Disordered Beliefs About Food and Your Body: When to Seek Help

By Caitlin Hopkins, LMSW

As a therapist for the women, I have noticed one unfortunate, heart-wrenching truth: no matter what she originally came to therapy for, somewhere woven within her story will be a disordered eating thought, experience or belief.

These false beliefs, (such as that small bodies are better bodies) are rooted in misogyny, diet culture and unrealistic beauty standards. They are so engrained in society that many times at first glance, clients don’t even realize their harm. A few examples of normalized disordered thoughts and phrases that perpetuate this harmful “thin ideal”:

• “Sweating for the wedding.”

We do not need to make our bodies smaller to be worthy of marrying, nor do we need to lose weight to fit into a dress. Dresses are made to fit our bodies, as they are, not the other way around.

• Postpartum women “getting their body back.”

You just created life. You are magic. You are never going to be the person you were before having a child, and neither is your beautiful body. Accept her. Celebrate her.

• Restricting or excessively exercising before holiday meals.

Food does not need to be earned. This transactional practice of “now that I’ve burned the calories, I can have the meal” is a harmful, slippery slope, and one to be very mindful of.

These beliefs – especially when coupled with extreme stress, depression, and/or anxiety – have the potential to manifest in more dangerous behaviors and an eating disorder diagnosis.

If these messages are so prevalent in society, what is the difference between someone who has fallen victim to diet culture beliefs about bodies, and someone who has an eating disorder? When should they seek professional help?

The major distinction here is the amount of space these thoughts take up in your mind, and if they result in drastic behaviors to change your body. It is time to seek professional help if your daily quality of life is impacted. For example, if you are obsessing over the next meal, feel anxious about social events that focus on food, lie about or hide your eating habits from others, repeatedly check your body in the mirror, weigh yourself over and over again throughout the day, or if you are engaging in any behaviors that feel unsafe or extreme (restricting, binging, purging, excessive exercise).

Ultimately, whether you are someone who has an eating disorder or someone whose body image has been negatively impacted by these unrealistic societal beauty standards, your relationship with food and your body could benefit from some healing. We all deserve to enjoy food, celebrate our bodies for all they can do and accept the skin we’re in: stretch marks and all.

On Acceptance...

For the longest time, I practiced therapy utilizing primarily a Cognitive Behavioral Therapy (CBT) model.  Widely respected, utilized and researched the structural nature of this model really resonated with my “Type A” personality.  For those unfamiliar, a very short explanation of CBT is to assist clients in identifying maladaptive thought patterns or “cognitive distortions”, train the client how to reframe these distortions, engage in desired behavioral changes and a shift in overall mood and functioning will occur.  Easy, right? 

Over the years using this model, I’ve noticed a pattern with many of my clients, especially those with anxiety as their primary clinical issue.  While reframing distortions can take clients to a certain point in managing their distressing thoughts and feelings, for many it just wasn’t enough to really contribute to a satisfying shift in overall functioning.  The residual thoughts and feelings still created a barrier between the client and the rich meaningful life they desired.

Enter: Acceptance and Commitment Therapy. 

I was introduced to the Acceptance and Commitment Therapy or ACT (spoken like the word “act”) model a few years ago in a consultation group of therapists I belonged to where we talked about cases and consulted on challenges we faced in our roles as therapists.  My colleagues shared how using this model really changed the game for a lot of their clients.  I did a little research, and signed up for a training on the approach.   Slowly after the training I started implementing elements of the model into my practice and I watched as the lightbulb went off for many of my clients. 

Contrary to CBT, rather than resisting and trying to change one’s thoughts and feelings ACT encourages clients to radically accept their existence.  What changes is a person’s response to them.  Rather than trying to talk yourself out of your anxious thoughts, you instead “unhook” yourself from their grasp and choose to coexist with them.  Kind of like the music that is playing at the grocery store while you shop, these thoughts fade into the background and become white noise.  They are still there, they still exist, but they no longer dictate what direction you go.  Instead, a client identifies and engages in “committed actions” that will move them along their journey toward what they want, desire, and value in their life in the midst of these thoughts and emotions. 

For a lot of people the idea of acceptance feels like giving up.  And in a way it is.  It’s giving up a fight with something bigger than ourselves.  Something we may not have the control over we desire.  Awhile back I was going through a tough spot in my own life and I heard something on the radio (I said it was awhile back!) that literally stopped my in my tracks.  I can’t remember what program I was listening to, but the guest speaker said something I’ve never forgotten-  “Acceptance does not equal approval”.  This really shifted things for me at the time and I’ve repeatedly shared it over the years with my clients in different contexts.  When we accept something it doesn’t have to mean we have to be happy or ok with it.  It simply means we choose to stop fighting a battle we aren’t able to win.  And when we do that we can redirect that energy into pursuing the things we find meaningful, the things we value and that will bring richness to our lives. 

One of the hallmarks of ACT is the pursuit of values which I’ve referenced in this post and will discuss in more detail in a future blog, but until then if you are struggling in finding away to identify and pursue the things you value because of unhelpful thoughts, feelings, disfunction in your relationships or distress at home or work, please don’t hesitate to reach out to see if working with one of our therapists would be a good fit for you!

Let It Go!

My last blog post was all about the utility of worry, and how sometimes we can get “stuck” hanging on to these worries. This post is going to be all about learning to let go of unpleasant thoughts and emotions like worry and the steps to get you there.

Step 1 Feel It

The first step in letting go of worry is to first connect with your feelings. We are often moving through life at such breakneck speeds that we are unable to recognize how we are feeling until it has come to a head and and we are ready to either explode or implode. Either way, it’s no good. So to hit step one, it’s best to try to slow down and be mindful of your emotions.

