Review – Mindsight

Mindsight: The New Science of Personal Transformation

by Daniel J. Siegel, MD, published 2010

Triune brain

Vertical integration, bottom to top

brainstem, regulates energy, fight-or-flight response, generates “drive” w/ limbic

limbic region, generates and evaluates emotion, forms relationships, “story-telling” experiences

cortex, 3D mapping and sensing of reality, conceptualizing, meta-thought

Horizontal integration (bilaterality)

left

right

Prefontal cortex functions:

1. bodily regulation, sympathetic (speed up) and para-sympathetic (slow down)
2. attuned communication, alignment of emotional states
3. emotional balance, appropriateness of emotional response, resilience in extremes
4. response flexibility, pausing to think before acting
5. fear modulation, cortical override of amygdala-driven fear
6. empathy, abbility to see from other’s point of view, you-maps
7. insight, connecting past, present and future, me-maps
8. moral awareness
9. intuition, connection of visceral data to rational decision-making

The Tripod of Reflection:

1. Openness, avoiding “should”, embracing “is”
2. Observation, placing the self in a larger context than just the moment
3. Objectivity, not personifying one’s thoughts or emotions as identity

Eight Domains of Integration:

1. Consciousness
2. Horizontal (left and right brain)
3. Vertical (senses, head to toe, brainstem, limbic and cortex)
4. Memory
5. Narrative
6. State
7. Interpersonal
8. Temporal

Secure attachment to parents largely driven by the parents’ autobiographical narrative of their own upbringing

Adult & Child Attachment

Adult Narrative, Infant Strange Situation Behavior

Secure, Secure

Dismissing, Avoidant

Preoccupied, Ambivalent

Unresolved/disorganized, Disorganized/disoriented

Review – Feeling Good

Feeling Good: The New Mood Therapy

by David Burns, published 1980, 2008

This post is less a review of the book and more an exploration of its major philosophical principles and techniques.

Major Principles

All your moods are created by your cognitions, or thoughts, including:

• perceptions
• mental attitudes
• beliefs
• interpretations

When you are feeling depressed, your thoughts are dominated by pervasive negativity which infect all of your experiences, including:

• reflections on the past
• experience of the present
• projections/expectations of the future

Negative thoughts at the heart of emotional turmoil almost always contain gross distortions, therefore:

1. gains in objectivity of thoughts translate to elevated mood
2. the most crucial predictor of recovery is a persistent willingness to exert some effort to help yourself
3. it is a part of the human experience to be periodically upset, “getting better” means systematically employing CBT methods to master thoughts and moods over the course of a lifetime

Diagnosing Your Moods

You can use the Burns Depression Checklist (the author’s proprietary list of indicators of depressive thinking) weekly to chart the progress of your depression’s severity. This is important because it introduces objective data into your self-experience. By seeing the change in data over time as a result of specific action, you can break the allure common to all depressive episodes that the present experience is likely to continue on indefinitely, or only get worse.

Understanding Your Moods

Depression is not an emotional disorder, it is a disorder of thoughts.

Practice noticing the negative thought you had just prior to your negative feeling. This will help you generate awareness about the specific “triggers” that instigate a depressive mood. You will begin to notice that right before you feel downcast, you have made a critical or despairing assumption about yourself or other people.

One argument depressed people make is that their depressive mood is an accurate reflection of a depressing reality. However, emotions do not happen automatically based upon experiences, but rather experiences are processed in the mind and filtered through pre-existing thoughts before being translated into an emotional state. Therefore, if your understanding of reality is normal, your resulting mood will be normal; if your understanding of reality is distorted, your mood will be distorted as well.

Thinking you are the one “hopeless”, truly flawed person in the world is a sign of distorted thinking. This is a belief based upon fallacious logical thinking rather than an objective, existent fact about reality knowable to all.

In its essence, depression is a highly credible form of faulty faith in a reality that doesn’t exist. Truly, the cure for long-lasting depression is a “scientific mind” determined to observe and examine reality using sound logical principles.

The 10 Major Cognitive Distortions

Depressive episodes are triggered by one of ten common cognitive distortions, or fundamental logical fallacies embedded in the assumptions and thinking of the depressed individual:

1. All-or-Nothing Thinking, a form of perfectionism
2. Overgeneralization, believing a single instance is an inevitable pattern
3. Mental Filter, focusing on the negatives, ignoring the positives
4. Disqualifying the Positive, turning positive experiences into negative ones by rationalizing why it was luck, a mistake or otherwise unrepeatable or undeserved
5. Jumping to Conclusions,
   1. mind reading, convincing yourself others harbor negative thoughts or evaluations without checking it out
   2. fortune-telling, imagining something bad will happen without evidence or probability
6. Magnification and Minimization, creating a sense of inferiority by catastrophic thinking about flaws and mistakes, while downplaying strengths or achievements
7. Emotional Reasoning, confusing a negative feeling with a factual truth about reality
8. Should Statements, frustrating yourself by comparing yourself and others to a perceived ideal rather than accepting reality as it is
9. Labeling and Mislabeling, confusing your identity with a single action or perpetual state of being
10. Personalization, taking responsibility for things that have nothing to do with you, or are outside your control

Sometimes people experiencing depression worry that if they do not experience the grief and upset feelings of depression, they will not be living authentically. Getting in touch with and expressing valid emotions based upon valid thinking, is a form of emotional maturity; expressing invalid emotions based on invalid thinking is a personal and sometimes social problem that is not at all desirable. Emotional growth and development involves ridding yourself of invalid thinking and the harmful, deluded and invalid emotions that come with it.

Defeating Do-Nothingism

In a depressive state of mind, it can be difficult to summon the determination, motivation and interest in moving one’s goals and life plans forward. Using the major principle mentioned earlier, it is important to consider what kind of self-critical triggering thoughts precede this unwillingness to act. When you are suffering “do-nothingism”, consider the following as a new mental habit:

When I think about an undone task, what thoughts immediately come to mind?

You are likely to find that these thoughts are filled with the logic of futility, hopelessness and general nihilism and discouragement.

Common Mindsets that Yield Action to Inaction

Here are some common cognitive distortions that precede do-nothingism:

1. Hopelessness, the present pain is overwhelming and obstructs your ability to imagine an improved future
2. Helplessness, something other than your own actions stands between you and achievement
3. Overwhelming Yourself, you must do the whole tasks all at once, making it impossible
4. Jumping to Conclusions, assuming without testing to find out
5. Self-labeling, convincing yourself you’re fundamentally incapable by labeling yourself as such
6. Undervaluing the Rewards, the payoff is so small, why bother?
7. Perfectionism, preferring no progress to some progress
8. Fear of Failure, it isn’t worth an attempt if the potential to succeed lies in doubt
9. Fear of Success, you won’t be able to continue after your initial “luck”, so you don’t bother
10. Fear of Disapproval or Criticism, you will be judged harshly by others for your attempt
11. Coercion and Resentment, you are being forced to do something rather than choosing to do it for yourself
12. Low Frustration Tolerance, or Entitlement Syndrome, it should be easy to succeed, if it’s not easy, you must not be made out for success
13. Guilt and Self-Blame, punishing yourself over past perceived mistakes

You may notice that many of these cognitive distortions are simply “inaction-specific” versions of the earlier list from above.

Dealing With Anger

Anger is a common aspect of many depressive episodes. As depressed people tend not to carry out the values of their lives into action, they often experience frustration, resentment and anger about the seeming futility and malaise of their life, particularly when they are in touch with or aware of their latent talents and abilities. Anger is often directed outward at others as an expression of the pain within.

