Three Important Truths for Moms During the Pandemic

You are not making a wrong decision.  Parenting is already full of conflicting philosophies that leave us second-guessing our decisions. The pandemic has added a whole new layer to stress out about. Should I let me kids go to school and risk getting infected with COVID, or should I let them learn from home, but risk them missing out on social interaction or falling being academically? Should I let my kids still play with their friends whose families are less cautious or risk them feeling lonely and isolated if I don’t let them play?

Anxiety that goes along with making decisions is the fear of making the “wrong” decision. However, just as there is no perfect, right decision in this situation, there is no totally wrong decision. You will make the best choice for your family based on the information you have. That’s all any of us can do. 

Self care is more important than ever. It may seem a lot more challenging now, but self care is still a necessity, not a luxury. Moms are notorious for putting themselves last and doing things for themselves only if there is time leftover (which is basically never). You need to plan time for yourself to do the things that bring you a little bit of peace and joy. If the things you would normally do, seem too risky now, think of how you can still do something similar. 

If you normally enjoy an exercise class or going to the gym, see what you can find online to do at home. Walk, run, or hike outside. If you need some peace and quiet and you feel like you have nowhere to go, ask your partner or family member to watch the baby or kids while you take some uninterrupted time to yourself. If that is impossible at home, go for a drive and just park somewhere or walk around the block or to a quiet space. If you really count on time your friends and social support as part of your self care, try to schedule time to meet up outside or at least do a video chat with time set aside to actually enjoy each other’s company and check in.

Remember, self care does not have to be all-or-nothing. It may not be exactly how you want it right now, but that doesn’t mean you should just forget about it. Self care doesn’t have to be perfect to be valuable. 

It is okay to set boundaries. The pandemic has created a whole new area of conflict. The differences people are taking in precautions and social distancing has caused quite of bit of anxiety, anger, and hurt feelings. This is especially true when it involves family wanting to spend time with you and your children. While your idea of keeping your kids safe may seem overly dramatic to your parents or in-laws, their more frequent social outing may seem reckless to you. 

Since people have different ideas about what constitutes reasonable behavior during a pandemic, it is important to communicate what your expectations are. If you are worried that someone else’s behavior is putting your family at greater risk to virus exposure, explain clearly what you are comfortable with in order to spend time with your family. If they are upset by that or don’t agree, it is okay to wait. It may feel uncomfortable to you, but you have a right to your feelings and expectations and the right to determine what is best for your family.

Cognitive Distortions of Motherhood

We all have ways of thinking that distort reality a bit and make us feel bad about ourselves or others. Therapists call these thoughts cognitive distortions. They become much more frequent and intense when we are depressed or anxious, making us feel even worse. The distortions become so automatic, that we are often not even aware of how we are thinking. One of the most important elements to improving mental health and self esteem, is to become aware of how we are thinking and learn how we can challenge thoughts that are not accurate. 

In my experience, moms really know how to turn up the distorted thinking and channel it into all sorts of guilt and negative self judgement. The following examples of cognitive distortions are used by all types of humans, but I want to highlight some examples of how they can particularly apply to moms.

All-or Nothing You think in absolutes. It is black or white with no gray, good or bad with no acknowledgement of all the possibilities in between. Perfectionist frequently use all-or-nothing thinking.

Examples: I got frustrated and raised my voice at my children. I am a terrible mother.

If I don’t have perfect, beautiful decorations and food for my daughter’s birthday, then her day will be ruined.

Catastrophic: You take one minor issues and automatically predict the worst-case scenario.

Examples: My daughter’s preschool teacher told me that she has been not wanting to share lately. Something must be wrong with her and she is going to be labeled as the kid that is a troublemaker. She will probably continue to have a lot of emotional and behavior problems throughout her years in school. 

It is cold and flu season. If my son gets sick he will be hospitalized or die.

Should/Shouldn’t - You use should (or shouldn’t) in statements that create a sense of guilt.

Examples: I should be happy and enjoying my maternity leave. 

I shouldn’t miss having time to myself. 

Mindreading You make assumptions about what others are thinking.

Examples: When my friend told me about the parenting book she is reading, she was trying to give hints that she thinks I am a bad mom.

