Welcome to the very first of my Journey of a PPD Survivor Series!
I know many, many survivors whose journeys led them to helping other mothers feel less alone and suffer less than they themselves did. These women have gone on to become doulas, social workers, psychiatrists, psychologists, psychiatric nurse practitioners, peer support group leaders, founders of not-for-profit groups, bloggers (like myself), book authors (like myself), fundraisers, volunteers (like myself), etc.
Kathy Morelli, whom I’ve had the pleasure of knowing since we met in 2011 at the Postpartum Support International conference in Seattle, has the honor of being my very first interviewee for this series. Back in 2012, she wrote the most amazing book review for my book. She herself is a book author in addition to being a licensed professional counselor and licensed massage therapist for pregnant/postpartum women.
Thank you, Kathy, for taking the time to provide my blog readers some insight into your journey as a PPD survivor!
Can you please describe your journey to becoming a Licensed Professional Counselor and Director of BirthTouch, LLC and what motivated your passion for maternal mental health matters?
Ivy, lol, this could be a looooong answer! I’ll try to keep it reasonably brief! I came of age in the 1970s when feminism was just starting to impact our society. I was raised to believe that I could go to college and get a good job, just like the boys. But I was also enculturated to stay home with my children. My mom didn’t work outside the home. There was no Title IX, equal funding of boys’ and girls’ sports, etc. when I was growing up. There was no family leave, no daycare centers included on corporate campuses. So, the tantalizing idea that a woman could work equally as a man was out there, but there were no plans for what to do about motherhood. What to do with a newborn during a career trajectory. These things were not in the public discourse at all. So, I never thought about how the integration of career and family is an enormous life challenge. How would I know?
I was the first-generation Italian American in my family to go to college. I started my career in my 20s in data processing on Wall Street. I worked my way up to be an AVP at a major international bank. I managed the Database Department there. It was extremely stressful and not really emotionally fulfilling to me. But it was a good job that paid well. I was the only woman of 12 mid-level managers. It was challenging to be the only woman in this peer group. I never felt comfortable in that situation. They talked about things I wasn’t interested in. And sometimes they went to a strip club down the street for lunch. I certainly wasn’t going to do that.
The long commute led to my finding a job at another large data processing facility in New Jersey. My husband and I planned to start a family, and I didn’t want to commute on the subways while pregnant. I had my son (now 22!) when I was 37 years old. I never changed a diaper or babysat very much at all, as my older sister did all that! I also didn’t know much about the processes of pregnancy and birth, so it was all big mystery to me.
I actually had negative physical reactions to the idea of putting my son in daycare. Daycare was a new concept 22 years ago. We made the decision for me to stay home with my son for a few years. I had postpartum depression (PPD) after I had my son. Looking back, it’s obvious that the life changes and the identity shifts were challenging for me. I had always been a high achiever, so shifting to taking care of a baby, which I had never done before, was not easy. I felt isolated. The feelings of depression were difficult to handle and caring for a baby on top of that was just so overwhelming. In retrospect, I should’ve taken medication. But I wouldn’t, as I was nursing and I was concerned about the effect medication would have on my son. Back then, there wasn’t the abundant research regarding the relationship of psychotropic medication to breastfeeding that there is now. If I had the information available now on such sites as Mother to Baby , I would’ve been able to make an informed choice with research data as input. I would’ve chosen the medication. Even with counseling, I was depressed for two years. It was a joyful yet painful time.
In short, my journey to becoming a therapist has been founded on my desire to have a career where I could make a difference in the world. From my experience, I also had insight into what it was like to become a mother and go through a lot of biological and psychological shifts all at once.
Can you provide an overview of what services you provide?
I’m a Licensed Professional Counselor (LPC) and Licensed Massage Therapist in the State of New Jersey. As an LPC, I work with a broad range of people experiencing everyday family and marriage issues, depression, and anxiety. I have an integrative approach and use both traditional verbal therapies and mind-body therapies. For many years, I’ve had a special focus on perinatal mood disorders, the transition to parenthood, and birth trauma, but I see a broad range of people.
