Finding Peace: Your Guide to Therapy in Madison

Therapy can be a lot of things- challenging, interesting, and enlightening. You might even say life changing. The benefits of therapy can go well beyond you, the individual or couple that are the clients. It tends to have a ripple effect often impacting your relationship with kids, family members, friends and coworkers. It can impact how you see yourself, how you approach relationships and how to care for yourself. Therapy can help to break old patterns, even ones that didn’t start with you. It can help you have a better understanding of your though patterns, behaviors and how you respond in situations.

I specialize in working with women in reproductive and maternal mental health as a perinatal therapist in Madison. Many times a good chunk of our time is focused around the parent reparenting themselves. Many of you may want to do better for your children, but do not think to do better for yourself. One of your best teaching tools is the example that you set for your kids. If they see you regulating when you’re having big emotions, modeling how to talk about your emotions and handle conflict, how to take care of yourself, set boundaries, and speak up for yourself. If you model how to make mistakes, and how to make a repair in a relationship when you do make mistakes.

Initiating the therapy process can be hard, but it doesn’t have to be impossible.

Interested in learning more about therapy in Madison and finding your inner peace? Contact julie@kullcounselingmadison.com. If I am not the right fit for you, I will try to help you find a therapist that is.

Am I a mother after a miscarriage?

As we near the month of May, two dates stand out each year. The first is Bereaved Mother’s Day, which is the first Sunday of the month and the second is Mother’s Day which is the second Sunday of the month.

Each year I have at least one client in my office that wonders, “am I a mother”. Having an early loss (before 20 weeks of gestation) can feel confusing of what that means. For many of you that is not a question that is easily answered.

Some of you may identify with being a mother or being a bereaved mother, but for others you may not. This idea of motherhood often is a label that people get stuck on because you may not identify as a mother but you also not identify as a bereaved mother, but it may also feel like you are not not a mother. The idea of motherhood or being a parent may also evolve for you as you process and grieve your loss.

However you identify is okay, it can be less isolating to go through loss with others and find a group of people that you identify with but whether you identify as a mother, parent, bereaved mother, or person that had a miscarriage is okay. And their might be a group for that. Please know that even if you don’t identify as a bereaved parent, it is still okay to look for support in these communities if you feel like it is a fit for you. It is important to just show up for yourself during this month. Notice what it brings up for you and if you would like support with what you went through. For more information on pregnancy loss or to work with a therapist in Madison contact me here.

How therapy can help after a miscarriage

It is estimated that 1 in 4 women will have a miscarriage. You may be feeling like if it is so common that you “should” be able to deal with it on your own or that it will not impact you or maybe even that it isn’t a big deal. For most people it is a big deal and it can be pretty hard to cope with.

Statistics suggest that 30-50% of women experience anxiety and 10-15 percent experience depression up to 4 months following a loss according to FIGO.

NIHR discusses a study that found 1 in 3 women show signs of PTSD after a miscarriage.

So why is this important? We know that the mental health of the mother can greatly impact the child even in pregnancy. Their are many studies that discuss the impact of the mental well being of the mom in pregnancy and the long term impact it may have on the child’s physical, emotional and cognitive development. Many women will become pregnant again soon after a miscarriage but long before anxiety and/or depression symptoms have subsided. While it is common to think getting pregnant again after a loss will decrease anxiety it often does not. Seeking therapy after a miscarriage can impact your ability to cope and decrease anxiety/depression in subsequent pregnancy.

How can therapy help?

Normalize- Many of the feelings you may be feeling are common for those that have had a miscarriage. Knowing that your feelings are okay and that there are ways to cope. Knowing that it is hard to have a miscarriage, that women do seek therapy and sometimes medication after a loss and that most people do not just “get over it”, even if it is common.

