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Vanishing Twin Syndrome

When you first discovered you were pregnant, your sonogram showed two or more fetuses. You got all excited, and immediately started gearing up for more than you planned. But a month later, the sonogram confirmed that you have just one baby, growing hale and hearty. What happened? This is called the vanishing twin syndrome. For one reason or another, the second fetus was not viable and the one which was healthy prevailed. It was as if the twin fetus just vanished.

The first thing to remind yourself is that this is not really unusual. A generation ago women did not have sonograms, and the only evidence might be found in the placenta after birth, if there is any at all. Most women didn’t even know it occurred. The prevalence of good prenatal care and early sonograms has made us more aware of the phenomenon. It was actually first recognized in 1945 by Stoeckel, and refers to the disappearance of one or more fetuses in a multiple pregnancy.

When this occurs in the first trimester, the most common time for the syndrome to be discovered, there is more than likely a developmental problem with the twin that vanishes; this is the time of organ development, and as with miscarriages, if the body detects chromosomal or development problems, the body ‘ejects’ the ailing fetus. If there is another baby (the ‘twin’), then because of the continued presence of the nourishing placenta, the sick fetus is reabsorbed into the placenta, and any evidence of the fetus is hard to find. The mother may experience mild cramps, pelvic pain or spotted bleeding, but usually there are no physical symptoms at all. If the symptoms do appear another sonogram should be performed to ensure that everything is alright. The viable fetus grows into a healthy baby. It is nature’s way of making sure the healthy survive.

Experts studying the vanishing twin syndrome estimate that one-eighth of pregnancies begin as twins. Obviously, the number of twins that make it to maturity is much smaller. Dr. Carolyn Givens (Pacific Fertility Center) estimates that fifteen to twenty percent of twin pregnancies miscarry one fetus. In 1986, a sonogram study was conducted on 1,000 pregnancies; exactly 21.9 percent of the twin pregnancies resulted in the vanishing twin syndrome.

When it comes to the first trimester, the cause is not solidly known. It is considered usually chromosomal or developmental damage, or could be improper cord implantation. It seems to occur with the same frequency between identical and fraternal twins, but it is suggested that the sharing of the placenta between identical twins may contribute to the odds. There is no preventative measure which could be taken.

Older mothers (over the age of 30) do tend to have this experience more often; the twins are usually fraternal, since older mothers tend to release more than one egg; and older mothers more often have chromosomal abnormalities, causing a higher rate of miscarriages.

Sometimes the only sign that the vanishing twin syndrome has occurred is that approximately seven percent of these women deliver the healthy baby before the 28 week gestation period, as compared to one percent of singleton mothers. About one third of these surviving twins will be underweight, with the incumbent complications.

With the advent of in vitro pregnancies comes the increased chance of multiple pregnancies. Since these pregnancies are closely monitored, it has been documented that they often experience the vanishing twin syndrome.

While first-trimester losses of twin fetuses are rather common and have few if any effects, the story changes if the twin vanishes in the second or third trimester. There is an increased risk of death for the surviving twin. The pregnancy is considered high-risk at this stage. It is more likely that the ‘vanishing’ twin will not be completely absorbed or ejected, leaving a ‘flattened’ fetal remnant or tumor material.

Late-term vanishing twins can also result in cutis aplasia or cerebral palsy in the surviving twin. The mother may experience preterm labor, obstruction of labor, infection, consumptive coagulopathy, or puerperal hemorrhage. There are instances of small tumors with remnants of the vanished twin which may occur in the survivor.

Therefore, if after your first trimester it is confirmed that you are carrying a multiple pregnancy, it is important to get regular sonograms and have the pregnancy monitored closely to avoid any problems.

No matter when the syndrome occurs, there may be a feeling of loss, not only for the parents, but also within the surviving baby. There can also be feelings of relief or guilt that the survivor is healthy. These feelings should be addressed, and if necessary worked through with a counselor before they affect relationships.

