Interview: Dr. Uma Lerner on reproductive health and women’s lived body experience
Aagya Mathur, Aavia’s CEO and co-founder, spoke to Dr. Uma Lerner in August 2019 about her practice, life, and focus on women’s health. Dr. Lerner is a practicing Psychiatrist and Aavia’s mental health advisor. Dr. Lerner utilizes a combination of cognitive-behavioral, mindfulness, and psychodynamic techniques in addition to medication management and specializes in reproductive mental health.
Here is a shortened version of their discussion:
Aagya Mathur: We’re really excited to have you here! To start, can you tell me about yourself personally?
Dr. Uma Lerner: I’m the eldest of three; I have a younger sister and younger brother. I grew up between California, Texas, and London, and more recently I’ve been in California since 2005. I’m married to another psychiatrist and we have a daughter who is 7 years-old.
AM: Share with us about your practice — what does it mean to focus on women’s health?
Dr. UL: My practice focuses on women’s mental health or women’s wellness or reproductive mental health — women’s rapport. I see mainly women — across the age span, from teens to the rest of their lives; with a particular focus on puberty, premenstrual dysphoric disorder (PMDD), fertility, pregnancy, postpartum, and menopause.
AM: What attracts people to your approach to care?
Dr. UL: A whole variety of reasons. One of the major reasons why people come to see me these days is in regards to fertility, which is a shift from before. People who are going through fertility treatment and dealing with the ups and downs of hormonal changes as part of those treatments, or people who have suffered with pregnancy loss and are dealing with grief. Sometimes I even get referrals from fertility doctors to help people manage stress levels because high-stress can impact a person’s ability to get pregnant.
AM: Why do you feel that women’s health in general matters to you?
Dr. UL: My mother’s mother, my grandmother, died in childbirth. My family is Sri Lankan Tamil. Healthcare was very different back then for everyone, and particularly in Sri Lanka. People typically gave birth at home. My mom is the eldest, and in my grandmother’s third pregnancy, she and the baby girl died. It was very common in those days. My mom suffered the loss of her mother at the age of four, and so she never had a ‘mom.’ And as my mother’s daughter, I can still feel the impact of that on her.
AM: I’m so sorry to hear that. I can only imagine how that has impacted your life. How has that experience carried into your work and what has been your experience as a woman in the workplace? What does it really mean to be a woman psychiatrist?
Dr. UL: I think that there’s been a lot of great progress for women in the workplace thanks to all of the women older than me, and continuing today. The previous generations of women were willing to endure all sorts of isolation and sexism to make room in the workplace. We are all benefiting from their courage. Today, women are capitalizing on the progress made by shining a light on continuing problems and speaking up.
It’s still challenging to be a women in the workplace, and there continues to be gender discrimination. It can be very subtle, and it can be hard to identify and deal with. So, when you think about women’s lives and women’s stories, we have to also be mindful of the context in which women are living.
This is important to how I frame psychology and psychological theory as I work with a client:
Many of the early psychological theories were thought of by men who didn’t really have an understanding of the day-to-day of women’s lives; they didn’t understand a woman’s lived experience.
Many of the early psychiatric or psychological therapy relationships were a male therapist for a largely female-patient population. And the typical experiences of males and females are not always relatable. It’s really important to me to think about what are the normal and typical life experiences of women.
To really step away from pathologizing women’s lives and move towards recognizing and celebrating the diversity of normal.
AM: That’s a really important point about ‘celebrating the diversity of normal’. How do you think about the diversity within women?
Dr. UL: There’s huge diversity within women. Women are still transitioning in terms of feminism and gender equality. Women have had a wide variety of experiences with feeling valued, respected, and understood. Often the diversity of experience is within a single woman’s own life.
To be able to hold all of those experiences as they occur simultaneously in our one world, in one country, or even one’s own life is a challenge. But it is really important to feeling whole — as a person and as a community.
Our biology also has a fair amount of diversity as well. People born with a female body tend to have certain organs and hormones, such as ovaries and a uterus, and estrogen and progesterone. But the shapes, sizes, and amounts vary body to body, and the way people respond to those hormones, in particular, varies. And therefore, our experiences — physically, emotionally, and in relationships — can be very different.
AM: What are the most common things that you find your patients don’t know enough about? Or is it just very different for each person?
Dr. UL: Some of the common things I’ve notice:
Many people are not aware of their self-talk. On a meta-level, you are the friend that you are with all the time. You are your own longest relationship. We need to make sure that we are being a good friend to yourself… no frenemies wanted here.
I encountered many (generally kind and caring) women who are really mean to themselves. Perhaps it is because of low self-esteem or depression, or maybe they haven’t experienced being treated with love in their close external relationships. They don’t notice that they talk about themselves in a highly critical, self-deprecating, or dismissive way. When I notice it, I point out the speaking pattern so we can shift it to a more love-based relationship. The messages we tell ourselves are the messages we hear in our longest lasting, most constant relationship, so let’s try, as much as we can, to have it be a relationship based on love, affection, benefit of the doubt, and curiosity.
The other thing that I notice, is a lack of knowledge about bodies. A lot of women don’t have enough knowledge of their reproductive systems. The first step is to know female anatomy — internal and external. And beyond that, it’s important to know how our hormones work, the way our periods are regulated, which hormones do what, how hormones cycle, and how that cycle may impact you.
Women, we need to know our bodies better… and do it in a loving way.
AM: We agree there is a stigma about reproductive health. What is a way that we can work as individuals and as a community to help reduce the stigma?
Dr. UL: Recognizing the integration of our body: there is a mind-body connection. Our minds do not operate in isolation. And we don’t have total control over our bodies. Our minds, and our psychological health, is both neurologically and hormonally regulated, and significantly shaped by our environment and experiences we have had.
Also, we need to be more empathic with one another. Perhaps by expressing concern in an empathic way or in the form of a curious question and being open minded to find out what’s going on with others.
AM: Is there anything else you would like to share with Aavia audience right now?
Dr. UL: I love what I do. I love the people I work with. I think that women are beautiful and amazing creatures. We’re amazing in all that we are able to manage on a biological level, on a day-to-day level, how we care for one another, and how we care for societies and communities.
I love being a part of that world and being able to nurture and support the women that I see as truly amazing. I’m really excited to be part of Aavia because it gives me another avenue to be able to do that.
AM: And we’re so grateful to be able to work with you, and learn from you, and that our Aavia Insiders have access to you!