When you label someone, you tend to apply a mental filter that results in disqualifying the positive as you emphasize their poor traits and ignore their good ones. Labeling gives way to blame, blame leads to vengeance. Ironically, you can not enhance your self-esteem by attacking someone else’s, so this act of labeling and attacking the character of others in anger proves doubly harmful.

Mind-reading also leads to anger as you will tend to attribute false ideas and motivations to the other person’s behavior.

Magnification of the original negative event will cause greater than necessary pain and cause the pain to linger longer than it must.

Should/should not statements generate entitled beliefs and entitled thinking leads to resentment and frustration with other people as well as the self.

The perception of unfairness or injustice is the ultimate cause of anger. It is the emotion that corresponds 1:1 to your belief that you are being treated unfairly. Significantly, there is no universal standard for fairness or justice, only different ethical systems based upon tradition, circumstances and logical rationalization of self-interest and specific harmony.

Arguments over who is “right” are fruitless and unresolvable.

Some anger is healthy in motivating change. But to determine if your anger is motivational or de-motivational and depressive, consider these two criteria for anger:

• is it directed at someone who knowingly, intentionally and unnecessarily acted in a hurtful manner?
• is my anger useful? Does it help me achieve a desired goal or simply defeat me?

Techniques for managing anger:

• use the double-column technique to explore advantages and disadvantages of feeling angry and engaging in retaliation
• one you’re ready to calm down, use two column “hot thoughts” versus “cool thoughts” to explore angry versus rational thinking
• rewrite your “should” rules to break free of entitled thinking
• change your expectations of others, allow yourself the opportunity to see their behavior as predictable and not surprising
• try empathy, see the world from your oppressor’s eyes and understand how what they did made sense and wasn’t personal

Examing Depressive Thinking

Some people are so depressed, all they can do is carry their whining and complaining with them everywhere they go. How do you deal with a whiner? Try the Anti-Whiner Technique– when someone complains, agree and compliment, don’t try to help. People who whine never want help solving their problems, they are looking for validation and security from others that their pain is real. By offering solutions, you unwittingly end up sending the message to the whiner that they’re incapable of helping themselves, are being victimized by reality and thus should continue whining!

There is no such thing as a “realistic” depression, although there are realistic reasons for temporarily feeling sad. Consider these two ideas about “realistic” depression:

• sadness follows real loss or failure, is temporary and never impacts self-esteem negatively; this is a “realistic” depression
• depression follows flawed or distorted thinking, is recurring and stems from/causes a loss of self-esteem; this is an “unrealistic” depression

Preventing future depressions:

1. understand why you got depressed (many people never graduate beyond this step because they spend their entire lives in some form of depression!)
2. know how and why you got better; what techniques were effective?
3. acquire self-confidence and self-esteem
4. locate the deeper causes of your depression (many people suffer recurring depression because they never bother to understand what kind of life experiences have made them vulnerable to depression, so they can be on guard against repeating these experiences or the harm of taking the wrong lessons from them)

Downward Arrow Technique, used to mine automatic thoughts for “logical consequences” of silent assumptions, the residue of recurring depressive episodes; then “talk-back” is used the challenge these beliefs.

Taking Action Against Depression

What problems do you face? How are you solving them? This is where the action is, not “worth” or “true self”.

People can spend their whole lives trying to get beneath their depression to an authentic understanding of self when really the difference between a depressed person and a non-depressed person, ultimately, is a willingness to take action to solve one’s own problems.

Why treat yourself in ways it would be rude or uncomfortable to treat others? Encourage yourself to identify your problems and create strategies for resolving them. In taking action, you’ll find your own capability and begin to let the depression go.

Fighting perfectionism:

• make a list of pros and cons
• ask yourself if the standard could ever be realized
• use response-prevention technique and ride the discomfort of not checking
• become process-oriented, which is in your control, rather than goal-oriented, which is not
• unwillingness to make mistakes leads to lack of risk-taking; write yourself a note on the value of making mistakes
• take ownership of your mistakes and assert your right and necessity to make them to keep growing, to yourself and to others

Curated Sage Motherhood Advice (Running List)

 

1. “Babies are not meant to sleep alone.” – local La Leche League leader
   • I had asked at a meeting when Little Lion was nine months old, “How the heck do I get him to nap by himself?! He wakes five minutes after I leave the room!!”
2. “There is so much going on in their first year, especially towards the end of their first year, do not worry about weaning. All babies will wean eventually, when they are ready.” – local La Leche League leader
   • Another attendee had asked, my 11 month old STILL isn’t showing any interest in weaning, is that okay?!
3. The saying “eating for two” doesn’t really apply during pregnancy but rather AFTER childbirth and you’re breastfeeding! – myself
4. “Cool as a cucumber.” – fellow RIE parent and good friend
   • When we were discussing how to handle babies testing boundaries
5. “Do NOT get sucked into their vortex.” – Regalena Melrose
   • In reaction to her son throwing his first tantrum. Use in combination with previous mantra.
6. “This goes out to all the new mamas: you will be so scared of your baby growing too fast and yes, it will grow fast. But let me tell you: each phase your child passes through is beautiful in its unique way and incomparable to what you know. Getting to know your tiny human is the most beautiful job in the world and every step will be rewarded along the way. Enjoy every second of being a mother but never fear the future; embrace it for it gets more exciting and beautiful every day.” – @jojoula
7. “Be happy in the moment. That’s all we need. Each moment is all we need, not more.” – Mother Teresa
   • When I feel rushed or overwhelmed, I try to remind myself that… This is only a moment, and one day, I will wish to return to this moment to handle it better or to enjoy it more or whatever, and I won’t have that chance, so I only have the NOW to handle it better or to enjoy it more or whatever!

Review – The Drama Of The Gifted Child

The Drama of the Gifted Child: The Search for the True Self

by Alice Miller, published 1979, 1997

Recently I was discussing economic and social philosophy with some friends and the question came up about why certain philosophical ideas aren’t more popular or well-known if they seem to be more logically correct than the alternatives. We entertained a number of reasons why this might be but the one that stuck out to me as particularly weighty is the idea that the truth is deep, long and heavily nuanced and doesn’t make for quick, emotional soundbites. I made the quip, “Why is the economy the way it is? Do you have 5 years to study what you’d need to know to understand it?” followed by, “Why does the political system look as it does today? Do you have an entire lifetime to devote to studying all of human history?”

The other weighty suggestion that was offered is that there are many philosophies that cater to telling people what they want to hear (ie, an easy to accept reality) and only one that emphasizes telling it like it is (ie, a hard truth about reality).

I see echoes of these two notions in the opening of Alice Miller’s “Gifted Child”:

The damage done to us during our childhood cannot be undone, since we cannot change anything in our past. We can, however, change ourselves. We can repair ourselves and gain our lost integrity by choosing to look more closely at the knowledge that is stored inside our bodies and bringing this knowledge closer to our awareness. This path, although certainly not easy, is the only route by which we can at last leave behind the cruel, invisible prison of our childhood. We become free by transforming ourselves from unaware victims of the past into responsible individuals in the present, who are aware of our past and are thus able to live with it.

Most people do exactly the opposite. Without realizing that the past is constantly determining their present actions, they avoid learning anything about their history. They continue to live in their repressed childhood situation, ignoring the fact that it no longer exists. They are continuing to fear and avoid dangers that, although once real, have not been real for a long time. They are driven by unconscious memories and by repressed feelings and needs that determine nearly everything they do or fail to do.

This book asks the reader to consider two troubling ideas. The first is that they are likely to be carrying some emotional baggage from their childhood that originates with the way they were cared for by parents and other important adults in their lives. The second is that they are likely to transmit this baggage to their own children (if they have any) and other important, intimate relationships if they don’t find a way to come to terms with it beforehand.