My husband isn’t talking as much tonight. He must be mad at me.

Reverse Mindreading You think others (mainly your partner) should know what you’re thinking. These often involve some should statement.

Example: He should know that I am exhausted and need him to clean up the kitchen. I shouldn’t have to tell him.

Social Media Comparison: You look at photos and posts and assume people are leading perfect, happy lives without considering it is only a pictures of a moment in time. People often want to share positive things and not all of the dirty details of their problems. 

Examples: She is always doing such great activities with their kids. I’m so lazy and boring.

They always look like such a happy couple. I bet they never fight like we do.

Magnification/Minimization You focus on the negative and minimize the positive. If you acknowledge the positive, there is often a “but” statement that follows to discredit or minimize the good.

Example: We were able to all sit down together and have a dinner that everyone liked, but I really should have made something healthier. 

My kids had a great time at the park today, but I was tired and didn’t play with them enough.

Double Standard You apply a higher set of standards to yourself.

Example: You think other moms have a right to feel exhausted and take a break when there are too many activities to manage, but not you. You think you should be able to handle everything on your own without complaint. 

Overgeneralization You take one instance and apply it to all.

Example: I felt nervous and awkward at the mom’s group, so I know I will never make new friends.

I realize I have some of these thinking patterns, now what?

Changing how you think starts with awareness. Thought patterns become so ingrained and automatic that we often don’t even realize what we are thinking. It takes a lot of practice and effort to recognize cognitive distortions, but it you start to notice what you are thinking when you are feeling especially stressed, anxious, angry or sad, then you will better understand how your thinking is affecting your mood. 

So, when you realize your thinking involves cognitive distortions, what do you actually do about it? You want to be able to acknowledge that how you are thinking is not quite accurate and look at a better way to reframe your thoughts to something more realistic. 

Thought: “I got frustrated and raised my voice at my children. I am a terrible mother. “

Reframe: Although I wish I hadn’t raised my voice, I have had a long exhausting day. It is normal for moms to feel frustrated.

Thought: “It is cold and flu season. If my son gets sick he will be hospitalized or die.”

Reframe: I will take normal precautions to prevent illness, but I know that illness is a common part of childhood. The likelihood that something serious would happen to him is very low. I can talk to his pediatrician if there is a problem.

Thought: “I shouldn’t miss having time to myself. “

Reframe: It is normal to want time to do things I want to do.

These are just a few examples to give you an idea. Thought patterns don’t change overnight, so give yourself some time. Remember, reframing distortions isn’t just happy thoughts to trick yourself into feeling better. Depression and anxiety will lie to you and make you believe things that aren’t true. Working towards more a realistic perception, can make a dramatic difference in your overall wellbeing.

Mamaste

Therapists like to talk about the importance of self care and making time for yourself. Comical, I know. Where is this magical time going to come from? You may think “I can’t get 5 minutes alone to go to the bathroom, much less, time to renew and recharge my spirit. When we talk about self care and relaxation, we don’t mean a weekend at a spa retreat (although that would be really awesome). Ideas of holistic wellness may sound like a far-off dream, but we are actually referring to smaller, more realistic activities. We are talking about intentionally carving out time to do something that is relaxing or fun just for you. This can even be 10 minutes if that is truly the only possibility. Self care is not all-or-nothing. It’s not going to be perfect, so make it the best you can.

Movement Notice I said movement. I often avoid using exercise because this word seems to conjure up images of marathons and intense, two-hour sessions at the gym. I am talking about something that simply involves the movement of your body. A walk around the block, a yoga video, dancing, or whatever you are into is great . Something you are willing to start with that doesn’t sound too overwhelming. If you like it and can incorporate more of it, awesome. You will be more willing to start small and work your way up, than to dive right into an intense workout routine. The idea is to move your body for your overall physical and mental health, not to become some super-fit, workout machine. Exercise and movement can be very beneficial to improving your mood and reducing anxiety, so make it something feasible that you are more likely to do and stick with.

