The MALADIES are the FIVE most common conditions that make overcoming
the CRUMMIES (see my June 2006 NABBW column) more difficult. They are
probably have one or more in your life that complicate getting and
staying healthy.

MALTREATMENT can be past or present. It can take the form of
physical or sexual abuse in childhood, domestic violence and verbal
abuse in adulthood, or other neglect and privations. When I look back
over my thirty-seven years in practice, I would have to say that
between 70 and 80 percent of the eight to ten thousand women I have
seen, regardless of the setting, have reported the presence of some
type of current or past maltreatment in their lives. They may or may
not be coming in to see me for reasons related to that abuse, but their
capacity to recover, to respond to treatment, to live a productive,
satisfying life is very much affected by maltreatment. The fortunate
ones have become “survivors”. They have effectively used prior therapy
or found other social and spiritual resources to aid in their recovery.
The others remain trapped in a “victim” role, which not only leaves
them vulnerable to further abuse but keeps them from stepping forward
in the world in an assured, positive manner. Many, who come to therapy
for the first time in their forties and beyond, are revealing their
traumatic history or current abuse for the very first time. With the
sharing of their “secret” comes the opportunity for healing and
serenity. If you are reading this and the “secret” is still inside, I
encourage you to find the courage to share that secret a trusted
friend, a pastor or a therapist. With their help, you can begin a
journey beyond shame, a journey that can heal not only your emotional
and spiritual self but often your physical self as well.

MALFUNCTION comes in many forms as we age. We need arm-extenders
to read the menu as we resist the move to bifocals. The groan factor
becomes a part of life as creaky knees and pain-ridden backs heave our
often-overweight bodies out of chairs or up stairs. Diabetes,
hypertension, and heart disease suddenly become more than family
history and part of our own medical chart. Multi-tasking turns into
why-am-I-standing-in-my-kitchen. Menopause, as inevitable and normal as
it is, leaves us swimming in a pool of sweat, hot under the collar (and
in every other crevice!), and mean as a junkyard dog. Our worst fears
are realized as we look into the mirror, or see the looks on our grown
children\’s faces, and know for a fact that we\’ve just turned into our
own mothers! The overlay of physical discomfort, Chronic Illness, and
chronic pain greatly increase the likelihood that we will be stressed
on our jobs, more vulnerable to developing depression, and even at
higher risk to developing dependencies on chemical substances,
including pain and sleeping medications prescribed by our physicians.
Taking better care of our health, giving some TLC to those beautiful
bodies of ours, doing meditation, minimizing our intake of alcohol,
stopping smoking, getting daily exercise (even a ten to twenty minute
walk), getting a massage now and then—all can make a positive impact
and reduce our risks of psychological meltdown and spiritual burnout.

When the diagnosis is not the usual ill that a week off of our feet and
a few pills can cure, when that most feared diagnosis of terminal
cancer, or multiple sclerosis, or Parkinson\’s, or early Alzheimer\’s is
given us, then what? MALIGNANCY in all its varied forms often kills our
spirit before it destroys our bodies or our minds. When I think of my
most treasured moments during my long years in practice, I think of the
handful of extraordinarily courageous women who gave me the privilege
of being with them through the last months of their lives. What support
I could give to them was nothing compared to the uplifting experience I
had simply sitting with them as they made that last transition in life.
Often families are too close or too frightened to allow the sharing,
the laughter, the prayers, and, yes, even the joy, that can be a part
of this final and most important journey of our lives. There are so
many wonderful resources now for women facing chronic and even terminal
illnesses in addition to their own family and spiritual supports. Get
that computer whiz grandson of yours to find the nearest support group
for you.

MALPRACTICE may seem like an odd addition to this list of life\’s
complications. It is not surprising that with all the extra medical
care our aging bodies require, that now and then we find ourselves at
the receiving end of less than perfect medical care. I read an
interesting book some years back called Male Practice: How Doctors
Manipulate Women (by Robert Mendelsohn) which chronicled how women have
been under-treated and inappropriately treated over the centuries by
male physicians. When actual malpractice occurs, an attorney should be
consulted or the member services department of your health care
organization contacted. Most of the time, however, the women I see
complain of being unheard, ignored, patronized, or told “it\’s all in
your head” by their primary care physicians. That\’s when women end up
in my bailiwick. Crying in front of a physician—especially a male
one—is a sure ticket straight to psychiatry. Very real medical problems
can be caused or aggravated by stress, and even when they are purely
medical, it doesn\’t hurt to consider getting some supportive counseling
just to help you make the tremendous adjustments that living with a
chronic illness necessitates.

MALARKEY is the last in the list of MALADIES that complicate our
lives in our middle years. Oh, there\’s the usual malarkey that comes to
us from the media, politicians, and used car salesmen. But the malarkey
that most affects our lives comes from our own heads! And it got
planted there a long time ago while we were growing up. Think about it.
Did Dad\’s admonitions about the clean-plate-club contribute to that
lifelong eating disorder with which you\’ve always struggled? Did Mom\’s
warnings about not being selfish lead to a lack of Self-Care or
damaging codependent relationships? Did do-unto-others turn into
don\’t-do-for-yourself? Have your experienced too heavy a dose of Miss
Manners? Deeply held assumptions that women harbor in their souls very
often have to be uncovered, re-examined, and replaced with more
reasonable and workable guidelines for a sane and sustainable approach
to life.

Although you may escape the MALADIES, you rarely escape the OVERFILLED
PLATE. You find your plate heaped high with a three-layer GENERATION
SANDWICH, plus two helpings of EMPTY BIRD\’S-NEST SOUP, and a side of