What to tell our daughters

Based at 23 Devonshire Place, Central Health London was founded earlier this year to provide something unique in the UK’s private healthcare sector: physical healthcare along with mental healthcare — fully joined up, ethical, multidisciplinary care under one roof. When Lucy Lord MBE founded the organisation she said, “I wanted to build clinics that I would trust with my family”. Here, leading experts from Central Health London share their insights and various perspectives when it comes to explaining womanhood to those young people closest to us…

Jane Haynes

Relational Psychotherapist

As a self-styled 'Sage Femme', I embody many identities, delivering people towards a richer understanding of their subconscious states. When it comes to navigating between the Scylla and Charybdis of mother-daughter adolescent relationships, I find them to be more complex than the myriad dynamics in any romantic coupling.

In my practice I frequently see a plethora of awesome women who are struggling with stellar careers and bringing up their small children. I smile wryly as I explain that managing their day-to-day agendas alongside the nursery routine is a laugh compared to juggling the lives of teenage children who are avoidant of texting home.

Sometimes, the juggle involves relinquishing some control and accepting Fate’s power. Alex Blair, divorce lawyer at Melius Family Law, colleague and mother of three young daughters describes what her experience has taught her. “What I have learned most through my job, and I suppose through life in any event, is that life will ebb and flow,” she says. “That love is not the destination; it is part of the journey.”

Originally as a mother to a small daughter and now with grandchildren, I recognise that we can sometimes feel as if our bodies are one. When the daughter leaps into the world of sexuality, just as our diminishing hormones are becoming a cause of concern, it comes as a visceral shock. I don’t think it’s as much about talking to our daughters as it is about giving them a certain kind of permission (which of course needs to start in ‘the nursery’) to enjoy their bodies, to play, and take ownership of their power to participate equally in any dance between the sexes. Even as early as bath-time fun, we can start to teach our daughters that the consensual negotiation of their bodies is an essential experience to integrate into their lives.

I would want any daughter, or young patient in my care, to confront the world knowing that there is an important distinction between emotional intimacy and sexual satisfaction. I would want them to know that their looking glass was not only for examining their complexion, but equally to become more familiar with their genitalia. Furthermore, I’d want to ensure they knew that there are secure female websites, like start.omgyes.com (http://start.omgyes.com), which specialise in exploring the Eleusinian mysteries of the pelvic cavity and the mysteries of the orgasm.

I would want to explain to any young woman that she is a daughter of the Great Mother and never to underestimate her powers to make a mark in the world. I would want her to understand that Fate is blind, and the Sun is a great god who can ruin your skin forever. I would tell her that reading is knowledge, that knowledge is power and never to make the fatal mistake of becoming a non-reader. And, to encompass these lessons, I would gift her a copy of Ovid’s great exploration of The Arts of Love as well as a gift voucher to Coco de Mer.

Dr James Arkell

Consultant Psychiatrist

Across three decades of psychiatric practice I’ve been fortunate to have looked after some very impressive and resilient young women. I work in a private practice which affords me the luxury of long-standing relationships and the ability to share the victories as well as the tribulations. The reciprocity of this relationship means I glean wisdom as well as offering support and advice. I see the mother and daughter relationship from both sides. I look after women from menarche to menopause; from youth through parenthood to senescence. In this time, I’ve developed a witchy sense of what disturbs the fragile emotional “to and fro” tennis between mother and daughter.

I am a believer in the Donald Winnicott “good enough” parenting. Children often don’t need perfect husbandry but rather a stable platform from which to launch; they are often pre-programmed to seek out their most suitable environment to flourish if trusted to do so. Often, when a mother seeks reassurance from a professional about what to say to their daughter, their own instinct is often the right path.

However, being a mother to an adolescent daughter can be challenging. One mother of a daughter struggling to regulate her emotions said: “Sometimes I just must be present consistently, like a cow in a field. When my daughter is being contemptuous of me, I remind myself that given a choice in that moment I’d rather she hated me than herself.”

As important as it is to give an adolescent daughter comfort, one should also encourage them to break through into the world and face fears. Mother eagles construct their nest with thorns lined with cosy fur, feathers and moss; they slowly pick away the comforting layer so their fledgling eaglets experience some healthy discomfort and move away.

I have also encountered a range of mental and eating disorders among young women. I looked after a lawyer who struggled with bulimia for many years. She lives by a new understanding of her body — that it is in fact a machine, not an ornament. This is something I encourage all mothers to tell their daughters.

Likewise, I would want to encourage daughters to believe that they have ‘clever feet’ — a term that a patient once shared with me after they had been struggling with depression. In the 12-step fellowship, she found that her “clever feet” would put one foot in front of each other and help her to make the right choice, no matter what her mind was telling her. She is now a successful professional and a mother.