Meditation, Mindfulness and Calming Activities You Think You Can Never Do Have you ever tried meditation? It is hard. At first, it goes something like this: “I am going to clear my mind. I am going to try really hard not to think. I have so much to do after this. What was that noise? Okay, back to focusing on my breath. My legs are uncomfortable. Why did Judy make that rude comment to me at work yesterday? I’m so glad it’s finally the weekend. Crap, I’m thinking! What am I supposed to do? Oh yeah, not judge my thoughts. Imagine them floating away. Floating. Like that time I floated down the river with my brother on summer vacation. That was fun. How many years ago was that trip? Maybe we should plan something this summer. Oh no, I’m thinking again! I can’t do this. I’m not the type of person that can sit still and turn my thoughts off.”

Meditation takes a lot of practice. Despite stereotypes, you don’t have to be a super laid-back, hippie type or Buddhist monk to get the hang of it. Plenty of CEOs, military leaders, and athletes have espoused the benefits of meditation. Here is a helpful article that explains the basics of meditation.  You can also search for guided meditation on YouTube or even use an app like Headspace. 

If traditional meditation really isn’t your thing, there are still plenty of other ways to slow your mind down and be more present. The key is finding what speaks to you. There are an endless array of free YouTube videos. Do you feel relaxed at the beach or sitting by a mountain stream? Try sitting a few minutes with the sound of ocean waves or a river, close your eyes and imagine yourself there. If you need some help with imagining all of the sensations, look up guided imagery pertaining to whatever scene you prefer. Progressive muscle relaxation is a great way to release tension by focusing on different parts of your body. You might find it helpful to just sit in silence (clearly a bit difficult with small kids around) or put on headphones and listen to spa/relaxation music. Experiment to figure out what is most helpful for you.

Breathing Obviously, we all know how to breath. It our most basic and necessary task, yet there are some ways of breathing that can actually make us feel more anxious while deeper breathing can help us feel more calm and centered. Shallow breathing is when you breath in using your chest muscles. When you are anxious your shallow breathing tends to become more rapid and it can feel like you are not getting enough air, which in turn, signals to your brain that something is wrong, which makes you even more anxious. 

Diaphragmatic breathing is a deeper breath that uses your diaphragm. Where the heck is your diaphragm anyway? Basically, it is a muscle below your lungs. When you use the diaphragm to breath, you help manage stress and anxiety because it lowers your heart rate, reduces oxygen demand, and can lower your overall stress level. 

To practice, put your hand on your stomach. Close your eyes and breath in through your nose. As you breath in visualize the air going all the way down to your abdomen(this isn’t what is actually happening, but it helps in getting your muscles to move the right way) and your abdomen filling up like a balloon. Your abdomen will expand as you inhale and contract when you exhale. If you are not used to doing this, it feels weird and unnatural at first. The more you practice, the easier it becomes. I definitely suggest practicing at a time when you are not feeling anxious because when your are anxious you won’t remember what you are supposed to be doing. It is a good way to retrain yourself to breath all of the time, but it is also helpful to slow down and just focus on your breathing when you also want to slow your mind. Here is a good example of the basics of diaphragmatic breathing.

Go Outside You don’t have to be an “outdoorsy” type to enjoy the benefits of fresh air. Spending time outside can be a great way to boost your mood. It can be whatever setting that is desirable, feasible, and accessible to you. It doesn’t have to be a dreamy outdoor destination, it can be your backyard, an urban park, or anywhere outside you feel safe. Outdoors is a great place to practice some mindfulness. Notice what it feels like. How does a breeze or warm sunshine on your face feel. If it’s nice you can even take your shoes off. Feel the grass, the sand, or the dirt. Pay attention to what you hear and smell. What do you see that can really spend some time to fully observe for just a minute?  If you feel like adding in a walk or some movement, even better, but not necessary. You can also just sit there and do absolutely nothing. And if your outside time involves chasing around some kids, it can still be much more therapeutic and energizing for everyone than another day stuck in the house.

Also remember, it is important to spend time doing things that you enjoy. Even if you have long forgotten what it is you actually like to do, try to spend a little time figuring it out. Time for yourself is not a luxury and it is not selfish. It is a necessary element to being a healthy human. 

