One of the things I like about my camera, is that I don’t have to change lenses. It is a point-and-shoot, not a fancy camera. I find that I take the best photos when I am actually carrying a camera. This sounds silly but my little point-and-shoot fits into my purse as well as into the zippered pocket of my hiking shirt. (Yes, there is such a thing and I wear it over a t-shirt or around my waist.)

My camera has one lens and because of this it is much lighter. But I can’t see as much with it.

In my daily life, I feel that I am constantly changing lenses, the way I see the world. Sometimes, it changes so quickly that I can’t get a good view of anything, just constant changes, blurs of different colors and no definite shapes. These are very difficult days, among the most difficult. It is on these days that I feel frozen for anywhere from a few minutes to a day or two.

I added a cancer lens to my bag a couple of years back. Before the diagnosis, it was a general purpose lens, called, “bad medical stuff that is unlikely to happen but I get it checked out just in case”. And yes, I knew about the one out of eight figure for breast cancer in U.S. women. That’s still the minority and that’s a lifetime incidence, too. The percentage of cancer diagnosed at age 46 is considerably lower.

Then I found myself at age 46, diagnosed with breast cancer and having what would be revealed as four small invasive tumors, of low grade, meaning that tests estimated them to be relatively slow growing.

The cancer lens puts cancer at the center of view when it needs to be there. For me, it was the time of active treatment, which also coincided with continued assessment through scans and pathology reports, the latter occurring after each of my three cancer surgeries.

Now I am considered a “survivor” and  my cancer lens keeps the possibility of cancer in the periphery. I have been told that I have excellent peripheral vision, both literally and figuratively.

My energy continues to return. There are so many legitimate reasons that reduce the energy of a breast cancer patient, chemo, oral medications, repeated surgeries, stress, working to make loved ones feel better, etc.

The cancer lens is also one of those things that can wear us down. Thinking about cancer, every day, even if only for a moment. I see many women worn down by the fatigue of cancer and I believe that this is a very real part of the burden.

The cancer lens can also bring things into finer focus, though. The preciousness of life, the motivation to treasure moments and to appreciate them. This is where people get into this whole, “cancer is a gift” thing. And yes, I agree that it is not a gift. But having a life threatening illness forced my hand to cope with my life and take care of myself better. The way I have dealt with cancer, by and large, has been a gift I have given to myself.

This week, I’ve had a hard time with anxiety, despite the fact that I am on vacation.  I am somewhat disappointed with myself, to be totally truthful, but I am working toward acceptance of the fact that I am a very anxious woman at times and this is one of the times, right before the beginning of a near school year and my daughter’s birthday, when the business of my life can overwhelm me.

My friend, Nancy, also a psychologist and a breast cancer survivor, spent a few hours together earlier this week. We spoke of our friendship. Nancy remarked that even though I have dealt with some heavy problems as a parent and a person, she does not worry about me the way she might worry about her other friends. I actually feel the same way about her. Nancy is very smart, very kind, and very real. She is a very clear thinker. Most of the time, I think I think very clearly, too.

Clarity is a powerful tool.  Clarity means seeing things head on, the possibilities and the certainties. It is at times frightening, at other times just the tool needed to dig through a very deep problem, and at other times, absolutely liberating.

I am real. Sometimes that is hard for people, including me.

“Are you ready to frolic?”

I overhead the question, spoken in a gentle male voice, from a nearby campsite. After I turned my head toward the source, I saw that a father had asked his young girl, who couldn’t have been more than 17 or 18 months old, this question. She said something about “froggie”. He father responded, “Yes, let’s have froggie go frolicking with us, too.”

Camping brings forth images of enjoying stately woods in solitude, like one’s own personal communion with God. Unless one is a backpacker, this is typically not the case.

I am on vacation, camping on Orcas Island, which is part of the San Juan Islands in northern Washington state. We are extremely close to British Columbia, Canada. The islands are only accessible by boat. Some of them are accessible by public transportation, that is, the Washington State Ferry System, which is the largest of its kind in the U.S. It takes a good part of the day to get up here and there are very few campgrounds. We are staying at one of two on Orcas Island, the other being a dozen sites on Obstruction Pass, which are “walk in” (camp equipment is hauled down a mile long trail to the campground) and cannot be reserved ahead of time.

I reserved our campsite eights months ago and even that far ahead, most of the spots were already taken. So, the campground is a busy place. It also happens to be located right on the main road. Now, Orcas Island is far less densely populated than say, Manhattan Island, but car traffic is heard from our little campsite in the woods. We have also had visitors.  A little dog named, “Nacho” has visited three times since he arrived yesterday, along with his family, who hung both a U.S. and a Seattle Seahawks flag outside of their tent. Earlier this week, we had a number of visits from a blond toddler with big brown eyes. He just observed with curiosity, whatever we were doing in the seconds until his father, a gentle and patient Israeli man, walked down to scoop him up and take him back.

