Pregnancy and Postpartum

Struggling with body image during pregnancy

struggling with body image. weight scale. prenatal appointments and weighing in

The worst part of prenatal visits? Going to your healthcare provider’s office and stepping on that scale at Every. Single. Appointment. As if you need any reminder that your weight is increasing at an alarming rate. You know this. You feel huge. No other pregnant mom looks as big as you do. You shouldn’t have eaten that extra serving. Why won’t these pants fit anymore? … Do any of these thoughts sound familiar? Struggling with body image is a huge frustration during and after pregnancy.

Being pregnant can be incredibly challenging if you’re struggling with body image or disordered eating. Yes, rationally you’re aware that this peanut growing inside of you is taking up a lot of real estate. You’ve read all of the instagram posts about body positivity, and know you “shouldn’t” be feeling this way. But, all of that aside, you still feel lousy when you see your reflection or step on the scale. So what can you do? If you’re struggling with body image, here are some thoughts to consider:

Re-assess “normal weight gain” in pregnancy

When you’re pregnant, your body is truly being taken over. Your metabolism shifts, your energy wanes, stretch marks suddenly appear. It’s natural, and it’s hard. When you’ve spent a long time meticulously taking care of your weight and appearance, these drastic changes to your body feel jarring. Check in with yourself about how you are seeing these changes. Is there shame and personalization involved? Are you feeling at fault for gaining “too much”?

body mass index (BMI) and impact on body image. Addressing BMI during pregnancy. healthy weight gain guidlines

Unfortunately, we have been given guidelines that it’s “normal and healthy” to gain 15-30 pounds during pregnancy. But this number is based on BMI, which research continues to point out is a flawed system for assessing health. Your recommended weight gain varies on so many factors. This number shifts based on whether your BMI was over or under prior to pregnancy. Your weight gain will vary if you are having twins. The number on the scale will look different if you’re struggling with hyperemesis gravidarum or if you’re managing your nausea by eating differently. In reality, only a third of pregnancies stay with the recommended weight gain, while about 50% gain beyond this number.

Speaking for my own body, with my first son I gained 45 pounds during my pregnancy, whereas I gained 20 with my second. I didn’t do anything differently. Bodies changes and babies are different. It isn’t personal. You’re not doing it wrong. That number on the scale doesn’t say anything about you or how well you are doing this pregnancy.

It will not be forever

This is not your forever shape or size. I do not have a crystal ball to confirm you will go back to your pre-baby weight, and I won’t deny that perhaps you’ve gained weight. However, the size you are while pregnant does not stay on forever. Whether it’s 6 weeks postpartum or 6 months postpartum, your body will change after delivery. Remind yourself as many times as needed that it took you 9 months to help your baby develop. Give your body at least 9 months to settle back to what it considers is the “new normal”.

Find safe others

Talking to safe person about body image. Struggling with body image during pregnancy.

It’s easy to feel isolated with our crummy feelings. Body positivity is an amazing trend that our culture is trying to lean into; however, it doesn’t leave much space to acknowledge when we are struggling. When we feel ashamed or alone in our thoughts, it can be debilitating. We become worried that others will judge us, shame us or minimize our feelings. If you have judgmental folks like this in your life, they are not the ones to turn to right now.

Find those who truly appreciate how hard this is for you. They know that you want to be healthy AND they respect that body image is something you’re struggling with today. This person doesn’t need to know how to fix the situation. Instead, they just need to let you know that you’re heard, you’re loved, and you will always be safe with them irrespective of how your body looks.

Use movement

using movement to help address prenatal weight anxiety. walking to help with pregnancy and body image

During pregnancy, find ways to move whenever possible. Let go of the standards that you used to meet whether it was a certain distance, speed, repetitions, or weight level. Focus instead on what movements means to you. For me, movement provides me opportunities to let go of stress, it helps my body feel strong, and it helps me feel energized. Once I stopped trying to meet my old standards, it felt easier to accept that this is what exercise could do for me today.

Our Society and Thin Privilege

I won’t deny that being thin and beautiful doesn’t have privileges (read more about thin privilege). Thin privilege allows for your weight to not define you and how you move through your environment and world. There is an awful amount of discrimination with fat phobia. People living in a larger body have been overlooked, groaned at, or mocked because of their weight. In these situations, being thin means they will finally receive respect and courtesy from other people. Being thin means the ability to walk into a store and actually be able to buy clothes. If you’ve been subjected to others’ fat phobia, you may have coped by maintaining a certain weight. Pregnancy has thrown this weight plan out the window.

If being pregnant or weight gain puts you into a space of losing your self-respect or self-worth, that’s not okay. It’s not okay for society to put you in this position or for you to suffer simply because of the way your body naturally flows. So how do we learn to externalize this? How do we shift from assuming there is something wrong with us to there is something biased and unfair about the culture we live in?

Tips for boosting body image:

tips for improving body image. shifting the way we think about our bodies. diet culture. comparing.
  • Diversify what you see: Follow influencers of all shapes and sizes. Follow those who look like you and don’t look like you.
  • Stop the comparison game: Envy is a tough emotion to contend with, and it leaves us feeling lacking. Start by checking the facts: do you know for sure that this person truly has more than you? Do these factors make them better or happier than you?
  • Highlight your own positive attributes: Notice what is awesome about you, and spend time acknowledging these positive traits. e.g. expressing pride in your career or grades, appreciating the health of your relationships
  • Become critical of toxic diet culture: We all know it’s out there. Start by challenging these constantly shifting body ideals. Unfollow or speak up about the companies and individuals that make you feel bad about your body.
  • Focus on what your body is doing for you: What are your thighs, arms, and belly meant to do? What are their functions? Focusing on their role as a function vs.

What are you avoiding by focusing on body image and food?

Sometimes body image acts as a (horrible, awful, exasperating) scapegoat for our actual struggles. By focusing on that number on the scale, you may find that you can avoid addressing other things. You spend hours staring at the fridge, planning meals, going to the gym, organizing your closet with “comfy” clothes, that you don’t have time to deal with the real stuff.

We all cope in different ways. Previously, you may have turned to a glass of wine, a cigarette, or going out dancing to get rid of all your stress. Now that you’re pregnant, these coping mechanisms aren’t as available. Food, on the other hand, is always there and doesn’t take as much effort. It soothes our stressors and pains. But, using food as a coping mechanism offers a temporary solution. It doesn’t allow us to address the actual cause of stress and turmoil in your life.

So ask yourself, if you didn’t spend all this time on body image and food, what would you be left with? Would you suddenly have to address your loneliness? Are you more aware of your anxieties about work, the state of your finances, or your struggling relationships? If we looked at negative body image as a coping mechanism (again, not vouching that it’s a nice or effective one), we realize it’s trying to prevent you from dealing with a deeper vulnerability.

Addressing the original trauma: When did this struggle with body image start?

body image and teenager. Struggling with body image in pregnancy. trauma from childhood

Body image rarely shows up in pregnancy without some form of history. Consider when else in your life have you struggled with this issue. Have you been painfully aware of your appearance since adolescence? Have you managed to shove aside any struggles with your appearance by exercising and maintaining a “healthy” diet? When did you make the connection between your appearance and your self-worth? How was this message taught to you?

When it comes to body image struggles, pregnancy makes things worse. However, it’s not the culprit. After your little one is born, things may feel manageable with dieting and exercise, but it’s a fragile set up. Anytime that weight starts to increase, that same panic may come back.

If this has been your experience, then it’s important to recognize that there is some earlier trauma to be addressed. Your body image struggles could have slowly formed while participating in gym class, listening to your mom comment about her (or your) weight, looking at skinny actresses and models, or a myriad of events. These moments stayed with you. That vulnerable part of you still worries about your appearance, fitting in, or whether you will be considered “worthy.” This is where therapy can be helpful in processing these earlier emotional burdens.

Reach out

If you or a loved one is struggling with body image during pregnancy, reach out. Therapy is a safe space to voice your concerns and work through these difficulties. Schedule a free consult call to see if we would be a good fit.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Mental Health

Overcoming shame

Your system holds a lot of shame. There is shame about who you are as a person. You feel that you do not belong and are unloveable. You have been rejected by others. There’s no way you’ll put yourself out there again. You carry shame about earlier decisions. Because you acted this way, you feel raw and exposed. There is a constant sense of dread that reminds you, “Never again will I make that mistake.” You hold a lot of shame about failures. You’ve messed up, said the wrong thing, wrote the wrong answer. Your stomach goes in knots just thinking about it. You feel ashamed about inaction. It repeats incessantly that you should have done something, acted differently, or reacted faster. You feel ashamed about who you are as a parent. You keep thinking your kids would do better with someone else. When all of this is hurtling towards you, how do you overcome shame?

