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Steph interviews Karen Kleiman, MSW about her #speakthesecret campaign which helps new moms validate their feelings, share their fears, and start feeling better. Over 90% of new mothers will have scary, intrusive thoughts about their baby and themselves, but many are afraid to tell anyone. Moms are left feeling confused, frustrated, or scared about what these thoughts mean. On this show we reduce the shame and stigma and encourage moms to find a safe place to express themselves. This interview is a must listen for all new mamas and we hope you share this with all the new mamas in your life.
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Karen Kleinman 0:03
It’s not the feelings that you’re having that’s the problem. It’s how you interpret them, and how you appraise them, and how much they may or may not interfere with your functioning. That’s the problem.
Stephanie Greunke 0:19
Welcome to the Whole Mama’s podcast. We’re here to give you tools, resources and evidence-based information, so you can make the best decisions for yourself and your family. Whether you’re trying to conceive, or navigating life with a toddler or a teenager, we’ve got you covered. I’m Stephanie Greunke, Registered Dietitian and Program Director for Whole30’s Whole Mamas Club. I’m also the co-creator of Whole30’s pregnancy program. And my co-host is Dr. Elana Roumell, pediatric naturopathic doctor and founder of Nourish Medical Center.
Before we begin, I want to introduce this month’s podcast sponsor, Coconu, which is an organic coconut based lubricant that I personally love and feel good about using. Over the last couple of years there’s been a push for using more natural, safer options for beauty, skincare and even cleaning products, like we talked about in our last episodes, but personal care products like lubrication and tampons aren’t getting the love and attention that they deserve and Dr. Elana and I think it’s really important. So if you’re listening in, you may be in the process of trying to make a baby or you’re finding ways to keep your sex life alive and well after baby. Know that the ingredients in your lubricant matter. And while making sure the ingredients are safe is important, it also has to work well. So if you’re experiencing vaginal dryness, you want something that will allow you to enjoy the experience with more comfort and with less fear. If you’re actively trying to prevent conception or having another baby you want to safe option that won’t risk tearing. And while coconut oil on its own can be a great option, it doesn’t play so nicely with latex condoms and you risk having the latex break which is why I love that Coconu new offers a coconut water-based lubricant that plays nicely with condoms and other toys. Their organic coconut water and coconut oil-based lubricants are pH balanced, which is really important because a high pH in your vaginal area may contribute to infections and can allow bacteria and yeast to thrive. These lubricants are hypoallergenic, they don’t contain GMOs, and are alcohol, petroleum, paraben, gluten, fragrant and die free and they don’t perform any animal testing. I am actually headed on a trip with my hubby for our 10 year anniversary. And I love that their packaging is not only super cute, but it doesn’t scream lubrication. It looks like lotion, so it’s not a big deal if you accidentally leave it out on your bathroom counter or your nightstand. And plus they’re in three ounce bottles so they’re even safe for your carry on luggage. And in the event where you have to pull out your bottle in the middle of TSA, nobody’s going to think twice. If you’re interested in trying Coconu, we have two fun options. If you’re listening to this episode that day airs, head over to Whole Mama’s Club on Instagram for a chance to win a bundle that includes both the coconut oil and the coconut water based lubicants. The giveaway airs the day of this podcast air, May 7, so hop on over right away for your chance to win. They so generously offered five kits so you have a good chance at winning. If you miss the giveaway, you can use a code WHOLEMAMAS at checkout over at coconu.com to get 15% off your first order. We hope you love it, and your partners can thank us later. Happy mama, happy partner, happy family, right?
Today I am so excited to bring on one of my personal mentors and leading experts in the field of maternal mental health, Karen Kleinman. Oh, she is amazing! If you haven’t heard of her, she is known for her multiple books on perinatal mental health, including This Isn’t What I Expected, Overcoming Postpartum Depression, and her new book, which we’ll talk about on today’s show, called Good Moms Have Scary Thoughts. This is a collection of comics that outlines very real thoughts and concerns many new mamas have, in a relatable way that’s never been done before. Karen is also the founder and executive director of the Postpartum Stress Center, which provides comprehensive clinical intervention for any woman who suffers from the range of prenatal and postpartum mood and anxiety disorders. Karen also teaches professionals about these conditions through her two day in-person postgraduate professional training program. I think you’re going to love this episode! Alright, let’s welcome Karen to the show. Karen, gosh, I don’t know where to start! My jaw dropped when Kate from your marketing team reached out. She told us that she really liked the Whole Mamas podcast and she wanted to see if we’d be interested in having you on this show. To be honest, I have you on a list of dream guests, you’ve been on that list for over a year now. So when I saw her message, my heart just exploded with excitement. Not only the chance to meet you Karen and chat with you, somebody that I call a mentor, but also because I know how much value you’re going to bring to our show today. Your work is game changing. I want to thank you for taking the time out of your schedule to help our moms feel heard, feel understood and have resources to support their transition to motherhood. So thank you so much for being here.
Karen Kleinman 5:34
Stephanie’s It’s so sweet. Do you hear me smiling?
Stephanie Greunke 5:37
Oh, I do I do.
Karen Kleinman 5:40
I’m thrilled to be here. Honestly, dream guest is an awesome, awesome sort of label. I appreciate that. And I love doing this and helping moms get the get the most out of their experience and your passion just comes is so loud and clear that I love who you are and what you do. So I’m thrilled to be here.