Validate- I am just going to say it- people are sooo uncomfortable with grief. You may be finding it really hard to express your feelings with family and friends. This can be even harder with a pregnancy loss that it can be when losing a friend or a grandparent. Often the people in your life may have not had an attachment or even known about the pregnancy before. It can be hard for people to relate to what we call an ambiguous loss. It can be really healing to have your feelings acknowledged and validated.

Help you to identify healthy ways to cope with grief- Unfortunately trying again or gods willing it or at least you know you can get pregnant are not the kind of healthy ways you need to deal with grief. But, acknowledging your feelings, finding support, creating a container for your grief, nurturing yourself, honoring your loss, making meaning and acceptance can be.

Set boundaries and ask for what you need in relationship- If you are in a relationship you probably are already starting to realize that you are your partner are grieving this differently. This also applies to family members that may need a gentle reminder on what you need to feel supported or the acknowledgement that this person in your life might not have the ability to support you through this for whatever reason and ouch can that really hurt.

Understand the grief and trauma around pregnancy loss- Understanding a framework for grief and what you have or might experience can help. Looking at your loss and understanding the trauma that can be experienced can also be really helpful in understanding how it has impacted you and what makes it difficult to process. Working with those triggers, increasing your window of tolerance and helping you to feel more regulated can make a difference.

If you still aren’t sure..find out more or schedule a free 15 minute consult here with a therapist Madison.

Pregnancy after infertility

You have been trying for days, months, maybe even years. Part of you felt that it was never going to happen, maybe you even started to prepare yourself for that and then it does. And maybe you feel some joy, but you might also feel shock, denial or numb. It might not feel real even after you take pregnancy test after pregnancy test. Everyone has advice to give when it comes to getting pregnant when diagnosed with infertility but what happens when you get pregnant after infertility?

Does the infertility diagnosis go away?

No! You are not suddenly cured because you now are pregnant. It doesn’t take away the stress, the longing, the anger, the resentment, how its impacted your mental health or your finances or the impact it had on relationships.

Why do I feel like an imposter?

You may feel like an imposter after getting pregnant. You have wanted to be in this group of pregnant people for so long and now that you are here it doesn’t feel right. You feel like you don’t fit in. Infertility has changed you and changed this narrative you have had about becoming a parent.

Why do I fell guilty?

You may even feel guilty after becoming pregnant. It is common to feel guilty about leaving behind those that are still struggling with infertility. This can be isolating and feel very lonely. If you are feeling like an imposter in the pregnancy group, but also no longer feel like you fit in the infertility groups it can be hard to feel supported.

I am pregnant so I can’t complain.

It is so common for women to feel like if pregnancy is hard or not what they expected that they are allowed to feel this way. You may be telling yourself well this is what I wanted so I can’t complain or you may also be hearing this from others or well you got pregnant what did you expect. Even if you have a very wanted pregnancy that you tried very hard to get, pregnancy is still hard, uncomfortable at times, and not what you expected. Your feelings are VALID!

I don’t feel attached to my pregnancy.

It is common after infertility or a loss to not feel attached right away. This is your protective part telling you this isn’t safe, we need to protect you. For most of you this will grow and develop naturally. If it doesn’t feel like you are slowly starting to develop or that it is feeling more and more real- therapy can help.

I am feeling anxious.

It is common to notice some anxiety or sadness about being pregnant. If you are noticing these frequently or noticing that they are increasing it is important to get help. If you are noticing intrusive thoughts, nightmares or flashbacks there is help.

To learn more about infertility counseling in Madison or anywhere in Wisconsin or to set up your free 15 minute consultation you can reach me here for a therapist Madison.

Meditation for miscarriage, pregnancy after loss and new moms

I remember trying to meditate for the first time. I made every excuse in the book to avoid it. I convinced myself that I did not have time, convinced myself that it wasn’t a good use of my time, that I wasn’t doing it right so what was the point. It took YEARS until I developed a regular practice and it is still a work in progress.

Meditation has so many unbelievable benefits. According to Positive Psychology.com , meditation can reduce physical, mental and emotional disturbances. This can include anxiety, depression, pain, blood pressure, stress, migraines, IBS, ect. Meditation can be so effective.