Currently, I am shifting my focus to using interventions such as eye movement desensitization and reprocessing (EMDR), Somatic Experiencing (SE) and cranial sacral body work to treat post-traumatic stress disorder (PTSD) for single incident and chronic trauma. Single incident trauma can be birth trauma, trauma from even necessary medical interventions (such as for cancer), a car accident, a rape, etc. Chronic trauma includes childhood sexual, physical, and/or emotional abuse.
So many women talk to me about their pregnancy and birth experiences and how traumatic and medicalized childbirth is. Sometimes the medical trauma is something that is necessary such as when there are true complications and other times the medical trauma is from too many unnecessary, cascading interventions coupled with a general atmosphere that lacks compassion at an individual level.
So, I’m an advocate for woman and family-centered childbirth and have been for 22 years. I’m an advocate for social programs that promote a true family centered focus in our society.
You wrote three books, correct? Can you give an overview of what your books are about?
Yes, I did! They are all about self help and education for women and families in the childbearing year. They are all available on Amazon!
BirthTouch® Shiatsu and Acupressure for the Childbearing Year is all about education and self-help for the pregnant mom and her family. There’s information about the difference between infant bonding and attachment, emotional management and safe touch to promote the relaxation response and family bonding during and after pregnancy. There are numerous studies that conclude that safe massage promotes the relaxation response and family bonding. Safe touch promotes the release of relaxing endorphins and oxytocin and downregulates cortisol, the stress hormone. It’s all about self care in the family unit. Shiatsu is done fully clothed, and it’s a simple shiatsu routine, so even small children can participate, as well as an acupressure routine that is known to promote childbirth. As a massage therapist, I have certifications in shiatsu and acupressure, so the mind body connection is quite relevant to me and how I practice.
BirthTouch® Healing for Parents in the NICU is a slim volume meant for parents who have a baby in the NICU. The focus in the NICU, is, of course, on the baby, but this slim volume is meant for the parents to help remind them to turn towards each other and support each other through this difficult time. It is a short-seated shiatsu routine that can be done in a waiting room.
BirthTouch® Guide to Perinatal Mood Disorders for Childbirth Educator is a slim volume meant for childbirth professionals, who are often the first line of support for the new mom. This slim volume fully delineates the different perinatal mood disorders and their differential diagnoses for the childbirth educator, so s/he can know what to look for. It also explains why it’s not always easy to differentiate between the various perinatal mood disorders, because of the overlap and subtlety of symptoms.
Can you please explain how shiatsu and acupressure can help a pregnant/new mother? How did you learn these techniques and how did you discover that they can be effective in treating perinatal mood disorders?
I studied shiatsu and Jin Shin Do® Acupressure at the Meridian Shiatsu Institute in Pennsylvania from 1996 – 2000. I became certified in both modalities. The owner of the school retired over a decade ago and closed the school. I started BirthTouch® around that time, which was a massage and bright hypnosis business for pregnant moms and their families. Women and midwives started to ask me what the acupoints were to begin birthing. I would write them out on a piece of scrap paper at first for my clients, and then eventually I developed a short workbook. I began studying psychology. I found the intersection of my two fields, touch and psychology, in the seminal work of Dr. Tiffany Field at the Touch Institute in Miami. Her studies were really the first research examining the effects of touch on mood in pregnant/postpartum women and in infants. Now, it’s a mainstream idea and you can see there are hundreds of studies that validate the use of touch to promote relaxation and mitigate the symptoms of depression and anxiety in pregnant/postpartum women.
After working with many women and families, I realized that people wanted to learn some safe, easy techniques for touch during pregnancy, birth, and postpartum. After teaching these techniques for many years and seeing the clinical benefits, I wrote my BirthTouch® book in 2012. I hope to run a research project specifically around BirthTouch® techniques in 2019. I will keep you posted on this!
I can remember when I first met you at a Postpartum Support International conference a number of years back. How long have you been a member? What prompted you to become a member?
I think I’ve been a member of Postpartum Support International since 2010. I was a Warmline Volunteer for about a year on Wednesday evenings, but then it was too difficult to keep it up, as my practice was so busy and Wednesday evening is prime time! I now do some work for the New Jersey Chapter of Postpartum Support International. I wanted to become a member, as I wanted to complete their training and to attend the wonderful conferences and actually meet and be a part of the researchers and clinicians who work in women and family advocacy every day!
