Category: Pregnancy and Postpartum

peaceful black mother looking at sleeping newborn child on bed

Building a bond with your baby: Strategies to help when you struggle with postpartum mental health

Published on by kshanmuk

When it comes to postpartum mental health, many parents struggle to building a connection with their little ones. There may be feelings of resentment that our lives have changed. You may feel too tired to want to play or sing nurseries. Your anxiety feels too high for you to be comfortable spending time alone with your infant. Whatever the reasons may be, you’ve been coping these months by maintaining an emotional distance from your child and feel desperate to build a bond with your baby.

I want you to know that attachment can be formed irrespective of postpartum mental health. Our relationships can always grow and develop, even when the onset was rocky. The first five years with your child are pivotal, and there are many things that can be done from hereon in to nurture this new relationship safely and without overwhelming your nerves or emotions.

The following strategies will help you feel more secure to meet your baby’s needs. No, they’re not all about singing songs or giving massages. I recognize that singing and massages are great options, but not everyone is at this starting point. So, let’s start slow so that we can get you to a place of feeling more confident to building a better relationship.

1. Introduce your infant to activities that you enjoy doing.

bonding with your baby, attachment, postpartum depression, postpartum anxiety, strategies to cope

When the bond with your baby is already feeling tested, it’s incredibly hard to push ourselves to do “baby-focused” activities. Your motivation and desire to encourage tummy time or play peek-a-boo is next to nil. When you feel this way, it’s not helpful to ask you to force it. This may work for a day or two, but a stressful event will likely bring you back to square one. Instead, I want to encourage taking small steps that will feel more manageable for your system.

When you focus on your hobbies and interests, you’re often able to relax. There’s less pressure to perform. You have less anxieties about ensuring you’re “doing it right” and, instead, can just enjoy the task at hand. Whether it’s going for a run, cooking a meal, painting, reading a book, playing dungeons and dragons, there are creative ways to bring your baby into your world. Bust out that jogger to take your little one on a run with you. Introduce your baby to different smells, and speak to her about the different spices that are going into your meal. Show her the different colors you’re using while painting. Read outloud from your book so that your baby learns new words. Have her roll large dice for your various rounds in a board game. There are ways to still be you and foster your own interests while including your baby.

2. Build confidence with a support person

When you’re feeling insecure about being a parent, the pressure of parenting independently can feel like too much. Let your partner, friends, or family members know how you feel. Your sense of overwhelm with the baby does not mean you cannot be a good parent. Attachment struggles are a common sign of postpartum anxiety. Rather than avoid your baby all together (many have been here!), or become flooded with frustration or resentment, try and share the load.

postpartum mental health, attachment, bond with baby. family support.

Speak with your family members about spending more time together so that you can grow into this role. It’s easier to play with the baby or learn to handle colicky moments when you have a safe friend or family member supporting you. Your trusted person may give tips (tell them to cool it if it feels too much), or may provide you encouragement as you try. They may be wonderful at providing a distraction, so that you’re less focused on doing things perfectly. This support should also include your friend providing you a time out when you have met your limit and need to take a breather.

adult affection baby child
Photo by Pixabay on Pexels.com

A word of caution that it can feel tempting to step away and allow your family member to take over. But if you are hanging out with your little one and there’s a fellow adult around, the conversation feels easier, and there’s less strain to manage by yourself. When you’ve had enough practice with your infant, speak with your support person about coming over for shorter visits. By slowly reducing the amount of support available, you are practicing gradual exposure. This type of practice helps you work set realistic goals within your window of tolerance, and slowly build confidence as you spend more time independently parenting.

3. Make sure you are getting enough time to sleep.

postpartum mental health. building bond with your baby. sleep.

I know this point sounds strange as far as suggestions to improve the bond with your baby. However, one of the biggest turning points for postpartum mental health is having enough rest. You will never feel at your best if you are working off days or weeks of sleep deprivation. Trust that you will feel calmer, more energetic, more engaged and more like yourself when you’ve had sleep. Once you’ve had a solid week or two of rest, check in on your feelings towards your baby. Are you still feel that intense aversion or fear or has it shifted a bit?

For new parents, I strongly encourage working collaboratively to at least have longer segmented sleep. This might mean that one parent takes an early morning shift so that the other gets to sleep in. Or vice versa, whoever is the night owl takes on the later evening feed so that the other can rest. Understandably, parents will have to consider their comfort levels with pumping or formula feeding. While this is a personal choice, I want to emphasize that your system will feel significantly better after having at least four solid hours of rest.

4. Eye contact and Communication

Eye contact and verbal communication are effective ways to building a bond with your baby. These verbal and non-verbal cues help foster language skills and emotional intelligence in your little one. Your baby starts to recognize faces, understand facial cues, and builds a sense of safety with you. By communicating more, your baby will pick up on various words and gain a stronger understanding of language.

attachment and bond with your baby. Eye contact. postpartum in moms and dads

Maintaining eye contact can be incredibly difficulty, particularly if you struggle with attachment traumas or social anxiety. This strategy may not feel right for everyone, and I encourage you to be kind to yourself and where you are in your healing process. If it feels manageable, try and look directly at your baby while breastfeeding, changing diapers, and when doing any tasks related to your little one. Feel free to look away when the baby loses interest or is over-stimulated. I want to emphasize that doing even a little bit is better than nothing at all. If you are able to maintain eye contact while changing a diaper but feel overwhelmed during breastfeeding, work with that capacity.

Many parents with postpartum depression struggle to spend time with their babies, and it’s a big ask to encourage them to speak to their infants more often. If you are not “feeling it”, you don’t have to coo, speak in baby-talk, or sing nursery rhymes. Keep it simple. Describe what you’re doing in that moment with your baby, even it if it sounds like a tedious play by play. Talk about things that interest you in front of your infant so that they hear the variance in your speech patterns. Have conversations with other adults in front of your babies so they can witness different verbal and non-verbal expressions.

5. When there are no words, use hugs.

Perinatal mental health. Crying, fussy baby. Improving bond. improving attachment

Sometimes the baby cries, and it’s the most aggravating experience. You can’t figure it out. You have tried changing diapers, feeding, rocking, and nothing is working. Rather than stress yourself further, if you have the ability, focus on just holding your baby. There’s no need to walk around or figure out a soothing gait. Spend that effort on giving your baby a gentle hug. Touch is one of the most reassuring options for your infant and it provides them a sense of safety. Having that skin to skin contact, when you don’t know the right words or actions to take, can help both you and the baby feel calmer. Building a bond with your baby can involve a variety of different strategies, but sometimes the simplest action of being held can be enough.

6. When there are no words, walk away.

time outs. improving bonds. frustrated dad.

I know this seems contradictory to the previous point, but this is to give you the option to decide your current capacity. I encourage you to start with hugs when you are capable of this action. When you feel you cannot take it, and you are at your max, it’s essential that you have permission to put the baby in the crib and walk away. Giving ourselves timeouts is a wonderful option to take a break, find ways to regulate, and try again after a few minutes. I encourage using a distress tolerance skill (e.g. dialectical behaviour therapy skills like ACCEPTS or changing temperature) during your timeouts as it is a fast way to calm your system.

7. Plan your day

Boredom can be a significant trigger for many people. When you are bored, your mind starts to wander and, oftentimes, you’re back to that pattern of anxious, racing thoughts. Boredom can lead you to that rabbithole of social media where you fall into the trap of comparing your life to others. Boredom can be a common push factor towards drinking. When we are aware that boredom plays a role in our emotional struggle, we can form a plan. When your mental health improves, your ability to build a bond with your baby also improves.

While parental leave can be wonderful, it can also involve long and tedious days. In many ways, going to work provides us a lot of stability: we have a consistent routine of getting up, tasks to accomplish, opportunities for social interaction and consistent break times. If we know what the day will include, it can ease our anxieties, and we can plan ahead for boredom.

So, what will you do this week? Can you try and wake up and go to bed at the same time each day? Do you have opportunities to socialize each day? Are there playdates that you can schedule, outings that you can plan, activities that you’ve wanted to try out? Are there new play gyms that are available in your city? Will you register for a new online parent and baby class? Are there some new and exciting activities or hobbies that you’ve been wanting to take up (with or without your little one around)?

8. Building a bond with your baby does not require perfect parenting

Parenting has become a dreaded term. It’s a job that involves a lot of effort and patience on your part, and very little on the part of your babies. And as with any job, you may be striving to do it right. While your intentions are commendable, the desire to parent well can sometimes lead to additional stress.

When it comes to providing for your baby, “good enough” is more than enough. We are not able to get it right all the time, and it’s unrealistic to expect this of anyone. There are always going to be factors that pull our attention and that prevent us from being able to attend to our child’s emotional cues. In reality, we only get it right about 30% of the time. Other times, we are completely missing the mark on our babies’ cues or working to repair that misattunement. This is perfectly normal and expected in all parents. Rather than getting our hopes up to parent perfectly, we can focus our attention on repair if we have made a mistake. Repair work may involve: apologizing if you’ve been cross, paying attention if your child is trying to engage you in play, or providing that gentle hug if your baby gets frightened by your exasperated sigh. Our expectations can ease when we know that we will only get it right 30% of the time AND that this 30% attunement is what we can expect even in the most loving and secure of relationships.