So if it is so great, why isn’t everyone doing it? What I hear often is that it is hard, you may think you are doing it wrong and if you are doing it wrong what is the point? Other reasons can include you may feel uncomfortable, overwhelmed or don’t want to feel anything.

All of the reasons are valid. I like to invite my clients to start small. Try to take one minute everyday where you just try to tune into your body and breath and go from there. Many of you may find it is easier to do when you have someone guiding you. I certainly do! There are meditations everywhere it seems but finding one that resonates with you is important.

Recently I have created some meditations with you in mind. My library is building slowly but I currently have meditations for miscarriage, pregnancy after loss and motherhood. I will be adding more soon. If you are looking for a specific meditation that is a fit for you please- DM me, reply to this newsletter and let me know what you are looking for and I will do my best to make that available to you.

Interested in learning more about the meditations from a therapist Madison? Click here.

Happy Meditating!

Postpartum Care Physical Therapy in Madison, WI

I had the honor of interviewing local physical therapist, Jessica Dufault from Mindful Motion Physical Therapy to learn more about how she helps postpartum care in Madison. She specializes in pelvic floor and women’s wellness. She is an excellent resource for women in the pre/postnatal stage and also works with women that have experienced a pregnancy loss.

Julie: Hello Jessica,

Thank you so much for agreeing to speak with me. Would you start by introducing yourself?

Jessica: Hello,

I'm excited to be talking with you about pelvic health today and thanks for inviting me!

I'm a mom, partner, business owner and Pelvic PT in a small private practice. I support people throughout their lifespan (18+ years old, my wisest client was 94!)

Julie: Who can benefit from PT for the pelvic floor?

Jessica: Anyone with a pelvis! But specifically if you've gone through life transitions such as pregnancy, postpartum and perimenopause. During these times, your health and pelvis can undergo transitions that can be challenging to navigate alone and may sometimes require additional TLC.

Julie: I work with a lot of pre/postpartum moms. What are some symptoms that they may notice if they need physical therapy?

Jessica: Great question! If you are pre/postpartum, here are some things to look out for

Peeing when you don't want to

Prolapse which is a shift in position of pelvic organs (feeling of pressure, heaviness or a "falling out" feeling)

Difficulty with internal menstrual product use

Pain with penetration, including sex, exams, menstrual products

Scar tissue restrictions or pain (perineal or cesarean)

Diastasis Recti (separation of abdominal tissue) which can lead to feeling weak or even LBP

Pain in areas like the low back, sacroiliac joint, hip. As well as sciatica and pubic symphysis dysfunction

You may also be looking for guidance on exercise or fitness

You may want support for prepping your body for demands of pregnancy and birth

Julie: If someone has a cesarean birth is PT still helpful?

Jessica: Yes! I had an unplanned cesarean and I had NO idea how difficult the recovery would be and didn't have the support I needed (which is one factor that pushed me from an orthopedic PT to a pelvic PT!).

Taking care of the scar tissue, assessing the position and movement of pelvic organs and regaining abdominal strength are all very important to ensure good long term pelvic health.

Julie: I also work a lot with bereaved moms. I think a lot of times they don't always think about being postpartum because they are not given the same attention as a mom that is lucky enough to bring a baby home. Do you have experience working with bereaved moms? How might your work look different? What might be important for them to know?

Jessica: I don't have a lot of experience here but over the years I have supported a few people who've experienced loss in pregnancy, during birth or a few weeks after birth. And maybe my experience is limited because of what you've already mentioned, that they aren't given the same attention, resources and discussion on all aspects of physical postpartum support. And yet they have the right and deserve the same access to physical pregnancy/post-pregnancy care.

