As we mark the second anniversary of the seemingly endless global pandemic, let’s not allow it to eclipse International Women’s Day on March 8th, which doggedly rolls around year after year in the similarly seemingly endless march towards equality, justice and simple dignity. 

Some decades ago, when cigarette advertising was still legal in the US, the specially designed “women’s” smokes had the catchy ad slogan ”You’ve come a long way, Baby…” Well, maybe some, in the First World anyway, but we still have a long way to go. As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.

In 1970 pro tennis when male players were paid seven times (!) more prize money than their female counterparts (if women were admitted to compete at all!) and Billie Jean King fought for parity, it appeared as if female athletes were winning ground. Recent events like Chinese tennis player Peng Shuai’s “disappearance” and “silence” after speaking out about sexual abuse; or mysterious events surrounding teen Russian figure skater Kamila Valieva make me wonder.

As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.

Perhaps Valieva’s tumble is a fitting metaphor. Yes, we have a woman vice president and women are even driving now in Saudi Arabia, but as contemporary Peruvian author Sylvia Vasquez-Lavado recounts in her recent memoir, even in her short lifetime she learned early that making herself ugly was the only defense against the relentless sexual intrusions and obnoxious attention of any random man.

Because of my own interest in “mother-lessness” and motherhood, I chose to focus on that female issue because it can have such profound meaning and impact on development, trauma and neglect. I remember when I first started therapy in my 20’s, my mother railed “It is the blame your mother generation!” That is certainly not my intent. However, Vasquez-Lavado’s mother is a vivid illustration. 

In effect, “sold” into an arranged marriage at the age of 14; she had born three children while still a teen, until overwhelmed and overcome with tremendous shame and terror (and most likely dissociation), she fled. Vasquez-Lavado herself only learned her mother’s story years later, having always believed that the older relatives she thought were aunts and uncles, were her siblings. Of course, this all had a tremendous impact on her. 

Deception, a mother’s disrupted development: generations of mother-lessness begetting generations of mother-lessness. 

I have to wonder, with utmost compassion, what it was like for my mother growing up with my cold, upper-class intellectual grandmother. I believe there were a lot of nannies involved. And this, even before the explosion of the Nazi Holocaust.

Abortion

I was stunned and horrified when I heard the story on February 5th that a Salvadoran woman identified only as “Etsy” was released after completing ten years of a 30-year prison sentence. The crime: abortion. 

Well, they called it “aggravated homicide.” In El Salvador, abortion for any reason, including rape, incest, or danger to the mother’s health is strictly illegal. Still, in Etsy’s case it was an obstetric emergency that prompted her high stakes decision. Her release after ten years was a triumph of the international reproductive rights movement. 

I don’t know if Etsy already had children before going to prison. If she did, they were motherless for ten years, and Etsy, besides being robbed of a decade of her life in conditions that I hate to envision, would have been torn away from them, Not to mention the grief of losing a wanted pregnancy. 

This is all present tense. And as we all know, Roe v. Wade, the famous case that made abortion legal in the US in 1973, teeters on the precarious brink of survival.

Miscarriage

Etsy’s trauma hovered right at the interface between abortion and miscarriage. In El Salvador, the line is blurry between the two, and even women who suffer miscarriages and stillbirths can be prosecuted for murder. I could not find any other countries that criminalize miscarriage, but I did learn that in some other cultures, women who miscarry are viewed as “dangerous” or possessed of some sort of spell that would make them, at the very least a threat and thereby unwelcome at baby showers and the like.

How very sad! Their likely grief and loss is then compounded by social isolation and ostracization – rejection. All too often, women are blamed or stigmatized for miscarrying, and certainly, this trauma is poorly understood by most who have not experienced it.

I have seen numerous examples in my practice of women who lost wanted pregnancies grieving with profound and vacuous loneliness upon these traumatic losses, especially when their reproductive window may appear to be soon to close. Somehow our culture is clueless about miscarriage, not understanding it as the death of a beloved other. I guess perhaps we don’t know what to say. 

All too often, the grieving mother will hear something overly cheery like “you can try again…” or a quick jump to the joys of adoption, which may sound to the grieving “not-to-be-mother” like “this is no big deal,” or “there is nothing here to talk about,” or simply ”I don’t want to hear it.” The grieving one may then wonder if she is pathological or if her depression is exaggerated or self-indulgent. 

There may also be medical complications or hormonal shifts that make healing slow, difficult and again lonely. There are no sympathy cards. There is no funeral, in most cases no spiritual or religious marker, public or private—a lonely and poorly understood road. And when grief is complicated and traumatic, and there is a subsequent pregnancy, that child spends its early months of development in a womb still lost in grief, stress hormones and fears that it might happen again. We could certainly help those children and later, adults, by developing an understanding of how to support miscarrying mothers-to-be and also make it a safer and kinder world in which to talk about miscarriage openly.

