Depleted Mother Syndrome: Why Moms Burn Out, and How to Recover with Jan Hanson | Being Well

0:00 I was laughing today thinking about how many people when they're pregnant have a number of things that they say, "Oh, I'll do that after the baby comes." As if life is going to be easier. >> What's going on here? What do the doctors tell you? And they would just all report, "Oh, they say nothing. You're just a mom with kids." >> Wow. What do you hold your kids up with? Your will. It was just great to have a name for a problem and something to start working with. Having a sex conversation with my parents is truly interesting, but hey, we're all adults.

0:31 Hello and welcome to Being Well. I'm Forest Hansen. If you're new to the show, thanks for joining us today. And if you've listened before, welcome back. Today, we have a very, very special episode of the podcast for you. I am joined by two guests. First, as usual, clinical psychologist Dr. Rick Hansen, who, as you probably already know, if you've been listening for a while, is also my dad. and we are here making her podcast debut with none other than my mother Jan Hansen. Mom, how are you doing today?

0:59 >> Well, I'm doing just great, Forest, and thrilled to be here on my first attending of your podcast, although I've listened to many, many. >> I was about to say longtime podcast listener, first time caller. It's great to have you. This is so much fun. I've had we've gotten so many questions over the years of like, oh, are you going to do one of these with your mom sometime? And and here we are. So, this is so cool. Dad, how are you doing as well?

1:21 >> I'm great and I feel so honored to do this and kind of as a setup, we've been jumping through hoops for about an hour and a half to get our technical setup correct and it reminded me so much of the topic of this episode. what happens when you know baby makes three, right? And the scramble and everything that's involved in that. So it seems like kind of perfect that that's how we started today. So, this is obviously really exciting for us just on a personal level. It's so fun to do this with my mom. I want to tell you a little bit more about her and then I'm going to reinforce what Rick was saying about what we're talking about today. in addition to being a great mom, she also has a background as an acupuncturist and now has more than, I think, four decades of experience in nutritional medicine and integrative health. She's also the co-author of the book Mother Nurture, which she wrote with Rick and gynecologist Dr. Ricky Poly Cove. It originally came out back in 2001, 2002, something like that. And now they're releasing its fully revised successor, A Happy, Healthy Mom, Your Guide to Less Stress, Better Teamwork, and More Joy on the Journey. And A Happy Healthy Mom comes out or came out depending on when we can get this episode out on August 25th. It is very common for the mothers of young children to feel like they're running on empty. They're feeling stressed, worn out, stretched thin, generally just feeling worse than they used to. And those experiences are often brushed off by people as just what motherhood is. But today, we're going to make the case that those feelings have real causes and real consequences. And those causes are found all over the place in mom's biology, psychology, and social relationships. And if they're real causes, guess what? That means there's something that we can do about them. And that's what a happy, healthy mom is all about. So, mom, I actually just wanted to start here with your personal experience, which is why you guys wrote the book in the first place.

3:17 What was going on maybe around the time when I was like 3, four, 5 years old? How were you starting to feel? What was happening that inspired you guys to write this book? Being a mom is truly for me the most incredible thing I ever did. and your dad and I both wanted to do this in a way that really was optimizing your psychological health. So, we were very committed to this in every way. And the first thing I want to say is I would do it that way again.

3:47 There's very little I would change about what I brought to my kids. although they have let me know some of the mistakes I've made. But but you know, that is not what it's all about because that is truly wonderful. But it is about also taking care of yourself. So anyway, I actually have a pretty involved story with this. I have Forest. We're in love. We're all in love. You know, we have ups and downs, but it's pretty good. Good. And then along the line at Forest is about two and I get pregnant with his sister Laurel. Rick was at that time in graduate school, very involved in his work, and I wasn't that interested. I used to be very interested and now you know that was fraying a little bit. So our relationship was not as dirty as it had been before. So then I have Laurel and now my son suddenly it seems like whoa he's really an active almost three-year-old and you know that was normal before but now it's really a lot and >> you're dealing with a lot. Yeah.

4:54 >> Dealing with a lot. Exactly. And the bottom line was that I I just wasn't taking care of myself. And I just started to kind of get tired. I mean, and kind of flat, not very not excited. And I'm kind of wondering about myself. Why am I not able to do all of these things? I mean, I was still doing them all, but everything was a stretch basically. You know, I I developed chronic headaches. I had just a lot of kind of emotional reactivity. My digestive tract wasn't happy and you know, but I just kind of toughen it out here. So, you know, I think the thing is at what point do you really start to ask the question, what is really going on here? So for me, one moment was I was seeing a chiropractor for something and she looked at me and just said, "Wow, what do you hold your kids up with? Your will." And it was just kind of a moment of going, "Wow, I actually have something kind of problematic going on."

6:03 And you know, that was that was actually kind of a relief to hear that. So So that was kind of one step. Then I was out one day for what I thought was a special occurrence. I was at the mall. I liked to shop and I was with my favorite young man, Forest. Laurel was being taken care of by a babysitter, which was not a common thing for me to have that. And I just wasn't happy. I didn't want to have ice cream. I didn't want to shop. You know, I was wanting to bring the juice for forest, but for myself, it wasn't the same joyous thing. And I just remembered, I mean, I wasn't a psychologist, I was married to one, but that phrase that not feeling happy in the things that you've previously gotten joy from as a description of depression. And I went, "Oh my god, I am depressed." And you know, went home because we couldn't make a call from the mall at that time in the dark ages of no cell phones. and I called dad at work or whatever and said, "Wow, I think I'm depressed."

7:09 And it was it was just great. That was obviously a much more complicated picture, but to have a name for a problem and something to start working with. Then the whole next part is I was working seeing some holistic practitioners and I asked one of them I was starting to think oh I had all these muscle problems you know could minerals be a problem so I asked this guy to test my minerals and he did and along with that he also tested my amino acids and these are like charts where they're just doing many many different minerals many many different amino acids all of my minerals were low they were in like the kind of low five to 10% of what a person could keep moving with. I mean, they weren't gone because you wouldn't be able to stand up, but they were very low proportionally. And then also my amino acids were low. So, we've got the building blocks of your basic muscles and tissue. And then amino acids are the building blocks of your neurotransmitters and many other things.

8:18 So we just saw this whole picture of deficiency basically. And >> then layered on top of that, I think this was a later finding is you had an intestinal parasite maybe in part because your immune system had been kind of worn down. so was fighting pretty hard against this thing. You're dealing with these two kids and you guys were looking around and as you've you've told this story to me many times at this point just going like what's going on here? like we have great care and a great framework for supporting moms during pregnancy and we've got a pretty good framework for supporting them immediately after pregnancy.

8:56 And then I think that the the line I I think I first heard this from dad years and years ago from you guys was some version of the village it takes to raise a child is just kind of empty these days, >> right? >> And that was really the experience that here you are, you're now juggling these two young kids. you have a partner who is very engaged psycho emotionally, but he's trying to work. He's trying to get through graduate school. We, you know, had our own resource limitations, all of that kind of stuff at that moment in time, right?

