Consciously Female: How to Listen to Your Body and Your Soul for a Lifetime of Healthier Living

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The Body and Soul Reunion

What does it mean to be Consciously Female?

"I think that I will spend about half my life feeling like I am not myself. If you count the week or so every month before my period, when I am less than efficient, then throw in pregnancy, nursing, and recovery, and top it off with that whole perimenopause and menopause part, it really adds up. My question is--if I am not myself for so much of my life, who am I really?"

You are yourself. Every week of the month. Every month of the year. Every year of your life.

Let me show you how to embrace that reality.

Let me show you ways to work with your female physiology instead of feeling that your physiology is working against you.

Let me show you how to enjoy better health and a more fulfilling life by changing the way you take care of yourself--at every stage of womanhood, from your first menstrual periods through the last ones, and beyond.

As a woman's doctor--and as a woman--I am all too familiar with the complicated relationship we have with our well-being. We know it's important to eat right, exercise, get plenty of sleep, and so on, but we have trouble making the time. We yearn to be well yet ignore symptoms of problems. We nurture everybody else before ourselves. We depend on our strength even as we do nothing to build or maintain it. We find it easier to criticize, complain about, and obsess over our bodies than to admire, celebrate, or feel pride in them We dream about balance and rush to the next item on our to-do list.

Meanwhile, our energy levels, moods, appetites, and desires can fluctuate by the hour or the minute. Heck, even our waist size seems to change from one day to the next. A never-ending parade of female issues continually disrupts the brief periods of peace. PMS, irregular cycles, birth control decisions, pregnancy scares, pregnancy losses, pregnancy itself, postpartum weepiness, infertility workups, hot flashes, HRT decisions, yeast infections, lumps that show up on breast exams or abnormalities that appear on mammograms, problem Paps, cancer scares--you name it. Our reactions range from mild annoyance at each inconvenience to outright anger at the rude interruption in our lives. Sometimes we feel betrayed by our bodies. Sometimes we choose not to notice. Mostly we grit our teeth and wait for each "glitch" to pass and return us to our "real" self. Whoever that is.

We overlook the key fact that all of these experiences are real. The ups and the downs, the highs and the lows, the light moments and the dark ones. It's all authentic. It's all part of you.

It is you.

Unfortunately, the ordinary facts of femaleness have somehow become divorced from women's everyday lives. Our society may have more knowledge about the human body than at any time in history, for example, but many of my patients are surprisingly unfamiliar with their own anatomy, let alone the hormonal and reproductive rhythms that are such huge parts of being female. A woman's daily rhythms can blur by. We're almost too busy to eat or sleep, let alone respond to the more subtle messages our bodies and souls are communicating. Monthly rhythms get jangled, too. If I were to ask where you are in your cycle on this day, could you tell me? Periods are practically a relic of the past for the many women who choose to erase them altogether by continuously taking the Pill.

And the broader passages of a woman's life cycle are similarly downplayed, taken for granted, or ignored. Perspectives on fertility often amount to wishful thinking. Labor can be scheduled in advance and induced, its pain drugged completely away, all with an eye to convenience as much as medical prudence. For too many women I treat, menopause looms as a synonym for old age, despite the fact that it usually happens during one's forties or fifties--closer to the middle of life, considering that the average American woman's life expectancy is approaching eighty. Part of the widespread dismay over the findings linking one type of hormone replacement therapy with increased risks of coronary heart disease, breast cancer, and dementia, I think, was caused by women's perception that they were losing a magic bullet to offset the upsetting effects of aging.

I'm not saying that every medical advance is unwise, or that every aspect of each female passage is a thrill. But I believe that we are giving far too much away. We have made a huge part of what and who we are unconscious, and in so doing, we are not living the healthiest or most fulfilling lives that we can.

Our female souls have become disconnected from our female bodies.