Dealing with Shame

Overcoming shame. Why it is so hard to deal with shame.

It’s hard to acknowledge our shame. We worry that others will judge and reject us for our deepest insecurities, so we don’t speak up. Because shame is so uncomfortable, we tend to push it away. We avoid addressing it, only to have it repeatedly show up. We feel awful, alone, and hopeless in this pattern.

Thanks to Brené Brown, most of us have are familiar with the benefits of addressing shame and vulnerability. In theory, we know one of the best ways out of shame is to be nice to ourselves and accept that we are imperfect human beings. Dealing with shame involves validation, self-compassion and seeking connection with others. That’s the simpler answer. The more complicated answer involves addressing all of the parts of us that block this work. To overcome shame, we have to deal with many other internal layers (e.g. our inner critics, our avoidant parts, our self-hatred, our panic, and other struggling emotions).

Getting to know our parts:

Internal Family Systems therapy recognizes that our mind is compartmentalized into protective categories or “parts”. There are three different parts inside of us: Managers, Firefighters and Exiles. In order to overcome shame, we need to understand how these parts play a unique role in improving and delaying our healing.

Exiles

Overcoming shame. How our early experiences create exiled parts. Internal Family Systems therapy. IFS and shame

During traumatic and painful events, our minds suffer. We struggle to get through these horrible events. As time goes on, we start to carry negative beliefs about ourselves based on what we experienced. We suddenly feel we are insignificant, weak, unattractive, incompetent and don’t belong. These wounded parts of our personality are what IFS refers to as “exiles.” Exiles absorb the impact of traumatic and difficult events. Exiled parts carry our vulnerable emotions and beliefs. They learn to feel ashamed of themselves, that there is something fundamentally bad and flawed about them. Shame is not an innate feeling. We are not born feeling ashamed of ourselves. It is something we’ve learned based on our environment and experiences.

Sitting with our shameful exiles can feel unbearable, so we form some protection. We do whatever we can to prevent these parts from becoming triggered. We do whatever we can to shut them down quickly if they are triggered.

Managers

Manager parts. IFS and overcoming shame. Internal family systems therapy. Kasi Shan Therapy offers counselling support in Kitchener, ON

“Managers” are the first layer of protection. These parts help us stay safe by doing whatever is possible to stop our exiled parts from getting triggered. For example, if your exiles believe that you are unattractive, your manager parts may pester you to work out daily or wear makeup. If your exiles cannot trust your own judgement, then you may have manager parts that constantly seek reassurance from others. Worried about being stupid? Your manager parts prevent you from every trying or moving up the career path so your intelligence will never be assessed.

Manager parts focus on preventing us from feeling hurt, wounded, ashamed, or any other exiled emotion. They do this by pushing us, criticizing us, reminding us to keep going, doing more and never becoming vulnerable again.

Firefighters

firefighter parts.IFS and overcoming shame. protective layers to deal with shame

The second layer of protection is referred to as “firefighters.” When our exiled parts are freaking out inside, our firefighters know it’s important to contain that flame. So they react. They work on quick fixes to settle the fire down. They use distractions and various forms of self-soothing when our system gets triggered. For example: someone calls you unattractive, your firefighters seek comfort in a nice bottle or three of wine. You realize you made a mistake at work, your firefighter parts draw attention away by yelling at other colleagues. Your exiled part is triggered for overeating, your firefighters compensate by purging and over-exercise. Firefighter parts are aware that the pain has come up, and they focus on getting rid of that pain as quickly as possible through any means possible.

Shame Starts Young

When we are young, we long to be loved and accepted. We want to belong and feel significant. When our parents meet these needs, we’ve struck gold. Our system can relax when we make mistakes. We don’t personalize it, and we move on fairly quickly.

For those of us who have not “struck gold”, our system gets hijacked following a mistake. We fear reproach, criticism, disappointment, anger, or any form of negative feedback from our caregivers. As kids, we don’t have a whole lot of resources, so we internalize these messages. We start to believe that there is something wrong with us: We are a screw up, we are incompetent, we do not deserve good things. This moment creates our exiled parts.

How our parts become intertwined in the shame pattern

exiled parts. Internal Family systems therapy and overcoming shame. IFS

Despite knowing that we will continue to be hurt and rejected, we can’t help but reach out to our caregivers. What other choice do we have at a young age? Our exiled parts are always looking for a better ending. They want redemption. They want our parents to somehow stop their patterns of anger and criticism, and instead, turn to us with love and warmth.

Our manager parts are also paying attention to these attempts. Our managers learn what is and is not effective in keeping your exiled parts from getting in trouble and feeling ashamed. They are aware of what pisses off your parents, and triggers your exiles to feel ashamed once again. For example, if you know that being slim and attractive gets your mom’s approval, your managers will continue to berate you to go to the gym and start another diet. Ironically, these managers shame us for making the wrong choices in order to get us to learn. You don’t need your mom to continue to shame you, your manager parts will repeat her words for you.

endless cycle between manager and firefighter parts. IFS and handling shame.

Unfortunately, our exiled parts keep trying. Your mother may present as biting and cold, but this doesn’t stop your exiled part. You continue to invite her to outings, provide thoughtful mother’s day gifts and call every Sunday. When you are hurt and rejected by her lack of interest, your firefighters come in trying to extinguish the pain. They encourage you to drink, hook up with a random person, lash out at your partner, or any other means in hopes of releasing this shame. And, once again, our managers (e.g. that harsh inner critic) attack for making poor decisions.

Working with our protective parts to overcome shame

ogres, onions and protective layers. Dealing with shame metaphor

Forgive me for using a Shrek reference here. IFS reminds me of Shrek’s comments that ogres are like onions: we all have layers. There are layers and layers of protection we use to keep our exiled parts safe. We can’t deal with shame if we do not address the managers and firefighters that maintain our shame cycle. As Donkey wisely reminds Shrek: “”You’re so wrapped up in layers, onion boy, you’re afraid of your own feelings!” We get so caught in protecting ourselves, we get scared to actually help our exiled parts.

To overcome shame, we have to first work with our protective parts. It’s hard to show love and self-compassion if a harsh critical voice keeps dismissing your kindness. You may have difficulty forgiving yourself if a firefighter part continues to binge drink. Shame rarely works alone; it always come with protection. So to overcome shame, we have to work with your entire system. We have to gain trust and permission from these protective parts to give you some space so that you can work with your exiles.

Internal Family Systems Therapy and your shame

In therapy, I focus on creating a safe space for your entire system to show up. This includes all the parts of you that are eager to get started, as well as the parts of you that dread working on these issues. This is normal. When we have experienced shame or been shamed by others, our system launches into a protective stance. It’s braced for rejection and judgement, even in the context of a safe therapy setting. It’s important to take the time to build that therapeutic trust before launching in to your most vulnerable concerns.

Shame deserves self-compassion, belonging and validation. Healing comes from witnessing these painful moments, learning to see the safety in today, and trust in your own capacity to handle things differently. The resources you had back then are not what you have available today. Your exiles and protective layers aren’t always aware of that. They often see you still stuck in that place of trauma, and react accordingly.

Reach out

If you are struggling with shame, and would like to work with your internal system, reach out. Schedule a free consult to see if this is a good fit for you.

All the best,

Kasi


Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum

Shame and the postpartum experience

One of the biggest aversions to attending postpartum therapy is shame. You feel ashamed that your emotions are messy. This isn’t like you. Normally, you’re calm and cool. But, suddenly your hormones are all over the place, your hair is a mess and you can’t remember the last time you showered. There hasn’t been a single day where you haven’t burst into tears or rage.

shame and postpartum. perinatal mental health. shame and pregnancy.

You feel ashamed about your relationships. It feels like a huge risk to acknowledge how you truly act around your family. What would the other person say if you admit you don’t really like your baby? What if you told them you sometimes screamed at your children? Are they going to judge you if you tell them you’ve stopped breastfeeding? Would you get mocked for admitting you haven’t had sex in months? What if you revealed that you suddenly can’t stand your spouse? How will the other person react?

It’s incredibly vulnerable to open up to a stranger, especially if you worry how he or she will respond. So rather than talk, you stay silent. Shame feels awful, but it protects you. It keeps you safe from being judged. But it also means you are stuck with all these difficult thoughts and feelings bubbling inside.

The shame of mental health

Despite all of the social media posts, campaigns, and recognition about mental health today, there is still a stigma in admitting we are struggling with mental illness. You may worry about what it means to be attending therapy or starting medication. Does it make you incompetent? Are you still able to say you are a good parent if you also admit you are mentally unwell? How do you cope with your family members telling you to “suck it up” or “get it together?” All of these shameful questions and thoughts prevent you from admitting that you need help.

shame and postpartum. perinatal mental health. shame and pregnancy.