Stephanie Greunke 6:00
Thank you. Now before we begin, we usually do a nourish yourself segment. And as somebody who works with postpartum women, and someone who helps practitioners learn how to best support their mamas, I know you understand the importance of daily self care more than anybody and even if it’s as simple as washing your face with a brand new cleanser, or taking the time for a few deep breaths, I’d love to understand and ask you what you have done today, or what you’re planning on doing today to nourish yourself.
Karen Kleinman 6:29
Good question. So, you know, most of us who do this work are much better at taking care of other people than they are taking care of themselves, right? So you know that that’s unfortunately, sometimes more true than not. But, I would say the best answer for that is that today I decided to do something that’s hard for me personally, and challenging. And I’m doing it, and it feels really good and it feels really right. I feel really empowered by that.
Stephanie Greunke 7:03
Alright, yeah, we have to take those moments to appreciate those hard steps that we’re taking every day. I think it’s so easy to just move on, whether it’s a win that we have or a struggle that we have, we just like to brush past it. So taking that time to really breathe in your strength, your inner and outer strength, is so important. So thank you for sharing that. As far as what I’m doing today, it’s actually really interesting. There is a group meeting tonight. It’s a bunch of friends, including my podcast co host, Dr. Elana Romell, and they’re leading a discussion about what it means to be truly nourished outside of just food, and what we can do to bring that nourishment into our daily lives and those of our tribes. So I know this sounds like it’s just made it up, but it’s actually happening. It’s a two hour event. And I’m just excited because it’s not only girl time tonight, but we also get a deep dive and have a thoughtful conversation about how we’re all taking steps to nourish ourselves. So you know, as moms, we have a hard time doing this. Sometimes we take care of everybody else. And as practitioners, we take care of everybody else, and you know, absorb their energy. And it’s about taking that step back to really make sure we’re doing what we need to to fill our cup.
Karen Kleinman 8:22
Let me tell you why that feels so good to me personally, do you mind Stephanie? Before we had all these wonderful buzzwords, and I mean that very affectionately, and supportively, those of us who were fairly good at taking care of ourselves called it something else, because we were raised not to do that, right? I’m a generation ahead of you, I think. So I always thought I was good at “spoiling” myself. I was always good at indulging in certain things. I never really felt burdened by a lot of guilt that I saw a lot of my colleagues and friends and family have. So I always felt sort of blessed by this capacity to just like, ‘Hey, I worked hard, I am eating these Doritos.’ you know? So we laugh about it – Doritos is a sort of my go-to representation for all things bad/evil that I indulge in. And the word nourish is obviously a better word for this. But it speaks to that same sort of, ‘Can I balance how hard I work and how driven I am and whatever it is that I do, with some me time downtime, can I justify it? Can I enjoy? Can I relish in it? Can I refuel and restore myself from it?’ And nourish is such a great word that just encompasses all of that. And I do believe wholeheartedly that our clients, our friends, our family, our children, will get better at this if we role model it, if we show them how we are doing it.
Stephanie Greunke 9:59
Oh, hundred percent. I agree the word nourish – you think about food right away, like food is nourishment. But it really is how you’re nourishing your relationships, and how you’re nourishing your time, and your ability to be present with those around you. And there’s just so many meanings. So yeah, I’m glad we’re talking about it more. I’m glad it’s not looked at as like a “selfish” time. And people are promoting taking that time out for yourself.
Karen Kleinman 10:30
Uh huh. I love it.
Stephanie Greunke 10:31
Okay, let’s get into the questions. So, you are an internationally recognized maternal mental health expert. You’ve been doing this for over 30 years. So for anybody who doesn’t know you, that’s kind of your background. But I’d love to hear more about what got you interested in the field of perinatal mental health? What started this journey for you?
Karen Kleinman 10:52
Oh, gosh, I should expect this question, and I never have a really succinct answer. I’ve got all kinds of feelings that attached to it. And the answer, the answer could be 20 or 25 minutes. So let me see if I can do this quickly. The short answer is I did not have a perinatal depression or anxiety experience myself. But what I did have was there was a combination of so many influences all at once. When I had my son, we had a little experience with his birth, which was very scary, mildly traumatic, and then I just sort of tucked that away. And then after my daughter, a couple years later, I had a breast cancer scare, everything was fine. I did not have breast cancer. But it was it was enough. She was two months old. And I was breastfeeding. And I had a two year old. And I remember going back and forth to the doctor with this lump that I found in my breasts. And he was nervous, sent me to a surgeon and the surgeon promptly said, ‘Stop breastfeeding, you know, today.’, and I said, ‘Ah! My baby’s exclusively breastfed, and I’ve got a toddler, and we’re scared of breast cancer. And I’m now terrified. And what do you mean, stop breastfeeding today?’ Okay, so long story short – there weren’t a lot of resources 32 years ago, and I didn’t know where to go. I went to breastfeeding support. They said, ‘No, don’t stop breastfeeding.’ And I went to my pediatrician.