Unconsciously Female

What fascinates me is that this lack of awareness isn't limited to patients at a particular stage of life. It's as true of women just past puberty as it is of women well past menopause. It doesn't matter if they are healthy or sick, married or single, straight or lesbian, infertile or fertile. I see the same disconnect cutting across all economic groups, all levels of education, all races, and all kinds of professions. These are women who are smart, beautiful, accomplished, happy. Yet something vital is missing from their lives.

That missing element is consciousness, a nonjudgmental awareness of who you are and an ability to listen to the insistent murmuring of how you feel, inside and out. Your physical self, your body, is one dimension of you. Another, deeper dimension is your inner self or your soul--the essence of who you are as a human being. Your soul is the "you" that you encounter when you look past the immediate surface to encounter your feelings, dreams, fears, and instincts. Your soul is your inner voice. And your soul, as I'll show you, has needs that must be tended, just as your body does.

Optimal health requires being attuned to what both body and soul are telling you. A balance between the two--body and soul, equally nurtured, functioning in concert--is my definition of true wellness. When they are in sync with each other, your health can't help but benefit as a result.

The job of finding that balance rests with you. No one else can listen to you in the way that you can hear yourself. Your tears, your tension headaches, your laughter, and your energy surges--all are worthy of your close attention. Emotions, desires, and "gut feelings" are information about your state of being that are as valid and useful as your physical symptoms or your medical test results. Understanding all this data and using it to improve your daily living begins with a commitment to embracing it. If you don't value your sensations as messages, who will?

The irony is that it is the very same experiences that vex a woman so much that are her biggest picture windows into this consciousness. Menstruation. Pregnancy. Postpartum. Perimenopause. Menopause. Each experience we have been conditioned to view as a bother, a distraction from our everyday lives, is actually quite the opposite. The intrinsic nature of being female is cyclical: monthly (because of menstruation) and across the arc of a reproductive life. These rhythms allow us to access our inner realities in a profound, enthralling way--if we allow ourselves to pause and pay attention to them.

It's great to be female. It's even greater to be Consciously Female.

Annie's Story

From the time she wakes her family up in the morning until she makes the rounds locking doors and turning off lights at night, forty-one-year-old Annie feels dogged by a sense that there is something else more important she is supposed to be doing. "I get up before my husband and my kids, shower, dress, put on makeup," she says, "and that is probably the last time that I think about myself all day." By the time she drops her youngest child off at nursery school, her heart has already begun racing. She's always nearly late for work. Eight or nine hours of meetings, phone calls, e-mails, and deadlines later, she climbs back in her car to retrace her rushed, multitasked morning in reverse.

One day Annie showed up in my office complaining of a persistent burning sensation whenever she went to the bathroom. It turned out to be a severe urinary tract infection, which had probably worsened because she'd ignored the burning for three or four days before calling my office. I asked how often she drank water or other liquids and how often she urinated in a typical day. Annie looked embarrassed. "Do you know what?" she admitted. "I don't have time to go to the bathroom! I almost never leave my desk at work, and then I race home, start dinner, and figure out who has to be where. In fact, I cut way back on drinking fluids just so I don't need to be bothered going. I'm so busy that I resent the time it takes to pee!"

"I used to think it was pretty humorous that the only time all day that I could manage to get to the bathroom was when my bladder woke me up at three a.m.," she added. "It's not so funny now."

Your physical needs don't get much more basic than water, food, and sleep (and next maybe sex). When you get to the point where you're not even allowing yourself the most fundamental bodily functions--in essence, tuning them out--that's pretty scary. On a physical level, it's simply not healthy. Beyond the UTIs, Annie's practices were putting her at risk of dehydration and kidney stones. Her habits are troubling in another way, too. Neglecting to properly hydrate and void--elemental biological acts--reveals a deep disconnect with one's needs. If those things are missing, you have to wonder what else is missing. Later, in Chapter 3, I'll discuss five Centers of Wellness that every woman needs to stoke every day: mind (specifically, the intersection of your mind and your body), movement (including exercise and your body mechanics), nutrition (what you eat, or don't), spirituality (meaning a sense of meaning, purpose, and connectedness), and sensation (sensuality and sexuality, or pleasure that is carnal, tactile, visual, and so on). You can be sure that if you're at the point where you don't even have time to tend to your bowels and bladder, then the other foundations of a balanced life of good health, such as spiritual nurturing and sensual pleasures, probably flew out the window a long time ago.