Campgrounds are typically a home base for outings into the wild or at least the wilder. Nonetheless, communion with nature can even be found in a busy state campground. (Tip: In the U.S., National Park campgrounds tend to be prettier and more secluded than state campgrounds. However, state campgrounds often have showers.) In our few days here, I have seen the green mountain in back of Cascade Lake, visible from our campsite, the sun glistening on the water. The nights have been clear and dark. Two nights ago, I saw the constellations and the Milky Way.

I hear people complain a lot about car camping around here because of the people “spoiling” nature. And honestly, sometimes people can really be annoying in the woods. But to me, hearing a father asking his little girl if she’s “ready to frolic” is a most gentle gift.

This is the gift of the next generation learning how to love nature’s majesty and surprise.

And froggie gets to join them, too.

What could be more natural?


Some days have all of the ingredients for a delicious meal.

Then the salt is mistaken for the sugar and it’s all gone to shit.

I’m working to correct this day.

Sometimes the only solution is for time to pass. An early bedtime for me and then a do over for tomorrow.

Having admitted defeat to Wednesday, I am already starting to feel better.

My memories of high school and of my adolescence have changed over the years. I remember as a very young adult, being embarrassed at my adolescent immaturity. In most ways I was a square. It was not so much about whether I inhaled because I didn’t take drugs, smoke, or drink. Exhaling, however, was another matter. There were some not so bon mots that emerged from my big mouth. Over time, I came to appreciate that I was still pretty young with much to learn. That’s what youth is for, lots of rapid growth.

For a long time, I thought that high school, though not as horrendous as middle school, was pretty awful. Over the last two years, as I’ve reflected on my life in this blog, and further, as I’ve reconnected with old friends, I’ve questioned the accuracy of my recollection. Maybe it wasn’t so bad.

Memory is dynamic. It changes over time and I’m not just talking about the decay of memory. We also add information, without even realizing it. Our current state of mind also impacts what we remember and how we remember it. Imagine how this impacts our memory as we reflect time and time again about different events in our lives. It is a process that may or may not increase the accuracy of our memory but nonetheless solidifies our confidence in the correctness of recollection.

On Friday night, I attended my 30th high school reunion. I was on the reunion committee this time and I was in charge of the Facebook page for the reunion. It put me in the role of interacting with a wide number and variety of former classmates, not just the ones with whom I was friends.

By and large, it was a really fun thing to do. There are a number of interesting and kind people with whom I had the privilege of interacting in the months leading up to the reunion.

I received a lot of positive feedback for being active and inclusive in my handling of the Facebook page. It was gratifying because I worked very hard to do just that. And at the reunion a surprisingly big cheer emerged from the crowd when my name was announced as a member of the reunion committee.

People appeared to enjoy themselves a good deal last Friday. As the ”voice” of our reunion, I got more credit than I deserved for its success. A lot of people worked very hard on it, they just did so mostly behind the scenes.

The flip side of this is that by the next day, a few complaints started rolling in, some communicating privately and other posting publically.

I can’t speak for another person’s heart or mind, but a minority of the comments seemed rooted in pain from the past and negative memories of events from the past.

I attended my 20th reunion. At that time, I spent a lot of energy trying to remember everyone and our experiences. I was worried about people feeling forgotten and left out.

Something interesting happened this time, though. I  went to a large high school and was managing a Facebook group that contained nearly two-thirds of my graduating class. There was no way I was going to remember all of those people so I focussed a lot more on learning about people as they currently are.

I found that this helped me reconnect with old friends at a somewhat deeper level and to make new friends with people with whom I shared a very important time of life, our childhood.

Today, I realize that this is something that my husband and I are trying to do. We started dating in our late adolescence and I have long believed that there is a residual of the tumultuous aspects of that time in our lives that carries forward continued challenges to our relationship.

Added to that, my cancer was scary and confusing. When I am disoriented, I deal with the lack of a coherent knowledge of reality by using my memories, even for mundane daily events, as milemarkers in my life, in order to regain my footing and direction. John and I, however remember daily events quite differently.

This has led John and I to spend a lot of time arguing about differences in our memories for even daily logistics. This disorients me. It feels like being on different pages of different books written in different languages.

But when John and I talk about our current feelings instead of rehashing unpleasantness from the past, even the recent past, we almost always connect at a deep level.

