The weeks before Mother's Day are filled with advertisements for gorgeous jewelry and flowers. But it's the ads for the greeting cards that grab my attention. Even the most jaded adolescent girl can apparently find a card to express her adoration of her perfect mother, and in every commercial, the mom opens her cards surrounded by a loving husband and cherubic children.

For many years, all the focus on Mother's Day concerned me since I have so many patients struggling with infertility. For them, this holiday is like salt on an open wound -- having to endure a holiday that celebrates what they so desperately can't experience. But since my own mother died four years ago, I have begun to notice another aspect of this day: the pain it causes those of us who don't have the perfect mother, either because of death or because our mother doesn't seem to own that mothering gene.

One of my patients was talking to me recently about her definition of what a mother should be. She had come up with three expectations: trust, compassion, and respect. I told her that I would add one more: unconditional love. We then went on to talk about the challenges one faces when one has a mother who is unwilling, or unable, to meet all or even some of those roles. Her mother was unable to meet any of these. She solved the problem by establishing wonderful friendships and told me that, other than the unconditional love part, she felt that her friends could in effect be surrogate moms.

After the appointment was over, I began to think about our universal need to be mothered and how one copes when that person is missing in our lives? Some people miss it from the start; they might have a mother who is overwhelmed by the demands in her life and simply can't adequately mother her children. Some mothers are narcissistic and the needs of their children can't possibly compete with her need to focus on herself. And some of us have had mothers who did fill all of our needs, but they are gone. 

I had a mother who was extraordinary. She provided all of the things a mother should, but she also modeled for me an ability to not only focus on her husband and children, but many other people in her life. She was a giver but she never depleted herself. She was clear about her limits (and mine! Just one look was enough to set me straight most of the time) but she also nurtured herself without guilt. But what was truly amazing about her agility as a parent was that she had never been mothered.

My mother was born into a family in Germany where her own mother was the single focus. I would now venture a guess that her mother had a narcissistic personality disorder, but the end result was that my mother only saw her mother once each evening, when her mother would swoop into the nursery to kiss her good night. Yet despite the fact that my mother never was the recipient of that unconditional love all children crave, she was able to parent and share her heart apparently effortlessly. It strikes me as extraordinary that a person who never experienced mothering herself was able to turn it around in such a positive way.

So if you are someone who is mother-less this Mother's Day, either literally or figuratively, perhaps it is a good occasion to figure out how you can get your mothering needs met. Like my patient, really good friends can meet many of your needs. A supportive, loving, caring partner can as well. But perhaps it is also okay to look outside the box. Do you have other relatives who would love to include you in their lives? Do you know other women who would welcome a closer, warmer relationship with you? I have actually found that my 13-year-old daughter has started watching out for me. I work from home two days a week and have a bad habit of getting so caught up in my work that I forget to eat lunch. The first question Sarah asks me when she gets home from school is if I have eaten lunch yet. And if the answer is no, I get "that look" (which she inherited from my mother) and I am marched into the kitchen.

This Mother's Day spend some time thinking about how you can get your mothering needs met, and celebrate not necessarily only the woman who gave birth to you, but all the women in your life who love you.