Because if you have experienced a miscarriage in early or mid pregnancy prior to 20 weeks, or a stillbirth (whether vaginal or cesarean) at anytime past 20 weeks, your body has been impacted by hormones and all the accompanying physical changes to the body that pregnancy and birth can bring on. Which deserves attention and support!

We can start early education and support depending on each person's readiness however we wouldn't do a full pelvic assessment until 6 weeks post birth.

All of my clients are screened for mental and emotional health and this helps me to understand where they are in the (potential) grieving process as well as what support they've been able to access and then I can fill in referral gaps as necessary.

And with all clients, I follow their lead in how we approach the plan of care and meet them where they are and with what they (and their bodies) seem ready for. This is especially important for clients with a history of trauma or loss.

Julie: This is so helpful. Thank you! It is a great to know that you are aware and sensitive to the trauma and grief that all these moms are going through and ways to support them.

Julie: What are the benefits that PT can offer?

Jessica: Navigating changes in our bodies can be a lot and accessing a pelvic PT can help people feel well supported physically, emotionally & mentally. Knowing you don't have to "go at it alone" or "suffer in silence" can have a profound impact.

Also it's not just about the pelvic floor! My training and education allow me to support people with all aspects of their health and wellness as it relates to menstruation, fertility, pregnancy, postpartum, perimenopause & menopause.

Julie: If someone is interested in working with you, how do they initiate that?

Jessica: Our website is a great place to start. Lots of info there on who we support and all the options- like using insurance, choosing our ​self-pay programs or even our online programs. We also offer online scheduling through our website.

We do have a free and private Facebook group that everyone is welcome to join if they are looking for more community, support and general pelvic health education.

Julie: Thank you so much Jessica for taking the time to meet with me today. Is there any other information that would be important to know?

Jessica: I often get feedback that our space feels very warm and inviting and that talking with me is way easier than they anticipated (and they say "I wish I had come sooner!") We work hard to make the experience feel supportive and easy. If anyone has reservations, I'm also open to chatting via email or phone call as necessary to make sure it's the right fit overall.

Julie: Jessica you are a valuable resource to the community. Thank you so much for talking with me today and all that you do for the postpartum moms. One of the reasons I asked Jessica to speak today is because of all the great content I see her putting on instagram for free. If you haven’t found her on there yet she is

that_ pelvic _lady.

For more resources on pregnancy or postpartum mental health contact julie@kullcounselingmadison.com.

Anxiety therapist Madison: Still coping with Covid-19 and anxiety

This is an article that was modified from another article that I wrote in 2020 about anxiety during covid.

It is 2022. We are still dealing with Covid-19. If you are noticing the weight of it hitting you again you are not alone. We are at the two year mark, going on year 3. Your anxiety may be on the rise again as we head into another year. Here are some coping tips I offered in 2020 which are still applicable now. I have added in a few additional ones.

1. Exercise- exercise is important for physical and mental health. If you have an anxiety disorder exercise plays an essential role in managing anxiety. Exercise not only releases serotonin and endorphins to improve your mood but also can reduce activation in the amygdala which is the area of the brain that sends a distress signal to activate our fight, flight, freeze response. https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response

2. Get outside- Time in the outdoors can be restorative. Having deficient levels of vitamin D can also be linked to depression and anxiety. https://www.unitypoint.org/livewell/article.aspx?id=ca7f4766-8ba8-43a2-bbe7-0ef9efab5c6d

3. Meditate- Meditation can improve focus, decrease anxiety, and help with emotion regulation among other benefits.

4. Keep a routine- our bodies thrive on routines. Routines can improve productivity, setting expectations and having some control.

5. Sleep- REM sleep can also play a role in decreasing activation in the amygdala. Setting up a sleep routine can signal to our body when it is time to go to sleep.

6. Social Support- these are hard times. While you many be social distancing from friends you do not need to isolate. Reaching out to friends can provide a sense of normalcy and a sense of belonging.

7. Manage your screen time- Between work, school and socializing online many of your are getting more screen time than you ever have before. Screen time can impact anxiety, sleep and overall well-being.

