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Book Review: Will I Ever Be Good Enough?: Healing the Daughters of Narcissistic Mothers by Karyl McBride

November 14, 2013 Leave a comment

A green and white book cover with an image of a woman and her reflection.Summary:
A guidebook for adult women raised by a mother with Narcissistic Personality Disorder (NPD).  Dr. McBride is a therapist with many years of experience treating daughters of NPD mothers and also with treating people with NPD.  Additionally, she herself is the daughter of a woman with NPD.  The book is divided into three sections to help the daughters of mothers with NPD to heal and take charge of their lives.  The first section “Recognizing the Problem,” explains what maternal NPD looks like.  The second section, “How Narcissistic Mothering Affects Your Entire Life,” explains the impact NPD mothers have on their daughters, both as children and as adults.  The third section, “Ending the Legacy” is all about healing from the NPD mothering and breaking the cycle of Narcissism.  Dr. McBride offers clinical examples from her practice as well as detailed, clearly explained exercises to aid with healing.

Review:
It’s not easy to find a book addressing healing from abuse that manages to walk the fine line of understanding for all involved and absolute condemnation of the abusive actions and that simultaneously encourages agency and healing without making the survivor become stuck in a victim’s mentality.  Dr. McBride strikes this balance eloquently.

The three sections of the book work perfectly for guiding the reader through understanding precisely what happened in her childhood, how it impacts her adulthood, and how to regain agency of herself and her life.  NPD is not a mental illness that is well-understood or recognized.  The first section thus must explain NPD and how NPD leads to abusive mothering without demonizing the mother suffering from NPD.  It is incredibly difficult not to demonize people with NPD.  People with NPD tend to be self-centered, manipulative, and resistant to treatment.  McBride manages to simultaneously describe the person with NPD in a sympathetic light and condemn their behavior.  This section also serves to provide an aha moment for the reader.  It will immediately be clear if your mother has/had NPD or not, and if she does/did, it will shine a light on the daughter’s childhood, proving she is not crazy or ungrateful.  Some of the signs of a mother with NPD include: the mother demanding praise for everything she’s ever done for the daughter, a lack of compassion or empathy for the daughter, approval for who the mother wants the daughter to be instead of who she is, the mother perceives of the daughter as a threat, the mother is jealous of the daughter for various reasons, the mother is overly critical or judgmental, the mother uses the daughter as a scapegoat for her bad feelings, the mother treats the daughter like a friend, no boundaries or privacy, the mother involves the daughter prematurely in the adult world, and more.

This section also explains why the book is only about daughters of mothers with NPD and not for her sons as well.

A mother, however, is her daughter’s primary role model for developing as an individual, lover, wife, mother, and friend, and aspects of maternal narcissism tend to damage daughters in particularly insidious ways. Because the mother-daughter dynamic is distinctive, the daughter of a narcissistic mother faces unique struggles that her brothers don’t share….A narcissistic mother sees her daughter, more than her son, as a reflection and extension of herself rather than as a separate person with her own identity. She puts pressure on her daughter to act and react to the world and her surroundings in the exact manner that Mom would, rather than in a way that feels right for the daughter. (6-7)

The next section looks at what impact being raised by a mother with NPD has on the daughter’s adult life.  McBride factually explains where some of the daughter’s less healthy behaviors and thought processes may come from without falling into the trap many childhood healing books fall into of repeatedly directing negative energy toward the parent.  Some of the issues that may be present in an adult daughter raised by a mother with NPD include: high-achieving or self-sabotaging or waffling between the two, difficulty understanding and processing feelings, inappropriate love relationships that are dependent or codependent or giving up on relationships entirely, fear of becoming a mother herself, unconsciously mimicking her mother’s parenting with her own children or doing the exact opposite of what her mother did.

The final section is all about the daughter healing, overcoming, and taking agency for herself.  McBride encourages therapy, but also offers at-home tips and exercises for those who cannot afford it.  An example of one of these is the “internal mother” exercise.  This exercise involves many steps, but it essentially seeks to replace the internal negative messages the daughter has from her own mother with more positive messages that are the type the daughter wanted from her real mother.  The daughter grieves the mother she never got to have and learns to parent herself.  Much of the work in this section involves grieving the mother and childhood the daughter never got to have, accepting it for what it is, giving herself the encouragement and mothering she needs, learning to set boundaries, and the daughter coming to be in charge of her own life.  The exercises are not simple and may seem a bit overwhelming to the reader at first, but they do serve to mimic the real therapy process, encouraging introspection, journaling, grieving, and behavioral changes.