9:22 >> And it was all it was all real. >> And that all added up to to use a word that we've been using a lot on the podcast recently to this like biocschosocial problem. There were all of these issues in all of these different domains and it was kind of a death of a thousand cuts thing, right? any one of them might have been dealable, but you put them all together and you're really dealing with quite a lot, >> right? And kind of the the extra piece here is appreciating that and this is not the only thing but is that in certain cases that can actually result in a true health problem that you just get worn down enough you know and that doesn't happen to everyone although I think almost all moms are affected physically for sure they're affected physically big time but you know most don't get an illness from it but it does happen for a percentage of people. But yes, it's it's that whole combo. And I can look back at many of those areas of my life and just see things that weren't going optimally basically and were, you know, part of the wearing down of my well-being. Dad, I want to get you into this both to get your experience of whatever was going on here and also to get some more context around mom's experience and the typical experience of of many mothers who are raising young kids.

10:49 >> Well, I feel personally very touched here. Of course, you know, my beloved wife, the beloved mother of my beloved children is really just sharing very matter-of-actly, frankly, kind of the tip of the iceberg of the impacts stretching out over many years. And, you know, you were easily six or eight or nine or 10 before we really started, you know, wrapping our arms around this issue. And so listening to the particulars there there are a lot of particulars that have to do with your mom and in a bad good way she got the whole package and the experience I started to have as a father and also as a kind of young clinician was that what was happening with Jan was actually universal and routinely I'd be talking with a couple whose kids were teenagers who were kind of in trouble and I'd get the story and it went all the way back to the birth of their first child when the wheels started to come off. Just a detail. I'm cleaning out the garage these days and going through a lot of old papers and have came I came across recently my mother's diary of my first birthday party and she's listing all the people who've come and my mom was sort of formal about this sort of thing and the different presents they brought so she could write them thank you notes.

12:09 And there's just one sentence in there, Bill was not able to come and she kept going. Bill the name of my father and she wasn't critical it was just factual that in the role structure of the time in terms of his work and he was also toward he was getting a PhD at the time as well it was just expected you know he he was at work you know it was Thursday he's got a job but that left her in the lurch so when I started being aware of things like that and how my mom was being affected who at that moment when I was my birthday she was a month away from delivering ing my sister who is just 13 months younger than me. You can see how all these things come together.

12:49 So that's a huge takeaway is to kind of locate your own story in this larger picture and to face the fact that as I think Adrienne Rich wrote about a long time ago in her masterful book motherhood experience and institution. She coined the phrase the mask of motherhood that behind this socially constructed so effortful, such a heroic, diligent, stoic effort, not complaining, just but behind that mask is often a lot of personal suffering and a lot of wear and tear that then has consequences, biocschosocial consequences, including in her relationships with her mate and with others. And so we've wanted to kind of peel back that mask, take listen to the stories of many, many mothers that have gone into this book and to really think comprehensively, all right, what can we do about it?

13:48 >> You guys had this frame where mom was going through experiences. She was feeling a certain kind of way. You looked at this package of experiences and dad, you were you were training to be a psychologist at the time. >> Yeah. And then starting my practice as well. >> Yeah. Totally. And so so you were getting into it. you were you were in the material. And I don't know if at the time something like postpartum depression was as recognized a thing as it is these days. I'm I'm not sure actually what the history of that is or not. You would be you know that much better than I would. but you guys looked at it and you were like, "Wow, it's, you know, got aspects of that, but it's got these other aspects." And you coined this phrase depleted mother syndrome or DMS. Would you mind explaining what that is and how it's the same or different from these other constructs?

14:32 >> You you bet. And I should add too, at a moral level, I was bowled over with what my wife Jan was dealing with. You know, I was in full throttle, making money, driving to, you know, 50 miles each way to my grad school and back several times a week, worried about my career. I was putting it out there. And what I was doing, I considered to be less demanding and certainly less stressful than what she was doing. I also looked at the research and and I was just stunned that again and again and again I'd ask a mom whose kid at that point was 10 or 15 or even a young adult and certainly when they were young. So you're telling me that you feel really run down. You're in frequent conflicts with your partner about how to raise the kids and share the load. You just feel kind of fried.

15:24 You always muster for your children kind of sort of you muster for your home and your marriage. you rarely muster for yourself. What's going on here? What do the doctors tell you? And they would just all report, oh, they say nothing. You're just a mom with kids. Don't worry, it'll it's a phase. It'll pass in 20 years. That was it. And that made me mad and made me also curious like what's going on. So, I started looking around. As I've gotten a little older, I've really come to appreciate the quality of the sleep I get just as much as the quantity. One of the best ways to optimize sleep quality is by controlling temperature. I love sleeping in a cool room, but that's not always possible here in California. That's where our partner Orion comes in. Orion is a smart sleep system that fits right over the mattress you already have and adjusts your temperature to optimize your sleep and improve recovery. Orion helps you find the right temperature for every stage of your sleep cycles, boosting REM sleep and reducing overnight wakeups. Orion is a fraction of the cost of other smart sleep systems. It starts at $60 a month with no mandatory subscription and no replacing the mattress you have.

16:36 Right now, Orion is offering our listeners 15% off at orionleep.com/beingwell. That's o r i o nleep.com/beingwwell for 15% off. Get better sleep backed by your own data at oransionleep.com/beingwell. These days you start loading up vulnerabilities. You start having children at a later age. You start having very little community. You start seeing that some mothers sail through motherhood. That's great. They're super healthy during their pregnancies. Their births are uncomplicated. the children are wanted, there's a wonderful support system, their partner is really engaged. That's great. Let's think of that as the upper third. Then there's kind of the middle third who, you know, they make it through the first year or two of their kids' life and then they start coming out of it. There no additional things that happen around them like a second child or additional burdens like taking care of an aging parent or a move or a divorce. you know, they're they're affected, but they come out the other side. All right. Then there's the lower third of people who are most affected by the physical impacts compounded very often by the stresses of motherhood often landing on pre-existing vulnerabilities like to a health condition such as an autoimmune illness or a family history of depression. And then what I saw there was the the sort of real nater the lowest point was typically around the child's third or fourth birthday which often coincides with another child coming on or the coming in or the wheels really coming off in the marriage around that third or fourth or fifth birthday.

18:24 And that's a real slump. And then some women, you know, they come out of that slump eventually. Great. And some of them frankly are kind of are stuck there. You ask them, gee, when did this fill in the blank problem began? Oh, I don't know, when Bob around when Bobby was four and his baby sister came along. So, you can trace it that way. So, I don't use terms like syndrome or complex casually. You know, I I'm kind of annoyed at things like the Peter Pan complex or the Cinderella symptoms syndrome. I think these are words we want to use very carefully. So in the book to a fault you know people were proddding me be bolder Rick no I want to be really cautious about using the sword syndrome but yeah when you have a collection of symptoms associated with a collection of signs with complex origin and individual course that's a syndrome and so we propose that yeah indeed some significant fraction of of mothers call 10% 5% 25% transit through a phase of being truly a depleted mother which some come many come out of eventually although there can often be consequences of having been in that phase at all and some of them frankly get stuck there. So that's the notion of depleted mother syndrome. So, I want to pull out one piece of what you were talking about there, Dad. which is this notion that the low lows come two or three or four years after you first have your kid. This was something that you guys were saying back in 2002.