Perinatal mood and anxiety disorders are genuine illnesses. During pregnancy and postpartum months, an individual could live with anxiety, depression, OCD, bipolar disorder, or PTSD. The chance of experiencing any one of these illnesses is not uncommon (e.g. approximately 1 in 4 Canadian mothers reported experiencing symptoms of postpartum depression or anxiety).

As with any illness, you deserve appropriate treatment and care. It is not a matter of will power. We cannot wish it away. My favourite recommendation is to consider how you’d talk to a friend in a similar position. Chances are you would be more compassionate and open-hearted. For example, following a surgery, you would encourage said friend to attend medical appointments, take prescribed medications, and follow their health team’s recommendations. In the same way, would you be able to give yourself the permission to seek the treatment and attention that your mental health needs?

What if the therapist judges me?

Every therapist claims they are nice and nonjudgmental. That doesn’t mean you truly believe it. For those cautious and skeptical parts of you, I want you to know, that’s okay. It’s absolutely okay to have your guard up. Starting therapy feels awkward. As with every relationship, it takes time to build trust.

Take the time to share slowly, if that is what your system needs. Watch how your therapist responds to your words and concerns. You will notice that you either feel more settled and at peace, or if your shame increases. Trust this internal feedback. If you are comfortable, let your therapists know you feel this way, and see how they respond to your words.

Will I get in trouble?

shame and postpartum. perinatal mental health. shame and pregnancy.

One of the biggest fears that pushes clients away from voicing their experiences is the fear of how others will react. In prenatal and postpartum therapy, I see many clients hesitate to talk about how they truly are with their children and relationships. Not only are they managing their internal shame, but they are weary of judgement and negative consequences. Clients are often fearful because they fear the truth will lead to the therapist ending the relationship, calling the Children’s Aid Society or disliking the person. So let’s address these fears:

1) If I am truthful, my therapist will end the relationship:

In most cases, therapists will only end the relationship if they are outside of their clinical scope or the treatment goals have been met. If you have met your treatment goals, that’s wonderful! Celebrate all of your hard work. You don’t necessarily have to end your relationship with your therapist, but you can talk about tapering off sessions or increasing the time in between appointments. If it’s loneliness that drives you to stay, your therapist will support you in exploring how to improve outside relationships. It is not okay that the therapy room is the only space where you are heard, validated and supported.

If your counselling goals are beyond your therapist’s knowledge and skills, they will admit this to you. It isn’t personal. Consider your experiences with other specialists. You may really love your hairdresser, but this is not the person who can necessarily answer your medical concerns. You connect with the clinician who is best able to meet each of your needs. If you keep asking your hairdresser for advice on all things medical, neither of you will leave satisfied or confident that your goals can be achieved.

2) What if they call the Children’s Aid Society (CAS)?

shame and postpartum. perinatal mental health. shame and pregnancy.

This is a common myth that prevents parents from reaching out for postpartum therapy. Postpartum depression often shows up as rage, anger, outbursts and distress. I see many parents who are frustrated with themselves and with others, but are too scared to ask for help in fear of being reported. Postpartum depression deserves respect, compassion and appropriate support. The only reason to reach out to CAS is if there is a genuine concern about a child’s physical or emotional safety. If there is a worry about abuse or neglect, your therapist will ask you directly. However, yelling at your child does not mean an automatic phone call for outside authorities. Having negative or intrusive thoughts does not mean we are automatically contacting outside authorities.

3) What if my therapist dislikes me?

shame and postpartum. perinatal mental health. shame and pregnancy.

I can’t speak for other therapists, but I can speak for myself about this worry. The beauty of Internal Family Systems (IFS) therapy is that IFS therapists are always looking for positive intentions. This means, irrespective of the behaviour, words, or emotion (anger, infidelity, jealousy, disgust, etc), your IFS therapist is always trying to understand how there are parts of you trying to get you through a difficult moment. It’s not about assessing whether the outcome is successful or whether the efforts are worth it. It’s about understanding the actual intention.

IFS therapists go to their own therapy. It’s how we do the work we do. If I feel triggered in a session, that’s an indicator that there is some part inside of me needing support and attention. It has nothing to do with you; it has to do with my own history and experiences. That part, similar to yours, will need support and processing. I take it to my own session or my supervisor. IFS therapists’ intentions are always to keep our parts out of the session, because in therapy, it really is about the client. It’s not about my agenda or my needs; it’s about yours.

The shame of not meeting our own expectations:

You had lots of hopes and dreams of how your pregnancy or postpartum months would turn out. Chances are you did not wish for mental illness.

Many of us struggle when our expectations are not met. We feel a sense of shame and inadequacy in falling short. You may have hoped to be a Pinterest-parent, and realized you have zero interest in arts and crafts. Perhaps you thought you’d enjoy spending days with the baby, and found you were bored out of your mind by week 4. Maybe you thought you’d ace the whole sleep training thing, only to be struggling 15 months later with a toddler who refuses to go to bed. Somehow these results create a sense of failure that we equate into our self worth.

For any parent who struggles with this sense of “inadequacy”, please know that you are not alone. We all have moments where we worry about being good enough parents. Remember that you have so many years ahead of you to figure this out. We often label ourselves as success or failures, but we fail to pay attention to all the efforts and practice we need to improve our skills. We will screw up many times, and we will learn constantly. In this way, there is always space for us to grow.

goals, high expectations. shame and parenting

It isn’t fair to assume we’ll be great at parenting from day one. Think about how it was like when you first learned to drive. In the start, you were in the “conscious incompetent” stage where are very aware that you have no idea what you are doing. However, with time, you get to a place where you can automatically drive your car. Unfortunately, when we are at this place of “unconscious competence” (a.k.a. “I don’t have to think about it, I can do it in my sleep”), we forget how much we initially struggled. We forget the intensity and shame of not doing well.

Make it safe

We can all play a role in reducing the shame of mental illness and perinatal mental health. Talk about your experiences openly with safe others. Offer validation and compassion to those who are in this phase of life. Reach out to a therapist that you can trust. We can work to shift away from judgment, and instead, appreciate that we are all doing our very best.

Warmly,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

Starting trauma therapy? Tips to support those initial fears

It’s normal to feel a bit nervous when you’re connecting with a new therapist especially when you’re starting trauma therapy. This is the person you intend to tell your vulnerable history, and pray that they know what to do with all that information. The idea of opening up to share your lowest times can be an aversive factor in starting the work. I hope the following tips will provide you comfort and guidance as you consider starting trauma therapy.

Acknowledge the hesitation

starting trauma therapy. nervous. anxiety

There are parts of you that are cautious of opening up. Why wouldn’t they be? If you are nervous, there is a reason for this caution. So take a moment and pay attention to the thoughts and feelings showing up right now. What are those cautious parts of you needing in order to feel safe? Here are some questions to consider:

  • Is your anxiety asking you to go slowly?
  • Are these cautious parts of you concerned about becoming overwhelmed?
  • Are these parts worried how your therapist will react once you share your experiences? Have you been shamed by others in the past about this experience?
  • Does your system need time to feel safe and build a relationship before it feels willing to open the door to the past?
  • Are your anxieties worried about what they will find out if you start this process?

Everyone has reasons for hesitating, and it’s important to make space and create safety for those fears. When it comes to trauma therapy, sometimes going slow IS moving fast. Parts of you may be frustrated that you’re working at a glacial speed; however, taking the time to process slowly may be the safest option. There are safe ways to process traumatic memories without reliving or re-experiencing the events. The point of therapy is not to trigger you. Therapy should not make you reenact horrible events that you have already survived. It’s more about dual awareness: your system will slowly learn to talk about these events knowing that you are safe in the present moment.

You get to lead

This may sound obvious, so humor me as I clarify this point. Most folks come into therapy with the goal of “feeling better”. However, there are parts of their life that are an open book to review and many topics that are completely forbidden. This is fine! However, let your therapist know these boundaries. You may have experienced an eating disorder as a child. Perhaps you survived a sexual assault. You may be grieving the loss of a parent. Despite knowing this history, you may not want to open the door to these topics. Your therapist should be respectful of this boundary. At the end of the day, you are the boss in therapy. This is your life, and this is your wellbeing. You get to decide what feels most important to address. There will be times as you start trauma therapy when you realize these old wounds keep coming back. When this happens, your therapist will be honest with you and point out the value in addressing these topics. However, you are ultimately in charge of deciding whether this issue is worth exploring.

