Thoughts about Ebony


I was going to wait to publish this post until after I’d had time to read it through. But given that I just accidentally posted it, freaked out, made it private, I’m realizing that folks who got it through email will be able to read the entire thing anyway. SO. Here ya go. With a temporary title that obviously will be the permanent title – my ramblings and thoughts regarding Ebony Wilkerson, tragically better known as the mom in Daytona who drove  her minivan into the sea.

The public defender’s office said there was a reason she beat her stomach. “She {is} being held in seclusion naked in her cell,” said Craig Byer.

Public defender James Purdey at first asked for Monday’s hearing to get Wilkerson’s 1.2 million bond reduced.

Purdey instead asked his client be transferred from the Volusia County Branch Jail to a psychiatric ward for longer than a typical Baker Act hold, so she can get mental pre-natal care.

The judge did not rule on the request to move Wilkerson because the judge said it’s something that hasn’t been done before. (Source)

According to the Ebony Wilkerson narrative we have thus far, she drove to Central Florida from South Carolina to escape an abusive partner. Her family struggled to get her help but she signed herself out of the hospital and somehow managed to get the keys to the minivan and drive it and all of her children into the ocean despite the family’s efforts to hide the keys from her.

This week, we are told she has been held naked, in seclusion at the local jail and started punching her stomach, causing her defenders to push for her to be moved to a psychiatric ward for “mental pre-natal care.”

What the hell is wrong with this picture?

From an emotional and advocate standpoint, a lot.

From a logical standpoint, I can understand why these measures may need to be taken, particularly if Ebony has been suicidal. Of course you don’t want to give her anything that she could possibly harm herself with but there has to be a way to do that without completely stripping her down and removing all sense of dignity, something she was more than likely running low on if indeed she was escaping an abusive relationship.

The judge’s reluctance to move her may also be grounded in logic as well. Perhaps she did not feel she had enough facts to justify setting a precedence with Ebony’s case. Or perhaps the Volusia County Jail has the capability to be considered as “clinically appropriate” (as is required of examination/treatment in the Baker Act) and therefore the judge did not see moving her as a necessity. Or perhaps there simply wasn’t anywhere to move her to which offered the same level of security the judge felt Ebony requires at the moment.

But when examined from an emotional and advocate point of view, this is absolutely heartbreaking.

A pregnant mother, escaping an alleged abusive relationship, drives her kids into the ocean despite attempts to help her. To me, this screams of absolute desperation. This is beyond sanity. It’s more than a call for help. This type of behaviour requires action.

But is what Volusia County doing enough?

How do we best handle this type of situation in this day and age?

It’s like I tell my kids and my partner – we can’t fix a problem unless we know about it. Unfortunately, women (and men especially) who are in abusive relationships are often quiet about their situations until it’s almost too late, and some until it is too late. Why? Because they are often threatened by the perpetrator that if they don’t remain silent, there will be repercussions.

Silence is also a hallmark of Perinatal Mood & Anxiety Disorders for multiple reasons. Society believes we should be happy when pregnant or in the throes of new parenthood. Thing is, mood disorders have been happening since the dawn of time. Our responses to them over the centuries have varied but even early on, a few folks got it right. Take Asclepiades, for example. According to Thomas Millons Masters Of The Mind, he “argued against dark cells and dungeons for the mentally ill…thought patients should be in settings that were well lit and comfortable.” Asclepiades also proposed that “biological and chemically based treatment would be beneficial” in addition to dividing conditions into acute versus chronic and also distinguished between hallucinations, delusions, and illusions.

The main point of Asclepiades is that even in the early ages (171-110BC, by the way), someone recognized that locking away the mentally ill in dark, dank places was NOT the way to go.

Arataeus believed the “soul was the basis of psychic disturbances” and “mental disorders were exaggerated normal processes”. (Millon)

Then there’s Soranus who posited “consider(ing) culture as a factor in both investigating and treating mental patient.” (Millon, Masters Of The Mind). He also advocated for decent and kind treatment of the mentally ill, asking “his peers to remember who was ill; physicians should not view their patients as disagreeable persons who offended their self-image.” (Millon) It seems to this outside observer that Volusia County is not doing that in Ebony’s case.

Does being an abused woman or a woman at the hands of a Perinatal Mood Disorder excuse the type of behaviour Ebony Wilkerson has exhibited? No. But both are mitigating factors which led to her behaviour and should absolutely be taken into consideration as her case proceeds.