20:03 >> We started writing about this. I've seen it. I've got the proof. Back in like 1995, at which point you were 8 years old. That's when it started to really the light bulbs went off. Years and years later, the ACOG, so the American College of Obstatricians and Gynecologists redesigned postpartum care around what they called the fourth trimester. So this period against post pregnancy when mothers were not getting in their mind enough support. And so you guys were way ahead of the curve here in talking about this. a related point is that standard 6 to 8 week screening lands at roughly the lowest point on the symptom curve for a mom. So an early screening and saying, "Okay, you're doing just fine is really not telling you very much about the the ultimate course of mom's experience here." And there was this really cool maternal health study that was done in Australia that found that depressive symptoms at 4 years postpartum was 14.5%.

21:04 Right? And that was higher than at any measured point in the first 12 months. So depressive symptoms are increasing over time. The amount of care people are getting is decreasing over time. So there's this great split that's happening, right? And I'm wondering, Mom, in your experience, what do you think was adding up here? Why do you think it was harder when I was four than when I was 1 or when I was eight than when I was three? The real thing I believe is just cumulative. So first of all, you have had this pregnancy. For many women's they have breastfed. so but this goes on. So now you have the depletion of a pregnancy. Many women go into it without you know adequate frankly nutrition in their bodies to start with. They're not any better off at the end of their pregnancy. A little bit worse. And again you know I was privileged. You know I'm a middle class upper middle class person who you know could afford to eat and all that. So, we're not even talking about the a huge number of people who can't really even think about this. But anyway, so then then you end up that you come out of it a little bit worse maybe. And and I was laughing today thinking about this. How many people when they're pregnant have a number of things that they say, "Oh, I'll do that after the baby comes." You know, as if life is going to be easier after the baby comes. You're gonna have more time. I mean, you never say that for the second baby. Forget it. You know, it's not happening. But anyway, so then you've got the accumulation. You're breastfeeding or you're just busy and you're not taking care of yourself. So that's the physical part. And I mean, it's really amazing how moms will make a wonderful meal for their child for breakfast and not eat anything. You know, grab a cookie later or something like that. But then also I think you have a lot of wear and tear in the relationship. Things are going down. The mom is very focused on the kids and starts to think she can get away with a little less attention on her husband and she wants she wants and needs a lot from him. So that adds to the fray. And so if around four years you're starting to really have that marriage fall apart, man, that is an incredible stress. And I'm very thankful I did not have that.

23:27 But I know many women do have that around, you know, it starts to get rough around that point and then, you know, maybe continues until perhaps the marriage dissolves. But I had many friends who said things like, "Oh, you know, it's okay. We'll rekindle in 15 years." And I just thought, you are crazy. That is not going to work out. One of the things that I appreciate about the frame that you guys had throughout this was there's a structural part to this whole thing that I think is worth mentioning where as you guys are observing a lot of the pressures here get to there not being the levels of social support that we would wish mom to have.

24:11 >> Yes. Whether that be direct child care giving, whether it is from their partner or it's from other social systems, whether that's the demand of needing one and a half incomes at the very least these days in order to kind of make things work. You're doing that while you're raising a kid. That's hard for everybody involved. and as we often talk about on the podcast, there's this way where these structural problems land on the individual and they become individual problems for that we present as like it's the individual's job to solve them when really it's these big structures that we're engaging with that are creating these problems. And there's a kind of fundamental unfairness there that I do want to mention before we get into the more problem-solving part of the conversation. And I want to leave this really open for you guys. I'm a little bit more interested personally in the psycho and the social side of the spectrum. So your guys' relationship, how you supported each other, what you did to do deal with some of these issues that you've been talking about. But hey, I'm also here for the bio part of it. We just tend to talk about it on the podcast a little bit less. If you had to give a kind of prescription here for DMS, where would you start? How do you think about it? We think of DMS so-called as a very tentatively offered notion to encourage more research and attention to the you know long-term health and stress issues of mothers.

25:35 Personally, I have a view that if the the risks of health conditions that increase with the number of children a woman has, if those were actually present for men, this area would have seen a lot more research and a lot better funding for research over a number of years. That said, we're really interested in the ways in which what might seem like small things can really accumulate over time. E even if the person doesn't have the full package of maternal depletion which we think is anchored in physiological deficits and dysregulation. It's particularly physical. But even when the issues or the consequences of motherhood are not particularly physical for a woman, it's really worth attending to all the other ways in which she, you know, feels let down by others, stressed, and insufficiently replenished. You know, it's this fundamental model that you and I have used many times for us that a person's course is shaped by three factors. Their challenges, their vulnerabilities, and their resources. So with as children come along, challenges really go up.

26:45 Mothers will almost all say that having children was the most wonderful, best, most fulfilling thing they ever did in their life. Dot dot dot. And also the hardest, the most demanding, the most stressful, the most impactful, the most consequential. So challenges go up depending on the women they land on certain vulnerabilities including vulnerabilities to pre-existing pre-existing health conditions. The way to deal with it which is what we super focus on is how to increase resources. You know how to start filling that cup up increasingly both physically and psychologically and also certainly interpersonally. So to me that's kind of the framework. One thing I did poorly had to do with getting social support.

27:27 And I think this is very important, which is that my when you were born, my my friend I I had had a really wonderful friend life. I was going out to lunch with friends that I worked with every day. I mean, it was just very easy. So that that eliminated because I wasn't going to work in that way anymore. And and I had a lot of people around me who were offering to help. Let me know.

27:53 we'd like to help with this beautiful little baby. I didn't take anybody up on it. I thought, really? Do you really want to help? And so, there's a piece here for a mom taking care of herself, which is say yes to help. And I think I mean, obviously, we need to have more help offered, but at the first level is say yes to help. And I think this is something we could all do all of our lives and that would be good, but this is a particular time. So there there's a whole bunch of bringing in whatever social resources you can. Then I think a very important is all of the relationship stuff. relationship is very difficult and we we had one of our fine first moments when you know Forest was a week or two old and we were home from the hospital and it was kind of the first weekend of us being parents and dad started to list for me the things he was going to do on the weekend. He was going to go sailing. He was going to do this. He was going to do that. And as he watched my face drop, he realized, oh, I have to ask. But I think that this is an area that we did, right?