Like the consideration made about the popularity or penetration of certain economic and social philosophies, these ideas are troubling for most people to accept because it forces them to revise their current understanding of the relationships they have with important people in their lives, it forces them to take responsibility for the course of their lives and their choices and give up the perverse safety and security of seeing life through the eyes of the helpless victim and it forces them to concede that the present is not a unique or isolated moment pregnant with infinite possibilities, but rather one moment at the end of a string of moments stretching back into the earliest reaches of human history in which possibilities exist but are limited by certain choices and events which took place in the uncontrollable past.

There is of course great freedom in choosing to explore these troubling ideas but they come at the cost of a grave responsibility that few, based on my practical experience, seem willing to bear.

To find this freedom, one must seek out “the lost world of feelings.” Human infants are entirely dependent upon their adult caretakers for their survival, unlike most other animals who, while weak and undeveloped, are nonetheless able to move around, seek shelter, find food, etc., on their own almost immediately after birth. For a young human, being ostracized or unloved by ones parents is a death sentence. Therefore, the human psyche is wired at birth to prioritize adapting to the parents’ emotional needs over fully developing its own.

If certain emotional expressions or behaviors prove to be problematic for the relationship with the parents, the human child will work to repress and hide that part of themselves. They will disown it and their personality will become dichotomized into “me”, the feelings and behaviors and characteristics I acknowledge and accept because they have demonstrated value with my parents, and “not me”, the feelings and behaviors and characteristics I deny possessing or experiencing because they have been a source of conflict with my parents, on whom I depend for survival.

This is what Miller means when she talks about searching for the “true self.” The irony, however, is that

the child does not know what he is hiding.

That is, it is not as if the child knows what his true self is and isn’t and is lying to himself and others about who he really is. It is more like, he has shoddy vision and can’t see a focused image of himself in true detail, or else he has a map of himself leading to the buried treasure of his own reality but he doesn’t know how to read the map and therefore doesn’t know where his self is or even what he’ll find when he gets there. Every now and then this person might get a glimpse or a sense of their true self in a particularly emotionally charged moment but really all they’re experiencing is the anxiety indicating the existence of repressed and disowned selfhood, not a look at what is missing.

To heal, these emotions must be encountered and experienced. Further, painful emotions must be resolved by tracking down their genesis in early childhood experiences. Memories and relationships with respected and important adult caretakers must be studied and re-evaluated through the more objective eyes of an independent adult rather than the way they were first constructed by a subjective and immature child. This not only allows the adult of the now to be released from the terrors of the former child but it can enable the adult to have new modes of living and doing:

Rational, constructive action depends not only on the intactness of our intellectual faculties, but also on the extent to which we have access to our true emotions.

[…]

the inescapable conclusion is that for people to be able to organize their lives, they must have access to their emotions.

This is one of the many and for me, the most important, takeaways from this book. It is not enough to rationalize about a choice and a potential plan of action. To actually develop an impetus to act requires an emotional experience. Adults who repress certain parts of their emotional selves due to childhood traumas become incapable of acting in certain areas of their lives. They become procrastinators, perfectionists or otherwise evasive in the area of making a decision, acting on it and then sticking with it.

By finding and integrating one’s lost world of feelings, one has the opportunity to become active and empowered in new areas of one’s life that were otherwise mysterious, frustrating or dormant.

One question that comes up for some people as they consider all of this is, “But why did my parents ever treat me in such and such a way?” Using some of the memories and recollections of a famous cultural writer as an example, Miller says,

like so many gifted children [he] was so difficult for his parents to bear not despite but because of his inner riches. Often a child’s very gifts […] will confront his parents with conflicts that they have long sought to keep at bay by means of rules and regulations. These regulations must then be rescued at the cost of the child’s development.

The parents’ childhoods involved repression as well. For their own survival they learned to disown parts of their emotional experience or certain of their behaviors that caused trouble with their parents. They rationalized this turn of events and created rules for living that would help them avoid these perceived dangers. And then when they had children, these rules and procedures came into question by the existence of the innocent child. And so a new round of repression is started.

The only way the cycle can be broken is for the adult to make the painstaking effort to connect with his child self and understand what happened and how it has impacted him, and then he must choose to live his life differently with that new awareness of his past. This is hard for many to do because

What they do not see, because they cannot see them, are the absurdities enacted by their own mothers when they were still tiny children.

Another powerful idea contained in this book is an explanation of the appeal of irrational ideas to adults with traumatic childhood experiences. The trauma of childhood is itself irrational– there is no “reason” for any child to be abused or neglected by those who brought it into the world, and save those who are simply unlucky in having some external misfortune befall their family (ie, the child is made an orphan when the parents die unexpectedly), there is no excuse or justification the adults could offer a child as to why they are being treated as they are. For survival reasons, the child must make a place in their psyche for irrational ideas to exist because in doing so they “close the loop” on the irrationality and make it seem rational. “Some things just don’t make sense” is a way to make sense of things that don’t make sense.

When this space for irrationality exists, adults can become wedded to irrational ideas and beliefs, such as political ideologies, abusive social relationships or supernatural superstitions. On one hand, they lack the ability to rationally resist these ideas and beliefs because they are willing to accept that not everything has to make rational sense in their lives. On the other hand, they may positively identify with the claims of these ideologies because they appeal to their own experiences or sense of self as a victim who is oppressed by others, that is, they offer a way to feel like they’re getting even. On this point Miller is worth quoting at length:

Oppression and the forcing of submission do not begin in the office, factory or political party; they begin in the very first weeks of the infant’s life.

[…]

Political action can be fed by the unconscious rage of children who have been misused, imprisoned, exploited, cramped and drilled. This rage can be partially discharged in fighting “enemies”, without having to give up the idealization of one’s own parents. The old dependency will then simply be shifted to a new group or leader. If, however, disillusionment and the resultant mourning can be lived through, social and political disengagement do not usually follow, but our actions are freed from the compulsion to repeat. They can then have a clear goal, formed out of conscious decisions.

Once our own reality has been faced and experienced, the inner necessity to keep building up new illusions and denials in order to avoid the experience of that reality disappears. We then realize that all our lives we have feared and struggled to ward off something that really cannot happen any longer; it has already happened, at the very beginning of our lives while we were completely dependent.

The term “fighting yesterday’s battles” comes to mind when thinking about this irrational space.

While Miller’s analysis applies to any child and any adult experiencing emotional pain and depression (whether they’re aware of it or not!), the book is especially focused on the plight of “gifted” children because of the uniquely problematic experience they can have in this area due to their talents and abilities. Not only do “gifted” children tend to experience these emotional troubles more deeply,

many people suffering from severe symptoms are very intelligent

but they also tend to experience these troubles uniquely through feelings of grandiosity and contempt.

Grandiosity is the concept of identifying one’s personal value as a person with one’s special talents and abilities. One’s greatness isn’t just a part of one’s self, it IS the self. But this complicates the emotional life of the gifted child because it is inevitable that not every part of themselves is grand. There exists then another dichotomy, wherein all the parts that are grand (which may be very few and overall represent a quite limited part of the total person or experience of self) are “me”, and all the parts that are normal or weak (which is likely then the majority and the wider experience of self) are “not me”. And if my parents love and care for the grand gifts I have but dislike or don’t know how to deal with the unexceptional aspects of my self, then

we remain at bottom the one who is despised, for we have to despise everything in ourselves that is not wonderful, good, clever… we despise… in short, the child in ourselves and in others.

[…]

“Without these achievements, these gifts, I could never be loved. would never have been loved.”

An emotional experience that often goes hand in hand with grandiosity is contempt.

