The Apple Doesn't Fall Far From The Tree....

It's no secret that I am passionate about postpartum mood disorders. Most people also know that I experienced my own story with postpartum depression following the birth of my 2nd child, my daughter, who is now almost 7.
I had coffee with my mom this morning and had a chance to ask her a bit more about her own postpartum experience with me. I knew bits and pieces-- that I had been a difficult, colicky baby. That my mom had dreamed of having more than one child, until she had me. That things had just been tough in my early years. But I really had never asked for more information. Knowing what had happened to me, and the reading I have been doing about how having a PMAD (Postpartum Mood/Anxiety Disorder) can impact early childhood, made me very curious. She went on to tell me more in depth about how difficult it had been for her. We discussed bonding and she said, "I don't think I was able to bond with you until... oh, about a year". Wow. She also reminded me how they had made the move from California to Minnesota, in a car, with no air conditioning, across Death Valley, when I was two weeks old. I was sick often, and very colicky. She had little support.
Knowing what I do now, it really makes sense that my mom was depressed. I remember her being depressed and anxious when I was growing up. I am sure all of that was exacerbated postpartum. And back then, in the 70's, "doctors were so stupid" she said- nobody talked about or knew what PMADs were. I do believe growing up with a mother who had untreated anxiety and depression contributed to my own anxiety and PPD.
Now I have my own daughter (and I don't want to forget how my PPD likely affected my son, who was 2 1/2 when my daughter was born), and I can't help but wonder how my PPD affected her and our relationship. We did not bond for the first five months of her life. In fact, the thing that still breaks my heart is that I don't have a picture of me holding her as an infant. She was very colicky (which we now know was acid reflux and a milk protein intolerance, which it was likely I also had as an infant) and had complications from that. I even had a deliberate plan once to leave her and run away for six months and stay at a hotel.

My goal of writing this blog is not to bring you down. But it's about taking a long hard look at the intergenerational transmission of PMADs and how we need to talk about it. How we need to prevent, or at the very least, identify these issues sooner. My wish is that if my daughter ever has a baby and ever has a PMAD, the best gift I can impart to her is that she needs to speak out about it and get help. Don't suffer in silence. Don't become a statistic. Don't let it linger for months or years, and impact your child long-term. Speak out about it. Write out your birth and postpartum story so you can share it with your kids. And if you are able, talk to your own mother about her birth and postpartum experience. It may be scary and sad, but it can be very informative, and break down the shame of having a postpartum mood disorder.

Is your TV making your depressed?

A big part of mood and self-care is sleep hygiene, and one of the biggest issues I encounter is people having TVs in their bedrooms. There are many research studies (one example: http://news.discovery.com/human/depression-night-light-exposure.html) that say that this is a bad idea and not only does it interfere with sleep and potentially lead to mood disorders, it also interferes with relationships. Here’s how.

Your own sleep… the type of light that is emitted from any kind of screen (yes, this advice applies to computers, iPads, iEverything in addition to TVs) is the type of light that tells your brain to stay awake and alert. So- logically, watching TV or using a computer in bed, is going to keep your brain awake, and make it difficult to fall asleep. I have met many people who say they cannot fall asleep without the TV on, or that they sleep just fine with the TV on, but I am still skeptical that they are getting quality sleep. I invite you to take the Pepsi challenge, and either get rid of the TV and computer in your bedroom, or make sure to not be using it at least an hour before bed, ideally more. See if you notice a difference not just in how long it takes you to fall asleep, but how you feel when you wake in the morning.

Your partner’s sleep… if this applies. Perhaps you are convinced that you do need the TV to fall asleep. Or you don’t have to get up early in the morning, so you stay in bed watching TV while your partner is trying to fall asleep. Not only is this affecting their sleep (and likely, your own- see above) it is disrespectful. It sends the message “Your sleep isn’t important to me”.  Or perhaps they fall asleep, but are awakened everytime there is a loud noise or a light change on the TV screen, which definitely affects sleep quality. Consider watching TV in a separate room, or at the very least, use headphones.

Your relationship… you’re lying in bed wanting to watch the latest Seinfeld rerun, and faster than you can say “No Soup For You!” your partner’s libido is going down the drain. One of the top reasons that couples are unhappy is lack (or absence) of sex. Take a look at your TV habits. Are you using TV to avoid intimacy with your partner? If so, it’s time to have a talk about watching TV in bed- is it OK? If so, when? Are you feeling like TV is getting in the way of your sex life? If so, it’s time to limit it.

