Therapy from the Therapist’s Perspective

In this post, Stacy Stefaniak Luther, PsyD, LPC, answers some questions about therapy and what a new mom can expect should she decide to seek help from a trained therapist.

What are some opening thoughts you’d like to share about therapy?

Visiting a therapist can be very intimidating. It takes courage not only to schedule that first appointment but also to attend that appointment. It can be weird, or awkward, to share your personal story with a stranger. Despite these facts, therapy is an effective way to tackle a variety of mental health concerns including those experienced with a perinatal mood or anxiety disorder. Furthermore. therapy can also serve as a means of self-care, which can be difficult to schedule with an infant but is also critically important to mom’s overall well-being.

As a therapist, I recognize the strength it takes to walk into the office each session and bare your soul; sharing intimate details of yourself and your life. But there is something so special about each individual’s story and the details of this story are worked into the therapeutic approach. Therapy is grounded in research, but treatment isn’t one-size-fits-all.

What can I expect at my first session?

Typically, the first session is a “get-to-know-you” session where the provider will ask a lot of questions and you will be encouraged to ask questions as well. Information about follow-up sessions is discussed at this time in addition to diagnosis, treatment, informed consent, confidentiality, and other more technical aspects of therapy. The first impression during this session is critically important. If you are not comfortable, (say so!) and ask about different providers. A client needs to feel comfortable sharing details that may be private and sensitive; therefore, finding a provider who is a good-fit is essential. Professionals will never be offended if the relationship spark just isn’t there. The relationship is the catalyst for healing so don’t be discouraged if finding the right partnership takes time.

How long is a typical session?

Therapy sessions are anywhere from 30-60 minutes, with 45 minutes being average. During these sessions, you are invited to sit back, relax, and share. The therapist will listen and help you reflect. You will also have the opportunity to learn and practice different skills outside of session. Most importantly, there will be validation that the emotions you are experiencing and the thoughts you are having are real and okay.

How often do I need to come to session?

There are many factors that contribute to scheduling future sessions. Typically, although each situation is unique, you will be asked to schedule 1 session a week (or every other week). During these sessions, your willingness and ability to be open and vulnerable is instrumental in determining the effectiveness of therapy.

Can I bring my baby (and/or my older children) to therapy?

If it serves as a barrier to treatment, a good therapist will encourage women to bring infants (and other children) to session if they want to (or have to). Other times, a mom who is able, might choose to find childcare so that she can enjoy her session independently. It is up the mother to determine what she is most comfortable with and what her lifestyle allows.

What is a therapy office like?

Offices are set up in a variety of different ways, yet all are designed to promote comfort and ease. These are not like your primary care provider’s office. Therapy offices are set up with a home-like atmosphere and often reflect the therapist’s personality.

What is a final message you’d like to leave our readers with?

One theme that is extremely common for the women I work with is how alone they feel. The truth is, there are others out there who have had similar experiences or who are currently experiencing the same difficulties. The women I work with have struggled with infertility, experienced the heartbreak of miscarriage, stillbirth, and infant loss. I’ve seen women who did not want to be pregnant or have children who become pregnant, women who struggle to bond with their infant, women who experience intense, frightening intrusive thoughts, women who are sad, women who are scared, women who don’t feel like themselves…the list goes on. It is so important to know that you are not alone. Perinatal mood and anxiety disorders exist but so does treatment. There is no shame in asking for or receiving help!

We would like to thank Stacy Stefaniak Luther, PsyD, LPC, for sharing her perspective with us. If you would like to learn more about Stacy and/or are local to central Wisconsin and would like to schedule an appointment with her, you may find more information on her website: http://www.bhcwausau.com/learn-stacy-luther-ms/ .

You Can’t Tell by Looking

Recently, in our social media feed, we shared a graphic stating “you can’t always tell by looking”. The truth of this statement rings staggeringly true for so many moms fighting their way through the postpartum period.

First, let’s start by considering the expectations we (and society) have placed on ourselves well before baby’s arrival. The nursery needs to be perfect and the house clean and organized. Baby will be dressed in one of the many new, adorable outfits he or she was given and we should be back in our old jeans in no time. Breastfeeding will come easy. This will be the happiest time of our lives. For today’s moms, these impractical expectations are reinforced and perpetuated by idealic Facebook and Instagram posts that set a new bar to which we measure ourselves and our success as a mother.

When this picture was taken, the world saw a mother enjoying an afternoon with her kids at the park. But the reality was that I was at rock bottom and was being completely annihilated by my postpartum anxiety and OCD. While at the park, my mom was on her way to town to help care for my children. Because I was too afraid to be alone with them, this burden had fallen solely on my husband. Intrusive thoughts plagued my mind constantly and I hadn’t eaten or slept much in days. If I was forced to be alone with my kids, I’d keep them outside so that if I went crazy, a neighbor would hear me and save them. I incessantly asked my husband for reassurance, thought daily about checking myself into a hospital and often wondered how much longer I could go on this way. Surely, my kids deserved a better mother.

