Space to Grieve: Supporting loved ones through pregnancy loss

Although today’s culture is more open about discussing women’s mental health, pregnancy loss continues to be a topic seldom discussed. This silence around a common occurrence (10-25% of pregnancies are lost) can lead to feelings of isolation for the birthing partner and close family. Additionally, the lack of information can leave friends and family wondering how to show up for their loved ones and support them after loss. While every person’s experience of pregnancy loss is different, here are some general suggestions to help you be there for your loved ones: 

Show up 

Sometimes when we don’t know what to say, we decide not to say anything at all. This only perpetuates the post-pregnancy loss isolation that many individuals experience. While some individuals would prefer privacy, others would prefer to talk about it. Check-in, offer support, and communicate that you are a listening ear if and when they need you. It is important to note that by checking in or offering support, you are not prompting the person to think about the loss. Instead, you’re giving them an opportunity to share about something that is most likely already on their mind in one way or another. 

Listen and keep it simple 

If you are unsure where to start, sometimes the shortest phrases, such as “I’m so sorry,” can have the most impact. After that, the best thing you can do is listen and try to validate the person’s experience. Another important thing to listen out for is if the family has named the baby. If they have, it can be important to say the child’s name as a way to communicate to the family that you are listening 

Remember the whole family unit 

The person carrying the pregnancy is usually not the only one deeply affected by the loss. Spouses and partners may be grieving as well. While they have had to step up to support the expectant partners, this won’t necessarily mean they are “ok.” A small check-in can give them the space to share their feelings. 

Give space to grieve 

Because pregnancy loss is so misunderstood, those experiencing it may feel like they cannot grieve or if they do, they may feel that they are grieving for “too long”.  Mourning may even continue after a subsequent full-term pregnancy and that too is okay. Some important sentiments to communicate to your loved one are that grief has no playbook, there is no right way to grieve, and there is no timeline. By acknowledging the pain of the expectant individual, you are endorsing the real relationship with a baby that came to an end. 

It can be hard to know how to show up for someone when they experience loss. Your best bet is to approach your loved one with genuine empathy, care, and compassion. A little support during a very difficult time can go a long way in helping someone heal. 

Click here if you want to work with a therapist so you can best support your loved one.

The Good Enough Mother: Interrupting Perfectionism and Fostering a Healthier Relationship to Parenting

In parenthood there is often a desire and pressure to get it right, but not just right, perfect. The perfect schedule, the perfect educational toys, the perfect amount of independent play versus structured play, the perfect sleep schedule, the perfect amount of screen time, the perfect weight, the perfect latch, and so on, and so on…

With an endless list of tasks to perfect, most parents are left with an inevitable  sense of failure.  Feeling as though you are not meeting the mark of the perfect parent can lead to guilt, shame, anxiety, and/or depression. Several studies have even linked perfectionism to the development of postpartum depression. 

Alas, there is no such thing as a perfect parent, and in fact, no child needs a perfect parent. Children with perfectionistic parents are more likely to experience: 

• Depression and anxiety

• Poor coping strategies

• Self-criticism 

• Their own perfectionistic tendencies 

To back up this bold statement, I lean on the term “good enough mother” by the late renowned pediatrician and psychoanalyst Donald Winnicott. Winnicott posited that perfect parenting was not only unattainable but also undesirable. Of course, infants need attention and to have their needs met. But as children grow they are better off with a “good enough” parent, one who lets them explore their independence and encounter struggle and disappointment.  When a parent isn’t always perfectly attuned and doesn’t instantly meet every one of their child’s needs, the child is able to develop resilience. This resilience behooves the child as they grow up and encounter a world that will fail them many times. These later setbacks will not derail the child, as the “good enough” parent gave the child the space to learn to effectively deal with the frustrations of reality.  

All of this is to say, when we “fail” our kids in manageable, developmentally appropriate ways, we are actually helping them become healthier, more adaptive adults. 

Here are some strategies to move away from perfectionist parenting and lean in to the “good enough” parent: 

1. Be good to yourself. No one can do everything. Give yourself a break, ask for help, and practice self-compassion. 

2. Stop the comparison game.  Social media allows us to endlessly scroll through feeds of highlight reels which can often make a person feel inadequate. Do not worry about what others are doing with their families, do what is right for yours.