The function all expressions of contempt have in common is the defense against unwanted feelings. [ie, despising what is not grand about oneself]

[…]

Once we are able to feel and understand the repressed emotions of childhood, we will no longer need contempt as a defense against them.

[…]

Contempt as a rule will cease with the beginning of the mourning for the irreversible that cannot be changed… it is, after all, less painful to think that the others do not understand because they are too stupid.

Gifted people often experience contempt for others as an expression of insecurity about the repressed parts of themselves that are not part of their gifts. Unable to have empathy and kindness towards themselves in these areas, they become impatient and hostile towards those reminders of their own weakness that they see in others.

Sadly,

hating and offending an innocent person, using him as a scapegoat, can only strengthen the walls of our inner prison of confusion, isolation, fear and loneliness: it cannot free us.

And the most innocent person of all, the most unfair scapegoat a person can choose in this drama, is their child self. Whether these ideas are new or familiar, I encourage anyone reading this to consider the implications of the ideas contained in this book not as if they describe a set of generalized human experiences but rather as if they describe something specific and personal to the reader himself. If this book’s message can be taken to heart and internalized, it can be the jumping off point for great personal change that will ultimately resolve itself in what Miller refers to as a “healthy self-feeling”:

I understand a healthy self-feeling to mean the unquestioned certainty that the feelings and needs one experiences are a part of one’s self.

 

Looking Back On A Year Gone By

To Our Little Lion,

The allusion to a New Year reflection post is intentional, as is the suggestiveness of the title that time is moving past us at a regretfully quick speed. Although the first few weeks and months of your life you were changing every single day, the change appeared more gradual and more difficult to notice. Around six months, the pace of change accelerated and after a year you are already entering your personhood and the volume of change occurring is almost impossible for us to note with any detail.

Whereas in the past I sought to document some of the specific observations about your behavior and development that stood out to me, this time I want to share with you about an episode along the way which was particularly trying for the Wolf and me. I want you to understand what happened and how we came to our decision. Finally, I want to do some reflecting but not about you, rather, about us.

When you were born you had some trouble forming a proper latch when you were nursing. It took us several months to figure out that you had a minor and surgically correctable condition called a “tongue tie”– essentially, the fibers underneath your tongue connecting it to the floor of your mouth were a bit too taut for you to control your tongue the way you need to to make breastfeeding easy for you and your mother.

Eventually, with the help of some of our medical consultants, we realized what was going on and had the short (2 minute) procedure performed at a local dentist’s office. However, it took some time afterward for you to develop the strength and dexterity in your tongue necessary to nurse without difficulty. For five or six months, the Wolf was completely dedicated to pumping her milk for you which was then fed to you in a bottle. She had to do this six to eight times a day, for twenty to thirty minutes at a time, and then you had to be fed afterward. It was very hard for her and she was very sad and even angry at times as she learned to accept her choice, which was to provide you with a diet that was largely (75%+) still her breast milk — “the best milk” — even though you couldn’t get to it on your own by nursing. She made that choice because she believed you really needed her and it was important to your immunity, your brain and body development and long-term, your intelligence, health and well-being. It was a difficult challenge, and it was an opportunity for her to form an even stronger bond with you.

Eventually you gained the strength and ability to resume breastfeeding. You were taken back off the bottle and formed the relationship through nursing with the Wolf that she had hoped to have with you from day one. It was a great relief to realize she could give up the pumping routine and just enjoy feeding time with you like that… we were concerned it might never be possible.

Unfortunately, it took us some time early on to understand what was going on with your feeding and during that time you were undernourished. Then, as we made adjustments, you rapidly began gaining weight and strength. Perhaps because of this, your gross motor development was different than the average infant and you were considered, on a relative basis, to be slow to develop your sitting and crawling.

Because of the trying ordeal with your feeding early on, the Wolf and I decided it was important to get more checkups with your pediatrician than we otherwise would bother with because our principle is to not visit with medical professionals unless something seems to be wrong. At the time of this visit, nothing seemed to be wrong, just the opposite, you seemed very happy, healthy and growing every day. But we were fearful because of our early experience and we wanted to be sure. So your mother took you in for a checkup.

The visit with the doctor was uneventful until the pediatrician noticed you were not sitting up. She became extremely alarmed and said that this potentially indicated a major problem for your health and that you needed to be screened by specialists right away. She didn’t offer many other details beside that and was not willing to entertain questions or curiosities from your mother and me. She claimed she had never in her practice seen a child your age not sit up on their own.

To say this was hard for us to believe would be an understatement. I began calling some of the screening agencies she recommended and tried to understand what it was they wanted to do with you and why it was necessary. I tried to get names and contact information for the specialists who were actually knowledgeable about the specific concerns the pediatrician had for you so I could consult with them directly and skip a step. The more I dug, the more confusing the process we were referred to appeared to be and I began losing confidence in the pediatrician’s recommendation.

Your mother and I spent a three week period feeling absolutely awful. We were worried for you. We felt alone and vulnerable, not understanding what was apparently wrong and not having anyone in an authoritative position we could turn to to just ask questions. We were leaning towards taking the pediatrician’s concerns seriously, after all, we had been wrong in not recognizing your earlier nutritional challenges. On the other hand, it was hard to avoid the sense that we were facing a choice of believing her or our “lying eyes”, as you seemed otherwise to be a cheerful and ever-changing infant.

It seemed like a defining moment for us, and for you and for our relationship with you– to begin to see you symptomatically, as somehow “wrong” the way you were, or to have faith that if you were not showing signs of distress or pain you would develop in due time in your own way and that would be fine.

We did manage to visit with an occupational therapist for a consultation, skipping the strange screening process that was recommended to us. The occupational therapist observed you for a half hour and told us that she saw nothing to be concerned about, that she believed you would learn to crawl and sit up with time and that we could choose to work with her to accelerate the process through therapy if we liked. She seemed confident but we still had some uncertainty, what if you did not? What if there really was a problem and you got further and further behind developmentally, whatever that meant?

Ultimately we decided to wait. The very week the pediatrician raised the alarm you got yourself into a crouching (pre-crawl) position on your own, without any encouragement or assistance from us. Your body just told you to do that. As the weeks went by, your crawling changed and you began pulling yourself up against furniture. Eventually you sat up on your own and began playing and manipulating objects in that position. Today, you are on the verge of walking, spending more and more time every day pulling yourself up on furniture and ledges and practicing standing. It’s clear your body just keeps telling you to try this and you are gaining strength and confidence with each attempt.

In hindsight, there was nothing to worry about. You got there and you are getting there, on your own, in your own way. What might’ve been a disastrous path toward treating a “condition” that didn’t exist and becoming the ward of a variety of specialists and other agents that have no business interfering with your health and development at worst, or a subtle transformation in our own perception of you as somehow “flawed” and not okay as you happen to be at best, is instead an already seemingly distant but painful memory. As difficult as it was to go through, it certainly has given the Wolf and I increased courage to be patient with you and to look to the good in you, to focus on what you are capable of right now and what’s going well for you than to dwell on what you can not yet do or to focus on potential items of worry. It has consequently reduced our stress as parents a great deal to have experience to back this mindset.

So now, a reflection about us as parents.

When I watch other people interact with you, I am always surprised to see how much of what they do and say seems to be about them than about you. What I mean by that is, they seem to be playing out their needs and you are an object utilized in the goal, rather than they are thinking about your needs and treating you as the subject of a relationship they have with you.

What seems to be true of them could of course be true of us, your mother and father. And its something I think we need to be the most mindful of in our interactions with you.

Many people conceive of parenting as a project in filling up an empty vessel. Whether that vessel is to be filled with love, values, knowledge, experiences or anything else, the implicit idea is that the child is empty and the parents’ job is to put things in. The result is a “full person”, a wholesome, well-balanced individual.

