November 07, 2013

(+++) GETTING PAST THE SAD


How to Be Alone. By Tanya Davis. Illustrations by Andrea Dorfman. Harper. $17.99.

This Isn’t What I Expected: Overcoming Postpartum Depression, Second Edition. By Karen R. Kleiman, M.S.W., L.C.S.W., and Valerie Davis Raskin, M.D. Da Capo. $17.99.

     Although all of us face loneliness, it hits us in different ways, at different times, for different reasons. It can be a simple matter of feeling “the blues” after an extended period of dull, miserable weather, or a serious “down” time that turns into diagnosable clinical depression, or anything in between. And it is presumptuous to suggest that all experiences are comparable, all responses predictable, all solutions to loneliness equally applicable to everyone. Still, some people at some times will benefit from simply understanding that they are not alone, in the sense that even if they are by themselves and trying to cope, so are lots of other people. And that is the point that Tanya Davis makes in How to Be Alone, which is produced and packaged as a gift book with pleasant, nonthreatening illustrations by Andrea Dorfman. There is nothing particularly new or unusual in what Davis says: “You’ll find it’s fine to be alone, once you’re embracing it.” “You’re no less intriguing a person when you’re eating solo dessert and cleaning the whipped cream from the dish with your finger.” The illustrations help prevent the poem from seeming too simplistic and treacly, although it certainly does tend in that direction. The message here comes down to, “[A]lone is a freedom that breathes easy and weightless, and lonely is healing if you make it.” This is poetic but perhaps not entirely helpful – those who are lonely have surely heard often enough about “the interest of loving oneself” and “if you’re happy in your head, then solitude is blessed and alone is okay.” Still, as a gift book to a friend who has been feeling isolated and blue, How to Be Alone may be taken at face value as an attempt to help him or her (more likely her, based on the illustrations) feel at peace with the situation and understand that one is not alone forever or, if one is, then there are satisfactions to be had in the circumstances.

     There are no such satisfactions in postpartum depression, a form of aloneness that affects one in five women and can sap strength, joy, bonding time with a new baby, and relationships with a partner and other children. This Isn’t What I Expected, now in its second edition, is a thorough discussion of psychological and physiological factors involved in PPD, with advice on what to do to overcome it. This is not a matter of saying to yourself, “Snap out of it,” because that is not possible; nor is it helpful to be told by well-meaning friends, or even by professionals, that the condition will pass on its own. Karen R. Kleiman and Valerie Davis Raskin go beyond PPD itself to discuss conditions such as postpartum obsessive compulsive disorder and postpartum post-traumatic stress disorder. They discuss symptoms, methods of identifying the conditions, reasons they occur, and basic coping techniques; for example, “replacing distorted thoughts with positive statements” such as “I’m doing the best I can,” “It is okay to make mistakes,” and “There will be good days and bad days.” Positive (or even neutral) self-talk is not necessarily enough, though, and Kleiman and Raskin explain what happens when angry feelings surge (possibly because of a preexisting issue), and give clear dividing lines for reaching out for help – presenting them, when necessary, in capital letters: “IF YOU DO NOT FEEL CAPABLE OF TAKING CARE OF YOUR BABY’S AND/OR OTHER CHILDREN’S BASIC NEEDS, IT IS IMPERATIVE THAT YOU CALL SOMEONE TO HELP YOU CARE FOR THEM.” Left out here is what to do if you have no such “someone,” especially if PPD or other issues have left you estranged from your partner – anger toward him being a common element of PPD. Indeed, a supportive partner can make a big difference in dealing with PPD, and there is an entire chapter here called “Will My Wife Ever Be the Same?” The chapter repeats, in truncated form, an explanation of elements of PPD, and then gives specific advice that is quite good but, unfortunately, very difficult to follow: listen to her concerns, try to be patient, give her breaks, provide emotional support, avoid criticizing or judging, do not smother or overreact, and so forth. These recommendations would be a tall order for many men during normal relationship times – they may be simply impossible when there is a new baby in the house and a mother who is feeling sad, worthless, angry, guilty, inadequate and exhausted, and who often criticizes, attacks, fails to appreciate efforts made on her behalf, and does not respond to reassurance. In fact, the biggest failing of This Isn’t What I Expected is that it explores PPD and related conditions so thoroughly and painstakingly that it makes the subject seem overwhelming – both the conditions and the recommendations for handling them simply seem like too much for an average person or couple to manage. And this leads to the question of who would benefit from this book – and when it would be good to read it. Since PPD can occur without warning, people are most likely to reach for the book after they are in the throes of the condition – at which point the recitation of the symptoms and difficulties, and the 300-plus pages of explanations and advice, are likely to make the situation seem even more hopeless. This is not at all the fault of the authors: Kleiman is an expert on PPD and founder of the Postpartum Stress Center, and Raskin is an experienced psychiatrist, and they write knowledgeably and with genuine concern. But the very comprehensiveness of their work, a great strength, is also a weakness: the last thing a woman with PPD or her partner will need will be the feeling that this tremendously troubling condition requires careful reading of an exhaustively detailed book.

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