29:04 Which is, you know, cuz we we had some skills here. We were communicators. And so I think that that is the crux of a minimally functional relationship. If you don't communicate, you're up the creek, basically. So, we asked and we were both very generous with giving stuff that maybe wasn't exactly what we wanted to do that day. And I think that this actually has been probably one of the real keys of the fact that we're still married here now 43 44 years later. So, is that communicating and being willing to give something that you know wasn't your desire for the day. We all know that health issues don't follow a 9-to-f5 schedule. With our sponsor, Zachdoc, having no time to book a doctor's appointment is actually not a problem. So, when you suddenly remember that you forgot to schedule that appointment at 1:00 in the morning, or you tweak your back on the dance floor at a family wedding, or maybe you cut your finger making a midnight snack, you can go to Zukdoc anytime and find a doctor you love. Zdog is a free app and website that helps you find and book highquality in-et network doctors so you can find someone you love. Whether you're looking for dermatology or dentistry, maybe primary care, or one of the over 200 specialties offered on sock, you can book in-et network appointments with more than 150,000 providers across all 50 states. Want to see your doctor in person? Great. Do you prefer video visit? you can do that, too. And you can view thousands of verified patient reviews, which is probably my favorite part of the site.

30:49 If I needed to find a doctor, I'd use ZuckDoc. Stop putting off those doctor's appointments and go to zdoc.com/beingwell to find and instantly book a doctor you love today. That's zoodoc.com/beingwwell. zockdoc.com/beingwell. Thanks so for sponsoring this message. There's a whole I'm I'm trying to stay out of so social psycho bio. I mean, we have a lot of stuff in our book, our wonderful new book and that we can speak about about taking care of the health of a mom. And I think is okay if I just highlight a couple of those things?

31:36 >> Yeah, please. Yeah, totally. >> The first thing is really ma just major care, you know, go beyond the the fourth trimester, go beyond that 3 months and make sure you're checking in with a doctor around a year. Hopefully everything's fine. Hopefully they're running a little bit at least of lab work. So, but then also if you are tired, push it a little bit. you know, check your iron. This is a really important thing. You know, it gets checked if you're in good care many times through pregnancy, but then it says if it's normal. No, you know, I would say that in my practice, the single biggest thing I saw with moms is they were anemic and that feels terrible. It's very easy to remedy. It's just taking iron, you know, but if you don't know you need to do it, that's a problem, you know. Just have the basics checked. Sometimes you need to do more than that, you know. It's not obvious.

32:31 Sometimes a person's depressed. There's, you know, they need to do care for that. But what we proposed in the health world was something that we call the spectrum of care that literally went from energetic type medicine. So that could be acupuncture, that could be some kind of very non-touching body work. Then it might have gone to a muscularkeeletal type stuff, doing exercise, you know, rolling through. There are many different steps in this but you know doing a good diet specific nutritional stuff and rolling through a couple of other things herbs hormones to you know pharmaceuticals. So in my case, I did lots of stuff. I mean, I did go on an anti-depressant. I did take antiarasitic drugs and I it took two years to really nail that problem because I'd do a course of it. I'd feel good for a little while. It would come back. Like these guys had moved in. I don't know where or when I got them, but they I was not just on the plane home, you know? They had been living there for a while. And you know, they'd redecorated the living room. So, you know, they were committed to staying there. So, anyway, it took a long time. It took a lot of followup.

33:50 but, you know, I definitely used western medicine, but I also used nutritional medicine and I also used just wonderful healing stuff because I needed it all. >> Yeah, totally. And, we're going to air an episode that we have not aired yet. We've actually already had that conversation. It just happens to be the order that these things come out with where we're talking with Dr. Rachel's offness about pain and chronic pain. And in in prepping for that episode, I ran into some research.

34:19 So, you'll hear this story twice on the podcast if you listen to both these episodes about acupuncture that I thought was really interesting because hey, my mom's an acupuncturist. And as you know, mother, I'm a bit of an acupuncture skeptic in my own little way. but what it found was that Oh, really? You've never heard of that one? I know. We've never We've never gotten into an argument about this. >> It's true. It's true, actually. and one of the things that they found about acupuncture is that it is a really good treatment for chronic pain. Why is it a really good treatment for chronic pain, though? Cuz they've also compared it against like sham acupuncture. So, where you're putting the needles into like not the right points or you're even pretending to put the needles in. And typically, the differences between like full-on acupuncture and sham acupuncture are pretty minor. The point of this is a lot of what you're getting from these kinds of approaches and treatments is a feeling of social support. You're getting a feeling of somebody really paying attention to you for 30, 60, 90 minutes depending on how long you're doing it for. Somebody really caring about you, somebody who's really invested in your experience. So, whatever it is that you're doing in order to get that, I don't think that there's any doubt that particularly for a relatively new mom, this could be a very rewarding experience for a person, right? Whether that's gentle touch or it's acupuncture or it's whatever, you know, you're doing some some queang, some some anything in there, you know, have a good time. if you're getting that kind of social input and that kind of affectionate attention from a person who really cares, I think that it's like just an underrated piece of this whole thing, >> right? And for a for a mom just being away from your child with another adult, I mean, this is like one of the difference between the whole issue of sharing the load and who does what. It's like moms are home with these very wonderful and you know children that they're caring for and so just anything where you're with adults and you know just take a little break from your kids is really refueling. I remember the first time I went to actually a little workshop on homeopathy. So, but it was so fascinating and it was like 3 hours in the afternoon and I was just like, "Oh my god, I'm just I just felt like my my brain and feelers were they were a dried desert and getting some nice juice on them." So there are a lot of things and now you know I know forest you're a skeptic and by the way so am I which has been interesting in my career >> just skeptical of slightly different things periodically >> right but there also no there is some stuff to some of these things you're skeptical of that is more than just placebo anyway >> it's hard to say hard to say I mean maybe I think that for some of it like it just kind of depends on on the category and and what exactly you're using a treatment for I think that for me it's been really helpful to open my mind in general to for starters the enormous impact of placebo in all things. cognitive behavioral therapy. How much of psychology is wow somebody's really caring about me and like gives a about my problems?

37:36 Really hard to say. you know, there's some evidence that for some problems, graduate students or people without a psychology degree are actually more effective when they kind of talk with somebody about them than trained practitioners. Why is that? You know, if we're improving the science over time, we're getting better and better at it. Why would an untrained person be more effective? And to be clear, these very, very, very specific circumstances that they create. And I think again it gets to that power of like effective strong relationship and is that placebo? Who's to say? So, where you draw the line on this stuff gets really interesting.

38:10 I'm not a homeopathy person, as we both know, as we've had many, many, many discussions about, but hey, what a what a beautiful way to harness the power of placebo, which we know is one of the most effective interventions that we have physically. So, there's a lot in here where both through our relationship and I I just think in general me learning on the podcast, I've just lightened up about some stuff over time and hold some of these views a little bit less strongly strongly than I used to. But I love that you're really emphasizing the importance of caring for yourself >> and caring about mom filling her own cup.

38:48 >> Mhm. Right. >> just as much as they're filling the cups of other people. Definitely >> and caring about that social support >> aspect. Caring about still engaging with the things that are really meaningful for you also is a lot of what I'm hearing. cuz obviously your kids are meaningful, your partner is meaningful, but most people have other things that are very meaningful to them as well. And so are you able to keep on kind of checking that box and in these ways that really matter to you?