I was troubled to learn that in Spanish, or certainly in El Salvador, there is no word for miscarriage. The same word is used to refer to miscarriage as to abortion: aborto. So the mother of miscarriage is categorically likely to feel like a “sinner.” My recommendation to those who learn that a loved one or friend has lost a pregnancy and who don’t know what to say, is to just say that! Just say, “I don’t know what to say, but my heart goes out to you.” That is what I always recommend when we don’t know what to say, as it is a way to communicate that my silence is not because I don’t want to talk about this. I simply don’t want to make it worse. And it may serve as an invitation to let you know what would perhaps help.

Motherhood

I knew when I was five that motherhood was not for me. I was such a profoundly sad and lonely child, I knew I did not want anyone to ever come into the world and feel like that, and I feared I could not do better. I did not speak of it, but I always knew. As I got older, and my mother would refer to couples we knew who chose not to have children as “too selfish.” So, I concluded that my undisclosed plan for myself was another indication of my badness or defectiveness, it was probably true about me too. I was all the more compelled to be “unselfish.”

As I got older and saw how excited others and later my friends were about having families, I grew to believe that there was perhaps something monstrous about me and unnatural in my preference. In my thirties, as my window of possibility was narrowing, I had the good fortune to have a consultant, Mardy Ireland, who had recently written a book on the subject. All these years later, I still highly recommend that book: Reconceiving Women: Separating Motherhood from Female Identity. 

Both Mardy and her book helped me tremendously to make my peace with my decision, which I have never regretted. I was also fortunate to partner with a man who was on the fence about children and therefore left it up to me. I am blessed with a wealth of nieces and nephews whom I adore, and the one thing that really endeared me to Tim Cook, the CEO of Apple, is when I read an essay he wrote on the joys of being an uncle. Being an aunt is one of the great pleasures of my life. I am good with that.

Admittedly I can slip into feeling that motherhood is an act of heroism and courage that I lacked. I must be mindful that when a client is grieving what she has not “accomplished” in other areas, that I do not miss the mark or intrude with my own formulation. And we all live or wrestle, like George Floyd in his final breaths, with a deep memory of the at least then, most important person in the world. In that spirit, I do say, thanks mom.

In the 1970’s Women’s Movement, we used to say Women Hold Up Half the Sky.

Happy Women’s Day to all.

Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is Madre by Silvio Rodriguez.

When the pandemic began, there was a crazy run on toilet paper. Oy vey! An African client told me about exclaiming to his mother, “I don’t get it about this toilet paper thing. Americans don’t know how to clean their butts!” He explained to me that in his country their custom is to wash themselves with special cloths. For him, the TP “shortage” was kind of a joke.

In a fancy hotel in Cuba, I was fascinated by the bidet. I had never seen one of those before. When I texted the picture to my dear friend who is well-traveled all over Europe, she was intimately acquainted with them. I had a Greek boyfriend who squatted on the toilet seat—a balancing act I had never seen anyone do before. Admittedly I tried and never pulled it off too successfully. How often do we see what anyone does in the bathroom?

When we were kids, our dad used to go to the bathroom to hide or read. He might be in there for an hour. There was only one bathroom in our little apartment, but we knew not to knock or disturb. And admittedly, sometimes the man-sized odors made us want to run for it…

How we move our bowels is another of those unspeakable body functions, and like sex, no one really knows what anyone else does. We all think we are supposed to know and that whatever might seem different from the imagined “normal” is a point of shame. With neglect, where the experience is “no one gives a s—”, there is even less information shared, and sometimes even potty training or something as fundamental as having one’s diapers changed is missing.

I recently learned that one’s bathroom routine or ritual is as personal and unique as one’s walk or signature. Not only culture and experience but individual style shapes it. The same is true for how one thinks about it.

How we move our bowels is another of those unspeakable body functions, and like sex, no one really knows what anyone else does. We all think we are supposed to know and that whatever might seem different from the imagined “normal” is a point of shame.

Historically Speaking

Historically, humans have not been so squeamish about bowel function. In fact, before the heart was thought of as the “seat” of emotion, it was the bowels. In the Song of Solomon, one of the great love missives of all time, Solomon wrote:

“My beloved put in his hand by the hole of the door, and my bowels were moved for him.”

Voltaire was credited with saying:

“Persons who have an easy movement in the morning are the favorites of nature. They are sweet, affable, thoughtful, gracious and efficient. No words have more grace than a yes in the mouth of the constipated.” (Wow!)