I realized that the needs of postpartum women fall through the cracks. And we don’t really know, there was no community of who could address this for me. And I did find good answers. I found some not so good answers, and went back and forth and and realized that something was amiss in our new mother community. And I started to support breastfeeding moms. I trained as a lactation consultant. And I, you know, I had little children. So I thought this was a great way to spend my time. And when I started talking to new moms who were breastfeeding, I noticed that a lot of them were telling me how bad they felt. And, you know, I joke when I talk about this, it’s not so funny, but when you can talk about your nipples, you can talk about almost anything, you know, and moms would just started talking to me about their marriages, or talk to me about how tired they were, or talked to me about their mother in law, or, and I thought what is happening here?
So I started asking questions. And, you know, my clinical director always jokes around and says, I made up postpartum depression some 35 years ago when nobody was talking about it. But I literally started knocking on doors and and asking people. I put out questionnaires and ‘Did you just have a baby? And how did you feel? And what are you doing about that?’ I end this little piece of a story by saying women who had babies taught me everything I needed to know. When I went back into my private practice, they taught me everything they needed to know. And I started knocking on doors at OBs who were predominantly male and predominantly uninterested. And I said, you know, with no training and no expertise, and nothing but what we say, you know, a lot of chutzpah, ‘I’m a therapist in the local area who specializes in the treatment of postpartum depression, send me your moms.’ And they did. And so women started telling me about their distress and about their isolation and about their loneliness.
And one story, Stephanie, always stands out, and I always tell this story when I’m giving a talk. I put an ad in the local newspaper ‘therapist studying postpartum depression.’ You know, we didn’t talk about anxiety or distress or perinatal, it was just ‘Therapist studying postpartum depression. If you’ve recently had a baby, call me and I want to interview you.’ And I got three phone calls. And two of these three women were over 70 years old. And they each came to me each three are separately, each woman came to my office, and spoke to me and these two women, separately, told me identical stories of their shame and the darkness and not telling anybody and their fear of disclosing, and their fear of being judged, fear of going crazy, fear of losing their marriage, and they stayed behind closed doors. They didn’t talk to their mothers, their partners, their their friends, their neighbors about how bad they were feeling. And both women, it gives me the chills every time I tell the story, both women told me I was the first person they talked to. And that’s when, I promise you, I felt like I needed to do this. That this was almost not even a choice, I needed to make something available. So that women didn’t have to wait 50 years to talk about this.
Stephanie Greunke 16:01
Oh, man, I have the chills too. I can’t even imagine, because I kept those thoughts in for a year. And that just killed me inside. So to think about keeping it for 50 plus years? And feeling all that because I mean, at least not people are talking about it. But back then nobody was talking about this. So I’m sure they felt even more alone than some of the moms do today. And oh, my goodness, I see why you’re so pulled to do what you do.
Karen Kleinman 16:29
Yeah, it really is amazing. And you know, I think about that a lot. I think about over the course of all these years, how much has changed, and it’s so obvious how much has changed and that the momentum is just it’s hugely in the right direction. We’ve got all of these amazing advocacy, and the legislation, and the training, and the education and moms have social media now and they’ve got platforms for support and expression. But, those are all the things that we’ve worked so hard for. And then I sit back and I say yeah, but every single mom sitting at home in distress, still feels the shame, she still feels the pain, she still feels the terror. She’s still not telling people how bad she feels. Doctors and and healthcare providers are still not asking the right questions. They still don’t know what to do, if mom really does disclose the nature of her thoughts. They aren’t sure what to do. So in many ways we’ve changed and in many ways, we’re back to square one, but with the hope that it’s just going to continue to move in the right direction.
Stephanie Greunke 17:37
Yeah. And you know, what makes you so good at what you do is because you hold that safe space for women and let them talk about what they’re feeling and provide that really warm environment. And that’s what we need to be able to disclose these things. I know that’s something you’re trying to do with your latest campaign, which is #speakthesecret, which helps moms validate their feelings, and share their feelings, and start feeling better. So do you want to talk about why you have created this campaign and what your goals are for it?
Karen Kleinman 18:10
Sure, I love this. #speakthesecret evolved from just more of what I’ve all always done, but really just this notion, how can we get moms to talk? How can we get moms to bust through that stigma and make it more okay? We know that the more we silence ourselves, the more we introduce ourselves with with shame and self judgment. So we started this hashtag, well, Stephanie, you know, that technologically I’m impaired. And so with social media, we really wanted to let moms know that they have this place. And we started the hashtag. We sent them to our forum on the website, where they’re where they could anonymously post their scary thoughts. And these were sort of unfiltered. We wanted them to really be the words that came out of our mom’s mouths, and we were a little nervous. What are we going to see? And will it scare other moms? We knew it wouldn’t scare us. But would it scare other moms? And would this sort of blow up in our face? But it didn’t. It sort of exploded into a grateful subset of moms who found that it was very validating, reassuring and less isolating to see what other moms had written and ‘Oh, maybe mine’s not so bad.’ Or maybe ‘Hers is as bad as mine.’ And of course, with this forum, we also lead them to information on our website to encourage them to read about what are scary thoughts? And when is it okay, and when is it not okay? That’s when Molly when I grabbed Molly from afar, I had seen her work, Molly McIntyre, the illustrator, and we teamed up and said, let’s put this into illustration form. In my ever-present desire to stay relevant, I thought, you know what, we need to get to these young moms, and they’re not as interested in reading a 300 page book anymore. They’re busy, they’re overwhelmed, they’re doing more than they probably should. So let’s put it in a format that will speak to them.