A lot of research says that the bedroom should be for sleeping and sex- that’s it. Many people use their bedrooms for TV, computer, fighting, etc. and this creates a negative energy in the bedroom. Some things we have don’t have control over, but watching TV isn’t one of them. Discuss this with your partner today!

Preparing Your Soil

"You can devote your life to pulling out each single weed as it comes up -- and then ten lifetimes won't be enough for the job. Or you can prepare your soil in such a manner-- by spreading a certain chemical, let us say-- that it will be impossible for weeds to grow. This last is faster."~ Ellsworth Toohey to Peter Keating in The Fountainhead by Ayn Rand

I was so inspired by this metaphor, and it was so timely for the day that I have had, that I had to share it. Toohey is speaking metaphorically (I'm sure that's obvious) about putting out the fires in your life. Many people spend their time being reactive-- and putting fires out as they arise. The reality is that being proactive saves a lot of time and energy.

Ultimately, many of my clients come in not really knowing HOW to be proactive. They lack tools, time and energy, and need a little guidance to become expert firefighters. Here are the three main areas that seem to help people to most.

1) Self-care... I really should not be lecturing about exercise, because I suck at it too (hey, I'm only human!). But the things that we hear, read and see-- exercise, eating right, sleeping enough, building time into your life for relaxation-- are often enough to get some energy back. Start with small realistic changes. Go to bed 15 minutes earlier. Take a walk around the block. Skip that afternoon caramel latte. It all adds up.

2) Build your village.... many many clients, especially new moms, say that they really want more social support but aren't sure how to look for it, or they feel guilty asking for help. STOP! We are social creatures. Ask yourself who in your family may be able to help. Think about people in your neighborhood, school, church. Ask these people who they trust for babysitters and hire one. Join a mom's/dad's group, take a Zumba class, go to Bible study... whatever you did in the past that helped you feel happier and more supported- do it now!

3) Set boundaries... If your metaphorical yard is full of weeds, it's likely that you are giving to much to everyone and not enough to yourself, your marriage, your family, your job, the list goes on and on. Many people, especially women, struggle with saying no or being honest as a way to avoid hurting people's feelings. The problem is that these feelings of resentment that people feel for letting everyone stomp all over their yard gets stuffed and becomes anger, anxiety and depression. Practice telling people, "Let me get back to you" so you can prepare a script to let them down easy when you can't take anything else onto your plate. When you feel guilty, ask yourself if you are being fair to yourself. Did you really do anything wrong? If not, let it go.

Small changes add up! Think about how you will prevent weeds in your yard instead of pulling them!

Postpartum Depression and Social Media?

I read an article today (http://msrpostpartumstudy.cloudapp.net/) about Microsoft's new study to work on identifying, via social media, if new parents may be suffering from Postpartum Depression (PPD). My initial response was one of excitement. It is truly awesome, and a huge step in the right direction, that a huge conglomerate like Microsoft is stepping up and saying that more needs to be done to recognize PPD, and that we shouldn't be embarrassed to talk about it.
The skeptic in me (I call her "Evil Crystal") creeps out of the woodwork, or into my brain at 11 pm as I am trying to fall asleep, and I start thinking about this research, and what the results will look like. I think back to my own experience with PPD, and did not have Facebook as an outlet. However, I can hypothesize what my posts may have looked like...
"Motherhood is amazing! Having two kids is a breeze and I feel like our family is complete!"
OR
"I <3 being a mom! Every day is a blessing!!!"
OR
"Enjoying every minute!!!"

In reality, here is what I really would have liked to post (but never would have):
"Projectile vomiting... another change of clothes... LOL!"
OR
"Would it be OK for me to duct tape the pacifier to my daughter's face so that she may stop screaming for several hours starting at 4 am (for the fourth morning in a row)?"
OR
"Today, it took every ounce of strength to not carry out my plan to put my daughter down for a nap, pack my son up in the van, and take off to a hotel for the next six months".


PPD is so fraught with shame and embarrassment, and a job hazard of specializing in working with new parents that are struggling is that many of them have shared that they would NEVER tell people that they are having a hard time, or feeling like they may hurt themselves, or having intrusive thoughts. In fact, most of my clients actually talk about how they avoid Facebook like the plague because they see so many "My life is so perfect" themed comments. I have (unfortunately?) become a bit wary and watchful about the comments that are just a little too cheerful. So as much as I am thrilled that more research is being done, I have to admit my skepticism that they will really get solid evidence that people put comments about how hard of a time they are having (beyond, "Yawn, I am tired") for all the world to see. I hope I am wrong.