39:15 >> Yeah. >> And that's those are all the pieces that I'm really hearing and part of what you're saying. I also want to ask you guys about something if you're okay with me asking about your relationship a little bit here. >> the chapters in the book that are most about supporting your relationship include a statistic that I thought was really interesting. Two couples in three report a sharp drop in relationship satisfaction after kids. And the average couple has eight times as many arguments. I think those numbers come from work from the Gottmans. it's very easy to look at that and just go, "Oh, yeah, that sounds like parent time.

39:49 But I would like to take it a bit more seriously than that and ask you guys what was happening between you two as smart, caring, psychoeducated people that was generating this extra layer of conflict and what did you do about it? >> Well, I I'm kind of throwing this jump ball up. Either of you guys can can start with this one. Whoever Whoever's feeling brave here, maybe. >> I'm happy to. No, I I think it's just there's so much more to argue about.

40:22 There's kind of these two things. Your kids are really important if you have and to mom and dad. You've grown up in a family and there's in many ways underlying feelings about what to do, kind of automatic feelings about what to do that came from your parents. Maybe you even think they were terrible, but they still emerge. So, you know, you and so important. So, you know, you really want it to work. So, there's that. >> Yeah. When I look back, the how to raise children topic was pretty sympotico for us. the interesting thing about it is that before kids come along, you can agree to disagree about all sorts of things. But when they come along, you've got to agree because otherwise you'll drive your kids crazy. you know, one person gives them sweets, one person takes them away, one person lets them play video games, one person doesn't. So, you need to parent from the same page. That's a big issue in many couples. For us, it was not that big an issue, but there was another issue that started to surface which had to do with sharing the load.

41:32 And that's a big issue in many, many families. And you have three kinds of load. You have the task load, the stress load, and the emotional load. the executive load. And in our case, I did not want to be Fred Flintstone. I did not want to be the guy that so many women in my psychotherapy practice were talking about who just thought because he was a dad, a dude that, you know, he had the right to come home and just kind of clock out while she was continuing to take care of the kids. Either because she'd been doing that all day and kept continuing or she had been making a income elsewhere. But when she came home, well, that's mother's work. Go ask your mom about that. I did not want to be that kind of person. And so, we definitely worked pretty hard to make sure that we didn't have big issues around sharing the load. In part, what helped us was to create a bit of a schedule, to have expectations. We sorted that out, I think, pretty well.

42:28 Although I will say that I started watching your mom and this was sort of one reason why we were more distant just before your sister was born is that I would watch her making a big effort for you. She would even make a big effort for a friend who would call on the phone and your mom would shift over, but she wouldn't make an effort for me to be interested in what I was doing in grad school, which is kind of interesting and also really important because I came into my career kind of late. It was pretty high stakes for me and like she didn't care. And then also stuff around, you know, we're a little different in terms of the house, keeping it orderly, stuff like that. but she just really didn't care about that either. And it was for me an effort issue. And what really helped me with that was to gradually realize that as her chiropractor was saying it to her, it's not for lack of effort. It's for lack of juice. What do you hold your baby up with your will? You know, so it helped me to kind of think about these things in a more neutral way, in a common humanity kind of way rather than haram for haram. you know, my wife is, you know, letting me down here. So, that was the sharing and load part. The big issue for us was in so-called intimate friendship. that's a very common one where I'll just hit the headline and then pause to see what you know your mom has to say. It's that classically what I see is that she feels un unsupported on the teamwork dimensions of their relationship after kids come along. potentially either or both not sharing the load fairly and not parenting from the same page. You know, he just kind of is not there for that part. And on the flip of it, he feels like, huh, you know, where where'd my lover go? Where'd my partner go? Where' the lady go I walked down the aisle with? You know, I didn't what what's going on here? And the two feed each other, you know, is he feels less supported in a in the friendship dimension. he tends to step back on teamwork, the degree to which she feels less supported on the teamwork dimension, she steps back understandably on the friendship side and then you have a vicious circle, kind of a downward spiral. And we that was something that we definitely had to work on, >> right? And and I would say that we did work on it. So it wasn't it wasn't silent. It wasn't unspoken about. And and I do think and and I'm really the one to to say this. I think it's really important because I mean dad is saying this but there's a whole kind of time period here where for instance sexuality is just not of interest to the mom usually she's very physically demanded upon by this baby. She's biologically, if she's nursing, her tractor beam is on the baby. But guess what? The guy is not nursing, right? And you know, he's still there and he's, you know, I'm I'm saying this as a generality, but it is a generality. He is really wondering what happened to my to my wife. And I will say there are just, you know, this thing I was saying before, there are just so many women who think that, you know, this they should just roll with this basically. And I've literally had friends that say to me, "Well, you know, it's fine because I know we'll reconnect in this way, you know, when the kids are in high school, you know, when I have more free time or whatever." And I' I've seen most of those relationships end in divorce. And I'm not saying they all would, but you know, so I think dad and I, we talked about it. We talked about what he wanted where I was. I wasn't at zero. I mean, that was fine. So, you know, we kind of came to a a a sense about, you know, what he could rely on me for in that way. And that was just really good, you know, to to do that. And you know, I'm talking about intimacy in a context where two people love each other, nothing bad is happening. And that I would say that 100% of the time, even if I was a little sluggish moving into it, I was always happy and always felt connected when all was said and done. I think of u sex itself as maybe the last inch in the yard stick of intimate friendship which is so much about feeling like you matter enough to the other person. Yeah. For them to have an interest in you. I mean that let's say in a typical gender role allocation, you know, he comes home, let's say, from some kind of job and she really wants to talk about her day cuz now he's she's got an adult to talk with and you know, as tension wanders, she's just wants to do other things.

47:21 He's not bringing her his full attention. flipped the other way. he sees her rallying for all kinds of other people and the issue per se with him is not about sex itself, but wow, do I matter enough to you for you to rally in this area as well and oh, I guess I don't. So, you know, that's often very poignant. you know, we feel kind of let down by the other person and and it becomes embarrassing sometimes to talk about because these are vulnerable requests, you know, to to be listened to, to be cherished, to be, you know, regarded as a lover still, you know, that aspect hasn't completely disappeared. you know so yeah I just want to just surface and honor the ways that there's so much more to this area than just the pure physicality >> for sure. Yeah and having a sex conversation with my parents is truly interesting territory and I'm I'm glad we're here you know but hey we're all adults. no I I think this is actually a fascinating topic. If you're a therapist you know that the work doesn't end when your sessions do. There's scheduling, notes, billing, insurance follow-ups, all of the administrative parts of the job that accompany the work you actually trained to do. These are Elizabeth's least favorite parts of being a therapist, and they're why I want to tell you about our sponsor, Simple Practice. Simple Practice is an all-in-one EHR that is HIPPA compliant, high trust certified, and built specifically for therapists. It brings scheduling, billing, insurance, and client communication into one place, so you're not juggling multiple systems.

49:06 And if you're just starting out or growing your practice, they also have a credentiing service that helps you get panled independently. It takes the total headache out of insurance enrollment, giving you full autonomy over your own contracts without any middleman platforms taking a cut. So, if you are ready to simplify the business side of your practice, now is a great time to try Simple Practice. Start with a 7-day free trial, then get 50% off your first 3 months. Just go to simplerpractice.com to claim the offer. Again, that's simplerpractice.com.