I’ve written extensively about Postpartum Depression as a defense. Cases like these are both fascinating and heartbreaking because all at once, those of us who have experienced a Perinatal Mood & Anxiety Disorder, see fractions of ourselves in the women who make headlines. We collectively gasp and think, my God, what if I had given into all those thoughts racing through my head? I could be her. I could be Ebony. I could be Miriam, I could be Andrea, I could be Otty.

We shudder because we were there, with them, in the dark, in the hell, holding their hands and they fell as we watch in horror. The way their fall is paraded in front of society scares the crap out of us and drives many to silence. Is this healthy for society? Yes and no. We should be outraged when children are subjected to death (or the threat thereof) at the hands of their parents. But at the same time, we need to take steps to prevent this type of situation from occurring in the first place.

How do we do that when every single case, every single situation from mother to mother and from birth to birth is different? How do we catch a falling mother if we don’t know she is falling?

Even if we start by putting measures in place to check for signs of falling, we will still fail if the mother doesn’t admit to having a problem or, as in Ebony’s case, refuses help (for whatever reasons – cultural stigma, fear, etc) which is offered to her because she is far past the breaking point and sees death as the only way out. Do we just throw our hands up in the air and let her do what she may? No. So what do we do then?

I don’t know.

What I do know is this:

  • Mothers (and fathers) do not deserve to be alone in this battle
  • Mothers (and fathers) deserve emotional support
  • Mothers and fathers need a village
  • Perinatal Mood & Anxiety Disorders are not deserving of whispers, they require shouts
  • We need to speak up, every single time, not just when there is a crisis
  • Accept those who are hurting with open arms and provide a safe space for them to fall apart
  • Not judge those who have/are struggling so harshly

So what can we do to improve the situation for struggling parents across the globe with the very real (and often co-occurring) issue of domestic abuse/violence and Perinatal Mood & Anxiety Disorders?

  • Make it okay to reach out for help and ditch the supermom/superwoman/superman/superdad façade
  • Initiate requirements for ALL health professionals who may come in contact with an expecting or new mother to be well-versed in the ins and outs of a Perinatal Mood & Anxiety Disorders (this includes pediatricians, OBGYN’s, GP’s, Family Doctors, IBCLC’s, doulas, midwives, naturopaths, you get my point…)
  • Create local, state, and national referral networks which incorporate above said training on a regular basis
  • Create networks of parents willing to mentor other parents through these tough situations and make it easy to access across the board

Are these solutions going to fix our current problem? No. But they’re a start and sadly, most of it revolves around a tradition which our current technologically advanced society has strayed greatly from – the tight knit expanded family. It takes a village to raise a child but it also takes a village to raise a mother to raise a child right. In my post “On Not Wanting To,” I state the following:

Our village is in peril. Our village? FELL THE FUCK APART AND NO ONE GIVES A DAMN.

In America, we have a pitiful excuse for maternity leave. We are bombarded by stories of celebs who gave birth and look AHMAZING in less than three weeks after giving birth. We are insanely comparing ourselves to women who are a) genetically blessed and b) have crazy access to things like trainers, nutritionists, nannies… and then there are the way we compare ourselves to each other. Stupid idiotic milestones of when we went back to work, how much we manage to get done every day, pushing ourselves to be better than the next mom and still have it all pulled together.

It’s no wonder we are screaming out for help and some of us are doing so through extreme measures.

Let’s keep the “if I were her, I would” out of the conversation. We do not know what she’s going through. Even if we’ve been through hell ourselves, we do not know *her* hell nor should we take her story as one which portends the downfall of ALL women who struggle with domestic violence/abuse and a Perinatal Mood & Anxiety Disorder. Instead, reach out to mothers, to fathers, let them know it is okay to reach out for help. For that matter, teach it to your kids so that when they get older they don’t feel as if reaching for help is in essence, failure to handle something on their own. Yes, independence is a grand thing but there is a time and a place to lean on someone else. Not to lean in, but to lean on, sometimes for dear life.

Our village has forgotten how to do this very simple yet necessary human act. We are now expected to be everything to everyone and dear GOD help us if we are not. Should we assume something is wrong with every mother? No. But instead of oohing and ahhing at her baby, ask how she’s doing. Ask how Dad is doing. Do not dismiss their very real role in their new situation. By acknowledging them, you acknowledge their existence and empower them to express their feelings. And that, my friends, is possibly one of the most powerful things we can ever do for a new parent.

Will it keep more pregnant women from being held in seclusion, naked in a prison cell, after they’ve attempted to kill their older children and themselves? Not all of them, no. But it’s a start.

An even better start would be to continue educating people about Perinatal Mood & Anxiety Disorders, including those in the law enforcement and legal arena. I realize they are bound by the courts and must adhere to the law but if they had a better understanding of the facts behind Perinatal Mood & Anxiety Disorders, perhaps, at least, the treatment of mothers imprisoned for crimes committed whilst experience these disorders would stand a chance of improving.