Why do people blink when they sneeze?

sneeze

The sneeze, an automatic response to many stimuli, has engendered numerous myths and fairy tales. Among these is that if you sneeze with your eyes open, your eyes will pop out of your head. As silly as this might sound to some, it is due to the realization that a sneeze is so explosive. A sneeze sends particles out of the nose at the rate of up to 100 miles per hour. In truth, if you could manage to keep your eyes open, there would be no ill effects.

The blood pressure behind the eyes does increase during a sneeze, as the body tries to concentrate all related muscles into the process of expelling any unwelcome invader to the nose.

Sneezing (sternutation) results from nerve transmissions to and from an area of the brain called the sneeze center. The sneeze center coordinates diaphragm, chest, abdominal, vocal chord and eyelid muscles to achieve the sneeze and rid the nasal passages of irritants. The involvement of the vocal chord muscles can be seen in a person who has suffered a series of allergic sneezes and ends up with a sore throat. The eyelids sometimes evidence the pressure by releasing tears. Part of the nervous system involved is the ophthalmic nerve, which is near the eye and the maxillary nerve, which serves the sinuses. Since these parasympathetic nerve bundles tend to generalize to nearby nerves, the relationship to the eyes is probably not a direct need for the evoking of a sneeze.

Another relationship to the eyes is called photic sneezing, which occurs in about one quarter of the human population, when exposure to a bright light such as the sun causes sneezing. Since sun glasses or hats that shade the eyes can prevent the sneezing, it is assumed that the ophthalmic nerve is being stimulated.

The ophthalmic nerve is a branch of the trigeminal nerve, which runs along the eye. This type of ‘reverse’ effect can also be exemplified by a sneeze which occurs when a person is plucking her eyebrows.

Most people are aware of the superstition that evil demons are possessing the body and when a person sneezes he is expelling these evildoers. Hence the expression “God bless you”. This comes from somewhere around the Middle Ages. But sneezing myths existed long before that, being recorded as early as 401 B.C.

In the Odyssey, Odysseus’ wife Penelope was fending off suitors. When she heard that Odysseus might be alive, she vowed that he and his son would take revenge on the suitors, Just then his son sneezed, and Penelope saw that as a sign from the gods.

If this is true, the gods are also with the animal kingdom. Animals are known to sneeze, with the “sneeziest” probably being the iguana. Iguanas sneeze more often and more productively than any other animal in an attempt to rid their bodies of salts created during their digestion cycle. And their eyes, while quite mobile, are still set in their heads

 