And so we started with these comics. The first one went viral. And it was amazing. It was amazing! And it’s now been translated into several international languages. This is the one where her partner says, ‘Do you need anything?’ and her eyes are down, she’s holding her baby. And she says, ‘Nope.’ And then she says in her thought bubble, she says, ‘I need a home cooked hot meal, I need a shower, I need a break, I need some time to myself, I need some sleep, I need someone to understand how bad I feel sometimes, I need time, rest, help, food, hugs, support, cookies, quiet, nourishment, help with laundry, cleaning, cooking, I need acknowledgement, understanding and support.’ And so what we decided to do was make each comic say what she’s not saying and express the inexpressible. And sometimes it’s funny, more times it’s bittersweet. And sometimes it’s really, really, really, really, really scary. So, that’s how it evolved. And we’ve gotten enormous feedback from mothers who are so grateful that we’ve enabled them to say what they need to say, and, frankly, increase the likelihood that they’re going to get some of these needs met.
Stephanie Greunke 21:48
Yeah, I mean, I think what you’re doing is so smart by listening to your community, what they’re asking for, what their concerns and fears are, and then putting it into a forum that is so related, readable and easy. It just easily captures all of the different feelings that a chapter in a book really couldn’t. And I know when I posted a picture from your new book, Good Moms Have Scary Thoughts. And the feedback I got was by far more than most posts that I put up, because people resonate with these images, they can see themselves in the images. When you when you’re looking at it in a picture, you’re able to see it in a different way, like wow, that is way more powerful. And I didn’t realize all of the emotions and everything that I’ve been keeping inside and it has a way of pulling out what you’re thinking without you even realizing it just taps into yourself or your unconscious self.
Karen Kleinman 22:47
I do want to put in a plug for Molly here. Because, while I love getting all the credit, I love getting, you know, like, hey, Karen’s got a book out. But Molly is the magic behind this book. Because, you know, I have the expert guidance in there. And I have the the text of each comic that you know, I wrote the text. But Molly’s illustrations are nothing short of magnificent because, if you’re not familiar with her work, her work is very raw, and very real and very simple. And yet you can feel the feelings that these characters have. You can feel it. So the words are pouring in. And the words are maybe spot on for many women. But the combination of her pictures with these words, truly make the words come to life. And she’s just been a joy to work with.
Stephanie Greunke 23:45
Thank you so much, Molly. Yeah, I completely second of that. You just really created something beautiful, that will help millions of women, I know. Okay, so let’s talk about where you got these ideas and the stories for the cartoons. Was that from your #speakthesecret? Because you cover a whole range of topics from insomnia, to disappointment, to getting advice, to the six week checkup, to how to feed your baby and all the judgment that comes with that. And so, I would love to hear where this came from.
Karen Kleinman 24:14
So I guess it wouldn’t be fair for me to just say 35 years of doing this work. That that’s the quick answer. Yeah, I mean, we got it from my mom’s – from every mom that I’ve ever spoken to. We try to organize the book in a way so that moms could either go page by page or are just look at the page today, they you know, that speaks to them specifically. But we organize it so that the first chapter is basic mom, and we talk about what almost all moms might be feeling and worrying about and is this okay? We want to sort of help empower her to understand this might be normal, but if this feels really bad, here are some of the things that you may want to think about or do. Chapter two is her identity, things that she might be losing: her body image her, the losses – we never think of having a baby as bringing so many losses attached to it. Everybody expects this to be the best time of our life. So, so we talked about some of those normal, universal common experiences, and the very scary thoughts that can accompany that, like, ‘Does this mean I’m not a good mother?’ And then we go on to relationships, and then we go further into maybe you’re having really bad symptoms, or really scary thoughts, and some of the things that moms worry about most like depression, and anxiety, and OCD, and trauma. We do the gamut from what we consider to be normal anxiety, to what if it’s too much distress? And how do I determine if too much is too much? And subjective that can be, because what’s too much for me, may not be too much for you. And that kind of subjective assessment is really valuable, and it’s important information for her to take to her healthcare provider.
So let’s say somebodys flipping through the book, and they’re like, yeah, I relate to all these universal truths of motherhood with, you know, having a hard time making decisions and feeling a little bit of anxiety, like new parent worry. And then they’re flipping through it and they’re, they’re not so much relating it to themselves, but they’re like, ‘Oh, you know, I think my friend may be experiencing this, I see this in her’ or they want to make sure that their friends and sisters and partners feel supported. So what some of the things that those in our audience that may not be relating to the fears of, or the feelings of anxiety, or depression, or OCD, or some of the more clinical mental health concerns. What can they do to support those that are or that may be at risk?
You mean, outside of this book? What can they do?
Stephanie Greunke 27:22
Yeah, like, if they’re flipping through it, and they see some things where maybe they’re starting to see that their loved ones are experiencing a more severe form of anxiety than what they had realized? Or they’re concerned about somebody in their life?