One thing I really appreciate about McBride’s approach is how she handles the adult relationship between daughter and mother.  She 100% encourages the daughter to make the choice that is right for her own emotional health and that simultaneously does not expect miracles from her mother.  Since most people with NPD don’t receive successful treatment, McBride carefully admonishes the daughter to base her decision based on her mother’s proven behavior.  She encourages setting clear boundaries, and individuating oneself from mother.  But she also acknowledges that having a relationship at all with a mother with severe NPD might not be possible.

We have to acknowledge that a narcissistic mother may be too toxic to be around. In many situations, daughters have to make the choice to disconnect completely from their mothers because the toxicity damages their emotional well-being. While others around you may not understand it, this is a decision that you get to make for your own mental health. (184)

Refusing to give one-size-fits-all advice on the relationship between a narcissistic mother and her adult daughter is just one example of the many positives of this book.  McBride offers insight, advice, and isn’t afraid to say what might be painful to hear.  She has done an excellent job putting the therapy process into book format, as much as possible.

Overall, this book tackles an incredibly difficult topic in an even-handed, clear manner.  Its focus on just daughters of mothers with NPD allows Dr. McBride to give targeted examples and advice to the reader.  It never excuses the mother’s behavior, firmly condemning it, but still exhibits compassion for the mother suffering from NPD.  Any woman who thinks she may have been raised by a woman with NPD should read this book and see if any of it rings true for her.  Additionally recommended to anyone interested in how NPD impacts parenting and the next generation.

5 out of 5 stars

Source: Amazon

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The Neuroscience of Autism and Learning Disabilities (Science Librarian Boot Camp 2012 Tufts University)

Instead of inundating you with my notes from yet another professional development session, I decided to select out my favorite part to share with you all.  Out of everything I did in the Science Librarian Boot Camp, I enjoyed the Neuroscience presentations the most.  So, here they are. Enjoy!

“Genetics of Neurodevelopmental Disorders,” Dr. Anthony Moncao, Tufts University

  • Genetics studies Genes. Neurodevelopment studies Proteins and Regulatory DNA. Imagining studies the Brain.  Psychiatry studies Behavior.
  • Genes aren’t determinative.  They interact with the environment.
  • There is very strong evidence that genetic factors increase risk.
  • Susceptibility genes–genes that with environmental factors increase risk for these diseases
  • How do we find susceptibility genes?
  • Identify a chromosomal translocator and neurodevelopmental disorder.
  • Copy number variants –> Deletion or addition/duplication of material.  We all have these in some variation but in some instances they hit important areas.  They are inherited or de novo (neither parent had it).
  • What is “strict” Autism?
  • Impairment in: verbal and nonverbal communication, reciprocal social interaction, repetitive and stereotyped patterns of interest (don’t ilke change)
  • Onset before 3 years
  • male to female ratio: 4 to 1
  • Autism Spectrum includes Asperger Syndrome, PDD-NOS (removed from DSM5)
  • Autism Spectrum has a combined incidence of about 1%
  • 5% of Autism Spectrum disorders are comorbid with Fragile X, Tuberous Sclerosis, Down’s, muscular dystrophy, and other Mandelian disorders.
  • What are the genetic factors in Autism?
  • heritability is about 85 to 92%
  • rate among siblings is 3 to 9%
  • It is one of the most strongly genetic of childhood-onset psychiatric disorders.
  • No evidence yet for genes with variants in all forms of Autism.
  • Hardly any two autistic kids are gonna be the same (genetically).
  • Many of these genes are important in synapses.
  • Cadherin 8 (CDH8) is probably the culprit in these microdeletions.
  • Variable expressivity –> a deleted gene can cause multiple different outcomes (autsim, learning disorder, etc…) so evidence is strong environment is a factor
  • Future prospects include: Cohorts, sequencing, translation, use of rare CNVs diagnostically, genetic counseling, early intervention for sibs, CNVs may help us predict the outcome.
  • Projected future difficulties include: CNVs are common, so we have to be sure the one we’re calling Autism really is.  Ethical issues of testing children before they have any symptoms.
  • Autism has very complex etiology.
  • Collaboration is important to make progress.
  • Specific Language Impairment.
  • Just as frequent as dyslexia/autism.
  • It is a difficulty acquiring expressive and/or receptive language despite adequate intelligence and no physical problems (ie deafness).  Problems in producing and comprehending speech, problems reading, normal nonverbal IQs.
  • It has an almost 100% heritability.
  • Inheritance is simple but complex phenotype.
  • The damaged gene –> FOXP2
  • A transcription factor.
  • Important in how the rest of the gene is regulated.  Kind of like a master switch.
  • Not the gene for speech (found in nonverbal species but important in vocalizations.  Mice won’t squeak properly.  Songbirds can’t learn songs if it is damaged.)
  • FOXP2 inhibits CNTNAP2 from being expressed (Sitting on it and not letting it make RNA).
  • Where is FOXP2 expressed in the brain? In the basal ganglia, phallus, cerebellum (motor centers).
  • Chimps are more similar to mice than humans in this gene.
  • FOXP2 is a regulatory gene.  Its downstream targets offer entrypoints into neural pathways involved in speech and language.
  • Developmental Dyslexia.
  • It is a diagnosis of exclusion.
  • 5% of schoolchildren have it.
  • Males are 3 to 4 times more effected than females.
  • Gene variant is two times as frequent in dyslexics as in controls.
  • Variants in KIAA0319 repress the expression of the gene.
  • These variants increase risk in reading problems in the general population.
  • May inhibit migration of neurons to the right are of the cortex.
  • ectopia–small bundles of neurons in the wrong area of the cortex
  • 4 dyslexia susceptibility genes have been found so far.
  • All 4 play a role in neuronal migration and/or axonal growth.
  • DNA is not determinative.  There are many other factors involved.