Reach out

Everyone’s situation is unique. I don’t want to assume that the points I’ve listed out are going to meet your specific needs. If you are struggling with postpartum mental health and you’re concerned about the bond with your baby, reach out for a free consult. Postpartum mental health is treatable. You can get better, and your relationship with your child can be positive.

Take care,

Kasi

Schedule a free consult
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.

Contact Kasi

“They’d be better off without me”: Suicide and Postpartum Mental Health

Published on by kshanmuk

“They’d be better off without me.”
“I can’t do this. What am I doing here?”
“How am I supposed to do this everyday for the rest of my life?”

I hear sentences like these frequently in my work with postpartum parents. It is heartbreaking and I know that when someone gets to this place of rock bottom they are feeling helpless and overwhelmed. I’d love for the postpartum months to be an amazing time for parents, but oftentimes it’s not easy. Sure, the baby is cute. But the baby also keeps crying, won’t latch on properly and refuses to take a nap. It’s easy to get caught in a negative spiral of fatigue and insecurities. When this phase goes on long enough, many parents start to have passive or active thoughts of suicide.

Suicidality and postpartum care. Internal family systems therapy. Kasi Shan Therapy, counselling support in Kitchener, ON.

Suicide is a taboo topic, and it’s hard to talk about having these thoughts openly. Unfortunately, keeping our feelings buried tends to backlash for the majority of us. Postpartum depression does not necessarily mean you will have suicidal thoughts. However, when we are vulnerable, it’s not uncommon for our thoughts to shift into this space. Whether we are struggling with our baby, handling new stressors as a result of the baby (e.g. financial burdens, isolation), or addressing our already existing mental health diagnoses in combination with a baby, we want an escape. Suicide provides us one of the fastest option for escape. My hope today is to help you recognize that there are safe ways to support you. We can talk openly about suicide and get you to a place of feeling more at peace so that you no longer feel the desperate need to escape.

Step One: Name it

Mental health sucks. In our culture of independent, pinterest-loving super moms, it’s so hard to say that we’re struggling. The statistics for postpartum depression is 1 in 7 moms and 1 in 10 dads; these parents are not all seeking out help.

I appreciate the strong desire to be independent and feel competent. I have parts of me that also feel adamant to manage on my own. We can play this game for a long time and test our limit of how much we can handle. However, there comes a point when we recognize that even our best efforts are not actually effective. Despite going for a walk, eating well, or calling a friend, at the end of the day, you still feel bleak and beyond help.

Postpartum support for suicidal thoughts. Online and in person counselling in Kitchener, ON.

The first step in getting better involves accepting that you’re struggling with postpartum mental health. This is not your fault. When it comes to postpartum moods, there are so many lifestyle changes and hormonal changes that are beyond your control. This is not just a matter of will power. If you truly could manage to get through these months with determination and grit, I promise, you would have done it. However, if you realize that something is still feeling off, name this. Acknowledge that there is a part of you that is really having a hard time and is feeling helpless. This part deserves the space to talk, process, and recover.

Step Two: Reduce isolation

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

There is a reason that we have the saying, “it takes a village to raise a child.” Childrearing should be done with support, and in our culture, we don’t often have the network nearby. In line with our independent values, we are not always comfortable reaching out to these village members.

In encouraging a stronger support network, I ask that you reach out to any means of support that you feel is genuinely helpful and compassionate. This may include contacting family members, friends, neighbours, support groups, mental health counsellors, health care professionals, really, anyone who you feel safe around. If our loved ones are unaware of how much we are struggling, they may not recognize the need to offer help.

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

I know that some of us do not have the best support team. Sometimes our family members cause more harm than good. Their offering of help may come with judgments, criticism, or other consequences that make you feel worse than when you started off. Sometimes our family members become overwhelmed when we share our mental health struggles. Ironically, you may end up spending more time consoling them that your own needs are not addressed. In these situations, I encourage you to reach out to a local therapist (if financially feasible), or to find a non-profit counselling agency. Connecting with postpartum programs (e.g. Pregnancy and Postpartum Mood Disorders Program, Stork Secrets, Postpartum Support International) can help you find safe others that truly understand and are capable of helping with thoughts of suicide.

Your internal system

In Internal Family Systems Therapy, we recognize that our internal system is divided into parts. There are parts of us that are carrying wounds from the past (e.g. abandonment, betrayal, shame). These parts of our personality are often pushed away because they are too painful to acknowledge. In pushing away, we form protective layers. There are managerial parts of our system that work to prevent these wounds from getting triggered. These manager parts can appear as perfectionists, hard-working, critical, or conflict-avoidant. Their roles in our system is to run our day-to-day functioning without having our deepest burdens and wounds show up.

As I said before, when we push our feelings away, they tend to backlash. At some point, we get triggered. At these moments, we have reactive parts of our system that take over. They work to get rid of these vulnerable feelings as quickly as possible (e.g. drinking, anger, suicide). Ironically, whether our parts are playing a reactive or preventative role, there is a protective intent to help you from being overwhelmed by your wounds.

Step 3: Meet the key players of your internal system

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

In therapy, I work with clients to get to know all of the parts involved in pushing you towards or protecting you from suicide. We work on skills to separate from these intense emotions so we can observe them, hear them out, understand their fears and concerns, and have a better relationship with them. Can you imagine how you would feel if, when sadness took over, you could actually have the capacity to listen to it calmly without becoming overwhelmed? That is the beauty of IFS. When we can step back and listen to our system, we can begin to hear the fears, concerns and protective intent of even our harshest emotions. We are able to access those underlying wounds and support their recovery so that the rest of your system does not have to work so hard at preventing or reacting to triggers.

I understand this may sound unbelievable to many people. After all, you may have experienced suicidal thoughts for months and come to terms that you are “just an anxious mess” or “a pathetic parent.” Therapy can help shift this outlook. You are more than your anxieties, depression or other extreme parts.

Step Four: Address your coping mechanisms

In therapy, we take a close look at the patterns that your parts take on when they are active. We pay attention to what triggers your extreme emotions. We look at all of the coping mechanisms that are used to manage these extreme emotions.

Suicide and postpartum care. Internal family systems therapy to help work through suicidal ideation. Kasi Shan Therapy, counselling support in Kitchener, ON.

For many postpartum parents, their biggest fear is feeling incapable of taking care of their baby. When this fear gets triggered, these parents respond in anyway or form to self-soothe. Some of parents turn to drinking to help these thoughts calm down. Others look to their partners, parents or loved ones to take over, and avoid any time alone with their infant. Some parents get caught in a spiral of self-hatred, focusing on criticising themselves for being incapable. In therapy, we look at all of these coping mechanisms without judgement. These are the strategies that have kept you going all of these months, and we want to work with each piece respectfully, and discuss opportunities for change.

Change comes in many different ways. Each parent is unique and I don’t want to give generic advice when your needs may be significantly different from the next person. What’s important in understanding our system is that we learn to slow down to get to know these key parts better. We want to build trust that these coping mechanisms no longer have to be employed to keep us safe. We want to have permission to address those underlying wounds so that you have permanent healing.

Suicide is a quick fix for a problem with many alternative solutions

When it comes to postpartum care, I get that suicide is a fast response. We are struggling and we want the struggle to be over. Ending our life would be the fastest option out. While this may be true, this is a decision you can never take back. Before any part of you makes that ultimate choice, it’s important to ensure all of your alternative options are tested. The struggle in this request is that we may need some time to try out these other options. Your suicidal part is taking a risk in working with me. Rather than having a quick fix, I’m asking that we make some permanent shifts so that life does not feel so miserable.

If you would like to talk further, please feel free to reach out.

Take care,

Kasi

Schedule a consult
loving mother with anonymous son in floral shop

A Note for all “Mothers”

Published on by kshanmuk

On Mother’s Day, we are bombarded with social media posts doting on all the maternal figures in our lives. While there is no denying that there are some fantastic mothers out there, not all of us feel lucky to have this type of positive influence. Many mothers do not feel confident enough to call themselves fantastic parents. Working in the perinatal field, I am surrounded by mothers who struggle with this internal assessment of whether they are good enough parents to their children. On this Mother’s Day, I wanted to gather a few quotes that I hope will offer some comfort and guidance as you move through your own journey of understanding or experiencing motherhood.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I love this quote for recognizing that, as parents, we are working with a blank slate. Our interactions, guidance, compassion, and boundaries are all critical in teaching our children how to navigate in the world. In many ways, we will do an excellent job in offering the secure attachment to let them explore and gain independence. However, some of our own anxieties can come forward to affect the ways in which we influence our children. This does not have to be a deal breaker. Relationships grow. They can strengthen and weaken. Making a mistake or being imperfect is not a life sentence for your children or your relationship with them.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

We all carry wounded parts within our system. These wounds stem from trauma, heartbreak, grief, or other hardships we have endured in our lifetime. Sometimes, however, our wounds are not our burdens but those of our parents and the generations before them.

