therapy can look like.