3. Trust your child to figure it out. The best way for a child to learn coping skills to help them thrive in a challenging world is to give them the space to figure things out on their own. The best time for them to learn these important skills is when they are in the safety of their parents’ home. 

4. Focus on the present, not the future. Try to stay in your child’s experience of childhood, not on the movement towards successful adulthood. For example, find a school where they enjoy learning rather than a school with the best credentials. 

Ultimately, the “good enough” ideology stands in direct contrast to perfectionistic parenting. It recognizes that a parent cannot be everything all the time, and not only is that okay, it has its own set of benefits for children in the long-run. 

Tips for Stress Management

Are you looking for help to manage your stress? Below are steps you can take to feel more calm and in control.

First, try to find out what is causing the stress in your life. A good way to do this is to track it. Get a notebook and write down when something makes you feel stressed. Alongside the stressful event, write down a number from 1-10 (1 being least stressful and 10 being most stressful). This practice will help you to identify the areas of your life that are causing the most distress.

Once you have an idea about what is stressing you out, you can start to implement techniques to reduce the stress. You may not be able to eliminate stress completely, but below are some suggestions to help you lower your stress levels and make your life more enjoyable: 

Prioritize Your Responsibilities - Start Small
Having too many “to-dos” can be stressful, work on quickly knocking out small tasks to clear up your mind to focus on larger responsibilities. 

Develop good problem-solving skills
When faced with a stressful problem, try to clearly define what about the issue issue is causing a problem for you. Then generate a list of various ways the problem could be managed. Evaluate each potential solution and then make a decision. 

Take good care of yourself 
Get plenty of rest! Find and/or make time in each and every day for some self-care. It can be as small as scheduling a 5 minute mindfulness meditation, just any activity where *you* are the priority. 

Keep things in perspective
In the most stressful situations, problems can feel bigger than they are. Take a step back and ask yourself…will this matter in a week? In a year? 

Talk to someone 
Whether to friends or family, opening up about your stress can help! Getting additional perspectives can help you gain insights to your stressful situations. There is evidence that those who have a strong support network manage stress better. 

Laugh 
All jokes aside…when you are stressed your body tends to tense up. Laughing has been shown to relieve physical tension and relax muscles for up to 45 minutes. Laughing also produces a general sense of well-being which can diffuse the stress you were feeling. 

If these tips aren’t reducing your stress enough or you are finding yourself completely overwhelmed, it may be time to seek additional help. Here at Therapists of New York we have psychologists trained in helping individuals manage and understand their stress levels. Click here to book a consultation.

Surviving Toddler Tantrums

Your child asks for water. You give your child some water. And suddenly the screaming starts…What is going on? The water could have the wrong temperature, could be in the wrong cup, your child may not like the way you handed them the water – who knows. The one thing that is clear is that your child is about to have a tantrum. Read on to learn what tantrums are, why they happen, how to deal with them, and better yet, how to prevent them. 

Tantrums are your child’s form of protest. They come in all shapes and sizes and may involve screaming, stiffening limbs, an arched back, kicking, falling down, flailing about, or running away. In some cases, children hold their breath, vomit, break things, or hurt themselves or other people as part of a tantrum. 

Tantrums are normal, common, and expected. Between the ages of two and four, over 90% of children will have tantrums. Tantrum throwing tends to peak during this age range because children are still at the early stages of social, emotional, and language development. They can’t always communicate their needs and feelings which often leads to frustration.  And they’re learning that how they behave can influence others. So tantrums end up becoming one of the ways children learn to express their feelings and change what’s going on around them. 

Before moving into strategies on how to help prevent and ease tantrums, it is important to clarify what tantrums do not mean. Tantrums do not mean you are failing your child or are a bad parent. Tantrums are not a sign that you have a bad kid or that your child is trying to manipulate you. It is common for parents to take tantrums personally and react accordingly, but really what your child is doing is completely developmentally appropriate. 

Ways to make tantrums less likely to happen: 

• Identify tantrum triggers like tiredness, hunger, fears, or overstimulation. You may be able to plan for these situations and avoid the triggers

• Help your child understand their feelings so they do not feel as big. This can start at birth by using words to label feelings like “happy”, ”sad”, “angry”

• Have your child tune in to the feelings they have when they move through a stressful situation without a tantrum. For example “Mommy said we had to leave the park and you left without getting upset. How did that feel? Did you feel calm?”

