The Pattern Begins

You might be surprised to learn that from birth to age 15, I grew up in a New York City Housing Project.

It’s still there – Pomonok in Flushing, Queens. These photos are of my actual apartment building. My childhood there was lively. Street Slide008smarts and independence were developed early. I grew up on games like stick ball, stoop ball, hand ball, jump rope, and skully.

The apartments were small. I shared a bedroom with my younger brother in the cramped 2-bedroom apartment in which we lived with my single mom. Some families had 3, 4, and 5 kids in those same sized apartments. The kids shared bedrooms while the parents slept on pull-out sofas or rollaways in the living rooms.

While there is a lot of resilience to be gained from growing up in such an environment, it wasn’t easy. There were drug addicts in the stairwells, gunshots at night in the park behind our apartment, and the elevator, stairwell, and hallways smelled of urine. Domestic violence was commonplace and could be heard through the thin walls between the apartments.

I was a latch-key kid by the beginning of 1st grade. We lived on the top floor of the building, so if the elevator was out, I had to walk up the 7 flights alone. The addicts hung out on the last landing, so I would run up the last steps as fast as I could, slam the stairwell door behind me, and apartment keys already in hand, let myself into our apartment as fast as I could. My heart still starts to beat fast when I think about it.

I grew up with a more than moderate dose of looking over my shoulder…  thus the adrenaline fight-or-flight feelings – heart racing, fast breathing, slightly anxious undertones – were a familiar baseline chemical milieu for me.

The only way out of Pomonok was by my own steam. And I wanted out – badly.

Fortunately, academic achievement – and a tiny bit of entrepreneurship – came naturally to me. I used these to secure my escape!

In 4th grade I set up an enterprising macrame jewelry business and saved a little money. I remained top in my class. I tutored students who were struggling in class – often because of language barriers. By 6th grade I’d won several science fairs and spelling bees. My teachers doted on me. I volunteered, working with my mom to start and run a Young Democrats Club chapter in our neighborhood. I built my resume. It made me stand out.

Unfortunately, being bullied somewhat regularly in late elementary school was a price I paid – we humans can be mean to those who are “different” and my achievements set me apart at that time. But with grit – and the emotional and physical protection of a few loyal neighborhood pals (yes, Paula, if you are reading this, you were there for me and I’ve never forgotten it!) – I got through.

I was accepted into a prestigious public high school in the Bronx and joined its world-famous debate team (for the record, I no longer enjoy intentional arguing). It was a nearly 2-hour daily commute – each way – 1 bus and 2 trains to and from Queens and the Bronx. There was a long, long walk through dark neighborhoods in the wee hours of the morning and again in the late evening – alone as a 15-year old girl.

But it paid off. By age 15, I had been accepted into college, on scholarship. I was on my way to achieving my dream of becoming a physician. And getting out of the ‘hood. High achievement was my one-way ticket out and I left Pomonok behind me forever.

Or so I thought…

Maladaptive Default Patterns

Survival mechanisms are powerful driving forces. They also easily become hardwired as default behaviors. We may unwittingly continue to act and react to threats that are no longer present. Our fight-or-flight mechanisms kick into hyper-drive at the slightest whiff of danger – the hint of a threat that triggers a cellular memory of the actual threat. We hold onto these response patterns for dear life even when they are no longer needed – often unaware that we are doing it. Once adaptive and protective, these patterns can eventually become maladaptive.

In addition, it is a common human tendency to feel most comfortable with the emotional state most familiar from our childhood, and even to recreate it as adults regardless of whether it is healthy, as part of our maladaptive response.

In my case, my upbringing had forced me to make “achievement” and drive a priority, and living with stress my “normal” or familiar emotional state. Even when hyper-drive was no longer necessary, it was hard to slow down – I was achieving and constantly recreating the state of stress with which I was so familiar – only now I was doing it with deadlines and projects, rather than facing bullies after school or drug addicts in the stairwell!

Some years ago I was giving a keynote, and after I listened to myself being introduced – which typically includes someone listing off your accomplishments – I got up, took the mike, and said, “Wow, I’m exhausted just listening to that. The woman you just described is an overachiever.” I was joking – and also serious.

Self-Acceptance and Understanding

I’ve learned to accept that this ‘driven-ness’ is a part of who I am – and it’s not all bad.

lovethisshit-576x1121At this stage in my life my energy and drive lead to a passionate (and compassionate) desire to participate in making revolutionary healthcare and environmental changes for our present and future health. The overwhelming health and ecological crises we face inspire me to think, write, teach, and create. I’m filled with enjoyment in what I do. I recently saw a Pinterest picture that says “I work because I love this shit” and thought, “Yup!” As a colleague (Dr. Mark Hyman) said to me recently, “What we do is not just work, we’re on a mission.”