Your mother will pass many adaptive and effective qualities on to you. Other times, she will pass on teachings from her own hardships. Experiences like war, poverty, and racial injustice have taught the generations before us how to survive. Your mother’s emotional system had to change in order to adapt to these events. Accordingly, she may be anxious around police officers, she may push for frugality over spending, and she may express bitterness or anger towards a certain group of people. These behaviours are learned survival tactics. She needed them to manage in her world. It’s easy to pass on these tactics to you. These adaptive needs suddenly become part of your story, and you learn to navigate in the world using these behaviours, even though they may, or may not, be as relevant today.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I loathe when social media bombards us with pictures of idealistic parenting. I’m referring to those images of a parent serenely staring at her child (who is dressed to the nines and displaying perfect manners). Let’s face it: that is not reality. My child has meltdowns, just like yours. There are times when I have to coach myself before going to a grocery store or completing errands because I know my patience will tested. Being a mother can be very fulfilling. It’s full of love, laughter, elation, warmth and so many other beautiful feelings. Just as equally, motherhood knows exactly how to push your buttons. Your child is incredibly brilliant in knowing what will make you explode. And it is absolutely normal for you to want to some compassion and understanding (as well as a break!) during these moments.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

Following a birth trauma, we can get stuck in the narrative of how we conceived, carried, or delivered our child. This unsettling onset of motherhood can hold us in a state of frustration, guilt or even anger. Our traumas keep us caught in the past, and prevent us from fully enjoying the present moment with our newborn. Moreover, our trauma can keep us stuck in grief when we did not have the chance to welcome our baby into our lives.

For any parent who has experienced a birth trauma, I want to emphasize that healing is possible. Working through traumatic events can take time and support. Every mother goes through processing and acceptance at a different pace. However, PTSD does not nullify the fact that your life has changed. No matter how your birth experience turned out, your world has suddenly shifted. You may have brought home a new addition to your family. Your family may have lost the possibility of including a new member. No matter what has happened, your world looks different today than it did yesterday.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.
What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I love comparing these two quotes. Our kids can ground us and guide our lives. It’s easy to get sucked into their world doing after school activities, focusing on their development, and helping nurture their interests. However, as parents, our ultimate goal in child rearing is that our kids become independent people who no longer rely on us in this same way. In preparation for this eventual transition, I like to remind all mothers to not lose themselves completely in the process of parenting.

When we’ve done parenting right, our kids will leave us to live their own lives. It’s a big shift to suddenly focus on ourselves instead of them. To prepare for this change, nurture parts of yourself throughout their entire development. This may involve taking an hour to yourself at the end of the day, or going on mini-vacations on your own. It may mean developing your career alongside your childrearing. You were your own person before becoming a parent, and it’s important to not forget this pivotal detail.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.
What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

These are messages that I love to remind my perfectionist side. While my education has taught me how to provide therapy and support the emotional side of life, I am not an expert in all things related to motherhood. I recall panicking the first time my child had a fever. I remember feeling overwhelmed when I had to help my little one learn to sleep independently. There are countless memories of us trying to rush out the door on time for work, and of me losing patience.

While we want to be experts at everything, it’s next to impossible to achieve this goal. Your child did not come with a manual, and they will constantly throw new issues at you to figure out. Give yourself the time and patience to screw up and learn from these mistakes. You will not always be calm, you will not always know the right answer, and you will not always look like you have it together. That’s okay. We learn from all these experiences. Surround yourself with others who are also learning and can resonate with this need for patience and forgiveness. This is your support system that will get you through those hard moments. Mothers come in all different shape, sizes, capacities, histories, strengths and weaknesses. There is no formula that will be make us perfect parents, but we can do well in this job.

What does it mean to be a mother? Mother's day. Maternity. motherhood. kasi shan therapy offers counselling for mothers experiencing trauma and perinatal mental health.

I had to include this quote only because Matilda was one of my favourite books as a kid. But in many ways, Roald Dahl is right. Our kids can be ridiculous. They can be the obnoxious and make terrible fart jokes. They can be surly and give us the sassiest comments that make us want to scream. However, by the end of the day, we (usually) have our rosy-colored glasses back on and finding them to be magnificent, charming creatures.

To my fellow mothers, mothers-to-be, women who wish to be mothers, and maternal figures, I hope you all recognize your strength and patience in this process. Mother’s Day doesn’t have to be a special day if you don’t wish to celebrate it. Mother’s Day should not be only one day of the year that you are appreciated. I hope these quotes and messages offer you comfort and get you through this day. If you need support, please reach out.

Warmly,

Kasi

Contact Kasi for a free consult
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.

Contact Kasi
woman in gray tank top

Postpartum Rage: I am going to lose it!

Published on by kshanmuk

I feel like society normalizes feeling overwhelmed, insecure, and stressed as a new parent. While our society is more compassionate towards these vulnerabilities, there is much less acceptance when it comes to our anger. Postpartum rage is a common occurrence during the first year with a baby. It can show up as a symptom of postpartum depression, but it can also show up on its own. Unfortunately, since there is so much stigma about anger (especially anger towards an infant), parents hesitate to reach out for help. For this post, I’d like to open the conversation about postpartum rage. I’d like to normalize this anger, explain the ways it can show up, and strategies we can use to feel better.

What is postpartum rage?

Postpartum rage are short or lengthy bursts of overwhelming anger. Parents feels completely out of control, and struggles to get their temper under wraps. Everyone expresses anger differently; however, common signs of postpartum rage include:

  • screaming/swearing
  • physical expressions of anger (e.g. throwing items)
  • violent thoughts
  • inability to stop thinking about the upsetting situation
  • difficulty getting their emotions back to state of calm/neutrality

There is no one issue that triggers postpartum rage. Sometimes it’s the baby waking up at the middle of the night for the third time, other times it’s your partner forgetting to do the dishes. This can make it really hard for parents to predict when they will become upset. Or worse, they feel a lot of shame that a simple event, like forgetting to do the dishes, caused them so much distress.

When postpartum rage comes out, it’s extremely difficult to manage. For many parents struggling with this issue, they face a backlash of overwhelming emotions once the rage has subsided. This often includes guilt, self-hatred, shame, helplessness, or hopelessness. These reactionary thoughts and emotions can keep us spiraling in a low place well after the anger has passed.

Emotions last in our body for 90 seconds. After that, the physical sensation dissipates, UNLESS our cognitive brain kicks in and starts connecting our anger with past events.

Jill Bolte Taylor
(Neuroanatomist, author, and public speaker)

Anger as a secondary emotions

Working from an Internal Family Systems‘ perspective, I know that anger comes from a protective intent. It is often an impulsive act or last-case resort in responding to another issue. For many parents, postpartum rage is a result of feeling overwhelmed, resentful, isolated, uncertain or guilty. Unfortunately, these are all very common emotions during the postpartum year.

It’s easy to feel resentful of our single friends who can go out at night or sleep in on weekends. Many of us feel resentful towards our partners who have the option to get away from the baby for several hours a day to attend work.

A sense of isolation during maternity leave can feel debilitating. We are stuck at home with our insecurities, and only the company of a (demanding) baby for entertainment and companionship. The impact of isolation has become exponentially harder during the pandemic when activities like baby/mom groups, gyms, libraries, and other resources are no longer available.

photo of mother dressing an infant
Photo by William Fortunato on Pexels.com

The first year with a baby is full of so many overwhelming anxieties. From the baby’s first cold, to poor latches, and low weight, there are ample opportunities for a new parent to feel distressed. When we have had time to breathe, or if we have older children, we are more confident in our approach to parenting. We can forgive ourselves more easily after making a mistake. However, when we are vulnerable (e.g. being a first-time parent), the guilt and overwhelm can take over whenever we make mistakes.

Anger allows a safe option to cover up these underlying and more vulnerable emotions. It is an instinctive coping mechanism. Anger gives us a quick and fast way to release all of our pent up feelings. Once those feelings are released, we have more space to manage life, or we can push aside our resentment for one more day. In order to have anger soften, we have to work with these underlying issues. This can take time and trust with a therapist. After all, who actually likes acknowledging that they feel resentful or incompetent? Once these underlying factors feel more at peace, our anger will slowly start to shift. It no longer needs to take over in order to protect you.

What you can do on your own

Not everyone wants, is ready to attend, or can afford consistent therapy. Exploring your own underlying emotions is a unique journey. It will lead us to understanding your vulnerabilities, where they stem from, and what these parts of you may need from you in order to heal. However, if this is not an option for you today, there are things you can do independently.