Karen Kleinman 27:37
That’s a very good question. Again, you know, we don’t always know what somebody is experiencing. But if somebody in your audience is worried about somebody that they care for, you know, if they were to ask me, what should ‘What should I do?’ I would say, What is your relationship with this person and what what could that relationship tolerate? What level of intervention or or authenticity it can your relationship endure? Do you know what I mean by that? Because if it were me, I would go to my friend and say, ‘Are you okay?’ ‘Are you okay?’ is a word that I use with my clients when they come in and I know them, or I don’t know them, and I see a look, or I feel a feeling, or I get a sense of an energy that doesn’t feel right. I’ll look them in the eyes. And I’ll say, ‘Are you okay?’ And she’ll say, ‘Yes.’ And I’ll say, ‘Are you really?’ you know. This is what we talked about when we talked about holding – one of my my other books, how do you hold a woman in that much stress who’s trying really, really, really, really hard to present herself as somebody who’s in control? And okay, ‘Are you really okay?’ ‘Yeah, I am.’ ‘Are you really, because you don’t look okay. And I’m getting a feeling that you’re not okay. And I’m worried about you.’ So again, is this your sister? Is it your best friend? Or is it your neighbor? You know what I mean? So, you assess, what can the relationship endure? And then you ask the hard questions. I mean, people who know me know that one of the things that I do is I have no filter. That can be really great, that can be really not so great. But I need to know if you’re okay, and so we have to ask the hard questions. The other thing people can do is sort of the obvious is make themselves available for as much support as possible, even if somebody’s not asking for it. And we say don’t ask questions, we say just do it. Don’t ask open ended questions like ‘What can I do?’ or ‘How can I help?’ Say, ‘I’m bringing dinner over tomorrow,’ or` ‘I’m picking up your kids Thursday, and I’m going to take them to blah, blah, blah,’ you know what I mean? So being proactive as a person of support can be much more productive than asking a mom who’s overwhelmed and sleep deprived, what she would want from us.
Stephanie Greunke 29:54
Those are really, really great points. I love the first one is just asking a simple question. ‘Are you okay?’ And I would add to that, you know, giving a good pause, after you ask that question. Because if you it’s kind of like, when you’re walking down the street, and someone’s like, ‘Hi, how are you?’ And you’re already past them, and you’ve already walked a couple feet away, and you’re like, ‘Good,’ and you’re not actually giving them space, like you talked about holding space for their answer. When I go see my therapist, that’s one thing that she would do for me is ask, ‘So how are you?’ and then pause. And that quiet space is like her looking at me, her allowing me to have that platform to talk. That’s not what a lot of moms are getting these days, unfortunately. They’re not getting that question even asked to them a lot of the times, like ‘How are you?’ when they go in for their postpartum visit. It’s like, ‘Alright, how are things? Are you in any pain?’ just really quickly and and there isn’t often that space to talk about those feelings. Then people come over and they see the baby, and they want to know how the baby’s doing and hold the baby. And they might like ask mom, but not an way that gives her that platform that she needs, that really safe environment to speak her truth. So I thought that point was so good that you just said and then wanted to reiterate that.
Karen Kleinman 31:12
And with that Stephanie is also the expectation that I don’t need you to be okay. So if your mother’s asking you or if even your partner, sometimes who expects you to be strong and in control. I remember, I always tell the story of my father in law, bless his heart, when my children were babies. And I’ll never forget the day when, at the moment he called, I had one child with 104 fever, and the other one was like vomiting on my lap as we spoke. I picked up the phone, I’m like, ‘Hello?’ And he goes, ‘Hi, how are the kids? Good? Good. Listen, I need to blah, blah, blah.’ Like, no, no. And my husband would grab the phone and say, ‘The kids are fine.’ And I was like, ‘The kids are not fine. I am not fine!’` You know? And so there is an expectation, and even with the people who love us so much, and so well and hard, you know, ‘I need you to be okay, I need you to be strong, I need to be in control, I need you to get some sleep, I need you to stop complaining, I need you to…’, right? And so, as a friend, sometimes the best thing that we can do, is you don’t need to be okay with me. And you can tell me how bad this is. And let me help you determine what what you need to do next, and so forth. So that would be that’s a great gift from somebody who loves a new mom.
Stephanie Greunke 32:32
I also loved what you said about having, you know, just kind of taking that initiative because many times moms aren’t going to tell you that they need help, or they don’t even know what they need. There’s so many things that they need. They’re like, I don’t even know what to prioritize, to tell you that need. Like, I need my dishes wash, I need some food, like just like that cartoon you’re explaining in the beginning. And so you know, kind of taking upon yourself to look around. What I encourage my moms to do, and you know if before they have their baby, or even after they have their baby, is to kind of create a list of things that they’re comfortable having other people help them with kind of identify like, ‘Okay, I’m comfortable with you washing my baby’s clothes, but don’t touch my clothes, I’m comfortable with you. I’m putting my dishes in the dishwasher, but I don’t want you to wash them by hand’ or whatever it is, you know, we all have our little quirks. But to be able to identify what people can help us with, so they don’t feel like they’re intruding, and they feel like they’re contributing.
