I blame myself, do you?

I blame myself for having a cold. For not getting pregnant. For the floor, the miscarriage. All of it.

Illustration by Stephanie Davidson, @asiwillit

A phrase

The first time I first stepped into the office of a fertility acupuncturist was after trying to get pregnant for three months. Nothing was wrong, of course, not officially, but I had wanted a baby for five years and was not going to wait around for things like chance and luck. Three months seemed like forever at the time, and I was going to take some action. Taking a seat on the low, cream-colored couch in the bright waiting room, I breathed in the smell of sandalwood and took a picture of a quote that was written on a chalkboard and surrounded by chalk drawings of flowers: “Nothing blooms all year.” I felt a slight relaxing in the constricted muscles around my mouth and eyes. This was my place, I felt. This was where I would find peace. This was where I would find the solution. Those two things were the same.

I remember the way the acupuncturist gently touched my belly with her slender, cool fingers, her long blonde hair almost brushing her waist. I remember her saying softly, “we need to fill your cup before you have enough for the baby.” I remember her telling me, “we’ll get you perfect.” And then she administered the needles.

The idea that I needed to get myself perfect in order to get pregnant crept into my mind and planted roots, a topic which I treated at length in this essay. The idea grew and bloomed poison flowers and extended its suffocating vines. What I’m realizing, more than four years since I began my infertility journey, now also with an autoimmunity diagnosis, and still with all the normal ailments of being a human, is how broad my applications of this idea have stretched: if only I get my body perfect, I wouldn’t be sick like this. I just simply haven’t done enough.

A cold

Last week my son got a cold, my husband got a cold, and I got a bad cold. My cold is always the worst of the three. This is our family’s fourth cold in 2023, and between the beginning of this cold and the end of the one before it, we were healthy for five days. As we rounded yet another sick Monday with a sick one-year-old home from daycare, I realized that, in addition to my headache and exhaustion and feelings of uselessness and overwhelm around my sick toddler, I was also existing in the fumes of this idea: my colds are worse than my husband’s because my body isn’t tuned up. And my body isn’t tuned up because I messed it up by living a high-stress life. And I haven’t done enough to fix it. If only I could get myself perfect—those poison words float just at the surface of my subconscious—I would not be sick like this.

A floor

I suppose I was particularly susceptible to this line of thinking about my body; it is an extension of a mental habit that occurs many other places in my life. Last week, in addition to having a family cold, we also had our living room carpet replaced. The carpet, a medium pile emerald green monster that we inherited with the house, was covered with mysterious dark patches and ancient crusty clumps and an immense amount of dog pee from one week that we left our dog with a sitter and things went awry. After much hand-wringing about the state of the carpet, I initiated a project to get it replaced with hardwood. It was my first home improvement endeavor that was not done by my highly skilled father, and so I behaved like any self-respecting novice would: I made every effort to pretend I knew what I was doing while in the background desperately Googling “is oak flooring good,” and “what is bullnose,” and “square bullnose v rounded bullnose.”

As part of getting a new floor, I had to pick the flooring. This didn’t really occur to me at the outset: I figured I would tell the contractor sort of what I was looking for and he would recommend something. Instead, he sent me to a showroom, and one rainy Saturday, my husband, my son and I ventured out to see it. My husband is someone who is usually satisfied by any one of a wide range of options. What does he want for dinner? Any of six things would be great. This is a wonderful quality in many ways but not when picking flooring.

We walked up and down the rows of wood and learned from the salesperson about engineered hardwood and top layer thickness and types of sealant and rustic grade versus prime grade. We picked out various samples in shades so similar that it was difficult to perceive the difference without close examination in good light. After the visit, I carried forth alone, visiting a few other showrooms and, in fairly short order, selected a beautiful blonde rustic grade wide-plank 6 mm top layer oak. I had done a good job, I thought. Look at me, getting up to speed. The date was set for the floor installation, and I was exchanging emails with the contractor about purchasing the hardwood.

Then, during my usual awake period around 3 am, a doubt flickered. Had I really picked the right wood? In particular, did I really want the rustic grade, which would have many dark knots? And wasn’t I going to pay a bit too much for a 6 mm top layer when a 4 mm top layer would certainly do? Were the wide planks too trendy? Such doubts whirled in my mind and grew over the next few days. Then, in a flurry of anxiety, I emailed the contractor just before signing the contract to tell him I wanted to pick new wood. Bless that man, his patience with me went far above and beyond the professional requirements of his vocation, and he delayed the project in order to allow me to re-select my floor.

Here’s the point: my selection of anything, in this case flooring, carries much more weight than whether I’ll like the floor. Within that bloom of anxiety about whether I had chosen the right hardwood was a whole world of consideration about what my decision said about me. Here, faced with my first big house project, was I going to act like an adult? What did rustic grade flooring say about me? Was I going to overpay because I don’t know what I’m doing? Am I the type of person who overpays for low grade wood? Was I picking something trendy just because I had seen things like it on Pinterest? It sounds inane to write it out; no one will ever, ever, care about this floor but me; talk about silly problems; I’m embarrassed.