Step 2 Name It

Once you recognize that you are feeling something it’s important to know what exactly you are feeling. Some feelings like anger, frustration, impatience are actually masking other feelings like worry, hurt, fear and sadness. As part of Step One your challenge is to slow down and recognize your feelings, the next part is to think a little about your feelings and make sure that what is being expressed is really what the fundamental emotion is.

Step 3 Release it

This particular step can feel a little “hippy dippy” when I describe it to people, but it’s a necessary part of letting go of unpleasant emotions, like worry. This is where you make a conscious decision not to let this emotion take over. This can be done by simply taking a deep breath in and saying to yourself “By breathing in I recognize my emotion and by breathing out I release it”. Sometimes it can help to speak to yourself in the third person to lock your mind in to what you are asking it to do.

Step 4 Redirect It

The final step is to redirect your mental energy. It’s important to have an arsenal of pleasurable activities that engage your mind when you are feeling poorly and your mind is running away from you. Watching a favorite show, engaging in a hobby, doing something artistic or creative are all ways to distract your mind from your worry. This is not simply distraction on it’s own! It’s very important to do the other steps first and not just jump to this one. Engaging the entire process is imperative to letting go as opposed to just distracting your mind from it. We know when you just distract the thoughts and feelings have a way of coming back bigger and stronger.

Hopefully you find this information of use to you in letting go of unpleasant and stuck emotions. If you find you are still experiencing difficulty, you might find it useful to speak with a professional counselor or therapist to move you through your stuck points. Feel free to reach out on my contact page for more information.

Why Should I Worry?

Anyone else singing the song from the old Disney movie “ Oliver and Company?” Just me? OK, then let’s move on….

Worry. It’s kind of part of the human condition. If you care about anything or anyone in your life you will at some point worry about it or them. The problem is, that sometimes this worry gets in the way of our functioning. It takes us away from being present in this moment because we are still worrying about the last moment or how to face the next.

So is worrying just…bad? The answer is no. We have actually been “gifted” the ability to feel anxious or worried as part of our adaptive functioning to promote our survival. Our flags go up and we do things in order to ensure our safety. That’s a good thing, right? Not always, because sometimes people worry on overdrive, worrying about things that have nothing to do with safety, or things that can’t be controlled, or that they have little influence over. So, then what?

What I will frequently coach clients on is pulling what is useful or productive from their worry. So for example, we worry about our kid’s safety. OK, let’s make that worry productive. Go ahead and tell them to hold your hand or look both ways when they cross the street, buckle their seat belts in the car, and teach them not to speak with strangers, etc. All these things are good things. I encourage clients to respond to the worry in useful ways as long as it doesn’t interfere with their (or in this case, their child’s) functioning. Although it may help to ensure your or your kiddo’s safety, never leaving the house really isn’t an option, because that impacts the overall functioning of everyone involved.

But because anxiety and worry can be a real jerk sometimes it will always remind you of the “what ifs”. The elements you can’t control. This is the worry where there is nothing productive to pull from it. So what do you do with that? The answer is: you learn to let it go.

The sad truth is, somewhere today someone is worrying about something bad happening. They are overcome with the worry. Maybe it is even incapacitating them in some way. And, then the bad thing still happens. The worry did absolutely NOTHING to affect the outcome of what the person was worrying about. It only robbed them of any joy or experience of being present leading up to the event. The worry served no purpose but to make that person feel like garbage. The outcome may remain the same, but in letting go, the person has a better overall quality of life.

So, Elsa style (man I’m on a Disney kick today) we need to let go of that residual worry, which is easier said then done. So stay tuned, because my next blog post will include some tips/tricks on how to do just that. And as always, feel free to reach out with any questions you may have.

Dropping the Baby and Other Scary Thoughts: Book Review and Comparison

Dropping the Baby and Other Scary Thoughts

By Karen Kleiman

Buy on Amazon

Good Moms Have Scary Thoughts: A Healing Guide to the Secret Fears of New Mothers

By Karen Kleiman

Buy on Amazon

Cognitive Behavioral Therapy for Perinatal Distress

By Amy Wenzel

Buy on Amazon

As I may have mentioned before, I hate to read. However, it comes with the territory of the work that I do that I need to read and provide quality book recommendations to my clients. I knew that I needed to put books by therapist, author and PMAD pro Karen Kleiman and co-author Amy Wenzel at the top of my list. Based on what I’ve read so far, I can say with confidence that ANYTHING with Karen Kleiman as an author/co-author is going to be a valuable read (Yes I am fangirling here…she’s amazing and I want to be her when I grow up!) A few months ago I did a review on “Good Moms have Scary Thoughts” which you can read HERE, but I wanted to go back to the OG of books on scary thoughts, which is why the subject of this review is “Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts in Motherhood”.

Compared to “Good Moms” this book offers a much more in depth understanding of what exactly scary thoughts are, what causes them, and approaches on how to gain relief. The book is divided in three sections titled “What’s going on”, “Clinical Concerns”, and “Breaking the Cycle of Scary Thoughts”.

Section One differentiates between typical presentations of new mom worry, anxiety, and scary thoughts. It details the different types of scary thoughts that mothers have and includes examples and personal accounts from real women who share their own experiences. The authors do a really good job of normalizing some of these experiences for new parents. They also share some of the “why” behind the scary thoughts, which is very important to many mothers to help with externalizing symptoms and helping ease some of the blame moms place on themselves for having them in the first place. I think it’s important to note that at the end of each chapter they offer a “Take Home Point” for both mothers and clinicians. This was very helpful especially since there is so much good information it’s useful to boil it down to the most valuable information.

Section Two starts with helping mothers recognize when they need additional help/support in addressing their scary anxious thoughts. The different types of Perinatal Mood and Anxiety Disorders (PMADs) are discussed and “really scary thoughts” including suicidal thoughts and psychotic symptoms are also addressed. There is a chapter on barriers to relief and a chapter on screening. I think that these chapters speak a little more to the clinicians reading the book, however are valuable to mothers in order to predict potential obstacles and promote self-advocacy in their treatment.