Your feedback matters

You can let your therapist know when something is not working. This may feel very unsettling, but protecting your therapist’s feelings provides only short-term relief. It doesn’t actually help you in your recovery. That isn’t fair to you, and your therapist may not be aware that you are going through this internal battle.

You can ask questions, clarify where treatment is going. When it comes to starting trauma therapy, many folks are not clear on how therapy works, or what a session will look like. You are welcome to ask at any point in time about your questions. Whether it’s been a few weeks, or a few years, it’s fine to clarify! Therapy is meant to be a safe space to build a relationship. It should feel safe to ask questions or voice uncertainties.

Therapy takes time

This may seem obvious, but it’s an important factor to consider with starting trauma therapy. You may have seen TV shows where a sassy, brilliant therapist says some profound statement and the client walks away completely changed. This isn’t really the case in real life. Sure, you may learn more about yourself at each session. You may also have a deeper patience and openness to those difficult parts of you. Therapy is about having a better relationship with yourself. Having insight into your internal system is helpful and can absolutely make you look at the world differently. Understanding what all of your “problematic symptoms” are trying to do can help you shift to appreciating these parts of your personality. However, as with every relationship, it takes time. It takes time to build this understanding about yourself. It takes time to start to trust yourself.

Therapy is not forever.

Sure, therapy can sometimes take a few years to work through old wounds and feel regulated. You may continue more for the sake of check ins and maintenance work. But, this does not have to be a permanent arrangement. You are at the lead of deciding when your goals feel complete. The beauty of working in private practice is that clients can reach out when they want to work on something, and can leave when they feel this has been adequately addressed. If you hesitate to start trauma therapy because you fear you will be ongoing, please know that this is not the case. Your therapist is forever working him or herself out of a job. That’s the point of our roles. We support you in creating internal leadership so that your emotions can show up, express themselves, and feel safely supported by you.

Don’t settle

Just because you start with one therapist does not mean you are stuck with him/her forever. Research shows that the relationship matters. The quality of the relationship you have with your therapist is a solid predictor of how treatment outcome (irrespective of the type of therapy that is offered). What does this mean for those who are hesitant to start therapy? Ask yourself if you feel truly comfortable with the therapist. Is your clinician hearing you and understanding your needs? Do you feel judged? While you may not enjoy vulnerability, does it feel safe to be vulnerable in front of your therapist? Is there compassion? Your therapist should have a positive regard for you. If not, this isn’t the right fit.

Reach out

 If you have any questions about the above details, reach out for a free consult. Starting trauma therapy could finally provide that relief you’ve been searching for.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Uncategorized

Little Known Ways to Surviving The Newborn Stage

If you are in your first few days of parenting, congratulations! Welcome to the club! 🙂 The newborn stage is exciting and petrifying. If you are a first time parent, you may be tested in ways that you’ve never dealt with previously. I hope the following tips will help you during these early days.

The 5 S’s.

A fussy baby is one of the hardest part of the newborn stage. It’s not like they can communicate through words, and chances are you’re starting to feel frustrated when you can’t figure out how to settle your little one. If you have heard of Harvey Karp and the Happiest Baby on the Block, this tip will seem familiar for you. Dr. Karp encourages a method that helps calm a fussy baby very quickly, which he refers to as the Five S’s:

Step 1. Swaddle:

Yes, it may seem that your baby hates being swaddled. Your baby may kick up a storm or try and escape those tight confines. However, the swaddle resembles the safe and snug cocoon of the womb, which will feel comforting and familiar. Keeping your little one swaddled also prevents him from accidentally waking himself up due to the Moro reflex. Rather than give up right at this stage, get your baby swaddled and move forward to the next step. (TIP: Using swaddles with a velcro attachment will make life much easier because it reduces the likelihood of babies wriggling out).

Step 2. Side/Stomach position:

When babies are lying on their back, it often feels like they are falling. They are likely to display the Moro reflex when this occurs. While sleeping on their back is necessary, holding them on their side or stomach is a fast way to help soothe a fussy baby.

Another influencing factor is that your little one is watching you trying to comfort her. Although you are using a soft and soothing approach, you may end up stimulating her by maintaining eye contact. The next time you are trying to settle your little one, try holding her in this hold, and see how she responds.

Step 3. Shushing:

Your current strategy may involve ensuring the house is completely silent when it’s time for baby’s nap. After all, having a quiet and dark environment is the ideal way for you to go to sleep. Ironically, a silent environment is not as helpful for babies. When babies are in the womb, things are loud. They can hear all sorts of noises coming from inside of you (e.g. blood flow) and from your external environments (e.g. conversations). Rather than keeping a quiet space, it’s best to include white noise to mimic these familiar rumbling and indistinct sounds. Try setting up a white noise machine (or using a free app on your phone) to help introduce some sound to their sleep environment.

Step 4. Swing

The fourth step: Swing

While gentle rocking or swinging motion will be helpful, what is most effective in calming a fussy baby is using a bobblehead-type movement. The womb is not a smooth, gentle place. Instead, it’s quite jiggly. Take a look at the following video to demonstrate how to create the right swinging movement.

Step 5. Suck/Soother

The soother is either your best friend or your nemesis at this point in time. Many parents find that their baby takes the soother right away and it is a fast way to stop the tears. There is an equal number of parents who have bought 14 different soothers and feel frustrated that their baby continues to gag or spit them out. I find this video really helpful for introducing a pacifier.

Seeing it all in action

The following video shows Harvey Karp incorporating all of these tips together. Again, the newborn stage involves a lot of tears. Putting the 5 S’s together is a fast and effective option to help your little one settle.

The 5 S’s in action

Beware of the Google Trap

google trap. anxious parents. Surviving the newborn stage.

It’s easy to keep researching things. If you are anything like me during my first postpartum experience, you will have diagnosed your baby with 20 medical issues (none of which were actually the case). This is super common, and everyone is aware of the vulnerability of searching on WebMD when anxieties are high. Rather than getting into this spiral, reach out to your health care team (e.g. lactation consultant, family doctor, nurses, social workers). You may worry about “bothering” your health team, but I promise you, they are used to parents reaching out. It is common to have questions , especially if this is your first baby. Whether you are struggling with breastfeeding, worried about baby’s health, questioning your relationship, you don’t have to figure it all out by yourself.

Stay Connected

Whether it’s an online forum or with your fellow friends and neighbours, it’s important to have others to talk to. Getting through the newborn stage is tough. There are a lot of questions and anxieties as the baby does new things (or doesn’t do new things). Please know that with every worry you have had, another parent has dealt with the same fear. Anxiety is normal.

Online communities (e.g. What to Expect) are especially helpful for addressing fears that occur in the middle of the night. There is almost always someone available to support you irrespective of the time of day. Speak to your friends, family, and partner. Sometimes our anxieties can escalate. In these moments, it’s helpful to talk them through with a grounded and non-judgemental person.

Get some sleep

In the beginning, when you are on a two-hour feeding cycle, it may seem that sleep is impossible. The idea of sleeping when baby sleeps feels like a joke. This baby never rests unless being held. Whatever the circumstances are with your baby’s sleep patterns (or lack thereof), you still need some rest. I encourage all parents to find opportunities for shift sleeping. Decide among yourselves who is a night owl and who prefers early mornings. Have a bottle ready and let your partner be in charge for those hours. Ideally, you are trying to get a 4-hour chunk of sleep so that you have the opportunity to enter REM sleep. Remind yourself that this is not permanent. While, it’s hard and challenging, your little one will eventually sleep through the night.

Know when your baby is in Active Sleep

I remember that I used to rush in whenever my kids made the slightest noise during the night. I’d assume they were awake, needing another feed, and that I would have to help them settle in some way or form. Unfortunately, my attempts to intervene only frustrated them. This is because I was actually interrupting their active sleep.

Active sleep is noisy! It involves grunting, squirming and even crying. Of course, in my sleep deprived and anxious state as a first time parent, I would see these cues and rush over to “soothe” my eldest, not knowing he was still resting. This tip involves identifying active sleep, and learning to stay out of the way when baby is resting. This video is a great resource to help you identify active sleep:

Attachment can take time

Some parents feel enamoured with their baby from day one. However, many parents do not feel this way. Building an attachment with your baby can take time. It is perfectly normal to feel scared, overwhelmed, confused, nervous or a variety of other emotions when you first meet your child. The newborn stage is meant to be a time where you develop a relationship. You get to know your child, and like any other relationships, you build trust and communication.

Will this tiny person ever stop crying?

There is a hormonal surge that kicks into full gear as soon as we hear the baby cry. You may be among the few who dash from one end of the house, leaping through obstacles in order to stop the tears ASAP. Alternatively, you may feel a rush of anger coursing through your body when you hear your baby wailing. Both responses are common. Our lovely friend, oxytocin has turned things up a notch making parents incredibly sensitive to a newborn crying.