History is always important. Often it is important to reflect upon the past, even the painful past, in order to grow. I am learning more and more, however, to identify the times when this is not the case.

Sometimes in order to be on the same page of the same book, we have to put the book aside and talk to eachother

With my strong reaction to the “there’s nothing wrong with you” Facebook posts, I knew that I had some thinking to do. It’s not that there’s anything wrong with my strong reactions per se, it’s just that when the intensity of my emotional reaction to things surprises me, it is often because I’ve hit a sore spot.

I have come a long way in accepting my imperfections. I am mostly okay with myself as an individual. I am aware that despite my faults and mistakes, I am a very good mother.

To be perfectly frank, I have complained a great deal in my life about my husband’s sensitivity to criticism. Although my complaints are not entirely unfounded, something else is also true. When my husband complains to me or criticizes me, it hits a very tender part of my heart. The part of my heart that wants to be a perfect wife. I’ve long thought that I am a good wife, maybe even a very good wife. But it is the role in my life in which I fall down the most frequently.

I am actually pretty good at taking critical feedback, in general. I had music teachers that poke and prodded and talked me through every note. I had writing teachers that had me change every single word. I’ve had patients and their family get quite mad at me. In my friendships, I would much rather be told that I am doing something that concerns or bothers another person than to just be left guessing. A former boss of mine actually told me that responding appropriately to specific negative feedback was one of my strengths as an employee. That was a truly horrible work situation, during which I experienced the onset of my first of two depressive episodes.

I haven’t gotten depressed in over a decade and I am a happy person. But part of me feels like my heart is about to be shot whenever my husband criticizes me. It doesn’t happen every time, or even the majority of the time, but it happens enough so that it is a problem. My perfectionism is gets in the way of solutions and communication, two things that build a healthy and close marriage. I put a lot of stress on myself to be the “better person” in a relationship, to function better, to need less, and to give more. That’s appropriate for a mother. It’s also appropriate for a psychologist. My parental and professional relationships are not supposed to be reciprocal. But my husband is my a partner and a peer. Being the “better person” is not an equal relationship, nor is being dependent.

This is a work in progress, people. I am a work in progress.

It has happened so many times over the years that I don’t have a particular patient in mind as I write this. My first contact with a family is usually the mother of a patient. We usually talk on the phone for anywhere between 15-45 minutes so that she can get information from me and a sense of whether I am competent. And I get information about whether the referral is appropriate for me as well as a head start on honing the focus of my assessment. Mom usually tells me a list of concerns about her child. Things that don’t seem right. Things that seem harder than they should be. I am a child and adolescent clinical psychologist. Parents don’t want to meet with me if they think there is nothing wrong.

However, parents often tell their children, in front of me, “There’s nothing wrong with you.” It is meant to be a reassuring statement. It is not, even when it is said in all sincerity. (“There’s nothing wrong with you. The problem is that your school does not know how to teach you.”)

When a parent says this, it is damned confusing to a child or a teen. I mean little kids have fun when they come to my office. I play with them and mix in silly questions like, “If you had three empty swimming pools and could fill each with a different food or drink, what would you put in each one?” I also ask about things they would change about themselves if they could, questions about painful feelings, and other more heavy questions. Interviews with young children are not so much about questions and answers as how they interact with me and whether I can get a flavor for their personality and general cognitive level.

The other kids know. They know that they are struggling in school. They know that they are not getting invited to birthday parties. They know that they are getting yelled at by their parents. They know that their grades are bad. The older ones know which teachers actively dislike them.

This way of communicating sends the message that to have something wrong with oneself is too bad to speak of and must be avoided. It is a layer of non-acceptance that can make happiness very difficult. The confusion of being told that “nothing is wrong” when it is patently obvious plants the seeds of externalizing blame and/or internalizing shame, neither state being compatible with taking responsibility for one’s own life. Is it so bad to say something like, “Everyone has things they are good at and things they have to work on. You have a hard time making good choices sometimes. We will help you with this.”

This is part of the reason that the message I saw on Facebook the other day, “There’s nothing wrong with you” got me fired up. It is a seed that can grow into much unhappiness. I see so many wonderful people in my professional and personal life who struggle with perfectionism, never being satisfied that they are worthwhile and good people. I see very successful and outwardly happy people who I can tell, due to my own empathetic skills and life experience, seem like they are faking it. Pain has a way of bubbling to the surface, even when well hidden.

My own perfectionism, which has waned over the years, seems so unnecessary now. The part that remains is fairly stubborn but I will keep working on it. I know that parenting cannot stem the tide of the influence of our culture. But parenting matters and it matters a lot.

