Mai, fifty-four, came in looking unusually fashionable and trim. Her make-up was more than usual, tastefully done. She was smiling and bubbly, outside of her usual down demeanor. “I just came back from Puerto Vallarta and I feel great. It was a great trip. I feel like a new person,” she tells me with great enthusiasm and excitement. “It was nice to get out of your routine,” I say. “And it was nice to get away from my family,” she quickly responded. “That suggests that your family brings you down in some ways, such that when you settle back into your routine here, then you might return to your down feelings. Although your good feelings are wonderful to have, I wonder if they are a house of cards, bound to fall down with a slight wind.” I say, knowing that my comment could be interpreted as being negative, but hoping that she will see that the stronger her coping skills become, and the more honest she is about her life, the more she will be able to sustain these good feelings. “I realize that when I was away I let myself do things that I don’t let myself do here. I would never wear skirts here because I don’t like the way my legs look, but in Mexico I felt free to wear skirts and not care about my ugly calves.” Mai says with deep seriousness. “It is almost like you gave yourself a different rule book in Mexico which freed you up to be more relaxed about yourself and your body,” I say. “So what should I do?” Mai asks me, thinking that I won’t answer her question. “Burn your rule book,” I say, “with a ceremony so you have witnesses that you are going to give yourself more permission to be yourself, despite what you perceive are the outside pressures to be a certain way.” Mai laughs. “OK, when I have my holiday party, I will burn my book. That’s a deal.” She says with uncharacteristic good cheer and lightheartedness. We will see what the holidays bring. I hope the wind does not blow too hard for Mai.
Shirah Vollmer MD 