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Post Partum Depression and Mother-in-Law Issues

April 29, 2008

We live in an age where there is an abundance of information and awareness about so many aspects of our emotional lives. One of those is regarding "post partum depression" (PPD), a type of depression that can occur following the birth of a child - sometimes appearing within days of the birth, and sometimes not until months later. The new mom, often overwhelmed with the hormonal and emotional changes, may find herself lost and afraid, unable to cope with the added responsibilities and expectations. PPD can appear in many degrees, from mild to severe. Usually there is the added guilt of feeling so low when she "should" feel joyful for the miracle of birth and a healthy baby. Needless to say, this condition often wreaks havoc on family harmony.

Such was the situation with Chaya who came into my office with her husband, Moshe, to seek help for her depression. They had 3 children under 5, the newborn being 2 months old. She reports that since the baby's birth, she has not "gotten back to herself" - indeed, she finds herself crying a lot during the day; feeling like she has to "walk through molasses" to complete even a simple task. Everything seems to be a struggle. Even praying, which used to be a source of comfort and strength, now is difficult. Indeed, she feels afraid, misunderstood and, in her words, "abandoned by G‑d."

Moshe is frustrated with his wife's struggle. Although he tries to be sympathetic, he often feels it's "all in her head" - and he wishes she could just somehow "snap out of her bad mood." He reports that they have just moved into a beautiful new apartment. She has everything to be grateful for. And he simply can't understand why, with this child, her recovery is taking so long. In an effort to help his wife feel better, and on the advice of well-meaning friends and relatives, he encouraged Chaya to see a psychiatrist and get some medication. Chaya was upset about having to take pills, and is despondent over the fact that this birth was so different than the other two.

In helping this couple cope with the present crisis, I first stressed the importance of understanding what PPD is all about. I emphasized that fact that although Chaya had not experienced PPD with her other two children, every birth is different. And that PPD is not only a normal human response, but actually quite common. However, because it causes such guilt and self-blame, it often goes unreported and untreated, until, in severe cases, medication is warranted. It makes sense that Chaya would feel "abandoned" – but her reaching out for help, and her willingness to find answers, were already the beginning of the healing process.

Sometimes PPD is purely a result of the enormous chemical changes in the body, and in some cases medication is certainly recommended. However, as we talked about their marriage, I sensed that there were some underlying issues that might help us examine what is making Chaya so vulnerable this time. She expressed admiration for her husband, and love for her children and great satisfaction in being a home-maker. But, when I asked her what has been the greatest pain in her life - she quickly responded, "my mother-in-law." When I asked, "How long has this been going on?" She answered, "Since day one!" She seemed surprised and embarrassed at the quickness of her answer, and certainly Moshe looked surprised as well. Not only did he not know this information, he did not see the connection to what is going on now.

Chaya was quite reluctant to share honest feelings with Moshe for fear of "hurting him." After all, he's a good husband and provider, and a very caring father. However, with a little assurance and encouragement from both Moshe and myself, she proceeded to talk about how she felt her husband was pulled between his mother and herself. Chaya never felt comfortable with her mother-in-law's demands and her "nosiness." She gave several examples of such incidents. Although Moshe validated these examples, he never realized how deeply Chaya had been affected. He smiled and wondered if perhaps she was "too sensitive" and took everything "too seriously." His judgments made her retreat into herself further, alternating between self-blame and anger at him for not understanding her.

That, of course, led to a discussion of various personality types. Although the topic is quite complicated, because of all the variances, most people can, indeed, see themselves as defined by descriptions of introvert/extrovert, sensing/intuiting, feeling/thinking, and spontaneous/organized. In addition, we can describe those who are more "head" oriented, and those who are more "heart" oriented. Some are naturally more sensitive and dramatic. Others are more thinking types, and, still others, seem not to react too much altogether. We are born with these differences, and our strengths and weaknesses which eventually constitute our "repair work" – tikkun – in this world. The Torah's account of Jacob's 12 sons are a classic example of such personality types. Each son was a world unto his own, defined and acknowledged in the blessings they were given before their father's death. Perhaps we can apply the well known saying, "Maa'seh avot siman l'banim" – the deeds of our Fathers are a sign(post) for the children." Utilizing this knowledge helps us enhance and refine our relationships. A knowledge of the personality types will help to move us towards greater tolerance, forgiveness and appreciation of ourselves and others. (To educate yourself regarding the basic personalities, please see "The Enneagram Made Easy" by Baron and Wagele, "The Wisdom of the Enneagram" by Don Riso, or "Awareness" by Miriam Adahan. This information can be life-changing!)