49:42 Few things I want to want to pull out real quickly here. Particularly as we're talking right now, but also as we've been talking throughout the conversation, we're using a lot of very gendered language. And there are many different structures here that people have. We're existing inside of a kind of heteronormative frame because you guys are a heteronormative couple that had a sort of typical role allocation particularly when I was growing up. dad was the primary bread winner. You were working mom but I think it's fair to say that you were mostly focused on raising us at the very least during that early phase. You then went on to have your own full kicking career, do the whole thing, which is awesome. but that's the the moment of time that we're talking about. So, those are the dynamics that we're going to be kind of mostly focusing on as we have this conversation. And so, I just want to open up and appreciate that there are many different ways of doing this kind of thing and many different kinds of of relationships. The range of desire and importance and value placed on sex specifically is so wide that it's very difficult to generalize related to it.

50:47 I have friends who identify as ace, so they don't have much in the way of a particular sex drive. I have friends who identify quite the opposite. So, you know, there's a big range here. And that's going to really affect your personal experience with any issue related to this. But I think that that's why the focus on partnership, including intimate partnership, is a really good frame for it. because I don't know many people who don't want to feel supported by their partner and one of the verticals in for any form of support is physical sometimes for people. You might be somebody who doesn't much care for that. You might be somebody where that really matters. And that's where hello talking to your partner about all of this stuff becomes fundamental and essential, right? you know, it it has to be a piece of the equation here is having these open lines of communication about a topic that so many people are taught not to talk about. or so many people come into it with a layer of expectation and assumption about the the way men are or the way women are, and I'm deliberately using heavily gendered language there. And that then infects how I should be about this topic. And I would really nudge almost everyone in almost every relationship to really actually think about what your relationship with physicality is. What are the things that you are really looking for from another person? Like what are your desires here?

52:28 How is your relational touch battery filled or depleted? And do you have a relationship, and I certainly hope you have a relationship like this if you're having kids with this person where you feel comfortable talking about this stuff with your partner? And if you don't, wow, how could you guys become more comfortable talking about this stuff with each other? Well, I agree. knowing that our book is coming out and you know that we were going to have this conversation. And I was speaking with a young person who works with us, younger than me by 20, 30 years, and she was just saying, well, that in her world that those genders are often flipped, that actually the young woman is actually more wanting a a more physical relationship than the guy is, which I thought was interesting and just maybe spoke to ways things are changing around a little bit even in the >> Yeah. the impact of culture, all of it.

53:27 We we ascribe to biology so many things that are deeply cultural. >> Yeah. Yeah. Yeah. Yeah. But that is the important thing to be able I mean your dad and I you know we we spawned our relationship associated with this communication workshop that we put on for people and I I feel like it's the root it really is the root of so many things. you know, being able to communicate honestly, openly to say the thing that you're afraid to say. Dad always speaks about risking the dreaded experience, you know, which is what's coming up in communicating clearly and certainly communicating clearly about what you want in your touch, you know, what you need, what you know, just that back rub. And it changes over time, you know, in a relationship there. You know, it's but it's so great to whatever degree you can talk about.

54:26 Maybe that's not everything, but you can at least begin saying, "Oh, yeah. I'd love a little back rub right now." The >> first thing that struck me again and again when I was working with a couple or giving a talk and then opening it up for discussion with a mother's club, and I did that dozens of times. So, I, you know, I got an earful. I was struck again and again and again by how little it would often take to reset a relationship if it was sustained over 5, 10, 20 days. a little bit of conversation, a little bit of sustained interest, occasional touch, occasional romance, occasional sex that a little bit that didn't take a lot of time would make an enormous difference.

55:11 And it was startling to me both that it often would take very little and that many people would not even do that little partly because they were carrying baggage of undelivered communications going to mom's point about their grievances with the other person. So getting through some of that baggage to the point where they could bring a certain self-interested generosity at the scale of 5, 10 or 20 minutes in a in a row to the other person, you know, was really important to do. And one area where I saw that in particular was just around the the touch relationship, the affection u relationship. you know, looking at each other in the morning before you walk out the door and saying, "I love you and have a good day." And saying it when you get home, a little hug, a sympathetic murmur, you know, a gentle touch on the forearm when someone's, you know, bothered by something, leaning into a longer hug, maybe even a kind of romantic kiss.

56:11 These are really foundational and typically pretty easy to do and they help to renit the fabric of a relationship that's getting frayed inevitably. You know, rust does not sleep. Entropy keeps going. Relationships fray and they need energy to keep mending them together. >> I often think about my parents who were you know they they were lovely parents for me. They had their issues in relationship, but they also had their My dad came home from work at night, gave my mom a big old kiss and a hug, and then they'd sit down and have their martinis. I mean, that was the day.

56:51 Okay. So, but >> very madmanesque. I like this. Okay. >> And it was the kids. I don't know how they had established this. We did not I had two brothers. We did not bother them during that half hour. That was martini time. And you know, really was and it was very good for them, you know, that they had they knew they were going to have a little relaxation drink. They were going to have a big kiss. They're going to have a half hour that we didn't bother them. You know, it was very basic, but you know, it was connecting for them every day.

57:28 >> I think with so much of this, it gets back to this on the same team idea that I've been saying a lot in the podcast recently. Do you feel like you're fundamentally on the same team with this person that you're raising a kid with? You know, do you feel like your stuff matters to them? Like dad, how you were saying, right? Do you feel like their stuff matters to you? If you just can't be be if you cannot find the caring inside of yourself for whatever it is that they're dealing with on a day-to-day basis, that's going to be really tough. And often people, and you've seen this way more than me, Dad, just in your work with couples inside of your therapeutic practice, once you get to a place of resentment and frustration, it is very difficult to care about what the other person's going through in the same way because you've got your list of the two dozen times that they did not do that for you. and you're so frustrated about that that it's very challenging to extend those feelings toward them. I've experienced this in my own way inside of my own relationship. I mean, we we had to really work on some stuff that was focused on my resentment about various issues and I I had to get real with myself that I was resentful and that I was bothered by different things. And so this can all be kind of an unpacking process that you need to move through before you're able to get to the pot of gold at the end of the rainbow, which is that feeling of on the sync team. I don't know if there are aspects of that, that you would want to like talk about or or mention here. Obviously, we've done full many full episodes about relationships in the past, so you know, some of this has come up before. but I don't know if anything's coming to mind for you right now. A key thing that saved me was that I got the idea of the 8020 rule in which yes, I had 20% of my attention on how your mom could make more effort or listen to me better, clean up the house, something, but 80% was on how to be a better partner myself. And I would do the max. I would really try to listen to her complaints or requests or irritations with me. kind of sort out the wheat from the chaff, zero in on what I could deliver and then I wanted to deliver it. partly because that was my best odd strategy to take care of me, right? it was something I could do. I did want to do what I could do for the larger sake of the family, including you, Forest. And it was the quickest way to get your mom off my back to just zero out, you know, the complaints one after the other. I was relentless about it. I would joke internally. you know, I remember running across this phrase in grad school, relationship tasks. And it made sense to me because your mom was, you know, unhappy with me, disappointed.