When “Crabby” means “Put me to bed”—Kids and Sleep

As we pass the 4^th of July, I am reminded about sleep deprivation. Over the week, I had the conversation with both personal friends and clients about the importance of sleep for children, and how negative behavior can be so linked with a lack of sleep.

Adults really minimize how important sleep is. I have had several parents say, “Oh, but it’s summer. Kids need to be kids”. While I don’t disagree with that statement, since when does being a kid mean not getting enough sleep?

The fact is, many kids have a set biological clock. My son is 9, and he is at the age where is BEGGING me to be allowed to stay up later (he even polled his friends at school about their bedtime!). I would love to let him do this. However, he is awake at 6:30 AM no matter what time he goes to bed, which means he really needs to be in bed by 8:30. Of course, I have occasionally allowed him to stay up later for special occasions—there are exceptions to every rule—the problem comes when parents consistently minimize the importance of getting enough sleep.

So how much is enough? According to Mary Sheedy Kurcinka, author of “Sleepless in America” (if you haven’t read it- you should! She’s also a local author!), her beliefs are that kids need the following amount of sleep over a 24 hour period (including naps):

• Infant (0-12 mos) 14-18 hours
• Toddler (13-36 mos) 13 hours
• Preschooler (37-60 mos) 12 hours
• School-age (6-12 yrs) 10-11 hours
• Adolescent (13-19 yrs) 9.25 hours
• Adult 20+ 8.25 hours

Kurcinka also talks in her book about how up to 20% of kids diagnosed with Attention-Deficit/Hyperactivity Disorder (AKA ADHD) are actually suffering from a sleep disorder. 20%! That's a lot... 

I know, I know. Kids aren’t cookie cutters, but I have really found that most kids benefit from getting the amount of sleep somewhere around these averages. Some kids need even more.

At any rate, there is a huge correlation between lack of sleep and negative behaviors, physical illness, focus/attention difficulties, and hyperactivity. So if your child seems to be irritable, acting out, unfocused, getting sick frequently, etc. it is time to look at sleep hygiene.

Making time for your partner

I'm reading a book about Eve (as in Adam and Eve), and in one chapter, she ends by saying:
"But that summer, away from the Garden and pregnant again, surrounded by so many mindless and repetitive chores and too many mouths that needed and needed again, I felt cut off from Adam, shorn from the main stem of our love, and pruned so far back that any further growth was impossible."

Wow- even EVE felt this way (I know, this is a work of fiction based on research, but still!!). This issue has come up in my work with couples this week, and as a mother of young kids, I understand how hard it is to take care of your marriage, and not feel how much it changes once kids are added to the equation. Some research points to that marriage satisfaction dips as much as 90% when kids enter the relationship! That's a lot!
So how do we take care of our relationships? Why do we feel so inclined to put energy into relationships with co-workers, friends, kids, but not the person who is supposed to be our best friend? Sometimes it is because we don't know how, and sometimes it is because we just take for granted that our best friend will always be there for us. However, the divorce statistics say otherwise. The people having affairs says otherwise.

Some ideas:
1) Start small. Pick one time of the day, and work to set a habit of devoting at least 15 minutes to your partner, where you are sitting and talking about your day, something that is on your heart, just connecting. This CAN be done with kids around! You do not need to entertain your kids 24/7! You are not a bad parent if you tell the kids to keep themselves occupied while you connect with mom or dad. Set a timer, explain to them that this is grown-up time and there will be a consequence for interrupting (unless there is blood or vomit involved- then it's OK). They may interrupt a lot at first, but eventually, they will learn that this time is for grown-ups and they are fine.
2) Make a small sacrifice. Personally, once the kids are in bed, it is "me time", and I do not like giving that up. But sometimes, I have to. Many people feel this way. Or say they are too tired to connect with their partner. But consider this... what if someone else in your life needed 15-30 minutes of your time when it was not super convenient for you. Would you usually make it? Choose to make it for your spouse at least once a week (to start). Yes, you're tired- but you would do it for anyone else: your kids, your boss, your friend, your neighbor... why not your best friend?