In this case, we can see a clear example of a few factors that can trigger depression, or depressed/lowered feelings:

A) Lack of honesty in a relationship - having to "depress" the truth - usually for fear of "hurting" someone. In this case, Chaya's lack of communication with her husband for fear of "hurting" him actually ended up hurting both of them.

B) Not "knowing" oneself - "depressing" the intuitions and instincts that are built into our personalities. Chaya had been discounting herself since the beginning of her marriage. She, herself, had not understood the profundity of her pain. She never learned to acknowledge herself or "take herself seriously." And therefore, Moshe was not able to understand her either.

Once this major issue was "put on the table" - Chaya felt a great sense of relief. She was grateful that she was able to deal with the fear that her husband would never understand or accept her feelings. Moshe, despite his initial lack of empathy with Chaya's strong response to his mother, was finally able to accept his wife's feelings without resentment. We spoke about "safety" in the relationship - making each person feel heard and validated.

As Chaya and Moshe continued to work through their issues, Chaya felt increasingly supported by Moshe, and developed greater trust in his ability to stand with her as a strong unit. When there was any pressure from outer environment, especially his mother, they were able to successfully negotiate an approach which felt "safe" for both. As the situation improved and Chaya's depression lifted, the psychiatrist agreed to wean Chaya off the medication. And the "icing on the cake" came a few months later when Chaya volunteered to work on a hotline for women who were going through PPD.

Are We Soulmates?

April 22, 2008

How do I know if I have married my soul-mate?


Dear Rachel,

You know when you have married your soul-mate when you are standing beneath the chupah.

The Talmud tells us about an interesting two-thousand-year-old Israeli custom. After a young man would get married, people would ask him a curious question: "Have you found, or are you finding?" Depending on his answer, the questioner would then quote him a verse. If he says that he has "found," they would quote the verse: "A person who has found a wife has found good." If, however, he answers that he is "finding," they quoted the verse: "I am finding something more bitter than death, the wife (woman)."

The attitude for a great marriage is displayed by the ones who answer, "I found." They are saying that they are fully committed that this spouse is the one for them. They no longer are checking out and seeing whether they possibly made a mistake. They understand that with all the future hardships and broken fantasies, with all the personality flaws and shattered dreams, with all the arguing and tears that will be shed, even with all these things, this is the one for them. They are going to persevere and work through all their issues and create the relationship that they both deserve. People who have "found" their spouses and are constantly making them feel that they are the only one for them, "have found good."

On the other hand, spouses who are constantly "finding," evaluating if they have made the right decision, make their partners feel judged and never really give them a sense of security in the relationship; security that would allow them to trust that their spouse will be there no matter what happens. Such people will find themselves in a situation that feels "more bitter than death."

We must constantly treat our spouses as our soul-mates. It takes time to build the confidence necessary to show the real you, to let your spouse in deeper and deeper, as you peel away the layers of fear, anxiety and pain caused by past broken trusts. After years of growing closer and closer, treating your spouse as a precious and intimate part of yourself, you will discover the depth of your relationship and how you are both connected at a deep soul level, as soul-mates.

Married to Mr. Clean

April 13, 2008

Dear Tzippora,

I am married to Mr. Clean. This wouldn't be such a problem if he was the one who took care of the cleaning, but he expects me to do it and do it to his standards. There's no way I can do it to his satisfaction. I am just not into these things like he is, and I don't even notice small things like dishes in the sink, shoes on the floor, or even cobwebs in the corner. What should I do?

Born a Slob

Dear Born a Slob,

You need to speak this issue over with your husband, and discuss the problem together. Luckily the skills you need to communicate well are already evident in your letter. Speaking calmly, concisely, and with a gentle touch of humor should help you to keep the conversation on track and focused on the issue at hand. The conversation should be aimed at finding a mutually-agreeable solution to your dilemma. It is not a question of whether it is preferable to be a Mr. Clean or a slob, but rather how the two of you can live together without allowing this basic difference to become a point of contention between you.

You raise two possible solutions in your letter already. Is it possible for all or part of the cleaning to be handled by someone else, whether that someone is your husband or a hired cleaner? Is it possible for your husband to accept that when you clean, you won't be cleaning to his standards? What are his cleaning priorities, i.e. would he prefer you to do the floors or the dishes etc?

I would recommend a compromise involving a cleaning rotation between the two of you. On your day, you would clean according to your standards, and on his days, he would clean according to his standards. The general cleanliness level would therefore be at a midpoint between the two of you.