When you hear someone in distress, it triggers you to respond. You will reach for your baby and start to sing, rock, or nurse. You will use any old tricks to help her calm down. However, if you have found this experience tiring or unsuccessful, those tears can make you feel plagued by helplessness and anger.

What to do if you feel anxious or angry about your baby’s tears:

  • Pause for 15 seconds. Yes, your natural instinct is to rush and rescue, but give yourself a moment to regulate. Give your baby a chance to settle.
  • Remind yourself it’s not personal. Your baby is not mad at you. You are not a bad parent. Babies cry. All. The. Time. It’s their only way of communicating. Sure, it makes your blood pressure skyrocket, but it’s the only way they can let you know something is up. Trying to decipher those tears will take time and practice, but you and your baby are doing your very best in figuring it out.
  • Write a plan for yourself. When your baby is fussy, what will you do? Perhaps you will follow the 5 S’s listed above. You may choose to sit in a rocking chair. You might whip out a bottle to nurse him back to calmness. Whatever option you decide, it’s helpful for you to feel confident and aware of your next step.
  • Ask to switch out. If you’ve already been taking care of a fussy infant all day, you may feel at your wit’s end. Tap out. Have your partner, friend, family member take over for an hour. Try and get out of the house during this time if you’re fighting the urge to run in and fix, correct, or offer suggestions. Take this time for self-care.
  • Shower yourself with positive affirmations. Ideally you’re saying these positive thoughts to yourself. However, if that is too hard, have a loved one reassure you. Get your daily reminder that you are doing your best. These difficult moments do not make you a bad parent.

Reach out

Postpartum anxiety and depression are common and difficult struggles. They go beyond the stressors of the newborn stage. You may find that you are constantly irritable, overwhelmed, unable to sleep, feeling miserable, or disinterested. If you are struggling, please do not stay silent. Your moods can get better. Reach out to find out more.

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Mental Health

The fear of abandonment: Why am I trying so hard?

Does the fear of abandonment push you to act in undesirable ways? How often do you jump through hoops to suit another person? Do you feel a constant pressure to do more and be more so that others are not upset with you?

To cope with these fears, you may have learned to keep your guard up. Rather than acknowledge your humanness, you may try and hide inabilities or flaws. By demonstrating only these “acceptable behaviours”, you have managed to stay safe. This way, others will not walk away, be upset or disappointed with you.

Sound familiar?

The need for connection

I hope the above words do not cause shame or embarrassment. I am writing them to emphasize the commonality of this experience. Many of us fear being alone. This is normal. In its own complicated way, the fear of abandonment is meant to be helpful. To be human is to want connection. From an evolutionary standpoint, those who had community, had more resources and support.

“We humans are social beings. We come into the world as the result of others’ actions. We survive here in dependence on others. Whether we like or not, there is hardly a moment of our lives when we do not benefit from others’ activities. For this reason, it is hardly surprising that most of our happiness arises in the context of our relationships with others.

Dalai Lama

Understanding the roots of our fear:

The fear of abandonment does not come out of nowhere. It is a learned survival mechanism that comes after experiencing some form of hardship. I want you to consider how your own history. How did your experiences influence having this fear? The following questions can help you explore further:

  • Grief and Loss: Have you lost an important person in your life growing up? Did this experience cause you to worry about others leaving you?
  • Learned messages from parents: What were the rules growing up? What did your parents require of you? What behaviours did they praise and what did they reprimand? How did your parents respond to your successes versus failures? Did your parents’ love feel unconditional?
  • Learned messages from culture and society: What was idealized in the media? What were the rules that your parents followed, and then, asked as of you? If you witnessed others rebel outside of these standards, how were they treated?
  • Friendships: What messages did you pick up from your friends about fitting in? What caused fights? Did you experience rejection from peer groups? How did this come about? What did you do to “repair” the relationships?
  • Romantic relationships: How did your romantic partners treat you? What did your partner expect in a relationship? How did you handle things when the relationship ended? What happened when you set boundaries? Were your words respected or were they questioned?

Managing the fear of abandonment:

If you’ve ever struggled with the above scenarios, chances are that your system learned to protect itself with some careful strategies. There are two common protective patterns that show up to manage this fear of abandonment. The first strategy is to work incredibly hard to meet the expectations of others. These folks tend to:

  • Predict what will make others happy
  • Be hyper-alert about verbal and non-verbal cues (tone of voice, facial expressions, comments, etc)
  • Feel triggered by negative feedback because they fear it means others no longer like you.
  • Focus on people-pleasing tendencies to maintain peace
  • Say “yes” often (despite it feeling uncomfortable with their boundaries)

The second protective pattern that arises is the urge to stop trying all together. After all, if something scares you, why put yourself in that situation? These folks often appear dismissive. They may spend a lot of time alone. They prefer not to rely on others, or avoid getting close to someone. They fear that these actions will put them in a vulnerable place where they get attached to another person, and this person could have the power to hurt them.

What do I do?

fear of abandonment. Fear of being alone. How to address.

Working hard to meet others’ expectations is a form of coping. You don’t have to face the fear of abandonment so long as you follow these expectations. Staying isolated or avoiding any close relationship is a form of coping. You will not deal with rejection so long as you never get to a place of vulnerability.
At the end of the day, coping strategies are meant for short-term relief. They address the anxiety in that moment, but they do actually fix the core issue. Unfortunately, the fear is still there. So what else can you do? The following options can lead you to more long-lasting relief:

1. Seeking therapy to address the underlying wound.

If you have survived hardships like the loss of a parent, bullying, or abusive relationships, these are not small issues. Your system has experienced rejection and loneliness. It learned to cope in the safest way it knew at the time. Trauma approaches like EMDR and Internal Family Systems Therapy are wonderful strategies to help address the root causes for the fear of abandonment. Your system can feel less fearful once these underlying wounds have been healed.

2. Assess if your relationships are healthy.

This is obviously easier said than done. There is a lot of grief and stress in acknowledging unhealthy relationships. However, I want you to consider what may happen if you did not comply with someone else’s expectations. Will they abandon you? Is their love truly unconditional? Sometimes we need to break away from our unhealthy attachments to make space for new healthy relationships.

3. Is there truth to your fears?

Sometimes are our thoughts are just thoughts. They don’t have a lot of evidence behind them, but the fear alone drives us to stay complacent. If it is safe, talk to the other person and ask how they’re feeling. Clarify what you’re seeing or hearing, and ask about the other’s intentions. You may perceive a look or comment to mean abandonment, whereas the other person has zero intention of ending the relationship.

4. Take small steps to trust.

For those who are fearful of committing to a relationship, consider what feels like a safe starting place. You may not be ready to let your colleagues know about your deepest secrets, but you may feel more comfortable sharing how your weekend went, or discussing a difficult work project. In this situation, exposure therapy may be helpful in creating a shift.

5. Slow down

In similarity with exposure therapy, I encourage you to take a step back from the “do more, be more” approach. What happens when you don’t work so hard? What happens when you make small mistakes? I know this option isn’t easy, and I suggest you take the smallest step manageable in creating this change. It’s important for your system to be cautious and monitor how change is perceived. You may surprise yourself in seeing that a) others do not leave when you show your human side, or b) you start to step away from these difficult relationships.

Learn More

If you’d like to learn more about your own system, or you’d like to address fears of abandonment, reach out.

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

Considering trauma therapy? How to tell if EMDR is right for you

If you have been searching for trauma therapy, chances are that you have come across the term “EMDR”. While there are many types of therapy that can address trauma, EMDR has become well known in the counselling world as being an excellent and fast option for processing difficult life events. But how do you know if EMDR is right for you? I hope this post will provide you more clarity and answers.

What is EMDR?

What is EMDR and how do I know if EMDR is right for me?

EMDR stands for Eye Movement Desensitization and Reprocessing. Many clients come to counselling expecting a traditional talk therapy session. They may expect to share lots of details about their lives, and have the therapist ask stereotypical questions like, “How does that make you feel?” EMDR is not at all like this.

EMDR involves the use of bilateral stimulation (BLS) to process traumatic events. BLS is a fancy way of saying that a therapist will be adding some visual, auditory or tactile prompts during therapy. For example, you may be asked to follow a ball moving across the screen or listen to audio prompts. A shift starts to occur when you combine these sensory inputs while also thinking of a traumatic event. The understanding from EMDR creator, Francine Shapiro, is that this combination activates an adaptive neural network in your brain. What we see is that EMDR clients feel calmer when they think about these disturbing situations. To learn more about what an EMDR session is like, I’d encourage you to read this earlier post or watch the following video:

Why use EMDR?

