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What is self-care and why is it so hard?

Self-care can occur in many different ways: physically, emotionally, socially. We can practice self-care by doing a five-minute meditation, taking a walk, or paying for a day at the spa. It can be listening to music, getting your nails done, calling a friend, setting boundaries. There are so many ways to practice self-care, and yet it is extremely hard for many of us to put into practice.

We have all heard the saying, “you can’t pour from an empty cup.” We cannot give to or do for others when we do not take time to focus on ourselves and our needs. Perhaps this hasn’t been more true, for me personally, since becoming a mom. I feel myself becoming burnt out some days, and in turn losing patience, having less compassion, and yet those are certainly not the moments I allow myself to take five minutes for self-care. Why is that? Too often, time spent doing something for ourselves, such as ignoring a home/work task, and sitting outside with a cup of coffee, feels selfish. We know there are things to be done, and there’s some negative connotation in prioritizing something else instead. I can really appreciate the internal conflict that occurs in those moments. We fear those other things will suffer if we don’t attend to them for a day. We begin to feel guilty, for getting a babysitter or leaving our partners in charge, to do whatever this self-serving thing might be. We decide this means something ‘bad’ about us.

If you’re anything like me, you might also decide you shouldn’t prioritize this self-care thing, such as joining a yoga studio, because you’re too lazy, you’re afraid you won’t really commit to it & it won’t actually make you feel better. You’ve decided it might not be worth the financial burden. Of course, everyone’s financial situation is different, and there might not be a budget for things like exercise or expensive mental health treatment. For me, I also know that there are other areas where I am willing to spend money, despite budgets, without convincing myself it isn’t ‘worth it.’ Again, why is that?

 

Doing things we “want,” versus things we “need,” might bring up negative self-talk and uncomfortable feelings. After becoming parents, we quickly realize that, so often, our needs and desires take a back seat. While in some ways this is necessary, it does not always have to be our reality. How often do you feel better once you take a few minutes or hours for yourself? The shame that might come up from choosing to spend some time out of the home with friends typically dissipates once you’re there and you may soon notice that you feel reenergized.

So, if you want to increase self-care but have found yourself stuck, what can you do? I find that the first step in trying to make a change, is noticing. Notice what it is we want to do, but that we’re not doing. Notice the cognitive process (the internal conversation and thoughts), the anxiety that comes up when we think about these self-care tasks. Notice what we tell ourselves and what might be getting in the way. In this process, we want to be mindful of the “should” statements. We don’t want to get so caught up thinking we should be practicing more self-care, that it becomes something that feels overwhelming or negative. If it feels like it adds more pressure or stress, it’s not really self-care anymore.

After, try practicing opposite action; a DBT skill that encourages us to notice a current emotion and an action urge that accompanies it. If the urge is ineffective, not serving us well, or does not fit the facts of the situation, do the opposite. So, for example, I realize that I’m feeling exhausted and overwhelmed. I have a fleeting thought that I should read a “just for fun” book during my son’s nap time today. I feel embarrassed, angry for feeling exhausted, and tell myself that reading is a waste of time because I also have to do work and vacuum. My urge is to tackle the to-do list instead of read the book. The facts are: Yes, I have house chores to do and I’m also being reactive and short-tempered. The facts also include me being able to pick another time over the weekend for the “must do” list. The anger and embarrassment I feel are based on the dialogue in my head that says I’m too lazy, not a good mom, and not a good homeowner because I don’t want to do those tasks and, instead, I do want to relax and read. The practice of opposite action would invite me to read the book, despite the negative feelings, because they are not actually based in fact or reality. The hope is that we act opposite and, in turn, feel positive emotions. We are also then more grounded and able to effectively plan for the tasks on the to-do list. An important part of this is to (again) notice the after effects; notice if you feel better after prioritizing yourself & your needs. This is the only way to reinforce the continued practice.

Written by: Nicole Van Hessen, LCSW…co-founder of The Mom to Mom Collaborative

*note: the information in this blog is not a replacement for mental-health treatment.

Sheri Hovdestad, SBH Counseling Services LLC

As a therapist, I thought I had a general understanding when it came to the subject of
postpartum depression. If you approached me about it, I would have told you that postpartum depression pretty much looked the same for every woman, and that it has a defined beginning and end. I would have equated it with the “baby blues” and described a woman, who shortly after giving birth, presents as sad, crying, and disengaged from her baby. These symptoms might last a few weeks, but eventually this mother would start to feel less and less depressed, and more like her pre-baby self. The mothering instinct would kick in and she would bond with her baby like something out of a baby shampoo commercial. This is what I would have told you…before I became a mother myself in 2014 and had to face my own experience head on.

It was not what I was expecting, and I was not prepared. Becoming a mother made realize that I had so much more to learn. I would come to find out that the baby blues are very different from postpartum depression, and that postpartum depression falls under the larger umbrella of Perinatal Mood and Anxiety Disorders; something that wasn’t taught in my graduate school program (but should be!). It’s more than depression. It can be anxiety, constant worry and fear, anger, irritability, scary thoughts, obsessive and compulsive behavior. And it has nothing to do with your ability to be a mother or how much you love your baby.