Small changes lead to big changes. You will feel more connected and happier in your relationship!
                                                       

Asking for help... the other side

I meet many people in both my personal and professional life- and have been guilty of this myself- who have difficulty asking for help. Perhaps it is because they are afraid to bother people. Perhaps it's because they don't know what they want. And perhaps it is because they feel like nobody wants to help them. I would like to put you in the shoes of the other person- the one who is likely sitting there waiting to be asked for help- and hope this can be a useful perspective the next time you find yourself in need.
1) When you don't ask for what you need, you are putting the other person in the position of being a mind-reader. This can be frustrating all around. I have worked with couples in therapy that use a lot of energy wishing that their partner would "just know" what they need. Or that they should know, because their partner knows them better than anyone else, right? This is not fair or realistic. We are not mind-readers (and that works both ways!) so you can save a lot of hurt or resentful feelings by not assuming anything and just being direct.
2) The other person genuinely (usually) really wants to help. How many times, after something tragic happens, do people come up and say, "If you need something, please let me know". Ideally, the person offering could just do something, but more often than not, people just don't know what to do. But they really do want to help, and they really not know what you want or need. Sometimes you really don't want another casserole, or more phone calls, but would really love [insert want/need here]. Take people up on their offers. You are not being a bother.
3) Speaking of directness, I will just say it: sometimes it can just be downright annoying when a person continually refuses to assert their needs. You know the person- the one who complains, and then turns down offers of help or support? And then you hear second (or third) hand that the person is still really in need of your help. This really stirs up a yucky pot of mixed emotions, assumptions and misinformation. If someone offers help, and you really could use help, accept the offer.

I genuinely believe that for the most part, people are good and live by the Golden Rule. If somebody offers help, take it! If you need it, it is OK to ask for it- it doesn't make you a bad person- it makes you human.

When Mothers Day isn't happy

Tomorrow is Mothers Day (FYI, if you forgot!) and for many, this is a day of celebration and excitement. The day you are showered with love from those who appreciate that you gave birth to them. (There are moms who DON'T get showered... but that's a whole other blog!). However, for some women, Mothers Day can be downright painful. A day that they feel like climbing under the covers and sleeping the day away, just to not be reminded of the fact that they don't have children to show them love.
In my clinical practice, I specialize in all things pregnancy. Unfortunately, this sometimes includes infertility and loss. Many of these women really struggle with feeling sad, angry, and jealous on Mothers Day. They wish that people would acknowledge what is often the elephant in the room. Often, people just aren't sure WHAT to do or say, because it's uncomfortable, so they ignore it. If you know someone who is in either of these situations, I would like to offer some suggestions to you.

Infertility
For those of you who know someone who has spent many months or years trying to have a baby, Mothers Day is a reminder of what they don't or, in some cases, can't have. For some women, this is very fresh, and some other women have grieved to a point of acceptance so the feelings may not be as intense. It's still best to not ignore this. Here are some things NOT to say:

• I'm so jealous that you got to sleep in this morning. My kids made me a cold/burnt/unhealthy breakfast in bed at 5:30 AM. (A woman who desperately wants women would LOVE to have been woken up to this surprise). 
• I bet by next Mothers Day, you will have one of your own. (You can't say that for sure, and it minimizes that this Mothers Day is painful for her). 
• You can have my kids- HA HA HA... (Again, see the first example. She would love to have your kids!)

Instead, try saying something along the lines of, "How are you doing today? Is Mothers Day a hard day for you?" It is an open-ended question that allows her to either give a short response or elaborate on her feelings. Offer her a hug. Tell her that you are sorry that this is hard for her. Don't tell her you know you feel, unless you do.

Loss
For those who know someone who has experienced a miscarriage, stillbirth, or infant death, especially if it is recent, it is very common to want to avoid discussing it. It's painful, and many people, as with infertility, just aren't sure what to do or say. Here are some things to NOT say:

• You can always have another one.   (1) You don't know that for sure and 2) It completely dismisses the loss of the baby they are not holding in their arms). 
• He/She is in a better place/This was God's Will/etc. (Moms would really love to have their baby with them to be celebrating Mothers Day, rather than imagining how old the baby would be, or visiting a marker in a cemetary). 
• Anything in the above examples under infertility also applies here.

