shame | My Eyes Are Up Here

People, I’m going to get nerdy. I’m going to talk about a subject that strikes doom into many people’s heart. I am not joking even though I am using strong language.

I am going to talk about risk factors and what they mean from a research perspective.

When the media talks about “what causes/prevents cancer” or “what causes/prevents heart attack” or any other bad disease, they are usually referring to risk and protective factors. Example number 1. We know that smoking “causes” lung cancer. What that really means is that smoking is risk factor for lung cancer. We all know people who smoked throughout their lives and never got lung cancer. And some of us know people who got lung cancer who were never smokers.

So from a research perspective, smoking does not cause cancer. Smoking is a causal factor for lung cancer. It increases the risk of developing lung cancer by quite a bit.

“Elizabeth, that means that I can smoke, not feel guilty about it, and because George Burns smoked cigars all those years and lived to 100 years-old, I won’t get lung cancer?”

No, it means none of that. George Burns beat the odds. I mean literally just that. One, he lived much longer than average. Two, he lived much longer than average given that he was a smoker. No one reasonable ever said that there is a 100% chance of getting lung cancer if you smoke or that there is a 0% chance of getting cancer if you never use tobacco products in any way.

Okay, I promised to get nerdy but I am taking it back. Let me put this plainly. You can engage in activities or behaviors that are risk factors and end up with none of the risky outcomes. Risk is relative, not absolute. You can engage in activities or behaviors that are protective factors, you can be a teetotaler, never smoke, exercise regularly, eat well, be nice to your mother, and still end up with scary diseases. Those behaviors only reduce risk they do not eliminate any risk of disease.

And come to think of it, no matter what we do, some day, we will end up dying.

Does that mean that what you do today, tomorrow, or the next day doesn’t matter?

Thanks for understanding my need to be a a psychologist nerd. Yes, we are all about the thoughts, feelings, and behaviors but as Ph.D.’s, we are additionally, all about the research. Also, guilt is when you regret doing something that is in conflict with your beliefs and values. Sometimes I wonder when we talk about feeling “responsible” for our diseases that we are really talking about shame rather than guilt. Guilt actually can be productive and helpful. I didn’t believe that for most of my life until I understood the difference between guilt and shame. Guilt refers to behaviors that we can chose to change. Shame is the feeling, “I am bad.” That’s a lot different than guilt, “Wow, I wish I hadn’t done that.” Sometimes I do things that are at odds with my beliefs and values. I don’t think that I am alone in this. I try to treat myself with compassion. I am not always successful. I try to be compassionate and patient with myself for not living a perfect life. I am not always successful.

My proposal to myself and with all kindness, to you is, “How do you want to live your life today?”

Much love and peace to all of you,

Elizabeth

As a mother of an almost 17 year old girl, I try to keep my mouth shut when it comes to what she chooses to wear. What girls and women “should” wear. Yikes, what a thorny question. As a feminist, I hate the way clothing is so sexualized even for young girls. I remember seeing a two year-old wearing a sundress with darts sewn in at her chest, as if she had breasts. Maybe it’s a small thing but seriously, why would a clothing manufacturer make the extra effort involved to do this? On the other hand, I understand that for teens, dressing in different ways is an important part of identity development and part of that development is sexual. As a feminist, I hate the way girls are shamed by adults and peers about what they wear because it is “distracting” to boys or is “slutty” or “whorish”.

Another thing I keep my mouth shut about is her weight. Yes, it is true that 1/3 of adults are obese, that she eats an unhealthy diet, and that she no longer exercises regularly. However, there are so many messages to girls and women about what they should way and how they should look that it is nearly impossible to have a conversation about weight. I admit that up until a few years ago, I would nudge the scheduling of my annual physical by a couple of months every year so that I could lose weight in time for the appointment and not get “THE TALK” from my internist. And honestly, she gives “THE TALK” in the best way possible. But I still dreaded stepping on the scale. And for the record, I never managed to lose weight during those couple of months between my scheduled and rescheduled appointments.

As I’ve written many times before, I have struggled to maintain healthy weight since my teen years. Although I am not a person who people typically think of as overweight, my BMI has entered into the obese range twice in my life, once in my late 30’s and the second time in my mid forties. Each time, I lost 40 pounds. When my weight was either declining or in the healthy weight zone, I typically felt good about my body. When I was not, I had some pretty horrible things things that I told myself every day, like a tic. And when I was at a healthy weight, I still had a habit of comparing my weight to the people around me, even people I encountered while walking down the sidewalk.

As I wrote in the post, The Skin I’m In, the tic stopped after I’d done a lot of work on my body image, a natural thing to work on after breast cancer surgeries. At the time, I was at a healthy weight. I told my psychologist that I was concerned that if I were to gain weight again, that the tic, the tape in my head that told me “you’re fat” and other messages would come back. She told me that it might not come back.

By March of this year, I had gained back 25 of the 40 pounds I had lost between May and October of 2012. This was also, incidentally, at the time I went to The Second Chance Prom with my husband. We had a wonderful time. As I looked at the photos of myself from that day, I thought, “Yes, I’m overweight but I look beautiful.”

I realized that although a substantial amount of weight had returned, the tape in my head had not come back. I intended to write about this in my blog. Then I found that it was really difficult to write about. I was ashamed of how badly I had judged myself. I was also too ashamed to admit that I thought I was beautiful. Women are only supposed to say that about their young selves, after all.

Shame is a powerful emotion and it results from a sense of having violated society’s rules. One reason women and girls have a lot of body shame is because we have failed to achieve perfection. We also fail to stay young. But another one of society’s rules is that women and girls are to be dissatisfied with their bodies.

What a trap. What a no-win situation, if winning is defined as having a healthy body image.

A couple of months ago, I started following Weightwatchers again. It was the first time I’ve gotten myself back on an eating program without “hitting bottom”, that is, being motivated by shame and disgust in myself. I started referring to Weightwatchers as “wise-minded eating”. I do watch my weight to reduce chance of cancer recurrence since my cancer was highly estrogen and progesterone responsive and adipose tissue (basically body fat) has glandular function and produces female hormones. Also, a healthy diet is just good fuel for my body. I feel better when I eat well. I am also losing weight at a slow, but steady pace. My motivation, instead of eliminating shame is instead, seeking health.

One of the antonyms for shame is honor. I like that.

I honor my body for getting me this far in life. I will continue to do my best to treat it well.