In the meantime, I genuinely hope that Ebony Wilkerson receives the help she so desperately needs as she awaits trial for her actions on the fateful day she drove her minivan into the sea. We’re watching, Volusia County. Don’t fail us more than you already have failed Ebony.

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#PPDChat Topic 03.10.2014: Media Sensationalism & PPD


ppdchat-03-10-14

 

Join me tonight as we explore the issue of media sensationalism and PPD. So often, as I stated in my post “On Not Wanting To”, when a mom hurts herself or her children, we get the sensationalized version of it and the details of her journey to that point (and her journey after the event) are dramatized as well. I hope you’ll join me for a passionate and insightful chat into why this needs to change as well as why we owe it to ourselves and to society to reach out to every new mother dyad with care, compassion, and understanding.

We cannot let the village continue to fail.

Give up giving yourself up


Parenting is a ritualistic exercise in extreme sacrifice. We awake earlier than we want, watch television programs we don’t want to, make play-dates we could care less about, plan parties, go to parties, make nice with another parent because our kid likes their kid, etc, etc, etc, etc. It goes on forever.

But that’s what parenting is, right? Sacrifice?

Yes.

And yet a resounding no.

Last night, I asked on Twitter if Motherhood should trump Womanhood once it entered the mix. What ensued was an extremely interesting conversation. Answers varied from “If that’s what the woman wants” to “No, it shouldn’t” to “I don’t understand, isn’t Motherhood a facet of Womanhood?” It is, once it enters the mix. But what fascinates me is the way we, as women, and as society, measure a woman’s worth based on her desire to conceive or parent. Someone even pointed out a pet peeve with articles which identify someone as a Grandmother, Mother, etc., even when it’s not relevant.

In the infancy years when our children depend fully upon us, Mother is our defining role. However, we should still make time for ourselves as women as well. We are still us, we have merely added another facet to our skill set. Some of us are woman first, mother second. Some may be Mother and then Woman. That’s okay. It varies from woman to woman and is based on personal experience as well. Go with what works for you and your family.

For those who are woman first, mother second, we know we need to be valued as a woman. But no one will value us as woman if we fail to treat ourselves as woman first. But what is woman once she is a Mother? She is you, as you were before children, with the added responsibility of child-rearing. Woman is beautiful, exhilarating, compassionate, powerful, strong, complex, amazing, and full of heart. She is life, and yet at the same time, she can get so lost in roles demanded by society, she may be her own death. Swallowed whole by Mother, Wife, Employee, Caregiver, Daughter, Sister, Cousin, etc, she finds herself carried away by the powerful current of Life, not realizing until too late she is in dangerous waters.

Today I tweeted, with the intent of being humorous, “For Lent, I’m giving up giving up things.” I also posted it as my Facebook status. The responses surprised me. One of my friends on Facebook included a link to a post written by a friend of hers last year —On Eating Chocolate for Lent— which got me thinking –should we be giving up anything for Lent at all– especially when we already give up so much of ourselves as Mothers? If we continue to sacrifice ourselves at the rate we’re going, we will have nothing left to give our children or loved ones once we finish –if we finish– before we pass out, an exhausted heap in the kitchen floor.

Want to give up something for Lent? Give up throwing yourself under the bus for everyone around you. Give up saying yes to every responsibility you are asked to take on by friends, family, work, etc. Give up judging yourself for not keeping up with the Joneses. Stick with the bare necessities. Give yourself the gift of time to yourself, the gift of time with your children instead of racing around like crazy to keep family, friends, and society happy and smiling. Give yourself happy. Give yourself joy. Give yourself laughter.

Give up giving yourself up for 40 days. Be kind to you. You are worth it.

 

KevinMD guest post misses the mark about Mothers


This evening I happened upon a guest post over at KevinMD by Dr. Srini Pillay, MD, an author and an Assistant Clinical Professor at Harvard Medical School. KevinMD has been a site I read more and more these days. I enjoy the insight offered by his knowledgeable guests. Today’s post, however, has me shaking in anger.

Dr. Sirini Pillay’s post is entitled “What a psychiatrist learned in therapy sessions with mothers.” It’s also posted at Pillay’s other blog, Debunking Myths of the Mind under the title “I love my children but hate my life: Solutions to Dilemmas Mothers Face” with the subtitle of “A balm for all guilty mothers.”