We think you’ve got almost everything you need to be who you are. It’s inside of you, just waiting for the right time and place to come out. We can feed you, clothe you and care for you in any other way you need us but the real development work is done by you, not by us. In fact, we can interfere and get in the way of your natural development quite easily, but it is difficult to impossible to think of ways we could improve upon it.

The ways in which we would be tempted to interfere would be the ways in which we feel incomplete as ourselves. What we want to pour into you are the things we wish we were in touch with ourselves. If we feel empty in these ways it becomes more likely that the time we spend together is less about getting to know who you are and more about getting to know the distant parts of ourselves. The danger is that we use you like an object on this quest for self-knowledge.

The true heavy-lifting we can do as parents is to keep working on ourselves. If we can model whole, complete, satisfied individuals to you through our own lives, we give you an aspirational development goal that is in alignment with our parenting goal. If we spend at least as much time working to become the best versions of ourselves we can be as we do trying to be “better parents” with more tips, tricks, techniques, tools, knowledge, experience, values, resources, etc., we will be of far more value to you as you grow than we would be if we convinced ourselves that giving you things or putting things into you could make up for the existential emptiness we demonstrate to you with our daily lives, lives you are intimately aware of because you are right beside us the whole time.

What’s interesting about this for us to realize is that this is actually best for us, too. But since our goal is to live with empathy and look for ways to cooperate it maybe shouldn’t be surprising that what’s best for you is also best for us.

Review – Baby-Led Weaning

Baby-Led Weaning: The Essential Guide to Introducing Solid Foods-and Helping Your Baby to Grow Up a Happy and Confident Eater

by Gill Rapley, Tracey Murkett, published 2010

If you pay close attention to certain parenting and child development texts, you are likely to notice one of two paradigms at work– the exogenous development approach and the endogenous development approach. Those are fancy words I just thought up to say something simple, which is that you either believe children can develop pretty well on their own, with parents simply playing a nurturing, supporting role; or else you believe that children are mostly helpless to develop on their own, with parents playing a primary, directorial role.

The idea of “Baby-Led Weaning” (BLW) falls firmly into the endogenous development model, along with other philosophies we fancy such as RIE for parent-infant communication and relationship building, self-esteem centered personal growth philosophy, Montessori for educational and pedagogical practice, and nutrition-based health and well-being (ie, vaccine-skepticism). People who take the BLW approach to transitioning their infant to solids, aka “adult food”, see linear continuity between the infant’s ability to feed themselves at the breast and the later skill of the toddler being capable of feeding themself at the table. The BLW user asks the question, “Why should there need to be a period in the child’s eating skills development where they regress to parental intervention with mush and spoon?”

The actual practice of BLW doesn’t require more than a paragraph to describe. So long as your infant has reached the motor skill maturity to sit up on their own (or you are willing to prop them up on your lap for the duration of their “meal”), you can put a small variety of 2-inch long, stick-shaped food items from the adult meal in front of them and let them choose what and how they’d like to eat. If they want more, you can offer them more as they go. The first few weeks and months of learning to eat actually consists of them “playing” with their food by exploring taste, texture, smell and other properties of the foodstuffs– only later do they discover that the food is nutritious and helps to satiate their hunger. Plan on letting them discover at their own pace, cleaning up the inevitable messes and continuing to provide most of their sustenance by breast or bottle until they’re fully capable of getting the majority of their calories and nutrients from shared family meals, likely past the one year of age mark.

That’s really it. While there are certain foods that are easy to choke on (grapes not cut in half length-wise! hard nuts which are difficult to chew! pieces of fish or animal flesh with sharp bone fragments!) and things children may develop allergies to if exposed too early (honey! dairy! peanut butter?!), like the risk of rolling over and crushing an infant via co-sleeping being almost nil for a family that does not consist of alcoholic cigarette smoking fat asses, BLW is essentially safe and the risk of choking is overblown. It turns out that infants have a gag reflex that begins near the front of their tongue and not the back, and most “choking” actually happens with spoon-fed infants wherein the eating utensil circumvents the natural choke-avoidance mechanism and allows food to get into the back of their throat when they haven’t fully developed the muscle control to swallow.

Like most endogenous approaches, the biggest challenge for parents and other adult-caretakers is having patience to let the infant explore at their leisure and behave as comes naturally without thinking they need to get involved and add something to the mix for any reason other than safety. The temptation to “help” the child learn to eat or to show them a more “efficient” way to get the food into their mouth, for example, must be avoided if the child is to develop the important motor skills of controlling food with their hands, not to mention the need to let the child determine that food is safe and enjoyable to eat. Chewing and sucking endlessly on the same piece of sweet potato stick may not seem like an effective way to eat one’s meal for us, but for the infant it is an essential part of figuring out “What is this?” and “What can I do with it?” Infants are highly empirical and don’t really have an ability to learn by causal explanation and the provision of logical theory. They need to just do stuff on their own.

The book is much longer than a paragraph because it spends a lot of time repeating itself, calming potentially frayed nerves concerning overwrought risks, relating a series of “BLW Stories” of parents who did it with their small kids and had success, and interjecting numerous verbatims from happy practitioners seemingly at random in an attempt to build credibility in the approach. This last bit is likely aimed at female readers– sorry moms, but your cultural appropriation model is highly consensus-based due to evolutionary biology.

A good primer for anyone interested in the approach, though you can skim-read it.

My Postpartum Experience

As our lion cub is nearing his six month birthday and gaining more independence, I’m finding the time and energy to reflect on my postpartum experience. I want to document this for future reference for myself and for anyone else going thru postpartum.

Immediately after childbirth, I had a pretty good recovery. I gave birth at home, unmedicated, and so I was conscious and clear-headed within seconds of Little Lion’s birth. Getting to be at home with the whole family (my husband, our dog..) and in my bed after that crazy adrenaline surge was amazing. There is no other experience quite like it. I was tired from pushing for four hours, but I wasn’t quite ready to sleep yet (Mistake #1), so we had my in-laws come over and meet their first grandson. They commented at the calmness and peacefulness of our household despite the excitement and activity only hours earlier. Our lion cub slept next to me that night, but I barely slept because I was so excited; ‘There was a baby next to me.. That I had pushed out only hours earlier.. All-natural, at home, unmedicated.. I did it!!’

The months after childbirth are commonly referred to as The Fourth Trimester. It’s the adjust and adapt period: the hormones are regulating, the baby is learning to eat and sleep, and the new parents are rearranging their schedules and barely sleeping. Usually after this period, the new parents will gain some confidence and feel like they finally have a grasp on things (and maybe get some sleep!).

Postpartum Help 

After the birth, a nurse from my birth center came to check on me and the baby and to teach me when to feed, when to pee (yup, you read that right), and what vitals to monitor. My doula, who was present the whole day, came back within a couple days to “debrief” me 🙂 And my midwife and her assistant both called and were available by phone to answer any questions we had. I really appreciated the open line of communication because I was so glossy-eyed over this baby that I was forgetting what I had learned beforehand! It was great to have people help us process what had happened.

The Lion and I are extremely fortunate in that we have family members close-by who are ready and willing to help us. Grandpa and Grandma Lion live within a quick drive, and Grandma Wolf is retired and can come spend a few weeks with us at a time. Our lion cub arrived right around the holidays, so my sisters in law were around and came to make food, fold laundry, sweep and dust, and keep us company. It was a lot of fun to have everyone over, with Christmas spirit in the air, and the arrival of a new baby 🙂 The next day, Grandma Wolf flew in and stayed for three months. My mom did ALL the laundry and ALL the cooking (except breakfast) and ALL the cleaning. I’m not sure how we would have survived in those first three months without her help! I was definitely ready by the end of my mom’s stay to try it on my own and find our own rhythm, but when we were sleep-deprived and trying to work out the breastfeeding thing, I really appreciated not having to worry about our next meal or having clean underwear (although I did run out once…………………….).