Karen Kleinman 33:26
What a great segue into the next section of the book, Stephanie, the journal doodling part of this book, you know, that so the each each page when you open up, and this is not about the book, I just want your your audience understand. I’m so excited about this book because out of all my great achievements, this is my shining one, because this is the one book that literally has the potential to get into the hands of every mom. And as you said, not just the moms who have postpartum depression or anxiety, but every single mom who is overwhelmed potentially, and who loves her baby very much, and who may be sleeping through the night, and maybe has an enormous support system, and all her mental health pieces are right in place. But she’s still overwhelmed and exhausted, and not sure about what she’s feeling. So I’m so excited that that moms have access to this information. And so each page when you open up has the comic on the left, the top of the right page has expert guidance by myself – What’s happening here? And what do you need to know and do? Then the second part of almost every comic page is a self help exercise so that mom can do exactly what you’re just saying, ‘Can you list three people that you trust to ask for something? Who are the people that you can call when you need to?’ So that you have sort of this Handbook of resources that are very personalized and customized for you that you’ve given some thought to. What are the things you need? What are the things that are hard for you to ask? Who are the places do you can ask for? Who are some resources in the back of the book if you really if you need professional, or more support? So it’s a way for her to, even if she’s feeling great, especially if she’s feeling great, you know, to just get her resources in place in case she has a bad day.
Stephanie Greunke 35:23
Yeah, absolutely. We’re all about being as proactive as you can. And it’s never too late, right? You know, you could plan all this stuff out before baby becomes, or you can do it when your baby is in the newborn phase, or whether you have a toddler, or even a teenager. You know, there’s never a time where I feel like the postpartum period is defined as the year after you have your baby, in a lot of contacts. But I think that postpartum is forever, Karen, because you know, there are so many changes, postpartum is after you have your baby, right? There’s going to be changes to your identity when your kids is a three year old and a 13 year old and a 30 year old. I mean, they’re leaving their house. So you’re you’re changing your role from mother to mother and grandmother. So I really think that we can take a lot of these lessons and just like you were talking about in the beginning with that woman who was 70, who was still experiencing this, this book isn’t just about for those experiencing mental health concern, or new moms. It’s really for everybody that’s had a kid or, you know, maybe had a loss, or is trying to navigate their new identity.
Karen Kleinman 36:35
It reminds me of when my children were going to college and I said, ‘My umbilical cord only stretches five hour driving radius.’ So yes, it is forever. It is forever.
Stephanie Greunke 36:51
We talked about the comic where the woman is asking for help. Are there maybe one or two other comics that you’re holding really close and you feel are so important for women to look at? I know, it’s hard to describe a comic, but maybe just like the general overview of that.
Karen Kleinman 37:09
Yeah, this one that seems universal on page 16 has a mom sitting there with sort of washed out faces around her, you know, just sort of a mass of people. And she’s standing there holding her baby in her snuggly. And she’s thinking, ‘If I admit I don’t like this being a mother, and that this sucks a lot of the time does that mean I don’t love my baby?’ And that seems to be an overarching theme for many mothers who have moments or days or seconds or hours where they’re like, ‘You know what, I just can’t do this. I don’t want to do this. Oh, my God, if I were a good mother, how can I be thinking this thing?’ And so we spiral, we have one negative thought that’s actually very common, very universal, very expected. ‘I don’t feel like being a mother right now.’ And what happens is, then we get this secondary layer of shame and guilt, and ‘Oh, my God, and what does this mean? Something bad’s going to happen. What if, what if?’ And then if we go into the what-ifs: ‘What if I’m walking down the steps and I slip? What if I don’t, you know, take good care of my baby and something bad happens? Oh, my God! Now what’s going on with my head? Now I’m thinking these terrible thoughts. Am I going crazy? Am I is this psychosis? Is this what happens on the news, what’s happened? Oh, my God..’ and this spiral just goes and goes and goes, and it feeds upon each other. And the shame is so intense that some do, some don’t, but most don’t talk about this. And it all started with many women, it started with, ‘I just don’t feel like being a mother.’ And it can, if somebody that they trust, and somebody that they that cares for them, especially if somebody has some training and knows what they’re talking about, says, ‘It’s completely normal to have this feeling. It’s completely okay for you to not feel like being a mother today, or tonight and tomorrow. And let’s talk about what’s going on,’ and take the shame and the pain and the guilt away. It can be sometimes as simple as that, and that she will feel she’ll feel better, and she can dial her anxiety back. Or she can be left on that trajectory on her own, to cascade down and turn this into a full blown, you know, panic attack or anxiety disorder because she doesn’t have the information.
So one of the things that, as a teaching point, I would like to point out in terms of this distress that we’re talking about – distress is a word that we use to incorporate the depression and the anxiety, you know, there’s sort of a move to tease one out and tease, you know, are we talking about depression versus anxiety. But truthfully, for a long time, we’ve known that postpartum depression is a very agitated depression. And it’s usually accompanied with a lot of anxiety. So can there be depression without anxiety or anxiety without depression? Yes, but most of the time, we see them overlapping. And so one of the key take home points from this book, and from our talk today, is the following: it’s not the thoughts that you’re having that that’s the problem. It’s not the feelings that you’re having that’s the problem. It’s how you interpret them, and how you appraise them, and how much they may or may not interfere with your functioning. That’s the problem. So while five different people can have the same scary thought, pick a scary thought, you know, ‘What if I, what if I drop the baby going down the steps?’ That’s sort of universal, we hold on really tight, we’re so afraid. And we make sure that every step is taken, so we don’t fall drop the baby, so we don’t drop the baby. Well, one mom, my have this scary thought and think, ‘That was a scary thought.’ And they just go on with their day. Another mom might have that same thought, ‘What if I dropped the baby? What if I dropped the baby?! Do I want to drop the baby is that because I was yelling at my husband last night? Wait a minute, a good mother doesn’t want to drop, I don’t want to drop my baby…’ So it turns into something else. And now, with one woman, she’s not thinking about that anymore. And the other woman had the same thought and is up all night worrying about it. And tomorrow, she’s lost her appetite. And the next day, she’s having a stomach ache, and she’s not functioning as well as that she should be. So again, the level of distress is what tells us that you might need more support. And the level of distress is defined by how bad it makes you feel, and how much it interferes with your functioning. So it’s not the thought or the feeling, it’s the level of distress.