(Please note: All text below in italics and bold is directly from Dr. Pillay’s article)

 

Dr. Pillay pontificates a few reasons for the psychological issues/stress mothers experience during their lives. With every one of them, his explanation (in my opinion) places even more guilt upon the already exhausted and stressed out mother rather than offer true solutions for her success as a mother. Perhaps most glaring  in his examination of the trials and tribulations of motherhood is the omission of any mention of a Postpartum Mood Disorder as the source for the points upon which he offers his expert insight. I find it impossible to believe, given the statistics of Postpartum Mood Disorders (1 in 8 new mothers), Dr. Pillay has never seen a mother with a Postpartum Mood Disorder or is unaware of the additional issues a Postpartum Mood Disorder brings to the dynamic of Motherhood, especially if said Postpartum Mood Disorder goes untreated. It is both appalling and irresponsible to me for a Psychiatrist to fail to mention such a glaring issue in the face of addressing issues faced by Mothers.

First up, Dr. Pillay mentions Perfectionism. “New mothers often expect to be perfect rather than the best that they can be,” Why does the mother expect to be perfect, Dr. Pillay? Is it because SHE has placed those ideals in her head? No. It is because society has placed these ideals in her head. We are absolutely expected to be pristinely Stepford in our execution in the assigned task of Motherhood while Fathers are expected (also unfairly) to be aloof idiots. What Dr. Pillay fails to mention is that those of us who are obsessive perfectionists are at a higher risk for developing a Postpartum Mood & Anxiety Disorder. What he fails to mention is that, in order to overcome this “Peril of Perfection” society must also change their view of Motherhood. Instead, Dr. Pillay perpetuates the stigma and tells Mothers “you can always strive to be better by making small changes. Holding yourself to a standard of perfection can lead to burnout in all areas of life, because you are constantly striving for something that does not exist.” I agree, Dr. Pillay. But the same society fails us when they perpetually hold us to a standard of perfection, for which when not reached, we are then automatically judged and crucified.

Next up, burnout. Burnout is a direct result of perfectionism. It’s also the direct relation of attempting to care for an infant while struggling with the depths of a Mood Disorder. Study after study has proven the adverse effect of Postpartum Mood Disorders on sleep. Have a Postpartum Mood Disorder? You won’t sleep as well when you do sleep. Sleeping less and lower quality of sleep are both symptoms of a Postpartum Mood Disorder. Yes, everyone knows new mothers don’t sleep much. But moms with a Postpartum Mood Disorder sleep even less and achieve a lower quality of sleep when we DO sleep. Another kicker? Our children sleep less and at a lower quality as well. So now you have an exhausted dyad attempting to live up to an impossibly high societal standard which is now even further out of our grasp. Need more ammunition here? We’re also told to snap out of it if we seek help. Stigmatized. Made to feel guilty. Not allowed to have the “time” to be depressed because by God we have an infant to raise which is what we were bred to do. Failure is not an option. So we stay silent, we suffer, we weep, we wail, we dry our eyes in the face of the public realm because we’re not allowed to have emotions other than those seen in Johnson & Johnson or Pamper’s commercials. Everything is to be picture perfect. If it’s not, we’ve failed. Dr. Pillay’s suggestion here? “So rather than force themselves to think and feel differently, addressing the burnout can help many problems all at once.” I would have loved to have addressed the issue of burnout. I attempted to address the issue of burnout with each one of my children. I asked for help. I begged for a night nurse from the pediatrician once our second daughter came home after nearly a month in the NICU after being born with a cleft palate. His response? “Why do you need a night nurse?” I had a toddler. Two dogs. A husband who worked 70+ hours a week. I was exclusively pumping every three hours and running a Kangaroo pump on the same schedule. I had to clean my daughter’s PEG site and jaw distraction sites a total of 4-6 times a day on TOP of everything else. Sleeping would have been a gift from the Gods. Yet I was denied and landed in a Psych Ward less than two months after my daughter’s birth through no fault of my own. No amount of forcing myself to think and feel differently would have helped. But I tried to address the burnout. That too, failed.

Now we move into “The best balance.” This paragraph’s opening sentence really captures judgment of mothers across the world: “When women feel overwhelmed, they essentially need to ask themselves why they expect something impossible from themselves.” Again, he’s absolutely right. Yet again, it’s society which has trained us to expect the impossible from ourselves. Dr. Pillay goes on to suggest “The reality is that if a woman has a need to work and have a baby, she needs to find a best balance that is right for her and her family.” Again, I agree. But if a woman has a Postpartum Mood & Anxiety disorder, she is already wracked with guilt. Attempting to find balance in her life is not achievable until she has begun to heal from her fragile mental state. A woman with a Postpartum Mood & Anxiety disorder can barely survive her day let alone find balance in her life until her mental health issues are addressed. Any health professional or anyone I knew mentioning to me all I needed to do to improve was to “find a best balance” in my life when I was in my darkest days would have heard an earful. We’re barely able to keep our own heads above the fray – how are we expected to balance too?