Finally Section Three really gets at the meat and potatoes of how to get relief. The authors give ideas that are easy to implement and practice in order to begin experience change as well as a whole chapter on Cognitive Behavioral Interventions. This is Amy Wenzel’s chapter to really shine as she’s an expert in utilizing this approach with the perinatal population and co-authored a book with Karen Kleiman on this topic (and HEY I’ve shockingly already read it and it’s awesome! Check it out below!) They continue the section by discussing professional options like therapy and/or medication when self-help just isn’t moving the needle for readers as well as offer a chapter on enlisting help from the supports available to moms.

I would say the best chapter in the book is entitled “Your Personal Treatment Plan” which helps readers create an action plan of how to take all the information presented in the book and implement it. I think this is a great way to put everything in the book together. This is especially helpful for a new mom who is most likely sleep deprived and reading in a disjointed way making it difficult to remember what you read in chapter one by the time you get to chapter 11!

Compared to “Good Moms Have Scary Thoughts” this book is a little more “book-y” in that it’s longer and presented in a typical fashion, whereas “Good Moms” has a more relaxed approach to presenting information. I have a hard time imagining the moms I work with in their most anxious or depressed state sitting down to read this type of book. For that reason I am more likely to recommend “Good Moms” first. I say that while also recognizing that the moms I interact with are typically in significant distress which is why they are coming to me in the first place and a reader dealing with less intensive symptoms may do just fine with this book. I also want to acknowledge that I am also saying that as a non-reader and for someone who reading comes more naturally to, it may bring great comfort to sit and read a book of this nature. This book is a little pricey although I feel the info in it is of great worth. “Good Moms” is much more inexpensive which makes it giftable as a baby shower or new mom present.

To my understanding the book is currently being revised and updated but there was nothing in this book I felt was dated or irrelevant. All in all in my opinion this book is another winner by these authors, and I would highly recommend it to both clinicians and moms.

If you are interested in reading either of these titles click on the following links to purchase through Amazon. And as always, feel free to reach out through my contact page to get more info on this or any other topic relating to reproductive and maternal mental health.

Surviving Postpartum with Twins

The first in my guest blog series is all about the postpartum experience with twins written by therapist and twin mom, Lindsey Lowrance. Enjoy!

It’s Twins! (Gulp, Faint, Whaa?) Here’s What You Need to Know

What’s different about having twins?

While helping twin moms go from drained and distracted to powerful and fulfilled, I’ve learned that there are some things that are very different for parents of twins and multiples. I’m a twin mom myself and can also speak from personal experience. The question on everyone’s mind when this comes up is ‘what’s the difference?’ Isn’t it just an extra baby in the mix?

Actually, there’s a lot more to it than that. When one parent is on their own with both babies (whether this is running an errand or staying at home while the other parent works), they are outnumbered and often overwhelmed. Many moms of twins stress that they can’t do all the bonding activities that moms of single babies do, partially because of logistics and partially because there is so much extra work and attention that needs to be divided. Can you imagine taking two babies to a Mommy and Me class?

Logistics are one of the hardest obstacles new parents of twins have to conquer. Here are some examples: how will I get both babies in and out of the car at the same time? How will I feed both babies at the same time (or do I feed them one at a time while the second one screams impatiently and this doubles the time it takes me at each feeding)? What if I’m out in public and they both are crying- how can I help them both at the same time without an extra set of hands? Will people think I’m a bad parent because I don’t have time to shower or get dressed for the day and my babies keep crying while I take care of one and then the other back and forth in a frenzy?

Many moms of twins can feel envious of other moms that get to peacefully hold and rock just one baby the whole time they are in public, or gaze lovingly into their baby’s eyes without having any distractions (like a twin baby needing mom’s attention). First time parents usually try hard to do everything perfectly according to their parenting plans and ideals, but with twin parents they often have to quickly throw out any ideas of perfection, timeliness or organization and learn to accept the chaos.  

Don’t get me wrong, having twins is something so special and magical in its own way. While we often hear what is hard about it, there are so many wonderful things too like twins being best friends, or having a unique bond from the get-go. I’m happy to be a part of the twin community because I get a front row seat at the cool twin life and to witness their incredible relationships. I wouldn’t change it for the world! But there certainly are differences and challenges that are worth hearing about so you know that you aren’t alone.

What’s Different About Postpartum with Twins?

  Newborns take a lot of work and it can be stressful adjusting to huge life changes like this.

Parents with newborn twins are usually in survival mode, chugging away at tasks day and night to keep those little babies fed, clean, and healthy. Many couples assume it will be miserable the first 6 months or so because they’ve been warned that the first 6 months (or year) of having twins will be SO HARD. Parents of multiples also sometimes hear that the divorce rates are higher and that raising twins/ multiples is very tough on relationships.

It doesn’t HAVE to be miserable! Yes- it’s a lot of work and so many things change, but having twins CAN be wonderful in its own right.

What many parents of twins/ multiples don’t realize is that postpartum mood disorders are actually more common given all the stress and financial strains of having more than one newborn. Postpartum depression/anxiety tends to happen in the midst of chaos and sleep deprivation that it can be hard to notice that you are not dealing with the “normal” amount of stress. Let’s face it, it’s hard to know exactly what is normal when managing two or more babies at once!

How can we tell when we are dealing with a ‘normal’ and expected amount of stress or when there is something more going on?

While pregnant, we all imagine having these wonderful, magical bonding moments with our new babies and soaking it all in. We dream happily of the beautiful connection that moms have with their new babies and all the adorable little baby toes and fingers.