Treating a hypochondriac

hypochon-1

People who have gone through nursing or medical school have experienced the feeling that they have contracted each ailment as it is studied. And many have friends or relatives who, for want of attention, seem to be always “coming down” with something serious. It is easy to label such people as hypochondriacs, but in truth hypochondria is a real and serious ailment.
Basically, hypochondria is the belief that sundry symptoms are the result of a dire illness, when there is no evidence to support the claim. Out of this belief, the person can develop symptoms which are very real to the person, called psychosomatic (originating in the mind) symptoms. The person becomes even more ill with worry. This cycle is out of the control of the person suffering, and can affect both men and women in equal proportions. After seeking help from friends, family or health professionals, the symptoms may subside. Yet eventually the symptoms, or a new set of symptoms, re-emerge. The person is constantly examining his or her own body, and even if he or she is aware that the fear may be unfounded, the hypochondria is too powerful to resist.
Hypochondriacs (those suffering from hypochondria) find it hard to accept a negative diagnosis, and tend to misread ordinary bodily functions. For example, a normal person would interpret a headache as a sign of tension and take some aspirin, whereas a hypochondriac will run to a hospital in the false belief that he or she is suffering from a brain tumor. Such unfounded fear can interfere with the person having a normal life. He might miss a lot of work, or she might neglect her children. This condition usually begins in early adulthood. This belief is not to be confused with people who fake or lie about their perceived symptoms; they genuinely think that they are suffering, and in fact they are. They will take the symptoms they perceive to the Internet or medical books and try to find out which disease applies to them.
Often on the Internet or in cheap newspapers, people will relate stories of being misdiagnosed with a mild disorder when they in fact had a serious but treatable situation. This only fuels a hypochondriac’s fears.
It is important for the patient and his or her friends and relatives to recognize the severity of the hypochondria. The person may not believe that he is dying, but he will believe that he is suffering from something serious. Symptoms of the disorder include:
•    Thinking he has a disease after he reads about it
•    Doing an inordinate amount of health research
•    Regularly switching doctors when a doctor tells her there is nothing wrong, or seeking second opinions in this case
•    Having a long-term intense fear that he has a serious disease or health condition
•    Frequently checking vital signs (pulse, blood pressure, etc.)
•    Talking with family and friends constantly about the symptoms
•    Worrying that minor symptoms or simple bodily functions may indicate a serious problem
•    Going to doctors frequently and submitting oneself to expensive and complex testing; this may even include exploratory surgery
•    The symptoms or area of concern may change
•    The person’s concern interferes with work, family or social life
•    The person suffers from anxiety, depression or nervousness
The anxiety, and how a person handles it, can lead to further complications. Tests and procedures may create their own troubles, Friends, family and doctors may think that the patient is “crying wolf” and therefore miss real problems which can still occur. Invasive testing always carries with it a risk. She may become dependent on pain relievers or sedatives, or develop depression, anxiety or panic disorder. Loss of time at work due to excessive medical appointments may even cost the patient her job.
There are many suspected causes of hypochondria but nothing firm. Almost all alcoholics started with beer, but that doesn’t mean that a beer drinker will become an alcoholic. Patients with hypochondria often have a history of physical or sexual abuse. Other factors include having had a serious illness as a child, a poor ability to express emotions, the death of a loved one, being neglected as a child, knowing someone close who is suffering from a serious disease, or learning the behavior from a parent or close relative. It can’t be prevented because the symptoms have to arise before there is a suspicion of hypochondria.
Treatment for hypochondria can come from one of three fronts, and should eventually involve all three. First and foremost, if the patient himself or herself notices the similarity between the symptoms listed above and his or her own behavior, there is a good prognosis of healing the psyche. The second front is one’s family and friends. If they suspect a problem, they should approach the person and suggest seeking help. The third front is the doctor in care of the person. If the doctor just randomly or submissively calls for tests which are invasive or expensive, or if the doctor dismisses the patient as having nothing wrong, this will only aggravate the situation.
The person who suspects he or she is suffering from anxiety about illnesses that are not real can do a lot to help himself. Friends and family may make suggestions to which the person gives credence. He can avoid situations that trigger the anxiety such as self-examinations, reading disease-of-the-week stories, doctor-shopping, and avoiding drugs and alcohol. By getting active in sports, jogging, swimming or other exercise, the person can divert thinking away from himself. Or a doctor may suggest the situation. Above all, he needs to seek the proper doctor, one who will trust the patient’s suspicion and who will work with mental health professionals to help alleviate the hypochondria while keeping an eye out for real illnesses. There are also support groups he can join.
