The Sex-Mind Connection

Understanding how your sexual and mental health are interconnected is integral to taking care of your well-being.  Research has shown that sexual activity has a direct impact on mental well-being. A healthy sex life can improve the way you feel and express emotions. But what happens when menopause, illness, pain, or other factors get in the way? 

Sexual dysfunction and other issues related to sexual health can often lead to common mood disturbances in women. Many women may experience feelings of anxiety, low self-esteem, or depression. These symptoms usually appear in a cycle; sexual dysfunction impacts the mood, and mood disturbances further impact sexual health. Link here

Common sexual health concerns in women include a low sex drive (aka hypoactive sexual desire disorder), painful intercourse, difficulty reaching orgasm, and menopausal changes. Women facing these concerns should speak with their healthcare provider or gynecologist. Many of these issues are treatable, but can still be frustrating.  

Stress and anxiety even have a biological impact on the body that can affect one’s sexual health. Your body is programmed to react to stressful environments by producing a hormone called cortisol. Usually, it provides you with a short burst of energy to tackle an immediate problem in front of you. But, importantly, when your body is producing cortisol, it cannot release the essential hormones needed for sexual arousal. In a population study conducted by researchers Dunn et al. (1999), sexual concerns were affected by psychological issues in women more than men. Problems with arousal, inhibited enjoyment, and painful sex were strongly related to anxiety and depression measures in women. For men, sexual health concerns were connected to age and physical health more significantly than emotional issues. 

Your gynecologist, a sex therapist, and a cognitive behavioral therapist can each be critical   resources for women experiencing sexual dysfunction. The role of cognitive therapy can be to promote a healthy change in attitude around sex, reduce anxiety relating to sex, and improve a woman’s self-image in the context of dysfunction.  

We are not separate from our bodies.  Sexual health is crucial to your overall health. Despite the stigma surrounding sexual dysfunction, please don’t go it alone.

The Awkwardness of Authenticity

When we try something new in front of other people, we tend to worry about judgment or other negative consequences. And we tend to feel awkward because the experience between us is novel and unpracticed.  But the feeling of awkwardness doesn’t mean we actually are awkward (thankfully!).  But feeling awkward typically goes hand in hand with feeling vulnerable. 

We are often unaware that feeling awkward and taking emotional risks in front of other people eases them.  

Why? Because vulnerability cues other people that your communication is authentic and sincere.  It also cues other people that they too could be awkward, vulnerable, and authentic in safety.  That they too can try something new in front of others. 

No one can authentically connect with others without some vulnerability. If you have a hard time believing this, consider whether you have ever felt safely connected to someone who never displayed at least some vulnerability with you.

So even when it might feel initially awkward for you,  it might be time to reframe vulnerability and awkwardness as the necessary starter ingredients for authentic connection. 

Motherfectionism

Motherfectionism:  the cultural and intrapsychic insistence that mothers be perfect vessels of love and nurturance; responsible for, and in control of, all aspects of her child’s behavior and outcome.  


OK, so I made up my own word.  But it’s probably about time because it describes a process mothers often experience, and that I am witness to in my private practice and personal life. There are more examples of motherfectionism than I can count because women still bear the lion’s share of the emotional, logistic, and physical labor of parenting. And any form of perfectionism is first and foremost a coping strategy. 

Why am I framing the challenges of motherhood through this lens? Because I believe that our role as women’s mental health psychologists is to consciously not reinforce perfectionistic, unrealistic standards for mothers.  Indeed, there is a whole parenting advice industry that serves to replicate these standards, replete with two minute TikToks of confident, easy wins with our kids. I can’t tell you how many therapy sessions I have shared with mothers who feel confusion and shame in their parenting in the reflective glare of TikTok advice.

I believe our role as women’s mental health psychologists is to acknowledge the complexity of parenting,  and to shore up resilience within our female clientele for the emotional and pragmatic complexities - and labor - of motherhood. While we can offer parenting advice if needed, our job is to support you with all the flexibility and creativity that parenting requires.  Just like we do with every other important area in your life.