What's more, people like Annie who ignore their physical needs also miss their physical symptoms. Ideally, she would have taken care of herself so that she never developed an infection in the first place. But even if Annie had good self-care practices but was nevertheless prone to recurrent UTIs, had she been more Consciously Female she might have noticed the earliest symptoms, such as the first burning sensations or the need to urinate more frequently than usual. She might then have self-treated--for example, by drinking added fluids as well as cranberry juice, a proven way to curb the ability of bacteria to stick to the cells of the urinary tract. Unfortunately, patients who ignore their symptoms also tend to be patients who postpone entering the health care system--as Annie did--until their problems are more severe.

Our bodies and souls are constantly talking to us. They generally speak in insistent whispers. If we don't take the time to listen, they begin to shout.

Laurie's Story

It was close to nine o'clock on a summer night, and Laurie, a thirty-two-year-old ob-gyn resident, was getting ready to perform a cesarean section on a patient. It was a routine operation and all went well; both mother and child were fine. The only thing out of the ordinary, in fact, was that a scant three hours later, the doctor herself gave birth to her own firstborn! Now, granted, not all contractions hurt. And not every first-time mother experiences a protracted labor. But no labor--not even a quick one--happens without a considerable number of gradual physical changes working in concert in the mother-to-be's body. It hardly seems reasonable for a woman--even a highly trained and disciplined professional like Laurie--to acknowledge nothing out of the ordinary going on in her own body while preparing for so remarkable an event as imminent childbirth. What does that say about her level of self-awareness? As a friend of mine observed, "She had the event. But did she have the experience?"

Perhaps Laurie had adapted too well to the traditional, vaguely macho model of medicine, which holds that a physician's responsibility for patient care should be unimpeded by personal conditions such as illness, fatigue, or having something else on your mind--or wedging its way into your birth canal! But she had so effectively tuned out the ruckus of her body and soul that I suspect she would have been equally oblivious had she been watering the lawn in her backyard instead of performing major surgery in those hours before giving birth. I fear that Laurie, by living this day like any other, lost contact with a miracle. More than being an astounding biological feat, childbirth is also an amazing opportunity to gain unparalleled insights into one's body, one's strength, one's relationships, and even one's sexuality.

Many of my patients report a new awareness of their physical power and grace after delivery, for example. "I can't believe I did that" is a popular refrain--one that's uttered with a fair amount of astonished pride. Mindfulness in labor has not been formally studied. But I often see its benefits in action in women who have had Lamaze-style childbirth training. Lamaze, which highlights disciplining the mind along with relaxation, imagery (finding a focal point), and breathing management, is one proven method that helps women focus on the experience at hand, with better outcomes as a result: Women who take Lamaze classes generally use fewer medications, have a lower rate of forceps deliveries, and express more positive attitudes toward childbirth both during delivery and afterward. The effects are even more dramatic in laboring women who are already skilled in meditation and other mindfulness techniques. When I walk into the birthing room of such a woman (and in my practice I work with many who use such skills routinely in their daily lives), the sense of calmness is palpable. From the outset, they're very centered and approach labor as an opportunity to delve deeply into what is, after all, one of life's seminal events. Needless to say, they almost invariably report very positive birthing experiences and, often, transformative personal experiences as well.

Giving birth is so unique for every woman that it is impossible to say that you can expect this or that. But I can say that if you are willing to engage, you will be surprised. You will learn things about yourself. This is true not only of labor, but of any event or transition in your life.

How did we get here?

So what accounts for this rampant lack of consciousness among women about the state of their bodies and their souls? Why the collective tune-out? I think it's the by-product both of our conditioning and of our times. Let's look at four main threads that have brought us to this disconnect.