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(August 2006)

The MALADIES are the FIVE most common conditions that make overcoming the CRUMMIES more difficult.  They are MALTREATMENT, MALFUNCTION, MALIGNANCY, MALPRACTICE, and MALARKEY.  You probably have one or more in your life that complicate getting and staying healthy.

MALTREATMENT can be past or present.  It can take the form of physical or sexual abuse in childhood, domestic violence and verbal abuse in adulthood, or other neglect and privations.  When I look back over my thirty-seven years in practice, I would have to say that between 70 and 80 percent of the eight to ten thousand women I have seen, regardless of the setting, have reported the presence of some type of current or past maltreatment in their lives.  They may or may not be coming in to see me for reasons related to that abuse, but their capacity to recover, to respond to treatment, to live a productive, satisfying life is very much affected by maltreatment.  The fortunate ones have become “survivors”.  They have effectively used prior therapy or found other social and spiritual resources to aid in their recovery.  The others remain trapped in a “victim” role, which not only leaves them vulnerable to further abuse but keeps them from stepping forward in the world in an assured, positive manner.  Many, who come to therapy for the first time in their forties and beyond, are revealing their traumatic history or current abuse for the very first time.  With the sharing of their “secret” comes the opportunity for healing and serenity.  If you are reading this and the “secret” is still inside, I encourage you to find the courage to share that secret a trusted friend, a pastor or a therapist.  With their help, you can begin a journey beyond shame, a journey that can heal not only your emotional and spiritual self but often your physical self as well. 

MALFUNCTION comes in many forms as we age.  We need arm-extenders to read the menu as we resist the move to bifocals.  The groan factor becomes a part of life as creaky knees and pain-ridden backs heave our often-overweight bodies out of chairs or up stairs.  Diabetes, hypertension, and heart disease suddenly become more than family history and part of our own medical chart.  Multi-tasking turns into why-am-I-standing-in-my-kitchen.  Menopause, as inevitable and normal as it is, leaves us swimming in a pool of sweat, hot under the collar (and in every other crevice!), and mean as a junkyard dog.  Our worst fears are realized as we look into the mirror, or see the looks on our grown children’s faces, and know for a fact that we’ve just turned into our own mothers!  The overlay of physical discomfort, chronic illness, and chronic pain greatly increase the likelihood that we will be stressed on our jobs, more vulnerable to developing depression, and even at higher risk to developing dependencies on chemical substances, including pain and sleeping medications prescribed by our physicians.  Taking better care of our health, giving some TLC to those beautiful bodies of ours, doing meditation, minimizing our intake of alcohol, stopping smoking, getting daily exercise (even a ten to twenty minute walk), getting a massage now and then—all can make a positive impact and reduce our risks of psychological meltdown and spiritual burnout. 

When the diagnosis is not the usual ill that a week off of our feet and a few pills can cure, when that most feared diagnosis of terminal cancer, or multiple sclerosis, or Parkinson’s, or early Alzheimer’s is given us, then what?  MALIGNANCY in all its varied forms often kills our spirit before it destroys our bodies or our minds.  When I think of my most treasured moments during my long years in practice, I think of the handful of extraordinarily courageous women who gave me the privilege of being with them through the last months of their lives.  What support I could give to them was nothing compared to the uplifting experience I had simply sitting with them as they made that last transition in life.   Often families are too close or too frightened to allow the sharing, the laughter, the prayers, and, yes, even the joy, that can be a part of this final and most important journey of our lives.  There are so many wonderful resources now for women facing chronic and even terminal illnesses in addition to their own family and spiritual supports.   Get that computer whiz grandson of yours to find the nearest support group for you.

MALPRACTICE may seem like an odd addition to this list of life’s complications.  It is not surprising that with all the extra medical care our aging bodies require, that now and then we find ourselves at the receiving end of less than perfect medical care.  I read an interesting book some years back called Male Practice: How Doctors Manipulate Women (by Robert Mendelsohn) which chronicled how women have been under-treated and inappropriately treated over the centuries by male physicians.  When actual malpractice occurs, an attorney should be consulted or the member services department of your health care organization contacted.  Most of the time, however, the women I see complain of being unheard, ignored, patronized, or told “it’s all in your head” by their primary care physicians.  That’s when women end up in my bailiwick.  Crying in front of a physician—especially a male one—is a sure ticket straight to psychiatry.  Very real medical problems can be caused or aggravated by stress, and even when they are purely medical, it doesn’t hurt to consider getting some supportive counseling just to help you make the tremendous adjustments that living with a chronic illness necessitates.

  MALARKEY is the last in the list of MALADIES that complicate our lives in our middle years.  Oh, there’s the usual malarkey that comes to us from the media, politicians, and used car salesmen.  But the malarkey that most affects our lives comes from our own heads!  And it got planted there a long time ago while we were growing up.  Think about it.  Did Dad’s admonitions about the clean-plate-club contribute to that lifelong eating disorder with which you’ve always struggled?  Did Mom’s warnings about not being selfish lead to a lack of self-care or damaging codependent relationships?  Did do-unto-others turn into don’t-do-for-yourself?  Have your experienced too heavy a dose of Miss Manners?  Deeply held assumptions that women harbor in their souls very often have to be uncovered, re-examined, and replaced with more reasonable and workable guidelines for a sane and sustainable approach to life.