Schemas of aging: how they might actually impact how we age

If I were to say “close your eyes and picture a college dorm,” what image would your mind paint for you? You’d probably visualize a pretty nondescript room with twin beds, posters on the wall, a desk with a computer sitting on it, etc. But what if I were to say “close your eyes and picture a person in middle age.” Or, “picture a person in their 70s.” Now what do you see?

For a lot of us, thinking about aging usually evokes images and beliefs related to loss. Loss of mobility, health, beauty, or of feeling care-free. These beliefs and images are called “schemas,” and they can have a very powerful impact on how we move through life. Sometimes these schemas can be useful; like when my dorm room schema pops in my head and reminds me to buy the right sized sheets before move-in day, for instance.  

But what effects might these loss-heavy age-related schemas be having on us? Well, as Dr. Becca Levy details in her book “Breaking the Age Code,” research shows a significant relationship between such schemas and medical illnesses like high blood pressure, Alzheimer’s dementia, and heart disease (to name just a few). Simply put, those who endorsed more fatalistic beliefs about aging were statistically much more likely to experience actual health problems in older age.

In contrast, Dr. Levy found that those with more favorable attitudes towards aging were also more likely to recover from disability at a quicker rate, have better memory performance, and yes, even live longer. In other words, these individuals are living a self-fulfilling prophecy that is actually fulfilling!

How did they do it, you ask? According to Dr. Levy, this process involves three stages:

  1. Developing a greater awareness of harmful aging schemas- as they exist in both ourselves and in our external environments.

  2. Tracing these schemas to their original source: a society that conditions us to fear aging as a means of profit. ($75 wrinkle cream, anyone?)

  3. Disrupting and replacing these beliefs the moment they pop into our heads

If this process sounds familiar to you, you might either already be a patient at CTW, or at the very least have read some of our previous blog entries. Because what Dr. Levy describes here is at the very heart of the work we do in our therapy sessions. 

Together with our patients, CTW psychologists take time to unearth these schemas, explore their roots, and examine the vines they have grown. And if they are found to be the viscous, choking kind, we then work to apply some cognitive “weed killer,” so to speak. We attack them with relevant information (e.g., that it is possible to remain healthy and active as an older adult) and plant more nourishing beliefs (e.g., “being alive for longer gives me more time to explore the world and discover exciting new things about it”) in their place.

Just like actual weeds, these schemas of ours are often pesky and persistent. They sprout easily, demand regular intervention, and are impossible to prevent entirely. But that is no reason to let them grow wild and literally strangle the life out of an otherwise thriving existence. So if you are one of the many people out there who struggle to imagine themselves flourishing with age, perhaps this is your sign to get back in the garden and start digging.

You don’t have to do it alone, either. We are here to help. Contact us today to get started!

About Those New Beginnings

In the Northeast, we are pretty much programmed to anticipate new beginnings in September.  We may feel a surge of inspiration and energy that catapults us out of the last vestiges of summer.  

Changes in season often reflect in our mood, at least temporarily.  A key aspect of managing our moods is recognizing the transience of mood.  Everything - including our mood - changes. And while external factors, like a seasonal shift, might impact us briefly, we don’t always have to make a larger negative story out of it.  Sometimes our meta-story about our mood is the culprit in worsening it.   For example, a client might say “Every winter I get depressed”, and the result of that belief is that she feels anticipatory anxiety and dread as the winter approaches.  But a further examination of that statement reveals that most winters (not all) she feels a brief but significant drop in her mood that signals her to then anchor herself in her coping skills, and shift herself out of that low mood.   So a reframe of that statement could be “I typically feel a significant mood drop in late November. I am going to try to get ahead of that by being proactive and practicing my repertoire of coping skills to either prevent, or move more quickly out of a depressed mood if it arises.”  

Changes in mood are inevitable.  But our power lies in our willingness to directly influence the meaning we give to those changes.  If you would like support in doing just that, we’d love to help!