Is there one key piece of advice you would offer to an expecting or new mom?
Please plan for the Fourth Trimester! Here’s a link to my website BirthTouch®, with an article about the Fourth Trimester. Don’t try to do it all yourself or with your partner. If you don’t have local friends or family who are free to physically help you, then hire some help. It is well worth it! Ask for help, don’t be afraid to tell your doctor how you feel and if you need help, don’t suffer alone. Planning for the Fourth Trimester is key! Have list of resources at ready, in case you need them….friends, family, community resources, food prep, sleep plan, therapist phone number, doctor phone numbers, etc. Talking to a therapist and taking medication is not shameful!
What would you want to say to women currently suffering with a postpartum mood disorder?
Recognize that you have a treatable mood disorder and that taking care of your emotional health is as important as, if not more important than, taking care of your physical body. Talk to your primary care physician, your obstetrician, a therapist, or a psychiatrist. Perinatal mood disorders are treated by talking to a therapist and/or taking medication.
Taking care of a baby is hard work. Please get yourself help in many different ways: sleep, food prep, taking time off from baby care by asking family or hiring help, etc. This new dynamic of having an infant to care for sets off feelings where you wonder whether you need to attend to my baby’s needs or my needs? Of course, the baby’s needs must be fulfilled and you need to include your needs in there in some way as well. It’s a new way of being.
To find resources in your area, call Postpartum Support International’s Warmline where you will be connected to someone in your area who can refer you to perinatal mental health resources in your community.
Postpartum Support International Warmline: 1-800-944-4773
What advice would you offer to friends/family members of a woman who is currently suffering with a postpartum mood disorder?
Please recognize that your loved one needs support and understanding. Don’t undercut her mothering skills by giving suggestions on how she should manage her baby. If she is struggling, ask her how she feels. Use active listening techniques, ask open-ended questions, and help her get to a therapist and/or doctor to get the help she needs.
And also, as caregiver, try to remember to take care of yourself, although this can be challenging. Caregivers get burned out and depressed as well. Take it easy on yourself and practice lovingkindness towards yourself and others.
In your practice, what kinds of treatments for PPD do you recommend? Is there a type of therapy/ies you would recommend?
I think the best treatment is developing a realistic baby-feeding, sleeping and self-care plan that take into account both mom’s and baby’s needs….all of this can be truly overwhelming.
Going to a therapist who has special training in perinatal mood disorders to help process the feelings around the transition to motherhood and the feelings around childbirth events is a good way to manage perinatal mood disorders.
Sometimes talk therapy is not enough. If medication is needed, going to a psychiatric nurse practitioner or psychiatrist is a normal part of treatment. Feel proud you are taking steps to care for yourself.
In my practice, I take an integrative approach and use a variety of therapies tailored to the individual’s needs. My basis is insight-oriented therapy, combined with some dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and cranial sacral therapy (CST) tools.
What do you see as the biggest challenge in helping a mother recover from a postpartum mood disorder?
The biggest challenge is that people often don’t want to reach out for professional help. They think they can manage okay by toughing it out and ignoring their own needs. This approach isn’t emotionally healthy. You want to learn to optimize your own and your family’s emotional health. If mama ain’t happy, no one is happy!
What do you think medical health practitioners who come in contact with new mothers, like OB/GYNs, GPs and pediatricians, can do to help prevent, detect and treat perinatal mood disorders?
Prevention starts with a solid social safety net, which our society does not provide.
Individual medical practitioners can coach pregnancy moms and their partners about the possibility of the occurrence of perianal mood disorders, and help them recognize this before the mom becomes seriously incapacitated from a mental health issue. If a mom has a previous episode or a family history of perinatal mood disorder, then pre-treatment–with counseling and perhaps medication–is the best way to minimize occurrence.
Medical practitioners who come in contact with new mothers need to be trained to recognize the presence of a perinatal mood disorder and have resources to offer her and her family. Studies show that having the mom complete an abbreviated 3 question version of the Edinburgh Postnatal Scale is as effective as the original 10 question EPDS.
Medical practitioners who treat new mothers for perinatal mood disorders should take specific trainings in these disorders in order to effectively treat their patients. Postpartum Support International has such trainings and also a supportive professional community that shares resources and knowledge.