EMDR has been proven to work quickly in processing disturbing events. This is especially the case for those who have survived a single traumatic event (as opposed to complex trauma where a person has survived years of distressing circumstances). This therapy can be used irrespective of when the trauma occurred, be it yesterday or 50 years ago. EMDR has been effective in meeting the needs of diverse clientele regardless of age, race, gender and other identifiers. Beyond past events, this therapy can also help clients work through fears of a similar trauma happening again in the future.

How to tell when EMDR is working:

For clients who have had success with EMDR, they will notice several indicators to healing:

How do I know when EMDR is working?
  • Clients can speak and think about these traumatic events more calmly
  • Clients notice a change in their thinking pattern. Negative beliefs are transformed into more compassionate and positive perspectives. For example, a client who initially believed “I should have done more” may shift into thinking,”I did the best I could.”
  • Clients notice improvements of PTSD symptoms (e.g. intrusive thoughts, flashbacks, nightmares, anxieties, hypersensitivity).
  • Clients’ physical pains starts to ease. They can speak about the trauma without feeling tense, clenching their muscles, or experiencing other signs of constriction.

What prevents EMDR from working?

While all of this sounds great, there are some factors that can affect whether EMDR is right for you. As with any therapy, there is no guarantee that one approach will be the miracle cure. While EMDR has a high success rate, the following points should be considered:

1. Readiness:

Before starting EMDR, clients have to be open to addressing a painful part of their lives. While this may sound obvious, I want to emphasize how incredibly hard it is to sit with memories and thoughts that you have worked to avoid. Avoidance is a natural way to manage anxiety. If we find something frightening, we protect ourselves by staying away. As with any form of therapy, readiness involves taking the chance to stop avoiding in order to address these fears. This is much easier said than done.

2. Learning to work within our window of tolerance:

For EMDR to be the right approach for you, your therapist has to ensure that you are prepared. The goal of this therapy is to process disturbing events without overwhelming you. This means being able to think about these events without feeling emotionally hijacked. The point of EMDR is not to relive the trauma, but to recognize you are in a place of safety while thinking of a difficult past experience.

IS EMDR right for me? Trauma counselling online and in Kitchener, ON

If you go beyond your window of tolerance, the work will not feel safe. Your therapist will be monitoring how quickly or slowly to take trauma processing based on your emotional state. There may be pauses in treatment to help calm your system (e.g. deep breathing, relaxation exercises, calming visualizations, distress tolerance skills, etc). You may spend several sessions focusing on these calming skills before beginning BLS. This does not necessarily mean that EMDR cannot be used; however, there may be a delay in starting trauma processing.

3. Complexity:

Complex trauma and complex mental health (e.g. personality disorders, addiction) can take time to heal. Even with a fast approach like EMDR, clients may spend many months or years working through painful memories. You may have to spend a significant amount of time addressing these other mental health needs before starting to work through traumatic events. This does not mean that EMDR therapy is not helping; however, clients must be patient to work through these additional needs.

4. Current life stressors:

Is EMDR right for me? Learn about this form of trauma therapy

Are there current life stressors that are getting in the way? It is hard to focus on a past trauma if you are thinking about current financial struggles, work demands, or a recent arguments with your partner. When life feels unsafe or stressful, you may have a hard time focusing on the past. It is understandable that current needs keep distracting you. In these types of situations, you may need to pause EMDR, and address what changes need to occur today to help life feel more stable.

5. Fear of recovery:

This is a difficult point to make because the majority of people want to get better and the title insinuates that a person is avoiding healing. That is not my intent. There are a lot of changes that will happen in your life because of recovery. This may include embracing new routines after years of living a certain way. It may involve returning to work where there are old triggers and difficulties waiting. Perhaps recovery involves acknowledging that your parents were not kind or well-intentioned people. There is an understandable fear of what recovery might mean for a survivor, and those fears need to be supported and addressed prior to opening old wounds.

Is EMDR still right for me?

Trauma is a fact of life. It does not, however, have to be a life sentence. Not only can trauma be healed but with appropriate guidance and support, it can be transformative.

Peter Levine

While the concerns mentioned above may influence your therapy journey, EMDR can still be the right approach for you. It is best to speak with your therapist about these influences in order to problem solve. The solution may be to do EMDR in a slower manner to prevent overwhelm. Alternatively, your therapist may use a combination of other therapy styles (e.g. Internal Family Systems therapy, DBT) to address other mental health needs alongside trauma healing.

Traumatic events happen to every individual, and we cannot prevent it from taking place, unfortunately. While some recover on their own, many of us experience lasting symptoms from traumatic events. If you continue to be plagued by a traumatic event, reach out for support. EMDR may be the therapy you are looking for.

All the best,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Pregnancy and Postpartum

The pressures of breastfeeding

That first year with a baby is all about feeding, feeding and more feeding. For every parent, there is a time when he or she decides whether to breastfeed, exclusively pump, stick to formula, or use a combination approach. There are a variety of factors that push a parent towards one choice over the other. There is no “right” choice outside of what works best for a caregiver and baby.

pressures of breastfeeding. support for parents who are struggling to breastfeed

Unfortunately, there is a push in our society to breastfeed. We see signs of it right from the day we deliver. There are subtle cues from healthcare staff as they share latching tips before inquiring whether formula is preferred. We are provided pamphlets of breastfeeding support in our care packages before bringing our newborns home. There are posters for breastfeeding help at our midwives’ office.

This blog post is not to push formula feeds. I have no right to claim whether formula is better than breastfeeding, or vice versa. Ultimately, I am true believer that fed is best. As long as your baby is getting the nutrients he or she needs to develop, I consider it a win. Instead, this post is for the parents who are struggling to breastfeed. Whether by choice or by capacity, they are stuck in that internal battle of guilt, frustration and helplessness as they face yet another feed.

The pressures of breastfeeding:

We live in a culture where breastfeeding is encouraged and subtly (or sometimes, not so subtly) pushed as the best option for our baby. New mothers face an onslaught of judgemental messages about breastfeeding, and these comments are made in permanent and absolute terms: “breastfed babies have higher IQs”, “breastfeeding will prevent illness, infections and chronic conditions,” “breast is best,” “you won’t have a good bond if you formula feed,” etc, etc.

struggling with breastfeeding. postpartum support. new mother.

I agree that there are a lot of values to breastfeeding. However, I also work with parents who are driven to the point of exhaustion and anxiety in trying to produce enough supply for their baby. These parents are so angry at their bodies for failing them and not doing enough to support their baby’s growth. If the option of working with a lactation consultant or consuming fenugreek daily is working, then please keep it up! In fact, I encourage you to start here if you truly want to breastfeed. However, if your baby is losing weight, you are feeling stressed out, or are experiencing any number of production difficulties, I want you to take a moment and consider why you are trying to keep up with this expectation.

The “Mommy Wars”

New parents would love to have the ideal postpartum experience. We see images of celebrities looking beach-wear ready a few days after delivery. We see influencers posting feeds of their babes sleeping through the night. There are endless tweets and posts about the “right ways to parent”.

pressures of parenting. super mom. mommy wars.

With all of these messages of ideal parenthood, it makes sense that we are self-conscious about our own parenting. The Times wrote a beautiful article in reference to the Goddess Myth: “Like millions of other American moms, [mothers have] been bombarded by a powerful message: that she is built to build a human, that she will feel all the more empowered for doing so as nature supposedly intended and that the baby’s future depends on it. ” With this constant push for doing things “naturally”, moms carry the stress of parenting a certain way. There is a need to delivery vaginally, breastfeed on command, only feed your body the “right” foods, and of course, look stunning throughout the process. Of course, mothers then bear the burden of immense guilt when they are unable to meet these pressures.

This push to parent in a specific way also comes from mom-shaming experiences. These experiences can include rude comments and glances from others as a new mother orders a second cup of coffee, buys a drink, and of course, pulls out some formula. It’s as if there is a moral obligation that has been violated by not following the rules others deem best for our children. It’s no wonder that new parents are surrounded by a sense of failure and dread as they step into parenting.

Know that you’re not alone

The American Pediatric Society encourages breastfeeding for the first six months of your baby’s life. While 80% of mothers start off with this intention, the Center for Disease Control and Prevention state that only about 58% make it to the six months.

Why is this? Breastfeeding is described as natural and easy; however, any parent who struggles with breastfeeding can vouch that this is not the case. From poor latches, supply issues, mastitis, and other complications, many women start to experience a sense of dread when it comes closer to feeding times. These parents may undergo a period of grief as they cope with the disappointment of needing to put aside their hopes for breastfeeding.

