Specialists address the complexities of treating women’s emotional health

Statistics show that women are twice as likely as men to experience depression and several types of anxiety; females are also approximately nine times more likely to have eating disorders than males. But women may present with complexities that require therapy from psychologists who specialize in treating this population.

Wendy F. Habelow, Ph.D, owner of Beacon Behavioral Services, LLC in West Hartford, Connecticut, certified mediator and collaborative divorce coach, said that only a woman can truly understand what other women are experiencing.

Embracing a feminist perspective on life and in therapy, she believes there is “personal and professional value in helping women achieve everything in life they think they want.” She attempts to empower women to be the best they can be and to find their voices.

Habelow addresses relationship, life transition, and parenting issues as well as divorce and post-divorce matters, among other problems. She reported that women come to her with a variety of issues from body image and weight concerns to struggles with self-acceptance and identifying their role in terms of being a working person, mom, and wife. “They are overwhelmed by all the hats,” she said.

The intervention Habelow uses for each patient is “uniquely tailored to how psychologically minded the person is.” She searches for a root cause and examines the client’s internal monologue. She may use cognitive behavioral therapy (CBT) and/or focus on changing the negative narrative in the individual’s head.

Regardless of the problem, some women suffer for years until someone suggests seeking professional help. Habelow noted that these women require therapy that tries to undo years of thinking and behavioral patterns that become entrenched.

Traci Cipriano, Ph.D, JD, clinical faculty at Yale University, has found that the workplace can be toxic, especially for women. She embraces a belief in the mind/body connection and applies this theory to stress and health in the workplace.

In 2005-2006, Cipriano, who is transitioning to executive coaching, conducted research into work/family conflict among lawyers and found that women exhibited more stress when family life interfered with work life than men did.

Conversely, preoccupation about work while at home also negatively impacted women’s psychological health. She indicated that her findings could be generalized to other professions.

Women try to live up to the “super mom” ideal and strive for perfection. Cipriano said, “It will never be 50-50 work/family. You have to be able to accept the flows and recognize when what you’ve done is good enough.”

As a coach, Cipriano tries to help clients manage roles and expectations in healthy ways. Realistic expectations and self-care top the list of her recommended coping strategies. “You have to practice self-care. It takes repeated attempts and specific, serious commitment,” she said. “You have to find small ways to do this. Be creative.”

Additionally, Cipriano teaches the difference between assertiveness and aggressiveness. “As you know, women who are assertive are still frequently labeled as ‘difficult’,” she said. As a result, many women avoid being assertive.  

According to Diana L. Prescott, Ph.D, Hampden Psychological Consultation, PLLC, in Hampden, Maine, working with women might originate from a major event in life. For her, a bout with postpartum depression (PPD) prompted her to focus on perinatal care.

While her PPD ran a normal course, Prescott learned that the condition could persist longer than previously understood, but can resolve with support, therapy, and/or medication.

Prescott also addresses other issues, including domestic violence, substance use disorders, and eating disorders. Therapeutically, Prescott tries to reduce harm in these situations, help the patient become more functional, and find other ways to deal with stress.

“We work on a range of self-care strategies,” she said.

Prescott follows the tenets put forth by Alice Domar, Ph.D, executive director of the Domar Center for Mind/Body Health, who encourages women to incorporate relaxation into their day. “If women build in relaxing time, two weeks out they will see benefits,” Prescott said. “You need to try to develop triggers for the relaxation response.”

Some cases require professional skills or techniques that fall outside Prescott’s purview so she may collaborate with other psychologists. For example, she may recommend hypnosis or exposure therapy and refer her client to an appropriate practitioner.

Prescott creates a treatment plan collaboratively with her patients. Every three months they review goals and progress and may make changes.

Women of color may experience psychological disturbances common to all females, but trauma related to race and urban issues might be a strong underlying factor. Caribbean-born Maysa Akbar, Ph.D, ABPP, founder, Integrated Wellness Group in New Haven, Connecticut and assistant clinical professor, Yale School of Medicine, Child Study Center, grew up in a tough Brooklyn neighborhood and understands first-hand the issue of urban trauma.

“My life story and understanding of the science of human behavior and my focus on manifestation of racial trauma brought me to this career path,” she said.

Akbar cited epigenetic research that shows racial trauma has existed for the last 500 years since the trans-Atlantic slave trade; negative effects from this experience have passed from generation to generation and continue to affect those in toxic situations today.

While urban trauma affects both males and females, research shows women are the predominant carrier of the trauma gene, FKBP5, said Akbar. She explained that toxic stress during pregnancy and the birth process elevates cortisol levels in mom and baby.

“There is a health disparity and the mom is particularly important. That’s why we focus on moms.”

Women of color assume the quintessential role in the family as the strong one, the supermom, partner, cook, etc. It’s difficult for them to process the message that you don’t always have to be strong, Akbar said. “We try to create a holistic identify. You can be super and have moments of vulnerability. It’s a journey toward acceptance.”

Akbar explained that women of color traditionally approach clergy, family, or friends first. When a relationship simultaneously gets burdensome or fully dysfunctional, they are prompted to call her.

Stigma around mental health in general and within a community of color in particular poses a barrier to understanding that mental health is just as important as physical health.

Urban trauma is a not a diagnostic classification, Akbar pointed out. But this is an important condition that practitioners should be talking about. “We do CBT, but at the same time we have a discussion and interventions specifically tailored to urban trauma,” said Akbar.

Phyllis Hanlon has been a regular contributor to New England Psychologist since 1999. As an independent journalist, she has also written for a variety of traditional and alternative health magazines and business, consumer and trade publications.  She also serves as writer/editor for custom publications.