I would like to focus now on the meta-issue. You humorously call him "Mr. Clean" while referring to yourself as "Born a slob." This places the two of you on complete opposite ends of the spectrum. Beware of this type of polarization. Instead, think of yourself as having a shared identity as a couple. Are you part of a couple for whom cleanliness is important? His need then becomes part of the couple's need.

This type of thinking will strengthen your relationship, and this is what marriage is truly about. When you push yourself to be a little more careful and observant about cleanliness, you will be actively solidifying your connection. You will no longer be a born slob, but rather a married woman with a healthy recognition that all marriages involve compromise and change.

Falling in Love or Climbing in Love?

April 6, 2008

How hard do we have to work to find, create and maintain an ecstatic marriage? Or is the ecstasy something that comes naturally and spontaneously?

The Lubavitcher Rebbe expands on a traditional halachic distinction between Shabbat (Sabbath) and Yom Tov (i.e., Jewish holidays or festivals). Shabbat is an event that occurs without requiring man's participation. At sundown, each and every Friday night, the holiness of Shabbat enters our world, whether or not people have taken any particular action. In contrast, traditionally the start of a Yom Tov is based on a Jewish court's decision, setting the calendar for that month.

(For example, if the court declared that the month of Tishrei began on Friday night, September 22nd, then the holiday of Yom Kippur would begin 9 days later, on the 10th of Tishrei, Sunday night, October 1st. Even if the court later found that it had erred in its calculation, the timing of the Yom Tov would stand, based on the court's initial decree.)

"How will I know that this is the right person, the perfect person? And how do I know that our mutual attraction will last over time?"

Thus, the holiness of Shabbat occurs automatically, every seventh day, based on the astronomical calendar whereas the holiness of a Yom Tov is based on a human calendar, decreed by a Jewish court.

The "Shabbat versus Yom Tov" modes can be understood as a metaphor for marriage.

Many young people raise fears about making the commitment to marry. "How will I know that this is the right person, the perfect person, the person who is truly the other half of my soul (my bashert)?" "And even if I meet such a person, how do I know that our mutual attraction will last over time?"

I advise those young people to devote the same conscious planning to marriage that they devoted to finding a college and planning a life career. Become conscious of what kind of a person, you are likely to be happy with. Also, consider more broadly, what kind of personal characteristics predict stability in marriage, while identifying pitfalls that can lead one to choose inappropriately.

As well, while recognizing that a certain level of attraction is a necessity for a good marriage, we protect ourselves if we see the limitations of infatuation as a criterion. Etymologically, the root of "infatuation" means "to make a fool of." Infatuation alone has not protected millions of marriages from ending in divorce. Most important, the main guarantee that the initial attraction will persist and grow is the couple's readiness to act--to continue to actively re-create and deepen their love.

And it is here that the "Shabbat versus Yom Tov" metaphor is so helpful. The popular secular media report that love and marriage should be only like Shabbat: their magic and holiness should be an automatic gift bestowed upon us, without effort on our part. In contrast, Yom Tov teaches us that the highest, most infinite and transforming love is that which people actively create. We are given that creative power by G‑d. We need to trust that we are capable of the task. In fact we need both Shabbat--magical infatuation, and Yom Tov--earned closeness.

The main guarantee that the initial attraction will persist and grow is the couple's readiness to act: to continue to actively re-create and deepen their love.

Therefore, if we meet someone whom we feel has the fine qualities that are necessary to build a marriage, we can seriously consider marrying him or her, even if we don't feel totally overwhelmed with infatuation, Hollywood style. If we do feel a solid attraction to them, we can build the infatuation, and deepen the love, over time.

This interplay between Shabbat and Yom Tov continues over the course of marriage. Drawing on our connection to the infatuation of Shabbat keeps us committed and generous, even when we lack a rational solution to a specific moment of marital conflict.

Our strongest infatuation for our spouse is usually felt in the early years of our relationship, when we faced fewer responsibilities, or perhaps when we first met. So, at a point of marital conflict, when we feel ourselves being pulled away from our connection to our spouse, we have a potential resource: we can bring into mind the old feelings of infatuation; these feelings can overpower our irritation and keep us close to our spouse, even if we don't have an answer for the current problem.

A psychologist would state this as such: a couple can build a loving marriage logically by being good to each other and appreciating each other's dedication. In addition, there must be moments of trans-rational, magical infatuation, if the marriage is to reach its full potential. That infatuation is fuelled by the couple's consciously building into their lives moments of shared joy.

Feeling lonely in your marriage? Constant fighting, arguing and bickering? Money problems keeping your apart? Or is jealousy ruining your intimacy?

Even the best of marriages experience times of trial, while some marriages seem doomed to constant ugly conflict.

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