  • Pay attention to triggers. Write down when your bouts of anger happen, and start paying attention for commonalities. Is it a specific person that gets you going? Is it a certain time of day? By noticing when you are most likely to get angry, you can have more options to problem solve or work around this trigger.
  • Recognize your body cues. Your anger will often show up in the same way somatically. Take a moment to think about the last thing that really pissed you off. How does your system respond? Does your body start to tense up? Does your mind start to race? Do you notice if there is a certain location in your system that carries the most activation? Once we are aware of our somatic cues, we can start to respond to them faster. Similarly to knowing our triggers, it’s helpful to know our bodies. For example, if your heart starts to race and your hands get clammy, that can be a wake up call to have your partner take over while you take a break.
  • Evaluate your expectations. A lot of our guilt comes from high expectations of how we ought to be as parents. Consider if these standards you’re setting are fair. The best way to consider if you’re setting yourself up is to ask if you’d push these same expectations on a friend or loved one.
  • Address loneliness. It can be incredibly challenging to ask for help or voice to others that we are feeling isolated. Yet, if there’s one thing this pandemic has taught us, we need to stay connected. As human beings, it is in our nature to be social. This does not mean you have to plans everyday; however, scheduling a weekly check in with a friend, or going on a regular walk with your neighbour may be enough to shift out of the loneliness.
  • Prioritize sleep. I have written earlier posts about sleep hygiene, and I encourage you to try out these strategies. Your little one may be waking up several times at night, in which case, I recommend coordinating with your family members to have at least 4-hours of consolidated sleep. This allows you to have the opportunity to complete one full sleep cycle. It’s okay that this deep rest comes at 6 PM. As long as you are having these four hours daily, your mental health has a chance to be less distressed.
  • Make time for your own interests. You can be an incredible parent AND be your own person. It’s easy to lose ourselves in becoming parents. All of your interests, hobbies, and passions get dropped to the wayside to focus on your little one. While this is normal at the start, we want to ensure you create some balance. This little person will always be in your life, and it’s important you don’t lose your good habits (e.g. self-care, exercise, extracurricular activities, time with friends) while parenting. When you carve out some consistent time for your own interests right from the beginning, it can be an easier habit to maintain long-term.
  • Reduce your to-do list. Sometimes, in the sake of being productive and managing all of our expectations, we create a lengthy lists of tasks to accomplish. Postpartum rage is often a result of feeling overwhelmed, and one of the simplest ways to manage is to look at what can be dropped from your list. I get that we’d love to have a pristine household, be incredibly fit, have time for work, and manage a full social calendar. However, it’s not possible to achieve all of these needs at once. So consider what needs to be prioritized and what you’re willing to be flexible on.

Postpartum rage can get better

Postpartum rage is awful and it’s incredibly common. Unfortunately, for many of us, we carry so much shame in getting triggered. Postpartum rage is one of the many postpartum mood and anxiety disorders that can take place in the first year. As Postpartum Support International wisely tells all parents in this phase, “You are not alone. You are not to blame. With help, you will be well.”

Warmly,

Kasi

Schedule a free consult

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.

Contact Kasi
What to do with baby blues. Kasi Shan Therapy. Online and in-person counselling in Kitchener, ON. Image courtesy of Canva.com

Working through the Baby Blues

Published on by kshanmuk

Many postpartum parents can attest that the first two weeks after delivery can feel like a nightmare. With the numerous changes that a parent experiences (e.g. hormones, sleep patterns, feeding schedule, diaper changes, etc), those initial days are about surviving the storm. Unfortunately, for many of us, adapting to these new changes can feel like an emotional roller coaster, and we begin to experience baby blues.

Baby blues can show up in a variety of ways. Within the first few days postpartum, caregivers can experience one of the following symptoms:

  • Easily irritable and snappy
  • Feeling overwhelmed
  • Sadness or tearful (sometimes with limited reason or triggers)
  • Higher levels of anxiety and worry
  • Impatience
  • Restlessness
  • Fatigue
  • Difficulty sleeping (even when the baby is asleep)
  • Mood changes
  • Poor concentration

Unfortunately, baby blues is a normal part of the postpartum phase. It is experienced by approximately 80% of caregivers, and improves within two weeks without any intervention. While baby blues is no longer considered a mental health issue, many parents struggle during these early days. For anyone who has experienced this distress, you can relate to the desperation of needing to get off this emotional roller coaster. I hope the following tips will offer comfort to you and your family during these times.

1. Remember that it takes time to adjust

Beyond the hormonal fluctuation, a new parent is thrown into various physical and lifestyle changes. Your body has just gone through the painful experience of child birth, and is trying to recover. You are figuring out how to breastfeed, or coming to terms that you will use formula with your little one. You may have limited access to rest as you wake up every two hours to feed your baby. Perhaps you are struggling with regrets (e.g. you were hoping for a different delivery experience, or grieving that you have a baby boy instead of your preferred baby girl). Many mothers struggle to accept their post-delivery body, and resent that they still look pregnant. There is a huge learning curve with your partner in managing household chores and parenting. These are just a handful of changes that a parent can experience during these early days.

These changes are significant, and can take time to sort through. When it comes to adjustment, every one has a different capacity of how well they transition. For most people it can take anywhere from 4-6 months before accepting a new reality (e.g. adjusting to new job, new career, new city). This time frame will vary if there are additional stressors placed on our system (e.g. lack of sleep, financial constraints, loneliness, grief).

While we know that change can take time, we often have a hard time accepting that we need the time to adapt. Ideally, we’d love to shine and present as well-adjusted human beings irrespective of whatever stressors are thrown our way. While I hope you are one of the lucky few who are adaptive, chances are you are among the norm for needing some time to readjust. My favourite reminder during my own postpartum phase was that it took me 9 months to grow this baby, it’s okay for me to take the 9 months to learn and adjust. This time frame helped me ease my own expectations of getting things right or expecting fast results. What time frame have you set for yourself?

Watch out for shame

Baby blues is not your fault! I hope you repeat this line to yourself as many times as you need to in order for that message to sink in. The majority of your emotional distress is influenced by hormonal changes. During the course of pregnancy, there are thousands of hormones taking over a mother’s system. These hormones quickly leave your body within the first two weeks following your child’s birth. Unfortunately, this quick shift in hormonal fluctuation can create a huge emotional roller coaster inside. For example, a reduction in estrogen can affect our ability to concentrate, and a drop in progesterone increases our fatigue. Both estrogen and progesterone plummet once our body recognizes we are no longer pregnant.

Many new parents struggles with attaching to their newborn. While this is perfectly normal, it’s not often openly discussed. Instead, we are bombarded with images online of parents who are overjoyed and attached to their new baby as soon as delivery happens. There can be a lot of shame for parents to voice that they do not feel attached to their baby. I want you to know this is perfectly normal. In all other relationships you are given the time to build rapport and get to know another person. This doesn’t mean we stop taking care of the baby, or attending to its needs. However, like with any relationship, it’s okay to take the time to get to know one another. For many folks attachment can take a few months. We often see improvements when the baby becomes more interactive and starts to respond to smiles and other social cues.

As often as possible, I encourage you to practice self-compassion and forgiveness during these two weeks. You will, understandably, have less patience when you are sleep deprived and tired. It would make sense that you are having a hard time concentrating on what others are saying because you feel like a walking zombie. It’s normal to feel overwhelmed during a major life transition. As much as this is a beautiful moment in your life, it can also be a moment of suffering. This moment will pass, and you will keep surviving. As long as you are not jumping on that guilt/shame-train, you can get through this moment.

Find opportunities to rest

I found that the most frustrating tip that others gave to me during my postpartum period was to nap when the baby was napping. Unfortunately for me, I am not a napper. I realized I became more frustrated and upset whenever I tried to nap during the day.

So let go of the pressure to fall asleep. Instead of focusing on getting some shut eye, try to take some time for your body to relax. This may involve watching TV, reading a book, or taking some quiet time outside in your backyard. If you happen to take a snooze during one of these activities, great! But ease off on the pressure to make this rest happen.

If it’s feasible, make a sleep chunking plan with a partner or family member. Find a way to ensure you have four hours of uninterrupted sleep so that you have the opportunity to complete a full sleep cycle. For example, speak with your partner and assess which one of you prefers to stay up late versus wake up early. This might involve going to bed at 7 PM so that your partner can do the 11 PM feed. You may also have to problem solve with your partner about feeds. This may involve pumping or formula feeding in order to have this time for sleep.

Do you want help or do you need space?

Everyone’s need for space and help changes and fluctuates. Knowing what your system needs, and being able to request this openly with our loved ones can make a huge difference to our moods.

There may be times where you are really craving alone time with the baby, and this is perfectly healthy and allowed. Pushing yourself to see friends and family who are eager to meet the baby may actually be causing more stress than good. The majority of us are conflict-averse, and oftentimes, we say yes for the sake of avoiding potential drama. However, what does that short-term aversion create for your system? If you find you are irritable or tired for hours afterwards, you get to decide if this option is actually working for you. The hard part with boundaries is that they are OUR limits, not those of others. Others will keep voicing their own needs; however, our mental health struggles if we become a ‘yes person’ for too long.

What to do with baby blues. Kasi Shan Therapy offers perinatal mental health in Kitchener, ON & online.