“There is no one-size-fits-all type of mother, and different types of mothering produce different positive and negative outcomes.” Amen. And yet, society expects Sally to parent like Suzie and Suzie to parent like Bethany and Bethany to parent like Rebecca and Rebecca to parent like Jody and Jody to parent like.. well.. you get my drift. It’s the whole Stepford thing. Again, society does not allow for this sort of flexibility. Mothers with Postpartum Mood Disorders parent far differently than any other mother on the planet. We realize the value of self-care because it’s necessary for our survival. For some of us, it’s necessary for our children’s survival. We are judged for how we parent. How we HAVE to parent. We are judged for expressing our frustrations, for choosing to formula feed, for choosing not to go the attachment parenting route, for letting our little ones watch TV because we’ve had a tough day. Yes, we heal from a Postpartum Mood Disorder but when you’re in the thick of it and family members or random people in public are judging us, we have a harder time letting it go and then BAM. Hello guilt. Hello Xanax. I love the idea, I love the theory of “no one -size-fits-all type of mother,” I do. But it doesn’t work in the real world and certainly doesn’t work when the public thinks of mothers with Postpartum Mood Disorders. A mother with a Postpartum Mood Disorder is a horrible mother to most – we’re stigmatized and in addition to overcoming the every day normal judgmental issues which accompany motherhood – we must also overcome the additional perception of our “bad mother” rep.

The final paragraph recognizes that “It’s not all you.” It’s not. It’s genes. It’s how our child is wired to react. But guess what? Kids of depressed parents are more at risk for issues like ADHD. They sleep less. Their quality of sleep is less. Dr. Pillay says, “Parents who take on all the responsibility of this often distort this, feeling as though they are fully responsible for how a child turns out.” Wait a second. Aren’t we? What about Parents who are arrested for the behavior of their children? Parents who are judged because their child isn’t yet sleeping through the night or wets the bed or isn’t getting good grades in school? Or Parents who have infants who are not yet eating solid foods even though they keep trying? Yet, Dr. Pillay’s solution is for PARENTS not to blame themselves when their child doesn’t “lean on their own sense of responsibility.” He also goes on to add this gem: “Also, mothers who are alarmed by their own mistakes set a challenging standard for their children who may grow up to learn that mistakes are “bad” rather than inevitable but not a reason to give up.” Let’s say a mother has a doctor for her Postpartum Mood Disorder who keeps telling her she’ll get better with every therapy they try. Instead, she continues to worsen. Eventually she’s convinced the fault lies within her. That SHE is the problem. Some of these mothers may even give up and just live out the rest of their lives without trying any more therapy because they are the issue, not the therapy. So of course she will raise a child to believe mistakes are bad as opposed to inevitable. Of course she will raise her child to believe once a mistake is made more than once that giving up is the proper course of action. Or even worse yet, let’s say mom doesn’t get treatment at all (which is the case with most mothers struggling with a Postpartum Mood Disorder, by the way), this issue will spill over into how she raises her child and no amount of pulling herself up by the boot straps will change her thinking. She’s leaned on her own distorted sense of responsibility and it didn’t work for her. Why should she then expect it to work for her child? Why would she not consider herself fully responsible for her child’s behavior when society does just that on a daily basis?

My absolute favorite part of Dr. Pillay’s piece is the closing paragraph:

“Thus, when mothers find their relationships thrown into disarray, they may want to re-examine their own standards and relax their judgments toward themselves as they allow themselves to be more human and the very best that they can be without needing to be perfect.”

Sighs.

If only society would let us, Dr. Pillay. If only society would let us.

I’d like to add though should a mother finds her relationships thrown into disarray, she should not immediately blame herself for the fault of the disarray. Yes, she may truly be at fault but the other party may be at fault. She may be struggling with a Perinatal Mood Disorder or another type of mental illness. There are many additional reasons for the fault of relationships to be at fault other than the internal (yet societal driven) standards imposed on Mothers today. Perfectionism is imposed, not perceived. Failure to achieve perfection is perceived yes, but the standards we fail to reach were, at some point, imposed upon us by society. If we truly want to help mothers overcome the perception of succeeding by not being perfect, we need to first change society’s view of mothers, not mother’s view of themselves. The standards we try to reach our not our own… they are the fences between which we are forced to live. Until these barriers are removed, we will never succeed.