What if you don’t get those magical moments with your newborns? What if it’s all hard work and you don’t feel those happy, blissful moments when the babies are here?

It turns out that postpartum mood disorders (depression, anxiety, PTSD, and OCD) are all too common in the twin world, but we don’t really talk about it. Twin parents (yes partners too) are at a much higher risk of having a mood disorder in that first year. Why is that?

When having twins or triplets, there are some extra stressors that a couple deals with that put them at higher risk of postpartum moods.

·         Financial strain (2 babies equals 2 of everything, not to mention daycare costs and hospital bills)

·         Extra hormones from pregnancy & postpartum due to physically carrying more than one baby (Yes, your body is impacted more and has an increase in hormones and blood flow than a woman carrying one baby)

·         Extra stress! (It’s not just twice as much work, it’s the lack of breaks/ rest and being out-numbered when one parent goes to work or runs errands)

·         Little to no support from family or friends (it’s hard to keep in touch when you’re run ragged on baby tasks and little sleep. Unfortunately, many don’t have family nearby and can’t afford to hire help, which leaves them really strained to do it all without help)

·         Many parents of multiples experienced infertility or complications with pregnancy, birth or breastfeeding (When there are 2 babies the pregnancy gets more complicated and is treated as high risk. Birth can feel like it’s totally out of your control when medical teams decide what’s best and take charge.)

Each of these factors increase your chance of having depression, anxiety, or other impacts on your mood.

Baby Blues: The first 4 weeks after giving birth, it is completely normal to have extreme emotions and hormonal mood swings because your body is going through major changes. Any woman going through the intensity of hormone changes in her body will have some adjustment period. It is not necessarily depression or anxiety. If it continues, then it can be helpful to check in on how you’re really doing.

Did you Know:

·         If you have ever experienced depression, anxiety or any mental health issue before pregnancy that you have a much higher chance of developing postpartum (or prenatal) mood disorders?

·         High risk pregnancies, pregnancy complications, NICU time, and problems with breastfeeding can lead to more struggles with mood?

·         Perfectionists &/or people with high expectations are more likely to suffer?

Here is a checklist of some common things to look for so that you know if your struggles cross the point of needing something more.

Checklist for Postpartum (or during pregnancy) Mood Issues:

o   Zoned out or distant

o   Irritated very easily

o   Overwhelmed most of the time

o   Not feeling connected to kids/babies, partner

o   Feel like you’re just barely surviving day to day

o   Worried about _____ most days or for long periods of time

o   Fighting with your partner more than usual

o   Yelling at your kids often

o   Feeling like a failure

o   So much guilt!

o   It’s hard to be around other people

o   Not interested in things you usually enjoy

o   Scared that something bad will happen to your babies

o   Trouble sleeping even when the babies are sleeping

Checked a couple things on the list? It may be time to talk with your doctor, OBGYN/ midwife, or call a therapist to figure out how to make things better.

You CAN feel good while surviving the chaos of newborn twins, and you CAN enjoy moments with them and feel like yourself! It’s a big adjustment Momma, and you may need some extra support. There’s nothing wrong with that.

Brought to you by twin mom & maternal mental health specialist Lindsey Lowrance at Twin Mom Power. Lindsey is passionate about helping twin moms Go from Drained & Distracted to Powerful & Fulfilled! For more information & resources on surviving & thriving the twin life go to: www.lindseycounseling.com or Email: lindsey@exploringinnerpeace.com Phone: 720-243-3993

Myths of Motherhood Final Installment: The Myth of the "Good Mother"

Close your eyes. Create an image or picture in your mind of a “good mother” What does she look like? Dress like? Act like? How does she compare to how you evaluate yourself as a mother? Do you measure up or fall short?

Now think about where you got your idea of what a good mother is. Was it from the example your own mother set? From what you see your friends do? Maybe you got your idea from books, movies, or social media. How does thinking about this idea of the “good mother” make you feel?

So many women walk around with this idea of what a good mother is. The job qualifications are usually full of should-type thinking. A good mother should breastfeed, be happy to get up at night with her baby, love every minute of parenting, not miss her work/friends/life before baby. And when you don’t measure up, it’s pretty easy to start getting down on yourself.

I believe the myth of the “good mother” is actually a collection of myths through all the stages of parenting that starts even before you become a parent! I share some of these myths down below .

1. Pregnancy: Good mothers find it easy to get pregnant, and her pregnancy is welcomed and planned, she glows and is full of joy as she waits for her little bundle.

2. Labor and Delivery: A good mother believes that a natural delivery is the only way to go and the only thing that’s best for your baby, if she requires a c-section it means there is something wrong with her body and she has failed, once the baby has arrived she feels immediately bonded to her baby and an outpouring of love.

3. Parenting: The good mother always put herself last and does it happily, she never loses her patience or expresses anger ESPECIALLY toward her infant, she focuses on all the gifts parenting brings and can’t identify any loss/grief experienced in parenthood, makes perfect Pinterest creations for every birthday/celebration and does it all without asking for help which is a sign of weakness, she experiences “Mom Guilt” which is normal/natural and is the mark of a good mom.

If these are the messages we are immersed in how do we shift our thinking about the good mother? Here are some helpful tips.

First: Stop the comparison game. When you are comparing yourself and your life to others you are often comparing your blooper reel to someone else’s highlight reel. Rarely are people posting their most raw, vulnerable, ugly moments on social media or sharing it at a backyard cookout. Stay away from situations that suck you in to this comparison pattern. I often suggest moms to take a social media break or “break up” with that competitive mom friend. Check in with yourself and ask if what you are doing or who you are doing it with makes you feel good. If it doesn’t, stop.