I'm Scared I Might Kill My Baby

A mom is chopping vegetables for dinner and suddenly has the thought about a knife being dangerous and next thing she knows, she is having a thought about stabbing her child. Terrified that she even had that thought she puts the knife down, but can’t stop worrying that she may be capable of harming her child.

Another new mom is changing her son’s diaper. She thinks about how innocent and vulnerable a baby is. She wonders how anyone can molest children. Then she begins to wonder why she was even thinking that. She questions if she was thinking that because maybe deep down she is some sort of pedophile. She becomes tormented by this thought and is consumed by fear that she may molest her son. She begins to wonder what kind of monster she is to even think this and dreads changing his diaper and bath time. 

One of the most terrifying and misunderstood postpartum disorders is Obsessive Compulsive Disorder. OCD can take different forms, many people are somewhat familiar with certain types like the fear of contamination that leads to compulsive cleaning and hand washing. Intrusive thoughts is another category of OCD that often involves unwanted and repetitive thoughts involving violent or sexual thoughts and images. For postpartum women, intrusive thoughts tend to focus on their child. Thoughts may be about something horrible happening to their child and/or fear that the mother herself may hurt the child. 

Because most women have no idea what intrusive thoughts are, they often suffer in silence, too afraid to tell anyone what they are thinking. The important thing to understand is that what is happening is OCD, an anxiety disorder. OCD makes thoughts get stuck in your head and gain more power over you the more you try to fight them. That is why it is important to remember that these are just thoughts. Because you are thinking them, does not mean you will act on them or have any remote desire to act on them. We all have weird, random thoughts. Typically, we may have a weird thought and then just move on without analyzing it or thinking it has any meaning. However, when you are more vulnerable to depression and anxiety, like in the postpartum period, these thoughts may feel harder to ignore and you can’t let go of thinking it has some deeper meaning. 

You don’t have to suffer with intrusive thoughts. A therapist experienced in treating OCD can help you learn how to react to them. This mainly involves understanding these are just thoughts, learning to not fight them or try to block them, and practice tolerating the anxiety of experiencing these thoughts. You may also want to consider talking to your doctor. Not all doctors are familiar with postpartum OCD, so If you are not comfortable disclosing what you are experiencing, you can explain that you have been suffering with high anxiety. 

Just know that you are not crazy, you are not evil, and you are not alone. This is temporary and treatable. You are a great mom. 

Good Moms Have Bad Days

Motherhood. No matter how well-prepared we think we are for the all-consuming experience of being responsible for another human's every need, we're not. Its intensity is nearly impossible to understand until we are smack-dab in the middle of an all-nighter followed up by a morning errand that involves an hour and half of preparation just to get out the door. And that's before you realize that you have milk and spit up all over your new favorite outfit consisting of yoga pants and the t-shirt you slept in last night. 

As exhausting as the physical demands are, they can pale in comparison to the emotional roller coaster that never lets you off. Love and adoration can easily give way to anxiety and doubt. While some women seemingly ease into their new role, others struggle to find balance and joy. The negative feelings that can come with motherhood are talked about so little that women often worry that something is seriously wrong with them as mothers. We all know the good things that come with raising children, but we need to talk more about our uncertainty and fears and let go of the idea that good mothers never have fantasies of vacations in tropical locations WITHOUT their children. So, let's dispel some of those modern, mommy myths.

The bond between mother and child is not always instant. While you no doubt love your child and want the best for them, that unconditional, indestructible bond you have always heard about may not appear the second you meet. Many factors can affect how you bond with your baby including the circumstances around the pregnancy (it was unplanned, there is a strenuous relationship with the father, the pregnancy was very difficult), your own physical and mental health, and just simply because there is no exact formula for bonding with your baby.  It does not mean that you are a bad mother and that you are never going to feel closer to your baby. All relationship take time to develop as you get to know each other and the mother-child relationship is no different. Give it time to grow.