For some reason, we tell ourselves that the world must never know the pain we are feeling. A mom might tell herself that no one can know how hard it was for her to get out of bed today or that she hasn’t been able to sleep, even when baby is sleeping. No one can know that as she forces herself to rock her baby, she thinks about how she might have made a mistake and how she might wish she never became a mother. No one can know about the terrifying and disturbing thoughts and images that fill her head. So to keep these secrets, she slathers on the concealer, smiles and tells everyone all the things they want to hear.

You also can’t tell by looking, the woman who has suffered a miscarriage. Who is agonizingly grieving the loss of a baby that the world never knew. Or, the mother who carried a child only to lose him or her in some unimaginable way. She might wonder who could understand the physical and emotional torture she has experienced. And then there is, perhaps, the most extreme example of the “you can’t tell by looking” phenomenon which is the mother who hid her struggle and pain so well that the world is shocked when she takes herself from it.

It is true. We can’t always tell by looking but there are a few things we CAN do to help moms come out of hiding. We can ask moms how they are doing…how they are really doing. We can equip them with the information on and the symptoms of perinatal mood and anxiety disorders. We can preemptively point them to resources near them that can help should those symptoms arise. We can take the fear out of treatment – whether that be therapy or the need for medication. We can help moms feel less alone by sharing stories of our personal struggles and providing peer support. Finally, we can work towards ending the stigma around maternal mental health and dispeling the idea that motherhood requires perfection. So maybe you couldn’t tell by looking but I am grateful to have the courage to share that mine is the face of a perinatal mood and anxiety disorder. You are not alone.  

–Written by Alexis Bruce

Somewhere Along the Way

Somewhere along the way, mothers are often forgotten. After giving ourselves entirely to the process of growing and birthing a human, it’s unfair that we don’t still share the spotlight when our tiny miracles arrive. But the second we start to feel like we should receive a portion of that love and adoration, we shame ourselves for being selfish.

Somewhere along the way, we might have experienced trauma. And at some point, we started to believe that trauma had only one definition. And that because the pregnancy, labor or birth we experienced may not fit the criteria for this definition, we are not allowed to give it such a label.

Somewhere along the way, this motherhood gig started to look entirely different than what we envisioned. Picture perfect images of a glowing and rested mama holding her peaceful, sleeping babe are replaced with sleepless nights, alarming intrusive thoughts, nursing difficulties and an anguish that makes even the simplest of tasks seem insurmountable.

Somewhere along the way, we might feel as though we lost ourselves. We might grieve the life we once had. The freedom, the friends, the finances now might seem like worlds away. We might wonder if we made a mistake. We might wonder if we have what it takes to be a good mother. We might wonder if our families would be better off without us.

Somewhere along the way, we might feel hopeless. We may feel overcome by darkness and unable to see a way out. We might feel anxiety so intense that we are afraid to leave the house, afraid to sleep when baby sleeps or we might even be too afraid to be alone with the very being we once longed so strongly for. We might have flashbacks, or terrifying nightmares, of birth trauma that bring us instantly back to that wretched place. We might have thoughts that make us question our sanity, our baby’s safety or if we are truly a monster at our core.

But somewhere along the way, we realized that we are not alone. We realized that we are front and center in the spotlight of our baby’s eyes. We realized that baby doesn’t need perfection, just love and just a healthy, happy mama. We realized that trauma is subjective, that our feelings are valid and that we deserve to allow our wounds to heal. We realized that nothing about motherhood will likely be the way we envisioned and we realized that freedom from these expectations lies in acceptance of this fact. We realized that it’s okay to grieve the life we had while also exploring new facets of our identity. And, perhaps, most importantly, we realized that the darkness was not forever. We realized that help is available. We realized that it was in our struggle that we found our strength.

Written by Alexis Bruce

Entering the New Year with Radical Acceptance

A new year is upon us. We may not be ready to leave the one left behind; or, we may be grateful to let go and never look back. For some of us, this was a wonderful year. We achieved recovery. We worked incredibly hard, we saw the light at the end of the tunnel, we grieved, we cried, we conquered. And for some of us, the cloud of darkness hasn’t lifted as we are still in the throes of our battle with a perinatal mood or anxiety disorder.

The new year tends to make us want to set goals, both realistic and not. We attempt to define the best version of the person or mom we want to be. She, most often, is not the reflection we see in the mirror. This realization can lead to feelings of guilt, shame and defeat which perpetuate cycles of depression and self-loathing. But, trust me when I say, you are already enough, mama.

Instead of viewing the turn of the year as a fresh start or a new beginning, we spend time beating ourselves up about all the things we didn’t accomplish, the days we couldn’t get out of bed or the number of times we lost our patience. We relive the failed medication trials, the sleepless nights and the panic attacks. We dwell on the things we may have missed due to our illness and we question our strength and our resolve. We question if we were meant to be mothers at all.