Friends and family should get involved. If the person is exhibiting symptoms of hypochondria, people close to her should sit her down for a heart-to-heart discussion, explaining why they suspect the disorder. Once the patient has acknowledged the problem, those friends and family can encourage her to seek help, and assist her in finding the right kind of help. They should also be ‘kept in the loop’ as the patient learns about the disorder and experiences progress.
The medical profession has recognized hypochondria as a real illness, and has made great inroads on the treatment of this condition. Symptom criteria are spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It usually takes both medical and mental health professionals to diagnose and treat it. The patient would probably seek a doctor first, assuming he or she is suffering from an actual illness, but sometimes this fear is confessed to a mental health professional first. The medical doctor should take the tests necessary to look for illness, and the patient should have a psychiatric evaluation. The patient needs to work with both professionals, and stay with them rather than shop for others, to avoid duplicating testing and effort.
hyphchon-2The patient should have a regular physical exam, determining height, weight and vitals, with examination of heart, lungs and abdomen. The medical doctor will probably prescribe antidepressants such as selective serotonin reuptake inhibitors (SSRIs) (fluoxetine (Prozac), fluvoxamine (Luvox) and paroxetine (Paxil)), or tricyclic antidepressants such as clomipramine (Anafranil) and imipramine (Tofranil), to reduce worry and even physical symptoms. This would be needed if the patient was suffering from a mood or anxiety disorder. Rather than just hand out placebos or general sedatives, the doctor should prescribe directly for the disorder itself. Meanwhile, the doctor can regularly see the patient in order to determine any possible changes in the medication, and to keep a watch out for real problems which would occur with anyone. This supportive behavior eases anxiety in itself, and will help avoid unnecessary testing while handling real illness when it occurs. If there is a severe pain involved, pain inhibitors may be prescribed. A complete blood count (CBC) will be taken to screen for alcohol and drugs while checking on the condition of the thyroid. The intention of the opening treatment is to make the patient physically comfortable as possible and rule out other conditions which might bring on the symptoms. At the same time, any complications of the hypochondria can be isolated. The doctor will also have a series of questions to determine whether the patient does in fact have hypochondria. During this discussion period, the doctor will recommend mental health help, and find out what the patient has tried to do so far. The doctor can apprise the patient on regular questions such as how long treatment would be, what the patient can do on his own, and what treatment is involved. If available, the doctor will supply reading material for the patient to bring home.
Although the patient may feel that this is a medical problem, as noted above, the causes are psychological, and therefore it is imperative that the patient also get mental health support from a psychiatrist or psychologist. The mental health professional should have a thorough discussion with the medical doctor, then perform a psychiatric evaluation on the patient. This will include questions about thoughts, feelings and behaviors, when symptoms started, how severe they are, and how this or similar episodes have affected the patient’s daily life. Using talk therapy (psychology or Cognitive Behavior Therapy), the professional will help the patient recognize those things which seem to make the symptoms worse, and get more active, even with symptoms. Observation of the patient may include getting back to the medical doctor with suggestions about any changes in medication. Mostly, the mental health professional will help the patient learn how to cope with hypochondria, since this is usually a chronic disorder and rarely fully “cured”. A personality assessment is another tool that the professional may use to diagnose the disorder, after ruling out physical causes for the symptoms. While the main goal is to help patients learn to live and function as normally as possible, this is often difficult because the patient needs to be convinced that the symptoms are of an emotional or mental origin. hypochon-3Once this hurdle is passed, the patient can learn to deal in different ways with stress and improve functioning on a work or social level. If a thorough physical exam has not been done, the mental health professional will recommend it. The patient will be educated to recognize symptoms of hypochondria itself, such as obsessive research and self-examination. Sometimes counseling includes exposure therapy, wherein the patient confronts his or her health fears in a safe environment, learning how to cope with those uncomfortable sensations. Psychological counseling is the primary treatment for the disorder, so it is necessary that the patient stick to this and other treatments as a unit.
The disorder of hypochondria may never go away completely, so the person suffering from it needs to learn how to cope, how to trust support groups, medical, psychological and social, and how to recognize the difference between an hypochondriac episode and a real illness. This is quite difficult to achieve, so the person must be determined to achieve control over the disorder as he or she would with a medical illness. The person must stick to the treatment plan, taking advantage of professional and social observation, and never make a medication change on his or her own. Symptoms may recur. The person must be ready to manage and control associated symptoms and minimize functional problems.
Those people suffering from hypochondria can satisfy their desire to research by going to http://thehypochondriac.com/ where they can find information on the disorder, diagnosis and treatment.