But there is a dark side.  On some level, until recently, I had never truly left Pomonok behind. I have a successful life personally and professionally, and being a physician thankfully frees me from the likelihood of poverty; thus I should be able to relax and create purely from a place of enjoyment and passion. However, until recently, deep inside, I have been driven by the fears of that young girl from the projects – of poverty, of being stuck, of having no control of my life. I have lived as if the What If’s, the Scarcity Mentality, and the Fear of Being Trapped that were nipping at my heels as I high-tailed it out of my childhood were still relentlessly chasing me. Oddly, that fear created comfort and familiarity because it was a common feeling from my childhood.

As a result, I have spent an inordinate and unnecessary amount of time pushing and striving to achieve security. A nagging insecurity was pushing me to work too hard too often – not to prove myself to anyone, but out of old survival mode patterning. And all the while I was recapitulating familiar feelings of stress and anxiety.

There are risks to this type of living: emotional and physical burnout, even frank illness. I was lucky. I started living a natural, balanced, and healthy lifestyle at a young age – just after leaving Pomonok and moving to the Berkshires for college. I eat an uber-healthy diet, usually sleep about 7 hours at night, rarely drink coffee, and have done yoga and engaged in mindfulness practices for a few decades. Thus I’ve generally avoided the health pitfalls that living with these self-imposed stresses can cause.

Recently, after 7  long, grueling years of medical education – during which one almost constantly endured stress, pushing, striving, and anxiety, I decided that enough was enough. I’d had it with stress. With that old adrenaline feeling. It didn’t feel good anymore. I’d outgrown it. So I decided to make some changes. I was finally outgrowing my old Pomonok ways.

I decided to spend less time pushing and striving, and more time enjoying life, breathing deeply, trusting the world to be a friendly place. I decided to to experiment with allowing myself to feel secure and safe.

Push and Strive

Push and strive are a pair of really annoying twins. They are relentless. Push is an impatient task-master affecting peace of mind, sleep, and even our adrenals (that’s where that fight or flight biological mechanisms come from). Strive is all about control and so blocks creative flow.

I know I am not alone in my history of push and strive. Did you know that an average of 9.2 paid vacation days go unused by employees in the US? Seriously! People go to work extra instead of taking vacations – even staycations! This number has gone up steadily in the past few years. As a culture, we are spending more time at work than ever, eating lunches over our keyboards, sleeping less, subsisting on coffee and diet cokes, and not exercising much, all in the interest of achieving more. We have become driven by the fear of not having enough, not climbing high enough on the ladder, and we’ve been led to believe that high achievement requires continual pushing and striving.

Push and strive leave no room for just BEING IN THE PRESENT. Perhaps this is why most of us spend about 30% of our time worrying about the past, 60% of our time worrying about the future, and only about 10% of the time actually being in the HERE AND NOW. Push and strive directly oppose letting the magic and the process happen. For letting go and letting life…

Enter a New Way of Being: Don’t push, breathe…

There is a softer, dare I say more feminine way of going about achieving success in life – whatever that means to us individually, from being a great mom at home with your kids to being a corporate kick-ass queen – that has nothing to do with pushing or striving at all. I am dubbing it the No Push Method of achieving success and I am learning to live it!

Here’s how it goes.

If you’ve ever seen a birth scene in a movie, you know that women are typically told to hold their breath and push. Hard! Harder!! Harder!!! There’s a lot of straining and grunting coming from a beet-faced woman who appears likely to blow every blood vessel in her eyes. And a lot of screaming coming from nurses and friends counting to ten while the woman is exhorted to PUSH! PUSH! PUSH!

As a midwife it was extremely rare that I ever exhorted a woman to hold her breath and push hard like you see in Hollywood films. That technique was reserved for emergencies, because while widely portrayed and accepted as the way to have a baby, this method of pushing is not optimal. It can prolong the pushing stage, make the work much harder, increase the risk of tissue damage and tearing down below for the mom, and can deprive the baby of oxygen!

This is also true of life and the quest for success. When we are pushing too hard on our goals, worrying whether we will or won’t achieve this or that, we are expending energy ineffectively and unnecessarily. We are making the process longer, harder, and more traumatic.

This no-push method encourages us to give birth to projects – with openness, trust, letting go of tightly held muscles – much as we might imagine ideally birthing our babies. It includes more deep breathing. Being in the present and letting go of fear and worry. It’s also about defining and owning what success really means to you – and going for that.