There may be times when you need support. If so, try and be specific of what would be helpful. Do you want someone to watch the baby while you rest? Would you like your parents to bring over some home cooked meals? Do you need a friend to help you organise the nursery? Your loved ones may say no to these requests, which is allowed. However, they will not always know that this is the type of support you need unless it’s stated. We would all love for others to mind read and “know” just what we need and crave. However, until this ability becomes feasible, we just have to ask.

What can my family members do?

Whether you have your loved ones read this section, or you have to explain it to them, make sure they are well-versed in these points. Family members, please try the following suggestions:

  • Check your expectations. Delivery is similar to surgery; your body needs 6 weeks to fully recover. Pushing a mom to do chores, make meals, manage what she used to, have sex, or any other responsibilities may not be feasible right now. Asking for these requests will not work in your favour and will only cause this new parent to feel guilty, ashamed or enraged. For everyone’s sake, wait it out.
  • Show lots of compassion. This is not a parent’s fault. Baby blues is not based on will power. This is truly a biological upheaval that is happening before your eyes. Your loved one will get better, and you will see a semblance of that person in a few days.
  • Ask what would be helpful. A lot of us love to cuddle babies. But if your only offer of support is to hold the baby while mom rests, this may not actually be as helpful as you intend. The easiest way to avoid this issue is to simply ask or offer suggestions.
  • Find other support systems. This new mother may be your favourite person to talk to and confide in. While this relationship works beautifully most days, she may not have the capacity to attend to these needs right now. Ask her what’s preferred. Pay attention to cues of stress. If it’s too much, it’s okay to reach out to other friends and loved ones.
  • Learn about postpartum mental health. Your loved one may not see the signs of postpartum mental health struggles until it is too late. It can be challenging to acknowledge we are struggling, and most of us experience a time of denial or avoidance. By knowing the signs for postpartum mental health disorders, you can be aware when you see your loved one shows symptoms. Let them know that postpartum mental health is treatable, and they can absolutely get better with the right help.

When should you be concerned?

The Edinburgh Postnatal Depression Scale (EPDS) is a self-assessment that can be taken during pregnancy and postpartum to assess moods. Complete the EPDS during your first two weeks postpartum, and take it again when you are closer to 4-6 weeks postpartum. If this current struggle is truly baby blues, your score numbers will be down significantly (either 8 or lower) by 6 weeks postpartum. If your anxiety and sadness continue to be a struggle, you may be experiencing other perinatal mental health struggles like postpartum depression. The wonderful caveat about postpartum mental health is that it can improve! With support and the right interventions, you can start to feel like your old self.

If you have any questions about the above information, reach out.

Warmly,

Kasi

schedule a free consult

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.

Contact Kasi

Understanding Birth Trauma

Published on by kshanmuk1 Comment

You’ve been patient, waited 9 months, and dealt with all of the aches, nausea and fatigue in order to get to your delivery date. You may have an ideal birth story in your mind; many of us do. Some parents imagine a specific atmosphere while delivering (e.g. support people around, delivering at home). Some parents plan pain management strategies (e.g. I want an epidural). Others are keen to have skin to skin contact immediately after delivery. No matter what your plans are for delivery, there is hope that things go smoothly. Unfortunately, birth trauma can pull us far away from our ideal birth story.

Trauma is an unexpected and stressful experience that alerts our system of danger. We become acutely aware of impending harm or threat to our being. A birth becomes traumatic when we are fearful that we, or our baby, will die. Birth traumas happen in about 1 in 4 deliveries. These parents experience feelings of being abandoned, helpless, disrespected, scared, overwhelmed or powerless during their birth experience. Approximately 9% of parents experience their moods worsening into a diagnosis of postpartum post-traumatic stress disorder.

Types of Birth Traumas

There are various complications that can happen during or after delivery. Common birth traumas include:

understanding birth trauma. postpartum PTSD. Kasi Shan Therapy. Counselling in Kitchener, Ontario.
  • Emergency treatment following birth (e.g. stay in NICU)
  • Stillbirth/neonatal death
  • Preterm deliveries
  • Assistance during delivery (e.g. use of forceps)
  • Unplanned c-section
  • Prolapsed cord
  • Feeling a sense of abandonment or powerlessness
  • Lack of support or clarification during and after delivery
  • Lack of privacy or dignity
  • Physical complications (e.g. postpartum hemorrhage, unexpected hysterectomy, perineal tears, prolapsed uterus)

Following these birth traumas, caregivers begin to notice a change in their own moods and capacities. Similar to post-traumatic stress disorder, survivors can experience:

understanding birth trauma. postpartum PTSD. Kasi Shan Therapy. Counselling in Kitchener, Ontario.
  • Extreme sensitivity and awareness to surroundings (a.k.a. hypervigilance)
  • Easily startled
  • Difficulty concentrating
  • Change in appetite
  • Memory blocks (unable to remember parts of the traumatic experience)
  • Difficult coping behaviours
  • Intense shame, irritability, or anger
  • Suicidal urges
  • Sleep difficulties and nightmares
  • Difficulty in social relationships
  • Unpleasant intrusive thoughts
  • Flashbacks
  • Pain, sweating, trembling, when thinking of the birth
  • Avoidance of birth reminders (e.g. being with own child, seeing other babies, hearing other birth stories, medical settings)
  • Anger towards medical professional or others involved during delivery
  • Poor attachment with baby

As with any mental health struggle, this is not a matter of will power. You are not choosing to respond in this way. You are not in control of these overwhelming emotions. When traumatic experiences occur, our system cannot always manage. We lean into whatever coping strategies are available to help us survive. Some of these coping strategies are done intentionally (e.g. avoiding the baby), and other times, we have limited control over them (e.g. bursts of anger).

What influences PTSD?

During the first month following a birth trauma, we want to monitor a parent’s well-being. This time is pivotal. Trauma survivors continue to assess the world and whether it is safe and predictable once again. They need to see that this birth trauma is a unique experience, and that it is highly unlikely to reoccur. Grief, anger, anxiety, wanting to understand, and seeking support are all natural forms of processing that tend to occur during this phase. The body’s ability to naturally process and return back to a sense of safety can be influenced by the following factors:

Prenatal Stressors

Prenatal stressors can include miscarriages, unplanned pregnancies, health scares, physical complications, unexpected bed rest, or fertility stressors. During these months of pregnancy, an individual can survive a variety of unexpected hardships, such as financial burdens, divorce, or bereavement. Furthermore, some pregnant couples have lived through a traumatic experience earlier in life (e.g. medical traumas).

It is understandable that these parents enter the delivery room feeling more cautious and nervous. If we have experienced any of these earlier adversities, our nervous system has already been fighting for some time to cope. It is already experiencing symptoms like hypervigilance, intrusive thoughts and nightmares. When we have already experienced trauma, our window of tolerance becomes narrower. Another stressful event can push us past our limit of tolerance.

Interactions with medical staff

understanding birth trauma. postpartum PTSD. Kasi Shan Therapy. Counselling in Kitchener, Ontario.

The interactions you have with your healthcare team can immensely influence your experience of child birth. How did your healthcare provider connect with you following a miscarriage? Was there space for you to grieve or did your provider seem too busy? Was the physician empathetic or was he or she scornful? If you are already wary of medical staff, how would you feel entering a delivery room?

Deliveries are busy times times, and your healthcare team is focused on moving things as efficiently as possible. However, at a time when you feel vulnerable, it can easily feel like your healthcare providers are curt, dismissive or inconsiderate of your emotional needs. When decisions like C-sections or taking the baby immediately to NICU are outside of your decision making, it can feel like your autonomy and sense of control has been taken away. The medical team’s decision to take these steps are likely valid; however, caregivers are left feeling powerless and confused.

Lack of support

It is natural to want to hide when we are grieving. It is natural for us to avoid others if we feel ashamed or responsible for a difficult birth. Isolation and loneliness tend to worsen our moods. There is so much healing that occurs when we feel someone truly understands and recognizes our pain.

When parents express grief and distress following a birth trauma, many family members do not know how to respond. Our friends and family have good intentions when they reassure with comments such as: “At least the baby is here,” or “Count your blessings,” or “Be grateful for what you have”. These types of comments are, unfortunately, invalidating. A parent continues to feel alone and misunderstood by their support team.

understanding birth trauma. postpartum PTSD. Kasi Shan Therapy. Counselling in Kitchener, Ontario.

To offer better support, please ask caregivers if it’s okay to be with them during this time. If these parents want to talk, please listen with an open-heart. When we are grieving, our support team cannot fix the past or make the pain go away. However, by offering a safe space for these intense emotions, our friends and family provide us opportunities for healing.

Healing from a birth trauma:

Not everyone requires extra intervention following a birth trauma. Support from loved ones and time can be enough to help someone work through this intense and difficult experience. However, for more complicated situations, like postpartum PTSD, it’s imperative we reach out for help.

