Years ago, in the wake of experiencing miscarriage, I came upon Dr. Jessica Zucker and her work. She’d launched a global movement called #IHadaMiscarriage that culminated in a book that was part memoir and part manifesto. The call to action for both was for women to feel there was space in the world for their pregnancy loss experiences, and to be able to talk about them if they so chose.
Years after her miscarriage, I saw online that Dr. Zucker was battling breast cancer, another experience that is too often steeped in silence. I was inspired by her candor and rawness in sharing about that experience as well — and it reminded me again about the importance of regular mammograms.
I was thrilled to learn that Dr. Zucker was working on a new book dedicated to normalizing the varied experiences that impact so many women’s lives. She graciously answered some of my questions, and I hope that in her responses you’ll find inspiration to name the hard things too.
Ashley: I imagine in writing about your own heart-wrenching experience of pregnancy loss in your first book I HAD A MISCARRIAGE: A Memoir, a Movement, you anticipated how it might feel to have that story out in the world. Did your experience end up lining up with what you imagined? What surprised you about becoming a voice for people who had experienced miscarriage?
Jessica: That’s a very interesting question actually, because I’m not sure if I was able to fully conceptualize and anticipate how it would feel to put a memoir-meets-manifesto into the world.
What had partially prepared me for this transformative experience, I think, was the creation of the #IHadaMiscarriage campaign that originated with my first New York Times piece. I was shaking in my boots when I woke up the morning it was being shared by such a large publication on October 15th, Pregnancy and Infant Loss Awareness Day. This was the first time I was revealing the gory and psychologically intimate details of my second trimester miscarriage in such a public way. I wasn’t sure how people would respond, but I ultimately decided it was worth the risk of being excruciatingly vulnerable because it was an empathic call to action. A compassionate urging to people around the world to question culture when it comes to the hush hush nature of pregnancy and infant loss and life after. I dared people to think about their own experiences and how society has played a role in how they’ve felt about sharing (or not sharing) their pregnancy loss experiences out loud. I wanted people to investigate how they made the decisions they did with regard to talking about or not talking about their losses with others.
It’s not that I believe we all need to hop on a soapbox with our passionate messages, per se, but I do think we have to understand the roots of our choices to be silent about things that are meaningful to us. Experiences that have changed our lives. Traumas that alter us for good. Are we quiet because culture demands it and/or are we keeping things to ourselves because we’ve consciously opted to be private about it? Are we keeping things to ourselves because there’s self-blame, feelings of body failure, or shame packed tightly into our psyches? Either way, my central concern is the strident trifecta of silence, stigma, and shame that so often swirl around major milestone experiences in our lives. The silence begets the stigma begets the shame. Round and round it goes.
And when we live with shame in our minds and in our bodies, there are consequences. So my hope with all of my writing, and most especially my first book and now my second one too, is that women feel like there are additional options: I can share my story, not feel ashamed of it, not harbor self-blame or self-doubt, but instead take up space with my grief and my pain points.
What surprised me most about the writing I’ve done on the topic and ultimately the community I built, was how communing around this very important topic actually resulted in making us collectively feel less alone. We so often hear, “You’re not alone” (it’s a popular slogan these days) but to actually feel it, to know we aren’t alone in our bones is something else entirely. It has been an honor and a privilege to get to know people from all corners of the world based solely on the fact that we have one massively impactful thing in common: pregnancy loss. What a beautiful opportunity it is to candidly talk about aspects of this unrelenting pain with someone who truly gets it, with someone who wants to listen, and who wants to be heard. When we don’t easily come across this in our day to day lives, it can be deeply heartening to find it amongst an online community where support is swapped and anguish is acknowledged.
Ultimately, writing my first book and spearheading the #IHadaMiscarriage have been some of the most profound experiences of my life. I am humbled and grateful, ironic as it may be, to have become part of a community whose empathy and compassion know no bounds.