Within the first month or so, I invited some of my closest friends to come visit me, and I took them up on their generous offer to help (#unashamed). I asked them to bring their homemade chocolate chip cookies, I asked them to bring lunch, I asked to borrow their Moby wrap for our Little Lion, I asked them to grab me some olive oil and travel-sized bottles, I asked them to buy a Christmas outfit for the baby, I asked them for Pressed Juicery and acai bowls… These were friends who have either had babies or know what it’s like for new moms. I knew I wasn’t going to get judged for accepting help, I knew I didn’t have to shower or dress up, and I knew that they wouldn’t mind seeing my under eye bags or messy hair or postpartum belly. They were so loving and kind (and still are!), and I think having that support and encouragement (and advice!) really helped me a lot. Moms GET each other.

We are also fortunate in that my husband has the flexibility to change his work schedule and work from home as needed. The Lion worked hard to maintain a sense of normalcy within the first month when I was bedridden for most of the day. He made a big breakfast every day, he took over walking our dog TWICE a day, he ran for groceries after work, AND he got up to change diapers multiple times in the night. And somehow, he did all this while managing to have a good sense of humor and patience for me (and my mom 😉 ).

Recovery 

I did have some incontinence afterwards. My pelvic floor was s o r e and felt non-existent. I also had a tear and required some stitches, so I was pretty sensitive and tender down below. It was difficult to get in and out of bed, and walking short distances took a lot of time and effort. I didn’t immediately go back to practicing kegels because I was afraid of ruining the stitches. I also had hemorrhoids, which made going to the bathroom and even just sitting down a big challenge. I relied on my arms and my core a lot to help me sit up in bed to breastfeed in the middle of the night! My core was okay–I had made sure to keep up my core workouts during pregnancy, and at my six week check up, my midwife pressed around my abdomen and commented that my core was pretty strong, woohoo!

One midwife that I had interviewed had told me she usually recommends her clients stay inside for a few weeks: “a week in the bed, a week around the bed, and a week around the house.” I required much more time than that. I had thought that by having a natural, unmedicated birth meant that I would bounce back quickly, but it definitely takes a lot of time and patience to allow your body to heal!

Breastfeeding ( . )( . ) 

I will be writing a separate, more in-depth post about my breastfeeding experience, but the short of it is that we had a tough time with breastfeeding.

My milk came in about four days after giving birth. I did not realize (or remember?) that this would happen, and when I became engorged for the first time, I thought I had mastitis! I was terrified, not to mention I felt like a truck had hit me (and left me with humongous boulder boobs). I felt very sick, and my chest hurt so bad, heavy and stretched out from being so engorged. My mom would run in and out of our bedroom to get more hot towels from the kitchen for me so I could lay them over my chest. I tried pumping it out, but the sensation was so painful I couldn’t keep it up (I also had a regular pump vs a hospital one) and so nothing much came out. It. Was. Stressful. And painful.

The first few times Little Lion latched, it hurt. I kind of expected that, this being my first baby and first time breastfeeding, my nipples were not used to having a baby sucking and pulling on them, etc. But what I didn’t expect was the abrasion on one of my nipples, which caused extreme pain, worse than giving birth. I had to call in two different lactation consultants (IBCLC-certified; why IBCLC over CLC) to find some relief and validation and advice on what to do next. My nipple took almost two weeks to completely heal, longer than anyone expected. Furthermore, Little Lion had a tongue tie, which made his suck ineffective. By the time my nipple healed and we had figured out the tongue tie issue, I was feeling very depressed and discouraged, and our Little Lion was starting to become underweight. We eventually reached a happy medium, where I could provide him with breastmilk through the bottle, and he could nurse at night or before nap time (nursing “recreationally,” as I like to call it), but it took a lot of blood, sweat, and tears to get there.
I am fortunate to not have experienced mastitis, but I did have clogged ducts and the beginnings of an infection… My breast would be hard and tender, I would get a headache, and I’d have the chills. I felt like crap, and that wasn’t even mastitis! It was unpleasant enough the 2-3 times I experienced it that I work hard every day to make sure I empty out my breasts adequately (plus it helps supply stay up).

Weight loss 

During pregnancy, I ate well. I ate a lot of protein (did not really have any food aversion aside from bacon, which was a staple in our household!), a lot of veggies (to keep away the constipation), not much sugar or carb. I referenced the book Primal Moms Look Good Naked a lot. I also continued stretching and physical exercise, walking daily and dancing.

Regaining the pre-baby body (or closer to it) is still a work in progress. Every fiber of my being during the first three months postpartum was consumed with trying to figure out a solution to the breastfeeding, and so even though I received clearance from the midwife at six weeks to resume light exercise, I didn’t do anything. I don’t think I even left the master bedroom for good until at least eight weeks postpartum. I lost weight after childbirth with the fluids and placenta and hormones regulating, but I wasn’t losing much very quickly (naturally, since I wasn’t exercising), and it got kind of depressing.

My mommy friends all told me that breastfeeding helps you to lose weight, but they didn’t mention that breastfeeding also significantly increases your appetite! I was SO hungry, ALL the time. I would need to eat a meal between all the meals, and I was able to eat almost twice as much as I usually do. AND, I would wake up starving in the middle of the night! Even though I was eating all the same healthy foods as I did during pregnancy, I was eating so much of it that it was getting out of hand. My mom and my husband were both concerned because I was always telling them I was hungry… Furthermore, since my mom was doing all the cooking and wasn’t familiar with our usual serving sizes, the proportions were all out of whack (she made two servings into one serving… and I ate it ALL). I also had an unhealthy addiction to granola for about… four months. That’s A LOT of sugar to consume!

Eventually my appetite regulated, and once I taught my mom how to proportion all the food, I started noticing that I felt better and the weight came off easier. When I started walking our dog regularly again, I noticed a big change in my body shape. It took me almost five months, but I finally started going back to my dance classes, and I am doing yoga at home. I don’t do anything too intense because I can tell that I’m still regaining my strength, flexibility, and balance, and I definitely cannot afford to injure myself now. I don’t expect to regain my pre-baby body this year (although it’d be great if I did!) because I am basically starting from scratch–I haven’t done intense physical exercise in over a year! But it definitely feels good to be working towards it.

Anxiety 

A lot of my anxiety stemmed from our breastfeeding issues. It got depressing quick. And I couldn’t dig myself out of it, and I couldn’t bring myself to find help either. It was a roller coaster every day: I would wake up feeling optimistic and great, and then by evening I was a mess and depressed. Not leaving the bedroom probably didn’t help. Once we figured out the weight issue for the baby,  I felt a lot better and more hopeful. Also, healing up enough to get out of the house and get fresh air and see people made my days brighter (the seasons were changing too 🌥). I also started seeing my therapist that I hadn’t seen for a year. It was good to talk to her, but looking back, it almost seemed like I wasn’t ready to accept the help. I was in a brain fog with the sleep deprivation, the breastfeeding anxiety, the physical pain… Once the Little Lion started gaining weight and I felt a little better, I stopped seeing my therapist, thinking that I had nothing left to discuss. But feeling better is not getting better.