I try not to be preachy in my blog because I have tried to focus on my own personal experience. That tone is the most healthy for me. I was kind of preachy yesterday. But that’s okay. You can handle me being fired up every once in awhile. I also did not want to make my blog into a “psychologist’s blog” including advice. But today, I would like to share what I think is the very most important way to teach our children self-acceptance.

Work on your own self-acceptance. I have decided that not only am I not perfect but that perfection is a goal that is unworthy of me or of my family.

I deserve better. And so do you.

I had an entirely different idea for a post today. Then as I was closing Facebook in order to write it, I saw another one of those inspirational quotes that has come to make my skin crawl. There were examples of how potentially negative attributes have positive implications, as well. The ending of the quote was, “There’s nothing wrong with you.”

Why do so many feel it necessary to say this? I believe it is very unhealthy.

Everyone and I mean everyone has faults. Lots of personality qualities have both positive and negative implications. The positive implications don’t erase the negative or vice versa.

Why do we need to convince ourselves that we are somehow perfect?

We aren’t. It’s a lie. It’s an utter and outright lie.

The problem is not being imperfect. The problem is not accepting that we are still good and worthwhile despite imperfections.

There are lots of things wrong with me. There are mostly things right with me.

There are ugly things about me. There are mostly beautiful things about me, and I’m not talking about pretty.

There are dishonest things about me. I am mostly honest.

There are selfish things about me. I am mostly fair and generous.

If I have to tell myself that I am perfect to feel better about myself, how will I ever look at myself honestly, trust myself, value myself, and grow as a person?

Finally, let me put it this way. I am a clinical psychologist. My job is to help children and teens be happier and healthier. I know of no effective treatment that involves my telling my patients lies or teaching them to lie to themselves.

Honesty is the best policy and a keystone of self-acceptance.


I had my penultimate Lupron shot. Yes, my second to last jab, on the right hip this time, with a syringe of Lupron stored in a package decorated with a photo of a smiling African American man, whom I am to assume is to represent a prostate cancer patient. Because, you know, both women and men love it when we get our hormones turned off by Lupron. It’s a party!

Lupron made me infertile by disrupting the signal between my pituitary gland and my ovaries. Yeah, I know, I talk a lot in my blog about breasts, a secondary sexual characteristic. However, the ovaries, primary sexual organs, are also commonly involved in breast cancer treatment. That’s because a lot of breast tumors, including the ones that were discovered in what was formerly my right breast, grew in response to progesterone and estrogen, two female hormones.

I could complain about the fact that a big part of my breast cancer treatment has been both a surgical and chemical warfare on my femininity. Remove my breast, then remove my lady chemicals. Go ahead, make me a man!

I’m not going to complain about this. Yes, losing a breast is a big deal. But that happens to many women, regardless of the hormone responsiveness of their tumors. Having had tumors that are progesterone or estrogen responsive is actually a positive prognostic indicator. Reducing hormonal activity is something that can be done to reduce the chance of breast cancer recurrence.

Chemically induced menopause is rough. I can tell you this first hand. Menopause symptoms, on average, are worse. I can tell you this, first hand. At the peak of my menopause symptoms misery, I had about 50 hot flashes EVERY DAY. Does that sound intensely uncomfortable? If yes, I have done an effective job in describing it. IT WAS RELENTLESS.

Currently, I experience almost no menopause symptoms. Also, I do not menstruate. And it is impossible for me to get pregnant. In other words, I am in a state of bliss.

It is likely temporary. Lupron does not permanently shut down my ovaries. In six months, my body will be adapting to the absence of Lupron. I will be 49 years old. At that time, I may become fertile again. My menopause may pause! Thanks a lot, menopause! Let me get used to you for two years and then throw a wrench into the works!

Yes, Virginia, I’m going to have to start thinking about birth control again. Aaaaaaaaaaaaaah!

The last time I took a pregnancy test was at least five years ago. I knew it was unlikely that I was pregnant, but things were not as usual, and I wanted to be sure.

Based on my family history, I am likely to go back to a peri-menopausal state after I discontinue my Lupron shots. In other words, it unlikely that I will be able to conceive, but still possible. My last method of contraception was an I.U.D, which I loved, but then had to have removed, because it secreted female hormones, and I am not allowed to have those.

Yes, I know that I am solely responsible for contraception. And I have talked to my nearly 50 year old husband about perhaps, just perhaps, getting a vasectomy. The first time I raised the issue was when I was 37 years old. I did not raise it again until I was a breast cancer patient, nearly 10 years later. Neither conversation went particularly well. In my husband’s defense, I probably raised it too early the first time, and the second time, he was likely stressed by the prospect of his wife dying.