Ashley: In your new book Normalize It: Upending the Silence, Stigma, and Shame That Shape Women’s Lives, you share a wide variety of stories of women with different lived experiences. What was it like curating these stories that include a lot of delicate and painful circumstances? How do you as a psychologist and an author sustain yourself so that you can be with others in their most challenging seasons?
Jessica: My hope is that Normalize It is the mirror, the motivator, and the manifesto we’ve all been craving. Perhaps this book can act as a guide in helping us, once and for all, replace the antiquated cultural silence with storytelling.
It is a nuanced look at what it means to be a woman that yearns to make readers feel seen, heard, and empowered to tell their stories. By normalizing talking about difficult things, we open the door to creating cultural change that acknowledges and supports women’s truths. The book tackles topics from girlhood through menstruation—and everything in between—with the aim of illuminating just how insidious cultural messaging can be, starting in girlhood and weaving its way through the various milestones we navigate over the course of our lives. Composite patient stories bring these issues to life by showing (not just telling) how people wrestle with each phase, with the taboos that strangulate, and how they come to better understand why they are who they are in the therapy setting (and outside of it).
In these fictitious examples, patients work through their struggles out loud in the therapy room and grapple with how to speak their truths in other spaces: with friends and family, in support groups, in writing, in public forums, and elsewhere. We get a window into the complexity of what it means to scour our pain, our joy, our hopes, our anger, our disappointments in an effort to live with more freedom and flexibility. To shed shame. To step into more ease and vulnerability. And step far, far away from the silence and stigma that no longer serve us.
Curating these stories felt effortless in many ways because of the hundreds of women I’ve sat with in my office over the last decade and a half. Due to their openness and eagerness to do the work in therapy, I have had the privilege of getting to know people in such dynamic and emotionally intimate ways. In some cases, it felt quite complex delving into these patient portraits as I was also attempting to mine the trajectory of my life and the things I’ve navigated over the years, wanting to be sure to pepper in aspects of my own life lessons—the pitfalls and the triumphs, the pain and the hard won wisdom. This book is in no way a memoir, but I wanted to be sure to look at myself, too, and the lived experiences I bring as a psychologist to the therapy setting in order to do the book justice.
Your question about “sustaining” myself is a really important one that I don’t have a particularly cogent answer for, necessarily. Just a couple of weeks after my first book came out in 2021, I was diagnosed with breast cancer. This potentially life-threatening diagnosis brought my mortality into view in deeply uncomfortable and newfound ways. What it required—through multiple scans, surgeries, 5 weeks of daily radiation, and 5 years of estrogen-blocking medication—was rest. A lot of it. This experience, for better and for worse, helped me understand that rest is not a privilege or a luxury, it is a mainstay. A necessity. It is required sometimes. There are seasons of our lives that call us to slow down whereas other seasons when we might be able to go go go full steam ahead. I needed rest and I leaned into it. During that period, I wasn’t able to write my heart out, like I typically can. I was working, but was cognizant of how many people I saw in a day so that I could also prioritize my changing body.
Outside of that tumultuous experience, when it comes to writing and working with patients, I find both incredibly rejuvenating. I love connecting with people about why they are who they are; I am inspired by connecting with the blank page that stares at me as ideas bubble to the surface; and I find great meaning in talking with patients about the profundity of their struggles and their hopes. I feel lucky in that way—that my chosen lines of work really feed my soul and bring a sense of joie de vivre. I attempt to balance my work life with time for myself as well. Tending to myself through my own therapy, exercise, spending loads of time raising my children, traveling, venturing to new restaurants, reading, and time with friends and family fill my cup.
Ashley: You cover so many important and nuanced topics in the book – things that women so often experience in isolation. Which of the experiences felt most resonant for you personally?
Jessica: Chapter 1 titled “Where It All Begins” really resonated with me. In this chapter I unpack the various stereotypes and cultural pressures girls and women are bombarded with throughout their lives. The “shoulds” we contend with, the expectations placed on us, the assumptions that loom.