“Neuroimaging of Children’s Brains,” Dr. Jean Frazier, UMass Med

  • Goal: To explore how neuroimaging techniques provide insight into potential biomarkers for childhood onset neuropsychiatric disorders.
  • Basic principles of brain development: structures start small, get big, then get small again
  • 8 to 14 is an important age range.
  • They exuberate then prune, and it is the pruning that is important.
  • The more complicated a process is the more potential it could go awry.
  • Pruning is guided by “use it or lose it.”
  • The exact timing varies by structure.
  • birth to 3–time of rapid intellectual, emotional, and physical growth of brain and brain wiring
  • by age 6–95% of brain development completed
  • 8 to 13–2nd major brain growth spurt
  • 13 to 20s–pruning to organizing, especially in frontal cortex.
  • We can measure things that require energy using: PET, SPECT, fMRI, EEG, MEG
  • What MRI can tell us: structure, metabolites, blood flow, connectivity
  • MRS–noninvasive, analytic method to measure chemicals within body parts
  • If we are going to fully appreciate what is going wrong in brains, we have to fully understand what is going right in brains.
  • Whereas gray matter gets pruned, white matter increases.
  • Less gray matter, brain becomes more efficient.
  • But what happens in atypical development?
  • More blood flow in amygdala of depressed and anxious.
  • amygdala–governs ability to modulate our affect
  • Bipolars have abnormal connectivity in brain, especially in areas dealing with affect regulation and attentional capacity.
  • Application to Autism?
  • Recommends “Localization of white matter volume increase in autism and developmental language disorder” in Annals of Neurology by Herbert et al
  • Children with autism have more white matter.
  • Tracks most severely affected in Autism are growing/changing just after birth.
  • Biomarkers are a distinct characteristic that is an indicator of a particular biological condition or process.
  • Maybe the genetic risk factors are indicators of the dysfunction not the disorder.
  • Both schizophrenia and autism symptom is social withdrawal.
  • 1 in 54 boys and 1 in 252 girls (1 in 88 children) have Autism Spectrum, according to study from 2008
  • Inhibition of GABA and excitation of Glutamate are associated with autism.
  • Tuberous make too little of a certain protein. Fragile X makes too much.
  • Glutamate levels are higher in Autism.
  • Biomarkers could be used as predictors for treatment response.

Book Reread Review: Strawberry Girl by Lois Lenski

Girl in bonnet in a strawberry field.Summary:
Birdie’s just moved to Floridy from Caroliny to farm strawberries with her family.  But their neighbors, squatters headed by a mean drunk of a dad, won’t make life easy for them.

Review:
Rereading a childhood favorite is a dangerous endeavor.  However, last year rereading Reddy Fox went well, so when the ebook version of this Lois Lenski classic showed up on Netgalley, I just had to try it out.  I can see why I enjoyed it as a child, but I can’t really imagine adding it to the collection if I was a public librarian or, in the realm of more possibility, giving it to my nephew.