• Model positive coping strategies for handling stressful situations. “I am getting worried we will be late because of this traffic, I am going to take a few deep breaths” 

• Offer choices in decision making to encourage independence “Would you prefer to wear the orange shirt or blue shirt today?”

Ways to help you and your child through the tantrum: 

• Use a mantra - repeating a mantra can help you keep your cool, which will allow you to have more emotional resources to support your child. Some mantras include 

  • “It’s not personal - it is normal and developmentally appropriate”

  • “They are not giving me a hard time - they are having a hard time”

  • “Stop and take a breath”

• Say less - being rational adults, we like to talk ourselves out of problems, but when your child is in the throes of a tantrum sometimes saying less is more. Their feelings can be so big that any explanation is best saved for when the tantrum is over

• Offer empathy and acknowledgement  - Even though your child may be losing their mind over something that feels silly to you, like not being able to wear the ketchup-stained shirt from yesterday, speaking to your child with empathy will help them feel seen and understood 

• Stay calm but do not give in - your child will mimic what you do. If you take deep breaths and regulate your emotions, your child will have an easier time doing the same. You can acknowledge your child’s frustrations in a calm way and not give in, which will only reinforce the tantrums. An example of this type of statement would be “I see that you are very angry and frustrated that we have to leave the park, but we cannot stay here any longer” 

When you have made it through a tantrum, it is important to remind your child how loved they are even when their feelings are so big. A hug will remind your child that they are secure with you and you are not deterred by their tantrums. When the tantrum is over, it is important to debrief with your child and narrate the course of the tantrum, from the trigger to the behavior to the calm down. This will help your child understand that their feelings are in reaction to something. 

Tantrums can be very triggering depending on our own childhoods and the ways we learned to deal with negative emotions. If you are finding it difficult to follow these tips or remain calm in the face of your child’s distress, it may be important to better understand and process your emotional responses to your child’s dysregulation. 

If you’d like help navigating parenting, click here for a consultation with one of our parenting specialists.

Simple Grounding Techniques

While it is important to understand and feel our emotions, not every occasion is appropriate or useful for doing so. You can use these simple grounding techniques to help you detach from emotional pain that isn’t effective for you to feel in the moment. Grounding techniques work by shifting your attention and focus to something other than the difficult emotions or thoughts you are experiencing. 

Color Breathing

Mentally picture a color that represents how you want to feel (i.e. Blue for relaxation, orange for joy, green for healing) and a color that represents what you want to let go of in life (red, for instance). 

Get in a comfortable position and allow yourself to relax. Now breathe in the color of your choice for 2-3 seconds, imagining yourself bathed in the color. Now breathe out the color that represents what you want to let go of for 4-6 seconds, imagining it fully leaving your body. Note that your exhale should be twice as long as your inhale for best results. 

5-4-3-2-1 Grounding Technique 

Use all 5 senses to help you refocus and bring you back to the present moment

First, look around you and name in your head 5 things you can see (you can look within the room and out of the window)

Then touch 4 things you can feel (the silkiness of your skin, the material on your chair, the texture of your hair) 

Then listen for 3 things you can hear (traffic noise, birds outside...you would be surprised how many things you hear that you normally tune out when you’re mindfully listening!)

Then notice 2 things you can smell (hopefully nothing awful!)

And finally, 1 thing you can taste (the taste of your mouth, a sip of a drink)

Positive Self-Talk 

The way we talk to ourselves matters and affects our emotions. Notice how your mood shifts when you replace catastrophizing statements with more realistic and positive self-talk. Sometimes it can be useful to consider how you might speak to a friend or a child. It may help you realize how harsh you’re being to yourself. 

“There will be difficult moments as I take the test, I expect them and can handle them now” vs. “I am definitely going to fail”

“I feel good about myself and most of my abilities” vs. “I am a failure because I am struggling with one task”

“I may have done poorly on this test before, but now I have the skills to pass this test” vs. “I failed once and will likely fail again”

Remember: Although grounding techniques won’t solve the original problem causing your distressing emotions, they provide a temporary way to gain control over your feelings and prevent yourself from making things worse.