60:17 I'd come home, I'd play with you, I'd do the dishes, and I'd start coding my videotapes for my dissertation. And she'd go, "Well, what?" And I realized, oh, I was dropping the ball on so-called relationship tasks. And when I reframed that as, oh, it's part of my good enough husband, you know, job description, that worked for me. So that that's part of it is to realize that it's often in your own self-interest to deliver the goods to the max that makes sense to you and think about what it's like to be on the receiving end of someone who's you know morally committed to that. And then after some time a few weeks maybe of doing that pretty consistently even a few days you're just in a much better position then to ask for what you know you really need on the other side of the table. And it's okay to explicitly negotiate wants and come to some kind of compromises or trade, you know, in different ways. That's really okay. But it comes at bottom by taking responsibility and initiative yourself for the ways you do have agency. One of your what top three favorite words forest that you do have so that and exposure. Yeah, agency and exposure.

61:30 >> God, if we're doing being well bingo, we would need to really think through this. But yes, two of them are definitely agency and exposure. >> Yeah. Claim claim the agency you do have and be willing to tolerate exposing yourself to some dreaded experiences with your partner, >> you know. >> Yeah. >> Yeah. >> I'm wondering I'm thinking of a a thing that I've seen a lot of couples bounce off of, which is essentially the who goes first of it all. This feeling of I'm bothered by this thing that somebody else is doing.

62:01 I'm frustrated. I feel worn down. much as you're describing, mom, there were a lot of demands on you, a lot of pressures on you. A lot of pressures and demands on on dad, too. But, you know, how you got to a place where you were able to like make the first communication and actually say the thing that you felt like you needed to say, whether that was a request for more support or it was some kind of communication of, hey, this is just how I'm feeling these days. What helped you guys get there at this moment in time that you're describing where there was a lot of external pressure and you guys had kind of drifted away from each other a little bit?

62:43 >> Well, I think that for me when things just start to feel uncomfortable there there's just a point where, you know, I just feel like I have to push myself to communicate. And it might come out a lot of different ways. It might just come out with how I'm feeling. Sometimes it's how I think you're feeling. I feel like you're mad at me. You know, that kind of thing. And that actually could be a a common thing I might have felt. One thing I'm going to say here is that I think what made it doubly hard sometimes to communicate is again in those pre-baby days, you know, you could afford to lose basically. you know, I mean, you didn't have kids, you weren't really bound together. If the whole thing blew up, well, it blew up. I mean, obviously didn't want it to blow up, but you know, but once you've got those babies, it's harder to do. it's harder to risk the you know terrible experience because that could be that could impact your marriage, your children and everything. So it's even harder to take risks, but it's more important to because you know it if if you come from a reality that communicating and you know really having somebody you have a it's like having a shared knowledge that you've said what you have to say, you've heard what they've had to say and then you're in a clean place that that is like the the starting place of a healthy relationship. you still you just have to take that risk and it's really hard but you know I I know that we did we did do it and we did it about difficult things I think in all honesty your your dad was a lot better at it than me but I know that I did do it too and you know I probably you know just spoke more about my you know my own feelings and my thoughts about what he might be feeling >> well sweetheart when you talk like that, it pulls me right back in and into our personal history and it pulls me into countless situations with couples sitting in my office who once were in love with each other and yet it's as if they're on other sides of the Grand Canyon sitting four feet apart in chairs in my office and and in the room almost as invisible presences are their own children who will be very affected if this relationship really really really comes apart. For for me a little bit of a takeaway going forward for people listening thinking about okay going forward it's to realize that it's very important to keep putting energy back into a system to maintain its order. In other words, putting energy back into your relationship if you really want to keep it together. Now, maybe it's gotten to a point where it's already come apart or you can just tell that ship has sailed, that ground is stony, you're not going to regrow love there. Okay? And then you try to do the best you can at that point. But to realize that the stakes are very real. And the other thing with regard to a mother's health is to realize that the stakes are very real there too. Few things will rattle a mother's body in a normal curse in which three out of four women will have a child in America and around the world that birth rate might be higher or lower depending on the country. But you know few things will rattle your body like bearing and then birthing nursing and rearing a child. So it's high stakes. So because it's high stakes, it really behooves you to take a look at our book and other things like it that do engage a biocschosocial approach and give you many different ways to help make things better. Take it seriously. And I will also say that if you're someone who has had you know your children grow up and you're looking back on your life, well maybe there's some reflections here in terms of twists and turns in the journey that you can see. I still remember this mom telling me when her kids at that point were maybe six or seven or eight, she was describing an episode in which her husband with good intent was trying to support the friendship side of their relationship by insisting that she come to an outdoor rock and roll concert with him that they used to do. and she throughout the entire concert just felt so irritated with him for his so-called selfishness although he was trying to rekindle the relationship and she just missed her baby who was home with a good babysitter but still and then she said to me very calmly well my heart closed up to him that night and it's never opened since still married seven or eight years later and probably on the road to divorce eventually so it's it's really poignant so you look back. And also just to kind of put a plug for this one again, I've learned so much about what life was like for me during my earliest years, age 1 2 3 4 5 6 and so forth, by learning a lot more about how my own mother was affected by having kids and how affected she was also in the context of the 1950s in terms of gender roles and my father, a well-intended person, but doing a typical male role at that time. You know, there's a lot to learn here about your own psychology when you think back on the environment in which you were being raised, too. And I'm really glad and I really appreciate you for kind of pulling back the curtain, you know, on the mask of motherhood and enabling us to really talk about it here, not just for our own family history, but also for, families in and people in general.

68:41 >> Yeah. Mom, I'm wondering as we wander toward the end here, what do you wish that somebody had told you when you were 34 years old? >> I think the the big thing would be to just make sure that in the midst of loving these children and like I said, I wouldn't do anything different. I would still nurse him forever probably, but take care of yourself. You know, have a little meter on, you know, the juice coming to to you. It's okay. It's okay to even let your kid have a little bit of child care, you know, which I did way too little of in the early years would have been probably great for you and great for me. and you know just to to think about where where it's really at for you and say yes to help coming your way.

69:36 all the things we're talking about in relationship, many of them we actually did. Those were actually winners. We can talk about them from having done them. But I think the big thing was watching more carefully what was happening in my little Jan Hansen universe and kind of calling on it earlier than I did. I >> think that's a great answer. And the aspect of this that's something I've heard you guys talk about a kind of sense of entitlement to self-care.

70:04 >> Yeah. >> Like you are allowed >> to take care of yourself here. And it's not even just that you're allowed to. It's that the whole system is supported when you do. >> Yeah. >> And so that's just as important a piece of the puzzle as any of the other pieces here. And it's the one that gets dropped the most frequently. >> Yep. >> Is mom taking care of mom. >> And you know, there are of course exceptions to every rule.