Now don’t get me wrong, natural birth is a lot of work. So if you are creating a book if you are an author, a healthy home if you are a stay-at-home mom, or a company if you are an executive – I’m not saying there won’t be hard work and even some sweating along the way. There may even be times your work interferes with sleep. But working smart is different than working hard.

The No Push Method encourages you to take more time to relax and JUST BE, get more sleep, and even take some days off of work and away from your projects – all of which are associated with higher levels of work performance and productivity … and personal happiness.

So how am I taking this into my everyday life?

First, by affirming my personal definition of success – which includes plenty of personal time, freedom to pursue things just for fun and pleasure, time with family, and in nature. Yes, of course, financial security is important to me, and I do still kick into survival mode now and then. But I have learned to identify the signals that it is survival mode doing the talking – those racing, anxious, churning feelings that smack of fear. I don’t allow myself to act from this place. I take a few deep breaths. I don’t push. I tell myself I am safe. I give that girl from the projects an imaginary hug and honor the strength that my background does give me. I try to only take on projects that feed my spirit – not that feed my fear that I have to keep doing more and more to get to a safe place!

What have I been finding?  I am much happier while still able to create wonderful things – with and for wonderful people like you! Wonderful things are happening – and more easily. Sure, doubt and insecurity might start to creep in – but now I see them as a reminder of where I’ve been and how far I’ve come and can let them go quickly. And strangely, since I’ve been practicing this, they are visiting less often

I no longer need to create anxiety to feel comfortable. I recognize it for what it is too. I thank it for helping me to stay safe and get me where I am, and I remind myself that the mature woman feels comfortable with a relaxed heartbeat and deep belly breathing.

Of course I still work hard at my ventures –  I am happy when I am being creative, writing, teaching, and taking care of patients. And I am also playing a lot more, and in this, finding even more inspiration.

I hope that in sharing this, there might be some wisdom and inspiration for you to transform your own hard push into open surrender. To pursue your passions out of joy and positive drive, not fear and worry, and to create an inner milieu that reflects where you want to be in your life right now, not recreating an outgrown one from the past. I’ll be right there with you, working on it, too!


  1. Thank you for sharing!! I’ve been working on this too – for about 5 years! I’ve actually found that our son, now one year old, has been the best teacher for me. To commemorate this amazing year of being a new mom and learning so much, I actually got a beautiful tattoo reminding me to breathe. Success, like seeds and babies, must be nourished. It needs to incubate. 🙂

  2. I commend you for your honesty and vulnerability, it is something we need more of in our culture. As an entrepreneur, mother and graduate student, I identify with you in a huge way. I have been a yoga teacher and herbalist for about 20 years and even we fall off the “being present” wagon from time to time, although I do feel, that I am able to pick up on it a bit more quickly perhaps than some. Graduate school has been a huge challenge and took some getting used to as I was single and childless during undergrad 17 years ago so didn’t have as much to juggle. When I feel overwhelmed I remember that this too shall pass and that I chose this journey for a reason. I love what I am studying (Mental Health) and think one of the best things we can do for ourselves regardless of profession is to honor and practice good self care which includes giving pause…good luck on your journey and know that your words struck a deep cord in many of us out there today…Blessings, Jenn

  3. Bravo! Thank you so much for sharing so much of yourself with us. Your words touched me deeply. I am grateful that I gave myself “permission to pause” and read this lovely post. It is indeed easy to get sucked into the vortex of our culture. Much like the getting stuck in a rip tide, the more we struggle to stay in control, the further away from our core we get pulled. The answer is to do what you are suggesting – be calm, breath deeply and just BE. Thank you again!!

  4. Aviva! Thank you for sharing this message, especially since it was from a vulnerable place. I’m grateful for the knowledge and inspiration that you pass on to me and women all around the world.

  5. Thank you for this Aviva! It is so true we can get just as much done by grounding into our foundation, breathing and trusting. But so many of us we raised to only survive and not thrive. And I agree there is something so feminine about this new way. I am so grateful for teachers like you, shining the way!
    HMW student

  6. Thank you so much for sharing this Aviva, it couldn’t have come at more opportune time.
    I’m in the midst of the first year of owning my own business, and man is it ever stressful! I’ve always been a push-strive kind of person, and tend to give myself too much to do and then fret and worry when I can’t get it all done. It’s hard to break the pattern you’ve grown up to expect in yourself from a young age.
    Just yesterday my husband told me I need to stop worrying about the money (because starting a new business is expensive!!) and just worry about the work I’m doing and the creativity I need to let it bloom.
    The universe is certainly sending me some BIG signs when things like this come along in my life just when I need it too.
    Thank you again for sharing.