8. Focus on what you have control of- unfortunately with Covid-19 it may feel like there are many things that are out of your control. Focusing on these can lead to increased anxiety. Instead try focusing on what things are within your control. Make a plan for the things that are in your control, and let go of the things that are out of your control.

9. Stay present- Ask yourself what do I know in this moment instead of the what ifs.

10. Attitude of Gratitude- in the midst of all this chaos there is a lot to be grateful for. What do you feel grateful for? Write it down, say it out loud. Surround yourself with positive messages.

11. Be mindful when reading the news. Is it serving you? Are you finding out anything new? What does knowing this information do for you? How are you feeling when you read the news? Do you need a break?

12. It is okay if your comfort level changes- again, and again and again. Listen to your needs.

13. Get dressed for your day. Even if you are working from home. Even if you don’t have any meetings.

14. Weigh your risks. Everything has a risk when it comes to your physical and mental health. Calculate your risks versus what is important to you and then make your decision on what you are comfortable with.

15. Acceptance- you are living in a global pandemic. If you are having anxiety right now- accept that it is there. Acknowledge it, name it, allow yourself to notice how it feels- notice what sensations go with that feeling and allow them to be there.

    For more information on coping with anxiety during the pandemic or to set up a free 15-minute consultation email julie@kullcounselingmadison.com or 608.239.4807 to work with a therapist Madison.

The emotional toll of a Missed Miscarriage

Having a miscarriage can be devastating. You may know signs and symptoms to look for  when your body may be starting the process of miscarriage and look for those throughout the first trimester. However, you may not know  that you can suffer a loss, but the body may not show signs of a miscarriage. This is referred to as a missed miscarriage.

Having a missed miscarriage can add an extra layer to the grief and trauma around early pregnancy loss. According to www.progny.com, “A missed miscarriage, also known as a missed abortion or a silent miscarriage, occurs when a fetus is no longer alive, but the body does not recognize the pregnancy loss or expel the pregnancy tissue. As a result, the placenta may continue to release hormones, so you may continue to experience signs of pregnancy.” A missed miscarriage can be devastating when there has not been any symptoms, and often, these symptoms may be typical of a healthy pregnancy - i.e., fatigue, nausea, etc. For most of you, you will find out about missed miscarriages when you go into your doctor’s office for your first appointment. One of the happiest days of your life (when you get to see your baby for the first time) can quickly turn to one of your saddest (finding out your baby is no longer alive).

For many carrying partners this can feel like your body has failed you, twice. Once, that your body was not able to carry a baby to term, and twice, because if your pregnancy was to end in a miscarriage why did your body not do this naturally? This can lead to a strong mistrust in your body that may lead to abuse or neglect of yourself. This also can present in a subsequent pregnancy causing anxiety and depression or ptsd. It can feel like your body is not a safe place for a healthy pregnancy after a missed miscarriage.

Having a missed miscarriage also leads you to what can be a difficult and painful decision of deciding how to manage the miscarriage process. While some people will wait to see if their body can complete the miscarriage on its own, most doctors will encourage you to schedule an intervention to manage the miscarriage process for health concerns.

After a decision has been made it can still be weeks to months to complete the process and symptoms of pregnancy may linger for months after that.

It is common to feel many different things, some common ones being shock, anger, denial, grief, shame, jealousy. You may feel a loss of control. It can be helpful to get connected to support during a missed miscarriage whether that is a support group, or a therapist that can help you talk through your decision, feelings and support you through the process and after a loss. Having a miscarriage can be isolating, finding support can make a huge difference.

Finding ways to be present in your body can be an important part of your process. Whether this is through grounding, centering, breathe work or exercise, movement or dance, it is important to be in your body and find healthy ways to reconnect with your body.

For more resources on miscarriage and to learn about the miscarriage support group with a therapist Madison, sign up for my monthly newsletter here. https://www.kullcounselingmadison.com/