Stephanie Greunke 41:58
And that’s a really, really good point. Yeah. We’re talking about this in the postpartum period with dropping the baby. But this whole scenario could play out while babies in mom’s belly. Right? You know, ‘I don’t feel connected to my baby. I haven’t thought about my baby. I am working so hard. I forget that I’m pregnant sometimes. I haven’t talked to my baby. I haven’t gone to prenatal prenatal yoga. I feel disconnected. Does that mean I don’t love my baby?’ You hear that too, right?
Karen Kleinman 42:28
Yes, yes, absolutely. And again, depending on the nature of her distress, and other factors that may influence it, like her family of origin, her history of depression, her primary relationship, and support network, and all of these other factors. But just teasing that ou and looking at that right now, I can say to you that, if, for example, if there’s an OCD nature of that, we might not even talk about that, because that’s just become the object of her obsession. I am generally not worried about a pregnant woman attaching to her baby, eventually. We just don’t see that as a problem, by and large. What the problem is, is her anxiety about it. So we do see that a lot – women with anxiety can absolutely have terrible anxiety during pregnancy. It’s not as you know, protective, as they used to say, in the old days, women can have full blown anxiety experiences and disorders during pregnancy, or they can just express a worry that they’re not going to attach to their to their baby, or ‘Why did I get pregnant in the first place?’ Or ‘I don’t like this, I think I’ve changed my mind.’ The distress can be very, very high. And luckily, our work in this maternal mental health field has opened up to include pregnancy. There’s a lot of research that says, you know, now they’re coming out and saying, we can help prevent postpartum depression if we just go into the pregnancy and take better care of her when she’s feeling bad.
Yes, absolutely. Okay, so let’s tie this up, then. So, if that is a thought, like, maybe this means I don’t love my baby, do you have a list of things that the mom could do to feel more connected to the baby. So do you want to give a couple of examples like, Okay, if this feeling pops up, then what are some actionable things that we could do?
Before we get to the action, I think the biggest thing to do is sort of embrace that uncertainty and understand that some of this is perfectly normal within the pregnancy and the postpartum period. And then we talked about in the book, as you point out, is, we talked about, you know, skin to skin, there’s so much emphasis on that now, especially with dads too which is amazing. We just itemize things like play time, letting go of worry, cuddle time, looking into the baby’s eyes when feeding, putting your phone away. You know, as an old person, let me just say, on the record, who by the way, I do claim that I am also addicted to my phone, okay, so I get it, I totally get it. But moms should put their phones down. I’ve just lost half your audience, I’m sorry, but there’s just no good way to connect with your baby while you’re looking at your phone. I do feel really strongly about some of these old fashioned things, that nothing can replace eye contact, nothing can replace being fully mindful and present with your baby. I get it when you’re feeding every hour and a half and, and you’re exhausted and so forth. So I’m not going to gain any points by that comment. If your connection is fine, then don’t worry about it, do whatever you’re doing. If you’re worried about attaching to your baby, then I would say: stay close, look into the baby’s eyes, put the phone away, and don’t worry about your connection. Because it does happen. It actually just happens. It doesn’t happen like it does in the movies. It doesn’t happen with music in the background, but it does happen. And for some moms it takes longer than others. And that’s perfectly normal.
Stephanie Greunke 46:04
I’m so glad you mentioned that. Thank you. Okay, so I obviously love this book, I think every mom and mama-to-be should get it. And I wholeheartedly do believe that it can really change the trajectory of moms in the future and moms today. So I absolutely love it. But I don’t want to forget about your other books too, because I think there are some topics that people have no idea that there was an incredible book written about this. So can you talk about some of your other book babies and you know who they might be helpful for?
Karen Kleinman 46:38
Oh, you’re gonna make me pull this out of my head. Okay, so real fast. This Isn’t What I Expected was the first book it was written in 1994. How old is that sound? That continues, I must say, to be a great, great book. We did update it in 2013 and continues to be great book – sort of a little self-help oriented, has some exercises in there for postpartum depression and anxiety. And then we have a couple more little self-help books: The Postpartum Husband, not only is that good for husbands, but it is really, because it’s written in bullet form, it’s easy read what is postpartum depression, what do you need to do, what to say, what not to say. I will put a little disclaimer and say that this book was written before I became politically correct, and I’m not yet completely politically correct, but I’m working on it. And this book is does speak about husbands, does make references to, you know, the sort of the male/female gender bias, so totally need to redo that book. However, it still does remain a very sort of simple, easy way to get in and know, you know, what do we need to worry about and what not to worry about? That brings said the other one like that is What am I Thinking? Having a Baby After Postpartum Depression is really great for planning and being proactive if you’re planning a subsequent pregnancy, because we do know that moms who have experienced depression once or have a history of depression are more at risk to experience it. Again, Tokens of Affection is for your marriage after postpartum depression. The other one about intrusive thoughts, that’s it’s harder to read than Good Moms, because it’s a book. But Dropping the Baby and Other Scary Thoughts: Breaking the Cycle of Unwanted Thoughts really, really, really was key. And I’d like to think somewhat groundbreaking in bringing this subject out to moms and saying there’s a very real thing that’s happening and that postpartum anxiety is extremely treatable, extremely real. And there are things that you can do to help yourself feel better. So that’s just another book on postpartum anxiety and intrusive thoughts. And then there are a couple other really great things for clinicians. So if you have you have listeners, who are who are treating perinatal women in psychotherapy, a couple of my books, I think, are really important for for them to be their best self while they’re sitting with the postpartum woman in distress.