  7. Aviva

    I believe that this subject matter is extraordinarily important for this time. Understanding that the stories that were created when we were young are not who we are but just a way to navigate our experience. Finding the pearl of we really are underneath is a journey of letting go. I really like how you addressed this idea of how we get used to this pattern even though it is dysfunctional, it seems like we need to keep it because it is familiar. Having the courage to release these parts is complicated. I appreciate your viewpoint, honesty and process through. Thanks for writing this.

  8. I love how Anna said that success, like seeds and babies, need time to incubate. I needed to hear your alls words so very much today! Thank you Aviva for sharing!! I am on the path to med school…..( one in which Aviva had direct influence in encouraging- and she has no idea she did it! ) but I am ready to be there like yesterday!! I find myself in a state of panic and fluster because I want everything to speed along and be done! In the past few weeks I keep having things flop in front of me- like this blog post- to remind me about how everything happens in it’s own good time. BREATHE and stop and smell the roses! 🙂 Love ya Aviva!

  9. Oh Aviva, so much of this rings true for me. It’s so hard to break these patterns. Mine were set in childhood from religious training–fear and anxiety about never being good enough, reinforced by ten years in an increasingly emotionally abusive relationship (I couldn’t take enough responsibility for managing HIS anxiety), and now as I’m fighting myself to finish my graduate degree, I know I slip back into those old patterns simply because they’re comfortable and familiar. They’re awful and despair-inducing and I’m so tired of them.

    Thank you for sharing your story. It really helps to hear that someone I really admire fights similar struggles as I do.

  10. What a beautiful story that was very open and honest and felt very light, what a blessed awareness you have! Thank you for sharing, it struck home very deeply….

  11. Aviva! Thank you for this lovely post. I was *just* reading the section in “Birthing from Within” about the coaching/pushing culture and how counter-productive and harmful it can be for a birthing woman. The body speaks louder than words and it knows what to do! I feel that your writing about birthing creative projects and success — using this metaphor — is absolutely perfect! And, so many of us are running around in scarcity mode — many with no self-awareness at all. Resting into ourselves, leaning back into ourselves…can be a powerful experience…and can begin a whole new way of living and being. I feel that when we do this, we begin to rest into our own nobility and preciousness as a brilliant, small spark of something much bigger.

  12. “To pursue your passions out of joy and positive drive, not fear and worry…” That sentence alone if truly embraced could change the world! It is so important to be present in the moment and make sure that we pursue our goals in a way that make us happy because they make us happy. I can honestly look at some of the goals I went after in the past because of the fear and worry about not having enough money—and I was MISERABLE. I am now trying to go after new goals in a positive manner that bring me joy. Even though the money may not be there yet, just existing in the present has allowed me to meet so many amazing people and opened up so many doors–and I’ve just started. Thank you so much for posting this. It lets me know that I am on the right path! <3

  13. Thanks Aviva,

    You Inspire me!
    I am grateful for you sharing and being vulnerable. It’s amazing to feel that we all have more or less the same struggles and that we are more connected than we think.

  14. Hi Aviva,
    What an excellent realization. Your epiphany has been shared in my community. Our society values too highly physical achievements. We should never feel insecure by something outside of us. Security is a state of conscious knowing that the Universe and its Creator are benevolent beings that give us opportunities to become self realized and self actualized. When your drive to succeed became a mission to serve your work took on purpose and meaning. We are the beneficiaries of your striving. Thank you. Bless you. John

  15. Thank You Aviva! You Reflected your past in a Positive light Well! I Enjoy ur blog & books. Iam 81/2 months pregnant & hav been reflecting on my own childhood a lot lately, things I want to be better for her & better for my self! Some wold say my childhood was Ruff, but most days I can Thankfully say I wouldn’t change it. It made me who I am &i try to honor it & try to

    to see the positive like you 🙂
    Much Love You Spread

  16. Dear Aviva,
    Thank you so much for sharing your story. Although I have lived through a different (but similar in some ways) set of circumstances, I recognized the same feeling of pushing and struggling, unfortunately with little or no return. Whenever I approached a project or new direction it was with fear of failure, accompanied by a lot of anxiety, so I thought if I pushed hard enough I could succeed. However, I now see that relaxing into the work and creating projects from a sense of love and joy may actually bring more success than doing what I think I “should do” in order to succeed. Thank you so much, you sharing has created a breakthrough in my thinking. Many blessings, Betty

  17. Thank you for your share here. I can also relate and am still working on identifying when I am working from that place of anxiety and pressure and hope to learn to live from a place of trust and love which I know is so true. Soon I will be “on my own” in terms of my practice and work and passion – and I hope I can create this new self from the place of love and trust which I know is the best way…and not from a place of fear and doubt.