Recognizing RLS (Restless Legs Syndrome)

Woman Turning Off AlarmA person suffering from restless legs syndrome (RLS) is aware of the fact, but may not seek help for the condition. Like fibromyalgia, this is a disorder which cannot be quantitatively verified. The person has uncomfortable feelings in his calves, thighs or feet which seem to be impossible to allay except by walking, stretching or exercising. Soon after the relief of exercise, the symptom returns. The discomfort arises after rest, either from sitting for a long period of time, or after falling asleep. This restlessness interrupts the sleep, so it is often referred to as a sleep disorder.

Sufferers describe the symptoms in many different ways – itching, burning, pins and needles, “creepy crawly” feelings, throbbing, pulling, tugging, gnawing or downright pain. These discomforts are often mild, but can become intolerable, at which point the person will finally give in and seek medical help. The symptoms can be experienced as young as childhood, but appear to be most common as one gets older, especially after the age of forty. It is believed to affect about 10% of the population, but this is only a guess; due to the nebulous feelings, many people do not report it to their doctors. Symptoms can come and go, always more severe in the evening or night and nonexistent in the morning. Slightly more women tend to suffer from this syndrome, but it does affect both genders and may occur in other body parts.

The sufferer can hesitate to run to a doctor with the problem, for fear of not being taken seriously. Doctors may credit the problem to stress, nervousness, insomnia or muscle cramps. Recent attention from the pharmaceutical community has lent some credence to the existence of a real problem. Probably the patient’s best advocate is himself. By keeping a simple diary of incidents, the patient can find those things which may trigger the syndrome, such as being over tired, which causes a round-robin of restlessness, exercise and loss of sleep. On days when the patient has been walking a lot, there may be a remission of the symptoms. Some sleeping positions can aggravate the symptoms. Several studies indicate a genetic connection, so the patient should inquire within his family of others who may also suffer from the syndrome. The patient should note any occurrence which lasts an hour or more, and any occurrence in the upper legs or arms. He should note if it occurs during prolonged sitting, such as a road trip, classroom, movie theater or airline ride. He should also note if he is under stress or emotional upset.

Sometimes RLS is a side effect of certain drugs, so the patient should bring a list of those medications to the doctor. Antinausea drugs, antipsychotic drugs, antidepressants, and even allergy medications containing antihistamines are suspected of worsening if not causing RLS. The symptoms are recognized as being part of other illnesses such as diabetes and dopamine-related diseases such as Parkingson’s disease; there seems to be a relationship between restless legs and dopamine uptake. It is possible that a chemical imbalance of dopamine, which crosses the blood-brain barrier may be at fault.

About the strongest suspicions of cause are related to the body’s iron uptake. Pregnancy’s high usage of iron (ferritin) may be the reason RLS arises during gestation and subsides after birth. The patient should monitor his intake of high-iron foods, and discuss iron supplements with the doctor. The Mayo Clinic and Johns Hopkins Hospital are currently studying iron treatment for RLS.

Other contributing factors can be peripheral neuropathy from chronic diseases such as diabetes and alcoholism as well as kidney failure. The patient should evaluate all these possible causes and then determine his next moves. He should approach treatment according to the severity of the syndrome. Even mild RLS causes daytime fatigue, unclear thinking and depression. There is a great deal the patient can do before turning to the medical profession, where it is often misdiagnosed, and where medication treatment has had limited success if any.