Girlhood is typically the place where it all begins (silence, stigma, shame, repeat). We begin to muffle our voices (presumably unknowingly since we are too young perhaps to be conscious of this while it’s unfolding). We learn not to speak up or take up space in a bold way. We learn to not know what we know. Dr. Carol Gilligan researched this extensively and published her seminal book on the topic in 1982, In a Different Voice. In her work, she explored how the sense of shame girls begin to feel about themselves shapes their behavior and creates feelings of isolation as they age. Her research over subsequent decades has greatly informed psychology’s understanding of girlhood and helped illuminate the roots of shame and silence many women carry. She found that young girls don’t need to find their voice; they start out with one, but as they get older and increasingly receive cultural messages about themselves—their bodies, their brains, their desires, their worth—that voice is slowly silenced.
I had the honor of studying with Gilligan many years ago, and listening to her in our small group discussions and learning about the countless girls she worked with while conducting qualitative research was enlightening and deeply troubling. In writing this chapter, just like when I was studying with Gilligan, I was poised to do a deep dive into my own childhood experiences, to think back and try to understand the ways in which I was impacted by cultural and familial norms, and how the societal pressures—both subtle and demonstrative—shaped the woman I am today.
We can’t undo the past, but we can connect the dots between the historical and present day, find meaning, and attempt to create more consciousness around why we are who we are and perhaps carve out a path forward that might be a bit different, a path that includes pockets of liberation.
Ashley: What do you see as some of the most entrenched barriers to normalizing us as women connecting around some of these experiences? How do we start to deconstruct what can feel like very strong cultural, familial, and internal mandates to keep our heads down and stay quiet through the dark times?
Jessica: Thank you for this question! This is a tough one and one many people wrestle with when it comes to attempting to change patterns in our lives, break free from old ways of being, and chart new territory. The most entrenched barriers might be the stronghold culture has on relegating grief to the sidelines. Siphoning it so that it doesn’t spread like wildfire and overtake us. Since grief bleeds into so many aspects of life we wade through, we learn that we should “get over it”, “move forward”, or “focus on the silver linings.”
This can pertain to grief as a result of death but it also impacts the grief of a lost friendship, marriage, job, or a change in identity as a women, like becoming a mother or not becoming one, struggling silently in the throes of postpartum depression or anxiety, or even the potential shock of navigating perimenopause/menopause (since we don’t learn enough about this before, bam, we are in the depths of it). Grief can exist even in the brightest moments sometimes and culture wants us to choose one emotion, but we don’t have to. Life, feelings, and our experiences aren’t usually black and white, all or nothing, or so severely dichotomous. Instead, we can feel gratitude and grief all at once. We can love being a mother but sometimes resent the role. We can be relieved we got out of a relationship that no longer served us and also feel sadness for its end. We can be happy we opted out of motherhood and also feel bogged down by the incessant questions and pressures swirling around us. Two things can be true. And they often are.
We begin the work of deconstructing by allowing ourselves to feel our feelings in all their complexity. In their entirety. By allowing the panoply of emotions to spill out. By embracing that what we’ve lived through is valid and meaningful, no matter the cultural call to shut up about anything that isn’t picture perfect, we move the needle. In the face of this revolutionary zeitgeist shift, we have the chance to exist in the mess without feeling we are the mess.
Ashley: You incorporate so much into this body of work, but were there any topics that you would include if you had more space? Are there any other areas of women’s lives that are calling to be normalized?
Jessica: Yes! If I would’ve included every topic I wanted to, this book may have been a tome of gargantuan proportion. As it is, it is quite long, but I wish I had a chance to delve deeper into normalizing talking about issues surrounding aging — our own aging processes and that of our families. I may also have included additional mental health issues and disorders that are too rarely talked about, other reproductive cancers, as well as other experiences that often accompany the motherhood roller coaster, single mothers by choice, the importance of normalizing talking about adoption, reproductive technologies, surrogacy, and so much more. Let’s normalize talking about it all.
Grab your copy of Normalize It and let’s get more conversations going.