But we cannot live in either the past or the future; therefore, we must learn to accept wherever we are on our journey. We must embrace what we are capable of right now and truly believe that whatever that is, it’s okay. We need to sit with our emotions, good or bad, and acknowledge that both are part of the human experience. In doing so, we learn to sit with our anxiety, discomfort or pain and experience even greater joy when good times arrive again.

So, enter this new year day by day, or even moment by moment. Set appropriate boundaries and expectations for both yourself, and others. Ask for, and accept help, professional or otherwise. And perhaps, most importantly, do what you can to care for and love yourself for, without self-compassion, all other efforts are futile. Know that we often discover purpose in our pain and through this, you will learn so many amazing things about yourself. I know how hard you tried, mama. I know how hard you’re still trying and how you worry that you will never be able to NOT try so hard again. But you have it in you. This new year may not be without its trials, but you will overcome. You are enough…strong enough, brave enough and loved enough. And, you are never, ever alone.

-Written by Alexis Bruce

A Post of Hope: Jessica’s Story

Trigger Warning: suicidal thoughts

“Stop fighting with your past, it’s over now.”

This is something I have been telling myself for a long time. It’s still hard to believe and accept that I have lived through (and survived) the most difficult time in my life. My babies are my greatest gift and I work continuously to help them be smart, sweet and caring human beings. I love them. But, in the back of my mind, I still hear the word, “remember.” Remembering is something I have to do daily. I force myself to remember my struggle so that I will continue to implement the changes I worked so hard to put in place…don’t do too much during the day, stop and play with the girls, it’s 8:00 p.m., the dishes can wait till tomorrow. Remember to breathe. Remember it’s okay to say “no.” Remember to schedule some “me” time.

My story begins with the birth of my first baby and my struggle with (what I now know was) postpartum anxiety (PPA). I had a terrible birth experience and went home very sick. It was incredibly difficult and I still don’t know how I survived those early days. The breastfeeding fails, a baby who wouldn’t sleep, being alone a good part of the day, the complete and utter exhaustion. That was my life for the first few months. When I finally began to feel a little better, I went back to work. Being the “Type A” person that I am, I thought I could do it all and not ask for help. Everything needed to be perfect and in accordance with the way I wanted to to be done. I always wanted to have a plan and to know exactly what was coming. In hindsight, I can see that this was a way of trying to cope with the anxiety that’s been a part of me all my life.

Living with anxiety was much easier before baby. I had the time to clean, organize and make sure everything was done correctly. But having a baby made this nearly impossible. Now, the baby came first. I began to crack. I tried to balance it all while taking care of my baby and working as an RN; but, I became easily frustrated and angry. I felt full of rage and started to experience intrusive thoughts which just made my anxiety worse. I never fully recovered and I never got help. I knew something was wrong, but I just kept going.

I became pregnant with my second baby when my first was three. This pregnancy was harder than the first. Sickness, anxiety and depression began to kick in. I sought help from a therapist because I just couldn’t handle my thoughts sometimes. I also began seeing a psychiatrist. Wonder why it took me so long to get help? Well, for starters, I didn’t know I had PPA. It sounds odd, but when I continued to ask for help at multiple doctor appointments, I was told that I was a new mom and that all this was normal. I should have spoken up and taken a stand, but I just figured the doctors were right.

Thankfully, the postpartum period with my second was not as hard as my first. I remember thinking she was my second chance and I was so happy for the first few months. I decided not to go back to work after maternity leave and I resigned. This baby was much better; but, handling a three-year-old and a newborn began to take its toll.

To make a long story short, after multiple medication attempts, months and months of frustration, anger, yelling, struggling to get through day-to-day life and feeling like a terrible mother, I officially broke. In the summer of 2017, when my youngest was 18 months old, I just wanted to run away and I became suicidal. I wanted to be done with everything. I was exhausted from trying so hard and getting nowhere, exhausted from being with my thoughts and tired of thinking I was crazy.

By August of 2017, I was in a partial hospitalization program. For three weeks, I went daily and, thankfully, I came out a different girl. The tools I learned in the program helped me more than words; however, what helped me the most, was knowing that I wasn’t alone. Suddenly, I knew I wasn’t crazy, that there was help and that I was doing what I needed to do to survive.

Since completing the program, I continue to learn about myself. I have a few “rules” that I follow daily (which are difficult for me sometimes). 8 o’clock is my cut off time and whatever isn’t done, gets done tomorrow. I journal, I went back to work part time and my kids are in school full time. Life is different. It is good and a daily struggle all at the same time. But I got through it and so will you!

In conclusion, my fellow moms, my message to you is to ask for help. Stand up for yourself. Perinatal mood and anxiety disorders don’t just affect moms, they affect the entire family. Establish some rules for yourself to help you keep on track. Learn to say “no.” Remember you are doing your best and that your kids don’t want a perfect mom, they just want you. I will say that these changes won’t happen overnight. You’ll likely have good days and bad days but always remember that you matter. Your feelings are real and don’t ever let anyone tell you any different. Care for yourself everyday and continue to move forward by remembering that you can stop fighting with your past, it’s over now.