After determining which causes apply to himself, the patient can do a lot at home to cope with the situation and ease the symptoms. First, set up the bedroom as a comfortable place, retiring and rising at the same time each day. Use hot or cold packs on the legs to relax them (or try alternating the two), and practice gentle stretches, massage and warm baths before bed. During the day, make a decided effort to relax, perhaps with yoga or meditation to ease tension Avoid alcohol, tobacco and caffeine, since they may aggravate the symptoms. Tell others about your condition, so that they will understand your pacing and standing when others sit. Don’t fight the urge to move – get up, move around, find a productive activity to achieve something while exercising. Take walking breaks when travelling. Adapt your workspace to work from a standing position by elevating the desktop. Begin and end your day with stretching or massage. Over-the-counter pain relievers such as ibuprofen can help. Try all of these and decide which to continue, since there is no “cure” for RLS and you are facing a permanent and possibly worsening syndrome. All the over-the-counter creams and pills being advertised seem to have no effect other than to legitimize the syndrome.

If these tactics are not sufficient, a visit to the doctor is in order. When medical help is sought, the doctor cannot diagnose this syndrome with any accuracy. What she can do is eliminate similar and more serious ailments as the cause of the symptom. Blood tests should be run, and a thorough history of the symptoms, family, and medications needs to be taken down and analyzed. Some doctors may request a sleep evaluation, watching for twitching or periodic limb movements during sleep.

A blood test to look for underlying nutritional deficiencies should be performed. Under the doctor’s eye (for complications of these and prescription medications) supplements may be suggested for iron, folic acid, vitamin B and magnesium. There are many types of prescription drugs being tried for RLS, but results are mixed and controversial, so if the doctor decides to opt for this treatment, it will probably be experimental in nature.

Restless leg syndrome has also been called Willis-Ekbom disease, after two of the physicians who studied the disorder in depth and encouraged further research. The patient can join the Willis-Ekbom Foundation (formerly the RLS Foundation) to get access to support and news by signing up here. Because of all the uncertainties and controversies over cause and treatment the patient himself needs to evaluate and handle this newly-recognized syndrome himself.

What “quickening” is in pregnancy

pregnantYou know you’re pregnant – you missed your period, got tested, got scanned and have the dreaded morning sickness. So far, other than announcing it to your husband, the pregnancy is simply a fact, and not all that pleasant. Then comes the “quickening”. Suddenly the pregnancy is real, the baby is real, and you start building a relationship with your baby.

The quickening is that first moment when you feel your baby move. Actually, your baby has been floating around all along, but is finally at a size where its movements can be felt through the uterine wall and into the abdominal muscles. At quickening, the baby is only about four inches long, and weighs just over an ounce.

The origin of the word seems to be lost, but is traced back to the fourteenth century, perhaps as the quickening of seeds. In western culture, this is often considered the beginning of “life”. William Blackstone referred to quickening in the eighteenth century:

“Life… begins in contemplation of law as soon as an infant is able to stir in the mother’s womb. For if a woman is quick with child, and by a potion, or otherwise, killeth it in her womb; or if any one beat her, whereby the child dieth in her body, and she is delivered of a dead child; this, though not murder, was by the ancient law homicide or manslaughter.”

Political and legal ramifications are subject for a separate discourse. For now, we are simply recognizing and celebrating the recognition of the baby’s life by her mother.

Quickening during pregnancy occurs somewhere between the 13th and 26th weeks of gestation, depending on a variety of reasons. The sensation is often described as fluttering, butterflies, gas bubbles, indigestion, or as something inside, tapping on the uterus. It can even be mistaken for hunger pangs. Each woman experiences and describes quickening differently.

First-time mothers will usually feel it later than other mothers because they do not recognize it, and because their uterine walls are tight, maintaining more space between the uterus and the abdominal wall, which is where the sensation is actually felt. Overweight women may experience it later because the sensation has more fat to travel through to reach the surface. For this reason, women with smaller frames or who are slim will feel the baby’s movement earlier than those with large frames.

Once recognized, quickening is not a regular sensation. The baby’s movements might occur because it is in an uncomfortable position, the placenta is exposed to certain foods, there is pressure from a full stomach after meals, or because the mother is very still, as when lying down. The baby is stretching and flexing her limbs, or trying to get away from an uncomfortable position. Even this early, babies react to noise or the mother’s emotions. Eventually the mother may recognize a sleeping/waking cycle.

