Thursday, September 10, 2015

Old Wounds

As a marriage therapist, one of the biggest reasons couples present for counseling is because they say they want to fight less, and learn how to fight fairly. Many times, they think the solution is just about communication- reducing black/white/all/nothing statements, namecalling, stonewalling... all that good stuff. And while that is important, a bigger part of therapy that will result in deeper connections and healing is uncovering what is beneath the scars, and being vulnerable with each other about those old wounds.

Think back to your common conflicts in your relationships. Really observe what happens- like creating a flowchart in your mind. Where is the breakdown? What is the moment when all hell breaks loose? That is generally where an old wound has been triggered. That is where people will engage in negative behaviors, or shut down. When something from the past, whether childhood or previous relationships, or both, has been reopened. All of your insecurities, worries,
and fears come bleeding out, and you don't know how to stop it.

How to break this painful cycle? Here are some techniques that I have found helpful in my practice:
  • When you are both hurting, picture your partner as a child. When old wounds are sliced back open, we emotionally become a much younger age. In fact, many survivors of trauma find themselves stuck at the age they were originally wounded. Instead of holding on to that anger, attempt to connect with the vulnerability that your partner is showing, even in what is sometimes very ugly behavior. This visualization can often result in a much-needed emotional break for you both to regroup and reconnect in a better way. (Note: This does not apply to abusive behavior. If your partner, male or female, is harming you physically, emotionally, or sexually, that is a different topic, and one that requires seeking professional help). 
  • Sit down with your partner and make a timeline of the events in your lives that have wounded each of you. This will help you both see where you are vulnerable, and will help you be more aware of what to keep in mind when needing to have emotional conversations or conflict. Share each others events, and help your partner understand why this hurts you- even if it doesn't make sense, or seem logical. When we are in conflict, we are rarely logical. 
  • In conjunction with the timeline exercise, have a discussion about each of your families of origin. Talk about events, how conflict was handled (or not handled), how emotions were expressed, if there were emotions that were not allowed to be expressed, abusive behaviors, and other topics that you feel have shaped you. 
  • Read the book "Hold Me Tight" by Sue Johnson. It is just SO good, and all about attachment in relationships. It helps couples stick together when they want to push each other away. Enough said.

The key is awareness. Learn what your old wounds are, and be honest- not just with yourself, but with your partner. Take a chance to let him know what has happened that has contributed to that response. This is when true healing can begin. 

Monday, August 17, 2015

Not what I envisioned... Part 1

When I was inspired by this topic, I realized that I could take this post in two different directions. And since I am not a professional writer, I decided it would make more sense to my readers for me to break this subject up into two different blog posts.

With my specialty in perinatal mental health, I work with many people who feel shame about their emotions as they navigate new parenthood. Women especially grow up with an image in their heads about what being a mom was going to look like. They envisioned being blissfully pregnant, then having an unmedicated, vaginal birth, followed by a beautiful mother/baby bond that nobody could break. They would hold their baby and attend to every need, knowing exactly what to do.

I have never met anyone who actually had this experience. Have you?

Processing this involves grieving, which means stepping outside of your shame and embarrassment, and learning to accept that you will not get your dreamed of parenthood experience. And that this is OK. Normal, for lack of a better word. There are three main tasks involved in this process, although not everyone will go through these at the same rate, time, and even order. It is also helpful to note that if your partner has his/her emotions about becoming a new parent, s/he may not feel the same way that you do. And this is OK. Talk about it anyways.

Task 1: Getting angry. Many people are raised to feel that anger is not acceptable. You "shouldn't" feel this way, or anger is bad. Anger is not the problem. And anger is fueled by fear and anxiety. So take some time- a day, a week, a month- to understand your anger rather than judge it. Are you angry that you were robbed of your envisioned experience? Are you angry at someone in your life who contributed to this? Let yourself feel that. Journal about it. Write therapeutic letters to the people who you feel have wronged you, or to yourself (note: do NOT send these letters, at least not right now!). Talk about it with a trusted person or therapist. Just don't keep it locked inside, stuffed down by shame.