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Shining a Light on Perinatal Mood and Anxiety Disorders

As a clinician whose practice focuses on all aspects of maternal mental health, I was motivated to write June’s blog after reading a tragically resounding story that recently made national news. Among other reactions I had, this story reminded me that the information I hold as a specialist in this area is not common knowledge for the majority of women in this country. As such, through this month’s blog I hope to educate, normalize, and destigmatize a disorder that affects so many American mothers and their loved ones. 

Arianna Sutton had a history of postpartum depression after the birth of her first child. But after her second pregnancy, her symptoms returned more quickly and stronger. Nine days after giving birth to twins, Arianna died by suicide. Tragically, Ariana’s story is not uncommon. Moreso, it underscores the importance for awareness of and knowledge about the most common pregnancy related complication: perinatal mood and anxiety disorders (PMADs). 

What are PMADs? 

PMADs include a variety of disorders and symptoms that a woman may experience during both her pregnancy and the year following birth. Postpartum depression is the most commonly known among them, but it is just one experience that fits under the PMAD umbrella. Specifically, additional disorders include anxiety, panic disorder, postpartum bipolar disorder, obsessive compulsive disorder, post-traumatic stress disorder, and postpartum psychosis. 

According to Postpartum Support International, approximately 15 to 20% of women (or approximately one in seven) will experience symptoms consistent with PMADs. Additionally, women with a history of clinical depression or anxiety are at a significantly greater risk for developing PMADs, and those who have experienced PMADs during pregnancy are more likely to experience recurring symptoms in subsequent pregnancies. But important to also note is that a woman can be diagnosed with PMADs even if she did not experience symptoms during previous pregnancies. 

Although it captures most of the PMAD-related headlines, postpartum psychosis is a rare experience that occurs in 0.1% of women with onset two to four weeks postpartum (Postpartum Support International). Symptoms include, elated high mood, overactivity, racing thoughts, confusion, mania, suicidal or homicidal thoughts/actions, hallucinations and delusions. Though postpartum psychosis is a medical emergency that often requires hospitalization and medication, with early intervention, symptoms can typically resolve within weeks (Postpartum Support International).

In contrast, the so-called “baby blues” is a very common postpartum experience that occurs within two weeks of birth and whose symptoms include weepiness, fatigue, anxiety, and difficulty sleeping. Though the baby blues are typically resolved with simple self-care practices, if symptoms persist beyond three weeks postpartum, a diagnosis of PMADs may be considered.

Additional PMADs symptoms to be aware of include

  • Feeling sad or depressed

  • Irritability or increased anger

  • Difficulty bonding with your baby 

  • Feeling high or elated above and beyond what is typical 

  • Reduced need/desire for sleep 

  • Anxiety of feeling panicky

  • Upsetting thoughts that you can’t get out of your mind

  • Feeling as if you are “out of control” or  “going crazy”

  • Feeling like you should never have become a parent

  • Worries that you might hurt your baby or yourself

Treating PMADs

As many women feel shame, struggle to ask for help, minimize their symptoms, are fearful that they will lose their babies, or have limited support and awareness of PMADs, they often suffer their symptoms in silence. Fortunately for those affected, with proper intervention, PMADs are in fact highly treatable and have a favorable prognosis, often with a combination of medication management and psychotherapy.

Cognitive-behavioral therapy (CBT) is a highly effective form of psychotherapy treatment for PMADs, as it empowers sufferers to work in the “here and now” - as opposed to focusing on family of origin dynamics that are likely not helpful to the crisis at hand - to experience symptom relief.   CBT works with the interplay of a patient’s mood, thoughts, and actions, to provide a patient with alternative perspectives and experiences of her situation, healthy practices that can support her mood, as well as providing immediate coping strategies to the patient.  

At CTWPS, the specialized training our practitioners have into the specific challenges of women with PMADs makes us uniquely qualified to work with affected individuals. We strive to not only provide our patients with effective symptom reduction strategies, but also to normalize, educate, decrease shame, and improve their quality of life. If you, or someone you know, may be experiencing a PMAD, we at CTWPS are here to help and provide support. Reach out today!

References

https://www.today.com/parents/family/mom-dies-suicide-twins-rcna88579

https://www.postpartum.net/learn-more/