70:27 >> But often, a lot of the time, mom's got to take care of mom. >> And that's a good place to start and a good place probably to close our conversation here also. So I want to get you guys out of here. I know you've both got things to do also. and my mom has been dealing with a whole health thing and I appreciate her willingness to sit and chat with us for 75 minutes through it and has been doing just great. So, thanks so much for doing this with me today, Mom. This was really unique. This was really fun.

70:55 >> It was my privilege. Totally. I love being here with you, Dad, and getting to talk about this wonderful stuff. >> This was obviously a very special episode of the podcast for me. I've never talked with my mom on the show before and I hope you really enjoyed it. I loved having her on. I loved talking with her and my dad and I appreciate how unique an opportunity it is to talk to both of your parents in this way. I feel like a lot of people don't have a relationship with their parents that's like that and I feel extremely blessed by it. I also hope that this gave you some insight into their relationship, including the ways in which it had its own normal bumps and bruises and problems and conflict and it wasn't an idealized thing. But what was really wonderful was that they were open to doing some problem solving and they were clear the whole way through that they really loved and cared about each other.

71:53 They really loved and cared about me and my sister. And that's part of what motivated their problem solving. They wanted to help my mom feel better because hello, they really cared about my mom, but also because the system as a whole was on the same team with my mom, right? We were all committed to her feeling better as she went through this time when I was, you know, 0 to 7 or 8 years old in particular where things were just really tough for her. They were tough for her physically and emotionally and socially. She felt her world getting smaller and smaller. She didn't feel as much support as she wanted. And there was a lot of pressure on her both physical and otherwise.

72:35 And so they went through this real process of trying to figure out what the heck is going on here. And that's how they came to this idea of depleted mother syndrome. Their frame is that DMS is a biocschosocial condition where there's this combination of outpouring from mom, stress, vulnerabilities, and low resources. And this then drains and disregulates the body. They frame DMS as a predominantly physical condition that has a psychological impact. It doesn't require depression to be present for a mother and it often shows up a year or more after birth. It can then linger for years. They're also careful to say that this is a working hypothesis. It comes from both my mom's personal experience and the many conversations that they have had with many mothers over the years, including the conversations that Rick has had with parents through his therapeutic practice. And her story is not a unique story. She was pregnant in her early 30s. she had actually a miscarriage that she talks about in the book, then two C-sections. as she was committing to a very nurturing, supportive style for both me and my sister. And while she was doing all of that outpouring, well, that cup wasn't getting filled as much. She wasn't thinking about her diet and nutrition as much. She wasn't thinking about supporting her social circle. She was very consumed with her children. Rick was working. He was in graduate school.

74:00 He didn't have all of his attention available here. This is normal mom stuff. But just because it's normal doesn't mean it's optimal and it certainly doesn't mean that things should be that way. And that's why they wanted to pull all all of this information together for people and hopefully just advocate for this frame, this biocschosocial frame. It's the death of a thousand cuts out there. It's a lot of little things that add up and then a person increasingly feels like they're on an island in their relationship and that just makes things even more challenging. And this takes us to a common model of demands, resources, and vulnerabilities. What are the things that you have going for you? Those are your resources. What demands are being placed on you? Those are the demands.

74:46 And then you've got your unique vulnerabilities. What's the stuff inside of your system? That's pretty easy for something like having a kid or having a relationship issue or having an issue in your work life, whatever's going on for you. What are your unique vulnerabilities? And how might those demands land on your vulnerabilities in a way that really exacerbates some problems for you? And what you find with parenthood in general and maybe motherhood in particular is that this is a multi-modal problem. There are all of these different layers going on. So we need a multimodal solution. We need to look for a lot of different interventions in a lot of different places. And in the book, there's a lot of specific information about ways to support mom physically and also ways to handle the psycho and the social side of the spectrum. I do want to say something during the recap here that I hope my parents will forgive me for saying, which is that a good amount of the bio in the book is conventional western medicine, but there's also a lot of influence in the book from my mom's practice as a acupuncturist, from traditional Chinese medicine, from more naturopathic or alternative approaches, and just speaking sort of freely about it as I did on the podcast. Those approaches are not really my bag so much. I'm a pretty western medicine guy. So if you're somebody who tends a little bit more holistic or alternative, you'll probably find a lot in the book that you connect with. For me on the bio side of things, it's more like these are conversations I've had with my parents like over and over again over the years and we just have differences of view around them. A big piece of this that I really appreciated and how they talked about more the bio side of things was the self- advocacy piece. Keep your own health file. Bring your old labs. Talk to your doctor. advocate for yourself with them. There is a chronic dismissal of female pain in general, particularly postpartum pain. There's a lot of that's just the way it is being a mom out there. And I think that we have all of these assumptions that exist in this world. Like we talked about many of the assumptions during the episode that people apply to sex and sexuality and touch and how much touch do I need? How much touch does my partner need? Can we decouple touch from sex? I thought that was actually one of the best parts of the episode. that piece of it where people kind of take a step back and they go, "Wait a second. What do I really care about these days? How do I really feel? How do I feel in relationship to my partner?" Like, if we're dealing with some kind of a relational issue with each other, what's really true for me?

77:10 What's going on inside of me? Am I frustrated? Am I annoyed? Am I tired? Do I feel unsupported? Do I feel like I can communicate that to them? Why don't I feel like I can communicate that to them if that's a way that I feel? what would help me get there? what would help us get on the same team? And yeah, it takes two to tango for sure. You know, it's hard to get on the same team by yourself if your partner's just not willing to get there with you. And if you're in that situation, man, that sucks. I feel really sorry for you. I'm really sorry that you're dealing with that. But somebody a lot of the time has to go first. Somebody has to extend the olive branch here, particularly when things have broken down a little bit.

77:50 And it was frankly really cool to talk with my parents, both thoughtful, you know, loving, smart, psychoeducated people, about how they approach that inside of their own relationship. It's it's not very often when you hear a psychologist talk about their own challenges with this stuff because it's very easy for people on the outside to look at people in the mental health profession and and assume that, you know, they just have all the tools here. But that's often not the case. Like we struggle with our own lives. We struggle with our own material regardless of how much we've learned about this stuff.

78:26 Yeah, learning about it absolutely helps, but it's not like it's a silver bullet. And so, I hope you enjoyed today's episode. I'm really curious what people thought about it, how people felt about it. I hope that you enjoyed hearing from my mom. Of course, I'm very on her team. but even so, I would just love to hear what everybody's experiences with it was. And hey, if you liked having my mom on the show, maybe we'll be able to talk her into doing another one sometime. That would be really fun. So, if you made it this far and you haven't subscribed to the podcast yet, if you could take a moment and subscribe, I'd really appreciate it.

78:58 Really helps us out. You can find us on Spotify, Apple, YouTube, all the places where you get your podcast. And hey, you can also find us on Patreon. It's patreon.com/beingwellodcast. And for just a couple of dollars a month, you can support the show and get a bunch of bonuses in return. You can also find me on Substack. And is there anything else that I should plug? Oh, probably the book One More Time. It's titled A Happy, Healthy Mom, and it either came out or is coming out depending on when we release this episode on August 25th. I hope you'll check it out. So, until next time, thanks for listening and I will talk to you soon.

79:42 >>