Task 2: Allowing sadness in. This is another toughie for people. Sadness is often associated with depression, when really- sadness is a normal human emotion. Many men, especially, don't know how to express sadness, as they are raised to believe that it is not OK for boys to cry. Women tend to be more comfortable with sadness, but may feel guilty that they feel sad about their experience- they "should" just be happy that they have a healthy baby now. But reality is, that this is a process, and the more you fight sadness, the longer it will take. So feel it- again, journaling and letter writing can be helpful. Crying to a trusted friend or family member or therapist can also be helpful. Don't resist.

Task 3: Acceptance. First, we must define acceptance. Acceptance does not mean that you are happy with the way things went or turned out. It just means that you accept it. It is what it is. And you may have moments of feeling sad or angry at times, but you find that these are fewer and far between. You don't feel guilty for your feelings any longer. You have a new meaning for your experience, and some people use this meaning to help others.

There is no timeline for these tasks, and they will go more smoothly if you don't fight them. We are all a work in progress!

If you have recently had a baby, and you are finding it overwhelming to parent, help is available! My, and several other MN resources, information are all part of Pregnancy and Postpartum Support MN. See the resource list at, or call the PPSM Helpline at 612/787-7776. You are not alone!

Thursday, May 28, 2015

What about dad's village?

I have spent a lot of time this past month focused on maternal mental health. We had the Daisy Dash 5K (our annual fundraiser for PPSM) mid-May, a screening of a documentary on maternal mental health, Dark Side of the Full Moon, and today, spent the day at the Beyond the Baby Blues conference.
When people discuss perinatal mental health, much of the focus is on moms. This is definitely important, as statistics show that 1 in 5 moms will struggle with some form of perinatal mood or anxiety disorder. The numbers may be even higher.

But did you know... dads can also get postpartum depression (PPD)? Depending on which site you are looking at, stats are roughly 1 in 10 dads. That is way more than many people realize, and WAY more than we are talking about.

Why is this?

Men with depression look very different from women with depression. Men are not weepy, sad, or talking about their feelings (in general). They tend to become withdrawn and easy to anger, and pour themselves into their jobs, hobbies, and, sometimes, substances (alcohol or drugs). The odds of depression increase further if the dad has ever experienced depression in the past, and if his partner is depressed.

We need to talk about this. Dads need a "village" too. But their village may look very different, so it's important to recognize this.

Here are some ideas for dads who are struggling postpartum, and really need an outlet for that:

  • Self care is important. Aside from sleeping as well as possible, and eating, other things like exercise and time for yourself are key. Is it harder with an infant? Yes. But not impossible. If your partner is struggling too, have a discussion about how you are both going to take care of yourselves. It would benefit you to work out a plan or schedule for this. It may also be necessary to enlist help of others- such as friends or family members who can come be with your partner, so that you do not feel guilty taking time to go to the gym or going out with friends. It may mean asking someone to take the baby for an hour or two so you can go have a date with your significant other. 
  • Support... while there is definitely a shortage of men's mental health resources, especially postpartum, it is not impossible to find. Below, I will list some specific resources geared towards men, some specifically for depression, but others just more about the challenges of being a dad. Feeling at times like you don't know what you're doing. Feeling like you aren't sure what to do with a newborn who eats, sleeps, cries and poops. Wondering what happened to your partner.... while men tend to not talk about feelings, it is OK to share your story and speak your truth. 
  • Professional help may be a good idea. In my practice, it seems that men have an easier time accepting the idea of taking medication for depression versus going to therapy. AND THIS IS PERFECTLY FINE. If you have felt depressed, down, hopeless, angry, or having thoughts of running away or harming yourself, medication may be an option to explore. If you do decide you would like to talk with someone, whether that is therapy or a support group, it is really important to find someone who is trained in perinatal mental health or understands male depression. Resources like Postpartum Support International, and in Minnesota, Pregnancy and Postpartum Support MN, are great places to look to find people who will get it. It is hard to open up to a stranger about what is supposed to be the greatest event of your life, so make sure you have someone who understands. It is also an option to attend some sessions with your partner. If she is going to therapy, ask if you can come along sometime. She will probably LOVE that, and it is very helpful as a therapist to get both perspectives, and for me to assess depression or anxiety in both members of the couple. 
Dads are SO important. Your relationship with your baby matters too!


Locally (in Minnesota):

Dads groups can be hit or miss. But some places to check are and Facebook. PSI also has phone chats for men, and PPSM has a free HelpLine for all new parents and their providers who are in need of resources and support. 

P.S-- there are NO books specifically for dads with PPD!!!