Second: Focus on what you have done/accomplished rather than what you haven’t. Having young children is hard. Some days even a shower is hard to come by. Instead of focusing on the sink full of dishes or the clean laundry that hasn’t been folded, take inventory of what you have done today. How many diapers have you changed, sippy cups have you filled, kisses and cuddles have you given, etc, etc, etc. If you stop and think about it you are working all day long accomplishing many tasks that are essential to your baby’s well being. Pay attention to what you are doing instead of what you aren’t and give yourself a pat on the back.

Third: Let go of “should” thinking. There are capital “S” shoulds and lowercase “s” shoulds. The uppercase ones are non-negotiable like brushing teeth and buckling your seat belt. The lowercase ones are typically based on unrealistic expectations and usually serve no purpose but to make you feel like you are not measuring up. Let. Them. Go.

Fourth: Stop trying to be perfect and strive to be “perfectly good”. Perfection is unattainable, but being perfectly good is certainly achievable. Lowering the bar does not mean admitting defeat, it’s just meeting yourself where you are and allowing yourself to be human. You have little eyes on you that are learning how to treat themselves by watching you. Extend some self-compassion when you miss the mark, and keep trying your best.

Hopefully this series has been helpful. Please feel free to share with whomever you feel may benefit from the information. If you attempt the four tips above and still struggle with the impact the myths of motherhood have on your emotionally, mentally, in relationships or otherwise please reach out to a mental health professional for help.

Myths of Motherhood: Part 4

Myth Number Four: All Moms Worry

This myth is a tough one to “debunk”. Because the truth is, all moms will worry about their child at some point. This is certainly to be expected. One of my sayings with clients is that “it’s not a problem until it’s a problem”. How I define a problem is when there is a disruption in functioning.   When worry gets in the way of your sleep patterns, affects your appetite, work at home or in your place of employment, or is affecting your relationships, you know there is a disruption in functioning.

Unfortunately this level of worry and anxiety is common, (right now statistics show that Perinatal Mood and Anxiety Disorders affect 20% of mothers) which means that often moms will reach out to their providers, family or friends and are told that this is “normal”. There is a difference between common and normal. So even though this is seen frequently in women, it is NOT normal to worry to excessive levels that impact functioning.

Moms who worry constantly about something bad happening, experiencing obsessive intrusive thoughts, practicing rituals (cleaning, counting, reassurance seeking), racing thoughts, significant sleep and appetite disturbance, and/or panic attacks are suffering from clinical levels of anxiety which requires treatment.

Treatment may include medication, therapy or a combination of both which typical results in the best and quickest rate of recovery. If you or someone you care about are struggling during pregnancy or in the postpartum period , it’s important to get help to improve outcomes for both mom and baby. If you have any questions or concerns please feel free to reach out to me on my contact page.

Myths of Motherhood: Part Three

Myth #3: Since breastfeeding is natural it should be easy!!

NO WAY! Breastfeeding is NOT easy. So many moms get caught by the idea that since breastfeeding is natural it should come….well, naturally. But the thing is, breastfeeding is a learned skill for both you and your baby! Both of you are new to this, it can be messy, uncomfortable, and sometimes even painful. When moms struggle they often feel like this is some sort of failure on their part, but I assure you it is not.

There are so many variables that that determine the level of success or struggle that comes with breastfeeding. First let’s account for the fact that your baby is a complete stranger to you. You (hopefully!) wouldn’t walk up to someone on the street and offer your breast to them, so why would it feel any less awkward to do it with this brand new little person in your life???

Second, unfortunately, there isn’t a lot of support readily available to a new breastfeeding mom. In the hospital it is often a labor and delivery nurse who supervises the first breastfeeding session. Then you move to the maternity ward where you have another new nurse, or multiple new nurses with shift changes. In my personal experience a lactation consultant didn’t visit me until the day after my daughter was born and she completely contradicted what I had been told by the nurses! If after you go home you need additional support you need to seek it out and find it for yourself. Talk about stressful when you’ve got scabby, leaky nipples dripping with milk and a crying hungry baby!

Third, the sense of urgency and duty that comes with breastfeeding can often set you up for failure. Although the benefits of breastfeeding are undeniable, I feel we have gone a little off the deep end with all the “Breast is Best” campaigns. When a mom struggles to (or just plain chooses to not) breastfeed, they can often feel like they are somehow shortchanging their baby. They often try to muscle through the process, which can really have a negative impact on their moods, creating an even more risky situation for both mom AND baby.

Finally, you can’t force your body to do something it just isn’t able to do. I am aware of a lactation consultant who had all the training and resources around breastfeeding at her fingertips and she just didn’t produce enough milk to sustain her baby. No amount of breastfeeding cookies, biscuits or teas can overcome this biological barrier for some and it is not a reflection of you as a mom. All it means is that breastfeeding wasn’t a fit for you by no fault of your own.

What I know for sure is having support is going to set you up for the best chance at success. Consider taking a breastfeeding class when you are pregnant, hiring a postpartum doula for after baby comes (many are well versed in breastfeeding, are breastfeeding educators or lactation consultants themselves), and be sure you have the names and numbers of local lactation consultants handy BEFORE you need them. And as always, if you are experiencing a significant amount of distress around breastfeeding or other issues please reach out for help. You can click here to contact me.

Myths of Motherhood: Part Two

Last week I started a series on the “Myths of Motherhood”. We continue the series this week with myth #2

Myth #2: Bonding with a baby is instantaneous

Before I start first I want to ask you to Google the word “mother” and look up the images. What do you see? The majority of the images show beautiful, smiling, women, who are well dressed with their make-up on holding their newborn babies. Talk to just about any mother and they’ll tell you that the day their baby was born was the happiest day of their life and they felt instant love. I’m here to call “BS” on both!

The messages we receive communicate to us that these first days of motherhood should be blissful, and that as our babies are born the heavens part and angels descend showering us with a love greater than any other we’ve experienced. But the truth is, it’s very common and perfectly normal to feel the exact opposite, but many women are afraid to share their real feelings for fear of judgment from others.

