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Key Ideas & Coping Strategies to Support Mental Health During Pregnancy & Postpartum

Nikki Lively, M.A., LCSW
• May 08, 2020

It’s Maternal Mental Health Awareness week, and I’m so honored to have the opportunity to share some key ideas and coping strategies that I use in psychotherapy with my clients to support their mental health during pregnancy and postpartum. I’ll be sharing one per day everyday this week. I hope they can support and inspire a daily intention as you face each day. These strategies can be helpful at any time, but are especially poignant to consider now while we are all physically distancing which, needless to say, is adding to the feelings of isolation and overwhelm that are often part of the transition to parenthood. Your emotional and psychological wellbeing are the some of the best gifts you can give yourself and your children!

Tip #1:  The Wisdom of No Escape

05.04.2020  It’s Monday and there’s no escaping it — ha! So, I thought I would start with this strategic mind set as my first tip. The name of this Buddhist teaching, “the wisdom of no escape,” always makes me laugh because it sounds horrible and wonderful at the same time — and the lived experience of motherhood is exactly that. The heart of this teaching is using the fact that we cannot escape a situation, no distractions, no place to go, no one to talk to as an opportunity to turn towards the parts of ourselves that we usually turn away from and learn about these parts, and learn from these parts. It assumes there is nothing inside of us that deserves to be judged or abandoned.

Motherhood brings up incredibly strong feelings — some we feel are acceptable, and others we judge as unacceptable especially with so many cultural messages about how motherhood “should” feel. And yet, the heart of love and true wisdom is accepting ourselves just as we are.

Motherhood in quarantine is so hard and likely no one would choose these circumstances, but since they are here, this isolation provides an opportunity to turn towards ourselves and notice our feelings, see them all, and practice embracing them. This is the first step in developing self-compassion (more on this tomorrow!) — don’t run, don’t distract, cultivate the ability to just stay…with yourself.

Tip #2: Cultivate the Inner Mother

05.05.2020  Following from yesterday’s tip on the wisdom of no escape and turning towards our experiences and feelings, we turn to cultivating the inner maternal voice that soothes, accepts and protects us. This is harder for some of us than others depending on the type of care we received when we were little. Some of us have an actual voice from a parent, aunt, grandparent, teacher or mentor who loved and accepted us completely that we can channel in difficult moments with our own children, and there are others of us that need to learn to conjure that voice from what we wish we had or longed for, that we can now learn to give to ourselves.

A common way I work with new mothers in therapy is to have them practice embodying a soothing voice that can respond to harshness or self-criticism that comes up in the daily experiences of caring for a baby. You can learn to do this at home by either journaling statements from your harsh voice and practice writing responses that channel sensitive and loving responses to the criticisms, or by bringing to mind what you say to yourself when you are being unkind, and speaking out loud the soothing response you long for.

How we speak to ourselves is one of the most important factors in our emotional wellbeing, and motherhood needs and deserves to be supported by a sweet, loving and accepting inner mother. With practice, the soothing voice will get easier and easier to hear and quicker and quicker to respond in our painful moments. Not only will this make us more resilient to depression and anxiety, it is also one of the most helpful strategies in weathering the storm of other people’s opinions (more on this tomorrow).

Tip #3: Tune into Your Values

05.06.2020  When it comes to being a mother, there are a lot of people with a lot of opinions on how you “should” do things. Everyone from total strangers to your family to your closest friends may fall into this trap. I call it a trap because though (usually) well-meaning, it interferes with the natural process of you learning how to parent from your own gut.

The greatest parenting “advice” is the type that helps you slow down and get curious about what is important to you and why it’s important, that offers possibilities for how things could look, but ultimately leaves you space to choose what feels right to you and your child. It’s hard not to get knocked over, so to speak, by the strong wind of someone or some source of “expertise” on parenting when you are so new at it and want to do the best for your baby!

The problem when our parenting isn’t rooted in our own gut and observations of what works best with our unique baby and our unique circumstances, is that it leads to anxiety which then gets in the way of attuning to, and really seeing our baby (more on this tomorrow). It also interferes with the joy of motherhood as it sets us up to feel like we’re always chasing something we feel we the need to be a “good” mother versus learning to see that everything we need we will find inside of us along our journey.

Learn to root yourself amidst the changing winds of parenting advice by looking for the type that centers you and your experience, and encourages you to create the mom identity that feels right to you.

Tip #4: Your Baby is Your Parenting Manual

05.07.2020  Following from yesterday’s tip about choosing what feels right to you and your child, is the idea of letting your baby lead the way in your journey to learn how to parent. I wrote yesterday about the need for guidance that provides a menu of options on how things could look — which most new parents need around sleeping, feeding and soothing — since many of us won’t have any experience taking care of a baby before we become parents. However, your baby comes into the world with a unique little body with a unique little nervous system. What works for one baby, won’t work for another baby at all.

One size fits all doesn’t work with most areas of life, and it’s especially important for new parents to have the space and time to observe their baby and learn their baby’s cues and ways of communicating that their body is feeling OK or not OK. Seeing the baby as your guide to understanding the state of their little body is also a helpful strategy to avoid taking the baby’s responses personally.

It can feel especially bad emotionally to attempt to soothe your baby, and have them continue to cry. This is a risk factor for depression actually because new mothers can be vulnerable to seeing this as a sign that they aren’t good enough and that their baby is rejecting them. Remembering that your baby’s responses are telling you about how they feel on the inside can really help guard against this, and help you adopt a learning stance towards your baby’s cues that will help you find patterns and then inner confidence as you start to see what works.

Tip #5: Identify and Confirm Your “911 People” 

05.08.2020  This final tip of Maternal Mental Health awareness week is especially important during the shelter in place order.

Every new mother needs one to two people that they can call at any time to have a freak out — motherhood is exhausting and brings us to our emotional breaking point! To have someone completely dependent on others for their survival in your care is an awesome responsibility, so when we inevitably need to “lose it,” we need someone to call who gets it, and can handle our strong emotions and is able to “lose it” with us too.

It helps to identify these people ahead of time, and ask them if they are available for a reciprocal relationship of mutual support for this. Then, when we need them in a moment of crisis when our brain isn’t fully functioning, we will know just who to call without having to think.

One of my favorite parenting podcasts is called One Bad Mother. If all else fails, if we can’t identify anyone right now for this role or that person isn’t available for some reason, they have a phone line (listed on their website) for moms to call in and talk about their emotional break downs and just get it out. If they play your breakdown on the show, you’ll also get loads of empathy and validation from the hosts.

So, in short, prepare and expect moments of complete emotional overload and know who you can call to help you with those moments.

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We recognize that amidst the current pandemic, this is an extremely difficult time. If you need support, we can help. Call 847.733.4300 or visit our website to request a teletherapy appointment.

Nikki Lively, M.A., LCSW

Clinical Director, Transitions to Parenthood Program
Therapist

Ms. Lively is a certified Emotionally Focused couples Therapist (EFT) and her main area of expertise is supporting women, men, infants, couples and families in the transition to parenthood. In addition, she specializes in women's reproductive health.