I may be a two time champion of menopause achievement. It is not a title that I particularly relish but I guess they are far worse things in life to bear, like CANCER!!!!

As I’ve mentioned before, I am a fan of the show, RuPaul’s Drag Race. It is a comedy reality competition show. The contestants are drag performers. RuPaul Charles, who is a famous drag performer who also sings, created the show and hosts it.

RuPaul is a gay man in his early 50s. He dresses in women’s clothing when he performs. You know that he’s been called all kinds of names, been gossiped about, and beat up, many times in his life. One of the expressions he uses in his books (yes, I’ve read more than one of his autobiographies) and on the show is, “What other people think of me is none of my business.”

For those of us who are plagued with self-doubt, who feel lack of validation, who perceive and/or receive rejection from others, this is a very powerful statement.

At first, it sounds like a joke or some overly glib line.

How other people treat you is your business. These are actions.

But how many times have we read each others’ minds when we really don’t know? I know that I have done this a lot in my life, less so in recent years. But I still do it. We can’t know what another person is thinking. And if we did, pandemonium would ensue!

When I consider what people would hear if they could read my thoughts, I know that I would lose all of my friends and family. We all have careless half thoughts, mean thoughts, selfish thoughts, critical thoughts. But we have other thoughts, too. And sometimes, we may have a very nasty thought about someone, in the heat of the moment, only to soften later. I don’t want you to read my thoughts because they are private. It is my right to share them or not share them. In other words, they are my business.

And you know what else is my business? How I feel about me. Yes, I may sound like a children’s show, but think about it. What would your life be like if you worked toward accepting this in your heart?

“What someone else thinks of me is none of my business.”

Robin Williams was my middle school homework buddy. Yes, I used to do my homework in front of the television, which is a very bad habit. (Shhhhh, don’t tell my patients or my daughter.) As I recall, Mork and Mindy was a smash hit almost as soon as it debuted. Even as a kid, I could tell that the writing on that show was not that great. And some of the characters were not funny. But Robin Williams improvised a lot of his dialogue. He was fast, charming, impish, hilarious, and able to switch from utterly naive to lascivious in a split second.

As a young teen girl it was not lost on me that he was damned cute. So cute that despite my preference for clean cut boys (remember, I was a very young girl) who were on the pubescent side, I looked past Robin’s manly mane of chest hair that could clearly be seen peaking out of the top of his rainbow colored t-shirts. Mork was a stand up guy even when he’d sneak a dirty joke into each off his lightning fast riffs on the English language, pop culture, history, and astronomy.

Robin Williams went on to be a star and a good actor. I loved him as the lead in The World According to Garp. Very funny, very sweet. This was also the first time I noticed the sadness in his eyes. There is a common image of a comedian or a comedic actor as a “sad clown”. I don’t think that all funny people have to be sad but I do know that a good deal of famous funny people are sad. Frankly, I think most celebrities are sad. There is the drive to get attention with so much rejection interspersed. The attention and recognition are so inconsistent. When they come, I imagine it is like the high of a drug and you can never get enough.

I went on to enjoy most of his films over the intervening years and then he became involved in my school work once again in March of 1997. I was living in Florida at the time for my psychology internship. I had flown back to Chapel Hill, North Carolina for a couple of days because I was defending my doctoral dissertation. The doctoral defense is a centuries old tradition going back to the Middle Ages and deserving of its own post. Let’s just say that it is the day I wore a business suit, presented my dissertation research to five professors, they peppered me with questions for an hour and a half, then made me wait in the hallway for a half an hour while they determined whether I would get my Ph.D. or not. The whole thing lasted three hours and was the culmination of 6 1/2 years of graduate school.

There was another notable occasion occurring on campus that day. Robin Williams was just a little ways away filming Patch Adams. And I missed him! My friend and fellow graduate student, Jawana did not miss him. I excitedly asked her, “What was he like?” She replied, “He’s a small hairy man.” Ha! Not very nice, Jawana! Robin probably noticed this himself. Perhaps he would have compared himself to a muppet. Hairy, funny, and adorable.

Robin Williams, the world is never going to forget you and I’m not just saying that because I’m sad that you’re gone. You were a singular sensation. I could see the sadness behind your eyes. I could see the addiction to attention as well as other substances. The mania that delighted us when it was at the right speed. Nonetheless, you shocked me. You had lived through so much and escaped alive. You were 63 and somehow even though I’d heard you’d gone back to rehab, I thought you’d keep yourself around.

I am a professional who knows better. I was naive and hopeful. I thought you had enough Mork in you to keep you alive.

To feel alone with such love around you must have been devastating. I didn’t know you but you knew how to make me smile. Rest in peace.

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