You can love you better

Many women don't learn soon enough that their needs sometimes have to get top priority

January 18, 2007
TINA GLADSTONE
SPECIAL TO THE TORONTO STAR

It was while watching an all-woman country band in 2004 that Missi Smith first felt herself sinking into gloom.

The singer, in her little skirt and cowboy boots, reminded Smith of an earlier version of herself, when she used to take such pleasure in her own music, her writing, her poetry.

"What has my life turned into?" she wondered. A night like this – having fun with friends – had become all too rare for the full-time working mother.

Later in the evening, the talk turned to women and health. One of Smith's friends, who worked in drug development at Princess Margaret Hospital, lamented the fact that so many women end up getting sick because they don't go to their doctors for routine testing.

"I just can't understand why women don't take responsibility for their own health," she said to Smith. "We know we can catch and treat early cervical cancer if women have regular Pap smears. It's a five-minute test."

That conversation was a wake-up call for Smith. Not only was she guilty of letting medical symptoms go unchecked, but she realized that she wasn't looking after her emotional or spiritual health either.

"I was living inauthentically, going through the motions of my day at work, my night with my daughter. Somewhere along the way, I had lost me."

Smith decided to act on her physical health. For two years, she had been having abnormal menstrual bleeding and pelvic pain. Just 37, she was showing signs of early menopause.

But her visit to the doctor's office came too late. A few weeks and many medical tests later, Smith was diagnosed with an invasive form of cancer that had already spread from her uterus to both ovaries, her cervix and pelvis. The treatment was a complete hysterectomy, six months of chemotherapy and 30 radiation sessions.

"It was devastating. There went my chance to have a second child, there went my life," says Smith, now 39.

Looking back, she wonders how she could have missed such a huge illness for so long.

"It seemed that, all of the sudden, here I was a new mother, with a new mortgage, commuting to a temp job, with an older husband who was going through job changes of his own. It was all very stressful. I was too busy and too proud to take time for myself."

Dr. Melissa Snider-Adler is a family doctor who started the Centre for Women's Health in Richmond Hill in 2004. She says that while women make up more than half of all visits to doctors, there is a big subset of women much like Smith.

"These women, in their 30s, 40s, even 50s, are so consumed with taking care of children, preparing meals, making sure homework is done, that they don't listen to their own bodies. Often, they only come into the doctor's office when things are really bad."

Psychotherapist Brenley Shapiro, who sees women at Snider-Adler's clinic, says the problem comes from women's psychological makeup, at least in part.

"Woman are innately nurturing beings. They are also socialized to be the caregiver, which becomes a large part of how they define themselves," she says.

"So they put the needs of others higher up on their priority list, and their own needs go to the bottom, or don't make it on to the list at all. These women often end up hurting themselves."

Shapiro says the problem is so deeply ingrained in women that they often aren't aware of it. At a counselling group for young mothers, she remembers asking the women what they liked to do. The answer was almost invariably, "Taking care of my kids." She'd have to press them hard to talk about what they did for their own pleasure.

Shapiro says families can add to the problem.

"When a women finally says no to one of her children's requests, the child says, `What?'

"When I do assertiveness counselling with women, I teach them to create a boundary and say no, even if it doesn't go over well," she explains.
"When a woman changes her behaviour, it throws off the family equilibrium. And family members don't like it. Why would they? It's much easier when Mom does all the work. If someone was going to come and do your laundry and cooking, of course you'd let them do it."

Shapiro says the pressure on women today is worse than it was a generation ago.

"My mother used to put me in a playpen, but people feel they can't do that anymore. There's so much emphasis on stimulating your child's development," says Shapiro.

"Now, not only do women face the pressures of work and home, but they are running ragged taking kids from one program to another and being involved in homework."

Shapiro says some women are starting to make their mental and physical health a bigger priority, but only once they agree that they need some help. "(Some) really have to hit rock bottom before they'll walk into a doctor's office to get help.

"A line I use with my patients is `short-term pain for long-term gain.' The short-term pain is the not getting to something else on your priority list," she says. "But in the long run, these women are far better off if they rewrite their lists to give themselves higher billing."

Smith's health is considerably better now. She's still being monitored every three months, but after years of therapy, yoga and work with a life coach, she feels she's come a long way.

"If I haven't gotten it already, I'm getting it. Now, when my daughter asks me to lie in bed with her at night until she's asleep, I say, `No, I have things I have to do for me. I love you and I'll see you in the morning.'"

And she's finding time to enjoy music again. When a girlfriend recently called about getting tickets to the Dixie Chicks show, she thought about the high cost of the tickets, the dinner beforehand, the drinks afterwards, the babysitter and, in about two seconds, answered, "Count me in."