If you’d like to seek out more grounding techniques at Therapist of New York, contact us here.

More Than Just the Baby Blues: Postpartum Depression

When a baby is born, many assume that the birthing parent will be nothing less than overjoyed. However, it is more typical for birthing parents to experience a range of complex emotions after bringing a baby into the world. When these emotions become predominantly negative and longstanding, leaving parents feeling like they don’t know what to do, where to turn, or whom to ask for help, they may be experiencing Postpartum Depression (PPD).

There has been a steady increase in attention on PPD over the past two decades. There are two reasons for this. First, it was officially recognized as a distinct mental illness in the late 1990s which led to an increase in the science and literature on the subject. Second, celebrities have begun to speak out about their experiences with PPD, which may have eliminated some of the shame around the subject and helped others understand their own experience.  But what actually is Postpartum Depression? 

What Does PPD Look Like?

Many are familiar with the “baby blues”, or a two-week period after delivery where a birthing parent’s mood may be lower than normal due to a drop in hormones. This may look like intense crying, an increase in anger or anxiety, and feelings of sadness. The key is that whatever the symptoms are, they only last for a short time. Postpartum depression on the other hand tends to be more severe and long-lasting. Some of the symptoms of postpartum depression include: 

• Feelings of anger or irritability

• Lack of interest in the baby

• Crying and sadness

• Feelings of guilt, shame, or hopelessness

• Loss of interest, joy, or pleasure in things that you used to find enjoyable

• Possible thoughts of harming the baby or yourself

If you identify with any of these symptoms, the first thing to realize is that you are not alone….1 in 7 women and 1 in 10 men experience postpartum depression. These numbers may even be an underestimation, as experts agree that PPD is often under diagnosed because those who endure it may be too ashamed to seek help.  There is help though! 

Ways to get Help 

1. Build A Support Network

   1. New parenthood can be a very isolating time, so reach out! If you do not have close friends or family nearby, consider trying baby and toddler classes, join a local parent Facebook group, or download apps like Peanut that can connect you with other parents.

1. Take Care of Yourself

   1. So much of new parenthood is an identity shift, so finding ways to connect back to the “you before parenthood'' is critical in helping to cope with the postpartum period. This may look like, getting out in the sunshine, pampering yourself, exercising (when medically appropriate), or watching a favorite TV show. Whatever “it” is, finding space to have “you” time is incredibly important.

1. Psychotherapy and Medication

   1. Therapists can help an individual better understand their depression and also provide tools and skills that can help a person better cope with the postpartum period. Here at Therapists of New York there are clinicians specifically trained to work with individuals who are experiencing postpartum depression.

   2. If the depression is very severe a doctor may suggest antidepressants in addition to therapy to help combat the symptoms.

Resources and Ways to Learn More & Find Help

1. Postpartum Support International - https://www.postpartum.net/

2. Postpartum Progress - https://postpartumprogress.com/

If you’d like to seek out help for postpartum depression at Therapist of New York, contact us here. You can also read more on how we work here.

Before The Aisle: Building a Modern Marriage

As the “mental health generation” prepares to walk down the aisle, psychologically-minded couples are considering premarital counseling to start their unions on the right foot. Despite this growing interest, many couples wonder: what is premarital counseling, anyway? 

While some religious leaders require premarital counseling in order to marry couples, more and more couples are seeking secular marriage preparation to either supplement or replace this traditional practice. Regardless of religious or secular affiliation, premarital counseling is a strengths-based, wellness-focused approach to relationship health. At Therapists of New York, we see premarital counseling as an opportunity to capitalize on the excitement and hopefulness for the future that comes with the desire for a greater commitment. That is why we offer Before the Leap, a fun and interactive workshop for couples entering the next phase of their relationship that teaches the skills needed for happy, lasting partnerships.

Premarital counseling is quite different from couples therapy. When couples come to couples therapy, they have often been in crisis for far too long - studies show that couples spend, on average, six years in distress before seeking therapy! Couples therapy often must address long-standing, entrenched conflict patterns and communication issues, as well as years’ worth of resentment related to these ongoing cycles. Premarital counseling is an opportunity to foster open conversation and healthy communication habits at the outset of this next chapter. 