Eye Movement Desensitization and Reprocessing (EMDR) is an incredibly effective way to process and heal from birth traumas. This therapeutic modality helps an individual speak about traumatic memories while using bilateral stimulation (e.g. eye movement, audio cues, tapping) for short sets of time. In using this combination, EMDR triggers the traumatic memory network in the mind. Participants notice a reduction in distress and vividness to a traumatic memory. They also notice how the mind works to form connection with other events that have impacted this trauma, or have been impacted because of this trauma. Depending on the complexity of the traumatic events, clients can start to see improvement within 6-12 sessions. If you would like to learn more about EMDR, I encourage you to read this earlier post.

If you are struggling following a birth trauma, please do not stay silent. Reach out to a safe person such as a family member, friend, or a professional. If you would like to work through your birth trauma using EMDR or other effective therapy styles, please reach out.

Warm regards,
Kasi

schedule a free consult
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.

Contact Kasi

Wanting to be a better parent

Published on by kshanmuk

Every caregiver can appreciate the desire to be a better parent for their kids. We can also appreciate how this goal seems unachievable when we are snapping at our little ones after the third tantrum of the morning. The desire to be a better parent comes from good intentions; we want these tiny humans to develop into healthy adults. For those parents who are overwhelmed, fearful of screwing things up, close to burn out, or just feeling generally lost, I hope this post offers you some guidance and comfort.

Accept that perfection is impossible:

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

The perfectionist part of me hates this title. But this is a message that I tell myself as often as I tell my clients. In order to be a better parent, we have to get rid of this notion for perfection. We are not going to be perfect, and truthfully, we don’t have to be perfect.

There was incredible research done by child development expert, Dr. Ed Tronick, in the 1980s. He and his team showed the impact of attuning to our children. Meaning, when your child reaches out, is distressed, or needs attention, how do you respond? When it comes to secure attachment, we want to ensure our children are safe, soothed, and seen.

However, Dr. Tronick emphasizes that it is impossible to be attuned all the time. We are going to be busy, and have other responsibilities that pull our attention away. We cannot always respond when our toddler wants us to play or when our teen wants to talk. In fact, in his research, Dr. Tronick found that even the “best parents” were only attuned to their kids 30% of the time. Furthermore, this 30% is enough to raise secure and healthy children.

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

This number always floors me. While our perfectionist parts may want us to excel, it’s important to recognize that, our relationship to our kids can remain healthy and strong irrespective of making mistakes. This doesn’t mean that we’re being jerks the remaining 70% of the time. However, when our kid asks to play, and we’re busy putting away laundry or making supper, we cannot meet our child’s current needs. This is considered misattunement. I hope the guilt reduces when you hear that these moments of misconnection are not harmful. Your kids will be just fine, and will continue to have a secure relationship with you, despite these moments of being unavailable.

Own your mistakes.

This 30% guideline can also be helpful when we have moments of anger, frustration, irritation, or any other difficult emotion towards our child. This is normal! You are going to screw up. I am going to screw up. It sucks. Anger is a normal emotion for humans. However, anger can either stay in our heads as unpleasant thoughts or come out in some form of regretful behaviour. If the latter occurs, it’s essential we address it.

One of my favourite skills to address these regretful moments is a therapeutic apology. This term comes from Emotion-Focused Family Therapy. A therapeutic apology is a deeper acknowledgement when we have made a mistake. It involves validation, and taking the time to voice what these events must have been like for our kids. Therapeutic apologies also offers the commitment for change, and a promise for a better relationship.

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

You may dread bringing up the past once the conflict is over. It may feel messy to stir up a wound that is starting to recover. However, we don’t know the impact that these moments have had on our kids. Following divorce, domestic violence, substance use, and any other mental health stressors, our kids are affected. Despite their denials, dismissals, or refusal to talk about things, kids are influenced by these events. While we may not want to bring up the past, a therapeutic apology supports kids in letting go of any burden or weight they carry because of these events. Being a better parent involves taking the time to acknowledge our past mistakes. These meaningful acts help us repair relationship ruptures, and creates safety in the home to admit our mistakes.

Role Modeling

Our children look to us for guidance. The manners in which we handle difficult situations shapes the ways our children manage their world. Gone are the days when we proclaim, “Do as I say, not as I do.” Role modeling can seem daunting, but truthfully, it’s an opportunity. Don’t get me wrong, you are going to screw up (again, read the sections above!) However, you can strategically plan how you will role model. What can you take the time to show your children? If your child experiences anxiety, how can you role model staying calm? If your child struggles with negative self-talk, how can you role model self-compassion? I like to ask parents to think of what behaviours they would to see increased in their child. Then we create an action plan of how these parents can showcase this specific behaviour to their children.

Talk about the good and the bad

I find that it’s helpful to talk to our kids about when we are having good days and bad days. We want to explain things to them in child-friendly ways versus rehashing all the nitty-gritty details. However, it’s important for kids to know that stressors happen to everyone. We can share that we had a difficult encounter with our boss, and explain how we intend to carry forward. We can also normalize that some problems are not easily solvable, and that it can take time to consider options.

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

Many of us are raised in an emotional-avoidant culture. We don’t talk about difficult topics, and instead focus on happiness, sunshine, and rainbows. This doesn’t help our youth. They will face hardships as they grow up. Learning that hardships happen for others can help our kids realize they are not alone. It can give them a framework to compare and assess their own troubles. It will also provide our children with more coping strategies and problem solving if they encounter similar situations.

Plan for Melt Downs

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

The hardest part of being a parent to a young kid is the meltdowns. They happen, and it’s awful… especially when it’s in public. It’s important to take a moment and reflect what is being triggered in you during these moments. Are you frustrated that they’re not listening? Are you stressed because others are watching you? Maybe there’s a sense of helplessness in not knowing what to do. In taking the time to consider what parts get activated for you, you are better able to support your system. You are able to spend time with this triggered part, understand it’s fears, it’s protective intents, and build trust within your system (these are skills from internal family systems therapy).

Once you are feeling less triggered, you have more space to be a better parent. You’re able to stay present and attuned. This can mean holding your child and supporting them co-regulate. It may involve sitting down with them and asking for clarity in why they are feeling so intensely. And, in some cases, it may mean setting some limits about acceptable and unacceptable behaviour.

Setting Limits

Setting limits can be tough, and the best way to lose this game is through inconsistency. Take some time to consider what typically sets off your child. Or, just as importantly, what behaviours drive you bonkers?

I encourage having a conversation with kids about rules and expectations. While this may or may not stop the behaviour, it also gives the chance for kids to share feedback and problem solve how they want to handle these moments. It’s important that you and your kids are aware of what is inappropriate behaviours, and what will be the consequence (e.g. removal of privilege). Once these ground rules are established, it’s essential that we follow through.

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

Because it is important to carry out the established consequences, it helps to only pick a handful of behaviours you’d like to reduce. If you try and change too many things, it’s easy to lose track. So, pick your battles. What behaviours are most important for you to reduce? For example, in our household, we have set consequences when it comes to being physically aggressive.

I would highly recommend setting a consequence for a short period of time (e.g. for young kids, no longer than an hour; for school age kids, a maximum of a day; and for teens, no longer than a few days). When your child has broken curfew, or taken the car without permission, I get that you want to ground them for a month. However, this gives our children zero chance to redeem themselves. It also means you have to carry out the set punishment. Can you imagine following through on a consequence of no TV for two weeks? You will lose it as much as your kid. With older teens, rather than learning from the consequence, they are just focused on being angry at their stubborn parents.

Shaping behaviours through praise and attention

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

When you think of all the behaviours and skills you’d like to see in your kid, what’s most important? Let’s say that you’re noticing your daughter has a pattern of getting angry and slamming doors after arguments about curfew. You can remove a privilege whenever the door is slammed, but how do you reinforce what she is meant to do instead?

We’ve already discussed role modelling appropriate behaviours. Beyond this, it’s important to recognize whenever your child is doing well. This means paying attention to times when your daughter speaks calmly, walks away to take some space, and when she does home before curfew. When these occurrences happen, how do you reinforce them? While we can use rewards to help increase behaviours we want to see (e.g. extra dessert for every time you tidy up your room), praise and positive attention are equally effective.

As a forewarning, your teen will still scoff and roll her eyes when you praise her for talking calmly. However, on a daily basis, your child is bombarded with negative attention. Whether it is due to these arguments, social pressures, poor grades, or feedback from teachers, she is aware of her flaws. Positive attention is pivotal. We seek approval. When you can express this approval in a genuine manner, your child will slowly respond.

Make play a priority

We all have busy lives, and we cannot invest 10 hours to minecraft, even though our kid may beg. However, being intentional about setting aside some times for being with our kids is important. Spending time that doing activities that your child enjoys (and that you can tolerate) will allow some space for this relationship to heal. We can seek out quality time in various ways. This can involve chatting during a car ride home, watching a favourite show with them, playing video games, or inciting them with a promise of Starbucks if they would be willing to hang out.

wanting to be a better parent. parenting. EFFT. Emotion-Focused Family Therapy

Your kids will not always be enthusiastic about this type of attention. But we do not grow close to people who we barely talk to or see. It’s important that we carve out these opportunities, even though it may feel like pulling teeth with your teenager.