The biggest difference in a loss situation is that the woman did get to become a mother. Ignoring this fact is incredibly painful. Ask her how she is doing. Ask her if she would like to talk about it. Give her a Mothers Day card. If you can't find one at the card store, a blank one with a heartfelt note will speak volumes.
Ultimately, it is also OK if you just don't know WHAT to do or say. For some situations, there are no words. Your presence, a hug, an acknowledgement of her feelings, is enough. It's OK to say, "I don't know what to say". Just knowing that you are thinking about them and not ignoring their pain is enough.

Am I going to hurt my baby? Am I going crazy?

Michelle* was giving her baby a bath one evening and all of a sudden a picture popped into her head about the baby sliding under the water. Michelle was horrified by this image, and yanked her baby out of the tub, dried her off and put on her pajamas, weeping the whole time about the thought that she could possibly hurt her child. She decided not to mention this thought to anyone, because she was afraid that if she said it out loud, it might happen. Or worse, someone would think she was “crazy” and take her kids away. As the days went on, she dreaded bath time, as this image seemed to pop up out of her control. Michelle did NOT want to harm her baby, so eventually she asked her husband to start handling bath time.

Is Michelle “going crazy”? No. She is experiencing intrusive thoughts, which are sometimes a symptom within a postpartum mood disorder. Wikipedia defines intrusive thoughts as “unwelcome involuntary thoughts, images, or unpleasant ideas that may become obsessions, are upsetting or distressing, and can be difficult to manage or eliminate.” They are awful to have, but it does not mean that you are going crazy. It does not mean that you are going to act on them. In reality, women who have these types of thoughts very rarely act on them (like less than 1% rarely!). Other examples of intrusive thoughts involve something bad happening, germs, and some people even experience thoughts of a sexual nature. Intrusive thoughts are really hard to talk about, and bring a lot of shame and fear along with them, but they are NOT your fault.

So what to do? Find a trusted professional and talk about the thoughts. I live in Minnesota, where we have Pregnancy and Postpartum Support MN (ppsupportmn.org) which lists providers who are savvy with Postpartum Mood Disorders. Another great resource, if you live elsewhere, is Postpartum Support International (postpartum.net). Find someone who understands. They will help you identify the thoughts and work with them. Sometimes medication can be helpful in reducing these types of thoughts. If you are meeting with a professional who understands Postpartum Mood Disorders, you will not have your children removed or be locked up in a psychiatric hospital- you will get help, education and support to know that you can get through this, and be safe!

*Not her real name

Happy Anniversary?

On February 18th, we "celebrated" the one year anniversary of my husband's heart attack. It's a reminder that even though we are very happy that we made it beyond the heart attack, that not all anniversaries are happy ones. As the day approached, I started having more thoughts about what had happened. Hoping and praying we never have to go through that again, and at the same time, feeling very blessed that we had made it through it. My husband's experience was different- for him it was just a feeling of disbelief that it had been a whole year already.

I regularly work with clients who notice that as an anniversary of some kind of loss or major negative event approaches- a death, miscarriage, divorce, a loved one's birthday or wedding anniversary- they start having symptoms of anxiety or depression. Panic attacks, difficulty sleeping, nightmares, feeling sad or angry... all of these are very normal reactions to a traumatic experience.

The problem is that our culture doesn't know what to do with these experiences. People tend to minimize the importance of the date as it comes around. Some ignore it altogether. What is the best way to handle this situation?

1) If it is your anniversary reaction, honor it. Give yourself some time to have your emotions about it. That could be journaling, going out with a group of friends or family, or just having a good cry or fit about it. If it was a death, memorializing the event can help. Visiting the cemetary, lighting a candle, watching a video... all of these can actually help you remember that the pain you are feeling is very real, and it doesn't matter if it has been one year or 50. My grandmother lost a daughter on Easter weekend well before I was born- but every Easter weekend, she tended to be a bit melancholy. The intensity may decrease, but the pain never goes away completely.

2) If it someone else's event, it is appropriate to remember it somehow. Give them a card. Send them flowers. Offer to take them out. Or even just sending a note or calling them on the phone can be sufficient. Honoring it somehow lets the survivor know that what they went through was real and was not trivial.

3) If all else fails, you may have to stand up for yourself and ask for what you want. Ask a friend to take you out for a drink. Ask the survivor what would be helpful for them. Sometimes it is hard to know. But the worst thing you can do is ignore the event completely. And at the same time, you can't assume that the other person is feeling a certain way. In my husband's case, he really wasn't struggling with it.