Becoming a mother has made me keenly aware of the expectations women often place on
themselves in hopes of living up to the ideal of the ‘perfect’ mother. As a therapist, I am
passionate about helping women navigate the journey of motherhood in a way that allows for them to be open and honest in their experiences. I want to normalize the overwhelming feelings, and scary thoughts that all too often lead a mother to believe that she is not good enough. I want women to know that reaching out for help is a sign of strength, not a sign of weakness. And most importantly, I want women to know that it will get better. And that they are not alone.

While my initial training was in treating perinatal mood and anxiety disorders, I have expanded my practice to include services for infertility, perinatal loss and traumatic birth. I feel strongly about maternal mental health AND maternal physical health. I am encouraging our society and healthcare system to change the way it approaches the care of women after birth. When the focus shifts to the baby, often a mother will ignore her own emotional/physical symptoms. We repeatedly see women who reach out for help and be dismissed or not heard. We need to ASK and we need to LISTEN.

About Sheri

Sheri is a Licensed Professional Counselor in New Jersey and a National Certified Counselor. She earned her Master of Arts in Counseling and an Advanced Counseling Certificate from Montclair State University. Sheri has diverse experience working with children, adolescent and adult clients in various settings.

Sheri now owns SBH Counseling Services LLC, a private practice specializing in reproductive mental health. She has received advanced training in perinatal mood and anxiety disorders, perinatal loss and infertility counseling.

In May 2016, she joined the Maternal Mental Health Coalition in Washington D.C. as part of a delegation from New Jersey that met with members of Congress, to advocate for support of the Bringing Postpartum Depression Out of the Shadows Act; which was signed into law by President Obama in the 21st Century Cures Act.

Sheri Hovdestad, MA, LPC, NCC 

SBH Counseling Services LLC

https://sbhcounseling.com

609.795.7619

 

 

 

PCOS with Registered Dietician, Kim McDevitt

I once learned that PCOS is just another form of insulin resistance, manifesting itself in our guts. And, once we consider in that light, understanding how tweaking our diet can support insulin control is not only helpful, but may even make things simpler!

PCOS, Polycystic Ovarian Syndrome, is all about hormone imbalance. In the most basic sense, it stems from a woman’s inability to properly produce estrogen coupled with an overproduction of androgen (a hormone that interferes with egg production and release). Cortisol, along with insulin, (two other dominant hormones in our bodies) also play a part.

Insulin controls how our body processes sugar and starches and turns them into energy. When there is excess insulin production – due to overconsumption of refined carbohydrates and simple sugars with not enough fiber, protein and healthy fats – production of androgens increases, thus exacerbating PCOS.

Still with me? Here it is a bit simpler:

PCOS = excess androgens.

To much insulin = body makes more androgens = makes PCOS worse.

Where Diet Fits In

So if it were as simple as controlling insulin, we’d all be ‘cured’ of PCOS. And while it’s not that black and white there are some basic dietary principles that you can follow to help keep your symptoms at bay.

And, believe it or not, the same diet I promote all of us to strive to follow each day is virtually the same diet that’s going to help manage those suffering from PCOS.

So what is it?  

Aim to eat meals that are high in fiber, protein and healthy fats.

What does that look like? It looks like a plate that’s half vegetables, ideally many green ones. A protein that’s either lean animal or plant-based (a typical serving would be 4 – 6 oz but don’t get too hung up on that) and 2 – 3 Tbs of healthy fats (½ avocado, olive oil, raw nuts and seeds).

Essentially, you’re aiming to build a meal around controlling and/or limiting a surge in your blood sugar. What causes a surge? Carbohydrates. Especially when refined (think pasta, cookies, crackers, etc.) or eaten alone. So does this mean you need to completely cut out carbs and live a miserable life devoid of cookies? No. But it does mean you need to be smart around your meals and indulge mindfully.

Here are what some meals might look like:

Breakfast

  • 2 eggs, ½ avocado, 1 apple
  • Smoothie: 1 scoop protein powder, ½ banana (limit fruit to ½ cup), 1 tablespoon almond or peanut butter, 1 tablespoon ground flax or chia seed, handful baby spinach (optional!), unsweetened almond milk + ice to desired consistency

Lunch

  • 1 can tuna or salmon mixed with dijon mustard, plain greek yogurt, salt & pepper, capers. Eaten in romaine lettuce ‘boats’, with cucumber wedges, over salad greens, or stuffed in a red pepper. 1 square dark chocolate for sanity and sweetness.

PM snack

  • If needed, options: 1 apple w 2 tbs nut butter, greek yogurt (limit sugars to 10g or less, try Siggi’s!), protein powder shaken with almond milk, ½ avocado, ¼ cup total pistachios and almonds.

Dinner

(Think ½ plate veggies, ⅓ protein, ¼ carb. Healthy fat throughout)

  • 6 oz salmon roasted with salt & pepper, roasted crunchy broccoli (roast at 400 w olive oil), sweet potato wedges
  • Chicken tacos: pulled / shredded chicken, ½ mashed avocado, cabbage slaw, salsa, 2 – 3 corn tortillas (avoid flour tortillas or have over salad greens)

 

Essentially your focus is going to be on a diet that doesn’t create an aggressive release of insulin -> in other words, choose: protein, fat, fiber & greens.