From my many years as a psychiatrist, I’d advise mothers to trust their instincts, remain strong and unwavering and encourage their daughters to engage with their bodies and appreciate them as the glorious creations that they are.

Dr Ben Davis

GP and sex therapist

Crucially, a daughter should understand, trust and enjoy her body. In my clinical work as a GP and psychosexual therapist I am often struck by how long some women have suffered before seeking help. Menstruation, sex, childbirth and menopause have all been absorbed into a medical and cultural script that casts female embodiment of pain as something to be endured rather than examined and managed.

For generations, too many young women have lived with pain in silence, having been taught to normalise discomfort or fearing they wouldn’t be believed. When they have sought help, their symptoms have too often been minimised, misdiagnosed or outright dismissed. But there is good, effective treatment for many forms of suffering, whether it be painful periods, painful sex or hormonal changes. Finding a contraceptive choice which works for your unique body is possible. Don’t lose hope if the first choice feels like a disaster. But equally if something doesn’t feel right, trust your body’s response to protest and continue to explore.

I’d encourage any daughter to get to know their vulva, clitoris and learn what gives them pleasure. The clitoris is the only organ in the human body whose sole function is sexual pleasure. It contains around 10,000 nerve endings and is far more extensive than the small part visible at the surface (the glans). I’d want my daughter to understand her own anatomy and give herself the time and permission to take ownership of her own unique pleasure map. I’d want her to become curious and explore all the pleasure that her body can give her, but without feeling shame, or external pressure to continue when she doesn’t want to.

Although we should all be aware of the orgasm gap, I want to emphasise that you can’t expect your partner to be a mind-reader. Research shows that women in heterosexual relationships orgasm 65 per cent of the time during partnered sex, compared to 95 per cent of heterosexual men. The rate from penetrative vaginal sex is much lower (around 20 per cent). However, in relationships between women, the rate is significantly higher (75 per cent).

Penetrative vaginal sex is often centred on men’s sexual pleasure, but it doesn’t have to be that way. Understanding what bring you both pleasure — and learning how to communicate it — is a process which most people, regardless of gender, need to be taught. Get to know a partner’s pleasure! Becoming more articulate in verbalising and sharing what you want, or your secret fantasies, is the high road to shared and increased intimacy.

Being a woman means there may be many times in your life when your body feels like it belongs more to others than to yourself. Never forget your body’s innate power to speak for itself. Whatever you and your body experience, always find the confidence to reclaim your body. It is yours to know, to enjoy, and to trust.

Dr Lucy Lord MBE

Obstetrician and founder of Central Health London

If I were advising my daughter on her sexual health, I’d tell her finding a good gynaecologist, and if needed - an obstetrician, is of paramount importance, as hopefully they will become long term relationships of continued care. In a world that celebrates the wrong things, this can be a challenge. Women’s health is fragile, complex and often clouded by conflicting emotions and advice. It’s difficult to know who to trust when information and evidence is everywhere, and perspective and truth is hard to find.

Several years ago, I was seated a few feet from the then–Prince of Wales (now King Charles III) at a formal medical dinner. The room was full — around 200 of the UK’s most distinguished medical academics, physicians and surgeons. When he rose to speak, his opening words were: “We all know the most important quality in a doctor is their compassion and empathy.”

It was a heartfelt sentiment, and understandable coming from a thoughtful and kind layperson. But I remember thinking at the time: “That’s absolutely not what I want in a doctor”. Both compassion (to suffer another’s suffering as your own) and empathy (to feel another’s feelings as your own) are deeply human — but both can be dangerous in medicine if misapplied.

When doctors get the opportunity to talk honestly among themselves about the qualities we most respect in a colleague, compassion and empathy almost never top the list. We want competence, integrity, experience and judgement. We want someone who knows what they’re doing and who will always do the right thing, even when it’s hard or thankless — and, crucially, even when it conflicts with their own interests.

Charm and emotional resonance are comforting and attractive but can be misleading. A warm smile, perfect eye contact and a kind voice can hide self-interest and incompetence. Compassion can be performed. Empathy can be faked. Even when real, these traits can become liabilities if they dominate crucial decision making. If I feel all of your pain as my own, can I think clearly about how to relieve it? If I lose sleep over every patient, will I still be sharp and reliable when you need me most?

The best doctors are not hard-hearted. Most of us care deeply, otherwise we would not have chosen to be in this profession. But the care that matters most is not in how we feel. It’s in what we do: whether we make the right diagnosis, choose the right treatment, advocate when it counts, and most importantly we stay calm in a crisis. That’s what saves lives.

So, if I were advising my daughter on how to choose a gynaecologist/obstetrician, I would say: don’t be fooled by bed side manner. Look for skill, not sparkle. Choose someone who does what’s right — not just what feels good. Compassion and empathy are admirable qualities, but in medicine, competence and integrity are even more essential.

To find out more about the work of the health professionals above, visit Central Health London at centralhealthlondon.com