Grief is very uncomfortable, but you don't have to go it alone. As Jillian Michael's said in my yoga video today, "Get comfortable with feeling uncomfortable".

Violation of Company Policy

I am sure we all know somebody (or have heard of somebody) who was terminated from their job due to "Violation of Company Policy". This could be the person who was using the internet for, ahem, "personal reasons". Or dating a co-worker, or one who had an affair. Stealing office supplies... The point is, companies have rules that they expect you to follow. Most of them involve boundaries and respect (oh, and laws). Most people follow these rules. These rules are generally in writing, and made clear upon the start of the job. Some companies even require that you sign something showing that these rules were explained, and that you understood them, and that there are consequences for not following these rules.

Your relationship should have a "Company Policy", and many do. However, the policy is generally not in writing, generally not made clear to both parties, and generally nothing is signed saying that this "Policy" was explained, understood and what the consequences were for violating this policy.

Often times, we break rules in our relationships that we wouldn't dream of doing in our jobs. If we were running late to work, most people would call their boss and give him/her a heads up. If you made a mistake, or were confused by something that you were working on, there would be a staff meeting to discuss it. Or an apology made with a promise to do better next time. You have an annual review that goes over how you are doing, and where improvement is needed.

Our culture supports the structure and bureaucracy of corporate policies. There is not room for mind-reading. If things aren't in writing, someone could get sued. Unfortunately, our culture does not support the same respect for relationships, where couples would be taught the way to communicate and contract with each other what the expectations and policies are. But you can do this in your own relationship.

Sit down with your partner and ask what the unwritten rules are for your relationship. Where are the boundaries? What do you expect from each other? How do you continually assess how each other is doing? What happens when someone violates a rule? Some couples even choose to put this in writing, sign it, and hang it on their fridge. You can do this, but the most important piece is not leaving your relationship to chance. The consequences are much bigger than getting a warning, or not getting an annual bonus.

"I'm sorry"

"I'm sorry". A short phrase that can mean so many things, and have such loaded emotion, for many people. There are many different ways to apologize. Some people prefer words, while others prefer action. Here are some common relationship issues when it comes to apology. (Note: This blog is written in reference to romantic relationships, but these tips can apply to friendships, co-workers, etc. If you have difficulty in one relationship, there is often difficulty in others).
1) The inability to actually say the words, "I'm sorry". Some people are extremely uncomfortable saying these words, whether because they have difficulty admitting they were wrong or because they truly believe that they didn't do anything wrong. Apology isn't always about admitting you were wrong- although taking accountability for behavior is definitely important- but more about admitting that you hurt the other person. Sometimes there is no right or wrong, but if something hurtful was done, it can cause a lot of damage in a relationship to not take ownership that you recognize the hurt feelings and try to make amends for them.
2) For some, hearing the words is not as important as actually being shown that the other person is sorry. I have worked with couples who have often stated that their partner has difficulty actually saying they are sorry, but that they can tell the other person is sorry because they change their attitude, and do nice things for the other person-- giving a back rub, making a meal, offering to help more around the house. This can be perfectly OK, as long as the other party finds this acceptable, and knows that this is what their partner is trying to do.
3) Some have no difficulty saying they are sorry, but after repeatedly committing the same offense over and over, the words become meaningless. The person hearing the apology holds out hope that maybe this time their partner will actually change their behavior, only to feel let down time after time when that doesn't happen. Apology without change becomes meaningless.
4) Some say they accept the apology, but then their behavior and non-verbals show otherwise. This is a sign of a resentful person showing passive-aggressive behavior. This often leaves the other party feeling confused and hurt as well. Two people feeling hurt and confused in a relationship is not a good thing.
People often learn how to apologize (or not apologize) in their own families of origin. Think about what was modeled in yours, and how you are possibly repeating the pattern in your own relationship. What can you do about that? How was apology modeled in your partner's family of origin? They are likely doing what they learned as well.
Next, have a discussion with your partner about apology. Ask him/her how they like to receive apology. Are the words important, or do actions matter more? Do they want to have both? Try to find a way to give your partner what they are really wanting, and admit that it is hard for you. Ask yourselves what gets in the way of change. Is it your difficulty being vulnerable, or your partner's response? Is it because you don't know exactly what to do? Do you have difficulty receiving apology? Having an open discussion can clarify these things. After all, neither you nor your partner is a mind-reader.
Apology is a skill that most of us were not taught to do well. People can change.