The reality is that even though this baby is of you and your partner, they are still a complete STRANGER to you (and you to them!) It’s going to take time for you both to figure these new roles out. Not to mention the fact that you are doing it while you are bleeding, leaking, sore and sleep deprived. Especially with young infants, the relationship is very one-sided with parents giving, giving, giving and getting very little in return, it can be very difficult to feel connected.

So what do you do when you have a baby and you just aren’t quite feeling the love yet? The first thing is to give it time. Don’t put pressure on yourself to feel a certain way and just let it develop naturally. If however in additional to the lack of bonding you are noticing other things happening like excessive crying, sadness, irritability, sleep or appetite changes, a lack of interest or pleasure in things, or just plain not feeling like yourself you may be experiencing a perinatal mood or anxiety disorder like postpartum depression. This requires additional support and attention from a medical or counseling professional (or both!). If you or someone you know are experiencing these symptoms it is important to reach out. Feel free to connect with me if you have any additional questions or comments related to this topic, and stay tuned for Myth #3 next week!

Blog Series: Myths of Motherhood

Today I’m starting a five part blog series on the “Myths of Motherhood”. So many of my clients walk into sessions with a number of “shoulds” on their mind. This pattern of thinking tells them what a good mother should feel, say and do. These shoulds tell them how motherhood is supposed to be. The problem is that most of the time these ideas are unrealistic and based on their own distorted or unhelpful patterns of thinking. As a famous therapist Albert Ellis once said….Stop shoulding on yourself!! As you can imagine, it can make a real mess emotionally, behaviorally and relationally.

My goal with this series is to debunk some of these myths of motherhood to help you rethink the expectations you may be placing on yourself, help you realize you are not alone, drop the shoulds and maybe even extend a little self-compassion your way.

Myth #1: Every pregnancy is expected, wanted, excitement is the only acceptable emotion

Nope, they are not! In fact, the national average of unplanned pregnancies floats around 50%. That just goes to show you there are plenty of surprise babies walking around our streets every day (you might even be one of them!). The fact that a pregnancy was unplanned or even initially unwanted is NOT an indicator of whether or not you’ll be a good mother.

The thing is whether planned or not, pregnancies come with a ton of change, transition, loss and even grief. YES!  The “happiest time of your life” can include feelings of grief around the loss of your body, identity, freedom, spousal connection, work identity, finances, sex life, sense of self and SO MUCH MORE! Pregnancy can be delightful, or it can be really challenging. Just because you don’t love every minute (or ANY minute) of it does not make you a bad mom. This can be ESPECIALLY hard to accept for women who worked really hard to become pregnant. They often carry a sense that they should be grateful for every hemorrhoid and vericose vein that accompanies their pregnancy. I’m here to tell you….there AIN’T NOBODY WHO IS GRATEFUL FOR HEMORRHOIDS!

What’s really troubling is that we don’t get this kind of messaging as moms. The expectation by society, family, friends, and the media is the opposite. Images of happy, glowing moms flood our social media or Pinterest feeds. People ask leading questions like, “Aren’t you so excited?" or “Don’t you love being pregnant?”, with certain expectations for a happy, upbeat answer. You are frequently asked how you’re feeling but rarely is anyone is asking about your mental or emotional health. This puts a lot of pressure on moms to “perform”, often not being fully honest about how they are really feeling.

If you’ve ever watched “Sex and the City”, you might remember the episode where the character Miranda “fakes” her sonogram. When she finds out she’s having a boy the technician reacts with jubilation and expects Miranda to do the same. She follows suit, even though it’s not how she really feels. I’m sure anyone who has been pregnant before can identify with this pressure to be, or feel, or do to some extent.

Hopefully the acknowledgement of this idea as a myth allows you to be able to release the expectations and “shoulds” you are holding yourself to. If you find this difficult, or if your thoughts around this idea are interfering with your ability to function, you may benefit from getting some professional support on how to change this way of thinking. Feel free to reach out to me on my contact page for more information or support. Stay tuned for Myth #2 next week!!

Good Moms Have Scary Thoughts: A book review

Remember that song by Usher, “These are my confessions”??? Well here is my confession, it’s quite shocking…..I HATE TO READ. I really do. Even though I love to learn and find tremendous value in reading, I just don’t care for it (and don’t try and convince me to try audio books, because I just can’t absorb the information the same way in audio format!). But when this book by my hero, social worker and postpartum expert Karen Kleiman came out, I had to suck it up, purchase the book and dive in.

First a word about scary thoughts:

Most if not all new mothers will experience scary thoughts regarding the safety of their baby. These thoughts can be intrusive, vivid, and even violent at times, hence the name “scary thoughts”. These thoughts DO NOT mean that the mother is at risk of hurting her baby or herself. In fact, the distress caused by these thoughts, although quite unpleasant is a good sign to a therapist that the mother will not act on them. Unfortunately, moms are often terrified to share that they experience these thoughts for fear of being judged as “crazy” or even having their baby taken away.

The book is a great resource to provide education about these scary thoughts, normalize the experience and reduce the stigma around them. It is written in a lighthearted way with comics style illustrations depicting the types of secret scary thoughts moms experience while caring for their baby and in their everyday interactions.

In addition to the illustrations, the opposing pages have valuable information about what the thoughts mean, affirmations for moms, and even action steps for how to manage that particular thought or subject matter. The chapters address the different types of thoughts moms can have including general thoughts about motherhood, safety, the transition to parenthood, unsolicited advice from others, comparison, breastfeeding and much more.

Just because scary thoughts are common, what typically needs to be addressed in treatment is the distress that they cause. The book does a good job helping moms understand when and how to get help. The back of the book also has resources to access including helpful websites, how to find a trained therapist, and additional reading.