As always, the consistency matters. You can be clear to your kid about your intentions. It’s okay to say, “I miss you, and wish we were closer. Can we go for ice cream?” It’s helpful to let them know, after supper is when we get to hang out as a family and play cards. Having this consistency helps them recognize you mean it when you say you want to spend time. Especially for older kids, if there have been a lot of conflict, they’ll feel cautious in trusting you. As with any other relationship, rebuilding this trust takes time and patience.

Know that you are doing your best

Depression, anxiety, trauma, or any other form of mental health can affect the way you would like to parent. Daily life stressors, like a busy work schedule, demands from other children, or financial constraints, can affect the way you’d like to parent. We cannot always control these variables. However, the security and positive bond you have with your child is incredibly healing.

This post offers general strategies, and every person comes with their own history and unique set of needs. For support related to your own family and parenting, please contact me for a free consult. Stay tuned for further parenting supports via an Emotion-Focused Family Therapy workshop for advanced caregiving.

All the best,

Kasi

Schedule a free consult
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.

Contact Kasi

Postpartum OCD: The Curse of Never-Ending Scary Thoughts

Published on by kshanmuk

While postpartum depression and anxiety have become more widely-understood, there is still limited research about postpartum obsessive-compulsive disorder. This mental health struggles occurs in approximately 1-10% of parents. Since postpartum OCD presents as excessive worrying and helplessness, it is commonly misdiagnosed as anxiety, or worse, it is dismissed as “normal worrying”.

person washing his hand
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When you think of OCD, your mind may jump to stereotypical examples like excessive hand washing due to a fear of germs. With postpartum-OCD, parents are often struggling with scary thoughts regarding the safety and well-being of their baby. As a forewarning, some of the examples shared below can be triggering. Please read with caution, and reach out if needing support.

The first element of OCD: Obsessions

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There are two key components that make up OCD. The first is obsessions. Obsessions involves intrusive and distressing thoughts, images, or beliefs that continue to repeat incessantly. Individuals struggling with obsessions do not feel in control of these thoughts, and are quickly overwhelmed. Common OCD obsessions include:

  • needing order or symmetry
  • fear of harming yourself or other people
  • unwanted sexual thoughts
  • religious obsessions (e.g. fear of offending God)
  • fear of limited or lack of control (e.g. acting on impulsive urges to shoplift)

Common obsessions with Postpartum OCD:

crop mom dressing newborn on bed
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  • Contamination fears (e.g. bottles not being cleaned thoroughly)
  • Fear that baby will get sick or die (e.g. sudden infant death syndrome, car accidents)
  • Sexually intrusive thoughts (e.g. what if I am turned on when changing my baby’s diaper?)
  • Concerns about hurting the baby. For example:
    • What if I drop the baby and her head cracks open?
    • Intrusive thoughts about stabbing/shaking the baby
    • Image of drowning baby in bathtub
    • Urge to scream at baby
  • Concerns that others may harm the baby
  • Stress about making the wrong decisions (e.g. feeding the wrong food)
  • Rigidity to schedules/routine (e.g. nap times, feed times)

The second element of OCD: Compulsions

An individual with OCD is aware that these obsessions are not valid or logical. However, because the images or thoughts are so distressing, it feels important to get rid of them quickly. This is how compulsive behaviours start. When an obsession becomes too much to handle, compulsive behaviours are used to manage them. If you’re scared of germs, you start to wash your hands. If you’re scared of your baby dying during sleep, you may need to check repeatedly during the night to ensure safety. These compulsions are not effective in actually eliminating or addressing the fear; however, they provide a quick fix in that moment. Because the intrusive thought comes back quickly, the compulsive behaviour is repeated in order to help the individual calm down.

Common Compulsions with Postpartum OCD

When it comes to postpartum OCD, these parents are overwhelmed by the idea of harming their baby or being unable to protect their baby. Compulsive behaviours involve any means in which to offer their baby protection. Examples include:

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  • Avoidance of the baby
  • Checking repeatedly to see if bottles/supplies are clean
  • Excessive-reassurance seeking from health care professionals to confirm that baby is safe and healthy
  • Removing all sharp objects from the home
  • Avoiding any news or media related to child abuse (due to fear of being turned on)
  • Refusing to give baby a bath
  • Refusing to change diapers (due to fear of sexually abusing baby)
  • Avoiding breast feeding or eating certain foods to prevent contamination
  • Excessive praying
  • Isolating baby from loved ones
  • Not driving in the car with baby

Some compulsive behaviours seem normal. After all, double checking that the bottles are clean, or peeping in to the nursery to ensure your infant is asleep are perfectly normal tasks that all parents practice. The concern with compulsions is when these behaviours are done repeatedly. When intrusive thoughts are too distressing and compulsions take up a large chunk of time, our quality of life starts to suffer.

The commonality of intrusive thoughts

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Most of us, irrespective of having a mental health diagnoses, will have disturbing thoughts from time to time. In fact, intrusive thoughts happen to approximately 80% of new parents. We’ll have a fleeting thought about falling off a balcony, driving into oncoming traffic, or yelling at our family members. When we are not fraught with distress and fatigue, we can usually shake our heads and call it for what it is: a strange thought. We may scoff and think it’s odd, but we don’t put too much thought into it, and can move on. For those with postpartum OCD, intrusive thoughts are so distressing that these parents assume there is some truth or meaning to these obsessions. Rather than shaking their head and saying “what a weird thing to think”, they become overwhelmed with guilt and shame at ever considering these thoughts.

Fears in reaching out

In a previous post, I had talked about some of the barriers that prevent parents from seeking help. One of the biggest blocks in reaching out for help is the fear that expressing these intrusive thoughts will lead to a call to the Children’s Aid Society. For those who struggle with this fear, I would like to reassure you that having a scary thought does not mean you are going to act on them! Parents with postpartum OCD have the best intentions for their children. They are overwhelmed by the fear of causing any harm that they are willing to practice whatever forms of compulsive behaviours to avoid this potential issue. Seeking help does not mean a call to the authorities.

postpartum OCD and anxious thoughts
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Postpartum OCD is not a “mom’s issue”; it can also be experienced by dads, adopted parents, and other caregivers. If you or a loved one is experiencing intrusive thoughts during the postpartum months, please do not stay silent. Postpartum mental health is treatable. If you are concerned about your own symptoms, but are not ready to talk, you can fill out the Yale-Brown Obsessive-Compulsive Scale to complete a self-assessment.

Take care,

Kasi

Schedule a free consult
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.

Contact Kasi
Anxious thoughts during postpartum

Common anxious thoughts during the postpartum year

Published on by kshanmuk

Cognitive-behaviour therapy has taught us that there are certain themes to our anxious thoughts. These themes are referred to as “cognitive distortions” or “thought traps” in CBT lingo. Anxious thoughts can happen to any of us, irrespective of whether or not we have a clinically diagnosed mental health issue. More often, they tend to pop into our minds when we feel vulnerable. Unfortunately, during the postpartum year, there are numerous vulnerabilities that new parents face. Examples of these vulnerabilities include lack of sleep, hormonal shifts, adjustment to a new life, changes to routine, and an increased sense of responsibility. The following are a list of common thought traps, and examples of how they may show up for postpartum parents.

Common anxious thought patterns that new parents experience:

Over-generalization

common anxious thoughts during postpartum
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When we over-generalization, we are making assumptions based on limited information. This means we come to a conclusion about someone or something from a single piece of evidence. In future circumstances, we overestimate the likelihood that the same set of events will happen again. The following are a few examples of how over-generalization can show up during the postpartum stage:

  • “My baby is not latching right away, I’ll never be able to breastfeed.”
  • “This baby has been fussing for nearly an hour. I am never going to be able to get to sleep.”
  • “My spouse was so tired and cranky when he came from work yesterday. I don’t trust him to take care of the baby on his own in the evening now.”

Catastrophising

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This anxious thought pattern basically means we are magnifying an issue into something awful and disastrous. We may do this by exaggerating the meaning or importance of certain events. Often times when we catastrophise, there is a sense of dread in facing uncertainty. We don’t feel we have the skills or confidence to manage in this situation. Examples of catastrophising during postpartum care include:

  • “My spouse and I argued this morning. We must be heading towards a divorce.”
  • “I got angry with the baby. We are never going to have a good relationship. I’m not cut out to be a parent.”
  • “Sleep training was so hard yesterday. I can’t imagine that it’s going to get better.”
  • “My daughter freaked out at the doctor’s office. The staff must have been pissed that I couldn’t calm her down. I can’t go back there.”

All-or-nothing

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All-or-nothing thinking keeps us stuck between two restrictive options. This anxious thought pattern refers to when we things as falling into extreme categories without any middle ground. We are either perfect or a complete failure. Things are either good or bad. Life is either easy or impossibly hard. When we focus on these polarized options, we forgot to notice exceptions to these extreme thoughts. We don’t take into account all of the various and complex factors that may have affected achieving full success. We don’t consider how our self-worth is separate from our achievements.