Oscar Wilde’s Lady Chatterley “moved her bowels for the gatekeeper.” It would seem that Des Cartes’ mind-body split might have been a factor.

On the flip side, I remember one of the most rejecting insults a kid could make was, “I hate your guts!” That would imply something pretty essential.

Not long ago, I had a client extremely hesitantly recount not one but two recent episodes of leaking stool. (This same client had suffered an agonizing months-long bout of treatment-resistant constipation: a hideous parade of miserable visits to a spectrum of practitioners. I can’t remember how it finally remitted. It seems so long ago now.)  

The recent “leak” was just “a little bit,” but she was horrified. Post-menopausal, it had happened twice over a period of several years. It was a push to reveal it, or expose herself that way, even to me. She was surprised to learn that it is a not uncommon fact of aging.

I was similarly blindsided by the advent of urinary incontinence when I got into my 60’s. No one had warned me that is a not uncommon side-effect of menopause. I learned the hard way after being surprised by a flood, thankfully in the privacy of a gym locker room. It was a blessing that men may readily experience the same thing, and my husband knew every bathroom in the Bay Area for our longer bike rides.

I had another client once, an attractive sixty-something woman, impeccably dressed in Chanel suits, perfectly accessorized with Louis Vuitton bags, who matter-of-factly reported “fecal incontinence.” She was not alarmed about it, and she was not a child of neglect. It was a simple element of aging that one had to take precautions to manage—no big deal.

Constipation

I learned long ago that constipation is generally a communication of fear and terror. We have all heard the term “scared s—less.” In fact, when a mammal is under threat, and of course this includes us, priority goes to the survival functions of fight and/or flight. We don’t have the luxury of being able to commit energy to a “non-essential” body function like digestion. So that may stop for a while until the danger passes and the body returns to whatever homeostasis or regulation is possible for that organism or person.

Interestingly for humans, 30-40% of our energy is consumed by digestion. The Latin cultures have the right idea by observing siestas after their main meal, although I don’t know if they do that anymore.

Clearly, constipation can be a clear communication from the body of fear and terror or the body “speaking” to us about what is not consciously known or felt. A challenge of healing is learning to listen to these nonverbal utterances, and as parents, teachers, therapists and citizens of the world, making it safe and acceptable to speak out loud about body functions: dispelling the shame.

I remember “constipated” as being an insulting euphemism for “uptight” or not forthcoming. (“Anal” was used the same way.) It can, however, be essential information that informs treatment planning. It is certainly a point of inquiry or a marker of hyperarousal when doing neurofeedback assessment.     

Laxative abuse, or manipulating the digestive function, can be a symptom of or an eating disorder in its own right. As with sex, we must learn to listen and learn to speak with respect and curiosity, without taboo, shame or jest, about functions and dysfunctions that we all share.

It appears that Japan is ahead of us in this way. I discovered a “poop’ or “unko” museum.

Unfortunately, I cannot read Japanese, so I am not sure how to visit the virtual venue. But it is cheerful and natural and worth having a look at, at least to me. Like Voltaire, it portrays an “easy movement” as cause for celebration. Why not? Cheap thrills for the regulated? Another incentive for regulation? At the very least, an indicator of regulation and progress in recovery from trauma and neglect.

My husband’s grandfather was known for saying, “Never pass up a chance to fill your stomach or empty your bladder.” We might make an addendum to those words to live by!

Addendum: Poop in a Box

The recent ‘poop’ blog brought such a response that due to popular demand, I wanted to add one more little piece. Many with trauma and/or sexual trauma receive their doctor’s prescription for colonoscopy with dread and paralysis. In the US, it is recommended to get one regularly after age 50 for early detection of colon cancer, but many simply do not do it.

After I was 60, I finally took the hint. With a history of cancer in my family, this was not smart! I learned to my relief that I could fill the prescription with a ‘poop in a box’ system prescribed by my doctor. The specially designed box was delivered by FedEx and came with all the necessary instructions and accouterments. FedEx also picked it up, and it was done and gone. Poof, wiped away! I imagine for some medical conditions, and also in some geographic areas, it might not be available. However, maintaining health and safety while navigating trauma healing is a balancing act already. It may be worth looking into.

And because I can’t help myself, I will add that a ‘high point’ in Everest climber Silvia Vasquez-Lavado’s recent book In the Shadow of the Mountain, to be reviewed in a future blog, is when she not so happily poops at the cruising altitude of 30,000 feet! You can look forward to that! 

As we used to say in junior high, “hope everything comes out alright!”

Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is People Like Us by Talking Heads.