Areas of Practice

✺ What encompasses reproductive mental health? ✺

  • PMADs include symptoms of depression, anxiety, obsessive compulsive disorder (OCD), or bipolar spectrum illness that can occur during the perinatal period. The perinatal period refers to pregnancy and up to 1 year postpartum, although I believe that the postpartum period can last and impact people much longer. I am here to support everyone regardless of where they are on their journey.

    About 1 in 5 birthing parents experience PMADs, making them the most common complication of childbirth. PMADs can impact people who have never had mood or anxiety concerns before, including non-birthing partners. Symptoms can range from mild to severe. These concerns are treatable, and I use various cognitive behavioral approaches with clients.

    I also work with people experiencing mental health concerns prior to pregnancy, who want to take a proactive approach to manage symptoms or prevent worsening of symptoms.

  • People can experience re-activation of traumatic stress symptoms during experiences such as pregnancy, pregnancy loss, egg retrievals, childbirth, feeding, and caregiving. Medical complications or losses that evoke fears for the safety of the adult or fetus/infant in OB/GYN, pediatric, or oncology contexts can also be experienced as traumatic. These experiences can come with distressing reminders of previous trauma(s) that a person has experienced, including sexual violence, intimate partner violence, medical trauma, or discrimination. I often support people to develop and implement coping plans when they expect or are experiencing distress related frequent trauma reminders during pregnancy and postpartum.

    Most people who experience a traumatic event will not develop Posttraumatic Stress Disorder (PTSD), though some will. I provide Prolonged Exposure, an effective trauma treatment. I often work with people who want to engage in PTSD treatment after realizing that trauma is impacting their life, including how they are coping with reproductive stressors or life events.

  • Grief related to the loss of a birth experience when the birth differs from what a person had hoped for or dreamed of. People can be negatively impacted by their birth experience, whether they experienced it as traumatic of not. Processing emotions related to birth can help integrate the experience so that it does not interfere with living in the present.

    Grief in this context can look like sadness, disappointment, shame, anger at self and others, powerlessness, confusion, and feelings of failure. Guilt is also common; this is often fueled by common societal messaging, such as “you should be grateful”, or “all that matters is that everyone is alive and healthy”. It is normal and healthy to mourn.

  • Pregnancy, neonatal, or infant loss (e.g., miscarriage, stillbirth, neonatal or infant death) can impact people profoundly. Grief is a normal, non-linear journey through loss.

    I often utilize Acceptance and Commitment Therapy (ACT) in therapy focused on loss because ACT is anchored in each person’s values. In therapy, we use these values as a compass in the process of clients’ feeling and validating their emotions, finding their voice around their loss experience, coping, and trying on ways of continuing to live life while carrying loss.

    I also work with parents pursuing pregnancy after loss.

  • Making decisions regarding family building can often be challenging and stressful. It is common to feel ambivalent about pregnancy or the decision to have a child, have difficulty weighing important factors, and question one’s decisions or preferences.

    These decisions also include considering LGBTQ+ family building options, childfree living (by choice or not by choice), if/when to try to conceive, fertility preservation, pursuing assisted reproduction, considering selective reduction, pregnancy termination, and choosing single parenthood; I welcome and support all types of family building related decisions.

  • Bringing a baby into the world is a huge life event, whether it is your first baby or not. I work with parents of all gender identities navigating the highs and lows of this transition to promote their well-being.

    This work can focus on multiple facets of this experience, including and not limited to:

    • Navigating identity shifts and integrating that identity with other parts of yourself

    • Learning to trust your instincts as a parent and reducing self-questioning and self-criticism

    • Practicing self-validation related to stressors involved in caregiving. Reducing comparison to other caregivers

    • Practicing regulating emotions and responding effectively when activated or overstimulated by children’s emotions and needs

    • Processing welcoming a living baby after loss

    • Navigating old wounds from childhood being kicked up, and working toward intergenerational healing

    • Working through distress related to feeding challenges

    I support parents in shifting restrictive gender roles if desired in a way that works for their family, whether partnered or not.

  • Hormonal fluctuations and menstruation can impact mental health throughout female reproductive years.

    Therapy can focus on managing: premenstrual symptoms (e.g., Premenstrual Dysphoric Disorder), medical conditions that can impact reproductive health and/or trying to conceive (e.g., Polycystic Ovary Syndrome, endometriosis, autoimmune or endocrine conditions), lactation/weaning, pelvic pain, and symptoms of perimenopause (natural or medically induced).

    Cognitive behavioral therapy approaches can support clients navigating hormonally related mood and anxiety symptoms and physical symptoms. While our society often pathologizes and misunderstands hormonal shifts, I view these cycles as holding both challenges and benefits.

  • Navigating medical systems and procedures can be stressful. I provide therapy to people who experience anxiety about invasive medical procedures in OB/GYN, pediatrics/NICU/PICU, gynecologic cancer, and breast cancer domains. These procedures can include, but are not limited to: pelvic exams, cesareans, epidurals, fetal surgery, egg retrieval, endometriosis surgery, breast and cervical biopsy, cancer treatment (e.g., pelvic radiation, surgery, chemotherapy).

    Additionally, I work with people experiencing specific stressors related to medical concerns or diagnoses, which can include: complications with pregnancy or managing comorbid conditions during pregnancy; caregiving for infants in the NICU or PICU; navigating a medical treatment decision making process for their child; making decisions related to cancer treatment and/or navigating fertility preservation decisions related to a cancer diagnosis; being a “previvor” for gynecologic or breast cancer considering or undergoing preventive interventions (e.g., mastectomy, oophorectomy); and experiencing changes in body image or view of oneself after childbirth or cancer treatment.

    I also support clients who have previously had distressing experiences with medical care (e.g., poor patient-provider communication, medical trauma, mistreatment, discrimination) and are wanting to build their coping skills when trying to stay engaged in their own, their partner’s, or their child’s medical care.

I may be a good fit as your therapist if you are seeking support for any of the following challenges that connect to reproductive life events or concerns:

  • Adjusting to life transitions

  • Persistent worry, overthinking, rumination and avoidance (anxiety, OCD)

  • Intrusive memories of past trauma

  • Often feeling sad, guilty and unable to enjoy life

  • Grief and loss

  • Self-doubt, self-criticism, or perfectionism

  • Wanting to reconnect with or deepen your sense of self

  • Difficulty tolerating uncertainty about the future

  • Feeling overwhelmed by emotions

  • Difficulty making decisions

  • Working to interrupt patterns of generational trauma

  • Preventing or managing chronic stress or burnout (in caregiving and professionally)

  • Struggling to set and keep boundaries

 

Personalized therapy for adults in NC and PSYPACT states

I’d love to connect with you.