Around four and a half months, I felt overwhelmed with all that I had to do at home. Again, I couldn’t seem to get myself together to find help. Again, I was on the roller coaster: happy and productive one day, angry and frustrated and bored the next. I think having this roller coaster of emotions gave me a false sense of security, like maybe things would pass and I would feel better for good soon. It was a denial of sorts, probably because I thought that admitting I couldn’t handle it meant that I was failing at being a mom! On the bad days, all the emotions and anxiety from the first three months regarding breastfeeding resurfaced because I hadn’t dealt with them thoroughly. Compounded with the feelings of being overwhelmed, I couldn’t handle it and lashed out. The Lion reminded me of all the available resources I had: therapy, self-help books, friends, family. I was floored. ‘Of course! Why hadn’t I thought of this before?!’ I immediately reached for Feeling Good and called my therapist for an appointment.

I saw my therapist once a week every week for a month. Now I am going to see her every couple weeks, and I think eventually, once a  month. Talking to my therapist has been unbelievably helpful. I’ve made a lot of changes thanks to these 50 minute sessions​ with her. I look forward to getting to talk things out and have them reflected back to me, and I enjoy having my feelings validated and understood. I’ve learned a lot about self-judgment and acceptance from my therapist. Reading about how to feel good and understanding why and what causes me to feel not-good has been enlightening as well. I catch myself relapsing sometimes, but I try to combat the negativity quickly before it consumes me. Feeling Good taught me some ways to cope with negative thoughts that enter my mind, including changing specific phrasing in our thoughts and speech that we don’t notice is damaging until it’s too late.

I’ve learned to manage expectations, to have acceptance, to not judge myself, and of course, to take care of myself.

Self-Care

The Lion and I realized early on that in order for me to take care of Little Lion and the family, I needed to take care of myself. Whether it’s dinner out with friends, an exercise class, a mani/pedi, or even just some quiet time tending to our garden, I need it to feel refreshed and rejuvenated, I need it to energize me to continue with my job of caring for the family.

I realized that I needed these things. I need the time to put on a little bit of make up (or even to just brush my teeth) or to wear things that I feel comfortable in and feel like I look good in. Now, the clothes don’t need to be fancy because I need to be comfortable and able to lift my arms (aka, pick up the lion cub), and they’ll probably get spit-up on them by the end of the day anyway, but I want to look good as a new mama. None of my pre-pregnancy clothes fit me, and they actually all seemed outdated and dusty from sitting in my closet untouched for 6+ months. And I definitely didn’t want to continue wearing my maternity clothes because now they were too big. So I finally decided, since I wasn’t losing the weight as quickly as I’d liked, I’m going to give my body acceptance, a break, some grace. My body went through A LOT, and I deserved to have a new wardrobe, even if it’s a small one (because my body will change again once I DO lose the weight and/or once I stop breastfeeding). I needed something that I fit in, could nurse (or pump) in, and something that I could feel GOOD about myself in! I’m happy to keep the weight and work it off slowly because I know it’s important for breastfeeding, but that doesn’t mean I can’t feel and look good doing it.

The TL;DR of postpartum recovery is that caring for yourself, mentally and physically, is of utmost importance. Anytime that something doesn’t feel right, whether it’s the breastfeeding or feelings of anxiety, it’s time to find help, to find someone to discuss it with. I hope I remember that for next time because next time, I will have TWO lion cubs to care for!

 

Fear Of Childbirth, Or Lack Thereof

This was a draft that I had typed up during pregnancy and apparently never published! 
Recently, a good family friend asked how I was feeling, in terms of emotions. He asked if I felt scared or overwhelmed, maybe because his wife had exhibited those feelings when she was pregnant many years ago.

I responded that I feel excited! I didn’t feel scared. I have been taking an active part in this pregnancy and childbirth process. I have been preparing to understand what pregnancy is and means, what changes my body and mind are experiencing, the work of my uterus and my placenta, relaxation techniques and comfortable positions during pregnancy and childbirth, and generally, how to adapt and accept all these changes.

I’ve learned that there’s a difference between pain and suffering. Labor is painful, that is inevitable. But suffering? Suffering is not inevitable, suffering is a mental state. Natural labor has a rhythm, and if I am willing to ride the waves of contractions, labor will be much less suffering (but likely just as painful 😉

I want and am excited to have an “amazing” experience!

“Decode your body messages, modify your lifestyle, and if you are worried about labor, find out how you can help yourself.” -Kitzinger Complete book of childbirth and pregnancy

Why Do Some Families Lack Clean Water?

There is an ad pre-rolling on Youtube I have seen several times now that features Matt Damon for Stella Artois/Water.org pitching for some supposed concern they have for “solving the world water crisis.” Ignoring the fact that this phraseology makes it sound like a sudden act of nature and not a socio-cultural phenomenon that so many people around the world go without “clean water”, whatever the hell that means, this ad strikes me as utter bullshit worth commenting on for the following reason:

Damon says they SA/Water.org have partnered to bring clean water to “women and their families” in such stricken Third World environments. Why “women and their families”? Why wouldn’t it be “men and their families”? Don’t these women’s families include men? If so, why aren’t the men doing anything to provide the “women and their (the men’s) families” with clean water? Since women are just as capable as men (Feminist Truth), why aren’t women in these countries able to provide clean water on their own?

Why is clean water something that people in certain countries can do themselves, but in other places, we need Matt Damon and a beer company to shill so people will help out?

This is a fraud on a variety of levels, as indicated by the fact that Matt Damon is a part of the production.

Review – The Vaccine Book

The Vaccine Book: Making the Right Decision for Your Child

by Dr. Robert W. Sears, published 2011

How many people who are “pro-vaccine” have read a book about vaccines?

How many people are aware of the frequency, severity and treatability of diseases which have vaccines available before deciding to take the vaccine? How many people understand the common, rare and potentially severe side effects, the physical components in the vaccines, the method by which the vaccine is manufactured and the availability of competing vaccine brands and production methods?

How many people understand the common vectors of each vaccine treatable disease and thus how to potentially avoid exposure to it entirely?

Who is likely to be better read on the subject of vaccines (even if you argued that they are ultimately misinformed)– your average vaccine taker, or your average vaccine skeptic?

Dr. Bob Sears is “pro-vaccine”– he believes vaccines have done more good than harm in the history of medicine and that they are an important part of individual and public health practices and he believes the standard vaccine schedules for infants and adults should be followed with few exceptions. So why is he having his medical license put under review because he supposedly gave a “non-evidence based” recommendation to a family to not vaccinate their child?

Because it’s hard to imagine a world in which a doctor would come under the scrutiny of authorities for giving a pro-intervention recommendation to a patient that was “non-evidence based”, perhaps we can assume that it is because Dr. Bob has challenged the medical establishment on the most fundamental level possible by writing a book which posits that patients should be informed about their choices and should ultimately provide knowledgeable consent before proceeding with a potentially dangerous treatment regimen such as infant vaccination. Sadly, if you ask most doctors to explain why they want to treat you the way that they do, what you get is not “evidence based” dialog about your choices, but sarcastic reminders about whose medical school plaque is on the wall.

It’s sometimes more like a priesthood than a profession, even though that doesn’t necessarily mean their advice is wrong or should be ignored.

So that is the controversy, but what does Dr. Sears actually say about vaccines?

The first twelve chapters of the book are dedicated to one disease each and its respective vaccine; the remaining chapters explore vaccine research, vaccine safety, vaccine ingredients, vaccine side effects and other topics.

The disease chapters outline the common course of each disease including symptoms, severity and treatment, followed by the common vaccine options available on the market including their preparation method and ingredients and common and rare side effects. There is a “pro” and “con” section exploring reasons to consider administering the vaccine and reasons why people/parents have not wanted to take the vaccine, and then Dr. Sears weighs in with his own take on how important the vaccine is. Each chapter helpfully summarizes the information with simple boxed call outs indicating whether the disease is common, severe and treatable (without a vaccine).