No one else immediately knows what they are doing either. For some reason, we tend to have the assumption that good mothers always know just what their baby needs and know exactly how to do it. Advice from family and friends (and strangers) can make you second-guess your mothering abilities and wonder why they don't think you have a handle on things. An unconsolable, crying baby can make you believe that you don't know how to soothe your own child. And those Facebook posts with photos of sleeping babies whose mothers are proclaiming that their precious angels have been sleeping through the night since 3 weeks old make you want to punch the computer and head out to the nearest happy hour.  However, the truth is that there is no perfect mom out there who magically knows just what to do at all times. Everyone learns from experience. Babies have different temperaments. Moms have different personalities. Households run differently. You will get to know what works best for your child and your family. You may not always know exactly what your child needs, but you will figure it out. 

You will miss your old life. This doesn't mean you wish your child wasn't born. It does mean you will think fondly of the good ole days of accepting a dinner invitation without needing two weeks notice to plan for a sitter, showering whenever you want, or going to the grocery store without running NASCAR-like around the store in an attempt to avoid a level-10 meltdown. You may be surprised to realize that you now recognize 5 minutes alone in the bathroom to be a cherished part of your day or that getting up at 6:45am is considered sleeping in. And many women I talk to secretly, or not-so-secretly, are counting the minutes until they can return to work. All of this is normal and okay. Having times when you wish simple tasks were not as complicated as they are now does not mean that you don't love your child. Even though your world has changed, it is important to plan and make time for yourself. Motherhood may be the most important thing in your life right now, but it is not the only thing. Remember that you still need friendship, hobbies, and purpose besides motherhood. You will be a better mom and a healthier human being if you do.

Everything is not going to go as you have planned. This is especially hard for the type-A personalities to digest. Caring for a tiny human requires a lot of planning. You definitely need to develop some sort of routine and don't want to be caught off-gaurd without diapers and necessary supplies. However, given that children are free spirits of their own, you cannot control every factor in their life to produce the outcome you most desire. The more rigid you are in terms of your expectations, the more you are setting yourself up to be disappointed and frustrated. You can save yourself unnecessary anxiety by accepting that some elements will be out of your control. It doesn't mean YOU are losing control. Approaching motherhood with some flexibility and an understanding that we may have to change course at times can go a long way in preserving your sanity. 

You might end up resenting your very supportive partner.  You and your partner have alway divided up household duties and responsibilities. It was never assumed that you would be responsible for all of the domestic duties simply because of your gender. Your relationship has been built on mutual respect and equality. Then why do you find yourself glaring at his peacefully sleeping body and wishing you could stop his snoring by smothering him with a pillow? It may be that as the mother you find yourself the sole source of food if you are breastfeeding which makes for a lot of long nights and hazy days. You are also more likely (in the US at least) to be the one taking a longer maternity leave or choosing to stay home. So, he assumes you know exactly what to do and he doesn't want to get in the way or be accused of doing something wrong. Your typically insightful partner has seemingly regressed into some sort of child-like version of himself that has to be told what simple childcare task to do next, and you figure that you shouldn't have to tell him what to do, so you will just do it yourself. You end up angry, resentful, and exhausted. You can choose to keep things this way because he most likely is not going to magically transform into a baby whisperer. Or, you can communicate how you are feeling, what you need, and what he can do to be helpful. The latter is more likely to give you some type of relief rather than waiting for him to acquire the ability to read your mind. 

You are not going to permanently scar your child. The heated debates around various parenting philosophies and techniques are enough to leave you petrified of the long-term damage you may impart on your child if you do things the wrong way. Obviously, a framework of love, encouragement, and stability are essential. I am not saying that the parenting path you implore has no effect on you child. I am saying that your child is not automatically on a path of doom because you let her eat Fruity Pebbles or watch too much TV on rainy days. In the 15 years I have been working as a therapist, I have never had anyone tell me their depression or anxiety stems from being bottle-fed or because mom went back to work too soon. The people that have emotional issues and resentments stemming from childhood typically have endured parents that have abandoned them, frequently put them down, abused them, or showed a disregard for their feelings and wellbeing.  A lack of homemade, organic meals or perfectly-implemented enrichment activities has never been a complaint. 