If the quickening sensation seems to be regular, like a tap every five to ten seconds, it might be that the baby has the hiccups.

As a woman named Denise described it, “I am an extremely ticklish person, so much so that I’ve been known to jump straight out of bed from a dead sleep if my husband were to brush against my feet. I found that I’m very ticklish on the inside too. There was more than one inappropriate time with my pregnancies to Briana … and Georgianna … that I burst out laughing because I could no longer control the tickling feeling.”

While the event of quickening is exciting and makes the pregnancy seem much more real, its timing spans a broad range, and should not be a matter of concern until after the 26th week. Eventually, you will be very aware that there is a baby bumping and kicking around in there.

The Imposter Syndrome

Who is that, really?

Who is that, really?

Bob Sanders’ boss popped his head in and said “Got a minute?” To some this is unthreatening. To Bob it meant that probably something went very wrong with the last project, and he has been exposed as the fraud he always seems to be enacting. With dread, he went to hear the verdict.

“The ABC project went through with flying colors, Bob. Good job.”

“I had a great team of workers on this; without them it would not have sailed.”

Co-workers and supervisors see Bob as humble and hard working. They do not see the fear and insecurity which drives him.

Bob suffers from what is often called the imposter syndrome. More often recognized in women, this is a loose term describing someone who can’t believe that any success she or he has is because of his or her own capability, but rather a result of luck, others’ efforts, or a “con job” that the successful person has pulled off. This isn’t a fear of success; it is a total lack of faith in oneself.

This psychological tic is most often demonstrated in women, and has become a call to arms for women’s liberation, since it probably stems from a still-ingrained nurturing by society that women are “vessels” of good fortune, not the creators of the same. Women still externalize any success as coming from without – friends’ help, basic good nature of the child, support structures, good training by the university, just about any cause except their own intelligence.

Men are not exempt from this syndrome, although society does encourage males more to trust that they in fact did earn accolades. In other words, men are taught to internalize their success as having been a result of their own competence more often than are women.

Nonetheless, both genders have gotten caught in the trap of self-doubt instead of self-confidence. These victims see themselves as frauds – they can’t believe that they actually did cause a good outcome but rather that they were “winging it” and got away with it. They feel they are imposters of persons who actuate success. They are surprised each time their actions result in the right end.

In many ways this is a crippling attitude. Such a person never feels secure in his or her endeavors, and feels each step in life is yet another opportunity to fail. This is a person who will avoid challenges whenever possible, preferring the safe road well-travelled. Unless pushed by others who have more faith in the person, this person will not advance in work or life.

The causes are probably rooted in childhood, when achievements are not credited to the individual but rather the circumstances. A good grade on a test? That’s because your father made you review all that information the night before and drilled you. The nicest boy invited you out? That’s because Mom dressed you up just right. Cute remarks by a toddler? A result of accidental odd logic.

These treatments need to be reversed at the onset – you got a good grade on the test because you have a good memory and understand the material; you are a very sweet person, so it’s no wonder that boy asked you out; you have a sharp mind and see things differently than ordinary toddlers. These are examples of ways to internalize the success rather than denigrating the individual. Parents need to direct a child’s viewpoint back into the child, to see what is special about the child which caused a good outcome. Sadly, this is done more for children with mental or physical impairments than for ordinary children.

Culture plays a strong part as well. In many cultures, there is an attempt to keep children humble, to encourage them to keep striving harder. This undermines the inner strength to trust oneself and venture forward.Janus1

Symptoms of this syndrome are noticeable in people usually viewed as successes – actresses, writers, psychologists, business people and even scientists. In one way it keeps them striving for a “genuine” success, but in another way it keeps them from getting pleasure from the successes they did in fact already earn. They feel that they don’t really know what they are doing, and practice a lot of coping mechanisms to avoid being “found out”, including blustery pronouncements in meetings, avoidance of situations where they have to justify themselves (since they don’t feel they could), and statements of humility, giving credit to others. These people are afraid to admit their perceived incompetence, so they will not seek out help, ask questions, nor take on threatening challenges.