 

Finally, I’ll leave you with this. PCOS, or any other condition that’s unveiling itself in the form of infertility can feel like a lonely, confusing and just plain hard time. We all have the perfect image of what conception looks like and when it doesn’t start to follow that path, things can feel hard. I know this from experience.

Furthermore, if you’re staring back at the face of an infertility (or literally an infertility doctor) suddenly hearing and thinking about all the “what-ifs” and “what-nows,” you can’t help but feel shame and blame towards your own body. If this is you, know you’re not alone. Know it’s not ‘your fault’. And that while a healthy diet and exercise can’t cure infertility on its own, it can definitely help shift your mind into a more positive place, and sometimes that’s a big piece of the puzzle. Reach out to me at anytime if you’re in this place and need that support.

 

About Kim

Kim is a Registered Dietitian, mom and avid runner. She has been a nutrition coach for over 5 years and, after experiencing pregnancy and now motherhood, she found a passion in supporting other women navigate health and wellness through this season of life. A past partner with Princeton Nassau Pediatric group and a current private nutrition consultant, Kim thrives helping women and families navigate the noise around food and wellness. Like you, she lives amongst the chaos of a busy family life while trying to work full-time job(s), and recognizes the challenges around ‘keeping it all together’.  Kim lives in Princeton and you can reach her via kimmcdevitt.com.

THRIVE Women’s Health Physical Therapy

 

In November we had the pleasure of visiting Thrive Women’s Health Physical Therapy, and sitting down with the owner, Meredith Rassam, to talk a little bit about her business and why moms should see a pelvic floor therapist.

Pelvic floor physical therapy involves biofeedback and exercises to encourage relaxation and strengthening of the muscles of the lower pelvis. Pelvic floor physical therapy can help address sexual problems by improving chronic vaginal or pelvic pain and urinary incontinence.

Meet Meredith

Meredith Rassam is a women’s health physical therapist. She has been a PT for 15 years and in the last 4 years has devoted much of her time to learning about and treating women’s health clients. After having her second child, Meredith wanted to jump back into running and living the active lifestyle that she was used to. Stress and urge incontinence prevented her from enjoying higher level activity and instead of being a stress relief was a major cause of stress. Unable to pursue these activities, Meredith started studying and reading more about women’s health as well as taking courses and was able to help herself. Now, at Thrive Women’s Health Physical Therapy, she hopes to help many women who struggle with incontinence, Diastasis Recti, pelvic organ prolapse and other common (but not normal!) diagnosis’ many postpartum women have.

About THRIVE

About 6 months ago, Meredith felt a strong urge to create more for her patients; to create a space that was comfortable, supportive, calming and healing to treat women who have pelvic floor dysfunction. She was lucky enough to meet Faith at Relief Acupuncture who had extra space in her clinic, which was exactly the environment that she was looking for.

It is important that you have quality time with your physical therapist. This allows a thorough evaluation or treatment to be given each time you are here.  Each session is at least an hour and they do not provide cookie cutter treatments. Meredith’s goal is to work with you to improve your symptoms and improve your function as quickly as possible. Because of her own journey and the somewhat limited knowledge out there in the world of pelvic health, she wants to educate as many women as she can. She strives to help women feel strong again, to have less pain, and to thrive in their life!

Make an Appointment

If you want to make an appointment with Meredith, give her a call (717-685-9548) or email Thrivewhpt@gmail.com. We can check your benefits and see if you are covered for therapy. Then we will schedule your appointment and Meredith with complete a 1-2 hour evaluation. At Thrive, we are able to take the time to get a full history of your symptoms. When did your symptoms start, how much pain are you in, what was your birth like?, etc.  Getting a full history helps guide the evaluation. Then we gather objective date –  range of motion of your hips and back. Your strength is tested, flexibility is assessed. Tenderness to any ligaments, muscles or tendons is assessed as well. We look at posture and breathing. Once the orthopedic evaluation is complete, if comfortable, we will complete a pelvic floor assessment. This looks at the muscles of the pelvic floor, in and around the vaginal opening. We make sure the pelvic floor can contract, relax and lengthen properly. Similarly to muscles in the other parts of the body, we feel for any tenderness in the pelvic floor. We assess the strength of the pelvic floor, make sure all levels are able to contract. We assess the resting level of the pelvic floor – is it too tight? Or too weak? Once all this is tested, Meredith will develop a comprehensive home exercise program for you to begin working on. Ideally, we will meet every 1-2 weeks for 6-8 weeks to see how things are going and to properly progress your home exercises. Consistency is key for improvement of symptoms!

 


Thrive Women’s Health Physical Therapy is located at

7 Route 31 Pennington, NJ 08534

info@ThriveWHPT.com

717.685.9548

 

Mom to Mom (Peer Support Group)

Our Winter 2019 peer support group schedule is now released! We will meet 3 Wednesdays a month from January-March in Lawrence, NJ. Please visit our Mom to Mom page for more information about our group.

We hope to see you there!