What I like about the book is that the information is delivered in small "bites”, which are much easier to digest, not just for a non-reader like me but certainly for a busy and overwhelmed new mom. The information, while covering a serious topic is presented with a lighthearted tone which helps it to be accessible to everyone who reads it. The book rings in at about twelve bucks and change on Amazon which comes in way under some of Kleiman’s other works.

I highly recommend this book for any mom. I think it would make a great baby shower or new mom gift. I’m a big fan of the adage “an ounce of prevention if worth a pound of cure”, so if a mom read this book before she experienced any scary or anxious thoughts she may be less likely to be blindsided by them and more likely to talk about them or reach out for help. I also think the book can be a tremendous resource for the partners, family, and others who support new moms.

If you or someone you know are having scary thoughts that are causing a lot of distress or interference in their life. It may be time to get some help. Feel free to reach out to me on the “Contact Me” page for more information.

And click here to order your copy of “Good Moms Have Scary Thoughts”.

What NOT to Say to a Grieving Parent

Yesterday I had the opportunity to attend a seminar on Perinatal Bereavement hosted by a local hospital. The event was geared mostly toward nurses and medical staff but I found much of the information helpful for anyone who touches the lives of those who have experienced the loss of a pregnancy or baby at any stage.

In addition to the general information provided we were able to listen to personal accounts of parents who have experienced a loss. Hearing their testimonies was heartbreaking to say the least but it was also extremely helpful because they were able to share what “worked” and what didn’t in terms of the support they received from those around them during this difficult time.

In this post I wanted to share some of the things NOT to say (as well as some helpful alternate options) when supporting a grieving parent. I want to be clear that I am certain people that say these things do so with good intentions. Hopefully you find this list helpful should you ever encounter a parent suffering this type of loss.

1. “Everything happens for a reason” or “This is just nature’s way of taking care of something that was wrong” : No parent who has lost a pregnancy or baby would find a reason including “nature’s way” any consolation for their loss. What you can say instead: “I’m so sorry this is happening to you”.

2. “At least you know you can get pregnant” or “At least you have other children” : Each and every baby is beautiful and special and the fact that there may be a possibility of a future pregnancy or that there are other children does not erase or replace the pain of losing this one. What you can say instead: “Tell me about your baby.”, “Did you get a sense of his/her personality?” “Who does he/she look like?”, or “What is the baby’s name?”

3. “This is God’s will” or “God needed an angel”: It’s best to avoid any talk of God or spirituality. Even if you know the parent’s spirituality is the same as your own, it’ s quite possible that an event like this may cause someone to question their faith or be angry with God (which is totally understandable!). Your comments may not bring any comfort and may even be triggering. What you can say instead: “I can see how much you love your precious baby” or “I will keep you in my prayers”

4. “Let me know if you need anything”: Most parents are so overwhelmed at this time they have no idea what they need and may require some direction. It may be helpful to offer specific options for the parents to choose from. Offering to facilitate a meal train, make phone calls, take older children to the park, or help re-organize or re-decorate the baby’s room can mean a lot even if they don’t take you up on the offer. What you can say instead: “I am planning to have food delivered for you. I will leave it in a cooler on the front porch tomorrow if you are not in the mood for visitors” or “Can I just sit here with you?”

5. NOTHING: This baby lived and was part of this family’s life, if even for a short time. Once the initial event of losing the baby and any services/memorials have passed the family still has a long journey ahead. Even though life does goes on, it’s important to continue to acknowledge what happened and the baby. I can almost guarantee the parents will think about that baby in some capacity every day for the rest of their life, you will not be “reminding them” if you bring it up. The worst thing that you can do is to never acknowledge it. Remembering the baby on special dates is important and sending flowers, a card, a kind word, or even a text can mean so much. What you can say instead: “I was thinking about you and (baby’s name) today, how are you feeling?” or “I bet (baby’s name) is so proud of you/happy for you”

I hope you find this information helpful, although my real hope is that you never have to use it. And as always if you or someone you care about needs support around the loss of a child, please feel reach out.

Overcoming the Winter "Blahs"

Winter in Syracuse is still coming at us full force.  Schools have used all their snow days, and everyone seems to be climbing the walls with symptoms of cabin fever.  However, for some the intensity and duration of the winter weather can bring or exacerbate symptoms of depression.  Here is a list of tips for managing

1.        Sleep: The winter months can make us want to hibernate.  The days seem shorter with the dark hours lasting longer than in spring and summer.  Even though it may be difficult to climb out of bed when it’s still dark, it is so important to maintain a regular sleep schedule as part of overall sleep hygiene.  Sleep is such a crucial element to basic self-care and so many of us are significantly deprived.  Try to improve your sleep hygiene by maintaining a regular sleep schedule, keeping weekend sleep-ins or naps to a minimum, keep screens off 30 minutes to an hour before bed, and engaging in a regular pre-bed routine.  Just like we would do for an infant, we need to provide our body cues that it is time to settle in for the night.  Lowering your lights, taking a warm bath or shower, using lavender essential oils, listening to relaxing music or meditations, and/or light stretching or yoga are all different things you can include in your new healthy routine. 

2.        Nutrition: For me, fall and winter months usually mean bringing on the comfort foods.  Unfortunately, these foods usually include rich sauces, soups and gravy, and are carb heavy which can be quite a departure from typical lighter summer fare.  It is important to maintain your nutrition year-round to be operating at your maximum capacity.  That means still incorporating fruits and vegetables in your routine daily and watching the typical increase in in heavier foods.  You don’t have to avoid your cold weather favorites but find ways to lighten them up and be sure to balance it out with nutrient dense and protein rich options as well.  You may also want to check in with your primary care physician (if you don’t have one – get one!!!) and get blood work done if it has been awhile.  Most of us become Vitamin D deficient during the winter months, so it may be beneficial to add vitamin supplements to your diet, as long as it is approved by your doctor. 