The common/severe/treatable approach is interesting. I found a lot of the diseases covered not-threatening because of the various combinations they “checked” in each category: a disease might be severe and treatable, and not common, or common, but not severe and treatable. The worst combination would be common, severe and untreatable– I don’t remember any disease with that profile. Just the opposite, in fact. According to Dr. Sears, with thanks mostly to widespread vaccination, most of the diseases mentioned are not common (to the point that they’re actually or practically eradicated in the US/West) so there is almost no chance of catching it, vaccinated or not. Several others are typically so minor in their symptoms, especially in infants (versus adults), that they might be mistaken for a common cold if caught. And those that are potentially severe seem to be treatable with antibiotics in most cases, especially if diagnosed early in the course of the illness.

That being said, some of these diseases have the potential to put the victim in the hospital if the disease is not checked early, or it happens to be especially challenging to an individual’s immune system. In such a situation, even with a full recovery and no lasting damage the experience itself is likely to be stressful, costly, traumatic for the child and heartbreaking for the parents to watch– it’s not a joke as far as risks go, and it needs to be considered seriously. And a few of the diseases, if caught and if particularly intense in the course of the disease, do risk permanent neurological or organ damage even if successfully treated. That’s a terrifying possibility!

Reading between the lines a little bit here, Dr. Sears seems pretty clear that whatever risks there are for an unvaccinated child in contracting and fighting any of these diseases, they are even smaller for a child who is breastfed and avoids day care or other germ-ridden public child environments. Assuming this is the course a parent is following with their infant (as we are), it seems a lot more like a judgement call between accepting the risks of rare disease complications the child is likely never to get, or accepting the risks of vaccine side effects (short and long-term) which are inevitable and seemingly random in their frequency and severity. There are several diseases/vaccines mentioned which simply pose no risk whatsoever (chickenpox), or for which the illness can not be contracted by the infant without an infected mother who transmits it during pregnancy or birth, or for which the illness and vaccine do not become relevant until adolescence or adulthood (such as HPV, a sexually-transmitted disease). Taking what’s left, and given our commitment to breastfeeding and homecare/homeschooling, it just doesn’t look like vaccines make a lot of sense for our family.

That was the part of the book I struggled with the most, when Dr. Sears recommended a vaccine not for the infant’s safety, but for public health reasons, such as to maintain low prevalence of a disease across a population, or to protect at-risk family members or caregivers who could catch the disease from the infant and have a more difficult time fighting it (for example, Dr. Sears talks about how a pregnant school teacher could catch a disease from unvaccinated students that could harm her unborn child). This is all good information to have and consider in the event of one of these complicating circumstances actually being relevant to a family’s situation, and certainly the “moral” issues are worth considering and debating, but it seems clear that if the question is simply put as “Does this vaccine represent a worthwhile risk/reward profile to the individual being vaccinated?” the answer we arrived at was often “No.” That’s a very different question from “Is it our job to take health risks with our child to protect other people/children from health risks?”

Interestingly, smallpox has been eradicated but the vaccine is no longer given to preserve herd immunity. Instead it is controlled by the US government as a national defense reserve. In identical situations where a disease, such as polio, has been practically eradicated, Dr. Sears still recommends getting the vaccine for public health reasons, but with smallpox there is no suggestion that the public needs to keep getting vaccinated to be protected from an eradicated illness. Why the different logic?

Another item I made special note of was the relationship between traveling, domestically and internationally, and vaccination of an infant. Dr. Sears is explicit in saying that flying around on airplanes is not an easy way to catch a vaccine-preventable disease, and that there is essentially no risk of this happening for travel within the US, and there is very little chance of this happening for travel outside the US. He does suggest that people who are essentially “living in the bush”, doing missionary work in remote locations or areas where these diseases are endemic in the population, are at special risk for some of these illnesses, but again this doesn’t apply to us because we aren’t going to be traveling to poverty-ridden areas or where access to clean water might be an issue. It was comforting to know that travel as part of our lifestyle doesn’t really need to be changed because of our decision not to follow the recommended infant vaccination schedule.

The other thing I wanted to mention is Dr. Sears’s opinion about the state of vaccine safety research. In short, he says a lot of the studies are wanting. Here are some especially troubling quotes:

Some vaccines aren’t studied alone. Instead, they are given along with several other vaccines, so there is no way to know what their actual side effects may be.

[…]

Most vaccine side effects are monitored for a short time via parent questionnaires.

[…]

Out of the twenty-three major studies done to date that show no link between vaccines and autism, eighteen have some conflict of interest involving vaccine manufacturers. Similarly, the addition of the hepatitis B vaccine to the infant schedule was driven largely by research done by doctors who worked for the vaccine manufacturers.

[…]

What about the statistical chance that your child might get a severe, life-threatening case of one of these diseases? To my knowledge, that information has never been determined accurately through precise scientific statistical analysis. [… Dr. Sears estimates these risks as follows:] A very rough total of 55,000 cases of severe diseases each year in children. We know that the current US population of kids twelve and under is about 60 million. Dividing 60 million by 55,000 cases means that each child has a 1 in 1090 chance of suffering a severe case of a vaccine-preventable illness over the first twelve years of life. Note that flu and rotavirus are responsible for most of these cases. If one were to run the numbers without those two diseases, the risk of suffering a severe case of one of the uncommon disease is only about 1 in 6000. Most severe pediatric cases occur during the first two years of life. An estimation of severe cases in children two years and younger would be about 34,000 cases divided by 10 million kids, or about 1 in 300.

[…]

What is very clear, however, is that vaccines have triggered autism in a very small number of children. A phrase I recently heard sums it up very well: Vaccines don’t cause autism… except when they do.

[…]

If we were to throw out all research that has some conflict of interest, we would actually be left with very little on either side of the [vaccine-autism] debate […] the right type of research has not been done yet.

In addition, here is what Dr. Sears would consider to be the minimum standard for a valid safety research study, which might be helpful for people trying to evaluate various studies in making up their mind about the risks posed by diseases and their vaccines:

• Prospective: the study group is selected and then followed in real time. Virtually all current research has been retrospective, looking back into the past at data on groups of children who have since grown up (for which the outcome is already known).
• Randomized: test subjects are selected at random and placed in either the study or the placebo group in a random manner to avoid bias.
• Placebo-controlled: a study group exists that is not receiving the treatment in question (in this case, vaccines). This is the primary way to be able to draw conclusions with a high degree of accuracy.
• Double-blind study: the researchers and the study subjects don’t know who is receiving the test treatment (vaccines). This prevents bias as the researchers observe and collect, and the test subjects report, data.
• Large-scale research: this is needed for a study to be considered statistically significant and to prove the findings aren’t simply due to chance.

Interestingly, he explains why these studies haven’t been performed to date, and I am not surprised to report it is not an example of “market failure”! The government, as usual, plays a big role here.

A final note: There are several instances where Dr. Sears refers to a disease which has been practically eradicated, but which in recent memory has experienced a sudden outbreak in a localized community before being contained. Aside from a generic geographic description, such as “a neighborhood in Ohio” or something like that, there is no demographic data given about these outbreaks, if it is even collected and publicly known. Wouldn’t it be interesting to know that? If these periodic outbreaks are restricted to specific socio-economic populations, wouldn’t that change the implied incidence of risk for the population as a whole? I’d want to know that information, but the current state of medical research in our country considers this unscientific and irrelevant, so much so that it is politically incorrect to wonder about it. How can facts be offensive? It seems like there is an attempt to control political dialogue here, which I find disturbing.

This book has many virtues but its greatest one is that the information is both comprehensive and well organized, while still remaining succinct. It’s very easy to approach the question of vaccination, its risks and benefits, from a number of angles and find all of them anticipated by this book, and more.