But I’m also not alone. This type of emphasis on individual decision-making is endemic in American culture, an outgrowth of the American individualist belief that people are primarily self-made. Research shows that Americans are particularly prone to decision-making anxiety when compared to societies that prioritize community and cooperation over individual effort and success. Said one researcher on the topic:

"For Chinese (and other Asians), sense of self and self-worth are not tied up so much with notions of individual autonomy and choice. So a bad pair of jeans is just a bad pair of jeans. In the U.S., it's a bad pair of jeans AND a statement about you. Think how much weightier your decisions are if every one you make tells the world something about who you are."

Weightier indeed.

A body

The core belief here is that my decisions determine who I am. I have found that when this line of thinking is applied to my body, I am most thrown into a state of desperate, anxious, frantic grasping for control. In her book on her own chronic illness journey, The Invisible Kingdom, Megan O’Rourke writes:

My fatigue felt like a problem with something about my very being, I worked too hard, but without enough discipline; I exercised, but I ate junk food; I was sloppy where I should be ascetic. When I felt off, it was my fault, a sign of some internal weakness, a lack of moral fiber…Indeed: despite all my efforts to think objectively about whatever was wrong with me, I felt subject to distorting reflections.

In the case of my cold, I reflexively believe that my decisions about what I eat and how much I sleep make the sickness more severe. In the case of the baby, I believe my decisions make my body more or less able to have one. In the case of my autoimmune disease, like O’Rourke, I automatically believe my lifestyle triggered it and the decisions I make going forward can either put it in remission or not. If I make the right decisions, then I can be perfect. Perfect floor, perfect body.

Many writers on chronic illness have pointed out the obvious: if so many people are chronically ill with mysterious illnesses that seem triggered by environmental factors like food and chemicals, then one cannot personally solve the problem of one’s chronic illness by personally making individual decisions. These illnesses are instead a communal problem, a problem with our food system and our regulatory framework and our general preference for the health of companies over the health of people. In her beautiful book, On Immunity, Eula Biss writes, quoting her sister:

“The health of our body always depends on the choices other people are making…there’s an illusion of independence.”

Of course, this is true. That doesn’t stop me from completely ignoring the choices of everyone else in the world and focusing only on my own. The difficult thing about this topic, when it comes to health, is that even in my most self-forgiving moments, I do genuinely believe that my decisions can impact my health. I do believe in many alternative medicine notions around removing the barriers to natural healing, actions that are within my control. I also know for a fact that I cannot materialize a baby through my own force of will—believe me, I have tried. I know for a fact that it can’t possibly be the case that the one sugary drink I had caused that one IVF round to fail, though I genuinely do have thoughts like this. The potential mold in that horrible green carpet almost certainly isn’t contributing to my continued inability to conceive another baby. But I still had the carpet replaced, and this reason was definitely in the back of my mind. I feel I have some control and also I know I have little control. Biss calls this combination of agency and no agency, “empowered powerlessness.” It is a difficult state of affairs, to put it mildly.

An accusation

Last fall, I miscarried at nine weeks. The experience was more awful than I could have imagined, and I was also blindsided by how little I previously knew about miscarriages. (Miscarriage: a topic coming your way soon!) As I emerged slowly from the months of darkness surrounding the event, I gave an update on it all to an alternative medicine provider whom I was seeing at the time. I told him that the fertility doctor thought the miscarriage was probably due to a genetic issue with the embryo. Nothing I could have done, I said, trying to convince myself of the same.

“Ok, it might have been genetic,” he said, “but we can’t rule out all the environmental chemicals in your system. The best approach would be to try and get the numbers better, then try to get pregnant.”

I just told you the miscarriage was awful, but it was actually hearing this statement that sent me into my lowest state of the whole ordeal. It activated every predisposition I possess for individualistic thinking and self-blame. I had not done enough. I had not cleansed enough. I had not eaten clean enough. I had not replaced the carpet soon enough. And so I lost my baby. When I told my therapist about this event, I thought she might hunt down that man and punch him. Because she knew: that line of thinking, in my particular brain, well, that line of thinking could kill me.

An unshakable belief

To come to one of my favorite conclusions: it’s complicated. To use my good friend Alex’s favorite phrase: both are true. I can certainly impact my health somewhat, and I also can’t impact it in many ways. I will never know which things I did helped, and which hurt and which didn’t matter. But even as I write, “I also probably can’t impact it in so many ways,” my mind is thinking of all the stories about people who have single-handedly reversed their autoimmunity, people who had the gumption to do some yoni steaming and got pregnant, people who replaced a moldy carpet and whose allergies disappeared like magic.

You see, I can tell you that I don’t have control, that my decisions can’t fix everything, but deep down in the root of my brain I still believe they can. I have been fully and completely indoctrinated into that deluded notion of complete individual agency. I still think I can make myself perfect. I still blame myself when I’m not.

—Rae

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✍️ Join me in the comments

How do you navigate “empowered powerlessness”?

Do you worry about how stress impacts your health?

When you take care of your body, are you aiming for perfection?

Let’s talk about it in the comments.

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