This is part of a series that Lenski wrote and illustrated in the 1940s about children living in different regions of America.  The thought process was that kids saw children around the world in literature but not the vastly different ways of growing up all over America.  A good idea, for sure.  I can totally see why these books, written in painstaking vernacular to boot, were popular back then.  They just didn’t age as well as they could have.  Or, at least, this one didn’t.

Unlike the Little House series where the problems and dramas and joys are relatable, Birdie’s family basically repeatedly lets the neighbors walk all over them.  There are also odd conundrums, such as how is Birdie’s family so working class and yet mysteriously has money?  Most bothersome, though, is the fact that the central conflict of neighbor worthless father is wrapped up overnight when he gets saved at a revival meeting.  Only the most evangelical of children will accept that as a fix.  Plus, it gives an unrealistic expectation to children that the serious problem of an addicted parent can be solved with some yelling from a preacher.  Not the most useful of message to be giving to children.

Although it’s not an unenjoyable read and the details of life in rural Florida in the 1940s are painstakingly accurate, it just simply hasn’t aged as well as other classics.  It is still well-written, researched, and illustrated, however.  I’d recommend it to adults with an interest in the history of American children’s literature.

3 out of 5 stars

Source: Netgalley

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Book Review: It by Stephen King

February 3, 2011 2 comments

Creepy looking clown.

Summary:
In the late 1950s in the small town of Derry, Maine, children are being mysteriously murdered.  Seven misfit and outcast kids band together to face It, and they think they’ve beaten it, but 27 years later, the murders return.  Vaguely remembering a promise they all made, the now adults return to their hometown of Derry to face It again.

Review:
This tale is largely known in the States as “that scary clown story,” so for years I avoided it.  I’ve been terrified of clowns for as long as I can remember.  My parents tell me that the first time I ever saw one, I screamed uncontrollably.  My only encounter with Stephen King’s It (as it’s known in the States) was with a diorama of the clown from the movie in a haunted house I went through in Salem, MA.  It scared the crap out of me, so I was a bit nervous to read this book.  However, having read the Dark Tower series, I wanted to read all of the other stories that King lists as taking place in the same general universe, and It was one of them.  So I manned up and read it, and boy am I ever glad I did.

This is not a cheesy scary clown story.  What it is is first a character study and second a commentary on growing up.  The dual horror of being a kid and being excited and afraid to grow up and being an adult and being excited and concerned that you are grown up and may have lost a part of yourself in childhood.  King very clearly demonstrates that being a kid isn’t all fun and games–most of the kids in the group of 7 have bad home lives–but there is an essential hope that children have that is hard to reclaim as an adult.  A child is able to have a horrible experience with a shape-shifting werewolf or a bunch of bullies and then walk a couple of blocks and forget about it and be excited to see American Bandstand that night.  Children are incredibly resilient, and King demonstrates that.

What makes the story though is the return to Derry 27 years later.  King puts a hope in adults that although they may not remember exactly what it is to be a resilient child, they can still repossess that power in later life.  Although the first inclination of kids to survive is to forget the bad, an adult can remember and still survive.  For at the beginning, the characters don’t want to remember what happened to them as kids.

Did he remember?  Just enough not to want to remember any more. (Location 1416)

Yet the characters are brave and face their childhoods.  Yes, King personifies both the childhood evils and the remembering of them as an adult with It, but that’s part of what makes the story powerful.  There’s a reason people refer to memories as personal demons.  That’s how they feel.  In the end, the way the characters grow and change and overcome is to find

A way to be people that had nothing to do with their parents’ fears, hopes, constant demands.  (Location5631)

Beyond the excellent symbolism and allegory for the experience of surviving bad things in your childhood and facing them again as an adult, the horror itself is wonderful.  It comes at just the right frequency so that the reader settles into a sense of security only to be blind-sided by a terrifically horrifying experience.  There were sections that literally had me jumping at the sound of my own phone ringing in the silence.  These are some of the better passages of creepy horror that I’ve read written by King.

Of course, the allusions to the universe of the Gunslinger are there.  It gave me chills to recognize them as I read.  Among just a few were the turtle, spiders, and other worlds than these.  One particular line that gave me chills of recognition that other fans of the Dark Tower series will be sure to appreciate is

Eddie had drawn his aspirator.  He looked like a crazed malnourished gunslinger with some weird pistol.  (Location 20760)

Combining everything from the horror to the allegory of facing childhood demons to the allusions to the Dark Tower series make Stephen King’s It a remarkable read.  I recommend it to fans of Stephen King, as well as anyone interested in the idea of childhood demons who feels they can handle passages of horror.

5 out of 5 stars

Source: Amazon

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