  18. Oh Aviva, thank you for this beautiful piece. My background is different from yours but my internal struggles have been highly similar. As an over-achiever who unfortunately does experience health problems from pushing too hard, I am grateful to you for modeling ways to move more slowly and wisely. You have been a lovely mentor to me for 15 years, ever since my first pregnancy, I feel loving gratitude!

  19. You are an Uber-goddess Aviva! Thank you for sharing your struggles and insights. . As a stay at home mom I can feel a bit isolated and disconnected. Your writings are my favorite form of nourishment when I have those few spare moments.

  20. Aviva thank you for your honesty and sharing. Fortunately and unfortunately I can relate to your experiences. A girl for the projects who grew up in the Bronx (and yes we made fun back then of the smart kids on the way to that school, but now I know better) I have a great set of street smarts and knowing that I wouldn’t trade for the world. At the same time it has made for some stress related memories and I continue to be hyper-vigilant as an adult. Perhaps I am an overachiever though I find different ways to pursue that call such as the need to always be a class or workshop learning something else to add to my long list. Is it really learning for learning sake? Not sure. At this point I can truly relate to the section below I lifted from your writings. My pursuit of the work is about creating a place for change as opposed to working for works sake. It’s good to read that will all you have accomplished you sound grounded and real. Thanks

    You wrote “At this stage in my life my energy and drive lead to a passionate (and compassionate) desire to participate in making revolutionary healthcare and environmental changes for our present and future health. The overwhelming health and ecological crises we face inspire me to think, write, teach, and create. I’m filled with enjoyment in what I do. I recently saw a Pinterest picture that says “I work because I love this shit” and thought, “Yup!”

  21. thank you for sharing your story mom. your courage, wisdom, and passion to make change in the world is such an inspiration, and i am so proud to be your daughter.

  22. aviva,
    thank you for sharing your story. it struck a chord w/ me as well; and is quite timely as i’ve been struggling w/ my own push & strive past. your story is a nice reminder that i am not alone; but am in fact in good company. i admire your honesty & willingness to be vulnerable as you share of yourself…your writings are a reminder of how important it is as women that we be supportive & loving of each other…that we encourage & empower each other. thank you for sharing your wisdom, love and encouragement w/ all of us out here. you are indeed a blessing…
    peace & smiles to you…

  23. wow! I love how the universe truely brings us gifts right when we need them most. this blog was perfect timing.. Thank you so much for sharing. I as well have been peeling the onion of childhood fears/old patterns. after completely losing it (verbally)with my 3 year old this week i had a huge release and shift on my yoga mat. I realized that i was feeling resentful towards her for just being a child, something I don’t feel i got to do. the tears flowed, I gave myself permission to mourn this loss for the little girl inside and was then able to leave it in the past. even thru the tears I was immensely gratefyl for the gifts of yoga/growth and healing. I have such gratitude for the lessons learned thru parenting. our little ones truely gift us permission to heal our lifes in the most divine ways. this email I’ll be passing along and tucking away to read again later over and over for sure.
    keep up the beautiful healing work, much appreciated michelle

  24. Hello,
    I live in Pomonok and your story is very uplifting. I’m sure many children at the community Center would love to hear your story.

  25. As a fellow ‘striver’, it takes everything I’ve got to make myself slow down and breathe, and like you, it’s taken years of work and now, a new granddaughter, to show me how slowing down is so much more nourishing than a scheduled life with to-do lists and a resume full of achievements. Thank you for putting it all out there so honestly.

  26. This is an incredible, incredible post — the best post I’ve read in probably years. I’ve always had the utmost respect for you, Dr. Romm, and I’m so moved by your honesty, integrity, and profound insights. While I didn’t grow up in the projects, I can relate to SO much of what you’ve said here. And this is so timely for me. Thank you. My colleagues and I all LOVE you.

  27. Of course I am reading this…again. I have read this more than once, and although I was your loyal protector in an earlier life, you are a true inspiration and guiding force for all women! You not only give us guidance, you bring up the topics we need to discuss and your experience, intelligence and insight are amazing! Keep it up girlie – you will always be the sane and smart voice in my head.

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