Other parents prefer to not breastfeed. This decision could be based on a variety of reasons: struggles with hormonal shifts while breastfeeding, managing the demands of other children, returning to work, wanting support with nighttime feeds, sexual abuse histories, or simply not wanting to feed in this way. These are not selfish or bad parents. They care deeply for their children while also respecting their own boundaries. At the end of the day, a happy parent is better able to support their baby. If formula feeds provide a calmer structure for the parent, then this is the right decision for this family.

Worries about attachment

Sometimes we push ourselves because we think it’s what’s best for the baby. Sure there are physical benefits to breastmilk, but there are significant benefits to having a grounded and calm parent. If you are overwhelmed everytime you start nursing, that bond is going to feel so much more difficult. You have years to build and nurture the relationship with your child. It does not have to be perfect from day one. Listening to your mental, emotional and physical limits will set you up for success.

For those who feel that nursing creates a better attachment, I encourage you to consider your attachment with your own parents. Are you truly better connected with your mother because she chose to breastfeed versus formula feed? Is your IQ significantly higher than a peer who was formula-fed? Who even asks these questions today of other adults?

You are doing your best for your child

cheerful young multiethnic parents admiring sleeping baby on bed
Photo by William Fortunato on Pexels.com

A hungry baby is a cantankerous baby. A guilty mother is an unhappy mother. Pressures that come from strangers, the internet, and sometimes our own friends and family are perhaps meant with good intentions. However, you are this child’s parent. And if you are feeling stressed and guilty about breastfeeding, you are allowed to stop. You will always be this child’s caregiver, and your bond can be secure irrespective of how you feed this little one. Your baby will grow up and eventually eat food, and this pressure to breastfeed will no longer be the central focus of conversations. So for now, go and enjoy your child. Focus on getting those baby snuggles. Spend time playing, singing, talking, and teaching him or her. And when your little one gets hungry, feed them in whatever way is feasible for you.

All the best,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Mental Health

How to help someone who is grieving

What has been your experience with grief? Have you gone through the process yourself? Do you feel overwhelmed when others experience loss? Working in the perinatal field, I am surrounded by parents who have survived loss. These experiences vary vastly from the endless cycles of hope and loss during IVF treatment, to processing a miscarriage, or coming to terms with the dissolution of marriages. Grief can be isolating, and I hear repeatedly how much these parents yearn for understanding from their friends and family members. This post is for those who would like to help a grieving friend or loved one. I hope the following strategies will give you an idea of what you can do in these times of need.

8 Things to Consider when Supporting a Grieving Loved one:

1) Know that your job is to listen

Listen to what your friend is sharing and how he or she is feeling. Focus on maintaining a safe and nonjudgmental space for him or her to experience emotions openly. Respect boundaries if this individual is not ready to talk.

Listening to help someone grieving. Validation. Loss and support.

Supporting a grieving individual involves being genuinely present. This involves actively listening, reflecting back, asking questions, showing interest, validation, and providing compassion. There is no need to fix things or make it better because this is not possible. We often worry about being effective support persons, but I encourage you to consider what “effective” truly means in this context. You are not able to bring back the person or experience that has been lost. The best way to support is to be available and present if or when the grieving party is ready to talk or have company.

2) Show that you care

There are lots of ways to show you care from visiting, calling, dropping off food, offering practical help, or giving a hug. If you’re not sure that you’re properly supporting the other person, just ask. We sometimes worry about being a nuisance. Trust that the other person will tell you if they do not want this type of support.

Sometimes our own uncertainties get in the way. We question how often we should stop by, or whether we’re making much of a difference. In these scenarios, listen to your own capacity. Burning yourself out in the process of helping someone’s grief will not work well for anyone at the end of the day. Offer as much as you can comfortably manage.

Again, remember that the goal does not involve the other person necessarily “feeling better”. Sometimes we look for reinforcement that we are doing the right thing because the other person responds back, smiles, offers reassurance, and so forth. Depending on the intensity and recency of the grief, your loved one may not be able to offer this feedback.

3) Stop giving advice

A lot of bereaved individuals are provided support through advice giving. They hear endless phrases like:

  • You should talk about it more
  • It’s important to let it go
  • “Make sure to take some time to do the things you enjoy
  • You can always try again
  • Count your blessings
  • Think of your other children

These phrases are not meant to be malicious and the speaker has good intentions. However, it’s important to recognize that in these remarks are subtle messages informing the bereaved that they are grieving incorrectly. They are being told to feel or act differently from how they are currently experiencing their loss. Recognize that your role in this scenario is not be an advice giver, but to be a friend. Let the person feel how they feel, and trust that this is their way of processing.

4) There is no set time for when a person is done grieving

Some people come to terms with loss within a few months, whereas for others, it will take years. There’s really no set timing when it comes to grief. As far as the support role, the difficulty comes with being patient when the other person’s grief continues despite a lengthy time. I get that you want the other person to feel better, but be cautious of how this comes across. So long as the person is safe and not a danger to themselves (e.g. suicidal intent), step back. As worried as you may be that they are stuck, continue to let them know you are available, and let go of the pressure for them to “move forward” until they are ready.

5) Pay attention to your own discomforts

The pressure we feel to make the other person feel better comes from our own agendas. It comes from our own discomfort in seeing a loved one in pain. Of course, you want the other person to feel better. This is your spouse, your sibling, a dear friend, and you would never wish this type of sadness on them. However, it’s important that, in the grief process, the focus is not about you, but about the other person. We can easily shift into noticing our own systems feeling uncomfortable with intense emotions and wanting to help the other person shut down these feelings. This can be incredibly invalidating, and reinforces a sense of isolation for the grieving individual.

It is helpful to reflect on your own experiences with grief and intense emotions. How have you been supported during times of distress? Were you forced to manage on your own? Did your family members display big emotions? Were feelings welcome, or were you taught to bury your emotions? Did you witness your parents experience big emotions and start to fear them?

Understandably, we can have avoidant parts of our system that shy away from intense emotions based on childhood experiences. We want our caregivers to show us that the world is safe and that they can keep us protected. We need our caregivers to provide a safe environment for us to feel and process our emotions. When parents continue to present in dysregulated manners (e.g. intense grief, shaming us for experiencing distress), children have a hard time coming to terms with these emotions. They may learn to fear strong feelings as unbearable or a problem that must be resolved.

6) Try not to personalize.

If a loved one is grieving, chances are their emotional capacity can feel incredibly restricted. They may not have the space or awareness to consider how their remarks or feedback is landing on others, and you may bear witness to significant mood swings. It is normal to have ups and downs during grief. As a support person, this does not mean you tolerate becoming the emotional punching bag. You are always encouraged to set boundaries if someone is treating you poorly. However, in situations where the other person turns down spending time together, presents as moodier, is not emotionally available, or appears uninterested in your updates, try not to personalize. They are not doing this to be intentionally unkind, but are caught in their own feelings of loss.

7) Don’t be afraid to bring up the loss.

Grief. Supporting grieving individual.

Grief can be a taboo topic, and we are cautious about triggering the other person by avoiding bringing up the circumstances. Simply avoiding the topic does not mean the other person is not thinking about their loss. They are well aware of what’s changed in their life, and need the opportunity to talk about it. Rather than avoid, acknowledge the grief. Comment on milestones, anniversaries, birthdays, and other important dates. As time goes on, your loved one will appreciate that you are not forgetting their loss, and use the opportunity to talk, if it’s needed.

8) Be genuine.

If you truly understand the other person’s pain and have been through a similar experience, let them know. Otherwise, avoid saying phrases like “I understand” or “I know how you feel.” While these types of phrases are meant to offer comfort, they can unfortunately feel really invalidating. Pay attention to whether you use platitudes. While you may find comfort in trying to find the silver lining, the other person may not be ready or wanting to these hear these comments. Again, try not to personalize this, but work with the reality that this is not the way that this person processes grief.

Reach out

reach out. contact for therapy. counselling services for grief. postpartum loss

Whether you feel overwhelmed by witnessing grief, or if you feel your loved one can benefit from additional support, therapy can provide a safe space to process these emotions. It helps to have a neutral party to discuss intense feelings without fear of repercussion, needing to stay strong, or concern about overwhelming others. It takes a lot of courage to seek out for help; reach out when it feels right for you.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.

Trauma

Should I be concerned about PTSD?

If you have survived a traumatic experience, it’s natural that you are feeling worried about how to proceed. You may have many concerns running through your mind: How long will I feel this way? Am I supposed to seek treatment? Is it normal for me to feel like this? Whether it’s an unsettling birth experience, a difficult pregnancy, a sexual assault, or any other traumatic event, we are left feeling vulnerable and distressed. This post is for anyone concerned about experiencing posttraumatic stress disorder (PTSD). I hope the following information will provide you some clarity and empower you to seek the support that best meets your needs.