When something goes right, it’s because he was in the right place at the right time – when it should be because he was the right person for the job. If success is achieved, the person simply raises the bar for the next challenge, since the person feels he has simply dodged the bullet the first time. This person sees more of his mistakes and shortcomings than his strengths. This person always sees himself as a lesser person than his colleagues, who would have done an even better job, since others not only would have the external help but the internal strengths as well.

If a person recognizes himself as suffering from the imposter syndrome, he can overcome the situation even in adulthood. The first step is to believe supporting accolades from friends, family and peers. Another step would be to mentor another person; this not only keeps another from falling victim to the same attitude, it reinforces in the mentor that he in fact has something of value to offer; it cuts back on the tunnel vision. An objective analysis of successes and failures can help a great deal (although this should not be done in a vacuum). By recognizing exactly what actions caused a failure (Did someone else sabotage your efforts? Did you mistakenly trust the wrong source?) the person can avoid a recurrence while establishing the correct blame. By taking a hard look at success, the person can start to recognize when he actually did earn the outcome, and internalize the trait as a strength.

While the imposter syndrome is not considered an actual psychological handicap, it needs to be recognized as a handicapping attitude, along with fear of success or overconfidence. These are attitudes we carry with us that affect they way we earn a living, raise a family, or get along with the rest of society.

Further reading on the subject can be found at Why do so many successful women feel they are frauds? , which has some interesting examples, and Don’t let imposter syndrome sabotage your career.

bathing baby

bathing babySometimes I wonder just how desperate people can be to get their 15 minutes. This morning’s news was covering a story about a mother of three who (are you sitting down?) bathes her 3-month-old baby only once a week! Dreadful!! Must have been a slow news day.
I grew up with the traditional Saturday night bath, with 3 inches of water. My parents made it through the depression; my grandmother had a water heater in the kitchen and had to haul hot water to the bathtub in kettles.
I have sensitive and dry skin and hair. To this day I am a subscriber to the weekly bath. There are exceptions – when I’ve been swimming I need to shower out the salt or chlorine and actually go into the shower wearing my bathing suit and rinse it out at the same time. And when I have a big night I like to soak in a bubble bath to get into the right mood. If I have been sweating from a flu, I like to shower as soon as I can stand up.
I raised my kids the same way, although I did bathe them daily until they were toilet trained because they also had sensitive skin and needed to have the diaper area clean. By the time my youngest was trained, I was working 2-3 jobs to support them, since my husband had abandoned us. I had neither the time nor the wherewithal to bathe them every night. We were on weekly baths or showers from then on.
When my children became teenagers they found that their hair was very oily, like their father’s. That plus social pressure at school moved them into a daily shower routine. That’s fine – for them.
Let’s get back to this beleaguered woman. I wish I had caught her name; she deserves credit for daring to blog her attitude. When her second child was suffering from dry skin, the pediatrician told her she was bathing the child too often. And she did check with the pediatrician about baby number 3; the pediatrician said it was fine.
People, especially young mothers and housewives, have gotten obsessed with anti-bacterial cleaning, and germ-free kids. It’s no wonder that asthma and allergies have become so rampant. There is natural bacteria on our skin which functions as an immunological system. A child’s immune system develops in the first three years of life. During infancy the baby has its mother’s immunity. If a child is sheltered from the world – pets, dust, and good old fashioned outdoors — s/he will not develop an immunity to these things, and will eventually have allergies to them instead.
It is one thing to wash something if it’s dirty; it’s another to scrub everything (including your kids) just because “the girls” say it’s the right thing to do.

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