3.       Exercise: For many people, exercise is the thing they love to hate but it is a necessary component to your overall well-being.  For those who prefer to engage in outdoor activities, like running or biking it can be really challenging to maintain the same activity levels when the weather changes.  However, we know that winter comes every year, so it is important to make a plan and be intentional about how you are going to maintain your activity levels in the winter.  Join a gym, take a class, buy a treadmill, or break out your old Tae-Bo videos, just do something to move your body.  Research has shown that exercise 3-5 times a week for 30 minutes can have the same impact as a dose of Zoloft and for those already on antidepressants, exercise has been shown to enhance the results you are already getting.  

4.       Light Therapy:  For those who really struggle during winter months, light therapy may also be an option either on its own or in addition to medication management or psychotherapy.  The Mayo Clinic recommends that the lightbox should have an exposure of 10,000 lux of light and emit as little UV light as possible.  It is suggested you use the light within an hour of waking for about 20-30 minutes with about 16-24 inches between you and the light.  The lights are relatively inexpensive and can be found online for around 40-60 dollars.  Before you add a light to your Amazon cart it is important to check with your medical provider to ensure this is a good option for you, especially if you have any eye issues. 

5.       Socialization: Cold temperatures and snowy weather can make it easy to hunker down and stay inside, but when winter weather lasts 4-5 months a year, avoiding social interaction can really have an impact on your mood.  It just as if not more important to maintain social support and connections in the cold months as it is in the summer, even though it’s harder.  However, social support is an important factor in maintaining or elevating moods.  A tip I share with clients is to be very intentional about your social engagements.  When you run into a friend at the grocery store and share the pleasantry “let’s get together soon”, whip out your phone and schedule something then and there.  Life will often distract us from following up on that promise if we don’t do it right away.  Scheduling regular social dates can be helpful too, especially if you are trying to coordinate a group.  Planning to go out to eat every third Thursday means you start prioritizing your social commitments (read: prioritizing YOURSELF) and building your life around them, instead of the other way around.  Finally, if you don’t have many people to connect with a good resource can be www.meetup.com.  You can look up by region and find social groups for just about anything like book clubs, meditation groups, photography groups, dog walking, and more. 

If you know winter can be a difficult time for you, it’s important to try to get ahead of it by implementing these ideas sooner rather than later to beat the winter “blahs”.  If you try these and still find yourself struggling, you may want to reach out to your doctor or a therapist for additional support.  As always, feel free to reach out to me for any additional information or if you have questions. 

Postpartum Depression: NOT Just the Baby Blues

Having a baby is hard. Whether it’s your first or your fifth, the transition after bringing baby home can be challenging at best. And although that transition can come with a lot of emotional fluctuations, frequently referred to as the “baby blues”, Postpartum Depression is a whole other animal.

Frequently, when sitting across from a new mother in my office they share about their efforts to reach out for help. Maybe it’s to a family member, friend or medical provider (OB, Midwife or Primary Care Physician). What boggles my mind is how often they are told that what they are experiencing is “normal”. While unfortunately Perinatal Mood and Anxiety Disorders (PMADs) such as depression, anxiety, OCD, PTSD or bi-polar is very common affecting approximately 20% of mothers (and 10% of fathers and non-gestational parents) it is NOT normal.

I would like to share what differentiates the baby blues from a PMAD so in the event you or someone you care about is affected you will know when it’s time to reach out and get the right kind of help to feel better faster.

Baby Blues:

• Transient mood shifts throughout the day marked by tearfulness or irritability

• First 2 to 3 weeks (at most)

• Influenced significantly by hormonal shifts and sleep deprivation

• Does not significantly affect functioning

• Affects 70-80% of new mothers

• Not a mental health condition

• Resolves itself over time

PMAD (Postpartum Depression or Anxiety):

• Excessive sadness or worry most of the day for most days

• Extends past the first couple of weeks

• Impacts functioning for example, inability to sleep (even when baby sleeps), decreased appetite, unable to concentrate, decreased enjoyment in things

• Scary, vivid and intrusive thoughts about harm coming to baby (both intentional or accidental)

• Disconnection from or excessive clinginess to baby

• Feelings of guilt, shame, inadequacy, worthlessness and/or hopelessness (“Bad mother”)

• Low or no motivation to complete even simple tasks

• Just not feeling like yourself

• Does not get better over time

If you or someone you know are experiencing the symptoms of a PMAD it is imperative you reach out to a medical or mental health provider to get the appropriate help. Prognosis for recovery is much better the quicker the symptoms are recognized and appropriately treated. If your provider tells you it’s “normal”, and just take a walk or get some more sleep and you still feel like something is just not right, keep reaching out until someone listens! A wonderful resource is the Postpartum Support International helpline at 1-800-944-4773. You can speak with someone who can get you connected with providers in your area that can get you the support you need.

If you are local to Syracuse or the Central New York area and think you may be suffering from Postpartum Depression, feel free to reach out to me through my website or call me at 315-552-0180. You are not alone and you can get better with help!

I'm Writing a Blog!!

Welcome!

I am so glad you are here. One of my professional goals for 2019 is to write a blog in the area of reproductive and maternal mental health. The purpose of the blog will to be to provide education through posts, book reviews, links to resources and guest blogs!

Some topics that will be covered are:

• The difference between baby blues and postpartum mood and anxiety disorders (postpartum depression)

• How to recognize and manage anxiety

• Self-Care

• Finding and maintaining social support

• Infertility and loss

• Postpartum planning

• Getting sleep

• Grief of parenthood

And so many more!

Please feel free to comment below on any additional topics you want to hear about and stay tuned!!!