What is PTSD?

PTSD is a mental health diagnosis that occurs after an individual has survived or witnessed a traumatic event. What qualifies as a traumatic event differs for every individual. Whatever the circumstance, the individual experiences a significant threat to their physical, emotional or psychological safety, or the safety of a loved one. The situation is so distressing , that the person feels unable to cope.

In working with prenatal and postpartum parents, I see a lot of caregivers who have experienced trauma in the following circumstances:

Is it PTSD? What to do about trauma. Kasi Shan Therapy: counselling in Kitchener, ON
  • Prenatal Loss: e.g. stillbirths, miscarriages, unsuccessful IVF treatment
  • Unplanned pregnancies and abortions
  • Domestic violence, affairs, or marital separation
  • Pregnancy complications: e.g. infections, preeclampsia
  • Early labor or NICU visits
  • Unexpected health complications: e.g. positive screening for trisomy 21 or 18, car accidents

Not every traumatic experience leads to PTSD. There are many components that can influence your healing. Having resiliency factors (e.g. coping strategies, support from loved ones) can greatly improve how you process and move forward from this experience. Having a relatively safe life and limited trauma prior to this event can help us trust that the world is a safe place once again.

Depending on whether the traumatic event was a one time incident (e.g. mugging) versus a repeated event (e.g. ongoing civil war) can impact your healing. When it’s a one time event, our system is better able to see the situation as an anomaly. When there are repeated infractions, we struggle to see the world as a safe and predictable place, and there is increased risk for PTSD.

During a traumatic event:

PTSD versus trauma. what to do after a traumatic event. how to recover from trauma. Kasi Shan therapy: online counselling. Kitchener, Ontario

During a traumatic situation, our survival system kicks in automatically. We are outside of our window of tolerance because this event was unexpected, and our nervous system is experiencing a threat to our well-being. Without conscious effort, our traumatized mind shifts to a state of flight, fight or freeze. We try and escape the situation as quickly as possible, or we try and attack and fight our way forward. If neither option works, we fall into a state of shock or freeze response. When safety is returned, most of us can calm down. However, for traumatized individuals, it’s like their mind is still hooked in that place of danger, and they continue to respond in a flight, fight or freeze manner.

Symptoms of Trauma

A traumatized individual will show symptoms such as:

What should I do about trauma? Being aware of PTSD. Kasi Shan Therapy. Online therapy. Counselling in Kitchener,  Ontario
  • Hypervigilance: a need to assess for constant threat. This involves a high degree of alertness for anything related to the disturbing event.
  • Reliving the traumatic event: e.g. through flashbacks, memories, dreams or intrusive thoughts
  • Avoiding reminders of the disturbing event: this can involve avoiding even the most basic connection. For example, a mother with birth trauma may avoid going to hospitals or visiting medical professionals. She may refuse to talk about her birth experience or listen to others’ birth stories. In the hardest of scenarios, she may avoid any interactions with her newborn.
  • Increase in negative thoughts and feelings: e.g. numbness, guilt, shame, anxiety, irritability, hopelessness. The traumatized person often feels the world is unsafe or unfair. He or she may be cautious about trusting others.
  • Hyperarousal: Feeling on edge, jittery, difficulty relaxing
  • Dissociation or impaired memory recall: In some cases, the individual may forget parts of the trauma, or have blocked out this entire event.

Usually, we experience these symptoms right after a traumatic event; however, some individuals have a delayed onset.

When is it “normal” and when is it PTSD?

Posttraumatic stress disorder. What does it mean, and how do you get help? Kasi Shan Therapy. Online support. Kitchener, ON

The majority of us have survived a traumatic situation. In the beginning, we feel jittery, hyperalert, and avoidant. This is normal. There are parts of our system that are scared of a similar event happening again. In order to ensure safety, these parts will assess for danger and remain hypervigilant of repeat offences. During this time, you will likely experience a lot of distress. However, trauma symptoms tend to dissipate on their own within a month without any major influence. Short-term therapies, medication, and support from loved ones are effective tools that can help with this transition.

In order to have a diagnosis of PTSD, you must experience continue to experience trauma symptoms a month after the traumatic event. These symptoms may last for months or years following, and they cause significant impairment in the person’s daily life and relationships. If you are concerned about experiencing, PTSD, you can take the Posttraumatic Stress Disorder Checklist (PCL-5) as a self-assessment. Any scores approaching 40 warrant a conversation with your family doctor or a mental health professional.

What can I do if I still feel traumatized after a month?

I encourage you to seek therapy as soon as you feel ready to process the traumatic event. While counselling is not meant to be triggering, it can be hard to revisit a difficult memory. If you feel too overwhelmed to even think about the traumatic incident, your system may benefit from extra support to manage this anxiety first. This may involve medication, or specific counselling strategies focusing on distress management.

There are many different counselling approaches that can be used to process traumatic events. Some well known options include: include cognitive processing therapy, sensorimotor psychotherapy and narrative therapies. The following three options are services that can be provided via Kasi Shan Therapy.

Eye movement Desensitization and Reprocessing (EMDR)

EMDR. Eye movement desensitization and reprocessing. treating traumatic events. Kasi Shan Therapy. Counselling in Kitchener, ON and online.

EMDR is a powerful approach that divides a traumatic experience into smaller, manageable chunks to slowly process each part of the incident. Typically, the work starts with either the first or worst part of the memory, depending on what feels manageable for you. In EMDR therapy, we use a process called bilateral stimulation to help process traumatic memories (learn more about how EMDR works vis this post). IN EMDR, with each passing of bilateral stimulations, the traumatized individual starts to feel some distance from the traumatic event. The event feels less personal, and there is a continued lowering of distress level. An individual quickly moves from negative beliefs and high distress to more positive beliefs about themselves, less fear when thinking of the memory, and calmness in the body.

EMDR does not require you to go into specifics of a traumatic event. Instead, clients can express barebone details aloud while still making sense of a unpredictable and nonsensical event. This can feel helpful for those who are not ready to speak about the traumatic event in detail as of yet. In fact, for those who do get stuck in the narrative of a traumatic event, your therapist will keep checking that you are properly processing a memory versus getting retriggered.

Cognitive therapies and prolonged exposure

When it comes to traumatic events, we form negative beliefs about ourselves and about the world. Cognitive therapies help us challenge these beliefs by assessing their validity. We look at whether our assumptions about the world, others, and ourselves are fair and consistent. The therapist and client works to start formulating more neutral or balanced thoughts.

In addition, many therapists will encourage clients to practice in some form of exposure therapy. With trauma, there is a lot of avoidance of the traumatic event. Prolonged exposure involves slowly approaching the activities or individuals that remind us of the traumatic event. This is done at a gradual pace in order to not overwhelm the system, and to help build confidence in our capacity to manage distress and test out problematic beliefs.

Internal Family Systems Therapy (IFS)

internal family systems therapy. IFS and trauma.

IFS recognizes that our system can become divided following a traumatic event. There are parts of us that carry the wound of a traumatic event. We often bury or push this part away from our awareness. These exiled parts typically carry a lot of shame, guilt, fear or overwhelm. Because they are so overwhelming, we have other protective parts that compensate. We have proactive parts that prevent us from triggering these wounds. We also have reactive parts that respond when we are triggered trying to manage the intensity of these exiled emotions.

For example, following a miscarriage, we may have an exiled part of us that believes we are responsible for the pregnancy not lasting. Because this is such a painful burden to carry, we may have proactive parts that do not let us get pregnant again, cancel IVF appointments, or push fights with our partner to prevent intimacy. If another miscarriage occurs, we may have reactive parts that become extremely angry at ourselves or our partners. This part may lash out through verbal attacks, or may cause physical harm onto our own bodies in order to deal with the pain.

In using IFS to treat trauma, we have to work with all parts of your system. Rather than diving straight into addressing the wound, we work with these protective layers first. We focus on building trust and safety with these protective parts. When they have relaxed, we then start to work with the core traumatic wound.

Reach Out

You may notice signs of healing within the first month, and not require additional support. However, if it’s been longer than a month and you continue to express traumatic symptoms, interventions can be helpful. Trauma and PTSD do not have to be a life sentence, and there are ways to help your recovery. If you or a loved one is struggling after a traumatic experience, reach out.

Take care,

Kasi

Kasi Shan, MSW, RSW
Kasi Shan, MSW, RSW

Kasi Shan Therapy is located in Kitchener, Ontario. She offers in-person and online appointments supporting individuals with struggling with trauma and perinatal mental health.