Stephanie Greunke 49:14
Yeah, and you actually hold an in person training, too. So we do have a lot of practitioners that listen to our podcast. So do you want to talk about that, just really briefly of, you know, the the intense work weekend workshop?
Karen Kleinman 49:26
Sure, we offer this four times a year, quarterly, every March and June and September and December in Bluebell, Pennsylvania, at Normandy Farm Conference Center. And it’s an amazing group of 15 clinicians and Hillary, who teaches with myself, and it’s a Friday and Saturday. And it’s exclusively clinicians who have quite frankly, no other way to say this invested a lot in terms of their time and their energy, money, passion, like they are willing to leave their families and come sit here in Bluebell with us, and dig in. And they were and we do a lot of studying, we do a lot of laughing, we do a lot of support. These are clinicians who are enormously devoted to this population, who may already be well trained, or who may be new in the field. But we sit down and we emphasize the holding approach, which is the focus of one of my books. And and how do you hold a postpartum woman in distress and take care of yourself at the same time? And it’s, it’s if I do say so myself, every single time I do the training, I am I’m just sort of reborn. It’s just amazing work working with this closely with such dedicated clinicians.
Stephanie Greunke 50:54
Yes. And I can’t wait to attend one of those in the future. I’m so excited about that opportunity.
Karen Kleinman 51:00
That would be amazing. I would love that.
Stephanie Greunke 51:02
And then you have the Postpartum Stress Center. So do you want to talk a little bit about, that if if people are in the area, they can make appointments to come and see you or other experts?
Karen Kleinman 51:13
Yeah, the postpartum stress center is in Rosemont, Pennsylvania, we’ve been there since 1988. And we have super great clinicians, who I must say, are very well trained. And we we love the work that we do. Most new moms coming in, do not see me. But they see, you know, our team of amazing people who are only allowed to work here if they love doing this work as muchas I do. Otherwise, they’re they can’t stay. That’s what they get.
Stephanie Greunke 51:46
Yes. Well, yeah, definitely. They’re in good hands, if that is your standard. All right, Karen. So is there anything else that you want to leave our audience with today, things that they should know about or things you want to just leave as a last note?
Karen Kleinman 52:01
What what just popped in my head when you said that is you and I were talking about social media and and our audiences and women finding a safe place for them to feel safe to express themselves and feel supported, which is so amazing, and so wonderful. And without leaving this on a down note, I really do want to caution moms, who may be overexposed to some of this, and we really don’t know who all the sources of information are, and so I want moms to basically just trust their instincts. If being connected to an online community or so forth feels good to you, then then then stay there. If it stirs things up for you, if you feel worse afterwards, if you feel like you’re doing some of those things, like comparing yourself, you’re so vulnerable right now, that I really want moms in any stage, whether they’re pregnant, whether they’re planning a pregnancy, whether they’ve lost a baby, whether they’ve had a baby, whether they’re breastfeeding, a bottle feeding, there’s so much room for triggers out there, that I just implore you to take good care of yourself, and trust your instincts, if you need to protect yourself better.
Stephanie Greunke 53:12
Yeah, yep, it’s really easy to click that unfollow button and it can be really refreshing and take a whole lot of weight off your shoulders. So I second that completely. All right, Karen, thank you so much. This was an incredible interview. You are full of information. I absolutely love the book. So I’m honored you decided to come on the podcast and share it with us in more detail.
Karen Kleinman 53:34
Thank you, Stephanie. Seriously, I just love talking to you. This was wonderful. Thank you.
Stephanie Greunke 53:40
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Transcribed by https://otter.ai
- How common “scary thoughts” are for new moms
- How shame and stigma prevents new moms from getting help
- How to determine normal postpartum experiences from postpartum mental health concerns
- Support for postpartum partners
- How to support a friend or loved one postpartum
This episode's guest
Karen Kleiman, MSW is well known as an international expert on postpartum depression. Her work has been featured on the Internet and within the mental health community for decades. In 1988, Karen founded The Postpartum Stress Center, LLC, a treatment and training facility for prenatal and postpartum depression/anxiety disorders where she treats individuals and couples experiencing perinatal mood & anxiety disorders.
Kleiman is also the author of several books on postpartum depression, including This Isn’t What I Expected: Overcoming Postpartum Depression (1994), The Postpartum Husband: Practical Solutions for Living with Postpartum Depression (2001), What Am I Thinking? Having a Baby After Postpartum Depression (2005), Therapy and the Postpartum Woman (2009), Dropping the Baby and Other Scary Thoughts (2010), and Good Moms Have Scary Thoughts (2019).