Research supports the efficacy of premarital counseling; studies show that couples who have engaged in premarital counseling are 30% more satisfied in their relationships, report lower rates of conflict, and are less likely to get divorced. Premarital counselors guide couples through difficult conversations, and the sessions provide an opportunity for the development of a shared language to express your needs, wants and emotions to one another in the short-term and beyond. The sessions are an opportunity to reflect on your goals for your future together before walking down the aisle- many couples even end up incorporating some of what they’ve learned in premarital counseling into their vows!  While couples typically seek out premarital counseling once they are engaged, other couples come in anticipation of getting engaged, before moving in together, or before getting a pet together. Regardless of the type of commitment you are making, the same principles apply.

Premarital counseling can be conducted with the couple and the counselor, or in a group format. It is typically short-term and more structured than couples therapy. Topics explored in these sessions may include:

• The meaning of marriage (or commitment) for each of you

• Communication skills

• Conflict resolution skills

• Financial goals and priorities

• Family of origin dynamics

• Raising children

• Sexuality

• Religion

• Division of labor

• Building rituals

• Shared/individual goals and dreams

When planning a wedding, there are innumerable checklists, to-do lists, and traditions to keep track of. It can be easy to get swept up in the many decisions to make for that “big day”. In between the venue visits and cake tastings, remind yourselves what your wedding is ultimately about: the decision the two of you have already made, to make a powerful commitment to one another.  Premarital counseling is one way to honor and protect that commitment. 

If you’d like to seek out premarital counseling at Therapist of New York, contact us here.

Dating: Not for the Faint of Heart

Dating, especially in New York City, is not for the faint of heart. This is one of the most discussed topics for our single clients. We caught up with Dr. Nadia Nieves for her advice on how to deal with some common dating concerns we hear from our clients:

“Dating is scary. I'd like to avoid it all together but I know it's something I have to do to find a partner."

• Many of us find the world of dating to be not only scary but chaotic, uncertain, and unfortunately, necessary. If you are struggling with this fear, first know that you are certainly not alone. Putting yourself out there is a risk; there is a risk that you could be rejected AND (sometimes even scarier) a risk that you may make an important connection.

• Secondly, consider what aspects of dating are particularly fear-inducing for you. Is it the first date jitters? Is it the fear of being ghosted? Is it not knowing what it feels like to really click with someone? Or is it something bigger than all of that? Being curious and clarifying what specifically feels scary or threatening to you can help you confront those fears. It can also help you identify ways to adapt and make yourself more comfortable in this process.

• Thirdly, have you thought about how you want to find a partner? Online dating seems to be our go-to these days. However, it could be worth it to think about whether or not your preference is to meet someone in a specific environment. Do you feel more like yourself at Comic-Con or a Garlic Festival than you do at a bar or online?

• Lastly, consider the possibility that most fishes in the sea can feel just as scared as you.

"I'm starting to like someone but I don't know how they feel about me. I don't like initiating conversations like this. What do I do?"

• You've connected with someone and now you want to know where it's going. The issue is that you want to know where the other person's head is at without actually having to be the one ask. Let's break down this very common worry.

  • What are you expecting? In other words, what is your gut telling you about how this person will respond if you bring it up?

  • What does it mean to you to be the first to bring something up? We often assume that these conversations just happen and should be effortless. However, that does not accurately represent reality. Since we are not mind readers, we typically have to ask if we want to know what someone's thoughts are.

"I'm sick of being ghosted. It makes me want to give up."

• Ghosting totally sucks. You think you've connected with someone and then all of a sudden the person disappears off the face of the earth. It's hurtful to go from receiving attention and connection from someone to getting nothing at all from them and being left on read. When someone ghosts you, you are being rejected, but it's the type of rejection that feels unclear, which makes it harder to accept and deal with. At some point, we start to realize that the likelihood of you encountering this again is very high because the ones doing the ghosting are avoiders, and there are lots of them. Whether or not these people are avoiding conflict or emotional intimacy, you are still left with a not so great feeling in the end that can be pretty demotivating. If you can't get that person to reappear, it could be worth it to experiment with calling ghosting out when it happens.

If you feel like you need more help in navigating dating, contact us here and we can set you up with one of our therapists.