It is okay to talk about the challenges of motherhood. "Did you ever know you could love something so much?". "Everyday is a blessing".  "Nothing else matters anymore". Hearing heartfelt comments from well-intentioned folks gush about motherhood makes you wonder if your the only one that wants to hide under covers when the baby is waking . Of course you are not going to delve into a heartfelt discussion with every person that asks about your child. Yet, If we started talking more about the diversity of feelings that accompany motherhood, we could start to normalize mixed feelings and let go of the guilt. It makes us feel less alone and more understood. Many of the women I see struggling with ambivalence about motherhood, feel that any frustration or doubt is sign that they must be a horrible mother because "this is not how I am supposed to feel". We need to let go of the idea that we "should" or "should not" be feeling something. That only creates a cycle of guilt and loneliness. Know that your feelings are not right or wrong. Of course, if you have constant sadness and anxiety, then it is time to talk to a professional. But, if you find yourself with a mix of good days and bad days, joy and frustration, bliss and overwhelming stress...welcome to motherhood.

What Is Therapy Anyway?

So you’ve heard about therapy. Perhaps a friend has gone and said it was helpful or you doctor recommended you see a therapist for the depression or anxiety you’ve been experiencing. But what actually happens in therapy? Do I have to lay on a couch? Tell some new-agey healer all of my childhood fears? Take a psychological test to find out what is wrong with me? Does the therapist tell me exactly what I need to do to cure myself for good within a specific timeline? Does it mean I am crazy or weak if I go to therapy?

I have been asked all of these questions and more, but there isn’t a simple, black-and-white answer. For the purposes of this description, I am taking about individual therapy. However, therapy can involve couples, families and groups as well. Generally speaking, therapy involves a therapist that is either a psychologist or someone with a master’s degree in counseling or clinical social work. Therapists do not prescribe medication. Psychiatrist are Medical Doctors with a speciality in psychiatric medicine that prescribe medication. A therapist provides psychotherapy and will refer the client to a psychiatrist if medication if needed (although it is also common to start with the client’s primary care or OBGYN). 

We refer to the time between a therapist and a client as a session, which typically last 45-60 minutes. Typically, sessions are weekly or bi-weekly depending on the needs of the client. Sessions are usually moved further apart as the client progresses (or schedule or finances change). Some clients may see a therapist for a few sessions and feel improvement, while others may be working on deeper for long-standing issues that actually take a year or more to work through. While my goal is for clients to feel better as soon as possible, there is no quick fix or magic wand. Long-term solutions to improving mood, relationships, self esteem, and thought and behavior patterns, don’t happen overnight. However, that doesn’t mean you won’t see improvements for a long time. We see slow and steady improvements as signs of sustainable progress.

What actually happens during the therapy session can vary widely depending on the therapist’s particular orientation and the needs of the client. Therapy can explore very pragmatic coping skills and problem solving, expand understanding of how past experiences are impacting your current thoughts and behaviors, involve more experiential interventions like meditation, art, and hypnosis, or include any combination of these and numerous other practices. 

However, regardless of what intervention is used, research has showed time and time again, that the most important aspect of therapy is actually the relationship between the therapist and the client. A therapist can be an expert in all types of fancy psychological theories and practices, but if you don’t feel comfortable with them or trust them, there is not great potential for progress. I will make notes about what happens in session, but everything remains confidential unless I believe your are in imminent danger of hurting yourself or someone else or there is suspicion of child or elder abuse. Otherwise, I am required by law to not disclose any information about you without your written permission.

I totally understand that sitting in a room with someone you just met and telling them some of your most personal information and feelings can be an odd and uncomfortable experience. I do my best to make it feel less like some sort of Fruedian psychoanalysis, and more like a regular conversation. With issues around postpartum depression and anxiety, there will be some educational components of what is going on and what to expect. With all of my clients, we spend time trying to understand how the way your are thinking is affecting your feelings and behaviors and work to reframe those negative thought patterns. We will also examine how relationships are impacting you.

We will develop treatment goals. I can write up goals with typical measures and interventions that satisfy insurance and professional standards, but what I really want to know is what YOU want to get out of therapy. Bottom line, you are the expert in you. Therapy is not so much me telling you what to do, but helping you figure out how you can change what is not working for you. You understand better than anyone how you think, experience emotions, and how you want your life to be different and better. I will be your guide and biggest supporter in getting there.