Personalizing

Personalizing is when we take on the responsibility of a situation or take ownership of other people’s behaviours. This happens quite often with parents who take on the responsibility of their child’s behaviours as if they are fully to blame. It does not allow space for the many external factors that could have also influenced what had taken place.

  • E.g. the baby is teething and unable to fall asleep: “I’m a lousy parent. I can’t help my baby get some rest.”
  • E.g. Your partner received negative feedback from his/her boss. “It’s my fault. I kept my spouse awake by asking for help during the feedings.”
  • “It is my fault that my baby is not walking, talking, or meeting a developmental mile stone at this time. I must be doing something wrong.”

Should Statements/Perfectionism

This anxious thought pattern is really tough during the postpartum period. We are all trying our best as new parents, but the pressure to manage these high standards can be incredibly straining. Perfectionist thoughts involve terms like should, shouldn’t, must, must not, ought to, have to, etc. We use these thoughts as if they are iron clad rules. Unfortunately, there is a lot of frustration and resentment when we cannot meet these high expectations.

  • “I should be able to do the dishes, make supper, tidy up and take care of the baby.”
  • “I have to get to the gym. I can’t be walking around with all of this baby weight still.”
  • “I should be calm and soothing all the time, even when my baby is cranky.”

Do these anxious thoughts sound familiar?

Anxious thoughts can happen to any one. However, there is a higher vulnerability for anxiety during the postpartum year. If you are concerned that you may be experiencing postpartum anxiety, the Edinburgh Postnatal Depression Scale is a quick self-assessment that reviews signs of depression and anxiety in parents. Postpartum anxiety is treatable. If you are struggling, please reach out.

Schedule a free consult
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.

Contact Kasi

Unhappy relationship after a baby

Published on by kshanmuk1 Comment

Relationships are tested all the time when life throws curve balls. As much as we’d love for a new family member to bring us closer together, having a baby can actually worsen the sense of an unhappy relationship.

Working in perinatal mental health, I hear a lot of parents talking about their relationship dissatisfaction. I know they are struggling with poor communication, lack of sleep, and adjustments to new responsibilities. One parent is trying to maintain a sense of normalcy, continuing to work long hours to provide financial stability to the family. The other parent is spending hours with their infant intent on keeping their baby alive and thriving. While these goals are both compatible, it’s easy to get lost in our own perspective of what is most important or necessary. During postpartum stages, I hear parents constantly share how much they yearn to feel connected with their partners. They want the security of knowing they have their partner’s love, understanding, and support.

The Four Types of Relationship Conflicts

There are many factors that can create an unhappy relationship; however, I’ll focus on communication struggles for this post. The Gottman Institute recognizes that there are four common trends in relationship conflict, which they’ve coined “the four horsemen”. With decades of research, the Gottman Institute can confirm that the presence of these four conflict styles create and exacerbate unhappy relationships. These communication conflicts can happen to the best of us, but it’s important to recognize when it is an off-chance occurrence versus a continued pattern.

Criticism

Unhappy relationship after a baby: Things to notice, and ways to fix.
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This type of relationship conflict involves one partner expressing criticisms about the other’s personality or defects. Often, with criticism, the angry party will state “you always-” or “you never-” or others forms of extreme language in order to highlight a partner’s inadequacies. Instead of voicing the actual complaint, the focus is instead on attacking your partner’s character to the core. Rather than stating “I feel frustrated that the dishes haven’t been washed tonight,” the angry individual will state, “you are such a lazy slob” or “you always watch TV instead of doing what you promised.” It leaves the other person, whether he or she is in the right or wrong, to feel hurt and assaulted.

Defensiveness

Unhappy relationship after a baby: Things to notice, and ways to fix.

When met with criticism, it’s natural that you wish to defend yourself. In an ideal world where our defensiveness is less heightened, we can hear a complaint, take responsibility of our actions, and apologize if necessary. Instead, the hurt partner gets angry and attacks in turn. The argument cycle continues as the other partner then feels blamed and hurt.

There are various ways in which we can become defensive:

  • attack back with a critical comment of your own “Well, they’re mostly your dishes from breakfast. What made you so lazy this morning?”
  • claim innocence “I rarely watch TV. Why are you bugging me the one time I get to sit down?”
  • express righteous indignation “I was going to do it after this show.”
  • whine “I’ve had such a long day at work. Can’t you give me a break?”

Contempt

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Contempt is the extreme version of relationship conflict. It is the highest predictor for divorce. When we are being contemptuous, we are genuinely being mean and disrespectful. This includes: name calling, using sarcasm, ridiculing, giving condescending lectures, throwing insults, eye rolling, etc. When we use this form of conflict style, it makes it hard for partners to move past our sense of disgust and superiority towards them.

Stonewalling

This form of unhappy relationship conflict involves shutting down or “becoming a stone wall” when our partners express their feelings. This means we offer zero verbal or non-verbal language in response to their comments and questions. Stonewalling is a protective mechanism that attempts to block out rather than take in our partners’ criticisms, defensiveness or contempt. The stonewaller often feels overwhelmed and unable to think clearly or know what do about the situation. Rather than face the conflict, a stonewalling partner may instead tune out, become distracted by other activities, or simply walk away.

Crap! I do some of these things! How do I fix my relationship?

Unhappy relationship after a baby: Things to notice, and ways to fix.

If you happen to fall into some of these conflict styles, don’t worry! We all have moments of falling into these conflict styles. The following suggestions are some ways to improve the situation.

Use gentle and assertive communication

I love the DEARMAN acronym from DBT to help with assertive communication. This acronym helps us make requests or say no in a confident and conflict-reduced fashion. By using a gentle and assertive approach right from the start of a conflict, there is less likelihood for your partner to feel defensive or need to attack or shut down. Speaking assertively can push some of us outside our comfort zone, especially if your tendency is to stone wall and not express your feelings or needs. However, by asking clearly and respectfully, your partner has the opportunity to hear what you would like, and have the chance to negotiate with you on terms that seem manageable for him/her/them.

D= Describe the situation. Use a brief statement that sticks with objective facts. “I noticed there are still dishes in the sink.”

E= Express how you feel. Use an I statement to explain what emotions are showing up for you because of this situation. “I feel upset that the dishes haven’t been done because we had talked about sharing the household chores more equally. I feel disappointed that this task wasn’t completed.”

A= Assert what you want. Be clear about what change you are looking for at this time. “I would like for the dishes to be done after supper.”

R= Reinforce what is in it for the other person to follow through. It’s absolutely fair that you want your partner to “just know” that it’s right thing to do. However, it’s more helpful and efficient to provide a reminder for why it’s important to maintain a specific behaviour or make a change. “I was looking forward to relaxing at the end of the night with you. I’d love to cuddle up to watch some TV rather than waste our short chunk of evening time scrubbing away at dishes.”

M= be Mindful. Don’t use this as an opportunity to throw in twelve other requests. Focus just on this one situation.

A= Appear confident. There is no need to apologize when you are making a request for change.

N= Negotiate. Sometimes your partner will be willing to make a change so long as there is some wiggle room. Be willing to negotiate so that you can both come to a satisfactory middle ground.

Express appreciation and respect regularly

Unhappy relationship after a baby: Things to notice, and ways to fix.

One of the best antidotes for anger in a relationship is to voice appreciation and respect regularly. Are you turning towards your partner and commenting when they do a task you genuinely appreciate? Did you thank them for tidying up the garage or watering the grass this morning? It may seem unnecessary, but check in on the ratio of negative to positive attention that you provide your partner. How often are you expressing factors that you dislike? How often are you taking the time to express things you do like?

Expressing appreciation can also be done through behaviours. Consider small steps that would be helpful for your partner that he/she/they have expressed. Appreciative behaviours should not be grand gestures since this is unsustainable and can only happen so often. Instead, Dr. Gottman recommends “small things often.”

It’s also important during this phase to take note of our partner’s attempts for connection. When they are talking about their day, asking questions, or seeking physical touch, how do you respond? These are opportunities to express fondness, which goes a long way in strengthening your relationship.

Agree on safe time outs

For those who stone wall, it’s hard to problem solve or engage in an effective conversation. Turning away actually seems like the safest thing to do in that moment; however, it drives the other partner mad because they are getting zero feedback about how to move forward. In these situations, it’s important to have a clear conversation with one another on safe ways to ask for space. Perhaps this means stating clearly “I’m feeling overwhelmed. I need a few minutes.” It may mean practising some deep breathing exercises to help calm your body to feel less tense.

Turning your unhappy relationship into a positive relationship

Your baby needs you. No matter what the conflict or how intense it may feel, your baby need its parents to feel safe and secure. Your little one picks up on your emotional cues and recognizes signs of conflict at home. These comments are not meant to scare you but to encourage some introspection on the reality of your relationship. If it truly feels like your conflicts are getting out of control, reach out. Individual therapy can help you understand why you feel so contemptuous towards your partner or why there is a need to stone wall. Couples counselling can soften communication patterns and help you recognize when your partners makes attempts for connection. While conflicts are common, you do not need to be stuck in an unhappy relationship forever.

Best wishes,
Kasi

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